Efeitos da neuromodulação do córtex insular sobre a função cardiovascular em hipertensos submetidos ao exercício aeróbio: um ensaio clínico controlado e randomizado

• Autor(a) principal: Silva Filho, Edson Meneses da
• Data de Publicação: 2021
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/22694
• topic: Hipertensão arterial; Estimulação transcraniana por corrente contínua; Pressão arterial; Exercício; Arterial hypertension; Transcranial direct current stimulation; Blood pressure; Exercise; Hipertensión arterial; Estimulación transcraneal de corriente directa; Presión arterial; Ejercicio; CNPQ::CIENCIAS DA SAUDE::EDUCACAO FISICA

Introduction: Several non-pharmacological strategies have been used to manage blood pressure (BP) in hypertensive individuals, including physical exercise which reduces BP by decreasing sympathetic hyperactivity and vascular dysfunction. In the scope of non-invasive techniques, transcranial direct current stimulation (TDCS) stands out as a safe intervention to treat several clinical conditions, however, its effectiveness to potentiate the effects of physical exercise on hypertensive people have not yet been tested. Objective: To assess whether tDCS can enhance the effects of physical exercise on BP and heart rate variability in hypertensive individuals. Methods: A randomized controlled clinical trial that included individuals with arterial hypertension (systolic blood pressure >120 <160 mmHg and/or diastolic >80 <100 mmHg), who were randomized to the active tDCS + aerobic exercise group or tDCS sham + aerobic exercise group. tDCS was applied through the direct current with an intensity of 2mA for 20 minutes. Then, aerobic training session was performed for 40 minutes. Prior to the experimental protocol, hypertensive patients underwent biochemical tests, 24-hour BP monitoring, ergometric test, heart rate variability, and anthropometric measurements. At the end of the first and twelfth sessions, BP and heart rate variability were collected again. Results: Article 1: SBP during sleep was statistically lower in the tDCS active group after the intervention (p = 0.03). No statistical difference was found for DBP during sleep (p = 0.08). DBP 3 hours after the intervention showed a significant decrease in the active tDCS group (MD: -7.19; p = 0.01). Furthermore, in the intragroup analysis, there was a decrease in SBP 3 hours after the intervention, only for the active tDCS group (p = 0.04). There was no significant reduction in BP during wakefulness and 24 hours in the active or sham tDCS groups. No difference between groups was detected in heart rate variability. Article 2: tDCS was not able to potentiate the effects of physical exercise on systolic and diastolic BP and heart rate variability after 12 sessions. Conclusion: tDCS potentiated the effects of physical exercise on BP in the short-term during sleep and the first 3 hours after the session, however after 12 sessions no difference was detected between groups.