Estimulação Transcraniana por Corrente Contínua no Autismo: Uma Revisão Sistemática
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O transtorno do espectro autista (TEA) é caracterizado por apresentar prejuízos nas interações sociais, limitações nos comportamentos de comunicação, além de alterações comportamentais de interesses. Devido a sua complexa fisiopatologia, é imprescindível a existência de biomarcadores válidos e confiáveis para um diagnóstico e tratamento eficaz, objetivando a melhora da sintomática. A estimulação transcraniana por corrente contínua (ETCC), uma das formas de estimulação não-invasiva mais utilizadas, apresenta-se como uma técnica promissora com potenciais diagnóstico e terapêutico. Usando a metodologia PRISMA, realizamos uma revisão da contribuição e evidência científica para o uso da ETCC no TEA. Entre 43 artigos, foram identificados seis estudos relevantes. Os dados preliminares sugerem melhora nos sintomas comportamentais e cognitivos do TEA. Todavia, apesar da eficácia da ETCC, algumas divergências metodológicas foram observadas entre os artigos, trazendo a necessidade da realização de mais estudos bem desenhados e controlados para confirmar potencialidade real da ETCC no TEA.
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Referências
Amatachaya, A., Auvichayapat, N., Patjanasoontorn, N., Suphakunpinyo, C., Ngernyam, N., Aree-uea, B., … Auvichayapat, P. (2014). Effect of Anodal Transcranial Direct Current Stimulation on Autism: A Randomized Double-Blind Crossover Trial, Effect of Anodal Transcranial Direct Current Stimulation on Autism: A Randomized Double-Blind Crossover Trial. Behavioural Neurology, Behavioural Neurology, 2014, 2014, e173073. http://doi.org/10.1155/2014/173073, 10.1155/2014/173073
Amatachaya, A., Jensen, M. P., Patjanasoontorn, N., Auvichayapat, N., Suphakunpinyo, C., Janjarasjitt, S., … Auvichayapat, P. (2015). The Short-Term Effects of Transcranial Direct Current Stimulation on Electroencephalography in Children with Autism: A Randomized Crossover Controlled Trial, The Short-Term Effects of Transcranial Direct Current Stimulation on Electroencephalography in Children with Autism: A Randomized Crossover Controlled Trial. Behavioural Neurology, Behavioural Neurology, 2015, 2015, e928631. http://doi.org/10.1155/2015/928631, 10.1155/2015/928631
Amatachaya, A., Patjanasoontorn, N., Auvichayapat, N., Suphakunpinyo, C., Janjarasjitt, S., Thuleechan, W., … Auvichayapat, P. (2013). The Effects of Transcranial Direct Current Stimulation in Patients with Autism: Srinagarind Medical Journal (SMJ) - ศรีนครินทร์เวชสาร, 28(3), 311-319.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). American Psychiatric Association. Recuperado de http://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
Anagnostou, E., & Taylor, M. J. (2011). Review of neuroimaging in autism spectrum disorders: what have we learned and where we go from here. Molecular Autism, 2, 4. http://doi.org/10.1186/2040-2392-2-4
Au, J., Katz, B., Buschkuehl, M., Bunarjo, K., Senger, T., Zabel, C., … Jonides, J. (2016). Enhancing Working Memory Training with Transcranial Direct Current Stimulation. Journal of Cognitive Neuroscience, 1-14. http://doi.org/10.1162/jocn_a_00979
Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., & Brayne, C. (2009). Prevalence of autism-spectrum conditions: UK school-based population study. The British Journal of Psychiatry, 194, 500-509. http://doi.org/10.1192/bjp.bp.108.059345
Braun, J. M., Kalkbrenner, A. E., Just, A. C., Yolton, K., Calafat, A. M., Sjödin, A., … Lanphear, B. P. (2014). Gestational Exposure to Endocrine-Disrupting Chemicals and Reciprocal Social, Repetitive, and Stereotypic Behaviors in 4- and 5-Year-Old Children: The HOME Study. Environmental Health Perspectives. http://doi.org/10.1289/ehp.1307261
Breitling, C., Zaehle, T., Dannhauer, M., Bonath, B., Tegelbeckers, J., Flechtner, H.-H., & Krauel, K. (2016). Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS). Frontiers in Cellular Neuroscience, 72. http://doi.org/10.3389/fncel.2016.00072
