Abstract
Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients.
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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We express our gratitude to Imam Hossein Hospital and the Faculty of Rehabilitation at Shahid Beheshti University of Medical Sciences for collaborating with us and creating the required conditions for conducting this study.
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Conceptualization: [Narges Jahantigh Akbari] [ Nahid Tahan]; Methodology: [Narges Jahantigh Akbari] [ Nahid Tahan][ Sedigheh Sadat Naimi]; Formal analysis and investigation: [Alireza Akbarzadeh Baghban] [Nahid Beladi Moghadam]; Writing - original draft preparation: [Narges Jahantigh Akbari] [ Nahid Tahan]; Writing - review and editing: [Narges Jahantigh Akbari] [ Nahid Tahan][ Maryam Zoghi]; Supervision: [Narges Jahantigh Akbari] [ Nahid Tahan][ Maryam Zoghi].
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the human Ethics Committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran, granted approval for this study (No. IR.SBMU.RETECH.REC.1400.499). Informed consent was obtained from all individual participants included in the study.
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Akbari, N.J., Tahan, N., Naimi, S.S. et al. Comparing the effects of cerebellar and prefrontal anodal transcranial direct current stimulation concurrent with postural training on balance and fatigue in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial. Exp Brain Res (2024). https://doi.org/10.1007/s00221-024-06816-9
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DOI: https://doi.org/10.1007/s00221-024-06816-9