Efeitos da estimulação transcraniana por corrente contínua em pacientes com doença de Alzheimer: uma revisão sistemática

• Autor(a) principal: Martins, Wanessa Kallyne Nascimento
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/19320
• topic: Estimulação transcraniana por corrente contínua; Doença de Alzheimer; Ensaios clínicos; Transcranial direct current stimulation; Alzheimer’s disease; Clinical trials; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA

Introdution: Alzheimer’s Disease (AD) is the most common form of dementia between the elderly, responsible for about 60% to 80% of the cases. Because of the rapid disease progression, the high costs to health systems and the enormous burden for family members, diferente therapies are being investigated in order to adjuvante to conventional therapy. Among them, the transcranial direct current stimulation (tDCS). Objectives: To evaluate the effects of the tDCS under the cognitive functions, the funcionality and the behavioral and psychological symptoms in individuals with AD, besides providing support for clinical decision-making based on evidences. Methods: The search of the studies for this review it was made in the databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Offshore Vessel Inspection Database (OVID), PsycINFO, Scopus, Web of Science, Lilacs, ClinicalTrials.org, Currente Controlled Trials, Registro Brasileiro de Ensaios Clínicos (REBEC), Bancos de Teses – Capes, Biblioteca Digital de Teses e Dissertações – USP e ProQuest, published between January 1990 and November 2018. It were included randomized and controlled clinical trials, with patients with a diagnosis of probable AD, according to DSM-IV and/or NINCDS-ADRDA criteria, that they performed a intervention by tDCS, with the placebo (sham) control condition and the cognitive functions evaluated by instruments as ADAS-Cog, MMSE; the functionality of the individual evaluated by DAD; and the symptoms neuropsychiatric mensured through NPI. From the data obtained, it were performed analyzes of bias risk, from the effect of quality treatment and graduation of the evidence. The heterogeneity of interventions and the methodological quality of studies did not allow meta-analysis. Mains results: Seven articles were included in the analysis, being 4 of the parallel type and 3 with crossover design, totaling 170 participants. The risk of bias was classified as mixed, with a predominance of for low risk of bias. The body’s quality of evidence was considered moderate. The effect of the treatment demonstrated the efficacy of the active tDCS compared to the control group in almost all studies. Conclusions: There is not enough evidence that proves that tDCS is more effective than placebo therapy for patients with AD. Despite the findings, the indication of tDCS as a therapy adjuvante for this population should be stimulated, due to the low levels of adverse effects and effect size of active treatments. Therefore, clinical trials should be conducted in order to provide a body of evidence and allow clinical decision-making based on efficiente treatments protocols.