No abstract

Introdução. A fibromialgia afeta a saúde física e mental da população e é caracterizada por alterações na atividade cerebral. A estimulação transcraniana por corrente contínua (tDCS) é uma técnica não invasiva capaz de modular a excitabilidade cortical cerebral. Objetivo. Sistematizar e discutir os efeitos da ETCC na melhora da dor em pacientes com fibromialgia quando comparado ou associado à outras técnicas, partindo dos seguintes questionamentos: A eletroestimulação transcraniana por corrente contínua é eficaz para a melhora da dor? Modifica as características clínicas da doença? Método. Foram selecionados artigos publicados entre 2015 e 2020 das bases de dados Scielo, MEDLINE, Web of Science e PEDro. Resultados. Foram selecionados 9 artigos, dos quais 6 demonstraram resultados positivos na modulação da dor com estímulo anódico em M1, 2 em CPFDL e 1 em CPFDL + C2. Conclusão. A técnica se mostrou eficaz para a modulação da dor em pacientes com fibromialgia. No entanto, são necessários mais estudos com objetivo de definir a quantidade de sessões ideal, intervalos entre as sessões e dosagem.

Background: Fibromyalgia (FM) affects the population’s physical and mental health and is characterized by changes in brain activity and pain reporting. Objectives: To systematize and discuss the effects of tDCS on pain improvement in patients with FM as well as the “state of the art”. Design and setting: Systematic review with bibliometric. Methods: Articles were searched in the databases: MEDLINE / PubMed, Web of Science, Scopus and Physiotherapy Evidence Database. Randomized clinical trials, published between 1996 and 2021, that used tDCS to treat pain in patients with fibromyalgia were included. Studies that used tDCS associated with another technique (except pharmacological) were excluded. Methodological quality and risk of bias were assessed using the PEDro and Rob 2.0 scale. Software R. was used to perform bibliometrics. Results: Nine articles were included, totaling 306 participants. The main stimulated areas were the primary death cortex (M1) (6 studies) and left dorsalateral prefrontal cortex (CPFDL) (4 studies). Eight studies used the intensity of 2 mA and application for 20 minutes. Both stimulation of M1 and CPFDL showed effects on pain improvement greater than tDCS sham. As for the research institutes, Havard Medical School and the Federal University of Rio Grande do Sul lead the ranking. The author with the greatest impact was Fregni, F. (index h: 12, index g: 17, index m: 0.800, total publications 17, beginning: 2006). Conclusions: tDCS proved to be effective for the treatment of pain in FM. The production of studies is limited.

Background: The gestational period is a period of high prevalence of mental disorders, including depression, requiring effective therapeutic measures. Objectives: systematize the effects of Transcranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS) in the treatment of depression during pregnancy. Design and setting: Systematic review with bibliometric. Methods: Articles were searched in the databases: MEDLINE/PubMed, Web of Science and Scopus. Randomized clinical trials, case-control studies and case series, published between 2011 and 2020, that used tDCS and TMS to treat depression in pregnant patients were included. Studies that used transcranial electrostimulation associated with another technique (except the pharmacological one) were excluded. The quality of studies was evaluated independently by the reviewers according to the Cochrane Handbook for Systematic Reviews for Interventions for assessing bias. Software R was used to perform bibliometrics. Results: Seven studies were included, totaling 102 participants. The stimulated area was the dorsalateral prefrontal cortex (CPFDL). Two studies used tDCS with an intensity of 2 mA and application for 20 minutes and 30 minutes. Five studies used TMS, of which 2 used a frequency of 1 Hz, 2 used 25 Hz and 1 used 10 Hz. The University of Pennsylvania sets up the research center with the most affiliated articles, 8 in total. The author with the greatest impact was Kin, D.R. (index h: 6, index g: 7, index m: 0.462, total of publications 7, beginning: 2009). Conclusions: tDCS and TMS proved to be effective for the treatment of symptoms of depression during pregnancy. Systematic Review Registration: The review was registered in PROSPERO with protocol: CRD42021235355.

Background: The prevalence of fibromyalgia (FM) is estimated between 2% - 4% of the world population and is characterized by musculoskeletal pain accompanied by fatigue, depression, anxiety and sleep disorders. Therapeutic treatment for FM tends to be unsatisfactory, requiring the search for new therapeutic measures. Objectives: Analyze the evidence regarding the use and use of Transcranial Direct Current Stimulation (tDCS) in the modulation of pain and anxiety in patients with FM. Design and setting: A systematic review was carried out with meta-analysis. Methods: A search was performed in MEDLINE/PubMed, Web of Science, Scopus and Physiotherapy Evidence Databases (PEDro). Randomized clinical trials published between 2010 and 2021 that used tDCS to treat pain and anxiety were included. Articles that used tDCS associated with other techniques were excluded. Methodological quality and risk of bias were assessed using the PEDro Scale and the RoB 2.0. RevMan 5.3 software was used for meta-analysis. Results: Six studies were included, totaling 225 participants. Anodic stimulation (AE) over the left dorsolateral prefrontal cortex was better for pain control than tDCS sham (-1.56; 95% CI: -1.78 to -1.34; p <0,00001). AE on the primary motor cortex (M1) was better for pain control than tDCS sham (-1.45; 95% CI: -2.54 to - 0.36; p <0.00009), however , no difference was observed between AE over M1 and tDCS sham to improve anxiety (-0.63; 95% CI: -4.89 to 3.62; p = 0.52). Conclusions: The tDCS cam be effective for treating pain. More research needs to be done.