Abstract Details

Title A Teleintervention Program for Multiple Sclerosis (MS) Mobility: Exercise with Transcranial Direct Current Stimulation (tDCS)

Topic Neuro-rehabilitation

Presentation(s) P18 - Poster Session 18 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-006

Background

tDCS is a non-invasive brain stimulation technique that has the advantage to be delivered using a portable and handheld device, thus, it is increasingly being deployed through supervised self-administration in the home setting. In our previous study, we successfully piloted the in-clinic use of tDCS targeting the primary motor cortex to improve mobility in people with MS. To overcome the problems of access and adherence to exercise as a treatment for improving mobility, we piloted a telehealth intervention to provide a structured and accessible at-home program of daily exercise paired with our remotely-supervised tDCS (RS-tDCS) protocol.

Objective

To establish feasibility of a teleintervention targeting mobility impairment with at-home exercise and transcranial direct current stimulation (tDCS) in people with multiple sclerosis (MS).

Design/Methods

People with MS (EDSS<6.5) were enrolled in a sham-controlled pilot study to receive 10x20-mins daily at-home sessions of either active or sham tDCS paired with moderate intensity cycling training delivered by a small seated elliptical machine (Cubii Pro). Stimulation was administered over the primary motor cortex (2.5 mA; anode C3/cathode FP2). All stimulation sessions were supervised in real-time. Measurements of gait velocity were collected at baseline and at treatment end.

Results Participants were n=5 people with MS and moderate-to-severe levels of disability (age:48±12; M/F:2/3; median EDSS:3.0). All sessions were completed successfully and without any safety issues. Adverse events (AEs) were minimal and consistent with the established tDCS literature with transitory sensations of warmth/tingling/itching under the electrode. The average change in gait velocity measured for the active tDCS participants showed similar mobility gains (Δgait velocity RS-tDCS vs. in-clinic tDCS: 0.24±0.10 m/s vs. 0.33±0.12 m/s) found in our onsite RCT.

Conclusions

RS-tDCS paired with exercise offers a widely accessible and easily scalable tool to address mobility impairments in those with MS and it is generalizable for use across a range of neurologic conditions.

Authors/Disclosures
Giuseppina Pilloni, PhD (NYU Grossman School of Medicine) PRESENTER	Dr. Pilloni has nothing to disclose.
	No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lerhman. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for medscape. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLive. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Cleveland Clinic. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MCIC. The institution of Dr. Krupp has received research support from Biogen. The institution of Dr. Krupp has received research support from National Multiple Sclerosis Society. Dr. Krupp has received intellectual property interests from a discovery or technology relating to health care.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.