Recovery in elite youth basketball players: The responsiveness of the psychophysiological measurements and the role of testosterone concentration.

This study investigated the recovery responses to the Total Quality Recovery (TQR), Well-Being questionnaire (WBQ), and Heart Rate (HR) responses to Submaximal Running Test (SRT), and the influence of salivary testosterone concentration (TEST) on these responses in 25 elite youth (U15) male basketball players. TQR, WBQ, and HR measurements were assessed after 48 hours of rest (T1), 24 hours after the 1st day of training (T2) and 24 hours after the 2nd day of training (T3). Salivary sampling was conducted at T1 and T3. A significant decrease was observed for TQR (F = 4.06; p = 0.01) and for WBQ (F = 5.37; p = 0.008) from T1 to T3. No difference among the three-time points was observed for HR and HR Recovery, and the TEST concentration did not influence the results. These results show that TQR and WBQ are sensitive to acute transient alterations in training loads (TL) and may be utilized to monitor recovery in elite youth basketball players. The HR related measurements presented limited responsiveness, and the TEST seems not to influence the recovery of these players who are competing at highest performance level.

Anodal tDCS over the motor cortex improves pain but not physical function in chronic chikungunya arthritis: Randomized controlled trial.

BACKGROUND: Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia. OBJECTIVE: To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood. METHODS: In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (n = 15) or sham (n = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits. RESULTS: There was a significant interaction between group and time on pain (p = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (p = 0.0001). There was no interaction between time and group for the 2-minute step test (p = 0.18), but the groups differed significantly at day 10 (p = 0.01), first follow-up (p = 0.01) and second follow-up (p = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests. CONCLUSION: tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.

Intensity-Dependent Influence of Interoceptive Accuracy on Psychophysiological Responses During Aerobic Exercise in Physically Inactive Men.

We aimed to investigate the influence of interoceptive accuracy on affective valence, arousal, and ratings of perceived exertion (RPE) during 20 minutes of aerobic exercise at both moderate and heavy intensity among physically inactive men. We divided our participant sample into men with poor heartbeat perception (PHP, n = 13) and good heartbeat perception (GHP, n = 15), based on their cardioceptive accuracy. We measured their heart rate reserve (%HRreserve), perceived affective valence (Feeling Scale; +5/-5), perceived arousal (Felt Arousal Scale, 0-6), and ratings of perceived effort (RPE; Borg scale 6-20) every five minutes during an exercise session on a bicycle ergometer. During moderate-intensity aerobic exercise, the GHP group presented a greater decline in affective valence (p = 0.010; d = 1.06) and a greater increase in RPE (p = 0.004; d = 1.20) compared to the PHP group, with no group differences in %HRreserve (p = 0.590) and arousal (p = 0.629). Psychophysiological and physiological responses to the heavy-intensity aerobic exercise were not different between groups. We concluded that the influence of interoceptive accuracy on psychophysiological responses during submaximal fixed-intensity aerobic exercise was intensity-dependent in these physically inactive men.

Effect of transcranial direct current stimulation on homeostatic and hedonic appetite control and mood states in women presenting premenstrual syndrome across menstrual cycle phases.

PURPOSE: This study investigated the acute effect of anodal transcranial direct current stimulation (a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on appetite, energy intake, food preferences, and mood states in the luteal and follicular phases of the menstrual cycle in women presenting premenstrual syndrome. METHODS: Sixteen women (26.5 ± 5.2 years; 1.63 ± 0.1 m; 64.2 ± 12.8 kg; body mass index 24.0 ± 5.0 kg/m2; body fat 27.6 ± 7.5%) with the eumenorrheic menstrual cycle were submitted to a-tDCS and sham-tDCS conditions over their follicular and luteal phases. At pre - and post-tDCS, hunger and desire to eat something tasty, (analogic visual scale), the profile of mood states (POMS), and the psychological components of food preferences (Leeds Food Preference Questionnaire-BR) were assessed. Participants recorded their food intake for the rest of the day using a diary log. RESULTS: There was a trend towards main effect of condition for decreased implicit wanting for low-fat savory food after a-tDCS but not sham-tDCS regardless of menstrual cycle phase (p = 0.062). There was no effect for self-reported hunger, desire to eat, energy and macronutrient intake, and on other components of food preferences (explicit liking and wanting for low- and high-fat savory and sweet foods, implicit wanting for low- and high-fat sweet and high-fat savory food); as well as for mood states. CONCLUSIONS: Although no significant effects of a-tDCS were found, the present investigation provides relevant perspectives for future studies.

Transcranial direct current stimulation during a prolonged cognitive task: the effect on cognitive and shooting performances in professional female basketball players.

