title: Counteracting Fatigue in Multiple Sclerosis with Right Parietal Anodal Transcranial Direct Current Stimulation.
abstract: BACKGROUND
  Fatigue in multiple sclerosis (MS) patients appears to correlate with vigilance decrement as reflected in an increase in reaction time (RT) and errors with prolonged time-on-task.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether anodal transcranial direct current stimulation (tDCS) over the right parietal or frontal cortex counteracts fatigue-associated vigilance decrement and subjective fatigue.
  
  
  METHODS
  In study I, a randomized double-blind placebo-controlled study, anodal tDCS (1.5 mA) was delivered to the right parietal cortex or the right frontal cortex of 52 healthy participants during the first 20 min of a 40-min lasting visual vigilance task. Study II, also a randomized double-blind placebo-controlled study, investigated the effect of anodal tDCS (1.5 mA) over the right parietal cortex in 46 MS patients experiencing cognitive fatigue. tDCS was delivered for 20 min before patients performed a 20-min lasting visual vigilance task.
  
  
  RESULTS
  Study I showed that right parietal stimulation, but not right frontal stimulation, counteracts the increase in RT associated with vigilance decrement. Hence, only right parietal stimulation was applied to the MS patients in study II. Stimulation had a significant effect on vigilance decrement in mildly to moderately cognitively fatigued MS patients. Vigilance testing significantly increased the feeling of fatigue independent of stimulation.
  
  
  CONCLUSIONS
  Anodal tDCS over the right parietal cortex can counteract the increase in RTs during vigilance performance, but not the increase in subjective fatigue. This finding is compatible with our model of fatigue in MS, suggesting a dissociation between the feeling and the behavioral characteristics of fatigue.
authors.affiliation: Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Hanken
authors.affiliation: Department of Psychology, Carl von Ossietzky University Oldenburg , Oldenburg , Germany.
authors.forename: Mona
authors.initials: M
authors.lastname: Bosse
authors.affiliation: Department of Chemistry, Carl von Ossietzky University Oldenburg , Oldenburg , Germany.
authors.forename: Kim
authors.initials: K
authors.lastname: Möhrke
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen , Nijmegen , Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Eling
authors.affiliation: Department of Neurology, Klinikum Bremen-Ost , Bremen , Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kastrup
authors.affiliation: University Medical Center, Georg-August University Göttingen , Göttingen , Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Antal
authors.affiliation: Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Hildebrandt
keywords: anodal tDCS; multiple sclerosis; right frontal cortex; right parietal cortex; subjective fatigue; vigilance decrement