title: Transcranial Direct Current Stimulation Is Feasible for Remotely Supervised Home Delivery in Multiple Sclerosis.
abstract: OBJECTIVE
  Transcranial direct current stimulation (tDCS) has potential clinical application for symptomatic management in multiple sclerosis (MS). Repeated sessions are necessary in order to adequately evaluate a therapeutic effect. However, it is not feasible for many individuals with MS to visit clinic for treatment on a daily basis, and clinic delivery is also associated with substantial cost. We developed a research protocol to remotely supervise self- or proxy-administration for home delivery of tDCS using specially designed equipment and a telemedicine platform.
  
  
  METHODS
  We targeted ten treatment sessions across two weeks. Twenty participants (n = 20) diagnosed with MS (any subtype), ages 30 to 69 years with a range of disability (Expanded Disability Status Scale or EDSS scores of 1.0 to 8.0) were enrolled to test the feasibility of the remotely supervised protocol.
  
  
  RESULTS
  Protocol adherence exceeded what has been observed in studies with clinic-based treatment delivery, with all but one participant (95%) completing at least eight of the ten sessions. Across a total of 192 supervised treatment sessions, no session required discontinuation and no adverse events were reported. The most common side effects were itching/tingling at the electrode site.
  
  
  CONCLUSIONS
  This remotely supervised tDCS protocol provides a method for safe and reliable delivery of tDCS for clinical studies in MS and expands patient access to tDCS.
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Kasschau
authors.affiliation: Arizona College of Osteopathic Medicine, Glendale, AZ, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Reisner
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sherman
authors.affiliation: Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA.
authors.forename: Marom
authors.initials: M
authors.lastname: Bikson
authors.affiliation: Soterix Medical Inc., New York, NY, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Datta
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Leigh E
authors.initials: LE
authors.lastname: Charvet
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Feasibility; multiple sclerosis; remotely supervised; tDCS; telemedicine