Patient-reported outcome measures with multiple sclerosis on the effects of transcranial magnetic stimulation on communication difficulties

Abstract

Introduction: Multiple sclerosis (MS) can trigger difficulties in communication. Transcranial magnetic stimulation (TMS) is a treatment option. Objectives: To analyze the self-reported communicative ability of people with MS undergoing TMS. Methods: The protocol consisted of 10 interventions by TMS (primary motor cortex, left dorsolateral pre-frontal cortex). The domain 1 of the self-administered WHODAS 2.0 Disability Rating Scale was used before and after (30 days) TMS to identify patient’s opinion of communication. Scores ranged from 0 = minimum difficulty to 100 = maximum. Results: The study comprised 30 people with MS: 22 women, 8 men, age 33– 68 years (mean = 50.0, standard deviation [SD] = 10.6), EDSS 0-6.5 (mean = 4.6, SD = 1.9), time diagnostic 1–24 years (mean = 10.0, SD = 7.2). All patients mentioned preserved ability for general understanding of the interlocutors’ speech. Prior to TMS, n = 18/60% had moderate difficulty concentrating (including speech content/subject), moderate/severe to n = 24/80% in recent memory, n = 10/33%) in problem solving, and n = 10/33% in learning, fundamental mental and reasoning activities for communication, activity reported with a moderate degree of difficult in n = 18/60% to start and maintain conversations due to inability to recall words (language disorder) or impairment in speech intelligibility (dysarthria). Self-reports pointed to a decrease in difficulties after TMS. Conclusion: We observed that WHODAS 2.0 seems to be a favorable both to identify the patient-reported outcome measures about the communicative difficulties, and to analyze the effects of TMS, which, in turn, showed potential to improve verbal communication and requires longitudinal investigation.