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Event-related desynchronisation (ERD) and event-related synchronisation (ERS) reflect pain perception and integration of the nociceptive sensory inputs. This may contribute to the understanding of how neurophysiological markers of Knee Osteoarthritis (KOA) patients can differ from control individuals, which would improve aspects such as prediction and prognosis. We performed a cross-sectional analysis of our cohort study (DEFINE cohort), KOA arm, with 71 patients, compared with 65 control participants. The study aimed to examine possible differences between ERD and ERS in control participants compared to Knee Osteoarthritis (KOA) patients when adjusting for important covariates. We performed independent multivariate regression models considering as dependent variables the power value related to ERD and ERS for four different sensorimotor tasks (Motor Execution, Motor Imagery, Active Observation and Passive Observation) and four sensorimotor oscillations (Alpha, Beta, Low Beta, and High Beta), each model, controlled by age and sex. We demonstrate that the differences between KOA and healthy subjects are frequency specific, as most differences are in the beta bandwidth range. Also, we observed that subjects in the KOA group had significantly higher ERD and ERS. This may be correlated to the amount of lack of brain organisation and a subsequent attempt at compensation induced by KOA. Our findings strengthen the notion that subjects with KOA have a higher degree of brain plasticity changes that are also likely correlated to the degree of compensation and behavioural dysfunction.

Objective: Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES.Methods: We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided.Results: The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity.Conclusions: Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. Significance: We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials. (C) 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2021-11-08T21:12:21Z No. of bitstreams: 1 Solange Zilli Lo Presti Heinz.pdf: 2564767 bytes, checksum: 73658f53261d683bc0681274972223aa (MD5) Made available in DSpace on 2021-11-08T21:12:21Z (GMT). No. of bitstreams: 1 Solange Zilli Lo Presti Heinz.pdf: 2564767 bytes, checksum: 73658f53261d683bc0681274972223aa (MD5) Previous issue date: 2021-10-06 Objective: To evaluate the effect of anodal Transcranial Direct Current Stimulation (TCTE) on the left dorsolateral prefrontal cortex (DLCLC) associated with aerobic exercise (AE) on Heart Rate Variability (HRV), distance traveled on an ergometric bicycle and subjective perception of effort of individuals after chronic stroke. Methodology: Clinical, randomized, controlled and double-blind trial with 17 individuals, randomized into 2 groups: anodal tDCS (aETCC) and sham (sETCC) plus AE. The HRV was evaluated for 15 minutes at rest and after one session, and the distance walked together with the subjective perception of post-AE effort. Interventions: tDCS with anode electrode in left LMPLC, cathode in supraorbital region contralateral to the anode, for 20 minutes associated with AS. Data Analysis: HRV assessed by variance, rMSSD, low and high absolute frequency and sympathovagal balance, as well as distance covered and subjective perception of exertion, using the Mann-Whitney and independent-sample t tests. Results: Under baseline conditions, the groups showed greater vagal performance. After the TSCC and EA session, there was no significant difference in HRV, and after anodal and sham intervention, both groups maintained a predominance of performance. In the distance covered, with no significant difference, the active person covered 156 meters more than the sham, while the subjective perception of respiratory effort and lower limbs was greater for the sham. Conclusion: The study demonstrated that anodal tDCS in left LMPLC associated with AS did not promote significant changes in the modulation of the autonomic nervous system, optimizing vagal action. The performance of the distance covered, although better for the anodal group, had no clinical importance in this sample. Objetivo: Avaliar o efeito da Estimulação Transcraniana por Corrente Continua (ETCC) anodal no córtex pré-frontal dorsolateral (CPFDL) esquerdo associada ao exercício aeróbico (EA) na Variabilidade da Frequência Cardíaca (VFC), distância percorrida em bicicleta ergométrica e percepção subjetiva de esforço de indivíduos pós AVC crônico. Metodologia: Ensaio clínico, randomizado, controlado e duplo-cego com 17 indivíduos, randomizados em 2 grupos: ETCC anodal (aETCC) e sham (sETCC) mais EA. Avaliadas a VFC por 15 minutos em repouso e após uma sessão, e a distância percorrida juntamente com percepção subjetiva de esforço pós EA. Intervenções: ETCC com eletrodo anodo em CPFDL esquerdo, catodo em região supra orbital contralateral ao anodo, por 20 minutos associada ao EA. Análise de Dados: VFC avaliada pela variância, rMSSD, baixa e alta frequência absoluta e balanço simpatovagal, assim como distância percorrida e percepção subjetiva de esforço, pelos testes de Mann-Whitney e T de amostras independentes. Resultados: Em condições basais os grupos apresentaram maior atuação vagal. Após a sessão da ETCC e EA, não se observou diferença significativa na VFC, e após intervenção anodal e sham, ambos os grupos mantiveram predomínio da atuação. Na distância percorrida, sem diferença significativa, o ativo percorreu 156 metros a mais que o sham, enquanto a percepção subjetiva de esforço respiratório e de MMII foi maior para o sham. Conclusão: O estudo demonstrou que a ETCC anodal em CPFDL esquerdo associada ao EA, não promoveu alterações significativas na modulação do sistema nervoso autônomo, otimizando a atuação vagal. A performance da distância percorrida, embora melhor para o grupo anodal, não teve importância clínica nesta amostra.