Open AccessRemotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At‐Home Cognitive Training in Multiple Sclerosis
Author(s) -
Charvet Leigh,
Shaw Michael,
Dobbs Bryan,
Frontario Ariana,
Sherman Kathleen,
Bikson Marom,
Datta Abhishek,
Krupp Lauren,
Zeinapour Esmail,
Kasschau Margaret
Publication year - 2018
Publication title -
neuromodulation: technology at the neural interface
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.296
H-Index - 60
eISSN - 1525-1403
pISSN - 1094-7159
DOI - 10.1111/ner.12583
Subject(s) - transcranial direct current stimulation , multiple sclerosis , physical medicine and rehabilitation , cognitive training , cognition , neuroscience , stimulation , current (fluid) , psychology , training (meteorology) , medicine , psychiatry , engineering , geography , electrical engineering , meteorology
Objective To explore the efficacy of remotely‐supervised transcranial direct current stimulation (RS‐tDCS) paired with cognitive training (CT) exercise in participants with multiple sclerosis (MS). Methods In a feasibility study of RS‐tDCS in MS, participants completed ten sessions of tDCS paired with CT (1.5 mA × 20 min, dorsolateral prefrontal cortex montage). RS‐tDCS participants were compared to a control group of adults with MS who underwent ten 20‐min CT sessions through the same remotely supervised procedures. Cognitive outcomes were tested by composite scores measuring change in performance on standard tests (Brief International Cognitive Assessment in MS or BICAMS), basic attention (ANT‐I Orienting and Attention Networks, Cogstate Detection), complex attention (ANT‐I Executive Network, Cogstate Identification and One‐Back), and intra‐individual response variability (ANT‐I and Cogstate identification; sensitive markers of disease status). Results After ten sessions, the tDCS group ( n = 25) compared to the CT only group ( n = 20) had significantly greater improvement in complex attention ( p = 0.01) and response variability ( p = 0.01) composites. The groups did not differ in measures of basic attention ( p = 0.95) or standard cognitive measures ( p = 0.99). Conclusions These initial findings indicate benefit for RS‐tDCS paired with CT in MS. Exploratory analyses indicate that the earliest tDCS cognitive benefit is seen in complex attention and response variability. Telerehabilitation using RS‐tDCS combined with CT may lead to improved outcomes in MS.