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http://www.codas.periodikos.com.br/article/doi/10.1590/2317-1782/e20250002pt
CoDAS
Systematic Review

Efeitos da Estimulação Transcraniana por Corrente Contínua nas alterações de Fala e Voz para a Doença de Parkinson: uma Revisão Sistemática com Metanálise

Effects of Transcranial Direct Current Stimulation on Speech and Voice Changes in Parkinson’s Disease: a Systematic Review with Meta-Analysis

Renata Serrano de Andrade Pinheiro; Hercílio Barbosa da Silva Júnior; Bruno Braga Guimarães; Ivonaldo Leidson Barbosa Lima; Rafael Nóbrega Bandeira; Nelson Torro Alves

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Resumo

RESUMO: Objetivo: Esta metanálise tem o objetivo de avaliar a evidência existente dos efeitos da tDCS nas alterações de fala e de voz de pacientes com DP.

Estratégias de Pesquisa: PubMed, LILACS, EMBASE, Cochrane Central Register of Controlled Trials, Science Direct, Web of Science, Scopus e de literatura cinzenta Google Scholar e Open Grey. A busca incluiu os descritores: “Parkinson Disease, Transcranial Direct Current Stimulation, Voice, Speech” combinados com AND e OR.

Critérios de Seleção: Pacientes com a Doença de Parkinson, ambos os sexos. Uso da Estimulação Transcraniana por Corrente Contínua (tDCS) para tratar os parâmetros de voz e fala nos pacientes acometidos pela Doença de Parkinson.

Análise de dados: Um total de 1.345 artigos, 14 artigos incluídos na revisão sistemática e 6 artigos na metanálise. O risco de viés e o nível de evidência foram avaliados pelo software REVIEW MANAGER 5.4.1. e GRADE.

Resultados: Os resultados mostraram um tamanho de efeito geral da tDCS de Z= 0.89 (P=0.37). Estudos com área alvo no córtex pré-frontal (PFC) apresentaram maior tamanho de efeito 1.38(P=0.17), portanto com maior impacto para desfecho de fala e voz com uso de tDCS para DP. Três estudos apresentaram baixo risco de viés e três estudos apresentaram risco pouco claro.


Conclusão: Apesar do baixo número de estudos, os achados desta metanálise sugerem a potencial aplicabilidade da tDCS como ferramenta adjuvante no tratamento das alterações de voz e fala em pacientes com DP.

Palavras-chave

Doença de Parkinson, Estimulação Transcraniana por Corrente Contínua, Voz, Qualidade Vocal, Fala

References

1 Lent R. Neurociência da mente e do comportamento. Rio de Janeiro: Editora Guanabara Koogan; 2021.

2 Ortiz KZ, Brabo NC, Minett TS. Sensorimotor speech disorders in Parkinson’s disease. Dement Neuropsychol. 2016;10(3):210-16. https://doi.org/10.1590/ S1980-5764-2016DN1003007.

3 Behroozmand R, Johari K, Bridwell K, Hayden C, Fahey D, Ouden DB. Modulation of vocal pitch control through high‑defnition transcranial direct current stimulation of the left ventral motor cortex. Exp Brain Res. 2020;238:1525-35. https://doi.org/10.1007/s00221-020-05832-9.

4 Narayana S, Franklin C, Peterson E, Hunter EJ, Robin DA, Halpern A, et al. Immediate and long-term effects of speech treatment targets and intensive dosage on Parkinson's disease dysphonia and the speech motor network: Randomized controlled trial. Human Brain Mapping. 2022;43(7):2328-47. https://doi.org/10.1002/hbm.25790.

5 Nitsche MA, Cohen LC, Wassermann EM, Priori A, Lang N, Antal A, et al. Transcranial direct current stimulation: state of the art 2008. Brain Stimul. 2008;1(3):206-23. https://doi.org/10.1016/j.brs.2008.06.004. PMid:20633386.

6 Shamseer L, Moher D, Clarck M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647. https://doi.org/10.1136/bmj.g7647. PMid:25555855.

7 Higgins JPT, Thomas J, Chandler J, Cumpston M, Lit T, Page MJ, et al., editors. Cochrane handbook for systematic reviews of interventions version 6.2 (updated February 2021) [Internet]. Cochrane; 2021 [citado em 2021 Jul 17]. Disponível em: https://training.cochrane.org/handbook

8 Falavigna M. Qualidade da evidência em Ensaios Clínicos I: Cochrane Risk of Bias Tool [Internet]. Htanalyze; 2017 [citado em 2021 Jul 17]. Disponível em: https://www.htanalyze.com/blog/cochrane_rob/

9 Simonyan K, Horwitz B. Laryngeal motor cortex and control of speech in humans. Neuroscientist. 2011;17(2):197-208. https://doi.org/10.1177/1073858410386727. PMid:21362688.

10 Fox MD, Buckner RL, Liu H, Chakravarty MM, Lozano AM, Pascual-Leone A. Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases. PNAS. 2014;E4367-75. https://doi.org/10.1073/pnas.1405003111.

