Impact and safety of noninvasive cerebral neuromodulation in patients with systemic autoimmune diseases: double-blind, randomized, placebo-controlled study

• Grant number: 19/11776-6
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2020
• End date: June 30, 2022
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Samuel Katsuyuki Shinjo
• Grantee: Samuel Katsuyuki Shinjo
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Systemic autoimmune myopathies (SAMs) are rare rheumatic diseases characterized clinically by progressive, symmetrical and predominantly proximal muscle limb weakness. SAMs may also affect joints, lung, heart and gastrointestinal tract. Despite drug treatment and guidance on performing regular physical exercises, the high frequency of fatigue and chronic pain in these patients is remarkable. These factors, in turn, impair functional capacity and quality of life, generating a mechanism of vicious cycle between these parameters. Thus, it becomes relevant to establish therapeutic strategies that may result in a decrease and/or a break in this vicious cycle.Several studies have shown the efficacy of using transcranial non-invasive neuromodulation (e.g., transcranial electrical current stimulation - tDCS) in a several diseases to reduce fatigue, modulate and reduce pain, and consequent improvement of functional capacity and quality of life. However, to date, there are no studies evaluating the safety and benefit of tDCS in patients with stable MAS. In this context, our group initiated two studies, the preliminary results of which have shown that 3 sessions of the tDCS is safe, without leading to MAS relapses.The present project aims to perform a greater number of sessions of tDCS, associated to physical exercises, in patients with MAS and different disease activities. The effectiveness of the technique (local and diffuse pain, fatigue, overall functionality, mobility, balance, muscular strength, functional capacity and quality of life) will be evaluated. This combination of central and peripheral techniques may result in greater connectivity of the neural network, promoting additional effects on muscle excitability, thus contributing to decreased perceived pain and fatigue, resulting in greater muscle recruitment, improved strength, muscle function, mobility and balance. In summary, an improvement in functional capacity and quality of life in patients with MAS may indicate the use of these techniques for the clinical and rheumatologic practice.Moreover, as a relevant point, it is possible that this protocol could be extended to other systemic autoimmune diseases, aiming at the same benefits proposed in the present study. (AU)

Scientific publications

(15)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DOS SANTOS, ALEXANDRE MOURA; MISSE, RAFAEL GIOVANI; PIRES BORGES, ISABELA BRUNA; BUORO PERANDINI, LUIZ AUGUSTO; SHINJO, SAMUEL KATSUYUKI. Physical exercise for the management of systemic autoimmune myopathies: recent findings, and future perspectives. CURRENT OPINION IN RHEUMATOLOGY, v. 33, n. 6, p. 563-569, NOV 2021. (18/08735-3, 19/12155-5, 19/11367-9, 19/11776-6)

SHINJO, SAMUEL K.; DE SOUZA, FERNANDO H. C.; BORGES, ISABELA B. P.; DOS SANTOS, ALEXANDRE M.; MIOSSI, RENATA; MISSE, RAFAEL G.; MEDEIROS-RIBEIRO, ANA C.; SAAD, CARLA G. S.; YUKI, EMILY F. N.; PASOTO, SANDRA G.; et al. Systemic autoimmune myopathies: a prospective phase 4 controlled trial of an inactivated virus vaccine against SARS-CoV-2. RHEUMATOLOGY, v. N/A, p. 11-pg., 2021-10-19. (19/17272-0, 19/21211-6, 19/11776-6, 15/03756-4)

RAFAEL ALVES CORDEIRO; FRIDA MARINA FISCHER; SAMUEL KATSUYUKI SHINJO. Systemic autoimmune diseases and work outcomes in Brazil: a scoping review. Revista de Saúde Pública, v. 56, 2022-04-22. (19/11776-6)

FARIA, M. S. M. S.; SHINJO, S. K.. COVID-19 as potential aggravating factor for the natural course of new onset-dermatomyositis. REUMATISMO, v. 74, n. 1, p. 3-pg., 2022-01-01. (19/11776-6)

OLIVO PALLO, PABLO ARTURO; HOFF, LEONARDO SANTOS; PIRES BORGES, ISABELA BRUNA; TORRES-RUIZ, JIRAM; CASSIANO-QUEZADA, FABIOLA; GRANEL, AMELIA; GOMEZ, GRACIELA; PISONI, CECILIA; GOMEZ, RAMIRO; SHINJO, SAMUEL KATSUYUKI. Characterization of Patients With Dermatomyositis According to Anti-Melanoma Differentiation-Associated Gene-5 Autoantibodies in Centers from 3 Latin American Countries A Cohort Study. JCR-JOURNAL OF CLINICAL RHEUMATOLOGY, v. 28, n. 2, p. 5-pg., 2022-03-01. (19/11776-6, 19/11367-9)

