Marom Bikson speaks on “Home-Based Neuromodulatory Technologies for Migraine and Pain” on Sep 13, 2015 at the 22nd annual International Headache Congress in São Paulo, Brazil
PDF of slide.
New publication:
Kallene Summer Moreira Vidal, Beatriz Araújo Cavendish, Stephan Goerigk, Mariana Batista, Alisson Rafael Oliveira Lima, Bianca Silva Pinto, Adriano Augusto Neto Domingos, Juliana Pereira de Sousa, Rebeca Pelosof, Laiss Bertola, Valquiria Silva, Claudia Kimie Suemoto, Lais Boralli Razza, Marom Bikson, Giuseppina Pilloni, Leigh Charvet, Pedro H R Silva, Andre R Brunoni (2025) Transcranial direct current stimulation plus cognitive training for cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection: a randomized, double-blind, sham-controlled trial. Brain Stimulation, Aug 21:S1935-861X(25)00311-0. doi: 10.1016/j.brs.2025.08.018.
Download: PDF
Highlights
• PASC causes enduring cognitive deficits and anxiety/depression symptoms that impair quality of life.
• No therapies are currently approved for cognitive or mood impairments in PASC.
• The impact of cognitive training (CT) plus tDCS in PASC has not been evaluated.
• In a doubleblind, sham-controlled trial, tDCS+CT improved inhibitory control, processing speed, and divided attention, although the effects were small.
• Depression and anxiety improved similarly in active and sham groups.
Abstract
Background
Post-acute sequelae of SARS-CoV-2 infection (PASC) is characterized by persistent cognitive deficits alongside anxiety and depression symptoms that adversely affect quality of life. Cognitive training (CT) programs and non-invasive neuromodulation, specifically transcranial direct current stimulation (tDCS), have each shown promise for alleviating similar deficits in non-clinical populations. However, their combined efficacy has not yet been evaluated in PASC patients. Therefore, this study aimed to determine whether the combination of CT and tDCS produces benefits for cognitive and mood-related symptoms in individuals with PASC.
Methods
We conducted a double-blind, randomized, sham-controlled clinical trial in adults aged 18–75 with confirmed SARS-CoV-2 infection within the past six months and persisting cognitive complaints. They were randomized to a 4-week in-person intervention of 20 weekday sessions of either active (2 mA anodal-left, cathodal-right prefrontal stimulation) or sham tDCS paired with an app-based CT program. Primary outcomes were six standardized neuropsychological tests assessing verbal memory, working memory, executive functioning, attention, and language, administered at baseline and immediately post-intervention. As secondary outcomes, we assessed changes in depression and anxiety symptoms over the treatment period.
Results
Sixty participants (mean age 43.8 ± 13.2 years, 71.7 % women) were randomized to active tDCS + CT or sham tDCS + CT groups, and 52 finished the trial. Compared to sham, tDCS + CT resulted in significantly greater improvement in tests evaluating inhibitory control (effect size [ES] = 0.07, 95 % CI 0 to 0.23, p = 0.046), processing speed (ES = 0.08, 95 % CI 0 to 0.25, p = 0.034), and divided attention (ES = 0.08, 95 % CI 0 to 0.24, p = 0.039), but not in tests evaluating other domains. Both groups improved similarly in depression and anxiety symptoms. Participant's and rater's active guess rates did not differ between groups (ps > 0.20).
Conclusion
An intervention with prefrontal targeted tDCS + CT in patients with PASC with cognitive complaints might be effective in improving attention, processing speed and inhibitory control, although further studies are warranted to prospectively confirm these findings.
Prof Marom Bikson speaks at the 3rd Neuroscience of the Everyday World (N.E.W.) Conference.
on “Wearable Disposable Electotherapy”
Jul 28-29 2025
The third edition of the Neuroscience of the Everyday World Conference is bringing together leaders in the fields of computer science, biomedical engineering, cognitive science, neurology, and clinical neuroscience to present state-of-the-art research, all focused on the study of human brain function and continuous brain measurement in real-world activities. The presentations will all focus on innovative methodologies, different real-world contexts, and a range of healthy and disease states.
