Eficácia da neuromodulação e intervenção cognitiva sobre desempenho funcional e cognitivo global em pacientes com doença de Alzheimer em fase leve

• Ano de defesa: 2018
• Autor(a) principal: Andrade, Jamerson de Carvalho
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal da Paraíba; Brasil; Psicologia; Programa de Pós-Graduação em Neurociência Cognitiva e Comportamento; UFPB
• Palavras-chave em Português: Doença de Alzheimer; Intervenção cognitiva; Estimulação transcraniana por corrente contínua; Alzheimer's disease; Cognitive intervention; Transcranial direct current stimulation; Neurociência cognitiva; Doença de Alzheimer - DA; Estimulação transcraniana - corrente contínua; Neuromodulação - Alzheimer; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA
• Link de acesso: https://repositorio.ufpb.br/jspui/handle/123456789/13529

Alzheimer's disease (AD) is the most common form of dementia, and its prevalence has increased significantly in recent decades. It is characterized by a cognitive decline, which leads to a drop from an earlier level of functioning and to interference with daily functioning. AD remains without a cure; so far, the two drug classes approved for use (acetylcholinesterase inhibitors and N-methylD-Aspartate receptor antagonist) have shown modest effect on cognition measurements and activities of daily living. In this context of limited treatment efficacy, the use of nonpharmacological strategies has increased, among which we can highlight Cognitive Intervention (CI) and neuromodulation methods through non-invasive cerebral stimulation, such as Transcranial Direct Current Stimulation (tDCS). Few studies have been performed with the objective of verifying the efficacy of these techniques associated to the current treatment. Thus, the present study had the objective of evaluating the therapeutic effects of tDCS and CI adjuvant to pharmacotherapy in patients on cognitive and functional measurements in AD. Twenty-two (22) patients diagnosed with early-stage AD were enrolled in the study. The study is a double-blind, randomized, placebo-controlled clinical trial. Patients were treated for eight weeks and underwent two evaluations: baseline (T0) and at week 8 (T1). According to this objective, subjects were allocated into four groups receiving different interventions: (a) active tDCS and active cognitive stimulation; (b) sham tDCS and active cognitive stimulation; (c) active tDCS and placebo/sham cognitive stimulation; and (d) sham tDCS and placebo/sham cognitive stimulation. The evaluations were performed prior to initiation and immediately after the application of tDCS. The intervention consists of 3 sessions per week for 2 months, totaling 24 sessions. The instruments used were the portuguese versions of the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS - COG), as primary outcome and the Disability Assessment for Dementia (DAD) as the secondary outcome. The current intensity for the tDCS was 2m/A applied to 6 cortical regions, while the parameters for the CI were related to the functions performed by the 6 regions chosen to receive tDCS. The results indicated that there were no significant differences between groups for the ADAS - Cog and DAD measurements [χ² (1) = .182, p = .670]. However, considering the averages recorded from pre and post treatment evaluations, an improvement trend was observed by analyzing the overall cognitive assessment measurements in the group submitted to active tDCS and CI, suggesting that this combination of non-pharmacological therapies, in addition to being safe, may represent a promising alternative to adjuvant treatment in AD.