At-home online training with transcranial stimulation improves cognition in MS patients
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WEST PALM BEACH, Fla. — At-home use of online adaptive training paired with transcranial direct current stimulation improves cognition in MS patients, according to a presentation at ACTRIMS Forum.
“Cognitive involvement with MS is a common problem,” Leigh Charvet, PhD, professor of neurology at NYU Grossman School of Medicine, said during the presentation. “It is initially mild, affecting information processing, and then gradually progresses to other aspects of cognitive function. We know that these online brain training programs can improve cognitive functioning.”
Researchers tested this by assessing cognitive outcomes in a randomized, home-based sham-controlled clinical trial that paired transcranial direct current stimulation (tCDS) with adaptive cognitive training (aCT).
The study evaluated 106 patients, aged 20 to 72 years, with both MS and fatigue but without depression or severe cognitive impairment. Participants were randomized to either active or sham left anodal dorsolateral prefrontal cortex tDCS paired with aCT (Posit Science’s BrainHQ) for 30 daily, 20-minute sessions over a period of 6 weeks. All intervention sessions were completed at participants’ homes and tracked remotely.
Researchers randomized participants by high or low neurologic disability [Expanded Disability Status Scale (EDSS) low: 0.0-3.0 and high: 3.5-6.5] at study initiation and administered the Brief International Cognitive Assessment in MS (BICAMS) at baseline and at the end of intervention.
Results revealed that 99% of participants completed at least 25 sessions, indicating high tolerance of the treatment. Pre- to post-intervention change in BICAMS score increased and improved in the active group compared with the sham group (mean change = 0.05 ± 0.54 vs. –0.17 ± 0.46, respectively, P = 0.027).
Data also showed that although the active tDCS benefit was observed in both high and low EDSS strata, those with higher EDSS had greater and more significant change in BICAMS in the active vs. sham comparison. In addition, Charvet and colleagues noted that using only cognitive training (sham tDCS) did not result in improvement, suggesting that tDCS may play a significant role in potentiating training time.
“When we look at the stratification between high and low EDSS, you can see that the participants with the highest disability levels were the ones that had the most significant benefit,” Charvet said. “This intervention is highly feasible.”