Yishai Valter, Dennis Q. Truong, Yushi Kawasumi. Marom Bikson. Abhishek Datta. TMS targeting using MRI-free head modeling. Transcranial Magnetic Stimulation. Volume 5100188 December 2025. https://doi.org/10.1016/j.transm.2025.100188 PDF
Abstract: Methods to determine coil position are paramount in TMS. Existing approaches are limited to scalp heuristics or depend on some combination of neuronavigation hardware, average brain templates, as well as subject MRI and/or evoked responses. We developed head-model guided TMS targeting without subject MRI, specialized hardware, or evoked responses. The MRI-free approach involves three scalp measurements, akin to Beam-F3, which are then used to generate an individualized head model by applying an affine transformation to the MNI standard head model. Target localization is then performed on this individualized head model for any TMS scalp target. The coil position is then provided to the operator in simple geodesic measurements. This process was simulated on MRI data of fourteen subjects showing a mean error of 4.92 mm from an MRI-based target.
Charvet L, Goldberg J, Li X, Best P, Shaw M, Ryerson LZ, Gutman J, Bikson M, Pilloni G, Krupp L. Enhanced cognitive outcomes with telehealth-based tDCS in multiple sclerosis: Results from a sham-controlled RCT. Mult Scler J Exp Transl Clin. 2025 Jul 28;11(3):20552173251356704. doi: 10.1177/20552173251356704. PDF
Abstract
Background: Cognitive impairment is common in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) combined with adaptive cognitive training (aCT) may improve clinical outcomes.
Objective: To evaluate the effect of active vs. sham home-based tDCS + aCT on cognitive function.
Methods: Participants with MS and fatigue, without depression or severe cognitive impairment, were randomized to complete 30 remotely supervised 20-minute sessions of active (2.0 mA) or sham tDCS targeting the left anodal dorsolateral prefrontal cortex, paired with aCT. Randomization was stratified by high (H) vs. low (L) EDSS. The Brief International Cognitive Assessment in MS (BICAMS) was administered at baseline and intervention end, with scores converted to demographics-adjusted z-scores.
Results: Out of 117 participants, 106 completed BICAMS assessments. Compliance was high; 92% completed >25 sessions. Mean change in BICAMS z-score was significantly greater in the active (n = 55: 0.06 ± 0.56) versus sham (n = 51: -0.16 ± 0.50) group (p = 0.035). The interaction between treatment and EDSS for BICAMS z-score was not significant (p = .254), but benefits were greater in H EDSS (-0.00 ± 0.57 vs. -0.37 ± 0.39; p = .022) than L EDSS (0.11 ± 0.56 vs. -0.01 ± 0.53; p = .411).
Conclusions: Active vs. sham tDCS + aCT resulted in significantly better cognitive outcomes, with the greatest benefit in those with high neurologic disability.CLINICALTRIALS.GOV; https://clinicaltrials.gov/study/NCT03838770; IDENTIFIER: NCT03838770.
Keywords: Cognitive training; brainHQ; home-based; tDCS; telemedicine; transcranial direct current stimulation.
Visit Marom Bikson’s YouTube channel here.
Update
In 3 parts, a scientifically precise but simple explanation of how transcranial Current Stimulation (tACS) works from a cellular perspective, focusing on oscillations. How does polarization under direct current (tDCS) inform tACS through the polarization time constant. Increasing tACS frequency, decreases polarization. Very low sensitivity to kHz tACS. Modulation gamma oscillations. Modulating oscillation power. More complex changes in oscillations (sub-harmonics). Sub-threshold modulation of ongoing activity by tACS. High-Definition tACS (HD-tACS) and how to optimize for brain targeting. 4x1-HD-tDCS.
