Objective To investigate the neuromodulating effect of Transcranial Direct Current Stimulation (tDCS) on Neuropathic Pain (NP). Method A systematic review of articles published in the past five years in MEDLINE, LILACS, Cochrane, Scopus, ScienceDirect, and PEDro. The search was carried out from February to May 2017 using the keywords: neuropathic pain, neuralgia, nerve pain, central pain, peripheral nerve pain, tDCS. The selected studies were full articles written in Portuguese, English, or Spanish with at least one control group, and no less than one pre- or post-intervention variable, with the exclusion of case studies or case series, animal model studies, and studies with combined therapy. The quality of the selected articles was evaluated through PEDro scale, whereas the level of agreement among reviewers was measured with the Cohen's κ test, considering P < 0.05 to be significant. Results Eight articles were selected (PEDro: 8.5 ± 0.6; Cohen's κ test: 0.703, P < 0.01), six of which were randomized controlled trials and two were controlled clinical trials. The following causes of NP were observed: spinal cord injury (SCI), amputation, stroke, multiple sclerosis (MS), and radiculopathy. All of the studies showed significant effects of tDCS on NP when compared to the control group, except for one with SCI and another related to radiculopathy. Discussion The shortage of good quality articles, the varying of ramp-on and ramp-off durations, and number of sessions, as well as the diversity of results found did not allow any definite conclusion on the efficacy of the neuromodulating effect of tDCS on NP.

Background and aim: Environmental enrichment (EE) can be related to changes in the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus of adult rodents. Exposure to EE may also induce neurogenesis in the dentate gyrus (DG). The aim of this systematic review was to analyze the current literature on the correlation between neurogenesis and BDNF expression in the hippocampal DG region resulting from exposure to EE, which is associated with changes in memory, in rodents. Methods:Bibliographic searches of the Medline/PubMed and ScienceDirect databases were carried out, and 334 studies were found. A predefined protocol was used and registered on PROSPERO, and 32 studies were included for qualitative synthesis. The PRISMA was used to report this systematic review. Results: Most of the included studies showed that there is little evidence in the literature demonstrating that memory changes resulting from EE are dependent on BDNF expression and that there is an induction of neurogenesis in the hippocampal DG. However, the observed increase in molecular expression levels and cell proliferation is dependent on the age, the timing and duration of exposure to EE. Regarding the methodological quality of the studies, the majority presented a risk of bias due to the high variability in the age of the animals. Conclusion: There are few studies in the literature that correlate the molecular and cellular mechanisms involved in neurogenesis in the hippocampal DG with BDNF expression in this region in rodents exposed to EE; however, there are other factors that can modulate this neurogenesis. K E Y W O R D Senvironmental enrichment, hippocampus, memory, neurogenesis

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ABSTRACT Background: Individuals with migraine usually complain about lower memory performance. Diagnostic methods such as neuroimaging may help in the understanding of possible morphologic and functional changes related to the memory of those individuals. Therefore, the aim of this review is to analyze the available literature on neuroimaging changes related to memory processing in migraine. Methods: We searched the following databases: Pubmed/Medline, Psycinfo, Science Direct, Cochrane and Web of Science. We used articles without restriction of year of publication. The combination of descriptors used for this systematic review of literature were Neuroimaging OR Imaging OR Brain AND Migraine OR Chronic Migraine AND Memory. Results: Of the 306 articles found, nine were selected and all used magnetic resonance imaging (MRI). The studies used structural and functional MRI techniques with a predominance of 3 Tesla equipment and T1-weighted images. According to the results obtained reported by these studies, migraine would alter the activity of memory-related structures, such as the hippocampus, insula and frontal, parietal and temporal cortices, thereby suggesting a possible mechanism by which migraine would influence memory, especially in relation to the memory of pain. Conclusions: Migraine is associated to global dysfunction of multisensory integration and memory processing. This condition changes the activity of structures in various regions related to memory of pain, prospective memory, as well as in short- and long-term verbal and visuospatial memories. However, it is necessary to perform studies with larger samples in association with cognitive tests, and without the interference of medications to verify possible alterations and to draw more concrete conclusions.

Objetivo: Investigar os efeitos do treinamento cognitivo associado ao exercício físico no desempenho cognitivo de idosos com Doença de Alzheimer (Dos Santos Picanco et al.). Metodologia: Foi realizada uma revisão sistemática com metanálise de ensaios clínicos controlados e cross-over. A busca na literatura foi realizada nas bases de dados Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL e Web of Science, utilizando os descritores MeSH / DeCS. O risco de viés foi avaliado de acordo com as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e a metanálise foi realizada com o software RevMan 5.3. Resultados: Dos 1126 artigos obtidos na busca, nove foram escolhidos para a síntese qualitativa e dois para a metanálise. Os dados da metanálise mostraram diferenças significativas no tamanho do efeito para as funções executivas e atenção avaliadas pelo Teste do Desenho do Relógio (Z = 3,05; p = 0,002) e funções cognitivas frontais avaliadas pela Bateria de Avaliação Frontal (Z = 3,56; p = 0,0004). Na análise qualitativa, sete estudos demonstraram efeitos positivos do treinamento cognitivo associado ao exercício físico na manutenção e melhora das funções cognitivas de idosos com DA. Conclusão: Apesar das limitações encontradas nos estudos disponíveis sobre o tema, pode-se sugerir que o treinamento cognitivo associado ao exercício físico apresenta benefícios no desempenho cognitivo de idosos com DA. No entanto, a escassez de estudos desenvolvidos com melhor rigor metodológico limita generalizações desses resultados.

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Objective: To characterize rest-activity rhythm in chronic migraine (CM) and to investigate the relationship between this rhythm and depressive and anxiety symptoms in patients with CM. Methods: This was a study of adults aged 20 to 40 years. The rest-activity rhythm of patients with CM (n=23) and non-headache controls (NH, n=23) was assessed by actigraphy for 15 days, and they completed the following assessments: Visual Analogue Scale for pain intensity; Headache Diary; Headache Impact Test-6; Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Beck Depression Inventory; and State-Trait Anxiety Inventory. Results: Patients with CM showed less activity over 24 hours and more fragmented sleep. Reduced interdaily stability of the rest-activity rhythm was observed, with less robustness of this rhythm in the CM group. Multiple linear regressions revealed a significant association between the rest-activity rhythm and trait anxiety variables in patients with CM, specifically regarding the relative amplitude of the cycle, activity throughout 24 hours and during sleep, and robustness of the rest-activity rhythm. Conclusions: Our findings provide evidence that the robustness of the rest-activity rhythm, activity throughout 24 hours, and sleep fragmentation are associated with trait anxiety in patients with CM. Clinical trial registration: Brazilian Clinical Trials Registry (registration number: RBR-4M5J4S).

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