TMS in multiple sclerosis
Research type
Research Study
Full title
The effect of transcranial magnetic stimulation on cognition in multiple sclerosis
IRAS ID
243517
Contact name
Robert Dineen
Contact email
Sponsor organisation
University of Nottingham
ISRCTN Number
ISRCTN00000000
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
000, 000
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
Multiple sclerosis (MS) affects 127,000 people in the UK costing £2.3 billion annually. Cognitive impairment (CI) affects 40-70% of people with MS impacting on quality-of-life and employability. So far there has been no effective treatment for CI in MS. Theta Burst Stimulation (TBS), which is a type of Transcranial Magnetic Stimulation (TMS), is a noninvasive method studied in various neurological disease that applies magnetic pulses on the surface of the scalp to reach underlying brain tissue. There is growing evidence of using TBS in diagnosis, prognostication and treatment evaluation in MS patients. Our recent analysis of brain network showed that compared with MS patients without CI, MS patients with CI had impaired information flow from DLPFC to subcortical regions. Evidence showed that the excitability of a particular brain cortical region and its connected brain regions can be enhanced using high frequency repetitive TMS (rTMS). A recent study has showed the advantageous effect of high frequency rTMS of the DLPFC on cognitive performance in MS patients as compared to healthy people, which makes this area particularly of interest as stimulation site for MS patients. However, there has been evidence showing that high frequency rTMS poses some side effects including seizure, headache and neck pain. In contrast, a relatively new method of delivering TMS is the use of so called TBS, which utilizes short trains of low-dose stimuli at high frequency. Recent studies have suggested that TBS produces more sustained effect on the brain when compared to standard rTMS. Further, TBS appears to have a more favourable tolerability profile and a shorter duration of application. In this work we will evaluate the effects of a single session of TBS on the changes of the information flow from left DLPFC to the left subcortical regions in MS patients.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
19/WM/0051
Date of REC Opinion
24 Apr 2019
REC opinion
Further Information Favourable Opinion