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Advisor(s)
Abstract(s)
Introdução: Mundialmente, o Acidente Vascular Cerebral (AVC) é a principal causa de incapacidade a longo prazo no adulto, produzindo sequelas permanentes a nível motor e cognitivo, pelo que se torna imperativo o desenvolvimento de estratégias de recuperação pós-AVC. Pensa-se que a Estimulação Magnética Transcraniana repetitiva (EMTr) promova a plasticidade das vias neuronais danificadas. Assim, a nossa hipótese é que a EMTr bi-hemisférica em doentes com AVC isquémico da Artéria Cerebral Média (ACM) aumente a performance cognitiva e a função motora do membro superior, a curto e a médio prazos, e possa assim, ser usada como adjuvante na terapêutica de doentes com estas sequelas decorrentes de AVC. Desta forma, o objetivo deste estudo é avaliar as variações na cognição e na função motora do membro superior, respetivamente, através da aplicação da escala Montreal Cognitive Assessment (MoCA) e Frenchay Arm Test (FAT), com um follow-up de um mês.
Materiais e métodos: Seis doentes com AVC isquémico da ACM receberam 1000 pulsos de EMTr (1Hz a 100% do limiar motor de repouso (LMR)) sobre o hemisfério saudável e 1000 pulsos (10Hz a 90% do LMR) sobre o hemisfério isquémico, de forma sequencial, durante cinco dias consecutivos. Ambas as escalas foram aplicadas em três momentos: antes (momento 1), na semana após (momento 2) e um mês após (momento 3) a estimulação.
Resultados: Os resultados da escala MoCA revelaram aumentos estatisticamente significativos, havendo uma subida dos valores médios do momento 1 (19,83) para o momento 3 (22,83). Os resultados do FAT mostram uma tendência de aumento em todos os momentos avaliados.
Conclusão: Este é um estudo pioneiro na área cujos resultados sugerem que a EMTr bi-hemisférica poderá ser um adjuvante fidedigno na recuperação do Compromisso Cognitivo após AVC.
Introduction: Stroke is the leading cause of long term disability in adults worldwide, producing permanent motor and cognitive impairments, and, for that reason, it urges the need for new strategies of recovery after stroke. It is believed that repetitive transcranial magnetic stimulation (rTMS) promotes plasticity of damaged neural pathways. Thus our hypothesis is that bihemispheric rTMS in patients with Middle Cerebral Artery (MCA) ischemic stroke has the potential to increase cognitive performance and upper arm motor function at short and medium term, and consequently, that this could be applied as a complementary treatment in patients with impairments after stroke. Therefore, the purpose of this study is to evaluate the variations in cognition and motor function of the upper arm through the application of Montreal Cognitive Assessment (MoCA) scale and Frenchay Arm Test (FAT), respectively, with one month of follow-up. Methods: Six patients with ischemic stroke on MCA received sequentially 1000 pulses of rTMS (1Hz at 100% of the rest motor threshold (RMT)) over the unaffected hemisphere and 1000 pulses (10 Hz at 90% of RMT) over the affected hemisphere, for five consecutive days. Both tests were applied at three moments: before (moment 1) in the week after (moment 2) and one month after (moment 3) the stimulation. Results: The results on cognition, evaluated by the MoCA scale showed statistically significant increases: the average values increased from moment 1 (19,83) to moment 3 (22,83). The results of motor function, assessed by FAT show a rising trend in all evaluated moments. Conclusion: Our study suggests that bihemispheric rTMS may be a feasible adjunct in the recovery of cognitive impairment after stroke.
Introduction: Stroke is the leading cause of long term disability in adults worldwide, producing permanent motor and cognitive impairments, and, for that reason, it urges the need for new strategies of recovery after stroke. It is believed that repetitive transcranial magnetic stimulation (rTMS) promotes plasticity of damaged neural pathways. Thus our hypothesis is that bihemispheric rTMS in patients with Middle Cerebral Artery (MCA) ischemic stroke has the potential to increase cognitive performance and upper arm motor function at short and medium term, and consequently, that this could be applied as a complementary treatment in patients with impairments after stroke. Therefore, the purpose of this study is to evaluate the variations in cognition and motor function of the upper arm through the application of Montreal Cognitive Assessment (MoCA) scale and Frenchay Arm Test (FAT), respectively, with one month of follow-up. Methods: Six patients with ischemic stroke on MCA received sequentially 1000 pulses of rTMS (1Hz at 100% of the rest motor threshold (RMT)) over the unaffected hemisphere and 1000 pulses (10 Hz at 90% of RMT) over the affected hemisphere, for five consecutive days. Both tests were applied at three moments: before (moment 1) in the week after (moment 2) and one month after (moment 3) the stimulation. Results: The results on cognition, evaluated by the MoCA scale showed statistically significant increases: the average values increased from moment 1 (19,83) to moment 3 (22,83). The results of motor function, assessed by FAT show a rising trend in all evaluated moments. Conclusion: Our study suggests that bihemispheric rTMS may be a feasible adjunct in the recovery of cognitive impairment after stroke.
Description
Keywords
Avc Bi-Hemisférica Cognição Emtr Função Motora