Banca de DEFESA: CARLA DANIELE FERREIRA DANTAS
Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.STUDENT : CARLA DANIELE FERREIRA DANTAS
DATE: 15/12/2022
TIME: 14:00
LOCAL: Videoconferência
TITLE:
TRANSCRANIAL DIRECT CURRENT STIMULATION OVER THE DORSOLATERAL PREFRONTAL CORTEX IMPROVES PAIN AND MOOD STATE IN END STAGE RENAL DISEASE: A RANDOMIZED CONTROLLED TRIAL
KEY WORDS:
Transcranial direct current stimulation, hemodialysis, dorsolateral prefrontal cortex, chronic pain, depression, anxiety.
PAGES: 55
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:
Introduction: Chronic kidney disease (CKD) is an important public health problem worldwide with a significant increase each year and an estimated prevalence of 10% of the world population. Patients in end-stage renal disease (ESRD) on hemodialysis have a high prevalence of moderate to severe chronic pain, with an estimate of 50 to 80%. Chronic pain in ESRD is undertreated and neglected clinical condition, negatively interfering in quality of life, mood and functionality. Complementary techniques for pain control are suggested for this population and non-invasive stimulation can be an advantageous resource. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique applied through electrodes attached to the scalp in specific areas according to the objective to be achieved. tDCS is recommended for the adjuvant treatment of physical and behavioral disorders, reducing depressive symptoms, anxiety and pain. Objectives: The study aims to evaluate the effect of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) on pain (primary outcome), anxiety and depression in patients in ESRD undergoing hemodialysis. Material and methods: A double-blind, parallel, randomized and sham-controlled clinical trial was conducted at the Santa Rita Nephrology Center in Santa Cruz, Rio Grande do Norte. Ten non-consecutive tDCS sessions were performed with 2mA for 20 min and F3/Sp2 montage (anodal electrode on the left DLPFC and cathode over the contralateral supraorbital area). Pain (Visual Analog Scale – VAS) was assessed at baseline, on the first and tenth day of tDCS and at the 7-day follow-up. Anxiety (Hamilton Anxiety Scale) and depression (Beck Depression Inventory) were assessed at baseline and after the intervention. ANOVA showed a significant interaction between group and time on pain, F(3.54) = 10.220, p = 0.0005, partial η2 = 0.362. It was also possible to observe the interaction of time, F(3.54) = 34.787, p = 0.0005, partial η2 = 0.659. The ANCOVA showed a significant difference between groups for anxiety, F(1, 17) = 5.915, p < 0.02, partial η2 = 0.258 and a tendency for depression F(1, 17) = 4.426, p = 0.05, partial η2 = 0.207. Conclusion: It is suggested that anodal tDCS over the DLPFC could improve pain and mood in ESRD. This novel approach brings new perspectives for the adjuvant treatment of pain and mood disturbance in ESRD. Future studies are suggested to assess the long-term effects in this population.
COMMITTEE MEMBERS:
Presidente - 2646619 - RODRIGO PEGADO DE ABREU FREITAS
Interna - 1140906 - GERMANNA DE MEDEIROS BARBOSA
Externo à Instituição - ALEXANDRE HIDEKI OKANO - UFABC