LEANDRO DA COSTA LANE VALIENGO

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Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina

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  • article 8 Citação(ões) na Scopus
    Changes in motor cortical excitability in schizophrenia following transcranial direct current stimulation
    (2019) GORDON, Pedro Caldana; VALIENGO, Leandro da Costa Lane; PAULA, Vanessa Jesus Rodrigues de; GALHARDONI, Ricardo; ZIEMANN, Ulf; ANDRADE, Daniel Ciampi de; BRUNONI, Andre Russowsky
    Schizophrenia is a disorder associated with cortical inhibition deficits. Transcranial direct current stimulation (tDCS) induces changes in cortical excitability in healthy subjects and individuals with neuropsychiatric disorders depending on the stimulation parameters. Our aim was to investigate whether a previously published tDCS protocol associated with symptomatic improvement in schizophrenia would induce changes in motor cortical excitability, assessed by transcranial magnetic stimulation paradigms, i.e., short-interval intracortical inhibition (SICI) and intra-cortical facilitation (ICF). We assessed cortical excitability measurements in 48 subjects with schizophrenia before and after a single session of active tDCS (20 min, 2 mA, anode over left dorsolateral prefrontal cortex, cathode over left temporoparietal cortex) or sham. Those who received active tDCS had a significant increase of SICI in the left motor cortex compared to those who received sham stimulation (Cohen's d = 0.54, p = .019). No changes were observed for ICF. In addition, lower SICI was associated with higher age (beta = -0.448, p < .01). Increase in intracortical inhibition may indicate a mechanism of action of tDCS in this population. Future studies should investigate whether this finding is a biomarker of treatment response for schizophrenia.
  • bookPart
    Estimulação elétrica do sistema nervoso central e periférico
    (2019) CAVALCANTI, Antonio Sérgio Barata; VALIENGO, Leandro da Costa Lane
  • article 4 Citação(ões) na Scopus
    The Effects of Transcranial Direct Current Stimulation in Obsessive-Compulsive Disorder Symptoms: A Meta-Analysis and Integrated Electric Fields Modeling Analysis
    (2023) PINTO, Bianca Silva; CAVENDISH, Beatriz Araujo; SILVA, Pedro Henrique Rodrigues da; SUEN, Paulo Jeng Chian; MARINHO, Kalian Almeida Pereira; VALIENGO, Leandro da Costa Lane; VANDERHASSELT, Marie-Anne; BRUNONI, Andre Russowsky; RAZZA, Lais Boralli
    Transcranial direct current stimulation (tDCS) has been showing promising effects for the treatment of obsessive-compulsive disorder (OCD), but there is still no conclusion on its efficacy for this disorder. We performed a systematic review and meta-analysis of trials using tDCS for OCD and a computer modeling analysis to evaluate the electric field (EF) strengths of different electrode assemblies in brain regions of interest (ROIs) (PROSPERO-42021262465). PubMed/MEDLINE, Embase, Cochrane Library and Web of Science databases were searched from inception to 25 September 2022. Randomized controlled trials (RCTs) and open-label studies were included. The primary aim was the effect size (Hedges' g) of continuous outcomes and potential moderators of response. For EF modeling, SimNIBS software was used. Four RCTs and four open-label trials were included (n = 241). Results revealed a large effect of tDCS in the endpoint, but no significant effect between active and sham protocols. No predictor of response was found. EF analysis revealed that montages using the main electrode over the (pre)supplementary motor area with an extracephalic reference electrode might lead to stronger EFs in the predefined ROIs. Our results revealed that tDCS might be a promising intervention to treat OCD; however, larger studies are warranted.
  • article 75 Citação(ões) na Scopus
    Efficacy and Safety of Transcranial Direct Current Stimulation for Treating Negative Symptoms in Schizophrenia A Randomized Clinical Trial
    (2020) VALIENGO, Leandro da Costa Lane; GOERIGK, Stephan; GORDON, Pedro Caldana; PADBERG, Frank; SERPA, Mauricio Henriques; KOEBE, Stephanie; SANTOS, Leonardo Afonso dos; LOVERA, Roger Alberto Marcos; CARVALHO, Juliana Barbosa de; BILT, Martinus van de; LACERDA, Acioly L. T.; ELKIS, Helio; GATTAZ, Wagner Farid; BRUNONI, Andre R.
