Fatigue is a common symptom of MS, which leads to some people with MS leaving the workforce and being unable to maintain a social life and generally withdrawing from their friends and family.

Therapies to treat MS, specifically fatigue medications, exercise programs, and cognitive behavioural therapies may help to relieve fatigue but none of these treatments are able to consistently manage it in the long term.

In this study, Dr Leigh Charvet and her colleagues from NYU Langone Medical Centre, New York, USA, investigated a technique called transcranial direct current stimulation (tDCS) to help manage fatigue.
Transcranial direct current stimulation (tDCS) is a relatively recent therapy that utilises low-amplitude direct electric current to stimulate the brain. Patients undergoing the therapy wear headsets that look like protective head-gear that you would see some sportspeople wear.

However, they contain electrodes that apply low electric currents to the outside of the head (between 1.5 and 2 milliAmps of current). It is generally considered a safe, easy and low-cost technique.

This and other smaller studies have shown that this method may help reduce fatigue in people with MS.

In this study, the scientists recruited 62 people aged between 18-70 years old with relapsing remitting or progressive MS. The participants were then subdivided into two groups. Both groups had to play a specific set of computer games for 20 minutes while wearing a tDCS device, however the device was only active in one of the groups. To avoid biasing the results, neither the person wearing the device nor the supervisor knew if the device was active.

The participants were able to complete this study in their own home, whilst being supervised using videoconferencing facilitates, which makes this approach applicable to the real world. Some people participated in 10 sessions over two weeks, and others 20 sessions over four weeks.
Prior to the study all the participants underwent a standard psychological assessment for their fatigue, using what is known as the Patient-Reported Outcomes Measurement Information System (PROMIS). Following the completion of the study the participants were retested and changes in their fatigue levels determined.

People in the active group that completed only 10 sessions did show greater signs of improvement in the level of fatigue compared to the control group, however this was not statistically significant, and the researchers believe that this number of sessions is not enough to achieve an effect.

The people in the active group that completed 20 sessions did show a reduction in fatigue at the completion of the study. And this difference was statistically significant compared to those that wore the inactive device. They also reported feeling less fatigued at the end of the individual sessions compared to the start.

While this is a relatively cheap and convenient treatment, some patients did experience minor side effects, with participants that wore both inactive and active devices reporting tingly feelings, being itchy, and experienced a burning sensation. A couple of the participants reported experiencing pain and were withdrawn from the study.

This is the first trial of a non-pharmacological treatment for fatigue in people with MS. These promising results are encouraging and may pave the way for larger trials which will not only confirm these results but may also determine the number of sessions required to produce lasting relief from fatigue.

The crushing fatigue associated with MS dramatically reduces the quality of life of people with MS so it is vital that we add more tools to the toolbox to help make a positive difference.

With thanks to MS Research Australia – the lead provider of research summaries on our website.

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