Modulation of cortical excitability to normalise brain function and improve cognition in multiple sclerosis

The identification of treatment strategies that could ameliorate or even prevent symptom onset and progression in patients with multiple sclerosis (MS) remains a largely unmet need. Several recent studies have consistently demonstrated that modulation of brain functional plasticity within cognitive-related networks by using, for instance, tailored cognitive-rehabilitation procedures can help to restore cognitive abilities.1 In their JNNP paper, Hulst et al 2 investigated the effects of a single session of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral prefrontal cortex on working memory performance in 17 MS patients without cognitive impairment. Using the N-back task during functional MRI, they also assessed the consequences of rTMS on the recruitment and connectivity within the working memory network. The two main findings of this study are a significant improvement of N-back task accuracy for higher load conditions following real-rTMS …