Part 1 of 3: tACS basics. What is tACS dose (montage, duration, frequency, intensity)? What does frequency mean in tACS (what is Hz)? Peak intensity vs Peak-to-Peak intensity. Dose response if complex and not monotonic. Brain generated oscillations. Matching tACS frequency to brain oscillations. Neuronal polarization by tACS and role of frequency.
https://www.youtube.com/watch?v=lh7RU6KpGG4
Part 2 of 3: Role of tACS frequency, sub-threshold modulation of oscillations.
https://www.youtube.com/watch?v=VwHYQhHqvcM
Part 3 of 3: High-definition montages for tACS (HD-tACS).
https://www.youtube.com/watch?v=ksD1rwDzHuQ
Slides PDF download
New paper":
Marco Muccio, Giuseppina Pilloni, Lillian Walton Masters. Peidong He, Lauren Krupp, Abhishek Datta, Marom Bikson, Leigh Charvet, Yulin Ge. Resting-State Activity Changes Induced by tDCS in MS Patients and Healthy Controls: A Simultaneous tDCS rs-fMRI Study. Bioengineering 2025, 12(6), 672; https://doi.org/10.3390/bioengineering12060672 PDF
Abstract: Transcranial direct current stimulation (tDCS) is a safe, well-tolerated method of non-invasively eliciting cortical neuromodulation. It has gained recent interest, especially for its positive clinical outcomes in neurodegenerative diseases such as multiple sclerosis (MS). However, its simultaneous (during tDCS) and cumulative effects (following repeated tDCS sessions) on the regional brain activity during rest need further investigation, especially in MS. This study aims to elucidate tDCS’ underpinnings, alongside its therapeutic impact in MS patients, using concurrent tDCS-MRI methods. In total, 20 MS patients (age = 48 ± 12 years; 8 males) and 28 healthy controls (HCs; age = 36 ± 15 years; 12 males) were recruited. They participated in a tDCS-MRI session, during which restingstate functional MRI (rs-fMRI) was used to measure the levels of the fractional amplitude of low-frequency fluctuations (fALFFs), which is an index of regional neuronal activity, before and during left anodal dorsolateral prefrontal cortex (DLPFC) tDCS (2.0 mA for 15 min). MS patients were then asked to return for an identical tDCS-MRI visit (follow-up) after 20 identical at-home tDCS sessions. Simultaneous tDCS-induced changes in fALFF are seen across cortical and subcortical areas in both HC and MS patients, with some regions showing increased and others decreased brain activity. In HCs, fALFF increased in the right pre- and post-central gyrus whilst it decreased in subcortical regions. Conversely, MS patients initially displayed increases in more posterior cortical regions but decreases in the superior and temporal cortical regions. At follow-up, MS patients showed reversed patterns, emphasizing significant cumulative effects of tDCS treatment upon brain excitation. Such long-lasting changes are further supported by greater pre-tDCS fALFFs measured at follow-up compared to baseline, especially around the cuneus. The results were significant after correcting for multiple comparisons (p-FDR < 0.05). Our study shows that tDCS has both simultaneous and cumulative effects on neuronal activity measured with rs-fMRI, especially involving major brain areas distant from the site of stimulation, and it is responsible for fatigue and cognitive and motor skills.
