Segurança e tolerabilidade da estimulação transcraniana por corrente contínua anódica em crianças e adolescentes com paralisia cerebral

Palavras-chave: Crianças, Estimulação transcraniana por corrente contínua, Paralisia cerebral, Tolerabilidade

Resumo

O foco deste estudo é investigar a segurança e tolerabilidade da ETCC anódica em crianças e adolescentes com paralisia cerebral (PC). Participaram desse estudo dez crianças e adolescentes com PC do tipo hemiplégica e diplégica, com idade entre oito e 17 anos (média = 11,40, dp = 2,83). Os sujeitos participaram de cinco sessões de ETCC anódica no córtex parietal posterior (CPP) direito, com o cátodo posicionado no músculo deltoide esquerdo. Após cada sessão de estimulação foi aplicado um questionário padronizado para avaliação de efeitos adversos. Os resultados revelaram os seguintes efeitos adversos: as taxas de prurido (62%), sensação de queimação (16%) e formigamento (23%). A maior parte dos efeitos foi classificada como de intensidade leve pelos participantes, demonstrando a alta tolerabilidade e segurança da ETCC em crianças e adolescentes com PC.

Biografia do Autor

Thiago da Silva Gusmão Cardoso, Centro Universitário Adventista de São Paulo
Doutor em Ciências pela UNIFESP. Docente permanente do Mestrado Profissional em Promoção da Saúde do Centro Universitário Adventista de São Paulo, São Paulo (SP), Brasil.
Mauro Muszkat, Universidade Federal de São Paulo - UNIFESP
Docente permanente do Programa de Pós-graduação em Educação e Saúde na Infância e Adolescência da Universidade Federal de São Paulo, Guarulhos (SP), Brasil.

Referências

te Velde A, Morgan C, Novak I, Tantsis E, Badawi N. Early Diagnosis and Classification of Cerebral Palsy: An Historical Perspective and Barriers to an Early Diagnosis. J Clin Med. 2019; 8(10):1599. doi:10.3390/jcm8101599

Michael-Asalu A, Taylor G, Campbell H, Lelea LL, Kirby RS, Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update. Advances in Pediatrics. 2019; 66: 189-208. https://doi.org/10.1016/j.yapd.2019.04.002.

Hiratuka E, Matsukura, TS, Pfeifer LI. Cross-cultural adaptation of the Gross Motor Function Classification System into Brazilian-Portuguese (GMFCS). Rev. Bras. Fisioter. 2010; 14: 537-44. http://dx.doi.org/10.1590/S1413-35552010000600013

Stadskleiv, K. Cognitive functioning in children with cerebral palsy. Dev Med Child Neurol. 2020; 62: 283-289. doi:10.1111/dmcn.14463

Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul. 2012; 5:175-95. doi: 10.1016/j.brs.2011.03.002.

Kessler SK, Minhas P, Woods AJ, Rosen A, Gorman C, Bikson M. Dosage considerations for transcranial direct current stimulation in children: a computational modeling study. PLoS One. 2013; 8: e76112. doi: 10.1371/journal.pone.0076112.

Krause B, Cohen-Kadosh R. Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for cognitive training. Developmental Cognitive Neuroscience. 2013; 6: 176–194. doi: 10.1016/j.dcn.2013.04.001

Grecco LA, Duarte NA, Zanon N, Galli M, Fregni F, Oliveira CS. Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Braz J Phys Ther. 2014; 18: 419-27. doi: 10.1589/jpts.26.945.

Grecco LAC, Mendonça ME, Duarte NA, Zanon N, Fregni F, Oliveira CS. Transcranial direct current stimulation combined with treadmill gait training in delayed neuro- psychomotor development. J Phys Ther Sci. 2014; 26: 945.

Duarte NDAC, Grecco LAC, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLos One. 2014; 9: e105777. doi: 10.1371/journal.pone.0105777.

Grecco LAC, Duarte NDAC, Mendonça ME, Galli M, Fregni F, Oliveira CS. Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: A pilot, randomized, controlled, double-blind, clinical trial. Clinical rehabilitation. 2015; 29:1212-23. doi: 10.1177/0269215514566997

Moura RCF, Santos CA, Grecco LAC, Lazzari RD, Dumont AJL, Duarte NCDEA, Oliveira CS. Transcranial direct current stimulation combined with upper limb functional training in children with spastic, hemiparetic cerebral palsy: study protocol for a randomized controlled trial. Trials. 2016; 17:405. doi: 10.1186/s13063-016-1534-7.

Moura RCF, Santos C, Grecco LAC, Albertini G, Cimolin V, Galli M., Oliveira C. Effects of a single session of transcranial direct current stimulation on upper limb movements in children with cerebral palsy: A randomized, sham-controlled study. Dev Neurorehabil. 2017; 20: 368-375. doi: 10.1080/17518423.2017.1282050.

