Avaliação da modulação autonômica de pacientes hemiparéticos após estimulação Trascraniana por Corrente Contínua (ETCC) e exercício em esteira - ensaio clínico, controlado, randomizado, duplo-cego

Abstract

Introduction: Studies have shown that the Transcranial Direct Current Stimulation (tDCS) may modulate the autonomic nervous system (ANS) in healthy individuals, but little is known about these effects in CVA. Objective: To evaluate the effect of tDCS on heart rate variability (HRV) and blood pressure variability (VPA) in patients with hemiparetic post-AVE applied before a session of physical activity on a treadmill. Methodology: Clinical, crossover, controlled (sham), randomized, double-blind trial with 12 adult hemiparetic individuals due to stroke. HRV and VPA were evaluated for 15 minutes, pre and post tDCS and post exercise interventions. Interventions were randomized with 48-hour intervals: 1 (active tDCS and treadmill) and 2 (tDCS sham and treadmill), lasting 40 minutes (20min tDCS plus 20min treadmill). The anodic tDCS was applied on left temporal cortex (T3) and cathodic on contralateral deltoid muscle, intensity of 2mA. Data analysis: The HRV evaluation was performed by recording the R-R interval (ms) with spectral analysis. The variances of the pulse interval (PI) were linearly evaluated in the time domain and frequency domain. Twelve patients were evaluated so far. The results was no variation of the systolic blood pressure (SBPV) and the heart rate variability (HRV) between the tDCS and tDCS groups in the variables Variance, RMSSD, absolute LF and absolute HF, both in the tDCS and post exercise, but in the HRV analysis the effects of tDCS between the moments of each group, some differences were advanced. Conclusion: The tDCS does not have significant effects on the HRV and SBPV, an exception in the parasympathetic modulation (RMSSD and IP band of IP), thus, the most current are the different methods of evaluating the cardiovascular effect.