Members of the Neural Engineering Lab received the following awards and for their academic and research excellence at City College of New York’s 2025 BME Day:
Mohamad FallahRad: Wallace H. Coulter Award for Academic Service in Biomedical Engineering
Kyle Donnery: Harold Shames Award for Graduate Academic Excellence by a Master’s Student (BME & MTM), Wallace H. Coulter Award for Outstanding Graduate Research Performance in Biomedical Engineering by a Master’s Student
Matthew Saw: Harold Shames Award for Undergraduate Academic Excellence, Wallace H. Coulter Award for Outstanding Undergraduate Research Performance in Biomedical Engineering
Benjamin Babaev: Harold Shames Award for Undergraduate Academic Excellence, Wallace H. Coulter Award for Outstanding Undergraduate Research Performance in Biomedical Engineering
Jana Elwassif: Award for Undergraduate Academic Excellence in Biomedical Engineering by a Junior-level Student
Santiago Osorio: Wallace H. Coulter Award for Academic Service in Biomedical Engineering
Maria Jose Ruiz Gonzalez: Wallace H. Coulter Award for Academic Service in Biomedical Engineering
A new letter to the editor in Brain Stimulation journal “Importance of considering microscopic structures in modeling brain stimulation” PDF
Zhen Qi, Gregory M. Noetscher, Alton Miles, Konstantin Weise, Thomas R. Knösche, Cameron R. Cadman, Alina R. Potashinsky, Kelu Liu, William A. Wartman, Guillermo Nunez Ponasso, Marom Bikson, Hanbing Lu, Zhi-De Deng, Aapo Nummenmaa, Sergey N. Makaroff, Importance of considering microscopic structures in modeling brain stimulation, Brain Stimulation, Volume 18, Issue 4, 2025, Pages 1150-1152 https://doi.org/10.1016/j.brs.2025.06.003.
Khadka N, Wang B, Bikson M. Role of frequency-dependent and capacitive tissue properties in spinal cord stimulation models. J Neural Eng. 2025 May 27;22(3). doi: 10.1088/1741-2552/add76e. PDF
Abstract
Objective. Spinal cord stimulation (SCS) models simulate the electric fields (E-fields) generated in targeted tissues, which in turn govern physiological and then behavioral outcomes. Notwithstanding increasing sophistication and adoption in therapy optimization, SCS models typically calculate E-fields using quasi-static approximation (QSA). QSA, as implemented in neuromodulation models, neglects the frequency-dependent tissue conductivity (dispersion), as well as propagation, capacitive, and inductive effects on the E-field. The objective of this study is to calculate the impact of frequency-dependent tissue conductivity and permittivity in SCS models, across a broad frequency range.
Approach. We solved a high-resolution RADO-SCS finite element model to simulate E-field magnitudes in spinal column tissues under voltage-controlled (VC) and current-controlled (CC) SCS. Varied combinations of epidural space and dura conductivity based on prior SCS modeling studies (under the QSA-method), as well as values from the Gabriel (1996 Compilation of the Dielectric Properties of Body Tissues at RF and Microwave Frequencies) dataset for 1 Hz, 1 kHz, 2.5 kHz, 16.66 kHz, and 1 MHz were considered. We assessed the relative contribution of epidural space and dura permittivity on peak E-field magnitude and neural activation, and compared results to the QSA-method models.
Main results. Across published SCS models, the conductivities of epidural space (considered either fat or mixed tissues; 0.025–0.25 S m−1) and dura (0.02–0.6 S m−1) vary by over an order of magnitude, associated with differences in predicted spinal cord peak E-field magnitudes for VC-SCS (6.55–43.71 V m−1 per V) and CC-SCS (10.94–25.20 V m−1 per mA). These literature variations in conductivity and resulting peak E-field magnitude are greater than from epidural/dura tissue dispersion (1 kHz–1 MHz) based on Gabriel (1996 Compilation of the Dielectric Properties of Body Tissues at RF and Microwave Frequencies) database (VC-SCS: 7.26–8.09 V m−1 per V; CC-SCS: 21.14–21.25 V m−1 per mA). Changes in E-field magnitudes were not associated with significant changes in relative spatial profiles of the E-field or activating function. The impact of epidural space/dural permittivity (at 1 kHz) on E-field magnitudes and activating function was minimal (⩽1%) for both SCS modes.
Significance. The impact of dispersion/permittivity is significantly less than existing variations in tissue conductivities used across SCS modeling studies. As relative E-field or activating function profiles were not significantly changed by tissue conductivities, any impact of neuronal activation thresholds tracks changes in E-field magnitude. We limited our analysis to a single geometry and epidural/dural properties to isolate the impact of QSA.
