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Case Reports
. 2024 Jan 1;16(1):e51462.
doi: 10.7759/cureus.51462. eCollection 2024 Jan.

Transcranial Direct Current Stimulation Is Safe and Reduces Chronic Fatigue in Patients With Stable Systemic Lupus Erythematosus and Rheumatoid Arthritis

Vanessa P De Andrade  1 , Alexandre M Dos Santos  1 , Samuel K Shinjo  1
Affiliations
Case Reports

Transcranial Direct Current Stimulation Is Safe and Reduces Chronic Fatigue in Patients With Stable Systemic Lupus Erythematosus and Rheumatoid Arthritis

Vanessa P De Andrade et al. Cureus. .

Abstract

To the best of our knowledge, this is the first case series to assess a combined technique of transcranial direct current stimulation (tDCS - a non-pharmacological and non-invasive brain stimulation) and aerobic exercise in one patient with systemic lupus erythematosus (SLE) and another with rheumatoid arthritis (RA) and significant chronic fatigue. We conducted five sessions of tDCS combined with low-intensity treadmill exercise. Fatigue levels were assessed using the Fatigue Severity Scale and the Visual Analog Scale for fatigue before (pre), immediately after five tDCS sessions (post-zero), and after six months (post-6-mo). The level of fatigue decreased, and functionality improved significantly post-zero and remained sustainable post-6-mo in both SLE and RA cases. There was only one mild and transient side effect (headache) specifically in the patient with RA, and no disease reactivation occurred in any of the cases. Our data showed that tDCS combined with aerobic exercise appears to be safe and promising for reducing fatigue and improving functionality in patients with SLE and RA. Randomized studies with larger sample sizes are required to corroborate our findings.

Keywords: aerobic exercise; fatigue disorder; neuromodulation; rheumatoid arthritis; systemic lupus erythematosus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Fatigue Severity Scale (FSS) and Visual Analog Scale (VAS) for fatigue in systemic lupus erythematosus
pre - the week before the tDCS and aerobic exercise application; post-zero - one week after the completion of the protocol; post-6-mo - six months after the completion of the protocol tDCS - transcranial direct current stimulation
Figure 2
Figure 2. Fatigue Severity Scale (FSS) and Visual Analog Scale (VAS) for fatigue in rheumatoid arthritis
pre - the week before the tDCS and aerobic exercise application; post-zero - one week after the completion of the protocol; post-6-mo - six months after the completion of the protocol tDCS - transcranial direct current stimulation
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