The negative effect of prolonged cognitive demands on psychomotor skills in athletes has been demonstrated. Transcranial direct current stimulation (tDCS) could be used to mitigate this effect. This study examined the effects of tDCS over the left dorsolateral prefrontal cortex (DLPFC) during a 30-min inhibitory Stroop task on cognitive and shooting performances of professional female basketball players. Following a randomised, double-blinded, sham-controlled, cross-over design, players were assigned to receive anodal tDCS (a-tDCS, 2 mA for 20 min) or sham-tDCS in two different sessions. Data from 8 players were retained for analysis. Response Time decreased significantly over time (p < 0.001; partial η2 = 0.44; no effect of condition, or condition vs. time interaction). No difference in mean accuracy and shooting performance was observed between tDCS conditions. The results suggest that a-tDCS exert no additional benefits in reducing the negative effects of prolonged cognitive demands on technical performance compared to sham (placebo).Practitioner summary: Prolonged cognitive demands can negatively affect the athletes' performance. We tested whether transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) could attenuate these effects on cognitive and shooting performance in professional female basketball players. However, tDCS did not exert any additional benefits compared to sham.Abbreviations: tDCS: transcranial direct current stimulation; a-tDCS: anodal transcranial direct current stimulation; PFC: prefrontal cortex; DLPFC: dorsolateral prefrontal cortex; PCT: prolonged cognitive task; TT: time trial; RT: response time; NASA-TLX: National Aeronautics and Space Administration Task Load Index; RPE: ratings of perceived exertion; CR-10 scale: category rating scale; EEG: electroencephalogram; AU: arbitrary units.

Ten sessions of transcranial direct current stimulation for chronic chikungunya arthralgia: study protocol for a randomised clinical trial.

INTRODUCTION: The chikungunya virus infection is still an epidemic in Brazil with an incidence of 59.4 cases per 100 000 in the Northeast region. More than 60% of the patients present relapsing and remitting chronic arthralgia with debilitating pain lasting for years. Transcranial direct current stimulation (tDCS) appears promising as a novel neuromodulation approach for pain-related networks to alleviate pain in several pain syndromes. Our objective is to evaluate the effectiveness of tDCS (C3/Fp2 montage) on pain, muscle strength, functionality and quality of life in chronic arthralgia. METHODS AND ANALYSIS: This protocol is a single-centre, parallel-design, double-blind, randomised, sham-controlled trial. Forty participants will be randomised to either an active or sham tDCS. A total of 10 sessions will be administered over 2 weeks (one per weekday) using a monophasic continuous current with an intensity of 2 mA for 20 min. Participants will be evaluated at baseline, after the 10th session, 2 weeks and 4 weeks after intervention. PRIMARY OUTCOME: pain assessed using numeric rating scale and algometry. SECONDARY OUTCOMES: muscle strength, functionality and quality of life. The effects of stimulation will be calculated using a mixed analysis of variance model. ETHICS AND DISSEMINATION: The study was approved by the ethics committee of the Faculty of Health Sciences of Trairí, Federal University of Rio Grande do Norte (No. 2.413.851) and registered on the Brazilian Registry of Clinical Trials. Study results will be disseminated through presentations at conferences and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: RBR-469yd6.

Digitalized transcranial electrical stimulation: A consensus statement.

OBJECTIVE: Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES. METHODS: We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided. RESULTS: The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity. CONCLUSIONS: Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. SIGNIFICANCE: We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials.

Chronic Chikungunya arthralgia reduces functionality, quality of life and occupational performance: descriptive cross-sectional study / Artralgia crônica por Chikungunya reduz funcionalidade, qualidade de vida e performance ocupacional: estudo descritivo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Chikungunya virus (CHIKV) chronic polyarthralgia deteriorates general functionality and work productivity. The objective of this study was to evaluate functionality, pain, quality of life, and sleep quality of individuals with chronic CHIKV arthralgia and correlate them with clinical symptoms, work productivity, and activity impairment. METHODS: This is a descriptive cross-sectional study with 61 chronic CHIKV arthralgia patients. Functionality was assessed using the Health Assessment Questionnaire (HAQ). Pain intensity and interference were measured by using the Visual Analog Scale (VAS) and the Brief Pain Inventory Short Form (BPI), respectively. Quality of life and sleep were evaluated using the Short Form 36 Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the effects of health in general symptoms on work. RESULTS: Low and moderate level of function was present in 39.4% and 55.7% of the sample, respectively. Moderate pain (5.57 ± 2.25), poor sleep quality (47.54%), and sleep disturbances (42.63%) were also observed. Pearson correlations showed significant correlation between absenteeism and presenteeism with HAQ scores (p = 0.03; r = 0.39 and p = 0.01; r = 0.43, respectively), BPI interference (p = 0.02; r = 0.41 and p = 0.001; r = 0.58, respectively) and SF-36 physical score (p = 0.007; r = -0.49 and p = 0.01; r = 0.58, respectively). Activity impairment showed a significant correlation with HAQ (p = 0.01; r = 0.44), BPI interference (p = 0.006; r = 0.5), SF-36 physical score (p = 0.01; r = -0.6) and SF-36 total score (p = 0.01; r = -0.44). Overall work productivity loss only correlated with BPI interference (p = 0.04; r = 0.37). CONCLUSION: These results suggest that CHIKV chronic arthralgia showed bilateral moderate pain in large joints that impacts activities of daily life, work productivity, and functional activity. HIGHLIGHTS Chronic chikungunya reduces functionality and causes moderate pain and poor sleep quality Clinical symptoms impact daily living activity, work productivity, and activity impairment. Functionality, pain, and sleep correlate with occupational performance.