Bystad, M., Grønli, O., Rasmussen, I. D., Gundersen, N., Nordvang, L., Wang-Iversen, H., & Aslaksen, P. M. (2016). Transcranial direct current stimulation as a memory enhancer in patients with Alzheimer’s disease: a randomized, placebo-controlled trial. Alzheimer’s Research & Therapy, 8, 13. http://doi.org/10.1186/s13195-016-0180-3
Casanova, M. F., El-Baz, A. S., Kamat, S. S., Dombroski, B. A., Khalifa, F., Elnakib, A., … Switala, A. E. (2013). Focal cortical dysplasias in autism spectrum disorders. Acta Neuropathologica Communications, 1, 67. http://doi.org/10.1186/2051-5960-1-67
Costanzo, F., Menghini, D., Casula, L., Amendola, A., Mazzone, L., Valeri, G., & Vicari, S. (2015). Transcranial Direct Current Stimulation Treatment in an Adolescent with Autism and Drug-Resistant Catatonia. Brain Stimulation, 8, 1233-1235. http://doi.org/10.1016/j.brs.2015.08.009
D’Urso, G., Bruzzese, D., Ferrucci, R., Priori, A., Pascotto, A., Galderisi, S., … Bravaccio, C. (2015). Transcranial direct current stimulation for hyperactivity and noncompliance in autistic disorder. The World Journal of Biological Psychiatry: The Official Journal of the World Federation of Societies of Biological Psychiatry, 16(5), 361–366. http://doi.org/10.3109/15622975.2015.1014411
D’Urso, G., Ferrucci, R., Bruzzese, D., Pascotto, A., Priori, A., Altamura, C. A., … Bravaccio, C. (2014). Transcranial direct current stimulation for autistic disorder. Biological Psychiatry, 76(5), e5–6. http://doi.org/10.1016/j.biopsych.2013.11.009
Enticott, P. G., Fitzgibbon, B. M., Kennedy, H. A., Arnold, S. L., Elliot, D., Peachey, A., … Fitzgerald, P. B. (2014). A Double-blind, Randomized Trial of Deep Repetitive Transcranial Magnetic Stimulation (rTMS) for Autism Spectrum Disorder. Brain Stimulation, 7, 206-211. http://doi.org/10.1016/j.brs.2013.10.004
Fritsch, B., Reis, J., Martinowich, K., Schambra, H. M., Ji, Y., Cohen, L. G., & Lu, B. (2010). Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning. Neuron, 66, 198-204. http://doi.org/10.1016/j.neuron.2010.03.035
Gao, R., & Penzes, P. (2015). Common Mechanisms of Excitatory and Inhibitory Imbalance in Schizophrenia and Autism Spectrum Disorders. Current molecular medicine, 15, 146-167.
Gilbert, S. J., Bird, G., Brindley, R., Frith, C. D., & Burgess, P. W. (2008). Atypical recruitment of medial prefrontal cortex in autism spectrum disorders: An fMRI study of two executive function tasks. Neuropsychologia, 46(9), 2281–2291. http://doi.org/10.1016/j.neuropsychologia.2008.03.025
Herbert, M. R., Harris, G. J., Adrien, K. T., Ziegler, D. A., Makris, N., Kennedy, D. N., … Caviness, V. S. (2002). Abnormal asymmetry in language association cortex in autism. Annals of Neurology, 52(5), 588-596. http://doi.org/10.1002/ana.10349
Krause, B., Márquez-Ruiz, J., & Kadosh, R. C. (2013). The effect of transcranial direct current stimulation: a role for cortical excitation/inhibition balance? Frontiers in Human Neuroscience, 7. http://doi.org/10.3389/fnhum.2013.00602
Kuo, M.-F., Paulus, W., & Nitsche, M. A. (2014). Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases. NeuroImage, 85 Pt 3, 948-960. http://doi.org/10.1016/j.neuroimage.2013.05.117
Lee, E., Lee, J., & Kim, E. (2016). Excitation/Inhibition Imbalance in Animal Models of Autism Spectrum Disorders. Biological Psychiatry, 0(0). http://doi.org/10.1016/j.biopsych.2016.05.011
Medeiros, L. F., de Souza, I. C. C., Vidor, L. P., de Souza, A., Deitos, A., Volz, M. S., … Torres, I. L. S. (2012). Neurobiological Effects of Transcranial Direct Current Stimulation: A Review. Frontiers in Psychiatry, 3. http://doi.org/10.3389/fpsyt.2012.00110
Mondino, M., Brunelin, J., Palm, U., Brunoni, A. R., Poulet, E., & Fecteau, S. (2015). Transcranial Direct Current Stimulation for the Treatment of Refractory Symptoms of Schizophrenia. Current Evidence and Future Directions. Current Pharmaceutical Design, 21(23), 3373-3383.
Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., … Pascual-Leone, A. (2008). Transcranial direct current stimulation: State of the art 2008. Brain Stimulation, 1(3), 206-223. http://doi.org/10.1016/j.brs.2008.06.004
Nitsche, M. A., Liebetanz, D., Lang, N., Antal, A., Tergau, F., & Paulus, W. (2003). Safety criteria for transcranial direct current stimulation (tDCS) in humans. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology, 114(11), 2220-2222.
