Fatigue is one of the most common and persistent complaints from persons with multiple sclerosis (pwMS). Increasing physical activity is encouraged as a self-management strategy. However, fatigue itself, ironically, has been identified by pwMS as a key barrier to increasing physical activity and adhering to an exercise programme. A possible solution to this dilemma is to introduce a treatment that improves and primes the person for increasing physical activity, but does not generate more fatigue or adverse effects before and during physical activity engagement. Transcutaneous auricular vagus nerve stimulation (TaVNS) is a novel treatment that may alleviate MS-related fatigue via neuromodulation of the autonomic nervous system, brainstem and higher order vagus nerve pathways. Although TaVNS has been used for other conditions (such as epilepsy, depression and tinnitus) it has not been explicitly used in neuromodulation of fatigue and alertness. This is despite overlapping neurological and immunological pathways involved in the treatment effects of TaVNS on these conditions.
This project will be focused on exploring effective stimulation parameters, feasibility and efficacy of TaVNS on pwMS. Mainly quantitative research methodologies will be used, however, qualitative methodologies may be adopted for elucidating user experience. It is essential that the candidate is a qualified health care professional with use of electrical stimulation modalities within their scope of practice. Physical activity levels, subjective report of fatigue, cognitive functioning, sleep quality and psychological status will also be assessed. This project is supported by the Lothian Multiple Sclerosis Therapy Centre. It is anticipated links with other clinical services will also be developed to support this project.