Effect of transcranial direct current stimulation on central blood pressure in resistant hypertensive subjects

• Grant number: 16/02317-0
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• Start date: August 01, 2016
• End date: October 31, 2016
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Heitor Moreno Junior
• Grantee: Alessandra Mileni Versuti Ritter
• Supervisor: Felipe Fregni
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Institution abroad: Harvard University, Boston, United States
• Associated to the scholarship: 14/03285-9 - Obesity and target organs damage in resistant hypertension: role of metaloproteinases, BP.PD

Abstract

Resistant hypertension (RHTN) is defined as high blood pressure (BP) in spite of concurrent use of three or more antihypertensive drugs of different classes, combined at optimal doses and including a diuretic. The mechanisms of resistance to antihypertensive treatment is a multifactorial condition not fully elucidated, but it has been associated to hyperactivity of sympathetic nervous system (SNS). Indeed, invasive therapies have been development for the treatment of RHTN, but SNS hyperactivity remains as a challenge in clinical practice. Thus, the use of cerebral stimulation techniques, such as non-invasive transcranial direct current stimulation (tDCS) on cortex in HAR subjects seems promising due to potential modulation of SNS and BP. This project aims to learn and further implant the transcranial direct current stimulation technique in Brazil with the equipment DC Stimulation Plus SHAM (neuroConn GmbH, Germany), recently acquired by CEPID FAPESP process (2013/07607-8). Also, we aim to evaluate whether the use of tDCS is able to reduce BP levels in HAR. It will be done a double-blind, placebo-sham study in 10 patients RHTN. These patients will receive tDCS intervention during 2 weeks and the central BP (Sphygmocor) will be assessed in the pre- and pos-period of tDCS. We hypothesize that tDCS acutely reduce BP levels in RHTN patients by modulating the sympathetic nervous system. Learn and improvement neuroestimulation technique in Dr. Felipe Fregni laboratory at Harvard Medical School will provide scientific knowledge to implant tDCS procedure in our laboratory in Brazil, allowing a new therapy conduct for resistant hypertensive patients. (AU)