Enhanced cognitive outcomes with telehealth-based tDCS in multiple sclerosis: Results from a sham-controlled RCT.

IF 2.3 Q2 CLINICAL NEUROLOGY

Multiple Sclerosis Journal - Experimental, Translational and Clinical Pub Date : 2025-07-28 eCollection Date: 2025-07-01 DOI:10.1177/20552173251356704

Leigh Charvet, Judith Goldberg, Xiaochun Li, Pamela Best, Michael Shaw, Lana Zhovtis Ryerson, Josef Gutman, Marom Bikson, Giuseppina Pilloni, Lauren Krupp

{"title":"Enhanced cognitive outcomes with telehealth-based tDCS in multiple sclerosis: Results from a sham-controlled RCT.","authors":"Leigh Charvet, Judith Goldberg, Xiaochun Li, Pamela Best, Michael Shaw, Lana Zhovtis Ryerson, Josef Gutman, Marom Bikson, Giuseppina Pilloni, Lauren Krupp","doi":"10.1177/20552173251356704","DOIUrl":null,"url":null,"abstract":"Background: Cognitive impairment is common in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) combined with adaptive cognitive training (aCT) may improve clinical outcomes.Objective: To evaluate the effect of active vs. sham home-based tDCS + aCT on cognitive function.Methods: Participants with MS and fatigue, without depression or severe cognitive impairment, were randomized to complete 30 remotely supervised 20-minute sessions of active (2.0 mA) or sham tDCS targeting the left anodal dorsolateral prefrontal cortex, paired with aCT. Randomization was stratified by high (H) vs. low (L) EDSS. The Brief International Cognitive Assessment in MS (BICAMS) was administered at baseline and intervention end, with scores converted to demographics-adjusted z-scores.Results: Out of 117 participants, 106 completed BICAMS assessments. Compliance was high; 92% completed >25 sessions. Mean change in BICAMS z-score was significantly greater in the active (n = 55: 0.06 ± 0.56) versus sham (n = 51: -0.16 ± 0.50) group (p = 0.035). The interaction between treatment and EDSS for BICAMS z-score was not significant (p = .254), but benefits were greater in H EDSS (-0.00 ± 0.57 vs. -0.37 ± 0.39; p = .022) than L EDSS (0.11 ± 0.56 vs. -0.01 ± 0.53; p = .411).Conclusions: Active vs. sham tDCS + aCT resulted in significantly better cognitive outcomes, with the greatest benefit in those with high neurologic disability.CLINICALTRIALS.GOV; https://clinicaltrials.gov/study/NCT03838770; IDENTIFIER: NCT03838770.","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":"11 3","pages":"20552173251356704"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304595/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20552173251356704","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Cognitive impairment is common in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) combined with adaptive cognitive training (aCT) may improve clinical outcomes.

Objective: To evaluate the effect of active vs. sham home-based tDCS + aCT on cognitive function.

Methods: Participants with MS and fatigue, without depression or severe cognitive impairment, were randomized to complete 30 remotely supervised 20-minute sessions of active (2.0 mA) or sham tDCS targeting the left anodal dorsolateral prefrontal cortex, paired with aCT. Randomization was stratified by high (H) vs. low (L) EDSS. The Brief International Cognitive Assessment in MS (BICAMS) was administered at baseline and intervention end, with scores converted to demographics-adjusted z-scores.

Results: Out of 117 participants, 106 completed BICAMS assessments. Compliance was high; 92% completed >25 sessions. Mean change in BICAMS z-score was significantly greater in the active (n = 55: 0.06 ± 0.56) versus sham (n = 51: -0.16 ± 0.50) group (p = 0.035). The interaction between treatment and EDSS for BICAMS z-score was not significant (p = .254), but benefits were greater in H EDSS (-0.00 ± 0.57 vs. -0.37 ± 0.39; p = .022) than L EDSS (0.11 ± 0.56 vs. -0.01 ± 0.53; p = .411).

Conclusions: Active vs. sham tDCS + aCT resulted in significantly better cognitive outcomes, with the greatest benefit in those with high neurologic disability.CLINICALTRIALS.GOV; https://clinicaltrials.gov/study/NCT03838770; IDENTIFIER: NCT03838770.

Abstract Image

查看原文本刊更多论文

基于远程医疗的tDCS在多发性硬化症中的认知效果增强：来自一项假对照随机对照试验的结果。

背景：认知障碍在多发性硬化症（MS）中很常见。经颅直流电刺激（tDCS）联合适应性认知训练（aCT）可能改善临床结果。目的：评价主动与虚假家庭tDCS + aCT对认知功能的影响。方法：患有多发性硬化症和疲劳，没有抑郁或严重认知障碍的参与者被随机分配完成30个远程监督的20分钟的活动（2.0 mA）或假tDCS，目标是左淋巴结背外侧前额叶皮层，与aCT配对。随机化按高(H)与低(L) EDSS分层。在基线和干预结束时进行MS简短国际认知评估（BICAMS），并将分数转换为人口统计学调整的z分数。结果：117名参与者中，106人完成了BICAMS评估。依从性很高；92%的人完成了bb25次训练。活动组（n = 55: 0.06±0.56）比假手术组（n = 51: -0.16±0.50）BICAMS z-score的平均变化显著大于假手术组（p = 0.035）。治疗和EDSS对BICAMS z-score的相互作用不显著（p = 0.254），但H EDSS的益处更大(-0.00±0.57 vs -0.37±0.39；p = .022)比L eds(0.11±0.56和-0.01±0.53;p = .411)。结论：活动性与假性tDCS + aCT治疗的认知效果明显更好，对神经功能障碍高的患者获益最大。https://clinicaltrials.gov/study/NCT03838770;标识符:NCT03838770。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