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Relevance and safety of non-invasive cerebral neuromodulation in patients with systemic autoimmune myopathies: double-blind, randomized, sham-controlled study

Grant number: 19/12155-5
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): November 01, 2019
Effective date (End): February 28, 2023
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Samuel Katsuyuki Shinjo
Grantee:Rafael Giovani Misse
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Systemic autoimmune myopathies (SAMs) are a heterogeneous group of rare rheumatic diseases characterized clinically by progressive, symmetrical and predominantly proximal muscle limb weakness. SAMs may also affect joints, lung, heart and gastrointestinal tract. Despite drug treatment and guidance on performing regular physical exercises, the high frequency of fatigue and chronic pain in these patients is remarkable. These factors, in turn, impair functional capacity and quality of life, generating a mechanism of vicious cycle between these parameters. Thus, it becomes relevant to establish therapeutic strategies that may result in a decrease and/or a break in this vicious cycle.Several studies have shown the efficacy of using transcranial non-invasive neuromodulation (e.g., transcranial electrical current stimulation - tDCS) in a several diseases to reduce fatigue, modulate and reduce pain, and consequent improvement of functional capacity and quality of life. However, to date, there are no studies evaluating the safety and benefit of tDCS in patients with stable MAS. In this context, our group initiated two studies, the preliminary results of which have shown that 3 sessions of the tDCS is safe, without leading to MAS relapses.The present project aims to perform a greater number of sessions of tDCS, associated to physical exercises, in patients with MAS and different disease activities. The effectiveness of the technique (local and diffuse pain, fatigue, overall functionality, mobility, balance, muscular strength, functional capacity and quality of life) will be evaluated. This combination of central and peripheral techniques may result in greater connectivity of the neural network, promoting additional effects on muscle excitability, thus contributing to decreased perceived pain and fatigue, resulting in greater muscle recruitment, improved strength, muscle function, mobility and balance. In summary, an improvement in functional capacity and quality of life in patients with MAS may indicate the use of these techniques for the clinical and rheumatologic practice. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DOS SANTOS, ALEXANDRE MOURA; MISSE, RAFAEL GIOVANI; PIRES BORGES, ISABELA BRUNA; BUORO PERANDINI, LUIZ AUGUSTO; SHINJO, SAMUEL KATSUYUKI. Physical exercise for the management of systemic autoimmune myopathies: recent findings, and future perspectives. CURRENT OPINION IN RHEUMATOLOGY, v. 33, n. 6, p. 563-569, . (18/08735-3, 19/12155-5, 19/11367-9, 19/11776-6)
MISSE, RAFAEL GIOVANI; BORGES, ISABELA BRUNA PIRES; DOS DANTOS, ALEXANDRE MOURA; GUPTA, LATIKA; SHINJO, SAMUEL KATSUYUKI. Effect of exercise training on fatigue and pain in patients with systemic autoimmune myopathies: A systematic review. AUTOIMMUNITY REVIEWS, v. 20, n. 10, . (19/11367-9, 18/08735-3, 19/12155-5, 19/11776-6)
DOS SANTOS, ALEXANDRE MOURA; MISSE, RAFAEL GIOVANI; BORGES, ISABELA BRUNA PIRES; GUALANO, BRUNO; DE SOUZA, ALEXANDRE WAGNER SILVA; TAKAYAMA, LILIAM; PEREIRA, ROSA MARIA R.; SHINJO, SAMUEL KATSUYUKI. Increased modifiable cardiovascular risk factors in patients with Takayasu arteritis: a multicenter cross-sectional study. ADVANCES IN RHEUMATOLOGY, v. 61, n. 1, . (18/08735-3, 19/11367-9, 19/12155-5)
MISSE, R. G.; DOS SANTOS, A. M.; DE SOUZA, J. M.; SHINJO, S. K.. Transcranial direct current stimulation improves myofascial pain syndrome and chronic fatigue. REUMATISMO, v. 72, n. 3, p. 186-188, . (18/08735-3, 19/12155-5)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
MISSE, Rafael Giovani. Relevance and safety of non-invasive brain stimulation in patients with systemic autoimmune myopathies: a randomized, double-blind, sham-controlled cross-over clinical trial. 2023. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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