Table 6.

Studies investing the effects of transcranial direct current stimulation (tDCS) on multiple sclerosis fatigue.

	Ferrucci et al., 2014	Saiote et al., 2014	Tecchio et al., 2014
Design	Randomized, double-blinded, sham-controlled, crossover study (washout interval: 1 month)	Pseudo-randomized, double-blind, sham-controlled, counterbalanced, crossover study (washout interval: 2 weeks)	Randomized, double-blinded, sham-controlled, counterbalanced crossover study (washout “completed” when the percentage of MFIS difference from baseline becomes < 0.5 of induced effect)
Brain target	Bilateral M1	Left DLPFC	Bilateral whole body S1
Participants	22 RRMS, 3SP	25 RRMS	7 RRMS, 2 PP, 1 SP
Inclusion criteria	Fatigue for at least 6 months defined as MFIS >45; EDSS < 6.5	Fatigue for at least 2 month defined as FSS ≥ 4; EDSS ≤ 6	Experiencing fatigue defined as MFIS >38; EDSS ≤ 3.5
Outcomes	FIS	MFIS, FSS, MS specific FSS	MFIS
Electrodes	Two anodes placed at C3–C4 (10–20 EEG system); the 3rd electrode on the right deltoid	Anode at F3 (10–20 EEG system); cathode placed on the contralateral forehead	Anode on the central sulcus trace; the reference electrode at Oz (10–20 EEG system).
Parameters	1.5 mA, for 15 min	1 mA, for 20 min	1.5 mA, for 15 min
Results	Long-term sustainable effect up to the 3rd week. No correlation between fatigue response and age, disease duration, and EDSS	No significant changes in fatigue scores following stimulation. Changes in perceived fatigue lasting up to day 30. Correlation between lesion load and response to tDCS	Long term sustainable effects up to at least 2 months

DLPFC, dorsolateral prefrontal cortex; FIS, Fatigue impact scale, FSS, Fatigue Severity Scale; MFIS, Modified Fatigue Impact Scale; M1, primary motor cortex; PP, primary progressive; RRMS, relapsing remitting multiple sclerosis; SP, secondary progressive; S1, primary somatosensory cortex; EDSS, Expanded Disability Status Scale.