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tDCS improves lower limb motor function and walking distance in patients with multiple sclerosisTrial Shows Brain Stimulation Improves Lower Limb Function in MS

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Key Takeaway
Consider tDCS as a potential intervention for improving lower limb motor function and walking distance in MS.

This meta-analysis evaluated the impact of transcranial direct current stimulation (tDCS), both alone and combined with physical training, on motor function in 299 individuals with multiple sclerosis. The analysis focused on primary outcomes like lower limb motor function and secondary outcomes including walking distance, balance scores, and hand dexterity.

The synthesis indicates that tDCS significantly improved lower limb motor function (SMD = 0.31; 95% CI: 0.16 - 0.46, p < 0.0001) and walking distance (p = 0.0005). Additionally, static balance scores showed significant improvement (p = 0.0002). However, no significant improvements were observed in walking speed, dynamic balance, or hand dexterity (p = 0.11).

Specific parameters appeared to influence outcomes: high intensity (2.0-2.5 mA) and a 20-minute duration showed significant effects (p = 0.007 for intensity; p = 0.03 for duration), whereas low intensity (1.0-1.5 mA) for 15 minutes did not show significant benefits. The authors note that the efficacy of tDCS in improving upper limb fine motor skills remains unclear. Clinical application may focus on lower limb improvements using specific high-intensity protocols.

How this fits prior evidence

This meta-analysis addresses a gap in non-pharmacological interventions for multiple sclerosis by evaluating transcranial direct current stimulation (tDCS). While previous coverage has focused on disease-modifying therapies like rituximab, natalizumab, and cladribine to manage progression and relapses, this study provides evidence regarding physical motor outcomes. It specifically identifies that tDCS may improve lower limb function and walking distance in patients with multiple sclerosis.

This review looked at how transcranial direct current stimulation (tDCS) affects motor function in 299 people with multiple sclerosis. The study specifically looked at movements in the arms and legs, as well as walking distance and balance.

The results showed that tDCS significantly improved lower limb motor function and increased both walking distance and static balance. However, the treatment did not show significant improvements for walking speed, dynamic balance, or hand dexterity. These findings suggest that while the treatment helps with certain leg movements, it may not improve all types of mobility.

Researchers noted that specific settings mattered. Higher intensity (2.0 to 2.5 mA) for 20 minutes showed significant effects, while lower intensity and shorter durations did not show significant benefits. Because these results are based on a meta-analysis, they provide a broad look at the data but do not guarantee individual results. Talk with a doctor to see if this specific type of stimulation is appropriate for your personal treatment plan.

What this means for you:
tDCS shows promise for improving lower limb motor function and walking distance in people with multiple sclerosis.

Common questions

Does this treatment help with hand movements?

The study did not find a statistically significant difference in hand dexterity (9-HPT) for people with multiple sclerosis. While it helped lower limb motor function, its effects on upper limb fine motor skills remain unclear.

What specific settings were most effective?

The data suggests that higher intensity (2.0 to 2.5 mA) for a 20-minute duration showed significant results. In contrast, lower intensity (1.0 to 1.5 mA) and shorter durations of 15 minutes did not show significant benefits.

Does this treatment improve walking speed?

While the study found a significant increase in walking distance and static balance, it did not find any significant improvement in walking speed or dynamic balance for those with multiple sclerosis.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
OBJECTIVE: To assess the effectiveness of transcranial direct current stimulation (tDCS) in enhancing motor function recovery in the upper and lower extremities of individuals with multiple sclerosis. DATA SOURCES: PubMed, Embase, Web of Science, Cochrane Library, and China Knowledge Network (CNKI) databases from inception until December 28, 2025. STUDY SELECTION: Randomized controlled trials that investigated transcranial direct current stimulation and tDCS combined with physical training on motor function in the upper and lower limbs of individuals with MS. DATA EXTRACTION: Two reviewers extracted the data and assessed the risk of bias. Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated using a random-effects model based on heterogeneity. The analysis included 10 articles with a total of 299 subjects. DATA SYNTHESIS: The Meta-analysis shows tDCS significantly improves lower limb motor function in MS patients (SMD = 0.31, 95% CI: 0.16 - 0.46, p < 0.0001). Subgroup analyses found significant increases in walking distance (p = 0.0005) and static balance (Berg Balance Score, p = 0.0002), but no significant improvements were observed in walking speed and dynamic balance. For upper limb motor function, no statistically significant difference was found in hand dexterity (9-HPT) (p = 0.11). Notably, subgroup analyses of stimulation parameters showed that high intensity (2.0-2.5 mA, p = 0.007) and a 20-minute duration (p = 0.03) yielded significant effects, whereas low intensity (1.0-1.5 mA) and 15-minute duration showed no significant benefits. CONCLUSIONS: Transcranial direct current stimulation is effective in enhancing lower limb motor function in patients with MS. However, the efficacy of tDCS in improving upper limb fine motor skills remains unclear. Evidence suggests that stimulation at 2.0-2.5 mA for 20 min may be the optimal protocol for clinical intervention.
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