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Transcranial direct current stimulation (tDCS) combined with adaptive cognitive training (aCT) may improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of active vs. sham home-based tDCS\u2009+\u2009aCT on cognitive function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants with MS and fatigue, without depression or severe cognitive impairment, were randomized to complete 30 remotely supervised 20-minute sessions of active (2.0 mA) or sham tDCS targeting the left anodal dorsolateral prefrontal cortex, paired with aCT. Randomization was stratified by high (H) vs. low (L) EDSS. The Brief International Cognitive Assessment in MS (BICAMS) was administered at baseline and intervention end, with scores converted to demographics-adjusted\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      -scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 117 participants, 106 completed BICAMS assessments. Compliance was high; 92% completed &gt;25 sessions. Mean change in BICAMS\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      -score was significantly greater in the active (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200955: 0.06\u2009\u00b1\u20090.56) versus sham (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200951: \u22120.16\u2009\u00b1\u20090.50) group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.035). The interaction between treatment and EDSS for BICAMS\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      -score was not significant (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.254), but benefits were greater in H EDSS (\u22120.00\u2009\u00b1\u20090.57 vs. \u22120.37\u2009\u00b1\u20090.39;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.022) than L EDSS (0.11\u2009\u00b1\u20090.56 vs. \u22120.01\u2009\u00b1\u20090.53;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.411).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Active vs. sham tDCS\u2009+\u2009aCT resulted in significantly better cognitive outcomes, with the greatest benefit in those with high neurologic disability.<\/jats:p>\n                    <jats:p>\n                      CLINICALTRIALS.GOV;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT03838770;IDENTIFIER\">https:\/\/clinicaltrials.gov\/study\/NCT03838770; IDENTIFIER<\/jats:ext-link>\n                      : NCT03838770\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173251356704","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:04:35Z","timestamp":1753686275000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Enhanced cognitive outcomes with telehealth-based tDCS in multiple sclerosis: Results from a sham-controlled RCT"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4429-9713","authenticated-orcid":false,"given":"Leigh","family":"Charvet","sequence":"first","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Goldberg","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochun","family":"Li","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Best","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Stony Brook Medicine, Stony Brook, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Shaw","sequence":"additional","affiliation":[{"name":"Binghamton University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana Zhovtis","family":"Ryerson","sequence":"additional","affiliation":[{"name":"Hackensack Meridian Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Gutman","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marom","family":"Bikson","sequence":"additional","affiliation":[{"name":"City College of New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6226-5627","authenticated-orcid":false,"given":"Giuseppina","family":"Pilloni","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7003-807X","authenticated-orcid":false,"given":"Lauren","family":"Krupp","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","unstructured":"Lechner-Scott J Agland S Allan M et al. 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