Brain Stimulation May Relieve Multiple Sclerosis-Associated Fatigue

Fatigue is among the most debilitating adverse events associated with multiple sclerosis (MS), affecting up to 90% of patients. It can prevent patients from going about their day-to-day routines and force them to stop working. A large percentage of patients have rated fatigue as the most burdensome symptom, and there is currently no treatment indicated for MS-related fatigue.

Deep transcranial magnetic stimulation (dTMS), which is used to diagnose and treat neurological and psychiatric disorders, may be the solution to fatigue experienced by patients with MS, according to a study published by Neurology, Neuroimmunology & Neuroinflammation.

Treatment with dTMS involves an innovative technology called an H-coil that stimulates the brain 3 times deeper than standard TMS. The deep stimulation technique can significantly relieve fatigue experienced by patients with MS, according to the study.

Included in the study were 33 patients with MS who recorded their fatigue improvement using standardized questionnaires and the Fatigue Severity Scale (FSS). Treatment was administered to patients 3 times per week for 6 weeks.

Patients were either treated with dTMS or a placebo therapy. During treatment, H coils were placed above patients’ heads to generate a magnetic field and improve nerve activity and neural circuits within the brain.

Patients administered dTMS experienced a significant decrease in fatigue symptoms, according to the study.

The authors said that the new type of H-coil allows for targeted stimulation of brain areas that play a role in MS-associated fatigue.

Significantly, the researchers discovered no negative adverse effects associated with the H-coil or dTMS.

"We observed no serious side effects in patients treated with dTMS, and it is therefore worth stressing the tolerability of this noninvasive electrophysiological technique," said lead author Friedemann Paul, MD.

The authors noted that they plan to conduct a follow up study that will examine the efficacy of dTMS on a larger group of patients with MS.

These findings suggest that implementing dTMS as a routine clinical practice may be able to effectively treat fatigue in patients with MS, according to the authors.

“These promising results of relieving the very hard to treat fatigue symptoms in MS, brings a new hope for being able to provide a solution for the many patients who need it,” said contributing researcher Ronen Segal.