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Transcranial Direct Current Stimulation for Fatigue, Mood, and Cognition in Multiple Sclerosis

29 juni 2026 uppdaterad av: Asdrubal Rene Huerta Gallango, Universidad de Almeria

Transcranial Direct Current Stimulation for Fatigue, Mood, and Cognition in Multiple Sclerosis: A Randomized, Double-Blind, Sham-Controlled, Crossover Trial

Multiple sclerosis (MS) is a chronic, inflammatory and disabling disease of the Cnetral Nervous System characterized by relapsing and / or progressive somatosensory, motor and vestibular clinical manifestations. Moreover, fatigue, depression, anxiety, and cognitive impairment are also present in most MS patients. These symptoms substantially impact quality of life and often show limited response to conventional pharmacological treatment.

Transcranial direct current stimulation (tDCS) is a non-invasive technique that applies a weak direct current to the scalp via surface electrodes, modulating cortical excitability in a polarity-dependent manner.

The objective of this study is to evaluate the efficacy and safety of tDCS for fatigue, depression, anxiety, and cognitive performance in patients with relapsing or progressive MS.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

38

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Mexiko
      • Mexico City, Mexiko, 11580
        • Neurociencia Clínica Integral

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Age 18-55 years at the time of enrollment
  • Clinical diagnosis of Relapsing Multiple Sclerosis (RMS) or Progressive Multiple Sclerosis (PMS), with or without active progression, established per the 2014 McDonald diagnostic criteria
  • Expanded Disability Status Scale (EDSS) score of 0-3 at the time of screening
  • Time since initial MS diagnosis of at least 6 months
  • Active fatigue symptoms reported by the participant for at least the 6 months prior to enrollment

Exclusion Criteria:

  • History of neuropsychiatric illness (including major depression, bipolar disorder, schizophrenia, or any anxiety disorder) prior to the onset of multiple sclerosis
  • Diagnosis of neuromyelitis optica spectrum disorder (Devic's disease)
  • Presence of any other central nervous system disease
  • Disease duration greater than 10 years combined with an EDSS score of ≤ 2
  • Visual impairment secondary to optic neuritis, internuclear ophthalmoplegia (oculomotor disorder), or any other uncorrected visual impairment that would affect task performance on cognitive assessments
  • Current pharmacological treatment for fatigue or depression
  • Current neuropsychiatric pharmacological treatment, including any antidepressant, anxiolytic, neuroleptic, or anticonvulsant medication
  • Clinical relapse requiring corticosteroid treatment in the 3 months prior to enrollment
  • Severe upper-limb motor deficit that would prevent task performance on neuropsychological assessments

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Active, F3 anode, F4 cathode, 20 minutes, 4 mA, transcranial direct current stimulation
Enhet: Transcranial Direct Current Stimulation
Transcranial direct current stimulation (tDCS) is a non-invasive technique that applies a weak direct current to the scalp via surface electrodes, modulating cortical excitability in a polarity-dependent manner. tDCS has an established safety profile across the populations and protocols studied to date. This study uses an anodal stimulation montage of the dorsolateral prefrontal cortex (DLPFC).
Sham Comparator: Sham, F3 anode, F4 cathode, 20 minutes, 0 mA, transcranial direct current stimulation simulation
Enhet: Sham transcranial direct current stimulation simulation
Sham Comparator: Sham, F3 anode, F4 cathode, 20 minutes, transcranial direct current stimulation simulation

