Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial
Background: Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervi...
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| Veröffentlicht in: | Multiple sclerosis 2024-10, Vol.30 (11-12), p.1490-1502 |
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| container_issue | 11-12 |
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| container_title | Multiple sclerosis |
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| creator | Pilloni, Giuseppina Lustberg, Matthew Malik, Martin Feinberg, Charles Datta, Abhishek Bikson, Marom Gutman, Josef Krupp, Lauren Charvet, Leigh |
| description | Background:
Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home.
Objective:
This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS.
Methods:
Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT).
Results:
The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04).
Conclusion:
At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity. |
| doi_str_mv | 10.1177/13524585241275013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3105486680</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_13524585241275013</sage_id><sourcerecordid>3105486680</sourcerecordid><originalsourceid>FETCH-LOGICAL-c250t-4e8fbdf993955cea2c66d619756aa072a82a8c4a3b201ea12adec9f19e9caf853</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhSNERX_gAdggS2xYNMWO4zhmV00LrVSJBbCObuybGVeOPdhOS3khXhOPpoAEQrL8o_Pdc22fqnrJ6BljUr5lXDSt6MvEGiko40-qI9ZKWVMl6dOyL3q9Aw6r45RuKaVScvGsOuSq6fpOiKPqxxV4Q6bF62yDt35NrCfbGNYRU7J3SObFZbt1SJJ2GEOyidi5AHeYyL3NG5IvVp8IGIOG5EAMWPdA8BtGbROmd-ScbMKM9QipALE0C7P9juaUmLCMrgjOerM7pw3MtQ4-x-BcYXURrAZHcrTgnlcHE7iELx7Xk-rL-8vPq6v65uOH69X5Ta0bQXPdYj-NZlKKKyE0QqO7znRMSdEBUNlAX4ZugY8NZQisAYNaTUyh0jD1gp9Ub_a-5YlfF0x5mG3S6Bx4DEsaOKOi7buupwV9_Rd6G5boy-0K1dCOc8FUodie0uXzUsRp2EY7Q3wYGB12KQ7_pFhqXj06L-OM5nfFr9gKcLYHEqzxT9v_O_4E6cWnmg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3120633519</pqid></control><display><type>article</type><title>Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial</title><source>MEDLINE</source><source>SAGE Complete</source><creator>Pilloni, Giuseppina ; Lustberg, Matthew ; Malik, Martin ; Feinberg, Charles ; Datta, Abhishek ; Bikson, Marom ; Gutman, Josef ; Krupp, Lauren ; Charvet, Leigh</creator><creatorcontrib>Pilloni, Giuseppina ; Lustberg, Matthew ; Malik, Martin ; Feinberg, Charles ; Datta, Abhishek ; Bikson, Marom ; Gutman, Josef ; Krupp, Lauren ; Charvet, Leigh</creatorcontrib><description>Background:
Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home.
Objective:
This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS.
Methods:
Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT).
Results:
The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04).
Conclusion:
At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.</description><identifier>ISSN: 1352-4585</identifier><identifier>ISSN: 1477-0970</identifier><identifier>EISSN: 1477-0970</identifier><identifier>DOI: 10.1177/13524585241275013</identifier><identifier>PMID: 39268655</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Combined Modality Therapy ; Double-Blind Method ; Electrical stimulation of the brain ; ESB ; Exercise Therapy - methods ; Female ; Hand - physiopathology ; Humans ; Male ; Middle Aged ; Motor ability ; Motor Skills - physiology ; Multiple sclerosis ; Multiple Sclerosis, Chronic Progressive - physiopathology ; Multiple Sclerosis, Chronic Progressive - rehabilitation ; Multiple Sclerosis, Chronic Progressive - therapy ; Quality of life ; Rehabilitation ; Transcranial Direct Current Stimulation - methods ; Treatment Outcome</subject><ispartof>Multiple sclerosis, 2024-10, Vol.30 (11-12), p.1490-1502</ispartof><rights>The Author(s), 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c250t-4e8fbdf993955cea2c66d619756aa072a82a8c4a3b201ea12adec9f19e9caf853</cites><orcidid>0000-0003-4429-9713 ; 0000-0001-7003-807X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/13524585241275013$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/13524585241275013$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39268655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pilloni, Giuseppina</creatorcontrib><creatorcontrib>Lustberg, Matthew</creatorcontrib><creatorcontrib>Malik, Martin</creatorcontrib><creatorcontrib>Feinberg, Charles</creatorcontrib><creatorcontrib>Datta, Abhishek</creatorcontrib><creatorcontrib>Bikson, Marom</creatorcontrib><creatorcontrib>Gutman, Josef</creatorcontrib><creatorcontrib>Krupp, Lauren</creatorcontrib><creatorcontrib>Charvet, Leigh</creatorcontrib><title>Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial</title><title>Multiple sclerosis</title><addtitle>Mult Scler</addtitle><description>Background:
Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home.
Objective:
This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS.
Methods:
Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT).
Results:
The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04).
