Compared to healthy individuals, people with multiple sclerosis (MS) fatigue much quicker during everyday physical activities such as climbing stairs or shopping for groceries. This can be a major factor in reducing quality of life for people with MS. Dr Simranjit Sidhu’s work is focused on reducing MS-related fatigue.
Fatigue has two components: 1) within the muscle, and 2) within the brain and spinal cord or “central” fatigue. There is some evidence to show that MS fatigue is largely mediated by brain mechanisms or central fatigue.
To reduce the central effects of fatigue when applied on the brain of young individuals, non-invasive brain stimulation techniques involving low-intensity direct current (called “neuromodulation”) have been trialled. However, the results can be highly variable. This is possibly due to both individual factors such as age and sex, as well as external factors such as different experimental protocols.
One way to minimise this variability is to apply a priming dose of current first, with a short rest before the application of the “treatment current”, during fatiguing exercise. The aim of this research is to determine if applying this priming dose to the brain can modify the way neurons respond and reduce the magnitude of MS fatigue.
Neuromodulation with non-invasive brain stimulation is a potentially effective treatment for MS fatigue, but is poorly understood. This project will expand our knowledge of the exact mechanisms involved in priming neuromodulation and the effects on MS fatigue with a view for developing more reliable and effective treatments.
Dr Sidhu has completed data collection from 4 out of the proposed 5 study participants. Early analysis of the available data has been conducted.
This data is suggesting that the hand muscle of study participants with MS fatigued to a similar extent as participants without MS and this did not change with different neuromodulation conditions. This result could potentially be explained by many factors, including that the study participants with MS are just as physically active as those without MS.
However, this finding may not be the case for bigger more fatigable muscle groups of the body, and in people with MS who have greater disability and lower physical activity levels. Further work needs to be completed to elucidate the contribution of some of these factors.
Preliminary analysis also suggests that participants with MS did not benefit as much as those without MS in boosting neuron response after the priming stimulation. Further analyses on the existing data need to be completed and data from a larger group needs to be collected to establish clarity in this regard.
Updated 31 March 2022
Updated: 21 January, 2020
Laboratory research that investigates scientific theories behind the possible causes, disease progression, ways to diagnose and better treat MS.
Research that builds on fundamental scientific research to develop new therapies, medical procedures or diagnostics and advances it closer to the clinic.
Clinical research is the culmination of fundamental and translational research turning those research discoveries into treatments and interventions for people with MS.