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Home-based anodal tDCS targeting the left DLPFC reduces cognitive fatigue in a patient with refractory post-mTBI fatigue

A single patient with chronic post-mild traumatic brain injury (mTBI) cognitive fatigue received 14 days of home-based anodal tDCS (2 mA, 20 min daily) over the left DLPFC, guided by FDG-PET/MRI findings. Fatigue severity (FSS-7) improved from 5.4 to 3.7, exceeding the minimal clinically important difference, and cognitive performance improved (SDMT: 46 to 58; MoCA: 26 to 29). No serious adverse events were reported.

Last updated: Aug 21, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Case Report: Anodal DLPFC-tDCS for refractory post-traumatic cognitive fatigue in the hypometabolic brain.

observational

Glennon E, Yang Z, Stilling J · Frontiers in human neuroscience (2026)

Participants: N/A
Duration: 14 days
Intervention: Home-based anodal tDCS (2 mA, 20 min daily for 14 days) with anode over F3 (left DLPFC) and cathode over F4 (right DLPFC), concurrent with structured cognitive exercises
Outcome: Cognitive fatigue (FSS-7, MFIS), cognitive performance (SDMT, MoCA), mood, anxiety, quality of life
Effect Size: N/A (case report, no effect size reported)
Population: A single patient with refractory post-mTBI cognitive fatigue (more than a decade post-injury)

Result:

PubMed: 42602261DOI: 10.3389/fnhum.2026.1919849

Mechanism Graph

FDG-PET/MRI identified bilateral prefrontal hypometabolism (left > right) and parietal hypometabolism
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Left DLPFC selected as stimulation target based on hypometabolism
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Anodal tDCS applied to left DLPFC to modulate cortical excitability
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Result: Reduced cognitive fatigue and improved cognitive performance

Limitations

  • ⚠Single case report, no control group, limits generalizability
  • ⚠Concurrent use of methylphenidate and galcanezumab may confound results
  • ⚠No long-term follow-up reported
  • ⚠Potential placebo effects due to open-label design

Frequently Asked Questions

What is anodal tDCS and how is it applied?▼

Anodal tDCS is a non-invasive brain stimulation technique that applies a weak direct current to the scalp to increase cortical excitability. In this case, it was applied at 2 mA for 20 minutes daily for 14 days, with the anode over F3 (left DLPFC) and cathode over F4 (right DLPFC).

How was the stimulation target chosen?▼

The target (left DLPFC) was chosen based on FDG-PET/MRI findings showing bilateral prefrontal hypometabolism, with the left side more affected. This imaging-guided approach aimed to personalize neuromodulation.

What were the main outcomes?▼

Fatigue severity (FSS-7) improved from 5.4 to 3.7, exceeding the minimal clinically important difference. Cognitive performance improved on the Symbol Digit Modalities Test (46 to 58) and Montreal Cognitive Assessment (26 to 29). Mood, anxiety, and quality of life remained stable.

Are there any risks or side effects?▼

No serious adverse events were reported in this case. tDCS is generally considered safe, but common mild side effects may include tingling, itching, or headache at the stimulation site.

Products

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References

  1. 1.Glennon E, Yang Z, Stilling J. "Case Report: Anodal DLPFC-tDCS for refractory post-traumatic cognitive fatigue in the hypometabolic brain.." Frontiers in human neuroscience, 2026. PMID: 42602261 DOI: 10.3389/fnhum.2026.1919849
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.