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J Vis Exp. 2015 Dec 26;(106):e53542. doi: 10.3791/53542.

A Protocol for the Use of Remotely-Supervised Transcranial Direct Current Stimulation (tDCS) in Multiple Sclerosis (MS).

Author information

  • 1Multiple Sclerosis Comprehensive Care Center, Department of Neurology, NYU Langone Medical Center; Department of Neurology, Stony Brook Medicine.
  • 2Department of Neurology, Stony Brook Medicine.
  • 3Soterix Medical, Inc.
  • 4Department of Biomedical Engineering, The City College of New York.
  • 5Multiple Sclerosis Comprehensive Care Center, Department of Neurology, NYU Langone Medical Center; Department of Neurology, Stony Brook Medicine; Leigh.Charvet@nyumc.org.

Abstract

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that uses low amplitude direct currents to alter cortical excitability. With well-established safety and tolerability, tDCS has been found to have the potential to ameliorate symptoms such as depression and pain in a range of conditions as well as to enhance outcomes of cognitive and physical training. However, effects are cumulative, requiring treatments that can span weeks or months and frequent, repeated visits to the clinic. The cost in terms of time and travel is often prohibitive for many participants, and ultimately limits real-world access. Following guidelines for remote tDCS application, we propose a protocol that would allow remote (in-home) participation that uses specially-designed devices for supervised use with materials modified for patient use, and real-time monitoring through a telemedicine video conferencing platform. We have developed structured training procedures and clear, detailed instructional materials to allow for self- or proxy-administration while supervised remotely in real-time. The protocol is designed to have a series of checkpoints, addressing attendance and tolerability of the session, to be met in order to continue to the next step. The feasibility of this protocol was then piloted for clinical use in an open label study of remotely-supervised tDCS in multiple sclerosis (MS). This protocol can be widely used for clinical study of tDCS.

PMID:
26780383
PMCID:
PMC4780857
DOI:
10.3791/53542
[PubMed - indexed for MEDLINE]
Free PMC Article
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