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
• Duration: July 01, 2020 - 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

(4)

(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)

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. (19/11776-6, 20/10691-4)

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)

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)

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)