Atuação da estimulação magnética transcraniana na indução de neuroplasticidade na reabilitação pós-acidente vascular encefálico
DOI:
https://doi.org/10.33448/rsd-v12i11.43547Palavras-chave:
Estimulação magnética transcraniana; Acidente vascular encefálico; Terapêutica.Resumo
Introdução: Mudanças estruturais no nível celular impactam mudanças funcionais no cérebro como resultado de conexões entre as múltiplas redes responsáveis pelas funções do Sistema Nervoso Central. O AVC modifica o padrão de conectividade funcional das regiões cerebrais, resultando em déficits intrínsecos ao papel agora desempenhado pelos neurônios perdidos. Objetivo: compreender, a partir da literatura, as implicações terapêuticas da Estimulação Magnética Transcraniana em pacientes vítimas de acidente vascular cerebral. Metodologia: trata-se de uma revisão narrativa da literatura. Resultados e discussão: A isquemia em regiões do córtex motor primário resulta em uma assimetria entre os hemisférios cerebrais, caracterizada por aumento do recrutamento e redução anormal da inibição cortical no córtex motor primário contralateral ao hemisfério lesionado. Essa assimetria na inibição inter-hemisférica produz disparidade no desempenho da reabilitação. Consequentemente, a recuperação é centralmente limitada. A estimulação do córtex motor primário contralesional e do cerebelo melhora a espasticidade muscular e a discinesia dos membros. A estimulação de repetição tem demonstrado importante utilidade no tratamento da afasia pós-AVC concomitante à terapia fonoaudiológica. Entre as alterações do estado mental, a depressão é a mais comum. Considerações finais: As condições secundárias ao déficit neuronal causado pelo acidente vascular cerebral afetam múltiplas dimensões da vida do paciente. É uma estratégia segura, não invasiva e que produz bons resultados. É um dispositivo promissor cuja relevância não deve ser ignorada ou negligenciada.
Referências
Alexopoulos, G. S., Hoptman, M. J., Kanellopoulos, D., Murphy, C. F., Lim, K. O., & Gunning, F. M. (2012). Functional connectivity in the cognitive control network and the default mode network in late-life depression. Journal of Affective Disorders, 139(1), 56–65. https://doi.org/10.1016/j.jad.2011.12.002
Blesneag, A. V., Slăvoacă, D. F., Popa, L., Stan, A. D., Jemna, N., Isai Moldovan, F., & Mureșanu, D. F. (2015). Low-frequency rTMS in patients with subacute ischemic stroke: Clinical evaluation of short and long-term outcomes and neurophysiological assessment of cortical excitability. Journal of Medicine and Life, 8(3), 378–387.
Chen, J., Zeng, Y., Hong, J., Li, C., Zhang, X., & Wen, H. (2023). Effects of HF-rTMS on microglial polarization and white matter integrity in rats with poststroke cognitive impairment. Behavioural Brain Research, 439, 114242. https://doi.org/10.1016/j.bbr.2022.114242
Chen, Q., Shen, W., Sun, H., Zhang, H., Liu, C., Chen, Z., Yu, L., Cai, X., Ke, J., Li, L., Zhang, L., & Fang, Q. (2022). The effect of coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation on shaping early reorganization of the motor network after stroke. Brain Research, 1790, 147959. https://doi.org/10.1016/j.brainres.2022.147959
Chen, R. (2000). Studies of human motor physiology with transcranial magnetic stimulation. Muscle & Nerve. Supplement, 9, S26-32. https://doi.org/10.1002/1097-4598(2000)999:9<::aid-mus6>3.0.co;2-i
Chung, S. W., Hoy, K. E., & Fitzgerald, P. B. (2015). Theta-burst stimulation: A new form of TMS treatment for depression? Depression and Anxiety, 32(3), 182–192. https://doi.org/10.1002/da.22335
Dong, L.-H., Pan, X., Wang, Y., Bai, G., Han, C., Wang, Q., & Meng, P. (2022). High-Frequency Cerebellar rTMS Improves the Swallowing Function of Patients with Dysphagia after Brainstem Stroke. Neural Plasticity, 2022, 6259693. https://doi.org/10.1155/2022/6259693
