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经颅直流电刺激可调节自主神经系统并降低高血压患者的动态血压。

Transcranial direct current stimulation modulates autonomic nervous system and reduces ambulatory blood pressure in hypertensives.

作者信息

Rodrigues Bruno, Barboza Catarina A, Moura Eliezer G, Ministro Gabriela, Ferreira-Melo Silvia E, Castaño Javier B, Ruberti Olivia M, De Amorim Rivadávio F B, Moreno Heitor

机构信息

School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.

Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.

出版信息

Clin Exp Hypertens. 2021 May 19;43(4):320-327. doi: 10.1080/10641963.2021.1871916. Epub 2021 Jan 11.

Abstract

: Transcranial direct current stimulation (tDCS) seems to positively modulate the autonomic nervous system in different clinical conditions and healthy subjects; however, its effects on hypertensive (HTN) patients are not completely known. This study aimed to evaluate the effects of a tDCS or SHAM session (20 min) on blood pressure (BP) and autonomic variables of HTN patients.: Subjects (n = 13) were randomly submitted to SHAM and tDCS sessions (1 week of ). Hemodynamic and autonomic variables were measured at baseline, during, and immediately after tDCS or SHAM stimulation (Finometer®, Beatscope). Ambulatory BP measurement (ABPM) was evaluated after the experimental period.: Hemodynamic variables were not changed by tDCS, except for the fall in peripheral vascular resistance (Δ = -1696.51 ± 204.65 dyn.s/cm5). After the tDCS, sympathetic modulation was decreased (-61.47%), and vagal modulation was increased (+38.09%). Such acute autonomic changes may have evoked positive results observed in 24 hs-systolic blood pressure (Δ = -8.4 ± 6.2; = .0022) and 24hs-diastolic blood pressure (Δ = -5.4 ± 4.2; = .0010) in tDCS subjects compared with that in SHAM.: These findings suggest that the tDCS could promote positive acute adjustments on cardiac autonomic control and reduced values on 24-hs BP of HTN patients. More than a proof-of-concept, these results may point out to the future, where brain stimulation (tDCS) can be used to HTN syndromes, such as refractory HTN.

摘要

经颅直流电刺激(tDCS)似乎能在不同临床状况及健康受试者中对自主神经系统产生积极调节作用;然而,其对高血压(HTN)患者的影响尚不完全清楚。本研究旨在评估一次tDCS或假刺激疗程(20分钟)对高血压患者血压(BP)及自主神经变量的影响。

受试者(n = 13)被随机分为接受假刺激和tDCS疗程(间隔1周)。在基线期、tDCS或假刺激期间及刺激后即刻测量血流动力学和自主神经变量(Finometer®,Beatscope)。实验期结束后评估动态血压测量(ABPM)。

除外周血管阻力下降(Δ = -1696.51 ± 204.65 dyn.s/cm5)外,tDCS未改变血流动力学变量。tDCS后,交感神经调节降低(-61.47%),迷走神经调节增加(+38.09%)。与假刺激组相比,这些急性自主神经变化可能是tDCS组24小时收缩压(Δ = -8.4 ± 6.2;P = 0.0022)和24小时舒张压(Δ = -5.4 ± 4.2;P = 0.0010)出现积极结果的原因。

这些发现表明,tDCS可促进高血压患者心脏自主神经控制的积极急性调整,并降低24小时血压值。这些结果不仅是概念验证,还可能为未来指明方向,即脑刺激(tDCS)可用于治疗高血压综合征,如难治性高血压。

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