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Zaninotto AL, El-Hagrassy MM, Green JR, Babo M, Paglioni VM, Benute GG, Paiva WS. Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: A systematic review. Dement Neuropsychol 2019; 13:172-179. [PMID: 31285791 PMCID: PMC6601308 DOI: 10.1590/1980-57642018dn13-020005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Traumatic brain injury (TBI) is a major cause of chronic disability. Less than a
quarter of moderate and severe TBI patients improved in their cognition within 5
years. Non-invasive brain stimulation, including transcranial direct current
stimulation (tDCS), may help neurorehabilitation by boosting adaptive
neuroplasticity and reducing pathological sequelae following TBI.
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Affiliation(s)
- Ana Luiza Zaninotto
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions (MGH IHP), Boston, USA
| | - Mirret M El-Hagrassy
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School (HMS), Boston, USA
| | - Jordan R Green
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions (MGH IHP), Boston, USA
| | - Maíra Babo
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Department of Neurology, São Paulo, SP, Brazil
| | - Vanessa Maria Paglioni
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Department of Neurology, São Paulo, SP, Brazil
| | | | - Wellingson Silva Paiva
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Department of Neurology, São Paulo, SP, Brazil
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Poiani GDCR, Zaninotto AL, Carneiro AMC, Zangaro RA, Salgado ASI, Parreira RB, de Andrade AF, Teixeira MJ, Paiva WS. Photobiomodulation using low-level laser therapy (LLLT) for patients with chronic traumatic brain injury: a randomized controlled trial study protocol. Trials 2018; 19:17. [PMID: 29310710 PMCID: PMC5759360 DOI: 10.1186/s13063-017-2414-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Photobiomodulation using low-level laser therapy (LLLT) has been tested as a new technique to optimize recovery of patients with traumatic brain injury (TBI). The aim of this study is to evaluate inhibitory attentional control after 18 sessions of active LLLT and compare with the placebo group (sham LLLT). Our exploratory analysis will evaluate the efficacy of the active LLLT on verbal and visuospatial episodic memory, executive functions (working memory, verbal and visuospatial fluency, attentional processes), and anxiety and depressive symptoms compared to the sham group. METHODS/DESIGN A randomized double-blinded trial will be made in 36 patients with moderate and severe TBI. The active LLLT will use an optical device composed of LEDs emitting 632 nm of radiation at the site with full potency of 830 mW. The cranial region with an area of 400 cm2 will be irradiated for 30 min, giving a total dose per session of 3.74 J/cm2. The sham LLLT group contains only an LED device with power < 1 mW, only serving to simulate the irradiation. Each patient will be irradiated three times per week for six weeks, totaling 18 sessions. Neuropsychological assessments will be held one week before the beginning of the sessions, after one week, and three months after the end of LLLT sessions. Memory domain, attention, executive functioning, and visual construction will be evaluated, in addition to symptoms of depression, anxiety, and social demographics. DISCUSSION LLLT has been demonstrated as a safe and effective technique in significantly improving the memory, attention, and mood performance in healthy and neurologic patients. We expect that our trial can complement previous finds, as an effective low-cost therapy to improve cognitive sequel after TBI. TRIAL REGISTRATION ClinicalTrials.gov, NCT02393079 . Registered on 20 February 2015.
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Affiliation(s)
- Guilherme da Cruz Ribeiro Poiani
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil.
| | - Ana Luiza Zaninotto
- Division of Psychology at Hospital of Clinics, University of Sao Paulo Medical School, Sao Paulo, Brazil.,Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Ana Maria Costa Carneiro
- Institute of Biomedical Engineering, Anhembi Morumbi University, Sao Jose dos Campos, Sao Paulo, Brazil
| | - Renato Amaro Zangaro
- Institute of Biomedical Engineering, Anhembi Morumbi University, Sao Jose dos Campos, Sao Paulo, Brazil.,Center for Innovation, Technology and Education - CTE, Sao Jose dos Campos, Sao Paulo, Brazil
| | | | - Rodolfo Borges Parreira
- Salgado Institute of Integral Health; School of Postural and Manual Therapy, Londrina, Parana, Brazil
| | - Almir Ferreira de Andrade
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
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de Cassia Almeida Vieira R, de Oliveira DV, Teixeira MJ, Paiva WDS. Scales for assessment of patients with traumatic brain injury. Patient Prefer Adherence 2015; 9:1631-3. [PMID: 26622170 PMCID: PMC4654534 DOI: 10.2147/ppa.s97032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rita de Cassia Almeida Vieira
- Nursing School, University of Sao Paulo, Sao Paulo, Brazil
- Correspondence: Rita de Cassia Almeida Vieira, 478 Itapiru Street Apartment 93, Sao Paulo 04143010, Brazil, Tel +55 11 2691 1842, Fax +55 11 2548 6906, Email
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