I am an academic physiotherapist and neuroscientist with a long-standing interest in brain function, particularly aspects relevant to brain excitability, motor control and neuroplasticity. Over the past 10 years I have been working on developing non-invasive transcranial direct current stimulation intervention protocols to affect brain functions in health and disease.

It is estimated that every year the number of people diagnosed with MS increases by 4%. Worldwide MS affects about 2.8 million people. Every 5 minutes, someone, somewhere in the world is diagnosed with MS. Pain in this population is prolonged and gets worse over time. Using non-invasive transcranial direct current stimulation may be a safe and effective non-pharmacological treatment to reduce neuropathic pain and improve quality of life in this group of patients. If this new technique is found to be safe with long lasting effect in reducing pain, it has the potential to be readily translated into clinical practice as a safe and efficacious treatment for those patients who do not respond effectively to the current pharmacological treatment.

Currently there is no cure for MS as the exact cause of this disease is unknown. It is the most common demyelinating disease that is progressive in nature. Scientists around the world are working very hard to find the best way to stop this disease for good. One of the most fascinating research areas in MS is investigating how the function of oligodendrocyte precursor cells in the brain can be triggered to be able to facilitate the myelin repair in patient’s body.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can be used to decrease pain level in patients with MS. Application of tDCS over primary motor cortex has been heralded as an extremely promising technique for pain relief. In the previous studies, tDCS has only been used for 10 or 20 minutes which could modulate the excitability of this area for up to two hours. However, by repeated application of tDCS in one session with an appropriate inter-stimulus interval, the modulation of the corticospinal excitability could be prolonged up to 24 hours. We showed that by applying this intervention on patients with MS for five consecutive days, the pain will be diminished significantly for up to 2 weeks. In this study, we aim to investigate whether the electroanalgesic effect of repeated application of a-tDCS over primary motor cortex in patients with MS will be lengthened if patients receive two sets of “5-day” intervention with 2 weeks apart.

Pain is a key symptom in patients with MS and has been recognized as an important factor in their overall health-related quality of life and disability. It has been recommended that “quality of life for people with MS could be significantly improved through effective interventions to manage pain and mental health, and support people with MS to maintain independent living and relationships”. Pharmacologic interventions for central pain in this population are non-specific, and at target doses may cause drowsiness, impaired memory, organ toxicity and risk of abuse or addiction. These side effects result in administration of doses that are often insufficient or ineffective. Thus, central pain remains inadequately treated and is therefore potentially a highly important therapeutic target in MS. Using non-invasive tDCS may be a safe and effective non-pharmacological treatment to reduce neuropathic pain and improve quality of life in this group of patients.

It is very exciting to bring together patients, consumer organisations, clinical researchers, policy makers and health care professionals to address the knowledge gap. We aim to deliver outcomes that are a priority for the MS community and the Australian public, including community engagement and patient involvement during conceptualisation, development and implementation of the trial. However, the available funding to run the trial smoothly is always the most challenging aspect of our research projects.