Estimulação magnética transcraniana de baixa freqüência no tratamento da depressão

Abstract

ResumoEste artigo descreve aspectos neurofisiológicos e clínicos do uso da estimulação magnética transcraniana repetitiva (EMTr), especialmente a de baixa freqüência. Técnicas de neuroimagem e hipóteses sobre o funcionamento da EMTr em longo prazo são abordados. Alguns resultados de estudos que envolvem EMTr de baixa freqüência no tratamento da depressão são citados, especialmente um estudo realizado na Universidade de Brasília usando a aplicação da EMTr de baixa freqüência (0,5Hz), duas vezes por semana, durante quatro semanas, em dez pacientes. Neste estudo utilizando a escala de Hamilton de 17 itens, os pacientes foram analisados em três momentos: T-0, T-1 e T-2, respectivamente, início, meio e final das aplicações. Como resultado se observou um decréscimo significativo (p ≤ 0,01) nas suas pontuações, quando comparados os três momentos, utilizando-se o teste x 2 de Friedman. As possíveis vantagens desta técnica são discutidas.Palavras-chave: Estimulação magnética transcraniana, baixa freqüência, depressão. AbstractThis article describes neurophysiological and clinical aspects of repetitive transcranial magnetic stimulation (rTMS), especially low frequency rTMS. Neuroimaging techniques and hypothesis about long term actions of rTMS are discussed. Some results of low frequency rTMS on the treatment of depression are mentioned, especially one study in the University of Brasilia using low frequency rTMS twice a week, during 4 weeks in 10 patients. In this study, using the 17 item Hamilton scale, patients were scored at three different moments: T-0, T-1 and T-2, respectively, at the beginning, at the middle and at the end of the treatment. According to x 2 Friedman´s test there was a significant decrease (p ≤ 0,01) in depression scores. When the three moments were compared. Possible advantages of this technique are discussed.

Transcranial direct current stimulation in mild cognitive impairment: methodology for a randomized controlled trial

“…The effects of electric currents upon neuronal function have been studied for decades (Priori, 2003). More recently, after several reports of beneficial effects of TMS upon symptoms of many neuropsychiatric disorders, such as depression (Pascual-Leone et al, 1996;Boechat-Barros, 2004;Boechat-Barros & Brasil-Neto, 2004;Leo & Latif, 2007;O'Reardon et al, 2007;Brunoni et al, 2010b;Holtzheimer & Mayberg, 2012;Rothwell, 2012;Iannone et al, 2016) and chronic pain (Nguyen et al, 1999;Leo & Latif, 2007;Rosen et al, 2009;Galhardoni et al, 2015) and neuropathic pain (Brown & Barbaro, 2003;Fagundes-Pereyra et al, 2010;Nguyen et al, 2011;Nizard et al, 2012), transcranial direct current stimulation (tDCS) has also been the subject of many studies due to its ability to modulate cortical function in a non-invasive manner. For that reason, there is a great deal of interest in its potential applications in the fields of neurology and psychiatry (Alonzo et al, 2012;Demirtas-Tatlidede, VahabzadehHagh & Pascual-Leone, 2013;Elder & Taylor, 2014;Flöel, 2014;Kuo, Paulus & Nitsche, 2014;Dedoncker et al, 2016;Iannone et al, 2016).…”

Transcranial direct current stimulation in mild cognitive impairment: methodology for a randomized controlled trial

“…The effects of electric currents upon neuronal function have been studied for decades (Priori, 2003). More recently, after several reports of beneficial effects of TMS upon symptoms of many neuropsychiatric disorders, such as depression (Pascual-Leone et al, 1996;Boechat-Barros, 2004;Boechat-Barros & Brasil-Neto, 2004;Leo & Latif, 2007;O'Reardon et al, 2007;Brunoni et al, 2010b;Holtzheimer & Mayberg, 2012;Rothwell, 2012;Iannone et al, 2016) and chronic pain (Nguyen et al, 1999;Leo & Latif, 2007;Rosen et al, 2009;Galhardoni et al, 2015) and neuropathic pain (Brown & Barbaro, 2003;Fagundes-Pereyra et al, 2010;Nguyen et al, 2011;Nizard et al, 2012), transcranial direct current stimulation (tDCS) has also been the subject of many studies due to its ability to modulate cortical function in a non-invasive manner. For that reason, there is a great deal of interest in its potential applications in the fields of neurology and psychiatry (Alonzo et al, 2012;Demirtas-Tatlidede, Vahabzadeh-Hagh & Pascual-Leone, 2013;Elder & Taylor, 2014;Flöel, 2014;Kuo, Paulus & Nitsche, 2014;Dedoncker et al, 2016;Iannone et al, 2016).…”