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MS and CNS Inflammatory Disease: Quality of Life, Symptoms, and Symptomatic Therapy III Session
April 10, 2018
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At-Home Transcranial Direct Current Stimulation Benefits Depression and Cognition in Multiple Sclerosis: Two Case Reports (P4.416)

April 10, 2018 issue
90 (15_supplement)

Abstract

Objective:

We present two cases with positive responses following tDCS delivered at home using a telerehabilitation protocol of tDCS combined with cognitive training.

Background:

Depression is common in MS. Transcranial direct current stimulation (tDCS) is an investigational intervention that may benefit mood and cognition.

Design/Methods:

The Hamilton Depression Rating Scale (HAM-D), Positive and Negative Affect Schedule (PANAS), and the Beck Depression Inventory (BDI), as well as memory and cognitive processing speed tests were administered at baseline and treatment end.

Results:

Case 1:

A 54 year old woman with a 20 year history of secondary progressive MS, refractory bipolar depression, and cognitive impairment received 40 remotely supervised tDCS sessions (RS-tDCS; 2.0 mA × 20 minutes, dorsolateral prefrontal cortex left anodal montage) combined with cognitive training. Following treatment, her HAM-D score decreased from 15 to 11 and mood improved as shown by a linear increase in positive affect. Processing speed increased (SDMT score of 26 to 39) and memory scores increased (RAVLT z-score: −1.19 to −0.94, WMS LMII SS: 5 to 9, and BVMT-R z-score: −3.94 to −1.45).

Case 2:

A 19-year old woman with a 7 year history of pediatric-onset MS presented with moderate recurrent episodes of major depression. She was enrolled in two trials also receiving two sets of 20 RS-tDCS treatments (1.5 mA × 20 minutes, DLPFC left anodal). After the initial 20 session treatment period, her depression resolved (BDI score of 12 to 0) with improved cognitive processing speed (SDMT score of 58 to 69). Her depression gradually returned and she completed a second set of 20 treatments, again responding with resolution of depressive symptoms.

Conclusions:

tDCS delivered through a remotely supervised protocol is a safe, well-tolerated non-pharmacological option for the management of MS-related depression and can also help improve cognition.
Disclosure: Dr. Clayton has nothing to disclose. Dr. Charlson has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Dobbs has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Krupp has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with as a speaker, consultant and/or participant on an advisory board from Biogen Idec, Novartis, Teva Neurosciences and Multicell; grant support from the National Multiple Sclerosis Society, National Institutes of Health and the Department of Defense. Dr. Krupp has received research support from research support from Novartis, Biogen Idec, Celgene Corporation and Genentech and support from the Lourie Foundation, Slomo and Cindy Silvian Foundation and the Multiple Sclerosis Foundation. Dr. Shaw has nothing to disclose. Dr. Charvet has nothing to disclose.

Information & Authors

Information

Published In

Neurology®
Volume 90Number 15_supplementApril 10, 2018

Publication History

Published online: April 10, 2018
Published in print: April 10, 2018

Authors

Affiliations & Disclosures

Ashley Clayton
Neurology, New York University Langone Health New York NY United States
Robert Charlson
Neurology, New York University Langone Health New York NY United States
Bryan Dobbs
Neurology, New York University Langone Health New York NY United States
Jonathan Howard
Neurology, New York University Langone Health New York NY United States
Lauren Krupp
Neurology, New York University Langone Health New York NY United States
Michael Shaw
Neurology, New York University Langone Health New York NY United States
Leigh Charvet
Neurology, New York University Langone Health New York NY United States

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