b'Medicine & ResearchI nnnoovvaattiinnggHHeeaalltthhccaarreeInwwiitthhNNoonniinnvvaassiivveeBBrraaiinnSSttiimmuullaattiioonnTelemedicine allows for daily, at-home treatment by a clinician By Dr. Leigh CharvetTherearemanyexcitinghealthcarepain). In addition, stimulation of a brain technologies that offer new therapeutic optionsregion that is engaged with concurrent training for people living with multiple sclerosis. Oneexercises may boost the training benet. In rapidly developing area of new technologiesthisway,tDCSmaybeusedtooptimize is the eld of noninvasive brain stimulation.motor or cognitive rehabilitation.This refers to a range of techniques developedTherearemanyMSsymptomswhere to deliver mild electrical current to regions intDCS may be benecial. Preliminary studies the brain with the goal of modulating its function.suggest it might be used to treat fatigue and These noninvasive brain stimulation therapiesto improve cognitive functioning and other are being studied and developed for use in auses for symptom management. One example widerangeofneurologicandpsychiatricof a promising area of study is the use of conditions. There are many different devices andtDCS to improve walking ability. Impairments approaches to noninvasive brain stimulation,in walking are common in MS and represent a but the two most extensively studied techniquesmajor unmet treatment need. Studies suggest are transcranial magnetic stimulation andthat brain stimulation during exercise can transcranial direct current stimulation. enhance the already well-known benets to lead TheMultipleSclerosisComprehensiveto stronger and more lasting improvements Care Center at NYU Langone Health focusesin walking. on determining the benefits of these newIn a NYU Langone Health study, people technologies,especiallyforthemanyMSwith MS and walking impairment completed symptoms that compromise quality of life10 sessions of exercise (seated pedaling). The but remain without reliable treatments. Theparticipants were randomly assigned to have research program has focused on the use ofeither active or sham (placebo) stimulation tDCS in MS. during the exercise. After 10 sessions, the people Brain stimulation who had the active tDCS had signicantly tDCS has been extensively studied andgreater improvements in their walking speed shown to be safe and well-tolerated by peopleand other gait measures. Further, this benet of all ages and different conditions. Thewas maintained when tested during a one-stimulation can be therapeutic on its ownmonth follow-up. Importantly, it also found without a paired behavioral intervention (forthat there was no benet after just one session, instance, in the treatment of depression ordemonstratingthattDCSworksonlyafter 46 msfocusmagazine.org'