What is the Best Option for Patients with Multiple Sclerosis: Anodal tDCS, Cognitive Training, or a Combination of the Two? A Randomized, Double-Blind, Parallel-Group Study

Leila Simani, Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York City, United States


In 40 to 70 % of patients with multiple sclerosis (MS), cognitive impairments are present during their illness. Only a few studies have examined the effects of anodal transcranial direct current stimulation (a-tDCS) with cognitive training on cognitive performance in MS. This study aims to determine whether multi-session a-tDCS with or without cognitive training impacts cognitive performance.

Participants and Methods:

Eighty MS patients received a-tDCS, cognitive training, a-tDCS plus cognitive training, and sham for ten consecutive daily sessions. Cognitive function (including episodic memory, attention, and inhibitory control, working memory, and visuospatial skill) was measured at baseline, week 4, and week 12 after the intervention.


All cognitive functions significantly improved after the intervention compared to the sham condition. This effect also showed persistence during follow-up for some cognitive tasks in the a-tDCS and a-tDCS combined cognitive training groups. Although the cognitive training group experienced an immediate improvement in attention and inhibitory control, the difference was not significant at follow-up. Also, there were no significant differences between these three groups in cognitive scores after the intervention.


Using a-tDCS by itself or in combination with cognitive training, compared to sham, seems to offer a promising therapeutic approach to enhance cognitive performance in MS patients.

Category: Cognitive Intervention/Rehabilitation

Keyword 1: attention
Keyword 2: multiple sclerosis
Keyword 3: cognitive rehabilitation