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Study of paresis and speech after stimulation by transcranial direct current (ETCC) of low intensity in patients with ischemic stroke


Ischemic strokes are the main cause of disabilities in adults. Even though there have been many achievements in its prevention, specific treatment, and rehabilitation, a great number of patients still remain disabled, leading to a high personal, familiar and social cost. Previous studies have shown that the Transcranial Eletric Stimulation (by continuous current) appear to be a safe technic, able to contribute to these pacients' recovery. It’s a non-invasive method, unpainful, with a very low risk and with the ability to perform a local modulation of the cerebral activity that could result in positive effects in motor and cognitive functions. Therefore, in this project we are willing to evaluate the benefits in motor and cognitive functions in patients with disabilities of isquemic strokes using the Transcranial Electric Stimulation. The study will be held in São Paulo's Santa Casa's Medical School, with 32 patients (two groups of 16): Group 1, in which patients will be submitted to the cathodic stimulation of the non-leasoned hemisphere and Group 2, in which patients will be submitted to placebo stimulation. On the first day, all patients will be submitted to evaluation tests of motor and cognitive functions. Considering that there is the possibility of a learning curve, the patients will take these tests until the results are stable. Both groups will participate in 10 stimulation's sections on consecutive days, with each of them lasting 20 minutes, and with an intensity of electric current of 2mA. Patients will be submitted again to the motor and cognitive tests in the fifth and tenth day after the first stimulation and also after 15 and 30 days from the end of the stimulations. The evaluation scales will be conducted by an evaluator that does not know which group the patient belonged to. The motor symptoms will be evaluated by the following instruments: the Fugl-Meyer scale for patients with isquemic stoke, Schwab and England Activities od Daily Living, time of simple motor reaction, time of chosen motor reaction, Pegboard, hand spring scale. Confusion factors will be evaluated by: (visual scales) attention scale suring the test (1-7; 1= no attention and 7= maximum attention), fatigue (1-7; 1=maximum fatigue and 7= no fatigue), pain or a stimulation discomfort (1-10; 1= no discomfort or pain and 10 discomfort and maximum pain). The cognitive evaluation will be obtained by the tests: mini-exam of the mental state, Stroop (Victoria version), of the five dots, Symbol Digits Modalities test, numbers - direct or reverse order (WMS), verbal fluency. Eventual side effects will be evaluated by the scales of Udvalg for Kliniske Undersogelser (UKU - the compréensive Udvalg for Kliniske Undersogelser Side Effect Rating Scale) (Lingjaerde et al., 1987) - this evaluation test contains 48 items divided into 4 categories of side effects: psyquic, neurological, autonomic and others. (AU)

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(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)
SIMIS, MARCEL; DI LAZZARO, VINCENZO; KIRTON, ADAM; PENNISI, GIOVANNI; BELLA, RITA; KIM, YUN-HEE; TAKEUCHI, NAOYUKI; KHEDR, EMAN M.; ROGERS, LYNN M.; HARVEY, RICHARD; KOGANEMARU, SATOKO; TURMAN, BULENT; TARLACI, SULTAN; GAGLIARDI, RUBENS J.; FREGNI, FELIPE. Neurophysiological measurements of affected and unaffected motor cortex from a cross-sectional, multi-center individual stroke patient data analysis study. NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY, v. 46, n. 1, p. 53-61, FEB 2016. Web of Science Citations: 5.

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