Santos, R. B. C., Galvão, S. C. B., Frederico, L. M. P., Amaral, N. S. L., Carneiro, M. I. S., de Moura Filho, A. G., Piscitelli, D., & Monte-Silva, K. (2019). Cortical and spinal excitability changes after repetitive transcranial magnetic stimulation combined to physiotherapy in stroke spastic patients. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 40(6), 1199–1207. https://doi.org/10.1007/s10072-019-03765-y
Du, J., Yang, F., Hu, J., Hu, J., Xu, Q., Cong, N., Zhang, Q., Liu, L., Mantini, D., Zhang, Z., Lu, G., & Liu, X. (2019). Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. NeuroImage: Clinical, 21, 101620. https://doi.org/10.1016/j.nicl.2018.101620
Duan, H., Yan, X., Meng, S., Qiu, L., Zhang, J., Yang, C., & Liu, S. (2023). Effectiveness Evaluation of Repetitive Transcranial Magnetic Stimulation Therapy Combined with Mindfulness-Based Stress Reduction for People with Post-Stroke Depression: A Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 20(2), 930. https://doi.org/10.3390/ijerph20020930
Fahmy, E. M., & Elshebawy, H. M. (2021). Effect of High Frequency Transcranial Magnetic Stimulation on Recovery of Chronic Post-Stroke Aphasia. Journal of Stroke and Cerebrovascular Diseases, 30(8), 105855. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105855
Fingelkurts, A. A., & Fingelkurts, A. A. (2015). Altered Structure of Dynamic Electroencephalogram Oscillatory Pattern in Major Depression. Biological Psychiatry, 77(12), 1050–1060. https://doi.org/10.1016/j.biopsych.2014.12.011
Frey, J., Najib, U., Lilly, C., & Adcock, A. (2020). Novel TMS for Stroke and Depression (NoTSAD): Accelerated Repetitive Transcranial Magnetic Stimulation as a Safe and Effective Treatment for Post-stroke Depression. Frontiers in Neurology, 11, 788. https://doi.org/10.3389/fneur.2020.00788
Ge, R., Humaira, A., Gregory, E., Alamian, G., MacMillan, E. L., Barlow, L., Todd, R., Nestor, S., Frangou, S., & Vila-Rodriguez, F. (2022). Predictive Value of Acute Neuroplastic Response to rTMS in Treatment Outcome in Depression: A Concurrent TMS-fMRI Trial. The American Journal of Psychiatry, 179(7), 500–508. https://doi.org/10.1176/appi.ajp.21050541
George, M. S., Lisanby, S. H., & Sackeim, H. A. (1999). Transcranial magnetic stimulation: Applications in neuropsychiatry. Archives of General Psychiatry, 56(4), 300–311. https://doi.org/10.1001/archpsyc.56.4.300
Georgiou, A. M., Phinikettos, I., Giasafaki, C., & Kambanaros, M. (2020). Can transcranial magnetic stimulation (TMS) facilitate language recovery in chronic global aphasia post-stroke? Evidence from a case study. Journal of Neurolinguistics, 55, 100907. https://doi.org/10.1016/j.jneuroling.2020.100907
Hardy, S., Bastick, L., O’Neill-Kerr, A., Sabesan, P., Lankappa, S., & Palaniyappan, L. (2016). Transcranial magnetic stimulation in clinical practice. BJPsych Advances, 22(6), 373–379. https://doi.org/10.1192/apt.bp.115.015206
Huang, Y.-Z., Edwards, M. J., Rounis, E., Bhatia, K. P., & Rothwell, J. C. (2005). Theta burst stimulation of the human motor cortex. Neuron, 45(2), 201–206. https://doi.org/10.1016/j.neuron.2004.12.033
Huang, Y.-Z., Rothwell, J. C., Chen, R.-S., Lu, C.-S., & Chuang, W.-L. (2011). The theoretical model of theta burst form of repetitive transcranial magnetic stimulation. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology, 122(5), 1011–1018. https://doi.org/10.1016/j.clinph.2010.08.016
Jiang, S., Zhan, C., He, P., Feng, S., Gao, Y., Zhao, J., Wang, L., Zhang, Y., Nie, K., Qiu, Y., & Wang, L. (2023). Neuronavigated repetitive transcranial magnetic stimulation improves depression, anxiety and motor symptoms in Parkinson’s disease. Heliyon, 9(8), e18364. https://doi.org/10.1016/j.heliyon.2023.e18364
Katai, S., Maeda, M., Katsuyama, S., Maruyama, Y., Midorikawa, M., Okushima, T., & Yoshida, K. (2023). Cortical reorganization correlates with motor recovery after low-frequency repetitive transcranial magnetic stimulation combined with occupational therapy in chronic subcortical stroke patients. Neuroimage: Reports, 3(1), 100156. https://doi.org/10.1016/j.ynirp.2023.100156
