Fatigue is a frequent and debilitating symptom in patients with central nervous system diseases. Up to 90% of patients with multiple sclerosis (MS) suffer from fatigue that drastically affects the quality of life. MS patients also complain of anxiety and depressive symptoms and these three manifestations tend to cluster together in this clinical population. The objective of this work was to assess the effects of transcranial direct stimulation (tDCS), a noninvasive brain stimulation technique, on fatigue as well as anxiety and depressive symptoms. Eleven fatigued MS patients randomly received two blocks (active and sham tDCS) of five consecutive daily sessions of bifrontal tDCS (anode/cathode over the left/right prefrontal cortices, respectively) in a crossover manner, separated by a 3-week washout interval. Evaluation took place at day 1, day 5 (right after each block) and 1 week later. Active but not sham tDCS resulted in a significant improvement of fatigue at day 5 (p < 0.05), an effect that seems to last at least 1 week following the stimulation (p = 0.05). Active tDCS also significantly improved anxiety symptoms, but the effect emerged 1 week later (p < 0.05). No significant effects were obtained regarding depression (p > 0.05). Bifrontal tDCS seems to modulate fatigue in PwMS. The observed anxiolytic effects could constitute delayed after effects of tDCS or might be mediated by fatigue improvement. These findings merit to be addressed in large-scale controlled trials.

疲劳是中枢神经系统疾病患者常见且使人衰弱的症状。多达 90% 的多发性硬化症 (MS) 患者患有严重影响生活质量的疲劳。MS 患者也抱怨焦虑和抑郁症状，这三种表现往往在这个临床人群中聚集在一起。这项工作的目的是评估经颅直接刺激 (tDCS)，一种非侵入性脑刺激技术，对疲劳以及焦虑和抑郁症状的影响。11 名疲劳的 MS 患者以交叉方式随机接受连续 5 天的双额 tDCS（分别在左/右前额叶皮层上的阳极/阴极）每日两节（主动和假 tDCS），间隔 3 周。评估发生在第 1 天，第 5 天（在每个区块之后）和 1 周后。主动而非假 tDCS 导致第 5 天疲劳的显着改善（p  < 0.05），这种效果似乎在刺激后至少持续 1 周（p  = 0.05）。主动 tDCS 也显着改善焦虑症状，但效果在 1 周后出现（p  < 0.05）。对抑郁症没有获得显着影响（p  > 0.05）。双额 tDCS 似乎可以调节 PwMS 中的疲劳。观察到的抗焦虑作用可能构成 tDCS 的延迟效应或可能由疲劳改善介导。这些发现值得在大规模对照试验中加以解决。