RESUMO JUSTIFICATIVA E OBJETIVOS: A poliartralgia crônica do vírus Chikungunya (CHIKV) deteriora a funcionalidade e a produtividade do trabalho. O objetivo deste estudo foi avaliar funcionalidade, dor, qualidade de vida e sono de indivíduos com artralgia crônica por CHIKV correlacionada com sintomas clínicos, produtividade do trabalho e comprometimento das atividades. MÉTODOS: Trata-se de um estudo transversal descritivo com 61 pacientes crônicos de artralgia da CHIKV. A intensidade e a interferência da dor foram medidas usando a Escala Analógica Visual (EAV) e o Brief Pain Inventory Short Form (BPI), respectivamente. A qualidade de vida e o sono foram avaliados usando o Short Form 36 Health Survey (SF-36) e o Pittsburgh Sleep Quality Index (PSQI), respectivamente. O questionário Work Productivity and Activity Impairment (WPAI) foi usado para avaliar os efeitos dos sintomas gerais da saúde no trabalho. RESULTADOS: Foi observado um nível de funcionalidade baixo em 39,4% e moderado em 55,7% da amostra. Nível de dor moderada (5,57 ± 2,25), má qualidade do sono (47,54%) e distúrbios do sono (42,63%) também foram observados. O teste de Pearson apresentou correlação significativa entre absenteísmo e presenteísmo com as pontuações de Health Assessment Questionnaire (HAQ) (p = 0,03; r = 0,39 e p = 0,01; r = 0,43 respectivamente), interferência do BPI (p = 0,02; r = 0,41 e p = 0,001; r = 0,58 respectivamente) e score físico do SF-36 (p = 0,007; r = -0,49 e p = 0,01; r = 0,58, respectivamente). O comprometimento da atividade mostrou uma correlação significativa com o HAQ (p = 0,01; r = 0,44), interferência do BPI (p = 0,006; r = 0,5), pontuação física do SF-36 (p = 0,01; r = -0,6) e pontuação total do SF-36 (p = 0,01; r = -0,44). A perda geral de produtividade no trabalho correlacionou-se apenas com a interferência do BPI (p = 0,04; r = 0,37). CONCLUSÃO: Esses resultados sugerem que a artralgia crônica da CHIKV apresenta dor moderada bilateral em grandes articulações com impacto nas atividades de vida diária, produtividade no trabalho e atividade funcional. DESTAQUES A Chikungunya crônica reduz a funcionalidade e causa dor moderada e má qualidade do sono. Os sintomas clínicos afetam atividades de vida diária, a produtividade no trabalho e comprometimento de atividades. Funcionalidade, dor e sono estão correlacionados com o desempenho profissional.

Does anodal transcranial direct current stimulation over left motor cortex show body side pain-related difference in fibromyalgia? / A estimulação transcraniana por corrente contínua anódica sobre o córtex motor esquerdo apresenta diferença na dor entre os hemicorpos na fibromialgia?

ABSTRACT BACKGROUND AND OBJECTIVES: Fibromyalgia (FM) is a chronic widespread musculoskeletal pain resulting in central sensitization of nociceptive signaling. Transcranial direct current stimulation (tDCS) over the left motor cortex (M1) is a non-invasive neuromodulation technique indicated for a broad range of chronic pain disorders, including FM. Studies suggest that left and right M1 (contralateral and ipsilateral hemisphere of tDCS stimulation) are modulated. But it is necessary to clarify the differences in clinical pain perception comparing the right and left side of the body. This study aimed to evaluate the pain-related difference between right-left side of the body after five sessions of anodal tDCS in women with FM. METHODS: A double-blinded, parallel, randomized, sham-controlled trial with 30 women with FM was performed. Five sessions of anodal C3 and cathodal supraorbital (Fp2) tDCS were conducted (2 mA for 20 min). Pain, impact of FM and anxiety were evaluated. No statistically significant three-way interaction between time, stimulation type and body side were found. RESULTS: Active-tDCS showed significant improvement in pain, but impact of FM and anxiety did not show significant improvement. CONCLUSION: Five sessions of anodal tDCS over the left M1 improves pain in women with FM, however there was no difference between right-left body sides.