Marc Teichmann, Clara Sanches. Angelina Bourbon, Dennis Q. Truong, Marom Bikson, Antoni Valero-Cabré. (2025) Transcranial direct current stimulation over the temporal-parietal junction yields no lexical-semantic effects in logopenic primary progressive aphasia: a double-blind sham-controlled study. NeuroImage: Clinical. https://doi.org/10.1016/j.nicl.2025.103798
Download PDF
Dr. Davide Reato, former PhD student of Marom Bikson and Lucas Parra visited the neural engineering lab on May 5-6, 2025 and lectured. It was a great pleasure to have this brilliant and successful lab alumni visit.
Podcast
The Big Bang of Ideas
with Jay Govindji
Episode 7. Marom Bikson “The Current of Thought: Brain Stimulation, Neuroenhancement, and the Future of Human Thought”
March 24, 2025
In this episode, we discuss brain stimulation, including the research and the use cases from medical to cognitive enhancement, with Dr. Marom Bikson, a globally recognised leader in the field of neuroengineering and brain stimulation. Together, we unravel everything from the core ideas behind brain stimulation and neuroenhancement to the future of brain stimulation technology
Dr. Marom Bikson presents at the 2025 Bioelectronic Medicine Forum New York Academy of Medicine, New York, NY | April 10, 2025 . Event information
Bikson presents on “Wearable Medicine”
Assessing the Effect of Automated Thermo-Mechanical Therapy on Abdominal Blood Flow With Magnetic Resonance Imaging
Jacek P. Dmochowski, Luis Cardoso, Niranjan Khadka, Kiwon Lee, Sungjin Kim, Kaeun Kim, Hyelim Chun, Sunghye Choo, Hyun Jin Kim, Ahmed Duke Shereen, Marom Bikson. NMR in Medicine. 2025
https://doi.org/10.1002/nbm.70024 Download PDF
Citation: Dmochowski, J., Cardoso, L., Khadka, N., Lee, K., Kim, S., Kim, K., Chun, H., Choo, S., Jin Kim, H., Duke Shereen, A. and Bikson, M. (2025), Assessing the Effect of Automated Thermo-Mechanical Therapy on Abdominal Blood Flow With Magnetic Resonance Imaging. NMR in Biomedicine, 38: e70024. https://doi.org/10.1002/nbm.70
Adantchede Louis Zannou , Mojtaba Belali Koochesfahani , Gabriel Gaugain , Denys Nikolayev , Marc Russo , Marom Bikson. Computational Optimization of Spinal Cord Stimulation for Dorsal Horn Interneuron Polarization. Neuromodulation. 2025 Apr 3:S1094-7159(25)00028-5. doi: 10.1016/j.neurom.2025.01.015.
Abstract
Objectives: The proposed mechanisms of spinal cord stimulation (SCS) follow the polarization of dorsal column axons; however, the development of subparesthesia SCS has encouraged the consideration of different targets. Given their relative proximity to the stimulation electrodes and their role in pain processing (eg, synaptic processing and gate control theory), spinal cord dorsal horn interneurons may be attractive stimulation targets.
Materials and methods: We developed a computational modeling pipeline termed "quasiuniform-mirror assumption" and applied it to predict polarization of dorsal horn interneuron cell types (islet type, central type, stellate/radial, vertical-like) to SCS. The quasiuniform-mirror assumption allows the prediction of the peak and directional axes of dendrite polarization for each cell type and location in the dorsal horn, in addition to the impact of the stimulation pulse width and electrode configuration.
Results: For long pulses, the peak polarization per milliampere of SCS with a spaced bipolar configuration was islet type 3.5mV, central type 1.3mV, stellate/radial 1.4mV, and vertical-like 1.6mV. For stellate/radial, the peak dendrite polarization was dorsal-ventral, and for islet-type, the peak dendrite polarization was in the rostral-caudal axis. For islet type and central type cells, peak dendrite polarization was between stimulation electrodes, whereas for stellate/radial and vertical-like cells, peak dendrite polarization was under the stimulation electrodes. The impact of the pulse width depends on the membrane time constants. Assuming a 1-millisecond time constant, for a 1-millisecond or 100-μs pulse width, the peak dendrite polarization decreases (from direct current values) by approximately 33% and approximately 88%, respectively. Increasing the interelectrode distance beyond approximately 3 cm did not significantly increase the peak polarization but expanded the region of interneuron polarization.
