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Estimulação transcraniana por corrente contínua no tratamento da fibromialgia
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Abstract(s)
A fibromialgia é uma doença caracterizada por alterações na atividade cerebral implicando um aumento da perceção da dor e défices cognitivos. Recentemente tem sido sugerido na literatura que a Estimulação Transcraniana por Corrente Contínua (ETCC), uma técnica que permite a modulação da excitabilidade cortical, desencadeia melhorias na sintomatologia característica na fibromialgia. O objetivo do presente ensaio clínico é avaliar a eficácia da ETCC no tratamento da fibromialgia, nomeadamente: na diminuição da intensidade da dor; diminuição da sintomatologia depressiva; diminuição da sintomatologia de ansiedade; melhoria da qualidade de vida; e diminuição das alterações cognitivas associadas. Vinte e cinco participantes foram aleatorizadas por três grupos de modo a receberem estimulação anódica no córtex pré-frontal dorsolateral, no córtex motor primário ou estimulação sham. Cada participante realizou 10 sessões de ETCC, cada sessão com a duração de 20 minutos. Os grupos experimentais receberam uma corrente contínua de 2mA e o grupo sham arrecebeu uma corrente contínua de 2mA nos 50 segundos iniciais e não recebeu qualquer estimulação no tempo restante. Um avaliador cego realizou avaliação neuropsicológica em dois pontos no tempo, antes e após as 10 sessões de ETCC, em que foram medidas: a sintomatologia depressiva; sintomatologia de ansiedade; a qualidade de vida; e medidas cognitivas (atenção, memória de trabalho e funções executivas). Em todos os grupos verificou-se: diminuição da intensidade da dor, diminuição da sintomatologia depressiva; diminuição da sintomatologia de ansiedade, aumento da qualidade de vida; melhoria da atenção; maior velocidade de processamento; e aumento da flexibilidade cognitiva ao longo do tempo. Contudo, verificou-se que a estimulação anódica no córtex motor primário ou no córtex pré-frontal dorsolateral não desencadeou uma melhoria estatisticamente significativa relativamente à estimulação sham. Verificou-se a presença de efeitos secundários ligeiros e benignos, com a duração máxima de poucos minutos após o término de cada sessão de ETCC. Concluindo, os resultados sugerem que a ETCC não é eficaz no tratamento da fibromialgia. Na ausência de efeitos secundários graves e na presença de melhorias em várias das variáveis medidas ao longo do tempo, sugere-se que se aprofunde o estudo da ETCC na fibromialgia de modo a ultrapassar as limitações do presente ensaio clínico.
Fibromyalgia is a disease characterized by changes in brain activity, resulting in increased pain perception and cognitive deficits. Recently the scientific literature suggests that Transcranial Direct Current Stimulation (tDCS), a technique that allows the modulation of cortical excitability, triggers improvements in the characteristic symptoms of fibromyalgia. The objective of the present clinical trial is to evaluate the efficacy of tDCS in the treatment of fibromyalgia, namely: in decreasing the intensity of pain, decreasing depressive symptoms, decreasing anxiety symptoms; improving the quality of life and; decreasing cognitive changes associated. Twenty-five participants were randomized by three groups to receive anodic stimulation in the dorsolateral prefrontal cortex, in the primary motor cortex or sham stimulation. Each participant performed 10 tDCS sessions, each session lasting 20 minutes. The experimental groups received a direct current of 2mA and the sham group received an direct current of 2mA in the initial 50 seconds and received no stimulation in the remaining time. A blinded evaluator performed a neuropsychological assessment at two points in time, before and after the 10 sessions of ETCC, in which the following symptoms were measured: depressive symptoms; anxiety symptoms; the quality of life; and cognitive measures (attention, working memory and executive functions). In all groups, there was: decreased pain intensity, decreased depressive symptoms; decreased anxiety symptoms, increased quality of life; improved attention; higher processing speed; and increased cognitive flexibility over time. However, it was found that anodic stimulation in the primary motor cortex or in the dorsolateral prefrontal cortex did not trigger a statistically significant improvement over sham stimulation. There were mild and benign side effects, with a maximum duration of a few minutes after the end of each ETCC session. Concluding, the results suggest that tDCS did not show efficacy in the treatment of fibromyalgia. In the absence of serious side effects and in the presence of improvements in several of the variables measured over time, it is suggested that the study of ETCC in fibromyalgia be further investigated in order to overcome the limitations of the present clinical trial
Fibromyalgia is a disease characterized by changes in brain activity, resulting in increased pain perception and cognitive deficits. Recently the scientific literature suggests that Transcranial Direct Current Stimulation (tDCS), a technique that allows the modulation of cortical excitability, triggers improvements in the characteristic symptoms of fibromyalgia. The objective of the present clinical trial is to evaluate the efficacy of tDCS in the treatment of fibromyalgia, namely: in decreasing the intensity of pain, decreasing depressive symptoms, decreasing anxiety symptoms; improving the quality of life and; decreasing cognitive changes associated. Twenty-five participants were randomized by three groups to receive anodic stimulation in the dorsolateral prefrontal cortex, in the primary motor cortex or sham stimulation. Each participant performed 10 tDCS sessions, each session lasting 20 minutes. The experimental groups received a direct current of 2mA and the sham group received an direct current of 2mA in the initial 50 seconds and received no stimulation in the remaining time. A blinded evaluator performed a neuropsychological assessment at two points in time, before and after the 10 sessions of ETCC, in which the following symptoms were measured: depressive symptoms; anxiety symptoms; the quality of life; and cognitive measures (attention, working memory and executive functions). In all groups, there was: decreased pain intensity, decreased depressive symptoms; decreased anxiety symptoms, increased quality of life; improved attention; higher processing speed; and increased cognitive flexibility over time. However, it was found that anodic stimulation in the primary motor cortex or in the dorsolateral prefrontal cortex did not trigger a statistically significant improvement over sham stimulation. There were mild and benign side effects, with a maximum duration of a few minutes after the end of each ETCC session. Concluding, the results suggest that tDCS did not show efficacy in the treatment of fibromyalgia. In the absence of serious side effects and in the presence of improvements in several of the variables measured over time, it is suggested that the study of ETCC in fibromyalgia be further investigated in order to overcome the limitations of the present clinical trial
Description
Keywords
Fibromialgia Dor Ansiedade Depressão Cognição Estimulação Trancraniana por corrente contínua (etcc)