Transcranial direct current stimulation for fatigue in patients with Sjogren’s syndrome: A randomized, double-blind pilot study

Pinto, Ana Carolina Pereira Nunes; Piva, Sara R.; Vieira, Aléxia Gabriela da Silva; Gomes, Samantha Guerra Cabó Nunes; Rocha, Aline Pereira da; Tavares, Daniela Regina Brandão; Santana, Márcia Valéria de Andrade; Carlesso, Cristiane; Andriolo, Adagmar; Santos, Fânia Cristina; Fregni, Felipe; Trevisani, Virgínia Fernandes Moça

doi:10.1016/j.brs.2020.12.004

Cited by 18 publications

(17 citation statements)

References 51 publications

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“…Exercise and neuromodulation techniques have shown positive effects on fatigue in pSS (41,43,45). Nonpharmacological studies represent a great potential in the management of fatigue in general.…”

Section: Discussionmentioning

confidence: 99%

“…Based on this hypothesis, and the evidence that increased cortical excitability by anodal cortex stimulation is capable of modulating the HPA axis activity, a Brazilian double-blind pilot study randomized 36 female pSS patients to receive transcranial direct-current stimulation (tDCS). The tDCS improved fatigue (ESSPRI and FSS) and seemed to promote greater improvements in mental (ProF-M) than somatic fatigue (ProF-S) (45).…”

Section: Non-pharmacological Treatmentmentioning

confidence: 93%

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Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

et al. 2021

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Sjögren’s syndrome (SS) is an autoimmune disease affecting the salivary and lacrimal glands. Symptoms range from dryness to severe extra-glandular disease involving manifestations in the skin, lungs, nervous system, and kidney. Fatigue occurs in 70% of patients, characterizing primary SS (pSS) and significantly impacting the patient’s quality of life. There are some generic and specific instruments used to measure fatigue in SS. The mechanisms involved with fatigue in SS are still poorly understood, but it appears fatigue signaling pathways are more associated with cell protection and defense than with pro-inflammatory pathways. There are no established pharmacological treatment options for fatigue in pSS. So far, exercise and neuromodulation techniques have shown positive effects on fatigue in pSS. This study briefly reviews fatigue in pSS, with special attention to outcome measures, biomarkers, and possible treatment options.

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Section: Discussionmentioning

confidence: 99%

Section: Non-pharmacological Treatmentmentioning

confidence: 93%

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

et al. 2021

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“…Beyond the effects on pain, a significant amount of evidence demonstrates improvements in physical function, mood and health-related quality of life [40,41]. Concerning SARDs, one recent study showed notable improvements in fatigue related to primary Sjögren's syndrome [42],…”

Section: Discussionmentioning

confidence: 99%

“…with no adverse effects related to tDCS and the disease status parameters. This result suggests tDCS is a potentially safe and efficient way to improve fatigue in patients with Sjögren's syndrome [42]. However, the authors applied tDCS with no other concomitant interventions [42].…”

Section: Discussionmentioning

confidence: 99%

“…Transcranial direct current electrical stimulation (tDCS) is a noninvasive brain stimulation technique that has shown promising results on pain modulation, fatigue reduction, and improvement in functional capacity in patients with regional complex pain [12,13], refractory myofascial syndrome, chronic fatigue [15], and fibromyalgia [12]. Recently, Pinto et al [14] showed that tDCS was largely effective in decreasing fatigue in patients with Sjögren's syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Transcranial direct current electrical stimulation in combination with aerobic exercise is effective in reducing fatigue and pain in post-COVID-19 systemic autoimmune rheumatic patients

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Santos

Borges

et al. 2021

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Objectives: Currently, no studies have assessed the efficacy of transcranial direct current stimulation (tDCS) to treat fatigue and pain associated with or potentiated by post-COVID-19 syndrome in patients with systemic autoimmune rheumatic diseases (SARDs). Methods: This study included nine patients with different types of SARDs. All patients had previously confirmed RT-PCR test for COVID-19 as well as significant, persistent fatigue and pain that began to worsen after infection. Anodal tDCS was administered in five daily sessions (2mA, 20 minutes) over the C3 or C4 10/20 EEG positions, with the cathode placed at Fp1 or Fp2. Concomitantly, patients were involved in an aerobic exercise program by treadmill walking. All participants were evaluated using specific questionnaires and strength assessment by handgrip and physical function by timed-up-and go test and sit-to-stand test at baseline (within one week before tDCS protocol), and one week after tDCS protocol. During all procedures, the patients’ treatments remained unchanged. Results: The sample was composed of eight women and one man with a mean age of 48.7±9.6. After the tDCS protocol, the pain and fatigue significantly improved by a visual analog scale (P<0.05). The physical function also improved 9.5±2.7 vs. 6.8±0.8 (P=0.001) for timed-up-go-test and 10.3±3.7 vs. 15.1±4.0 (P=0.037) for sit-to-stand test. No subject experienced adverse events. One-hundred percent of patients adhered to all protocols. Conclusions: The present study showed tDCS in combination with aerobic exercise was effective in improving the physical function, and reducing fatigue/pain in SARDs patients with post-COVID-19 syndrome.Clinical Trials: NCT04890483.

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The effects of resistance training in patients with primary Sjogren’s syndrome

et al. 2021

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Transcranial direct current stimulation for fatigue in patients with Sjogren’s syndrome: A randomized, double-blind pilot study

Cited by 18 publications

References 51 publications

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

Transcranial direct current electrical stimulation in combination with aerobic exercise is effective in reducing fatigue and pain in post-COVID-19 systemic autoimmune rheumatic patients

The effects of resistance training in patients with primary Sjogren’s syndrome

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