Lazzari RD, Politti F, Belina SF, Grecco LAC, Santos CA, Dumont AJL, Lopes JBP, Cimolin V, Galli M, Oliveira CS. Effect of Transcranial Direct Current Stimulation Combined With Virtual Reality Training on Balance in Children With Cerebral Palsy: A Randomized, Controlled, Double-Blind, Clinical Trial. J Mot Behav. 2017; 49: 329-336. doi: 10.1080/00222895.2016.1204266.

Grecco LAC, Oliveira CS, Duarte RAC, Lima VLC, Zanon N, Fregni F. Cerebellar transcranial direct current stimulation in children with ataxic cerebral palsy: A sham-controlled, crossover, pilot study, Developmental Neurorehabilitation. 2017; 20:3, 142-148. doi: 10.3109/17518423.2016.1139639

Novak I, Mcintyre S, Morgan C, Campbell L, Dark L, Morton N, et al. A systematic review of interventions for children with cerebral palsy: state of evidence. Dev Med Child Neurol. 2013; 55: 885-910. doi: 10.1111/dmcn.12246.

Wilson AJ, Dehaene S, Pinel P, Revkin SK, Cohen L, Cohen D. Principles underlying the design of "The Number Race", an adaptive computer game for remediation of dyscalculia. Behavioral and Brain Functions. 2006; 2: 19-10. doi: 10.1186/1744-9081-2-19

Duprat ML. Escala Wechsler de Inteligência para Crianças: Wisc IV. Manual Técnico/ David Wechsler. São Paulo: Casa do Psicólogo; 2013.

Brunoni AR, Amadera J, Berbel B, Et al. A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. Int J Neuropsychopharmacol. 2011; 14: 1133-1145. doi: 10.1017/S1461145710001690

Muszkat M, Cardoso TSG. Neurodesenvolvimento: conceitos e modularidade. In: Muszkat M, Grecco LAC. Estimulação cerebral não invasiva nos transtornos do neurodesenvolvimento. Curitiba: CRV; 2017.

Cohen-Kadosh R, Bien N, Sack AT. Automatic and intentional number processing both rely on intact right parietal cortex: a combined FMRI and neuronavigated TMS study. Front. Hum. Neurosci. 2012; 6:2. doi: 10.3389/fnhum.2012.00002.

Wang L, Uhrig L, Jarraya UB, Dehaene S. Representation of numerical and sequential patterns in macaque and human brains. Curr. Biol. 2015; 25: 1966-1974 doi:10.1016/j.cub.2015.06.035

Moliadze V, Antal A, Paulus W. Electrode-distance dependent after-effects of transcranial direct and random noise stimulation with extracephalic reference electrodes. Clinical Neurophysiology. 2010; 121: 2165-2171. doi: 10.1016/j.clinph.2010.04.033.

Amatachaya A, Jensen MP, Patjanasoontorn N, et al. The short-term effects of transcranial direct current stimulation on electroencephalography in children with autism: a randomized crossover controlled trial. Behav Neurol. 2015; 2015: 928631. doi: 10.1155/2015/928631.

Bandeira ID, Guimarães RS, Jagersbacher JG, Barretto TL, De Jesus-Silva JR, Santos SN, Argollo N, Lucena R. Transcranial direct current stimulation in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a pilot study. J Child Neurol., 2016; 31:918-24. doi: 10.1177/0883073816630083.

Reiner PB. Comment on ‘‘Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for cognitive training’’ by Krause and CohenKadosh. Dev Cogn Neurosci. 2013; 6:195–196. Doi: 10.1016/j.dcn.2013.05.002

Andrade AC, Magnavita GM, Allegro JV, Neto CE, Lucena Rde C, Fregni F. Feasibility of transcranial direct current stimulation use in children aged 5–12 years. J Child Neurol. 2014; 29:1360–1365. doi: 10.1177/0883073813503710.

Krishnan C, Santos L, Peterson MD, Ehinger M. Safety of noninvasive brain stimulation in children and adolescents. Brain Stimul. 2015; 8:76–87. doi: 10.1016/j.brs.2014.10.012

Moliadze V, Andreas S, Lyzhko E, Schmanke T, Gurashvili T, Freitag CM, Siniatchkin M. Ten minutes of 1 mA transcranial direct current stimulation was well tolerated by children and adolescents: self-reports and resting state EEG analysis. Brain Res Bull. 2015; 119: 25–33. doi: 10.1016/j.brainresbull.2015.09.011.

Palm U, Segmiller FM, Epple AN, Freisleder FJ, Koutsouleris N, Schulte-Körne G, et al. Transcranial direct current stimulation in children and adolescents: a comprehensive review. J. Neural Transm. 2016; 123: 1219–1234. doi: 10.1007/s00702-016-1572-z

Publicado
2021-02-26
Seção
Artigos Originais