Estimulação Cerebelosa Não Invasiva em Ataxias Cerebelosas Hereditárias
DOI:
https://doi.org/10.46531/sinapse/AR/123/2025Palavras-chave:
Ataxias Cerebelosas/tratamento, Cerebelo, Estimulação Transcraniana por Corrente Contínua, Estimulação Transcraniana MagnéticaResumo
As ataxias cerebelosas hereditárias (ACH) constituem um grupo heterogéneo de doenças neurológicas com mecanismos genéticos diversos. Os tratamentos são escassos, mas o crescente interesse na neuroestimulação do cerebelo tem revelado resultados promissores. O nosso objetivo foi rever os estudos sobre estimulação transcraniana por corrente contínua (tDCS) e estimulação magnética transcraniana (TMS) em ACH. Realizou-se uma pesquisa na plataforma PubMed®, utilizando os termos: [“cerebellar stimulation” OR “transcranial direct current stimulation” OR “transcranial magnetic stimulation”] AND [“spinocerebellar ataxia” OR “hereditary ataxia” OR “Friedreich ataxia” OR “Machado Joseph disease”]. A seleção baseou-se na leitura do título e resumo seguido da leitura do artigo. Criou-se uma base de dados com a informação relevante de cada artigo incluindo elementos referentes ao desenho de estudo, protocolo de estimulação, dados clínicos e genéticos, escalas clínicas utilizadas e parâmetros neurofisiológicos. Identificaram-se 72 artigos, dos quais 25 foram excluídos. Embora os diferentes estudos tenham incluído doentes com ACH, alguns apresentaram grande heterogeneidade genética ou incluíram ataxias adquiridas. A maioria dos protocolos de tratamento consistiu em sessões de estimulação em dias consecutivos, com repetição ao fim de um período variável. Em ambas as técnicas, não foram registados efeitos adversos significativos; na maioria, foi evidente benefício motor ao nível da postura e marcha. Verificou-se uma maior duração do efeito da estimulação na tDCS. Os resultados são encorajadores no que respeita à segurança e melhoria motora, em particular da ataxia axial. A realização de mais estudos, em amostras geneticamente homogéneas, poderá contribuir para a definição do papel das técnicas de neuromodulação no tratamento das ACH.Downloads
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Direitos de Autor (c) 2024 Sara Costa, Joel Freitas, Márcio Cardoso, José Barros, Teresa Coelho, Joana Damásio

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