The treatment of fatigue by non-invasive brain stimulation

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Neurophysiol Clin. 2017 Apr 11. pii: S0987-7053(17)30038-2. doi: 10.1016/j.neucli.2017.03.003.

The treatment of fatigue by non-invasive brain stimulation.

Lefaucheur JP, Chalah MA, Mhalla A, Palm U, Ayache SS, Mylius V.


Abstract
The use of non-invasive brain neurostimulation (NIBS) techniques to treat neurological or psychiatric diseases is currently under development. Fatigue is a commonly observed symptom in the field of potentially treatable pathologies by NIBS, yet very little data has been published regarding its treatment. We conducted a review of the literature until the end of February 2017 to analyze all the studies that reported a clinical assessment of the effects of NIBS techniques on fatigue. We have limited our analysis to repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). We found only 15 studies on this subject, including 8 tDCS studies and 7 rTMS studies. Of the tDCS studies, 6 concerned patients with multiple sclerosis while 6 rTMS studies concerned fibromyalgia or chronic fatigue syndrome. The remaining 3 studies included patients with post-polio syndrome, Parkinson's disease and amyotrophic lateral sclerosis. Three cortical regions were targeted: the primary sensorimotor cortex, the dorsolateral prefrontal cortex and the posterior parietal cortex. In all cases, tDCS protocols were performed according to a bipolar montage with the anode over the cortical target. On the other hand, rTMS protocols consisted of either high-frequency phasic stimulation or low-frequency tonic stimulation. The results available to date are still too few, partial and heterogeneous as to the methods applied, the clinical profile of the patients and the variables studied (different fatigue scores) in order to draw any conclusion. However, the effects obtained, especially in multiple sclerosis and fibromyalgia, are really carriers of therapeutic hope.

Copyright © 2017 Elsevier Masson SAS. All rights reserved.

KEYWORDS:
Brain stimulation; Cortex; Fatigue; Fibromyalgia; Fibromyalgie; Multiple sclerosis; Neuromodulation; Sclérose en plaques; Stimulation cérébrale; Traitement; Treatment; rTMS; tDCS

PMID: 28410876
DOI: 10.1016/j.neucli.2017.03.003

 

[MastBCrazy]

I confirm that the treatment can indeed positively impact mental fatigue. I also found that there was a sweet-spot in the treatment. While the research study continued past this point, there was improvement overall.

Following a course of intense rTMS treatments as part of a research study, I had a remission of chronic depression. My treatment focused on an area intended to 'turn off rumination'. However, there was a permanent impact on executive function. Note that my personal trial is 'dirtied' with other measures, as I made gut, diet, supplement changes and DHEA. Also, I have 'reinforced' the treatment using daily treatments with PEMF (low frequency, low intensity version, iMRS 2000 - had a pubmed study that I discussed with the study's neuropsychiatrist, and he found it valid, plausible, but limited statistical weight due to small study size). So YMMV definitely applies.

If I get a really good day, I've planted the seed, so will share more details if I can recall.

 

[IreneF]

I can see how NIBS might help mental fatigue, but I don't see how it would help conditions where there's been tissue damage, such as Parkinson's or MS.