EVALUATION OF HEMODYNAMICS AND SAFETY OF TRANSCRANIAL DIRECT CURRENT STIMULATION DURING HEMODIALYSIS: A RANDOMIZED CLINICAL TRIAL
Motor Cortex, Chronic Renal Insufficiency, Rehabilitation.
Introduction: Patients with end-stage renal disease are often exposed to an exhausting routine of hemodialysis far from their homes, dietary restrictions, water intake limitations, and polypharmacy. Safe and non-pharmacological approaches, such as transcranial direct current stimulation (tDCS), may be associated with conventional treatment with the aim of improving physical and behavioral symptoms. However, the safety of its application needs to be established for routine clinical use. Objective: This study aims to assess the effects of tDCS on blood pressure and heart rate in patients with end-stage renal disease undergoing hemodialysis. We also aim to evaluate any adverse effects and side effects during and after tDCS use. Method: This is a parallel, double-blind, randomized, placebo-controlled trial that included hemodialysis patients. The patients received ten non-consecutive sessions of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1-SO montage). At the beginning of the study and after each of the ten sessions, blood pressure and heart rate, as well as potential adverse effects, were measured during the four hours of hemodialysis. Results: tDCS did not alter the mean blood pressure, systolic and diastolic blood pressure, or heart rate of end-stage renal disease patients undergoing hemodialysis. No side effects occurred, and the reported adverse effects were consistent with those described in the literature (tingling sensation, itching at the electrode site). Conclusion: There were no differences between the groups in the studied variables, suggesting that the application of tDCS during hemodialysis may be safe and feasible.