Acute and Short-Term Autonomic and Hemodynamic Responses to Transcranial Direct Current Stimulation in Patients With Resistant Hypertension

Abstract

Previously, we demonstrated that acute transcranial direct current stimulation (tDCS) reduced blood pressure (BP) and improved autonomic modulation in hypertensives. We hypothesized that acute and short-term tDCS intervention can promote similar benefits in resistant hypertensive patients (RHT). We assessed the impact of one (acute intervention) and ten (short-term intervention) tDCS or SHAM (20 min, each) sessions on BP, pulse interval (PI) and systolic blood pressure variabilities, humoral mechanisms associated with BP regulation, and cytokines levels. True RHT subjects (n = 13) were randomly submitted to one and ten SHAM and tDCS crossing sessions (1 week of “washout”). Hemodynamic (Finometer®, Beatscope), office BP, and autonomic variables (accessed through spectral analysis of the pulse-to-pulse BP signal, in the time and frequency domain – Fast Fourrier Transform) were measured at baseline and after the short-term intervention. 24 h-ambulatory BP monitoring was measured after acute and short-term protocols. Acute intervention: tDCS reduced BP, cardiac output, and increase high-frequency band of PI (vagal modulation to the heart). Short-term protocol: tDCS did not change BP and cardiac output parameters. In contrast, central systolic BP (−12%), augmentation index (−31%), and pulse wave velocity (34%) were decreased by the short-term tDCS when compared to SHAM. These positive results were accompanied by a reduction in the low-frequency band (−37%) and an increase of the high-frequency band of PI (+62%) compared to SHAM. These findings collectively indicate that short-term tDCS concomitantly improves resting cardiac autonomic control and pulse wave behavior and reduces central BP in RHT patients, https://ensaiosclinicos.gov.br/rg/RBR-8n7c9p.

The Effect of Transcutaneous Electrical Nerve Stimulation in Peripheral and Central Hemodynamic Parameters on Resistant Hypertension: A Case Report

“… 10 Recently, a Brazilian group demonstrated that the acute transcranial direct current stimulation (tDCS), a noninvasive procedure, decreased central and peripheral hemodynamic parameters and improved autonomic modulation in individuals with RH. 30 Apparently, both methods (TENS and tDCS) present the same pathophysiological basis for reducing the central and peripheral BP, possibly mediated by autonomic modulation.…”

When blood pressure refuses to budge: exploring the complexity of resistant hypertension

“…Therefore, there may be broader benefits associated with using tCDS extending to treating refractory hypertension. The initial investigation on the effects of tDCS on systemic blood pressure revealed a significant reduction as measured by 24 h ABPM, potentially mediated by cardiovascular autonomic balance ( 171 ). While it has shown promise in treating various neurological conditions like depression and chronic pain, its efficacy in addressing hypertension requires further study.…”

Estimulação Transcraniana por Corrente Contínua no Tratamento da Hipertensão: Uma Hipótese Plausível?

“…No entanto, nada sugeriu mudanças significativas nos valores de variabilidade. Um terceiro estudo de Rodrigues et al 15 envolveu 13 participantes com HAS resistente. Com um intervalo de pouco menos de 1 mês, avaliou uma intervenção aguda e uma intervenção de curto prazo.…”

“…A third study by Rodrigues et al 15 involved 13 participants with resistant arterial HTN. At an interval of just under 1 month, it evaluated an acute intervention and a short-term intervention.…”