Transcranial direct current stimulation combined with computer games at home reduces cognitive symptoms of multiple sclerosis
NYU Langone Medical Center Mar 04, 2017
People with multiple sclerosis (MS) had better problem solving ability and response time after training with a technology called transcranial direct current stimulation (tDCS), according to a new study published February 22, 2017, in the journal Neuromodulation: Technology at the Neural Interface.
Led by researchers at NYU LangoneÂs Multiple Sclerosis Comprehensive Care Center, the new study reports that participants with MS who used tDCS while playing the cognitive training computer games designed to improve information processing abilities showed significantly greater gains in cognitive measures than those who played the computer games alone. Importantly, the participants completed the cognitive training and tDCS while at home.
By enabling people to be treated without repeat visits to the clinic, which can be a major challenge for people with MS as the disease progresses, the approach may improve quality of life for this patient population, according to the studyÂs authors.
ÂOur research adds evidence that tDCS, while done remotely under a supervised treatment protocol, may provide an exciting new treatment option for people with multiple sclerosis who cannot get relief for some of their cognitive symptoms, says lead researcher Leigh E. Charvet, PhD, associate professor of neurology and director of research at NYU LangoneÂs Multiple Sclerosis Comprehensive Care Center. ÂMany MS medications are aimed at preventing disease flares but those drugs do not help with daily symptom management, especially cognitive problems. We hope tDCS will fill this crucial gap and help improve quality of life for people with MS.Â
In this study, the brainÂs dorsolateral prefrontal cortex was targeted for tDCS.
Twenty–five participants were provided with a tDCS system and a headset they learned to apply with guided help from the research team. In each session, a study technician would contact each participant through online video conferencing, giving him or her a code to enter into a keypad that commenced the tDCS session in order to control for dosing. Then, during the stimulation, the participant played a research version of computerized cognitive training games that challenged areas of information processing and attention and working memory systems.
Members of the tDCS group participated in 10 sessions, and the researchers compared their results to 20 participants with MS who only played cognitive training games in their 10 sessions.
Researchers found participants in the group treated with tDCS showed significantly greater improvements on sensitive, computer–based measures of complex attention and increases in their response times across trials compared to the group that did cognitive training games alone. Improvements were shown to increase over time with the number of sessions, which suggests the tDCS may have a cumulative benefit. But, more research is needed to determine how long these effects may last following culmination of sessions.
The group that participated in tDCS plus cognitive training, however, did not show a statistically significant difference from the group that only played cognitive training games as measured by less sensitive standard neuropsychological measures like the Brief International Cognitive Assessment in MS (BICAMS) tests or on computer–based measures of basic attention. Those findings suggest the cognitive changes brought on by tDCS may require more treatment sessions to have noticeable improvements in daily functioning, according to Dr. Charvet.
The device was designed in conjunction with inventor Marom Bikson, PhD, a professor of biomedical engineering at The City College of New York, and Abhishek Datta, PhD, the chief technology officer of Soterix Medical, which holds a patent on the tDCS device.
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Led by researchers at NYU LangoneÂs Multiple Sclerosis Comprehensive Care Center, the new study reports that participants with MS who used tDCS while playing the cognitive training computer games designed to improve information processing abilities showed significantly greater gains in cognitive measures than those who played the computer games alone. Importantly, the participants completed the cognitive training and tDCS while at home.
By enabling people to be treated without repeat visits to the clinic, which can be a major challenge for people with MS as the disease progresses, the approach may improve quality of life for this patient population, according to the studyÂs authors.
ÂOur research adds evidence that tDCS, while done remotely under a supervised treatment protocol, may provide an exciting new treatment option for people with multiple sclerosis who cannot get relief for some of their cognitive symptoms, says lead researcher Leigh E. Charvet, PhD, associate professor of neurology and director of research at NYU LangoneÂs Multiple Sclerosis Comprehensive Care Center. ÂMany MS medications are aimed at preventing disease flares but those drugs do not help with daily symptom management, especially cognitive problems. We hope tDCS will fill this crucial gap and help improve quality of life for people with MS.Â
In this study, the brainÂs dorsolateral prefrontal cortex was targeted for tDCS.
Twenty–five participants were provided with a tDCS system and a headset they learned to apply with guided help from the research team. In each session, a study technician would contact each participant through online video conferencing, giving him or her a code to enter into a keypad that commenced the tDCS session in order to control for dosing. Then, during the stimulation, the participant played a research version of computerized cognitive training games that challenged areas of information processing and attention and working memory systems.
Members of the tDCS group participated in 10 sessions, and the researchers compared their results to 20 participants with MS who only played cognitive training games in their 10 sessions.
Researchers found participants in the group treated with tDCS showed significantly greater improvements on sensitive, computer–based measures of complex attention and increases in their response times across trials compared to the group that did cognitive training games alone. Improvements were shown to increase over time with the number of sessions, which suggests the tDCS may have a cumulative benefit. But, more research is needed to determine how long these effects may last following culmination of sessions.
The group that participated in tDCS plus cognitive training, however, did not show a statistically significant difference from the group that only played cognitive training games as measured by less sensitive standard neuropsychological measures like the Brief International Cognitive Assessment in MS (BICAMS) tests or on computer–based measures of basic attention. Those findings suggest the cognitive changes brought on by tDCS may require more treatment sessions to have noticeable improvements in daily functioning, according to Dr. Charvet.
The device was designed in conjunction with inventor Marom Bikson, PhD, a professor of biomedical engineering at The City College of New York, and Abhishek Datta, PhD, the chief technology officer of Soterix Medical, which holds a patent on the tDCS device.
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