But more work is needed to identify best approach for treatment
by Lindsey Shapiro, PhD | August 23, 2023
Noninvasive brain stimulation (NIBS) may offer promise for treating spasticity in multiple sclerosis (MS), but more work is needed to identify the best approach to use for patients, according to a new review study.
The studies under review generally indicated that a type of brain stimulation called repetitive transcranial magnetic stimulation, or rTMS, could ease spasticity — when muscles become abnormally tight, as commonly occurs in MS. However, evidence for another approach, known as transcranial direct current stimulation or tDCS, was more limited.
“Seven studies that used rTMS demonstrated a significant decrease in spasticity in PwMS [people with multiple sclerosis] after the intervention,” the researchers wrote, noting that “the remaining studies that provided tDCS did not show meaningful effects.”
The team said more clinical trials with long-term follow-up are needed to find an optimal approach.
The study, “Non-invasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials,” was published in the journal PM&R.
Looking for better treatments for spasticity in MS
Most MS patients experience muscle spasticity, characterized by abnormal tightness over time, which can lead to muscle stiffness and spasms that inhibit mobility. This difficult-to-treat MS symptom also can further exacerbate other disease manifestations, such as pain, bladder issues, and sleep problems.
Anti-spasticity medications are available, but their use typically is accompanied by significant side effects. Thus, shifting the focus toward other types of interventions, such as physical therapy or brain stimulation, may offer an alternative option for managing this symptom.
Noninvasive brain stimulation, dubbed NIBS for short, includes techniques such as rTMS and tDCS. In general, NIBS refers to interventions in which brain cells are stimulated via electrical currents administered to the scalp. In the case of rTMS, a magnetic field is used to stimulate the brain cells, whereas tDCS accomplishes this via low levels of direct electrical current.
It’s thought that this stimulation helps to induce neuroplasticity, the process by which the brain rewires in response to new inputs. This is believed to be of benefit for people with MS and other neurological diseases.
While a variety of studies have indicated that NIBS can safely benefit MS patients, its specific effects on spasticity warrant further investigation, according to researchers.
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