{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:09:05Z","timestamp":1791238145183,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>Fatigue is a universal and constructive experience, yet chronic fatigue\u2014defined as a persistent lack of energy that limits daily life as assessed by modified Fatigue Impact Scale (mFIS)\u2014remains nowadays a symptom waiting for effective mitigation. Evidence across neurological, oncological, and psychosocial conditions shows that fatigue shares a common neurophysiological substrate: disrupted sensory-motor imbalances and network synchrony that can be targeted by established interventions\u2014physical activity, mindfulness, yoga, and cognitive-behavioral therapy. Within this landscape, non-invasive neuromodulation stands out as an effective and safe tool to restore sensorimotor balance to integrate behavioral interventions. The Faremus protocol, based on five daily sessions of 15-min bilateral anodic transcranial Direct Current Stimulation (tDCS) over the somatosensory cortex, has shown consistent clinical benefits in multiple sclerosis: an average 26% reduction in fatigue severity, persisting for weeks or months, with excellent tolerability and home-use feasibility. Converging meta-analyses, neurophysiological central and behavioral investigations, and reviews confirm the reproducibility and mechanistic validity of this approach, positioning neuromodulation among the most promising evidence-based strategies in supporting fatigue relief. This perspective highlights neuromodulation as a transversal instrument to counter fatigue across conditions, and as a cornerstone of integrated, multidisciplinary strategies aimed at preserving brain plasticity, enhancing resilience, and restoring sustained well-being.<\/jats:p>","DOI":"10.3389\/fnins.2026.1735954","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:00:45Z","timestamp":1775800845000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Fatigue relief: the contribution of non-invasive neuromodulation (FAREviaNM)"],"prefix":"10.3389","volume":"20","author":[{"given":"F.","family":"Tecchio","sequence":"first","affiliation":[{"name":"Laboratory of Electrophysiology for Translational neuroScience (LET\u2019S) \u2013 ISTC \u2013 CNR","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Paulon","sequence":"additional","affiliation":[{"name":"Laboratory of Electrophysiology for Translational neuroScience (LET\u2019S) \u2013 ISTC \u2013 CNR","place":["Rome, Italy"]},{"name":"Independent Researcher, Engineer Freelance","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"449","DOI":"10.5812\/IRCMJ.3597","article-title":"Comparison of the effect of 8 weeks aerobic and yoga training on ambulatory function, fatigue and mood status in MS patients","volume":"15","author":"Ahmadi","year":"2013","journal-title":"Iran Red Crescent Med J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1021\/ACSCHEMNEURO.2C00589","article-title":"Exploring the role of neurotransmitters in multiple sclerosis: an expanded review","volume":"14","author":"Akyuz","year":"2023","journal-title":"ACS Chem. 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Psychiatry"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/S10549-019-05278-W","article-title":"Yoga has a solid effect on cancer-related fatigue in patients with breast cancer: a meta-analysis","volume":"177","author":"Dong","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1017\/S0317167100048691","article-title":"The impact of fatigue on patients with multiple sclerosis","volume":"21","author":"Fisk","year":"1994","journal-title":"Can. J. Neurol. Sci."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"16311","DOI":"10.1038\/s41598-021-95084-6","article-title":"tDCS randomized controlled trials in no-structural diseases: a quantitative review","volume":"11","author":"Gianni","year":"2021","journal-title":"Sci. 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Neurol."},{"key":"ref001","doi-asserted-by":"publisher","first-page":"2240","DOI":"10.1093\/brain\/awx153","article-title":"The fatigue conundrum","volume":"140","author":"Kuppuswamy","year":"2017","journal-title":"Brain"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1177\/1073858420985447","article-title":"The neurobiology of pathological fatigue: new models, new questions","volume":"28","author":"Kuppuswamy","year":"2022","journal-title":"Neuroscientist"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"Lee","year":"2012","journal-title":"Lancet"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"389","DOI":"10.5014\/AJOT.57.4.389","article-title":"Test-retest reliability and convergent validity of the fatigue impact scale for persons with multiple sclerosis","volume":"57","author":"Mathiowetz","year":"2003","journal-title":"Am. J. Occup. Ther."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.critrevonc.2017.12.011","article-title":"Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis of randomized trials","volume":"122","author":"Oberoi","year":"2018","journal-title":"Crit. Rev. Oncol. 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Neurol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"103813","DOI":"10.1016\/J.MSARD.2022.103813","article-title":"Home treatment against fatigue in multiple sclerosis by a personalized, bilateral whole-body somatosensory cortex stimulation","volume":"63","author":"Tecchio","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1177\/1352458512452921","article-title":"Cortico-muscular coherence as an index of fatigue in multiple sclerosis","volume":"19","author":"Tomasevic","year":"2013","journal-title":"Mult. Scler. J."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"912","DOI":"10.3389\/FPSYG.2016.00912","article-title":"Clinical utility of mindfulness training in the treatment of fatigue after stroke, traumatic brain injury and multiple sclerosis: a systematic literature review and Meta-analysis","volume":"7","author":"Ulrichsen","year":"2016","journal-title":"Front. 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