Fatigue is a hidden symptom of Multiple Sclerosis (MS) disease that nevertheless impacts severely on patients’ everyday life. Evidence indicates the involvement of the sensorimotor network and its inter-nodes communication at the basis of this symptom. Two randomized controlled trials (RCTs) showed that the personalized neuromodulation called Fatigue Relief in Multiple Sclerosis (FaReMuS) efficaciously fights multiple sclerosis (MS) fatigue. By this Proof of Concept study, we tested whether FaReMuS reverts the alteration of the brain-muscular synchronization previously observed occurring with fatigue. The cortico muscular coherence (CMC) was studied in 11 patients before and after FaReMuS, a 5-day tDCS (1.5 mA, 15 min per day) anodal over the whole body's somatosensory representation (S1) via a personalized MRI-based electrode (35 cm²) against the occipital cathode (70 cm²). Before FaReMuS, the CMC was observed at a mean frequency of 31.5 ± 1.6 Hz (gamma-band) and positively correlated with the level of fatigue (p = .027). After FaReMuS, fatigue reduced in average of 28% ± 33% the baseline level, and the CMC frequency reduced to 26.6 ± 1.5 Hz (p = .022), thus forthcoming the physiological beta-band as observed in healthy people. The personalized S1 neuromodulation treatment, ameliorating the central-peripheral communication that subtends simple everyday movements, supports the appropriateness of neuromodulations aiming at increasing the parietal excitability in fighting MS fatigue. The relationship between central-peripheral features and fatigue profile strengthens a central more than peripheral origin of the symptom.

疲劳是多发性硬化症（MS）疾病的隐藏症状，但仍然严重影响患者的日常生活。证据表明，在这种症状的基础上，感觉运动网络及其节点间的通信也参与其中。两项随机对照试验（RCT）表明，称为多发性硬化症疲劳缓解（FaReMuS）的个性化神经调节有效对抗多发性硬化症（MS）疲劳。通过这项概念验证研究，我们测试了FaReMuS是否能恢复先前观察到的因疲劳而发生的脑肌肉同步变化。在FaReMuS前后，通过基于MRI的个性化电极在整个身体的体感表征（S1）上进行为期5天的tDCS（1.5 mA，每天15分钟）阳极，研究了11位患者的皮质肌肉连贯性（CMC）（35厘米²）紧贴枕骨阴极（70 cm ²）。在FaReMuS之前，CMC的平均频率为31.5±1.6 Hz（伽马带），并且与疲劳水平呈正相关（p = .027）。FaReMuS后，疲劳平均降低了基线水平的28％±33％，CMC频率降低至26.6±1.5 Hz（p = .022），因此在健康人群中出现了生理性的β谱带。个性化的S1神经调节治疗改善了日常简单运动所引起的中枢与周围的交流，支持了神经调节的适当性，旨在增加顶叶兴奋性，对抗MS疲劳。中心周围特征与疲劳状况之间的关系比症状的周围起源更能增强中心。