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Cerebral alteration perfusion induced by transcranial stimulation of the prefrontal cortex: a randomized, placebo-controlled study, using 99mTc SPECT

Grant number: 19/07256-7
Support type:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): August 01, 2019
Effective date (End): December 31, 2021
Field of knowledge:Health Sciences - Medicine - Psychiatry
Principal researcher:Andre Russowsky Brunoni
Grantee:Lais Boralli Razza
Home Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

tDCS (transcranial Direct Current Stimulation) has been extensively investigated in recent years for the treatment of mental and neurological disorders. However, studies analyzing its efficacy have presented heterogeneous results, raising questions about its application as a monotherapy treatment. On the other hand, recent research has shown that tDCS combined with other therapies is more effective than when applied by itself. Therefore, this project proposes to investigate the effects of tDCS combined with Theta-Burst Stimulation (TBS), a repetitive Transcranial Magnetic Stimulation (rTMS) technique. In this double-blind study, the combination of effects of tDCS and TBS on Dorsolateral Prefrontal Cortex (DLPFC) will be evaluated using the Single Photon Emission Computed Tomograph (SPECT) and a working memory task (n-back task). We will recruit 30 healthy subjects between 18 and 45 years old that will undergo four randomized stimulation protocols (sham tDCS + sham TBS, anodal tDCS + sham TBS, sham tDCS + active iTBS and anodal tDCS + active TBS), with one-week intervals between them. During the last nine minutes of the tDCS session, iTBS will be performed on the left DLPFC. Sequentially, an injection of technetium-99m (99mTc-ECD) will be administered and neuroimaging will be acquired within one hour of the session's end. N-back task will be applied before SPECT tomography. Our hypothesis is that there will be a difference in cerebral perfusion alterations between groups. Therefore, the protocol presenting the greatest effect, verified by the increase in cerebral perfusion and performance of working memory, can be used in further studies with psychiatric patients.In the final five minutes of each session, an injection of technetium-99m (99mTc-ECD) will be administered and neuroimaging will be acquired within one hour of the session's end. N-back task will be applied before SPECT tomography. Our hypothesis is that there will be a difference in cerebral perfusion alterations between groups. Therefore, the protocol presenting the greatest effect, verified by the increase in cerebral perfusion and performance of working memory, can be used in further studies with psychiatric patients. (AU)

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VEICULO: TITULO (DATA)
VEICULO: TITULO (DATA)

Scientific publications (9)
(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)
LAÍS B. RAZZA; LEONARDO AFONSO DOS SANTOS; LUCAS BORRIONE; HELENA BELLINI; LUIS C. BRANCO; ERIC CRETAZ; DANTE DUARTE; YGOR FERRÃO; RICARDO GALHARDONI; JOÃO QUEVEDO; et al. Appraising the effectiveness of electrical and magnetic brain stimulation techniques in acute major depressive episodes: an umbrella review of meta-analyses of randomized controlled trials. Revista Brasileira de Psiquiatria, v. 43, n. 5, p. 514-524, . (19/07256-7)
SUDBRACK-OLIVEIRA, PEDRO; BARBOSA, MARINA ZANICHELLI; THOME-SOUZA, SIGRIDE; RAZZA, LAIS BORALLI; GALLUCCI-NETO, JOSE; LANE VALIENGO, LEANDRO DA COSTA; BRUNONI, ANDRE RUSSOWSKY. Transcranial direct current stimulation (tDCS) in the management of epilepsy: A systematic review. SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, v. 86, p. 85-95, . (19/07256-7, 19/10760-9)
BORRIONE, LUCAS; BELLINI, HELENA; RAZZA, LAIS BORALLI; AVILA, ANA G.; BAEKEN, CHRIS; BREM, ANNA-KATHARINE; BUSATTO, GERALDO; CARVALHO, ANDRE F.; CHEKROUD, ADAM; DASKALAKIS, ZAFIRIS J.; et al. Precision non-implantable neuromodulation therapies: a perspective for the depressed brain. Revista Brasileira de Psiquiatria, v. 42, n. 4, p. 403-419, . (19/07256-7)
RAZZA, LAIS B.; DE SMET, STEFANIE; MOFFA, ADRIANO; SUDBRACK-OLIVEIRA, PEDRO; VANDERHASSELT, MARIE-ANNE; BRUNONI, ANDRE R.. Follow-up effects of transcranial direct current stimulation (tDCS) for the major depressive episode: A systematic review and meta-analysis. PSYCHIATRY RESEARCH, v. 302, . (19/06009-6, 19/10760-9, 19/07256-7, 18/10861-7)
JONES, BRETT D. M.; WEISSMAN, CORY R.; RAZZA, LAIS B.; HUSAIN, M. ISHRAT; BRUNONI, ANDRE R.; DASKALAKIS, ZAFIRIS J.. Protocol for a systematic review and meta-analysis of the placebo response in treatment-resistant depression: comparison of multiple treatment modalities. BMJ OPEN, v. 11, n. 2, . (19/07256-7)
RAZZA, LAIS B.; BUCHPIGUEL, CARLOS A.; DE SMET, STEFANIE; KLEIN, IZIO; BAEKEN, CHRIS; GALHARDONI, RICARDO; VANDERHASSELT, MARIE-ANNE; BRUNONI, ANDRE R.. Combined effects of theta-burst stimulation with transcranial direct current stimulation of the prefrontal cortex: study protocol of a randomized, double-blinded, sham-controlled trial using Tc-99m-ECD SPECT. Trends in Psychiatry and Psychotherapy, v. 43, n. 4, p. 293-301, . (19/07256-7, 18/10861-7)
LAÍS B. RAZZA; CARLOS A. BUCHPIGUEL; STEFANIE DE SMET; IZIO KLEIN; CHRIS BAEKEN; RICARDO GALHARDONI; MARIE-ANNE VANDERHASSELT; ANDRÉ R. BRUNONI. Combined effects of theta-burst stimulation with transcranial direct current stimulation of the prefrontal cortex: study protocol of a randomized, double-blinded, sham-controlled trial using 99mTc-ECD SPECT. Trends in Psychiatry and Psychotherapy, v. 43, n. 4, p. 293-301, . (18/10861-7, 19/07256-7)
RAZZA, LAIS B.; DOS SANTOS, LEONARDO AFONSO; BORRIONE, LUCAS; BELLINI, HELENA; BRANCO, LUIS C.; CRETAZ, ERIC; DUARTE, DANTE; FERRAO, YGOR; GALHARDONI, RICARDO; QUEVEDO, JOAO; et al. ppraising the effectiveness of electrical and magnetic brain stimulation techniques in acute major depressive episodes: an umbrella review of meta-analyses of randomized controlled trial. Revista Brasileira de Psiquiatria, v. 43, n. 5, p. 514-524, . (19/07256-7)
RAZZA, LAIS B.; PALUMBO, PRISCILA; MOFFA, ADRIANO H.; CARVALHO, ANDRE F.; SOLMI, MARCO; LOO, COLLEEN K.; BRUNONI, ANDRE RUSSOWSKY. A systematic review and meta-analysis on the effects of transcranial direct current stimulation in depressive episodes. DEPRESSION AND ANXIETY, v. 37, n. 7, . (18/16927-0, 19/07256-7)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
RAZZA, Lais Boralli. Effects of combined transcranial stimulation interventions of the prefrontal cortex: a factorial, randomized, double-blind, sham-controlled trial. 2021. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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