Testing Repetitive Transcranial Magnetic Stimulation rTMS on the Left Premotor Cortex to Reduce Fatigue in Adults with Multiple Sclerosis

What this Trial Is About

Researchers are investigating whether repetitive Transcranial Magnetic Stimulation rTMS applied to the left premotor cortex can reduce fatigue in patients with Multiple Sclerosis MS and if this approach is feasible as a treatment. The study also aims to better understand fatigue in MS by comparing real rTMS with sham inactive rTMS. The primary focus is to see if rTMS decreases fatigue symptoms and changes brain activity balance in the targeted area. Participants will receive either real or sham rTMS for 30 minutes daily over five consecutive days, Monday through Friday. The treatment uses a specialized coil guided by MRI and robotic positioning to target the left dorsal premotor cortex. The study involves a baseline period, the intervention phase, and a follow-up period. Brain scans using ultra-high field MRI and neurophysiological tests are conducted at baseline, during, and after treatment to measure changes. During the study, participants will visit the clinic before treatment and six days after to undergo clinical testing, MRI scans, and neurophysiological measurements. They will keep a fatigue diary and wear an activity tracker before, during, and after intervention. Additional online questionnaires are completed one day and four weeks after treatment. The main outcome measured is the change in fatigue severity from baseline to six days after intervention, supported by brain imaging and other fatigue-related assessments. Safety and compliance are closely monitored throughout the trial.

Fatigue Alleviation Through Neuromodulating Therapy in Multiple Sclerosis