11 Miterko LN, Baker KB, Beckinghausen J, Bradnam LV, Cheng MY, Cooperrider J, et al. Consensus paper: experimental neurostimulation of the cerebellum. Cerebellum. 2019;18(6):1064-97. https://doi.org/10.1007/s12311-019-01041-5. PMid:31165428.

12 Manto M, Argyropoulos GPD, Bocci T, Celnik PA, Corben LA, Guidetti M, et al. Consensus paper: novel directions and next steps of non‑invasive brain stimulation of the cerebellum in health and disease. Cerebellum. 2021;21(6):1092-122. https://doi.org/10.1007/s12311-021-01344-6.

13 Zhu X, Dai G, Wang M, Tan M, Li Y, Xu Z, et al. Continuous theta burst stimulation over right cerebellum for speech impairment in Parkinson’s disease: study protocol for a randomized, sham-controlled, clinical trial. Front Aging Neurosci. 2023;15:1215330. https://doi.org/10.3389/fnagi.2023.1215330. PMid:37655339.

14 Peng D, Lin Q, Chang Y, Jones JA, Jia G, Chen X, et al. Causal Role of the cerebellum in auditory feedback control of vocal production. Cerebellum. 2021;20(4):584-95. https://doi.org/10.1007/s12311-021-01230-1. PMid:33555544.

15 Montemurro N, Aliaga N, Graff P, Escribano A, Lizana J. New Targets and new technologies in the treatment of parkinson’s disease: a narrative review. Int J Environ Res Public Health. 2022;19(14):8799. https://doi.org/10.3390/ijerph19148799. PMid:35886651.

16 Saluja A, Goyal V, Dhamija RK. Multi-Modal Rehabilitation Therapy in Parkinson’s Disease and Related Disorders. Ann Indian Acad Neurol. 2023;26(Suppl 1):S15-25. https://doi.org/10.4103/aian.aian_164_22.

17 Weismer G. Oromotor nonverbal performance and speech motor control: theory and review of empirical evidence. Brain Sci. 2023;13(5):768. https://doi.org/10.3390/brainsci13050768. PMid:37239240.

18 Chang Y, Peng D, Zhao Y, Chen X, Li J, Wu X, et al. Transcranial direct current stimulation over left dorsolateral prefrontal cortex facilitates auditory-motor integration for vocal pitch regulation. Front Neurosci. 2023;17:1208581. https://doi.org/10.3389/fnins.2023.1208581. PMid:37457017.

19 Baig FN, Wong MN, Koo CPB, Loh J. Update on the therapeutic efficacy of noninvasive brain stimulation for the recovery of dysarthria: a systemic review. Brain Stimul. 2023;16(1):234-5. https://doi.org/10.1016/j.brs.2023.01.354.

20 Balzana P, Tattersalla C, Palmer R. Non-invasive brain stimulation for treating neurogenic dysarthria: a systematic review. Ann Phys Rehabil Med. 2022;65(5):101580. https://doi.org/10.1016/j.rehab.2021.101580. PMid:34626861.

21 Pietrobon CA, Rocha RMG, Deus JS, Lima MFR, Cavendish BA, Buratto LG. Terapia de produção audiovisual associada a estimulação por corrente contínua melhora nomeação em paciente com afasia de Broca e doença de Parkinson. Audiol Commun Res. 2021;26:e2343. https://doi.org/10.1590/2317-6431-2020-2343.

22 Rosa RR, Cielo CA, Paglarin KC. Effects of transcranial direct current stimulation (tDCS) on voice and speech in Parkinson’s disease: a case report. Audiol Commun Res. 2023;28:e2795. https://doi.org/10.1590/2317-6431-2023-2795en.

23 Johari K. Speech and voice outcomes following HD-tDCS over the left SMA. Baton Rouge: Louisiana State University and A&M College; 2024.

24 Pereira JB, Junqué C, Bartrés-Faz D, Martí MJ, Sala-Llonch R, Compta Y, et al. Modulation of verbal fluency networks by transcranial direct current stimulation (tDCS) in Parkinson’s disease. Brain Stimul. 2013;6(1):16-24. https://doi.org/10.1016/j.brs.2012.01.006. PMid:22410476.

25 Leydon C, Brooks B, Feng G, Hsu DT, Schwartz G, Fabus R. Speech changes after transcranial direct current stimulation in individuals diagnosed With Parkinson's Disease. SIG 2 Neurogenic Communication Disorders. 2022;7(2):347-56. https://doi.org/10.1044/2021.

26 Brabenec L, Kovac D, Mekyska J, Rehulkova L, Kabrtova V, Rektorova I. Short-term effects of transcranial direct current stimulation on motor speech in Parkinson’s disease: a pilot study. J Neural Transm (Vienna). 2024;131(7):791-7. https://doi.org/10.1007/s00702-024-02771-5. PMid:38592459.
 


Submitted date:
01/06/2025

Accepted date:
06/25/2025

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