Nitsche, M. A., & Paulus, W. (2001). Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology, 57(10), 1899–1901. http://doi.org/10.1212/WNL.57.10.1899
Oberman, L., Eldaief, M., Fecteau, S., Ifert-Miller, F., Tormos, J. M., & Pascual-Leone, A. (2012). Abnormal modulation of corticospinal excitability in adults with Asperger’s syndrome. The European Journal of Neuroscience, 36(6), 2782-2788. http://doi.org/10.1111/j.1460-9568.2012.08172.x
Oberman, L. M., Rotenberg, A., & Pascual-Leone, A. (2015). Use of Transcranial Magnetic Stimulation in Autism Spectrum Disorders. Journal of autism and developmental disorders, 45(2), 524–536. http://doi.org/10.1007/s10803-013-1960-2
Ozonoff, S., & Miller, J. N. (1996). An exploration of right-hemisphere contributions to the pragmatic impairments of autism. Brain and Language, 52(3), 411-434. http://doi.org/10.1006/brln.1996.0022
Palm, U., Hasan, A., Strube, W., & Padberg, F. (2016). tDCS for the treatment of depression: a comprehensive review. European Archives of Psychiatry and Clinical Neuroscience. http://doi.org/10.1007/s00406-016-0674-9
Pedapati, E. V., Gilbert, D. L., Erickson, C. A., Horn, P. S., Shaffer, R. C., Wink, L. K., … Wu, S. W. (2016). Abnormal Cortical Plasticity in Youth with Autism Spectrum Disorder: A Transcranial Magnetic Stimulation Case-Control Pilot Study. Journal of Child and Adolescent Psychopharmacology. http://doi.org/10.1089/cap.2015.0183
Peterson, D., Mahajan, R., Crocetti, D., Mejia, A., & Mostofsky, S. (2015). Left-hemispheric microstructural abnormalities in children with high-functioning autism spectrum disorder. Autism Research: Official Journal of the International Society for Autism Research, 8(1), 61-72. http://doi.org/10.1002/aur.1413
Rosenberg, A., Patterson, J. S., & Angelaki, D. E. (2015). A computational perspective on autism. Proceedings of the National Academy of Sciences, 112, 9158-9165. http://doi.org/10.1073/pnas.1510583112
Roy, L. B., Sparing, R., Fink, G. R., & Hesse, M. D. (2015). Modulation of attention functions by anodal tDCS on right PPC. Neuropsychologia, 74, 96-107. http://doi.org/10.1016/j.neuropsychologia.2015.02.028
Rubenstein, J. L. R., & Merzenich, M. M. (2003). Model of autism: Increased ratio of excitation/inhibition in key neural systems. Genes, Brain, and Behavior, 2(5), 255-267.
Said, C. P., Egan, R. D., Minshew, N. J., Behrmann, M., & Heeger, D. J. (2013). Normal binocular rivalry in autism: Implications for the excitation/inhibition imbalance hypothesis. Vision Research, 77, 59–66. http://doi.org/10.1016/j.visres.2012.11.002
Schneider, H. D., & Hopp, J. P. (2011). The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism. Clinical Linguistics & Phonetics, 25, 640-654. http://doi.org/10.3109/02699206.2011.570852
Sesarini, C. V. (2015). GABAergic neurotransmission alterations in autism spectrum disorders. Neurotransmitter, 2. http://doi.org/10.14800/nt.1052
Sokhadze, E. M., El-Baz, A. S., Tasman, A., Sears, L. L., Wang, Y., Lamina, E. V., & Casanova, M. F. (2014). Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: an exploratory study. Applied Psychophysiology and Biofeedback, 39, 237-257. http://doi.org/10.1007/s10484-014-9264-7
Stagg, C. J., & Nitsche, M. A. (2011). Physiological Basis of Transcranial Direct Current Stimulation. The Neuroscientist, 17(1), 37-53. http://doi.org/10.1177/1073858410386614
Steenburgh, J. van, Varvaris, M., Schretlen, D., Vannorsdall, T., & Gordon, B. (2016). Bifrontal Transcranial Direct Current Stimulation Enhances Working Memory in Adults with High-Functioning Autism (S9.001). Neurology, 86(16 Supplement), S9.001.
Taub, E. (2015). Neuroplasticity and Neurorehabilitation. Frontiers E-books.
Théoret, H., Halligan, E., Kobayashi, M., Fregni, F., Tager-Flusberg, H., & Pascual-Leone, A. (2005). Impaired motor facilitation during action observation in individuals with autism spectrum disorder. Current Biology, 15(3), R84-R85. http://doi.org/10.1016/j.cub.2005.01.022
Tortella, G., Casati, R., Aparicio, L. V. M., Mantovani, A., Senço, N., D’Urso, G., … Brunoni, A. R. (2015). Transcranial direct current stimulation in psychiatric disorders. World Journal of Psychiatry, 5, 88-102. http://doi.org/10.5498/wjp.v5.i1.88
Vandenbroucke, M. W. G., Scholte, H. S., van Engeland, H., Lamme, V. A. F., & Kemner, C. (2008). A neural substrate for atypical low-level visual processing in autism spectrum disorder. Brain: A Journal of Neurology, 131(Pt 4), 1013-1024. http://doi.org/10.1093/brain/awm321
Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current opinion in neurology, 26(2), 146-153. http://doi.org/10.1097/WCO.0b013e32835ee548
Wokke, M. E., Talsma, L. J., & Vissers, M. E. (2015). Biasing neural network dynamics using non-invasive brain stimulation. Frontiers in Systems Neuroscience, 8. http://doi.org/10.3389/fnsys.2014.00246