Dear Soheil,

Transcranial direct current stimulation is a cheap, easy-to-use technique for stimulating the brain in an non-invasive manner. It has little to no side effects. It consists of putting an anode and a cathode over specific brain area depending on the symptom you are aiming to target.

In a recent review, we have revisited the available literature concerning tDCS and fatigue syndromes :

The treatment of fatigue by non-invasive brain stimulation.

Lefaucheur JP, Chalah MA, Mhalla A, Palm U, Ayache SS, Mylius V.

Neurophysiol Clin. 2017 Apr;47(2):173-184. doi:

Our experience is mainly in patients with multiple sclerosis, suffering from physical and cognitive fatigue. We used a current intensity of 2 mA with the anode placed over the left dorsolateral prefrontal cortex and the cathode over the right orbitofrontal cortex. We picked this cortical target because we identified it to be involved in the generation of fatigue in MS. we performed daily 20 minute-session over a week and found significant results. Repeating the sessions might help to maintaning long term effects.

You can find attached one of our papers. Below are our work in this field:

Sincerely yours,

Moussa

-Long-term effects of tDCS on fatigue, mood and cognition in multiple sclerosis.

Chalah MA, Lefaucheur JP, Ayache SS.

Clin Neurophysiol. 2017 Nov;128(11):2179-2180. doi: 10.1016/j.clinph.2017.08.004. Epub 2017 Sep 2.

-Long term effects of prefrontal tDCS on multiple sclerosis fatigue: A case study. Ayache SS, Lefaucheur JP, Chalah MA.

Brain Stimul. 2017 Sep - Oct;10(5):1001-1002. doi: 10.1016/j.brs.2017.05.004. Epub 2017 May 16.

-Fatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation. Chalah MA, Riachi N, Ahdab R, Créange A, Lefaucheur JP, Ayache SS.

Front Cell Neurosci. 2015 Nov 30;9:460. doi: 10.3389/fncel.2015.00460. eCollection 2015. Review.

-Effects of left DLPFC versus right PPC tDCS on multiple sclerosis fatigue.

Chalah MA, Riachi N, Ahdab R, Mhalla A, Abdellaoui M, Créange A, Lefaucheur JP, Ayache SS.

J Neurol Sci. 2017 Jan 15;372:131-137. doi: 10.1016/j.jns.2016.11.015. Epub 2016 Nov 1

Sir Moussa Antoine Chalah thanks a lot for your attention .

There are several functional neuroimaging techniques ( e.g. near infrared spectroscopy, EEG, MEG, fMRI and etc) can be used to monitor both physical and mental fatigue. These techniques are chosen for the particular application based on their spatial and temporal resolution and mobility. The following references are for two different studies on fatigue:

[1] K. M. Ranjana and P. Raja, "Effects of Mental Fatigue on the Development of Physical Fatigue: A Neuroergonomic Approach," Human Factors, vol. 56, pp. 645-656, 2014/06/01 2013.

[2] M. Tanaka, A. Ishii, and Y. Watanabe, "Neural effect of physical fatigue on mental fatigue: a magnetoencephalography study," Fatigue: Biomedicine, Health & Behavior, vol. 4, pp. 104-114, 2016.