Conclusion:
At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.</description><subject>Adult</subject><subject>Aged</subject><subject>Combined Modality Therapy</subject><subject>Double-Blind Method</subject><subject>Electrical stimulation of the brain</subject><subject>ESB</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Hand - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor ability</subject><subject>Motor Skills - physiology</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis, Chronic Progressive - physiopathology</subject><subject>Multiple Sclerosis, Chronic Progressive - rehabilitation</subject><subject>Multiple Sclerosis, Chronic Progressive - therapy</subject><subject>Quality of life</subject><subject>Rehabilitation</subject><subject>Transcranial Direct Current Stimulation - methods</subject><subject>Treatment Outcome</subject><issn>1352-4585</issn><issn>1477-0970</issn><issn>1477-0970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhSNERX_gAdggS2xYNMWO4zhmV00LrVSJBbCObuybGVeOPdhOS3khXhOPpoAEQrL8o_Pdc22fqnrJ6BljUr5lXDSt6MvEGiko40-qI9ZKWVMl6dOyL3q9Aw6r45RuKaVScvGsOuSq6fpOiKPqxxV4Q6bF62yDt35NrCfbGNYRU7J3SObFZbt1SJJ2GEOyidi5AHeYyL3NG5IvVp8IGIOG5EAMWPdA8BtGbROmd-ScbMKM9QipALE0C7P9juaUmLCMrgjOerM7pw3MtQ4-x-BcYXURrAZHcrTgnlcHE7iELx7Xk-rL-8vPq6v65uOH69X5Ta0bQXPdYj-NZlKKKyE0QqO7znRMSdEBUNlAX4ZugY8NZQisAYNaTUyh0jD1gp9Ub_a-5YlfF0x5mG3S6Bx4DEsaOKOi7buupwV9_Rd6G5boy-0K1dCOc8FUodie0uXzUsRp2EY7Q3wYGB12KQ7_pFhqXj06L-OM5nfFr9gKcLYHEqzxT9v_O_4E6cWnmg</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Pilloni, Giuseppina</creator><creator>Lustberg, Matthew</creator><creator>Malik, Martin</creator><creator>Feinberg, Charles</creator><creator>Datta, Abhishek</creator><creator>Bikson, Marom</creator><creator>Gutman, Josef</creator><creator>Krupp, Lauren</creator><creator>Charvet, Leigh</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4429-9713</orcidid><orcidid>https://orcid.org/0000-0001-7003-807X</orcidid></search><sort><creationdate>202410</creationdate><title>Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial</title><author>Pilloni, Giuseppina ; Lustberg, Matthew ; Malik, Martin ; Feinberg, Charles ; Datta, Abhishek ; Bikson, Marom ; Gutman, Josef ; Krupp, Lauren ; Charvet, Leigh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c250t-4e8fbdf993955cea2c66d619756aa072a82a8c4a3b201ea12adec9f19e9caf853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Combined Modality Therapy</topic><topic>Double-Blind Method</topic><topic>Electrical stimulation of the brain</topic><topic>ESB</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Hand - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor ability</topic><topic>Motor Skills - physiology</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis, Chronic Progressive - physiopathology</topic><topic>Multiple Sclerosis, Chronic Progressive - rehabilitation</topic><topic>Multiple Sclerosis, Chronic Progressive - therapy</topic><topic>Quality of life</topic><topic>Rehabilitation</topic><topic>Transcranial Direct Current Stimulation - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pilloni, Giuseppina</creatorcontrib><creatorcontrib>Lustberg, Matthew</creatorcontrib><creatorcontrib>Malik, Martin</creatorcontrib><creatorcontrib>Feinberg, Charles</creatorcontrib><creatorcontrib>Datta, Abhishek</creatorcontrib><creatorcontrib>Bikson, Marom</creatorcontrib><creatorcontrib>Gutman, Josef</creatorcontrib><creatorcontrib>Krupp, Lauren</creatorcontrib><creatorcontrib>Charvet, Leigh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Multiple sclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pilloni, Giuseppina</au><au>Lustberg, Matthew</au><au>Malik, Martin</au><au>Feinberg, Charles</au><au>Datta, Abhishek</au><au>Bikson, Marom</au><au>Gutman, Josef</au><au>Krupp, Lauren</au><au>Charvet, Leigh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial</atitle><jtitle>Multiple sclerosis</jtitle><addtitle>Mult Scler</addtitle><date>2024-10</date><risdate>2024</risdate><volume>30</volume><issue>11-12</issue><spage>1490</spage><epage>1502</epage><pages>1490-1502</pages><issn>1352-4585</issn><issn>1477-0970</issn><eissn>1477-0970</eissn><abstract>Background:
Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home.
Objective:
This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS.
Methods:
Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT).
Results:
The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04).
Conclusion:
At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>39268655</pmid><doi>10.1177/13524585241275013</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-4429-9713</orcidid><orcidid>https://orcid.org/0000-0001-7003-807X</orcidid></addata></record> |
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| identifier | ISSN: 1352-4585 |
| ispartof | Multiple sclerosis, 2024-10, Vol.30 (11-12), p.1490-1502 |
| issn | 1352-4585 1477-0970 1477-0970 |
| language | eng |
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| source | MEDLINE; SAGE Complete |
| subjects | Adult Aged Combined Modality Therapy Double-Blind Method Electrical stimulation of the brain ESB Exercise Therapy - methods Female Hand - physiopathology Humans Male Middle Aged Motor ability Motor Skills - physiology Multiple sclerosis Multiple Sclerosis, Chronic Progressive - physiopathology Multiple Sclerosis, Chronic Progressive - rehabilitation Multiple Sclerosis, Chronic Progressive - therapy Quality of life Rehabilitation Transcranial Direct Current Stimulation - methods Treatment Outcome |
| title | Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial |
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