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Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

1
EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France
2
Service de Physiologie – Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, 94010 Créteil, France
3
Neurology Division, Lebanese American University Medical Center Rizk Hospital, Beirut 113288, Lebanon
4
Gilbert and Rose Mary Chagoury School of Medicine School of Medicine, Lebanese American University, Byblos 4504, Lebanon
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(3), 185; https://doi.org/10.3390/brainsci10030185
Received: 16 February 2020 / Revised: 20 March 2020 / Accepted: 22 March 2020 / Published: 23 March 2020
(This article belongs to the Special Issue Novel therapies for Multiple Sclerosis)
Background: Cerebellar and motor tracts are frequently impaired in multiple sclerosis (MS). Altered hand dexterity constitutes a challenge in clinical practice, since medical treatment shows very limited benefits in this domain. Cerebellar control is made via several cerebellocortical pathways, of which the most studied one links the cerebellum to the contralateral motor cortex via the contralateral ventro-intermediate nucleus of the thalamus influencing the corticospinal outputs. Modulating the activity of the cerebellum or of the motor cortex could be of help. Method: The main interest here is to evaluate the efficacy of transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, in treating altered dexterity in MS. Forty-eight patients will be recruited in a randomized, double-blind, sham-controlled, and crossover study. They will randomly undergo one of the three interventions: anodal tDCS over the primary motor area, cathodal tDCS over the cerebellum, or sham. Each block consists of five consecutive daily sessions with direct current (2 mA), lasting 20 min each. The primary outcome will be the improvement in manual dexterity according to the change in the time required to complete the nine-hole pegboard task. Secondary outcomes will include fatigue, pain, spasticity, and mood. Patients’ safety and satisfaction will be rated. Discussion: Due to its cost-effective, safe, and easy-to-use profile, motor or cerebellar tDCS may constitute a potential tool that might improve dexterity in MS patients and therefore ameliorate their quality of life. View Full-Text
Keywords: multiple sclerosis; transcranial direct current stimulation; tDCS; motor cortex; cerebellum; hand dexterity multiple sclerosis; transcranial direct current stimulation; tDCS; motor cortex; cerebellum; hand dexterity
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Ayache, S.S.; Riachi, N.; Ahdab, R.; Chalah, M.A. Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial. Brain Sci. 2020, 10, 185.

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