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2021-11-08T20:55:03Z No. of bitstreams: 1 Glauber Heinz.pdf: 5143836 bytes, checksum: d29ab243ef4302247059fecf9718b1b1 (MD5) Made available in DSpace on 2021-11-08T20:55:03Z (GMT). No. of bitstreams: 1 Glauber Heinz.pdf: 5143836 bytes, checksum: d29ab243ef4302247059fecf9718b1b1 (MD5) Previous issue date: 2021-10-06 Introduction: Dysautonomy of the Autonomic Nervous System is a frequent consequence after a stroke resulting from changes in the connection between the brain-heart axis, with increased cardiac risks in these patients. Thus, studies have been growing for cardiovascular recovery and control, such as aerobic exercise (AE) and the possible use of Transcranial Direct Current Stimulation (tDCS) as a supporting technique in autonomic modulation. Objective: To investigate the effect of tDCS associated with aerobic training on the autonomic nervous system, physical performance, and cognitive performance after chronic stroke during the 1st, 12th, 24th, 36th sessions and after a 30-day follow-up without interventions. Methods: Clinical trial, double-blind, controlled, and randomized in two groups, being group 1 (tDCS anodal + AE with nine individuals) and group 2 (tDCS sham + AE with eight individuals), totaling 17 individuals, in a mean age range of 53 ± 10 years of both sexes. Assessments: Heart Rate Variability (HRV) 15 minutes before and after the 1st, 12th, 24th, and 36th sessions of anodal or sham tDCS + EA and a 30-day post-follow-up without interventions; cognition by the ADDENBROOKE (ACE) questionnaire by the total score and by the domains and physical performance by the distance covered for 30 minutes on the ergometric bicycle for three months of AE three times a week interspersed, with an intensity of 50 to 70% of the reserve heart rate. The tDCS applied for 20 minutes during AE, the anode in the left dorsolateral prefrontal cortex (DLPFC) and cathode in the contralateral, supraorbital region (Fp2), the intensity of 2mA. Results: There was no statistical difference in intergroup and intragroup HRV in sessions and after follow-up. But Intragroup, we observed that the parasympathetic performance after the 24th session in the active, increased 50% compared to the post from the 1st session and 11% compared to the baseline by the rMSSD index, showing the Variance Index value, which represents the total variation of the RR intervals analyzed in a time range, after the 24th session, of 17% above the index of the 1st session (1075.9 – 1262.3ms2) and 7% above the baseline condition (1184.2 – 1262.3ms2), indicating a better prognosis, however, this effect was not significant. Cognition showed levels of evidence inactive, where it was better in the language subscale at baseline p=0.041 and follow-up p=0.002. Better memory at follow-up p=0.005 compared to sham. There was a non-significant increase in physical performance in both groups. Conclusion: tDCS applied on left DLPFC plus AE did not change HRV and physical performance for three months and after follow-up between groups. However, there was an improvement in cognitive performance, especially in language and executive memory, after using anodic tDCS on the left DLPFC associated with AE. Introdução: A disautonomia do Sistema Nervoso Autônomo é uma consequência frequente após o Acidente Vascular Cerebral (AVC) decorrente das alterações da conexão entre o eixo cérebro-coração, com aumento dos riscos cardíacos desses pacientes. Deste modo vem crescendo estudos para a recuperação e controle cardiovascular, como exercício aeróbico (EA) e o possível uso da Estimulação Transcraniana por Corrente Contínua (ETCC) como uma técnica coadjuvante na modulação autonômica. Objetivo: Investigar o efeito da ETCC associada ao treinamento aeróbico no sistema nervoso autônomo, performance física e desempenho cognitivo pós AVC crônico durante a 1ª, 12ª, 24ª, 36ª sessões e após o follow-up de 30 dias sem intervenções. Métodos: Ensaio clínico, duplo-cego, controlado e randomizado em dois grupos, sendo o grupo 1 (ETCC anodal + EA com 9 indivíduos) e o grupo 2 (ETCC sham + EA com 8 indivíduos), totalizando 17 indivíduos, numa faixa etária média de 53 ± 10 anos de ambos os sexos. Avaliações: Variabilidade da Frequência Cardíaca (VFC) 15 minutos pré e após 1ª, 12a, 24ª e 36ª sessões de ETCC anodal ou sham + EA e pós follow-up de 30 dias sem intervenções; cognição pelo questionário ADDENBROOKE (ACE) pela pontuação total e pelos domínios e performance física pela distância percorrida por 30 minutos na bicicleta ergométrica por 3 meses de EA três vezes por semana intercalados, com uma intensidade de 50 a 70% da frequência cardíaca de reserva. ETCC aplicada por 20 minutos durante EA, ânodo no córtex pré-frontal dorso lateral (CPFDL) esquerdo e cátodo na região supra orbital contralateral (Fp2), intensidade de 2mA. Resultados: Não houve diferença estatística da VFC intergrupos e intragrupo nas sessões e após follow-up. Mas Intragrupo, observamos que a atuação parassimpática após 24ª sessão no ativo, aumentou 50% em relação aos pós da 1ª sessão e 11% em relação à linha de base pelo índice rMSSD, apresentando valor do índice da Variância, que representa a variação total dos intervalos RR analisados numa faixa de tempo, após 24ª sessão, de 17% acima do índice da 1ª sessão (1075,9 – 1262,3ms2) e 7% acima da condição basal (1184,2 – 1262,3ms2), indicando melhor prognóstico, no entanto esse efeito não foi significante. A cognição mostrou níveis de evidências no ativo, onde foi melhor na subescala da linguagem na linha de base p=0,041 e no follow-up p=0,002. Já a memória melhor no follow-up p=0,005 em relação ao sham. Houve aumento não significativo da performance física em ambos os grupos. Conclusão: A ETCC aplicada sobre CPFDL esquerdo mais EA não alterou a VFC e a performance física durante 3 meses e após o follow-up entre os grupos. Entretanto, houve uma melhora no desempenho cognitivo, principalmente com relação ao desempenho da linguagem e da memoria executiva após o uso da ETCC anódica no CPFDL esquerdo associada ao EA.