Deep transcranial brain stimulation – a new treatment approach in patients with multiple sclerosis


A pilot study conducted by researchers from Charité’s
NeuroCure Cluster of Excellence has shown that treatment with deep
transcranial magnetic stimulation (dTMS) significantly reduces symptoms
of fatigue in patients with multiple sclerosis (MS). Published in the
current issue of the journal Neurology: Neuroimmunology & Neuroinflammation, results from this research suggest that TMS is a safe option for the treatment of patients with MS.

Up to 90 percent of people living with MS report experiencing severe
fatigue. Fatigue can have a serious impact on both a person’s work and
social life, and leads many patients to give up work. In fact, a large
percentage of people with MS rate fatigue as one of the most bothersome
symptoms of the disease. Treatment options are scarce, and no licensed
pharmaceutical treatments are available. In contrast, dTMS has been used
in the diagnosis and treatment of a range of neurological and
psychiatric disorders.

A team of researchers, led by Prof. Dr. Friedemann Paul of the
NeuroCure Clinical Research Center (NCRC), has shown that dTMS, using
the proprietary H-coil, a technology that allows brain stimulation three
times deeper than that of standard TMS, is capable of producing
significant improvements in fatigue symptoms. The severity of
MS-associated symptoms was assessed using a standardized questionnaire
and the Fatigue Severity Scale (FSS). 33 study participants with fatigue
received thrice-weekly sessions of dTMS for a duration of six weeks;
this involves a stimulation H-coil being placed above the patient’s
head, which generates a magnetic field that influences nerve activity
and neural circuits in the brain. A control group received a sham

“We observed no serious side effects in patients treated with dTMS,
and it is therefore worth stressing the tolerability of this noninvasive
electrophysiological technique,” says Prof. Paul, the study’s principal
investigator. Further, it is also worth noting that the treatment was
delivered using a new type of H-coil, which had been developed
specifically for use in this study. This coil permits the targeted
stimulation of areas of the brain which, according to the latest
research, play a major role in MS-associated fatigue. A follow-up study
involving a larger number of participants is being planned. This is
intended to verify the efficacy of this treatment method, and to help
ensure the implementation of dTMS for MS-associated fatigue into routine
clinical practice. “We are excited about the collaboration between
Prof. Dr. Friedemann Paul and his team at Charité’s
NeuroCure and Brainsway for studying the use of our patented Deep TMS
technology for the benefit of MS patients, a new neurological field for
us. These promising results of relieving the very hard to treat fatigue
symptoms in MS, brings a new hope for being able to provide a solution
for the many patients who need it.” Says Ronen Segal, CTO of Brainsway

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