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Abstract Details

Neuroimaging Indicates Response to Transcranial Direct Current Stimulation Treatments in Multiple Sclerosis
Neuro-rehabilitation
P8 - Poster Session 8 (8:00 AM-9:00 AM)
15-002
To measure real-time brain response to transcranial direct current stimulation (tDCS) before and after 20 at-home tDCS treatments targeting fatigue in multiple sclerosis (MS).
Noninvasive brain stimulation using tDCS has therapeutic potential for reducing symptoms and improving rehabilitative outcomes in MS. Benefit is cumulative following repeated treatment, but the underlying mechanisms remain largely unknown. We employed a simultaneous-tDCS/functional-MRI system (tDCS-fMRI) to test real-time response to stimulation before and after 20 remotely supervised-tDCS (RS-tDCS) treatments.

MS participants underwent a baseline tDCS-MRI (Soterix Medical) in a 3T MRI (Prisma, Siemens) for 15 minutes x 2.0mA left anodal dorsolateral prefrontal cortex stimulation. Participants then completed 20 daily at-home RS-tDCS sessions (20minx2.0mA). After completion of the RS-tDCS sessions, participants again underwent simultaneous tDCS-MRI. During the simultaneous tDCS-MRI, imaging was acquired before, during and after stimulation. We acquired T1 mprage images (TR=2.3s; TE=2.98ms; 1x1x1mm voxels) for structural and a 2D echo planar interleaved acquisition sequence (TR=2s; TE=25ms; 35 slices; 3x3x3mm voxels) for functional data.
MS participants (n=15, age 47±11.7, EDSS median 3.5 [0-6]) completed the protocol. At baseline (n=22), stimulation was associated with a reduction in activation of frontal regions. After 20 treatments, repeat tDCS-MRI showed increased activation and neuronal recruitment to frontal regions with significantly (p=0.01) greater difference in the right medial frontal cortex and bilateral superior frontal gyrus. Neuronal activity contrast during the second visit was significantly greater (p=0.012) compared to healthy controls. At baseline, default mode network connectivity was slightly weakened in response to stimulation, however after treatment there was an enhanced synchronicity between the network regions.
Cumulative tDCS treatments resulted in a greater increase in neuronal recruitment of frontal brain regions and may improve synchronicity between the regions of this network. These changes may serve as a marker of clinical response.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
Claire Sunha Choi, MD Ms. Choi has nothing to disclose.
No disclosure on file
No disclosure on file
Lauren B. Krupp, MD, FÂ鶹´«Ã½Ó³»­ (NYU Langone Medical Center) Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
No disclosure on file
Leigh E. Charvet, PhD (NYU Langone) Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.