Effects of a Non-focal Plasticity Protocol on Apathy in Moderate Alzheimer's Disease: A Randomized, Double-blind, Sham-controlled Trial

Imagem de Miniatura
Arquivos
art_SUEMOTO_Effects_of_a_Non_focal_Plasticity_Protocol_on_2014.PDF (358.15 KB)
Citações na Scopus
97
Tipo de produção
article
Data de publicação
2014
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
NAKAMURA-PALACIOS, Ester Miyuki
MORILLO, Lilian Shafirovitz
Citação
BRAIN STIMULATION, v.7, n.2, p.308-313, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Apathy is the most common neuropsychiatric symptom in Alzheimer's disease (AD) and it is associated with changes in prefrontal neural circuits involved with generation of voluntary actions. To date no effective treatment for apathy has been demonstrated. Objective: We aimed to investigate the effects and safety of repetitive transcranial direct current stimulation (tDCS) on apathy in moderate AD patients. Methods: Forty patients were randomized to receive either active or sham-tDCS over the left dorsolateral prefrontal cortex (DLPFC). Patients received six sessions of intervention during 2 weeks and were evaluated at baseline, at week 1 and 2, and after 1 week without intervention. Clinical raters, patients, and caregivers were blinded. The primary outcome was apathy. Global cognition and neuropsychiatric symptoms were examined as secondary outcomes. Results: The mean MMSE score at baseline was 15.2 +/- 2.9 and the mean Apathy Scale score was 27.7 +/- 6.7. Changes on apathy scores over time were not different between active and sham tDCS (P = 0.552 for repeated measures). Further analyses confirm that changes from baseline did not differ between groups after the sixth session (active tDCS -1.95 (95%CI -3.49, -0.41); sham-tDCS -2.05 (95% Cl -3.68, 0.42); P = 0.9891. Similarly, tDCS had no effect on secondary outcomes (P > 0.40). tDCS was well tolerated and not associated with significant adverse effects. Conclusion: In this adequately powered study for minimal clinically significant difference, our findings show that using the parameters we chose for this study, repeated anodal tDCS over the left DLPFC had no effect on apathy in elderly patients with moderate AD.
Palavras-chave
Apathy, Dementia, Alzheimer's disease, Cognition, Depression, Transcranial direct current stimulation
URI
https://observatorio.fm.usp.br/handle/OPI/7367
Referências
  1. ALEXOPOULOS GS, 1988, BIOL PSYCHIAT, V23, P271, DOI 10.1016/0006-3223(88)90038-8
  2. BLISS TVP, 1993, NATURE, V361, P31, DOI 10.1038/361031a0
  3. Boggio PS, 2009, J NEUROL NEUROSUR PS, V80, P444, DOI 10.1136/jnnp.2007.141853
  4. Boggio PS, 2006, J NEUROL SCI, V249, P31, DOI 10.1016/j.jns.2006.05.062
  5. Brunoni AR, 2013, JAMA PSYCHIAT, V70, P383, DOI 10.1001/2013.jamapsychiatry.32
  6. CUMMINGS JL, 1994, NEUROLOGY, V44, P2308
  7. Fern C. P, 2005, LANCET, V366, P2112
  8. Ferrero-Arias J, 2011, ALZ DIS ASSOC DIS, V25, P213, DOI 10.1097/WAD.0b013e3182087dbc
  9. Ferrucci R, 2008, NEUROLOGY, V71, P493, DOI 10.1212/01.wnl.0000317060.43722.a3
  10. FOLSTEIN MF, 1975, J PSYCHIAT RES, V12, P189, DOI 10.1016/0022-3956(75)90026-6
  11. Fritsch B, 2010, NEURON, V66, P198, DOI 10.1016/j.neuron.2010.03.035
  12. Hadley D, 2011, J ECT, V27, P18, DOI 10.1097/YCT.0b013e3181ce1a8c
  13. Herrmann N, 2008, J CLIN PSYCHOPHARM, V28, P296, DOI 10.1097/JCP.0b013e318172b479
  14. Holthoff VA, 2005, BIOL PSYCHIAT, V57, P412, DOI 10.1016/j.biopsych.2004.11.035
  15. Levy R, 2006, CEREB CORTEX, V16, P916, DOI 10.1093/cercor/bhj043
  16. MCKHANN G, 1984, NEUROLOGY, V34, P939
  17. McKhann GM, 2011, ALZHEIMERS DEMENT, V7, P263, DOI 10.1016/j.jalz.2011.03.005
  18. Mintzer J, 2012, GERONTOLOGIST, V52, P625
  19. Mizrahi R, 2007, DRUG AGING, V24, P547, DOI 10.2165/00002512-200724070-00003
  20. Mohs RC, 1997, ALZ DIS ASSOC DIS, V11, pS13
  21. Murer MG, 1999, NEUROSCIENCE, V88, P1015, DOI 10.1016/S0306-4522(98)00219-X
  22. Nardone R, 2012, INT J ALZHEIMERS DIS, V2012, DOI [10.1155/2012/687909, DOI 10.1155/2012/687909]
  23. Padala PR, 2010, AM J GERIAT PSYCHIAT, V18, P371, DOI 10.1097/JGP.0b013e3181cabcf6
  24. Prince M, 2009, WORLD ALZHEIMER REPO, P8
  25. Rosen HJ, 2005, BRAIN, V128, P2612, DOI 10.1093/brain/awh628
  26. Sink KM, 2005, JAMA-J AM MED ASSOC, V293, P596, DOI 10.1001/jama.293.5.596
  27. Stagg CJ, 2011, NEUROSCIENTIST, V17, P37, DOI 10.1177/1073858410386614
  28. STARKSTEIN SE, 1992, J NEUROPSYCH CLIN N, V4, P134
  29. Tapia-Arancibia L, 2008, BRAIN RES REV, V59, P201, DOI 10.1016/j.brainresrev.2008.07.007
  30. Wagner T, 2007, NEUROIMAGE, V35, P1113, DOI 10.1016/j.neuroimage.2007.01.027

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/15
Carregar mais