Abstract General Information

Title

Outcome of non-invasive neuromodulation on the communication ability of people with multiple sclerosis

Abstract

Introduction: The effect of multiple sclerosis (MS) on communications is considered an important factor of disability. Transcranial magnetic stimulation (TMS) is a treatment option. Objectives: To analyze the self-reported communicative ability of people with MS undergoing TMS. Methods: The protocol consisted of 10 interventions by TMS (primary motor cortex, left dorsolateral pre-frontal cortex) during 10 consecutive working days. The 6 items from domain 1 (cognition) of the self-administered disability assessment scale of the Brazilian version of World Health Organization-Disability Assessment Schedule 2.0 (WHODAS) was used before and after (30 days) TMS to identify patient’s opinion of ability to understand and communicate. Difficulty levels were rated on a 5-point Likert scale (0, none; 1, mild; 2, moderate; 3, severe; 4, extreme). Scores ranged from 0= minimum difficulty to 100= maximum. Results: The study comprised 30 people with MS: 22 (73%) women, 8 (27%) men, age 33-68 years (mean=50.0, SD=10.6), EDSS 0-6.5 (mean=4.6, SD=1.9), time diagnostic 1-24 years (mean=10.0, SD=7.2). All patients mentioned preserved ability for general understanding of the interlocutors’ speech. Prior to TMS, n=18/60% had moderate difficulty concentrating (including speech content/subject), moderate/severe to n=24/80% in recent memory, n10/33%) in problem solving, and n=10/33% in learning, fundamental mental and reasoning activities for communication, activity reported with a moderate degree of difficult in n=18/60% to start and maintain conversations due to inability to recall words (language disorder) or impairment in speech intelligibility (dysarthria). Self-reports pointed to a decrease in difficulties after TMS. Conclusion: We observed that WHODAS 2.0 is a favorable tool to identify the patient-reported outcome measures (PROMs) with MS about preserved abilities and cognitive impairments generated by disease, and to analyze the evolution of interventions. Non-invasive neuromodulation by TMS showed potential to improve verbal communication.