    This randomized clinical trial studies the efficacy and safety of transcranial direct current stimulation compared with sham as an add-on treatment for patients with schizophrenia with predominant negative symptoms. Importance Negative symptoms represent a substantial burden in schizophrenia. Although preliminary studies have suggested that transcranial direct current stimulation (tDCS) is effective for some clusters of symptoms, the clinical benefits for negative symptoms are unclear. Objective To determine the efficacy and safety of tDCS vs sham as an add-on treatment for patients with schizophrenia and predominant negative symptoms. Design, Setting, and Participants The double-blind Schizophrenia Treatment With Electric Transcranial Stimulation (STARTS) randomized clinical trial was conducted from September 2014 to March 2018 in 2 outpatient clinics in the state of Sao Paulo, Brazil. Patients with schizophrenia with stable negative and positive symptoms and a minimum score of 20 points in the negative symptoms subscale of the Positive and Negative Syndrome Scale (PANSS) were included. Interventions Ten sessions of tDCS performed twice a day for 5 days or a sham procedure. The anode and the cathode were positioned over the left prefrontal cortex and the left temporoparietal junction, respectively. Main Outcomes and Measures Change in the PANSS negative symptoms subscale score at week 6 was the primary outcome. Patients were followed-up for an additional 6 weeks. Results Of the 100 included patients, 20 (20.0%) were female, and the mean (SD) age was 35.3 (9.3) years. A total of 95 patients (95.0%) finished the trial. In the intention-to-treat analysis, patients receiving active tDCS showed a significantly greater improvement in PANSS score compared with those receiving the sham procedure (difference, 2.65; 95% CI, 1.51-3.79; number needed to treat, 3.18; 95% CI, 2.12-6.99; P < .001). Response rates for negative symptoms (20% improvement or greater) were also higher in the active group (20 of 50 [40%]) vs the sham group (2 of 50 [4%]) (P < .001). These effects persisted at follow-up. Transcranial direct current stimulation was well tolerated, and adverse effects did not differ between groups, except for burning sensation over the scalp in the active group (43.8%) vs the sham group (14.3%) (P = .003). Conclusions and Relevance Transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia. Question Is transcranial direct current stimulation (tDCS) a safe and effective add-on therapy for negative symptoms in schizophrenia? Findings In this randomized clinical trial of 100 patients with schizophrenia with predominant negative symptoms, active tDCS was superior to sham in ameliorating negative symptoms, with superior response rates (20% improvement) for negative symptoms. These effects were sustained at follow-up, and tDCS was not associated with significant adverse effects. Meaning Transcranial direct current stimulation is an affordable, safe, and effective add-on treatment for negative symptoms in schizophrenia.
  • article 36 Citação(ões) na Scopus
    Transcranial direct current stimulation (tDCS) in the management of epilepsy: A systematic review
    (2021) SUDBRACK-OLIVEIRA, Pedro; BARBOSA, Marina Zanichelli; THOME-SOUZA, Sigride; RAZZA, Lais Boralli; GALLUCCI-NETO, Jose; VALIENGO, Leandro da Costa Lane; BRUNONI, Andre Russowsky
    Purpose: Current therapies for the management of epilepsy are still suboptimal for several patients due to inefficacy, major adverse events, and unavailability. Transcranial direct current stimulation (tDCS), an emergent non-invasive neuromodulation technique, has been tested in epilepsy samples over the past two decades to reduce either seizure frequency or electroencephalogram (EEG) epileptiform discharges. Methods: A systematic review was performed in accordance with PRISMA guidelines (PROSPERO record CRD42020160292). A thorough electronic search was completed in MEDLINE, EMBASE, CENTRAL and Scopus databases for trials that applied tDCS interventions to children and adults with epilepsy of any cause, from inception to April 30, 2020. Results: Twenty-seven studies fulfilled eligibility criteria, including nine sham-controlled and 18 uncontrolled trials or case reports/series. Samples consisted mainly of drug-resistant focal epilepsy patients that received cathodal tDCS stimulation targeted at the site with maximal EEG abnormalities. At follow-up, 84 % (21/25) of the included studies reported a reduction in seizure frequency and in 43 % (6/14) a decline in EEG epileptiform discharge rate was observed. No serious adverse events were reported. Conclusions: Cathodal tDCS is both a safe and probably effective technique for seizure control in patients with drug-resistant focal epilepsy. However, published trials are heterogeneous regarding samples and methodology. More and larger sham-controlled randomized trials are needed, preferably with mechanistic informed stimulation protocols, to further advance tDCS therapy in the management of epilepsy.