MISSE, RAFAEL GIOVANI; BORGES, ISABELA BRUNA PIRES; DOS DANTOS, ALEXANDRE MOURA; GUPTA, LATIKA; SHINJO, SAMUEL KATSUYUKI. Effect of exercise training on fatigue and pain in patients with systemic autoimmune myopathies: A systematic review. AUTOIMMUNITY REVIEWS, v. 20, n. 10, OCT 2021. (19/11367-9, 18/08735-3, 19/12155-5, 19/11776-6)

DE SOUSA, L. F. ADSUARA; MISSE, R. G.; DOS SANTOS, L. DE MACEDO; BAPTISTA, A. FONTES; TANAKA, C.; GREVE, J. M. D'ANDREA; SHINJO, S. KATSUYUKI. TRANSCRANIAL ELECTRICAL STIMULATION IS SAFE AND EFFICIENT IN PATIENTS WITH SYSTEMIC AUTOIMMUNE MYOPATHIES. ANNALS OF THE RHEUMATIC DISEASES, v. 80, p. 2-pg., 2021-06-01. (19/11776-6)

CORDEIRO, RAFAEL A.; FISCHER, FRIDA M.; SHINJO, SAMUEL K.. Work situation, work ability and expectation of returning to work in patients with systemic autoimmune myopathies. RHEUMATOLOGY, v. N/A, p. 9-pg., 2022-07-22. (19/11776-6)

CARBONI TRUZZI, NATASSIA CRISTINA; HOFF, LEONARDO SANTOS; PIRES BORGES, ISABELA BRUNA; CARLOS DE SOUZA, FERNANDO HENRIQUE; SHINJO, SAMUEL KATSUYUKI. Clinical manifestations, outcomes, and antibody profile of Brazilian adult patients with dermatomyositis: a single-center longitudinal study. ADVANCES IN RHEUMATOLOGY, v. 62, n. 1, p. 9-pg., 2022-11-12. (21/04892-0, 19/11776-6, 19/11367-9)

CAETANO, ALINE MARQUES; BORGES, ISABELA BRUNA PIRES; DA SILVA, LILA MORENA BUENO; SHINJO, SAMUEL KATSUYUKI. High prevalence of necrotizing myofibers in adult dermatomyositis muscle biopsies. CLINICAL RHEUMATOLOGY, v. 41, n. 11, p. 7-pg., 2022-07-11. (19/11776-6, 19/11367-9)

PALLO, P. A. OLIVO; SHINJO, S. K.. Different clinical phenotypes in anti-melanoma differentiation-associated protein 5-associated positive dermatomyositis. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, v. 41, n. 2, p. 1-pg., 2023-02-01. (19/11776-6)

DE SOUSA, L. F. A.; MISSE, R. G.; DOS SANTOS, L. M.; TANAKA, C.; GREVE, J. M. A.; BAPTISTA, A. F.; SHINJO, S. K.. Transcranial direct current stimulation is safe and effective in autoimmune myopathies: a randomised, double-blind, sham-controlled trial. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, v. 41, n. 2, p. 9-pg., 2023-02-01. (19/12155-5, 19/11776-6)

JOÃO CALVINO SOARES DE OLIVEIRA; ALEXANDRE MOURA DOS SANTOS; MARIANA FREITAS DE AGUIAR; JUCIER GONÇALVES JUNIOR; ALEXANDRE WAGNER SILVA DE SOUZA; ROSA MARIA R. PEREIRA; SAMUEL KATSUYUKI SHINJO. Particularidades dos Pacientes com Arterite de Takayasu em Idade Mais Avançada: Estudo Coorte, Retrospectivo e Transversal. Arquivos Brasileiros de Cardiologia, v. 120, n. 1, 2023-01-09. (20/10691-4, 19/11776-6)

DOS SANTOS, ALEXANDRE MOURA; MISSE, RAFAEL GIOVANI; PIRES BORGES, ISABELA BRUNA; GOMES DA SILVA, SARAH LUIZA; KIM, ANA WOO SOOK; PEREIRA, ROSA MARIA R.; SHINJO, SAMUEL KATSUYUKI. High prevalence of fatigue in patients with Takayasu arteritis: a case-control study in a Brazilian centre. RHEUMATOLOGY ADVANCES IN PRACTICE, v. 6, n. 2, p. 9-pg., 2022-05-06. (19/12155-5, 20/10691-4, 19/11776-6, 19/11367-9)

CORDEIRO, R. A.; FISCHER, F. M.; SHINJO, S. K.. Analysis of patient-physician discrepancy in global assessment of systemic autoimmune myopathy disease activity. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, v. 40, n. 2, p. 7-pg., 2022-02-01. (19/11776-6)