Abstract Number: Esoc2026ot108 Viability and Effectiveness of a Multimodal TDCS-Based Intervention for Post-Stroke Fatigue

Abstract Background and aims Post-stroke fatigue (PSF) is a prevalent and disabling condition that limits physical activity, participation, and quality of life after stroke. Despite its clinical relevance, effective non-pharmacological treatments remain scarce. Non-invasive brain stimulation, such as transcranial direct current stimulation (tDCS), may modulate disrupted neural networks associated with PSF. Methods To evaluate the effectiveness of tDCS in reducing PSF three-months post treatment measured with Fatigue Assessment Scale. Results Randomized, single-blind clinical trial conducted according to CONSORT guidelines. Twenty-seven participants per study arm are being recruited from the Stroke Unit of Hospital Clínic de Barcelona. Adults with first-ever ischemic or hemorrhagic stroke and clinically significant fatigue (FAS24) will be randomized into two groups: (1) therapeutic education plus sham tDCS plus aerobic exercise and (2) therapeutic education plus active tDCS plus aerobic exercise. The multimodal intervention is delivered over five weeks. Therapeutic education is first provided individually addressing PSF mechanisms and coping strategies, is open to relatives, and includes a question-and-answer period. This is followed by eight intervention sessions consisting of active or sham tDCS applied before physical exercise. Physical exercise comprises 20 minutes of aerobic training, effort monitored using the modified Borg scale. tDCS targets the left dorsolateral prefrontal cortex (anode F3, cathode O2; 2 mA for 20 minutes). Conclusions Outcomes are assessed at baseline and at one- and three-months post-intervention by two blinded physiotherapists and include FAS, HADS, IPAQ, PROMIS-Sleep, EQ-5D following the International Classification of Functioning framework Conflict of interest