Influence of Transcranial Direct Current Stimulation and Exercise on Fatigue and Quality of Life in Multiple Sclerosis

Abstract

Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to a great deterioration in the quality of life. Objective: We aimed to assess the effectiveness of two individual programs, one based on transcranial direct current stimulation (tDCS) and another based on the effect of physical exercise on fatigue and quality of life in patients with MS. Methods: A total of 12 patients with relapsing–remitting and progressive secondary MS participated. Fatigue and quality of life were assessed before and after intervention. The exercise program and tDCS were carried out over a 4-week period, with a washout period of 5 months. Results: The results show significant improvements in the different quality of life subscales after the application of tDCS, activities of daily living (r = 0.625; p = 0.037) (g = 0.465), psychological well-being (r = 0.856; p = 0.004) (g = 0.727) and coping (r = 0.904; p = 0.18) (g = 0.376), and in those after the application of exercise, activities of daily living (r = 0.853; p = 0.003) (g = 0.570) and psychological well-being (r = 0.693; p = 0.041) (g = 0.417). After the application of both therapies, more than 50% of the subjects did not have a positive fatigue score on the MFIS scale. Conclusion: The major findings suggest that the application of both therapies produces a beneficial effect with significant improvements in the quality of life of this sample.

Quantifying Fatigue Using Electrophysiological Techniques and Non-invasive Brain Stimulation in People With Multiple Sclerosis- A Review and Discussion

“…The included studies used a variety of study designs to detect, quantify and examine MS-related fatigue. The 19 articles, shown in Table 1, employed the following study designs: 5 studies case–control studies (Buyukturkoglu et al, 2017; Conte et al, 2016; Gscwind et al, 2016; Russo et al, 2017; Vecchio et al, 2017), 3 cross-sectional studies (Chaves et al, 2019; Newland et al, 2021; Paolicelli et al, 2021), one prospective-observational study (Chalah et al, 2019); one correlational (Russo et al, 2017); one single blind, within-subject design (Fiene et al, 2018), and one cross-over study (Muñoz-Paredes et al, 2022). Seven of the 19 studies utilized a double-blind RCT study design.…”

“…Seven studies (Cancelli et al, 2018;Chalah et al, 2017Chalah et al, , 2020Charvet et al, 2018;Hanken et al, 2016;Mortezanejad et al, 2020;Muñoz-Paredes et al, 2022) tested the effect of tDCS on cognitive fatigue. Among these 7 studies, 6 used a cross-over design and only one was an RCT (Muñoz-Paredes et al, 2022). Investigators in all 7 studies reported fatigue was significantly improved after tDCS.…”

“…Investigators in all 7 studies reported fatigue was significantly improved after tDCS. Four studies (Chalah et al, 2017;Charvet et al;Mortezanejad et al;Muñoz-Paredes et al, 2022), using…”

“…Investigators in all 7 studies reported fatigue was significantly improved after tDCS. Four studies (Chalah et al, 2017; Charvet et al; Mortezanejad et al; Muñoz-Paredes et al, 2022), using either the MFIS and FSS, or both, examined the intervention in the dorsolateral prefrontal cortex (DLPFC). One study that used a cross-over study design did not include randomization procedures (Muñoz-Paredes et al, 2022).…”

“…Four studies (Chalah et al, 2017; Charvet et al; Mortezanejad et al; Muñoz-Paredes et al, 2022), using either the MFIS and FSS, or both, examined the intervention in the dorsolateral prefrontal cortex (DLPFC). One study that used a cross-over study design did not include randomization procedures (Muñoz-Paredes et al, 2022). Cancelli et al examined the primary somatosensory cortex using a tCDS-designed stimulation treatment protocol.…”