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Updated: Jan 26, 2026

A Protocol for the Use of Remotely-Supervised Transcranial Direct Current Stimulation tDCS in Multiple Sclerosis MS
Published on: December 26, 2015
A pilot study on the efficacy of transcranial direct current stimulation applied to the pharyngeal motor cortex for
Domenico A Restivo1, Enrico Alfonsi2, Antonino Casabona3
1Neurological Unit, "Garibaldi" Hospital, Catania, Italy.
Objective:
we investigated the effect of anodal transcranial direct current stimulation (tDCS) applied over the pharyngeal motor area in dysphagia associated with multiple sclerosis (MS).
Methods:
Eighteen MS patients with dysphagia associated with brainstem involvement were randomized to receive either "real" or "sham" tDCS.
Primary Outcome:
The Penetration/Aspiration Scale (PAS).
Secondary Outcomes:
changes in electromyographic (EMG) parameters and pharyngeal cortical motor evoked potentials (MEPs). Patients were evaluated at baseline (T0), at the end of 5-session cycle of tDCS stimulations (T1), after two (T2), and four (T3) weeks.
Results:
the PAS values were significantly lower in the active group than in "sham" group at T1, and at T3. Over the post-stimulation periods, PAS significantly improved only in the "real" group. As regards the secondary outcomes, we observed a statistically significant difference between the 2 groups only in the MEPs amplitude at T1. The comparison between baseline and each of the post-stimulation times showed significant differences only of the "real" group across all the secondary parameters.
Conclusions:
Our findings support a beneficial effect of anodal tDCS applied to the pharyngeal motor cortex in MS-associated dysphagia.
Significance:
Considering its safety and efficacy, tDCS may represent an important resource in MS-associated dysphagia.
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