Transcranial Direct Current Stimulation Is Feasible for Remotely Supervised Home Delivery in Multiple Sclerosis

Neuromodulation. 2016 Dec;19(8):824-831. doi: 10.1111/ner.12430. Epub 2016 Apr 18.


Objectives: Transcranial direct current stimulation (tDCS) has potential clinical application for symptomatic management in multiple sclerosis (MS). Repeated sessions are necessary in order to adequately evaluate a therapeutic effect. However, it is not feasible for many individuals with MS to visit clinic for treatment on a daily basis, and clinic delivery is also associated with substantial cost. We developed a research protocol to remotely supervise self- or proxy-administration for home delivery of tDCS using specially designed equipment and a telemedicine platform.

Materials and methods: We targeted ten treatment sessions across two weeks. Twenty participants (n = 20) diagnosed with MS (any subtype), ages 30 to 69 years with a range of disability (Expanded Disability Status Scale or EDSS scores of 1.0 to 8.0) were enrolled to test the feasibility of the remotely supervised protocol.

Results: Protocol adherence exceeded what has been observed in studies with clinic-based treatment delivery, with all but one participant (95%) completing at least eight of the ten sessions. Across a total of 192 supervised treatment sessions, no session required discontinuation and no adverse events were reported. The most common side effects were itching/tingling at the electrode site.

Conclusions: This remotely supervised tDCS protocol provides a method for safe and reliable delivery of tDCS for clinical studies in MS and expands patient access to tDCS.

Keywords: Feasibility; multiple sclerosis; remotely supervised; tDCS; telemedicine.

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Home Care Services
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / therapy*
  • Telemedicine / methods*
  • Transcranial Direct Current Stimulation / methods*
  • Treatment Outcome*