{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:58:05Z","timestamp":1788184685258,"version":"build-2803163510"},"reference-count":72,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Fatigue and cognitive impairment are common issues for People with Multiple Sclerosis (PwMS), affecting over 80% and 40\u201365%, respectively. The relationship between these two debilitating conditions is complex, with cognitive deficits exacerbating fatigue and vice versa. This study investigates the effects of a multimodal intervention combining cognitive rehabilitation and neuromodulation to alleviate fatigue and enhance cognitive performance in PwMS. Methods: The research employed multiple baselines across the subjects in a Single-Case Experimental Design (mbSCED) with a cohort of three PwMS diagnosed with Relapsing\u2013Remitting MS. The intervention protocol consisted of a baseline phase followed by a four-week treatment involving transcranial direct current stimulation (tDCS) and cognitive training using RehaCom\u00ae software (version 6.9.0). Fatigue levels were measured using the modified Fatigue Impact Scale (mFIS), while cognitive performance was evaluated through standardized neuropsychological assessments. Results: The multimodal protocol exhibited high feasibility and acceptability, with no dropouts. Individual responsiveness outcomes varied, with two PwMS showing significant decreases in fatigue and improvements in cognitive performance, particularly in the trained domains. Their motor performance and quality of life also improved, suggesting that the treatment had indirect beneficial effects. Conclusions: This study provides preliminary evidence for the potential benefits of integrating neuromodulation and cognitive rehabilitation as a personalized therapeutic strategy for managing fatigue and cognitive impairments in MS. Further research is needed to delineate the specific contributions of each intervention component and establish standardized protocols for clinical implementation. The insights gained may lead to more effective, tailored treatment options for PwMS.<\/jats:p>","DOI":"10.3390\/brainsci15080807","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:05:47Z","timestamp":1753711547000},"page":"807","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["tDCS and Cognitive Training for Fatigued and Cognitively Impaired People with Multiple Sclerosis: An SCED Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-7771","authenticated-orcid":false,"given":"Teresa","family":"L\u2019Abbate","sequence":"first","affiliation":[{"name":"Department of Psychology, International Telematic University UniNettuno, 00186 Rome, Italy"},{"name":"Laboratory of Electrophysiology for Translational Neuroscience (LET\u2019S), Istituto di Scienze e Tecnologie della Cognizione, CNR, 00196 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-4303","authenticated-orcid":false,"given":"Nefeli K.","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2351-7411","authenticated-orcid":false,"given":"George","family":"Dimakopoulos","sequence":"additional","affiliation":[{"name":"Biostats\u2014Statistics & Software, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-5059","authenticated-orcid":false,"given":"Franca","family":"Tecchio","sequence":"additional","affiliation":[{"name":"Department of Psychology, International Telematic University UniNettuno, 00186 Rome, Italy"},{"name":"Laboratory of Electrophysiology for Translational Neuroscience (LET\u2019S), Istituto di Scienze e Tecnologie della Cognizione, CNR, 00196 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7495-6863","authenticated-orcid":false,"given":"Grigorios","family":"Nasios","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.msard.2016.07.003","article-title":"Brain Health: Time Matters in Multiple Sclerosis","volume":"9","author":"Giovannoni","year":"2016","journal-title":"Mult. 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