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Exercise with motor cortex high-definition transcranial direct current stimulation enhances cardiovascular efficiency and lower-limb function in multiple sclerosis: A crossover, double-blind, and proof-of-principle study.

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Τίτλος: Exercise with motor cortex high-definition transcranial direct current stimulation enhances cardiovascular efficiency and lower-limb function in multiple sclerosis: A crossover, double-blind, and proof-of-principle study.
Συγγραφείς: Chaves AR; University of Ottawa Institute for Mental Health Research at The Royal, ON, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada. Electronic address: Arthur.Chaves@TheRoyal.ca., Peters A; School of Human Kinetics, University of Ottawa, ON, Canada., Curbelo-Torrejon K; Département de psychoeducation et de psychologie, Université du Québec en Outaouais, QC, Canada., Pourlotfi S; Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada., Pumphrey JD; Department of Psychology, McGill University, QC, Canada., Islam T; Neuroscience, The Ottawa Hospital Research Institute, Ottawa, ON, Canada., Walker LAS; Neuroscience, The Ottawa Hospital Research Institute, Ottawa, ON, Canada; University of Ottawa Brain and Mind Research Institute, ON, Canada., Tremblay S; University of Ottawa Institute for Mental Health Research at The Royal, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada; Département de psychoeducation et de psychologie, Université du Québec en Outaouais, QC, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, ON, Canada., Pilutti LA; Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada; University of Ottawa Brain and Mind Research Institute, ON, Canada.
Πηγή: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2026 Oct; Vol. 114, pp. 107668. Date of Electronic Publication: 2026 Aug 18.
Τύπος έκδοσης: Journal Article; Randomized Controlled Trial
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier B. V Country of Publication: Netherlands NLM ID: 101580247 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2211-0356 (Electronic) Linking ISSN: 22110348 NLM ISO Abbreviation: Mult Scler Relat Disord Subsets: MEDLINE
Imprint Name(s): Original Publication: [Amsterdam] : Elsevier B. V.
Ιατρικοί όροι (MeSH): Transcranial Direct Current Stimulation*/methods , Motor Cortex*/physiopathology , Multiple Sclerosis*/physiopathology , Multiple Sclerosis*/therapy , Multiple Sclerosis*/rehabilitation , Exercise Therapy*/methods , Lower Extremity*/physiopathology, Heart Rate/physiology ; Humans ; Cross-Over Studies ; Female ; Double-Blind Method ; Male ; Adult ; Middle Aged ; Proof of Concept Study
Περίληψη: Combining exercise with high-definition transcranial direct current stimulation (HD-tDCS) could offer a strategy to help people with Multiple Sclerosis improve outcomes. In this crossover study, participants with MS (Expanded Disability Status Scale ≥3.0, n = 12) and controls (n = 10) completed baseline testing, followed by three randomized experimental conditions: 1) exercise+active HD-tDCS; 2) exercise+sham HD-tDCS; and 3) HD-tDCS alone. Exercise performance metrics [heart rate, work rate, heart rate-to-work rate (HR/WR) ratio, and perceived exertion] were compared across the exercise conditions. Secondary outcomes included the Symbol Digit Modalities Test (SDMT), Timed 25-Foot Walk (T25F), Nine-Hole Peg Test (9HPT), and acute symptom ratings (fatigue and pain), assessed pre-, immediately post-, and 1h-Post. Cardiovascular efficiency (HR/WR ratio) significantly improved during exercise+HD-tDCS compared to exercise alone, particularly in older MS participants (p = 0.010). SDMT declined immediately post HD-tDCS alone, 1h-post-exercise alone, and at both time points during exercise+active HD-tDCS (p < 0.05). Both groups increased walking speed only post-exercise+active HD-tDCS, while no condition affected upper-limb function (p < 0.05). These results are in line with the tDCS literature in the general population, suggesting that tDCS improves exercise performance and selectively improves engaged motor function. The trade-off between physical and cognitive outcomes underscores the importance of personalized neuromodulation strategies in neurorehabilitation to maximize therapeutic benefits while minimizing adverse effects, and warrants further large-scale, long-term investigations of this approach in MS.
(Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Arthur R. Chaves reports financial support was provided by Multiple Sclerosis Society. Arthur R. Chaves reports financial support was provided by University of Ottawa. Lara Pilutti reports financial support was provided by Canadian foundation for Innovation. Lara Pilutti reports financial support was provided by Ontario Research Fund. Sara Tremblay reports financial support was provided by NSERC Discovery Grant. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Exercise; Multiple sclerosis; Neuroplasticity; Non-invasive brain stimulation; Rehabilitation; Transcranial direct current stimulation
Entry Date(s): Date Created: 20260826 Date Completed: 20260907 Latest Revision: 20260917
Update Code: 20260917
DOI: 10.1016/j.msard.2026.107668
PMID: 42648013
Βάση Δεδομένων: MEDLINE
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  Data: Combining exercise with high-definition transcranial direct current stimulation (HD-tDCS) could offer a strategy to help people with Multiple Sclerosis improve outcomes. In this crossover study, participants with MS (Expanded Disability Status Scale ≥3.0, n = 12) and controls (n = 10) completed baseline testing, followed by three randomized experimental conditions: 1) exercise+active HD-tDCS; 2) exercise+sham HD-tDCS; and 3) HD-tDCS alone. Exercise performance metrics [heart rate, work rate, heart rate-to-work rate (HR/WR) ratio, and perceived exertion] were compared across the exercise conditions. Secondary outcomes included the Symbol Digit Modalities Test (SDMT), Timed 25-Foot Walk (T25F), Nine-Hole Peg Test (9HPT), and acute symptom ratings (fatigue and pain), assessed pre-, immediately post-, and 1h-Post. Cardiovascular efficiency (HR/WR ratio) significantly improved during exercise+HD-tDCS compared to exercise alone, particularly in older MS participants (p = 0.010). SDMT declined immediately post HD-tDCS alone, 1h-post-exercise alone, and at both time points during exercise+active HD-tDCS (p &amp;lt; 0.05). Both groups increased walking speed only post-exercise+active HD-tDCS, while no condition affected upper-limb function (p &amp;lt; 0.05). These results are in line with the tDCS literature in the general population, suggesting that tDCS improves exercise performance and selectively improves engaged motor function. The trade-off between physical and cognitive outcomes underscores the importance of personalized neuromodulation strategies in neurorehabilitation to maximize therapeutic benefits while minimizing adverse effects, and warrants further large-scale, long-term investigations of this approach in MS.&lt;br /&gt; (Copyright &#169; 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Arthur R. Chaves reports financial support was provided by Multiple Sclerosis Society. Arthur R. Chaves reports financial support was provided by University of Ottawa. Lara Pilutti reports financial support was provided by Canadian foundation for Innovation. Lara Pilutti reports financial support was provided by Ontario Research Fund. Sara Tremblay reports financial support was provided by NSERC Discovery Grant. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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