Effects of transcranial alternating current stimulation on cognitive function in people with multiple sclerosis: A randomized controlled trial

Wan-Yu Hsu; Theodore Zanto; Jee Eun Park; Adam Gazzaley; Riley M Bove

doi:10.1016/j.msard.2023.105090

Effects of transcranial alternating current stimulation on cognitive function in people with multiple sclerosis: A randomized controlled trial

Mult Scler Relat Disord. 2023 Dec:80:105090. doi: 10.1016/j.msard.2023.105090. Epub 2023 Oct 19.

Authors

Wan-Yu Hsu¹, Theodore Zanto², Jee Eun Park³, Adam Gazzaley², Riley M Bove⁴

Affiliations

¹ UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, 1651 4th St, San Francisco, CA 94158, USA. Electronic address: wan-yu.hsu@ucsf.edu.
² UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, 1651 4th St, San Francisco, CA 94158, USA; Neuroscape, University of California San Francisco, San Francisco, CA, USA.
³ UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, 1651 4th St, San Francisco, CA 94158, USA; Neuroscape, University of California San Francisco, San Francisco, CA, USA; Department of Psychiatry, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea.
⁴ UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, 1651 4th St, San Francisco, CA 94158, USA.

PMID: 37925960
DOI: 10.1016/j.msard.2023.105090

Abstract

Background: Cognitive impairment is a core symptom that profoundly impacts the lives of people with multiple sclerosis (PwMS). Since the existing disease modifying therapies can only stabilize, but not actively treat, cognition in PwMS, there is an unmet need to expand approaches to treat these cognitive symptoms. Transcranial alternating current stimulation (tACS) permits frequency-specific entrainment of neural oscillations intrinsic to cognitive activity. However, the effects of the tACS on cognitive function in PwMS have not yet been assessed. We aimed to evaluate the potential efficacy of applying frontal theta-tACS to improve information processing speed in PwMS.

Methods: 60 PwMS with cognitive complaints were enrolled in a double-blinded, randomized, controlled trial with three stimulation groups: 2 mA, 1 mA, or sham control. A single session of theta-tACS was applied while participants were engaged in a cognitive program which has shown to improve processing speed in PwMS. tACS effects were examined by the Symbol Digit Modalities Test (SDMT). Tolerability, side effects and acceptability were measured.

Results: 1 mA groups had a significantly higher SDMT score after stimulation compared to their pre-stimulation score, 2 mA group showed a marginally significant improvement of their SDMT score, while the SDMT score in the sham group did not change. Overall, 49% of the stimulation group participants showed a clinically meaningful SDMT improvement (4+-point increase).

Conclusion: tACS is a well-tolerated, non-pharmacological intervention. Based on the positive effects observed in the current study of a single session of tACS applied during cognitive engagement, the effects of repeated tACS on cognitive function in PwMS merit further research.

Trial registration: ClinicalTrials.gov NCT04466228.

Keywords: Cognition; Cognitive function; Multiple sclerosis; Transcranial alternating current stimulation.

Publication types

Randomized Controlled Trial

MeSH terms

Cognition
Cognitive Dysfunction* / etiology
Cognitive Dysfunction* / therapy
Humans
Multiple Sclerosis* / complications
Multiple Sclerosis* / therapy
Neuropsychological Tests
Transcranial Direct Current Stimulation*

Associated data

ClinicalTrials.gov/NCT04466228