Walking in multiple sclerosis improves with tDCS: a randomized, double-blind, sham-controlled study.

Abstract

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.

• Authors: Giuseppina Pilloni, Claire Choi, Michael T Shaw, Giancarlo Coghe, Lauren Krupp, Marilyn Moffat, Eleonora Cocco, Massimiliano Pau, Leigh Charvet
• Journal: Annals of clinical and translational neurology (Ann Clin Transl Neurol) Vol. 7 Issue 11 Pg. 2310-2319 (11 2020) ISSN: 2328-9503 [Electronic] United States
• PMID: 33080122 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

Chemical References

• Placebos

Topics

• Adult
• Aged
• Combined Modality Therapy
• Double-Blind Method
• Exercise Therapy
• Female
• Humans
• Male
• Middle Aged
• Motor Cortex
• Multiple Sclerosis (physiopathology, therapy)
• Outcome Assessment, Health Care
• Placebos
• Severity of Illness Index
• Transcranial Direct Current Stimulation
• Walking (physiology)