Effects of Sensory Peripheral Electrical Stimulation (SPES) on cerebral hemodynamics in healthy volunteers

• Grant number: 21/08286-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2021
• End date: November 30, 2022
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Adriana Bastos Conforto
• Grantee: Pedro Henrique Fonseca de Castro
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Stroke is one of the leading causes of death and disability worldwide, resulting in a huge social and economic burden in developed and developing countries. Despite significant progress in reperfusion methods in acute ischemic stroke (thrombolysis and mechanical thrombectomy), there is still a great need to improve clinical outcomes. A study performed with the functional magnetic resonance imaging technique (fMRI) suggested that Sensory Peripheral Electrical Stimulation (SPES), a non-invasive neuromodulation intervention, may increase cerebral perfusion in healthy individuals. However, fMRI use is very limited due to its high cost, need for specific software for interpretation and it is generally not available in emergency services in public hospitals. This study aims to evaluate the effects of SPES on cortical perfusion, aiming to analyze possible hemodynamic changes in the primary motor, primary sensory and premotor cortices after stimulation in healthy individuals through optical methods, which are excellent alternatives for evaluations cerebral hemodynamics because they are more logistically accessible, less expensive, safe, non-invasive, allow constant monitoring and are easier and more practical to handle. A minimum of 10 and a maximum of 20 healthy individuals will be selected for the study. The two interventions (placebo and real) will be applied to the stimulated upper limb in each session, with the order randomly defined in the initial randomization process and lasting 2 hours each. Before and after each session, patients will be submitted to cortical microvasculature perfusion evaluation using the optical method of NIRS (near-infrared spectroscopy). The primary outcome is change in cerebral oxygenation and cortical blood flow (in the areas indicated above) detected through this optical method of assessment. It is expected to find an increase in blood flow in the areas of the brain analyzed after peripheral stimulation, indicating that SPES would have the capacity to improve cerebral perfusion, and could be used as an auxiliary technique in the recovery of patients with stroke. If these results are obtained, the next step will be to carry out another study on the effects of SPES on cerebral blood flow evaluated by optical methods, in the acute phase of stroke.(AU)