01 Mar Multiple Sclerosis Patients Show Cognitive Benefit From Remotely Supervised Transcranial Direct Current Stimulation
MedicalResearch.com Interview with:
Leigh E. Charvet, PhD
Associate Professor, Department of Neurology
Department of Neurology
New York University Langone Medical Center
New York, NY
MedicalResearch.com: What is the background for transcranial direct current stimulation? What are the main findings of this study in multiple sclerosis patients?
Response: The application of tDCS is a relatively recent therapeutic development that utilizes low amplitude direct currents to induce changes in cortical excitability. When paired with a rehabilitation activity, it may improve learning rates and outcomes.
Multiple repeated sessions are needed for both tDCS and cognitive training sessions to see a benefit. Because it is not feasible to have participants come to clinic daily for treatments, we developed a method to deliver tDCS paired with cognitive training (using computer-based training games) to patients at home. Our protocol uses a telemedicine platform with videoconferencing to assist study participants with all the procedures and to ensure safety and consistency across treatment sessions.
When testing our methods, we enrolled 25 participants with multiple sclerosis (MS) completed 10 sessions of tDCS (2.0 mA x 20 minutes, dorsolateral prefrontal cortex, left anodal) using the remotely-supervised telerehabilitation protocol. This group was compared to n=20 MS participants who completed 10 sessions of cognitive training only (also through remote supervision).
We administered cognitive testing measures at baseline and study end. We found that both the tDCS and cognitive training only group had similar and slight improvements on composites of standard neuropsychological measures and basic attention. However, the tDCS group had a significantly greater gain on computer-based measures of complex attention and on a measure of intra-individual variability in response times.
MedicalResearch.com: What should readers take away from your report?
Response: tDCS is a promising new treatment that will require larger trials to inform us of dosing optimization and treatment parameters. The goal of the remotely-supervised protocol is to enable larger scale clinical trials to answer questions concerning who will gain benefit and how it the treatment should best be delivered.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: An important next step is to extend the treatment to more sessions and to include a sham comparison condition to confirm and better understand our findings.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Neuromodulation. 2017 Feb 22. doi: 10.1111/ner.12583. [Epub ahead of print]
Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis.
Charvet L1, Shaw M1, Dobbs B1, Frontario A2, Sherman K1, Bikson M3, Datta A4, Krupp L1, Zeinapour E3, Kasschau M5.
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