Open AccessWalking in multiple sclerosis improves with tDCS: a randomized, double‐blind, sham‐controlled study
Author(s) -
Pilloni Giuseppina,
Choi Claire,
Shaw Michael T,
Coghe Giancarlo,
Krupp Lauren,
Moffat Marilyn,
Cocco Eleonora,
Pau Massimiliano,
Charvet Leigh
Publication year - 2020
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51224
Subject(s) - medicine , transcranial direct current stimulation , multiple sclerosis , randomized controlled trial , gait , physical therapy , physical medicine and rehabilitation , pilot trial , expanded disability status scale , stimulation , psychiatry
Objective To evaluate whether multiple sessions of transcranial direct current stimulation (tDCS) applied to the primary motor (M1) cortex paired with aerobic exercise can improve walking functions in multiple sclerosis (MS). Methods MS participants were recruited for a double‐blind, parallel‐arm, randomized, sham‐controlled trial and assigned to 10 sessions (5 d/wk for 2 weeks) of either active or sham tDCS paired with unloaded cycling for 20 minutes. Stimulation was administered over the left M1 cortex (2.5 mA; anode over C3/cathode over FP2). Gait spatiotemporal parameters were assessed using a wearable inertial sensor (10‐meter and 2‐minute walking tests). Measurements were collected at baseline, end of tDCS intervention, and 4‐week postintervention to test for duration of any benefits. Results A total of 15 participants completed the study, nine in the active and six in the sham condition. The active and sham groups were matched according to gender (50% vs. 40% female), neurologic disability (median EDSS 5.5 vs. 5), and age (mean 52.1 ± 12.9 vs. 53.7 ± 9.8 years). The active group had a significantly greater increase in gait speed (0.87 vs. 1.20 m/s, p < 0.001) and distance covered during the 2‐minute walking test (118.53 vs. 133.06 m, p < 0.001) at intervention end compared to baseline. At 4‐week follow‐up, these improvements were maintained (baseline vs. follow‐up: gait speed 0.87 vs. 1.18 m/s, p < 0.001; distance traveled 118.53 vs. 143.82 m, p < 0.001). Interpretation Multiple sessions of tDCS paired with aerobic exercise lead to cumulative and persisting improvements in walking and endurance in patients with MS.