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Modified Fatigue Impact Scale (MFIS) - Total Score
Tidsram: Assessed at baseline (Day 0), immediately following the first 5-day stimulation block (Day 5), and immediately following the second 5-day stimulation block (Day 26 after washout)
The MFIS is a 21-item multidimensional self-report scale assessing the impact of fatigue on physical (9 items), cognitive (10 items), and psychosocial (2 items) functioning over the past 4 weeks. Each item is scored 0-4; total score ranges from 0 to 84. Higher scores indicate greater fatigue impact. The primary comparison is post-active-tDCS total score versus post-sham total score.
Assessed at baseline (Day 0), immediately following the first 5-day stimulation block (Day 5), and immediately following the second 5-day stimulation block (Day 26 after washout)
Modified Fatigue Impact Scale (MFIS) - Physical Subscale
Tidsram: Baseline, Day 5, Day 26
Physical subscale of the MFIS (9 items; range 0-36). Assesses impact of fatigue on physical functioning. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
Modified Fatigue Impact Scale (MFIS) - Cognitive Subscale
Tidsram: Baseline, Day 5, Day 26
Cognitive subscale of the MFIS (10 items; range 0-40). Assesses impact of fatigue on cognitive functioning. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
Modified Fatigue Impact Scale (MFIS) - Psychosocial Subscale
Tidsram: Baseline, Day 5, Day 26
Psychosocial subscale of the MFIS (2 items; range 0-8). Assesses impact of fatigue on psychosocial functioning. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Hospital Anxiety and Depression Scale (HADS) - Anxiety Subscale
Tidsram: Baseline, Day 5, Day 26
7-item subscale of the HADS assessing anxiety symptom severity. Each item is scored 0-3; subscale range 0-21. Higher scores indicate greater anxiety. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
Hospital Anxiety and Depression Scale (HADS) - Depression Subscale
Tidsram: Baseline, Day 5, Day 26
7-item subscale of the HADS assessing depression symptom severity. Each item is scored 0-3; subscale range 0-21. Higher scores indicate greater depression. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
Visual Analog Scale (VAS) - Fatigue
Tidsram: Baseline, Day 5, Day 26
Participant-rated 0-10 point visual analog scale for subjective fatigue severity (0 = no fatigue, 10 = worst imaginable fatigue). Used as a brief supplementary measure alongside the MFIS.
Baseline, Day 5, Day 26
Visual Analog Scale (VAS) - Depression
Tidsram: Baseline, Day 5, Day 26
Participant-rated 0-10 point visual analog scale for subjective depression severity (0 = no depression, 10 = worst imaginable depression). Used as a brief supplementary measure alongside the HADS.
Baseline, Day 5, Day 26
Symbol Digit Modalities Test (SDMT)
Tidsram: Baseline, Day 5, Day 26
Validated test of information-processing speed and working memory, part of the Brief International Cognitive Assessment for MS (BICAMS). The participant substitutes symbols for digits within 90 seconds; higher scores indicate better performance. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
California Verbal Learning Test-II (CVLT-II)
Tidsram: Baseline, Day 5, Day 26
Standardized measure of short-term verbal learning and memory, part of the BICAMS battery. Assessed as total correct recall across learning trials; higher scores indicate better performance. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26
Brief Visuospatial Memory Test-Revised (BVMT-R)
Tidsram: Baseline, Day 5, Day 26
Standardized measure of short-term visuospatial memory and learning, part of the BICAMS battery. Assessed as total correct recall across learning trials; higher scores indicate better performance. Compared between active tDCS and sham conditions.
Baseline, Day 5, Day 26

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Adverse events - frequency and type
Tidsram: After each of the 10 stimulation sessions (Days 1-5 and Days 22-26)
Adverse events assessed by structured interview after each stimulation session, including tingling, stinging, burning, headache, dizziness, numbness, forgetfulness, difficulty concentrating, blurred vision, muscle spasms, nausea, and difficulty breathing. Frequencies compared between active and sham conditions using McNemar's test.
After each of the 10 stimulation sessions (Days 1-5 and Days 22-26)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Universidad de Almeria

Utredare

  • Huvudutredare: ASDRUBAL R HUERTA GALLANGO, MD / PhD, Universidad de Almeria
  • Huvudutredare: Luis Fernando Sánchez-Santed, PhD, Universidad de Almeria

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 augusti 2023

Primärt slutförande (Faktisk)

30 augusti 2024

Avslutad studie (Faktisk)

30 augusti 2024

Studieregistreringsdatum

Först inskickad

23 juni 2026

Först inskickad som uppfyllde QC-kriterierna

29 juni 2026

Första postat (Faktisk)

2 juli 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

2 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

29 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • TDCSMS-001

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

De-identified individual participant data (IPD) underlying the results reported in the published article will be made available to qualified researchers upon reasonable request. Shared data will include the de-identified clinical dataset (outcome scores at baseline, post-sham, and post-treatment time points for all 33 completers), the statistical analysis plan, and the data dictionary. Requests should be directed to the corresponding author (asdrubalhuerta@gmail.com) and will be reviewed on a case-by-case basis. Data will be shared after deposition of the dataset in an institutional or public repository upon publication of the primary manuscript.

Tidsram för IPD-delning

Starting 3 months following publication of the primary manuscript; available for at least 5 years thereafter.

Kriterier för IPD Sharing Access

Researchers with a methodologically sound research proposal and a signed data access agreement with the corresponding institution. Requests submitted to the corresponding author.

IPD-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • SAV
  • ICF
  • ANALYTIC_CODE
  • CSR

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Nej

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