Efeitos da estimulação transcraniana por corrente contínua de alta definição (HD-tDCS) na atividade muscular de membros superiores de pessoas com ela: protocolo de intervenção e relato de três casos

Abstract

INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS) is an acquired, neurodegenerative and disabling disease of the nervous system, causing motor and extra-motor symptoms. It is characterized by functional decline in those affected. In ALS, synaptic alterations occur that promote depolarization of the glutamate reuptake membrane. With HD-TDCS mounted in target areas, with the central electrode current being of the anodic type, it is believed that there is an increase in cortical excitability and synaptic efficiency The aim of this study was to evaluate the acute effects of a HD- TDCS protocol on upper limb muscle activity, fatigue and pain in people with ALS. METHODOLOGY: This is an intervention protocol. Participants underwent five consecutive days of intervention with HD-tDCS (3mA, 20 minutes), associated with some functional exercises, carried out at home and by a trained researcher. In addition, three assessments were carried out, one before the intervention (PRE), another one week after the interventions (POS1) and a third one two weeks after the intervention (POS2). Recruitment was carried out at the HUOL Neuromuscular Diseases Outpatient Clinic and included people diagnosed with ALS according to the revised El Escorial criteria, aged between 18 and 80, both sexes, cognitive level greater than 15 points on the ALS Cognitive Behavioral Screen scale and absence of musculoskeletal disorders capable of interfering with the performance of motor tasks, based on verbal commands. Results: It was found that in the tasks of opening a bottle, drinking water and performing the “ok” gesture, most of the characteristics of the analyzed muscle activation signals (anterior deltoid and biceps brachii) were higher in POS2 compared to PRE and POS1. DISCUSSION: Changes were found in the electromyographic signals after the intervention was applied, indicating that the protocol provides promising preliminary results for the use of HD-tDCS in ALS. CONCLUSION: It is therefore important to carry out further studies in order to obtain results that can be applied clinically and incorporate this intervention into the treatment of people with ALS