Remotely supervised transcranial direct current stimulation: A feasibility study for amyotrophic lateral sclerosis.

Area of Science:

• Neuromodulation
• Neuroscience
• Rehabilitation Medicine

Background:

• Transcranial direct current stimulation (tDCS) is a therapeutic neuromodulation tool with limited research in amyotrophic lateral sclerosis (ALS).
• Patient accessibility, especially in advanced stages, hinders ALS research for tDCS.
• Telerehabilitation offers remote supervision of home-based tDCS protocols, enhancing participation and adherence.

Purpose of the Study:

• To explore the safety and feasibility of a remotely supervised tDCS (RS-tDCS) protocol in individuals with ALS.
• To assess preliminary effects of RS-tDCS on disease progression and functional outcomes in ALS patients.

Main Methods:

• A pre-post case series design involving two individuals with ALS.
• Participants underwent 24 remotely supervised anodal tDCS sessions (20 minutes, 2 mA).
• Outcomes measured included adherence, compliance, disease progression, walking speed, fall risk, endurance, fatigue, and depression.

Main Results:

• Both participants completed the study with no major adverse events.
• Minor side effects like mild itching and throbbing under electrodes were reported.
• Clinical outcomes demonstrated minimal to no changes across all measured parameters.

Conclusions:

• The RS-tDCS protocol is demonstrated to be safe and feasible for individuals with ALS.
• This protocol provides a model for future long-term studies investigating tDCS efficacy in ALS.
• Further research is needed to evaluate the clinical and neurophysiological effects of telerehabilitated tDCS in ALS.