Transcranial direct current stimulation in multiple sclerosis - a review

Introduction: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system and a leading cause of disability in young adults. Many disablingsymptoms in MS, such as spasticity, pain, fatigue, depression and cognitive deficits are not fully controlled by drug treatment. Transcranial direct current stimulation(tDCS) can be used as tools for modulating altered cortical excitability and plasticity MS patients, providing an improvement in disabling symptoms affecting suchpatients. This review summarized some of the most interesting recent achievements regarding the therapeutic use of tDCS in MS patients. Methods: We reviewed the clinical application of transcranial direct current stimulation (tDCS), emphasizing their effect on clinical symptoms and signs that are commonly involved in MS patients. In addition, we shortly described new protocols for therapeutic options in MS patients. Results: We reviewed studies focused on fatigues, motor performance, spasticity, pain and cognitive abilities. The most promising results have been published for the improvement of motor (i.e. hand dexterity) and cognitive performances (i.e. attentionand working memory) and pain s treatment by applying tDCS. Conclusion: There are still no official recommendations for the therapeutic use of tDCS in MS. The variability of tDCS efficacy is still a big challenge which needs to be solved. However, well-designed studies, deeper knowledge about pathomechanisms underlying MS, and the combination of such techniques with motor and cognitive rehabilitation might results in higher effectiveness of tDCS.

Keywords:

Transcranial direct current stimulation , rehabilitation , Therapy.