Lai, C. H. (2020). Effectiveness of repetitive transcranial magnetic stimulation and augmented reality in persons with chronic stroke – A pilot study. Clinical Neurophysiology, 131(4), e24–e25. https://doi.org/10.1016/j.clinph.2019.12.135
Li, D., Cheng, A., Zhang, Z., Sun, Y., & Liu, Y. (2021). Effects of low-frequency repetitive transcranial magnetic stimulation combined with cerebellar continuous theta burst stimulation on spasticity and limb dyskinesia in patients with stroke. BMC Neurology, 21(1), 369. https://doi.org/10.1186/s12883-021-02406-2
Li, K.-P., Wu, J.-J., Zhou, Z.-L., Xu, D.-S., Zheng, M.-X., Hua, X.-Y., & Xu, J.-G. (2023). Noninvasive Brain Stimulation for Neurorehabilitation in Post-Stroke Patients. Brain Sciences, 13(3), 451. https://doi.org/10.3390/brainsci13030451
Li, Y., Yu, Z., Zhou, X., Wu, P., & Chen, J. (2022). Aberrant interhemispheric functional reciprocities of the default mode network and motor network in subcortical ischemic stroke patients with motor impairment: A longitudinal study. Frontiers in Neurology, 13, 996621. https://doi.org/10.3389/fneur.2022.996621
Lioumis, P., & Rosanova, M. (2022). The role of neuronavigation in TMS–EEG studies: Current applications and future perspectives. Journal of Neuroscience Methods, 380, 109677. https://doi.org/10.1016/j.jneumeth.2022.109677
Low, T. A., Lindland, K., Kirton, A., Carlson, H. L., Harris, A. D., Goodyear, B. G., Monchi, O., Hill, M. D., & Dukelow, S. P. (2023). Repetitive transcranial magnetic stimulation (rTMS) combined with multi-modality aphasia therapy for chronic post-stroke non-fluent aphasia: A pilot randomized sham-controlled trial. Brain and Language, 236, 105216. https://doi.org/10.1016/j.bandl.2022.105216
Luk, K. Y., Ouyang, H. X., & Pang, M. Y. C. (2022). Low-Frequency rTMS over Contralesional M1 Increases Ipsilesional Cortical Excitability and Motor Function with Decreased Interhemispheric Asymmetry in Subacute Stroke: A Randomized Controlled Study. Neural Plasticity, 2022, 3815357. https://doi.org/10.1155/2022/3815357
Mao, J., Fan, K., Zhang, Y., Wen, N., Fang, X., Ye, X., & Chen, Y. (2023). 10 Hz repetitive transcranial magnetic stimulation (rTMS) May improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucination. Heliyon, e19912. https://doi.org/10.1016/j.heliyon.2023.e19912
Menon, V. (2015). Large-Scale Functional Brain Organization. Em A. W. Toga (Org.), Brain Mapping (p. 449–459). Academic Press. https://doi.org/10.1016/B978-0-12-397025-1.00024-5
Mousa, H., & Albaker, S. (2021). Repetitive transcranial magnetic stimulation effects on hemiparetic limb spasticity in stroke patients: A double blinded randomized controlled trial. Journal of the Neurological Sciences, 429, 119716. https://doi.org/10.1016/j.jns.2021.119716
Padberg, F., & George, M. S. (2009). Repetitive transcranial magnetic stimulation of the prefrontal cortex in depression. Experimental Neurology, 219(1), 2–13. https://doi.org/10.1016/j.expneurol.2009.04.020
Pellicciari, M. C., Bonnì, S., Ponzo, V., Cinnera, A. M., Mancini, M., Casula, E. P., Sallustio, F., Paolucci, S., Caltagirone, C., & Koch, G. (2018). Dynamic reorganization of TMS-evoked activity in subcortical stroke patients. Neuroimage, 365–378.
Peng, J.-J., Sha, R., Li, M.-X., Chen, L.-T., Han, X.-H., Guo, F., Chen, H., & Huang, X.-L. (2019). Repetitive transcranial magnetic stimulation promotes functional recovery and differentiation of human neural stem cells in rats after ischemic stroke. Experimental Neurology, 313, 1–9. https://doi.org/10.1016/j.expneurol.2018.12.002
Protasio, M. I. B., & Silva, J. P. L. da. (2020). Estimulação magnética transcraniana de repetição (EMTR) na redução do consumo de cocaína. Rev. Pesqui. Fisioter, 23–30.