Conclusions: Predicted maximum polarization of islet-cells in the superficial dorsal horn at locations between electrodes is 4.6mV for 2 mA, 1-millisecond pulse SCS. A polarization of a few millivolts is sufficient to modulate synaptic processing through subthreshold mechanisms. Our simulations provide support for SCS approaches optimized to modulate the dendrites of dorsal horn neurons.
Nasimova, M., Khadka, N. & Bikson, M. Computational modeling of neuromuscular activation by transcutaneous electrical nerve stimulation to the lower back. Biomed. Phys. Eng. Express 11, 035004 (2025). PDF
Abstract
Objectives: Transcutaneous Electrical Nerve Stimulation (TENS) to the lower back is an established electrical therapy for acute and chronic back pain. The efficacy and mechanisms of lower back TENS depend on the penetration depth of electrical current. We compare the intensity and spatial extent (depth) of current flow in the body during TENS with varied electrode positions/shapes on the human back.
Materials and Methods: A high-resolution MRI-derived anatomical model of the back was developed, considering major tissue compartments, including skin and muscles. TENS with upper and lower back electrode positions and varied electrode shapes (square, circular, rectangular) were simulated. An exemplary 50 mA current was applied under quasistatic approximation and quasiuniform electric field assumption of 6.15 V m−1 (low), 12.3 V m−1 (mid), and 24.6 V m−1 (high) neuromuscular activation thresholds were considered.
Results: Under all simulated TENS conditions (50 mA), electric fields at the skin exceed the high threshold (consistent with peripheral nerve activation) and at least some muscle regions exceed the mid threshold. Muscle activation was influenced by the anatomy of muscle in the medial-lateral direction and upper-lower back. The electrode shape had minimal effect on deep tissue current penetration.
Conclusions: Our simulations indicate significant current penetration into back tissue (electric fields above low threshold) to >8 cm in all TENS conditions simulated, consistent with nerve and muscle activation.
Significance: Anatomically precise models of upper and lower back TENS show current penetration to deep muscle, supporting direct muscle stimulation driving clinical benefits.
Brain Stimulation, Volume 18, Issue 2p280-286 March-April, 2025
Statistical method accounts for microscopic electric field distortions around neurons when simulating activation thresholds
Konstantin Weisea ∙ Sergey N. Makaroff∙ Ole Numssen∙ Marom Bikson ∙ Thomas R. Knöscheb
Highlights
• Microscopic field inhomogeneity alters neuron activation in neuromodulation models.
• Classical models miss the impact of brain microstructure on electric field effects.
• A novel statistical approach improves prediction of TMS neuronal activation thresholds.
• The results match experimental TMS thresholds, improving model predictions.
Abstract
Introduction
Notwithstanding advances in computational models of neuromodulation, there are mismatches between simulated and experimental activation thresholds. Transcranial Magnetic Stimulation (TMS) of the primary motor cortex generates motor evoked potentials (MEPs). At the threshold of MEP generation, whole-head models predict macroscopic (at millimeter scale) electric fields (50–70 V/m) which are considerably below conventionally simulated cortical neuron thresholds (175–350 V/m).
Methods
We hypothesize that this apparent contradiction is in part a consequence of electrical field warping by brain microstructure. Classical neuronal models ignore the physical presence of neighboring neurons and microstructure and assume that the macroscopic field directly acts on the neurons. In previous work, we performed advanced numerical calculations considering realistic microscopic compartments (e.g., cells, blood vessels), resulting in locally inhomogeneous (micrometer scale) electric field and altered neuronal activation thresholds. Here we combine detailed neural threshold simulations under homogeneous field assumptions with microscopic field calculations, leveraging a novel statistical approach.
