The effects of transcranial direct current stimulation on sleep in patients with multiple sclerosis-A pilot study.
Actigraphy
MS
Multiple sclerosis
Sleep
Sleepiness
Transcranial direct current stimulation
tDCS
Journal
Neurophysiologie clinique = Clinical neurophysiology
ISSN: 1769-7131
Titre abrégé: Neurophysiol Clin
Pays: France
ID NLM: 8804532
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
27
09
2021
revised:
10
12
2021
accepted:
11
12
2021
pubmed:
9
1
2022
medline:
23
2
2022
entrez:
8
1
2022
Statut:
ppublish
Résumé
Sleep complaints are commonly reported by patients with multiple sclerosis (PwMS). Several pharmacological and alternative interventions have been tried, but are usually faced by limited efficacy. Hence, exploring other methods such as transcranial direct current stimulation (tDCS), might be of interest. The aim of this study was to assess the effects of bifrontal tDCS on subjective (i.e., Epworth Sleepiness Scale (ESS)) and objective sleep measures (i.e., actigraphy). Seven patients completed the study. Patients randomly received two blocks of five daily sessions each in a crossover design (active and sham, with a washout interval of three weeks). The anode and cathode were placed over the left and right dorsolateral prefrontal cortices, respectively. Sleep assessment included ESS, sleep onset latency, total sleep duration, time in bed, sleep efficiency, waking after sleep onset, and number of awakenings. Compared to baseline scores (11.14 ± 4.06), significant decrease in ESS was obtained after active intervention (7.86 ± 4.18; p = 0.011), but not after sham intervention (9.57 ± 5.62; p = 0.142). No significant changes were observed with regards to actigraphy measures. Sessions were well tolerated, and no serious side-effects were reported at any time. Bifrontal tDCS resulted in significant improvement in daytime sleepiness, but did not yield any effect on objective sleep measures in PwMS. This discrepency might be explained by the modest association that could exist between objective and subjective sleep measures. In addition, it could be assumed that modulating objective sleep measures would require a larger sample size, more stimulation sessions, or modulation of other cortical areas.
Sections du résumé
BACKGROUND
BACKGROUND
Sleep complaints are commonly reported by patients with multiple sclerosis (PwMS). Several pharmacological and alternative interventions have been tried, but are usually faced by limited efficacy. Hence, exploring other methods such as transcranial direct current stimulation (tDCS), might be of interest. The aim of this study was to assess the effects of bifrontal tDCS on subjective (i.e., Epworth Sleepiness Scale (ESS)) and objective sleep measures (i.e., actigraphy).
METHODS
METHODS
Seven patients completed the study. Patients randomly received two blocks of five daily sessions each in a crossover design (active and sham, with a washout interval of three weeks). The anode and cathode were placed over the left and right dorsolateral prefrontal cortices, respectively. Sleep assessment included ESS, sleep onset latency, total sleep duration, time in bed, sleep efficiency, waking after sleep onset, and number of awakenings.
RESULTS
RESULTS
Compared to baseline scores (11.14 ± 4.06), significant decrease in ESS was obtained after active intervention (7.86 ± 4.18; p = 0.011), but not after sham intervention (9.57 ± 5.62; p = 0.142). No significant changes were observed with regards to actigraphy measures. Sessions were well tolerated, and no serious side-effects were reported at any time.
CONCLUSION
CONCLUSIONS
Bifrontal tDCS resulted in significant improvement in daytime sleepiness, but did not yield any effect on objective sleep measures in PwMS. This discrepency might be explained by the modest association that could exist between objective and subjective sleep measures. In addition, it could be assumed that modulating objective sleep measures would require a larger sample size, more stimulation sessions, or modulation of other cortical areas.
Identifiants
pubmed: 34996695
pii: S0987-7053(21)00127-1
doi: 10.1016/j.neucli.2021.12.001
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-32Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest MAC declares having received compensation from Janssen Global Services LLC, ExoNeural Network AB, Sweden, and Ottobock, France. TK has received travel expenses and speaker honoraria from Bayer Vital, Teva Pharma, Merck, Novartis Pharma, Sanofi-Aventis/Genzyme, CLS Behring, Roche Pharma and Biogen as well as grant support/donation from Bayer-Schering AG, Novartis and Chugai Pharma. FP is a member of the European Scientific Advisory Board of Brainsway Inc., Jerusalem, Israel, and has received speaker's honoraria from Mag & More GmbH and the neuroCare Group. His lab has received support with equipment from neuroConn GmbH, Ilmenau, Germany, and Mag & More GmbH and Brainsway Inc., Jerusalem, Israel. UP has a private practice with NeuroCare Group, Munich, Germany. SSA declares having received compensation from Exoneural Network AB, Sweden. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.