EFFECT OF TDCS STIMULATION OF MOTOR CORTEX ON CHIKUNGUNYA FEVER: A RANDOMIZED CONTROLED TRIAL
Chronic pain. Arbovirus Infections. Chikungunya virus. Rehabilitation
The chikungunya virus could present a clinical characteristic of chronic pain associated with a functional deficit that can last up to 6 years. After 2014, chikungunya became a pandemic in South America, with more than 170,000 cases reported in the middle of the 2016. Most of these patients develop chronic arthralgia and low functionality. The transcranial direct current stimulation (tDCS) could be performed in several populations with chronic pain, improving quality of life and physical function. The objective of this study is to evaluate the effects of 10 sessions of tDCS on pain, functionality, quality of life and sleep in patients in chronic phase of chikungunya fever. A double-blind, randomized controlled trial will be conducted with active group or sham group of 20 patients each. Primary outcome will be pain assessed by VAS and the Brief Pain Inventory. As secondary outcomes we will use the SF-36 Quality of Life Questionnaire, Functional Capacity Assessment - HAQ, Productivity and Decreased Work Capacity by WPAI and Pittsburgh Sleep Quality Index. The study will be 5 phases: (1) initial evaluation; (2) application of 10 tDCS sessions; (3) re-evaluation on the last day of application of the tDCS; (4) first follow-up two weeks after the end of treatment; (5) second follow-up four weeks after the end of treatment. The active group will perform a 2 mA tDCS for 20 minutes with the anodal electrode over the primary motor area and the cathodal over the contralateral supra orbital area. A mixed ANOVA will be performed observing the interaction between the improvement of the data, time and groups. When possible the post-test of Bonferroni will be used, as well as the conventional ANOVA. Significance p level of ≤ 0.05% will be considered. It is expected that tDCS improves pain and functionality in chronic chikungunya patients.