  • article 17 Citação(ões) na Scopus
    Gamma transcranial alternating current stimulation in patients with negative symptoms in schizophrenia: A case series
    (2020) HALLER, Nikolas; HASAN, Alkomiet; PADBERG, Frank; BRUNELIN, Jerome; VALIENGO, Leandro da Costa Lane; PALM, Ulrich
    Non-invasive transcranial brain stimulation therapies, such as transcranial direct current stimulation, have been found to improve negative symptoms in schizophrenia. Another new technique is transcranial alternating current stimulation (tACS). Here we report a series of three patient treated with twice-daily 10 min prefrontal 40 Hz tACS stimulation over ten days. Patients showed an improvement in the Positive and Negative Syndrome Scale, Scale for the Assessment of Negative Symptoms, and subjective well-being. Furthermore, there was an improvement in the Trait Making Test and word fluency. ytACS merits further investigation in the treatment of schizophrenia symptoms.
  • article 4 Citação(ões) na Scopus
    Gamma transcranial alternating current stimulation for treatment of negative symptoms in schizophrenia: Report of two cases
    (2020) HALLER, Nikolas; HASAN, Alkomiet; PADBERG, Frank; VALIENGO, Leandro da Costa Lane; BRUNELIN, Jerome; PALM, Ulrich
  • bookPart
    Interconsulta em doenças neurológicas
    (2021) JúNIOR, Renério Fráguas; VALIENGO, Leandro da Costa Lane; TERRONI, Luisa; ADDA, Carla Cristina
  • bookPart
    Transtorno afetivo bipolar no idoso
    (2023) CHENAUD NETO, Paulo; SILVA, Jéssica Formiga e; ECHEGARAY, Mariana Vieira Fernández; VALIENGO, Leandro da Costa Lane
  • article 7 Citação(ões) na Scopus
    Lithium safety and tolerability in mood disorders: a critical review
    (2014) APRAHAMIAN, Ivan; SOUSA, Rafael Teixeira de; VALIENGO, Leandro da Costa Lane; MACHADO-VIEIRA, Rodrigo; FORLENZA, Orestes Vicente
    Background : Lithium is a first-line treatment for bipolar disorder in all phases, also indicated as add-on drug for unipolar depression and suicide prevention. This study encompasses a broad critical review on the safety and tolerability of lithium for mood disorders. Methods : A computerized search for English written human studies was made in MEDLINE, using the keywords “lithium” and “mood disorders”, starting from July 1993 through July 2013 (n = 416). This initial search aimed to select clinical trials, prospective data, and controlled design studies of lithium treatment for mood disorders reporting adverse effects (n = 36). The final selection yielded 91 studies. Results : The most common general side effects in patients on lithium treatment were thirst, frequent urination, dry mouth, weight gain, fatigue and cognitive complaints. Lithium users showed a high prevalence of hypothyroidism, hyperparathyroidism, and decrease in urinary concentration ability. Reduction of glomerular filtration rate in patients using lithium was also observed, but in a lesser extent. The evidence of teratogenicity associated with lithium use is not well established. Anti-inflammatory non-steroidal drugs, thiazide diuretics, angiotensin-converting enzyme inhibitors, and alprazolam may increase serum lithium and the consequent risk for intoxication. Discussion : Short-term lithium treatment is associated with mild side effects. Medium and long-term lithium treatment, however, might have effects on target organs which may be prevented by periodical monitoring. Overall, lithium is still a safe option for the treatment of mood disorders.