Dos Santos Alexandre M, De Andrade Vanessa P, Silva Paulo Roberto S, Grecco Marcus V, D'Andrea Greve Julia Maria, Shinjo Samuel K
Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, BRA.
Movement Studies Laboratory, Institute of Orthopedics and Traumatology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, BRA.
Cureus. 2024 Nov 20;16(11):e74105. doi: 10.7759/cureus.74105. eCollection 2024 Nov.
Granulomatosis with polyangiitis (GPA) is a systemic vasculitis that can lead to persistent pain and fatigue, significantly impacting patients' quality of life. This study assessed the effects of transcranial direct current stimulation (tDCS) combined with aerobic exercise as a non-pharmacological intervention for managing fatigue in GPA patients. Two patients were randomly assigned to receive either active tDCS or simulated tDCS stimulation (sham) during low-intensity aerobic exercise. The assessments included body mass index, fat and lean mass percentages, waist-to-hip ratio, C-reactive protein, erythrocyte sedimentation rate, and disease activity using the Birmingham Vasculitis Activity Score. Chronic fatigue was measured using the Modified Fatigue Impact Scale, the Fatigue Severity Scale, and the visual analog scale for fatigue. Sleep quality, activities of daily living, and functional capacity were evaluated through standardized tests. Results indicated that tDCS significantly reduced chronic fatigue by approximately 60%, nearly twice as much as the sham patient. Additionally, the tDCS patient showed improvements in physical activity levels, functional capacity, handgrip strength, daily activities, and sleep quality. In contrast, the sham patient showed declines in physical activity and minimal improvement in chronic fatigue. Overall, tDCS appears to be a promising intervention to enhance chronic fatigue and the quality of life in patients with GPA without causing disease reactivation or adverse effects.
肉芽肿性多血管炎（GPA）是一种系统性血管炎，可导致持续性疼痛和疲劳，严重影响患者的生活质量。本研究评估了经颅直流电刺激（tDCS）联合有氧运动作为一种非药物干预措施对GPA患者疲劳管理的效果。两名患者被随机分配在低强度有氧运动期间接受主动tDCS或模拟tDCS刺激（假刺激）。评估指标包括体重指数、脂肪和瘦体重百分比、腰臀比、C反应蛋白、红细胞沉降率，以及使用伯明翰血管炎活动评分评估疾病活动度。使用改良疲劳影响量表、疲劳严重程度量表和疲劳视觉模拟量表测量慢性疲劳。通过标准化测试评估睡眠质量、日常生活活动能力和功能能力。结果表明，tDCS可使慢性疲劳显著降低约60%，几乎是假刺激组患者的两倍。此外，接受tDCS治疗的患者在身体活动水平、功能能力、握力、日常活动和睡眠质量方面均有改善。相比之下，假刺激组患者的身体活动下降，慢性疲劳改善甚微。总体而言，tDCS似乎是一种有前景的干预措施，可改善GPA患者的慢性疲劳和生活质量，且不会引起疾病复发或不良反应。
