Treatment of Cognitive Deficits in Multiple Sclerosis with High-Definition Transcranial Direct Current Stimulation
Abstract
A debilitating and common cognitive symptom in those with multiple sclerosis is the inability to retrieve words when needed. This inability to retrieve words affects one s conversations, ability to fluidly exchange information verbally, and retrieve information from memory. Our group has studied the ability to retrieve words using functional neuroimaging (e.g., fMRI) and electroencephalography (EEG), and we have discovered patterns of brain activity that are important for word retrieval. We have also found abnormal patterns of brain activity in patients who have problems retrieving words as a consequence of multiple conditions, including multiple sclerosis. We have used our observations of patterns of brain activity to design a noninvasive, non-pharmacological treatment for those with word retrieval deficits that uses High Definition transcranial Direct Current Stimulation (HD tDCS). We use HD tDCS to deliver low levels of painless and safe electrical stimulation to specific regions of the head to stimulate the brain regions underlying that electrode location. This stimulation is delivered from electrodes in a cap that is placed on the subject s head, which safely and painlessly delivers the stimulation. In this study, we plan to investigate the delivery of HD tDCS over specific brain regions of patients with multiple sclerosis and who have word retrieval deficits to determine if this will improve performance in verbal retrieval tasks. We will administer pre-treatment tests of verbal retrieval measures (assessing finding words, memory of the names of items in a list) as well as recording brain electrical activity from the scalp using EEG. This EEG will record both resting brain electrical activity and activity associated with performing tasks involving verbal retrieval. We will then administer 10 sessions of HD tDCS in approximately 60 multiple sclerosis patients, randomly assigned to receive active or sham stimulation, and to evaluate placebo and longitudinal effects. As there is nothing a person feels when the electrical stimulation is on, these patients will not know that they are receiving the stimulation or not. We will then compare performance between the active group receiving the HD tDCS and the sham group by performing the same tests of verbal retrieval that we performed prior to the treatment, immediately after the last treatment and 8 weeks after the last treatment session. This will allow for assessing whether the HD tDCS treatment had a significant effect on performing verbal retrieval tasks and to determine if there are changes in patterns of brain electrical activity to account for how this treatment worked. At the conclusion of this study, the effectiveness of HD tDCS for improving verbal retrieval deficits will be established, and we will determine if this is a useful treatment modality that significantly and functionally changes not only the performance on neuropsychological tests but also affects a person s day-to-day functions and quality of life. We predict that the treatment will improve a patient s ability to produce their words fluently in a conversation and remember the words that they want to say, leading to improved skills in both social and work situations. This treatment has the added advantage of having few, if any, known side effects, such as an individual might experience when taking medicine. The system used to deliver these electrical pulses is relatively inexpensive and easy to use. This treatment can be made widely available for Warrior Transition Units, military clinics, and Department of Veterans Affairs/Department of Defense medical centers, and even in civilian medical centers.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310618
Entities
People
- John Hart
Organizations
- United States Army
- University of Texas at Dallas