Results
We show that, provided brain-region specific microstructure metrics, a single statistically derived scaling factor between microscopic and macroscopic electric fields can be applied in predicting neuronal thresholds. For the cortical sample considered, the statistical method matches TMS experimental thresholds.
Conclusions
Our approach can be broadly applied to neuromodulation models, where fully coupled microstructure scale simulations may not be computationally tractable.
The 6th International Brain Stimulation Conference (Kobe, Japan), Feb 23-26, 2025. Full program.
09:00-17:00 Sunday, 23 February, 2025, 301 KICC Brain Stimulation at the Microscopic Scale: Multiscale Models and Cellular Studies PreCon. 4:00PM - 4:25PM Gregory Noetscher and Marom Bikson (WPI, CCNY, USA) - Microvascular modulation of brain stimulation with realistic large microvascular networks
08:30-10:30 Monday, 24 February, 2025, Portopia Hall Plenary Lectures. 09:00-9:45: [PL01] Marom Bikson, Wearable Disposable Brain Stimulation. slides PDF
Poster Session 1. 12:45-13:45 Monday, 24 February, 2025, Ohwada & Ohwada Foyer P1.095 Long-term effect of tDCS plus cognitive training in the quality of life of patients with Post-Acute Sequelae of SARS-CoV-2 (PASC): a randomized, double-blind, controlled trial Kallene S Vidal, Adriano Domingos-Neto, Beatriz Cavendish, Bianca Pinto, Mariana Batista, Pedro Silva, Alisson Lima, Rebeca Pelosof, Juliana Pereira, Stephan Goerigk, Leigh Chavert, Marom Bikson, Andre Brunoni
Poster Session 1. 12:45-13:45 Monday, 24 February, 2025.P3.122 High-Capacity tDCS in Bench-top and Wearable Platforms Kyle Donnery, Mohamad FallahRad, Mojtaba Belali Koochesfahani, Marom Bikson
16:00-18:00 Tuesday, 25 February, 2025, Ohwada Room On Demand Poster Symposium Session 3 ODS5.18 16:25-16:26 Wearable disposable transcranial direct current stimulation Marom Bikson
Leigh Charvet, Judith D. Goldberg, Xiaochun Li, Pamela Best, Matthew Lustberg, Michael Shaw, Lana Zhovtis, Josef Gutman, Abhishek Datta, Marom Bikson, Giuseppina Pilloni. Lauren Krupp. (2025) Home-based transcranial direct current stimulation paired with cognitive training to reduce fatigue in multiple sclerosis. Scientific Reports 15:: 4551 DOI: https://doi.org/10.1038/s41598-025-88255-2
Abstract: Fatigue is a common and often debilitating feature of multiple sclerosis (MS) that lacks reliably
effective treatment options for most patients. Transcranial direct current stimulation (tDCS), a safe and
well-tolerated type of noninvasive brain stimulation, is a low-cost and home-based approach with the
potential to reduce fatigue in MS. We conducted a double-blind, sham-controlled, randomized clinical
trial to compare active vs. low-dose (sham) tDCS paired with computer-based cognitive training,
delivered as a home-based intervention, to reduce MS-related fatigue. Participants with MS-related
fatigue, but without depression, were stratified by neurologic disability using the Extended Disability
Status Scale (EDSS) and randomized to complete 30 daily sessions over six weeks of either active or
sham tDCS paired with online cognitive training (BrainHQ). The primary outcome was the change in
PROMIS Fatigue score from baseline to the end of the intervention. A total of 117 participants were
randomized, with 92% completing all treatment sessions. Both groups showed significant reductions
in fatigue, with no significant difference between them. This suggests that tDCS does not provide any
additional benefit over cognitive training alone in reducing fatigue, but confirms the feasibility and
tolerance of this home-based intervention.
