Transcranial direct current stimulation for fatigue in neurological conditions: A systematic scoping review.

IF 1.5 Q3 REHABILITATION Physiotherapy Research International Pub Date : 2024-01-01 Epub Date: 2023-10-15 DOI:10.1002/pri.2054

Akhila Jagadish, Apoorva M Shankaranarayana, Manikandan Natarajan, John M Solomon

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Abstract

Background and purpose: Fatigue following neurological conditions negatively impacts daily activities, reducing overall quality of life. Transcranial direct current stimulation (tDCS) for fatigue management is still underexplored. This scoping review explores its use in managing fatigue among various neurological conditions.

Methods: A thorough literature search was carried out using PubMed, Scopus, CINAHL, Web of Science, Embase, ProQuest, and the Cochrane Library. Google Scholar and clinicaltrials.gov were manually searched for gray literature and ongoing trials, respectively. Regardless of the study design, all studies utilizing tDCS for the management of fatigue in various neurological conditions were considered. Two reviewers independently screened all the studies, following which the data were retrieved.

Results: Studies employing tDCS for fatigue management across neurological conditions is as follows: Multiple sclerosis (MS) (n = 28, 66%), stroke (n = 5, 12%), Parkinson's disease (PD) (n = 4, 10%), post-polio syndrome (PPS) (n = 2, 5%), traumatic brain injury (TBI) (n = 2, 5%), and amyotrophic lateral sclerosis (n = 1, 2%). All the studies used anodal stimulation, with the common stimulation site being the left dorsolateral prefrontal cortex for MS, stroke, and PD. A stimulation intensity of 1.0-4.0 mA with a duration ranging from 15 to 30 min in 1 to 24 sessions were commonly reported. The Fatigue Severity Scale (n = 21) and Modified Fatigue Impact Scale (n = 17) were frequently implemented outcome measures. Regardless of the study design, 36/42 (85.7%) studies reported an improvement in fatigue scores in the tDCS group. The common adverse events noted were tingling (n = 8, 35%), headache (n = 6, 26%), and itching (n = 6, 26%).

Discussion: Application of tDCS for fatigue was explored in individuals with stroke, PD, PPS, and TBI after MS. Even though a wide range of treatment parameters and outcome measures were adopted to assess and target fatigue, tDCS proves to have a promising role in alleviating this symptom.

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经颅直流电刺激治疗神经系统疾病中的疲劳：一项系统范围界定综述。

背景和目的：神经系统疾病后的疲劳会对日常活动产生负面影响，降低整体生活质量。经颅直流电刺激（tDCS）用于疲劳管理的研究仍然不足。这篇范围界定综述探讨了它在管理各种神经疾病中的疲劳方面的应用。方法：使用PubMed、Scopus、CINAHL、Web of Science、Embase、ProQuest和Cochrane Library进行全面的文献检索。谷歌学者和clinicaltrials.gov分别被手动搜索灰色文献和正在进行的试验。无论研究设计如何，所有利用tDCS治疗各种神经疾病疲劳的研究都被考虑在内。两名评审员对所有研究进行了独立筛选，随后检索数据。结果：采用tDCS进行神经系统疲劳管理的研究如下：多发性硬化症（MS）（n=2866%）、中风（n=512%）、帕金森病（PD）（n=410%）、脊髓灰质炎后综合征（PPS）（n=2,5%）、创伤性脑损伤（TBI）（n=2-5%）和肌萎缩性侧索硬化症（n=1,2%）。所有的研究都使用阳极刺激，常见的刺激部位是MS、中风和PD的左背外侧前额叶皮层。通常报告的刺激强度为1.0-4.0mA，持续时间为15-30min，持续1-24次。疲劳严重程度量表（n=21）和改良疲劳影响量表（n=17）是经常采用的结果测量方法。无论研究设计如何，36/42（85.7%）的研究报告称，tDCS组的疲劳评分有所改善。注意到的常见不良事件为刺痛（n=8,35%）、头痛（n=6,26%）和瘙痒（n=6,26%）。讨论：tDCS在MS后中风、PD、PPS和TBI患者中的疲劳应用进行了探索。尽管采用了广泛的治疗参数和结果测量来评估和靶向疲劳，tDCS被证明在缓解这种症状方面具有很好的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.