Abstract
Background In the last few years, transcranial direct current stimulation (tDCS) has emerged as an appealing therapeutic option to improve brain functions. The use of prefrontal tDCS has yielded promising data regarding its ability to augment cognitive performance and ameliorate several neuropsychiatric symptoms, namely pain, fatigue and mood disturbances. Such symptoms are commonly encountered in patients with multiple sclerosis (MS). In particular, they could suffer from chronic pain which would disturb their attentional capacity. Objective In the current work, our main objective was to evaluate the tDCS effects over the left dorsolateral prefrontal cortex on pain in MS patients. Our secondary outcomes were to study its influence on attention, fatigue and mood. Methods MS patients with chronic neuropathic pain were enrolled in a randomized, sham-controlled, and cross-over study. Patients randomly received two anodal tDCS blocks (active or sham), each consisting of three consecutive daily tDCS sessions, and held apart by three weeks. Evaluations took place before and after each block, and consisted of pain, mood and fatigue scales; an attentional task, and neurophysiological measures. Results Compared to sham, active tDCS yielded significant analgesic effects. There were no effects of any block on mood, fatigue or attention. Conclusion Our data are in line with other studies and shed the light over the prefrontal tDCS efficacy in reducing MS-related neuropathic pain. However, contrarily to previous trials, attention, mood and fatigue were not improved in our MS group. This controversy could be attributed to several factors, particularly the small sample size, the heterogeneity of our cohort and the short duration of our protocol. Hence, future large-scale studies addressing all these limitations are highly needed before drawing any conclusion.
Published Version
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