Rao, J., Li, F., Zhong, L., Wang, J., Peng, Y., Liu, H., Wang, P., & Xu, J. (2022). Bilateral Cerebellar Intermittent Theta Burst Stimulation Combined With Swallowing Speech Therapy for Dysphagia After Stroke: A Randomized, Double-Blind, Sham-Controlled, Clinical Trial. Neurorehabilitation and Neural Repair, 36(7), 437–448. https://doi.org/10.1177/15459683221092995
Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20, v–vi. https://doi.org/10.1590/S0103-21002007000200001
Sharma, H., Vishnu, V. Y., Kumar, N., Sreenivas, V., Rajeswari, M. R., Bhatia, R., Sharma, R., & Srivastava, M. V. P. (2020). Efficacy of Low-Frequency Repetitive Transcranial Magnetic Stimulation in Ischemic Stroke: A Double-Blind Randomized Controlled Trial. Archives of Rehabilitation Research and Clinical Translation, 2(1), 100039. https://doi.org/10.1016/j.arrct.2020.100039
Tryon, W. W. (2014). Core Network Principles: The Explanatory Nucleus. Em W. W. Tryon (Org.), Cognitive Neuroscience and Psychotherapy (p. 125–222). Academic Press. https://doi.org/10.1016/B978-0-12-420071-5.00003-X
Ünlüer, N. Ö., Temuçin, Ç. M., Demir, N., Serel Arslan, S., & Karaduman, A. A. (2019). Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Swallowing Function and Quality of Life of Post-stroke Patients. Dysphagia, 34(3), 360–371. https://doi.org/10.1007/s00455-018-09965-6
Vosgerau, D. S. R., & Romanowski, J. P. (2014). Estudos de revisão: Implicações conceituais e metodológicas. Revista Diálogo Educacional, 14(41), 165–190.
Wang, C., Zeng, Q., Yuan, Z., Wang, W., & Shen, M. (2023). Effects of Low-Frequency (0.5 Hz) and High-Frequency (10 Hz) Repetitive Transcranial Magnetic Stimulation on Neurological Function, Motor Function, and Excitability of Cortex in Ischemic Stroke Patients. The Neurologist, 28(1), 11. https://doi.org/10.1097/NRL.0000000000000435
Xie, Y., Guan, M., Wang, Z., Ma, Z., Wang, H., & Fang, P. (2023). Alterations in brain connectivity patterns in schizophrenia patients with auditory verbal hallucinations during low frequency repetitive transcranial magnetic stimulation. Psychiatry Research, 115457. https://doi.org/10.1016/j.psychres.2023.115457
Yaşa, İ. C., Mavi̇ş, İ., Şalçi̇ni̇, C., & Mi̇di̇, İ. (2023). Comparing the efficiency of speech and language therapy and transcranial magnetic stimulation for treating Broca’s aphasia. Journal of Stroke and Cerebrovascular Diseases, 32(6), 107108. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107108
Zhu, Z., Zhu, H.-X., Jing, S.-W., Li, X.-Z., Yang, X.-Y., Luo, T.-N., Ye, S., Ouyang, X.-C., & Song, W.-W. (2022). Effect of transcranial magnetic stimulation in combination with citalopram on patients with post-stroke depression. Frontiers in Human Neuroscience, 16, 962231. https://doi.org/10.3389/fnhum.2022.962231
Zrenner, B., Zrenner, C., Gordon, P. C., Belardinelli, P., McDermott, E. J., Soekadar, S. R., Fallgatter, A. J., Ziemann, U., & Müller-Dahlhaus, F. (2020). Brain oscillation-synchronized stimulation of the left dorsolateral prefrontal cortex in depression using real-time EEG-triggered TMS. Brain Stimulation, 13(1), 197–205. https://doi.org/10.1016/j.brs.2019.10.007
Zumbansen, A., Kneifel, H., Lazzouni, L., Ophey, A., Black, S. E., Chen, J. L., Edwards, D., Funck, T., Hartmann, A. E., Heiss, W.-D., Hildesheim, F., Lanthier, S., Lespérance, P., Mochizuki, G., Paquette, C., Rochon, E., Rubi-Fessen, I., Valles, J., Wortman-Jutt, S., & NORTHSTAR-study group. (2022). Differential Effects of Speech and Language Therapy and rTMS in Chronic Versus Subacute Post-stroke Aphasia: Results of the NORTHSTAR-CA Trial. Neurorehabilitation and Neural Repair, 36(4–5), 306–316. https://doi.org/10.1177/15459683211065448
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Copyright (c) 2023 Lucas Ferrari da Silva Mendes; Isadora Fonseca Pinheiro; Verival Ferreira Dias dos Santos Júnior; Anne Kaline Marques Portela Leal; Mizael Siqueira de Araujo; Rita de Kássia Santos Costa; Lourivan Leal de Sousa
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