RESUMO JUSTIFICATIVA E OBJETIVOS: A fibromialgia (FM) é uma dor musculoesquelética crônica generalizada que resulta na sensibilização central da sinalização nociceptiva. A estimulação transcraniana de corrente contínua (eTCC) sobre o córtex motor esquerdo (M1) é uma técnica de neuromodulação não invasiva indicada para uma ampla gama de distúrbios de dor crônica, incluindo a FM. Estudos sugerem a modulação do M1 esquerdo e direito (hemisfério contralateral e ipsilateral da eTCC). Mas é necessário esclarecer as diferenças na percepção clínica da dor comparando os lados direito e esquerdo do corpo. Este estudo teve como objetivo avaliar a diferença relacionada à dor entre o lado direito e esquerdo do corpo após cinco sessões de eTCC anodal em mulheres com FM. MÉTODOS: Foi realizado um estudo duplo-cego, paralelo, randomizado e controlado por sham com 30 mulheres com FM. Foram realizadas cinco sessões de eTCC anodais C3 e supraorbitais catodais (Fp2) (2 mA por 20 min). Foram avaliados a dor, o impacto da FM e a ansiedade. Não foi encontrada nenhuma interação de três vias estatisticamente significativa entre tempo, tipo de estimulação e lado do corpo. RESULTADOS: A eTCC-Ativa mostrou uma melhora significativa na dor, mas o impacto da FM e da ansiedade não mostrou uma melhora significativa. CONCLUSÃO: Cinco sessões de eTCC anodal sobre o M1 esquerdo melhoram a dor nas mulheres com FM, entretanto não houve diferença entre os lados direito e esquerdo do corpo.

Effects of Transcranial Direct Current Stimulation on Muscle Fatigue in Recreational Runners: Randomized, Sham-Controlled, Triple-Blind, Crossover Study-Protocol Study.

OBJECTIVES: The aim of this study is to evaluate the effects of transcranial direct current stimulation (tDCS) on central and peripheral fatigue in recreational runners. DESIGN: This is a clinical randomized, sham-controlled, triple-blind, crossover study. Twenty adult runners will be randomized on the first day of the intervention to receive active or sham tDCS before fatigue protocol. After 1 wk, the participants will receive the opposite therapy to the one that they received on the first day. The tDCS, 2 mA, will be applied for 20 mins over the motor cortex. The fatigue protocol will be performed after tDCS, in which the participant should perform concentric knee flexion/extension contractions until reaching three contractions at only 50% of maximum voluntary contraction. Central fatigue will be evaluated with the motor evoked potential of the quadriceps muscle; peripheral fatigue with the peak torque (N.m) using an isokinetic dynamometer; the electrical activity of the quadriceps muscle using surface electromyography (Hz); blood lactate level (mmol/L); and the subjective perception of effort (Borg scale). All evaluations will be repeated before and after the interventions. CONCLUSION: This study will evaluate the effect of tDCS on fatigue in runners, possibly determining an application protocol for this population.

Home-based training program during the SARS-CoV-2 quarantine: training load, motivation, and wellbeing in professional elite female basketball players.

BACKGROUND: Due to the quarantine caused by the Coronavirus disease 2019 (COVID-19), professional team-sports adapted their training routine to maintain the athletes' performance and minimize the negative emotional effects. The aim of the present study was to describe a home-based training program and extra-activities applied during the quarantine in elite professional female basketball players, and to compare the internal training load (ITL), session rating of perceived exertion (s-RPE), motivation, and wellbeing responses before and during the quarantine. METHODS: Nine female elite players (25.7±7.0 years; 180.0±8.0 cm; 79.0±11.0 kg) belonging to a professional basketball team performed a home-based training program during the quarantine. ITL, s-RPE, training motivation, and wellbeing were examined before (phase 1), at the beginning (phase 2), and during (phase 3) the quarantine. RESULTS: ITL was higher (main effect) in phase 1 (449.5±62.8 a.u.) compared to phase 2 (265.5±39.0 a.u.) and phase 3 (423.1±18.7 a.u.); s-RPE was higher in phase 1 (4.50±0.63 a.u.) compared to phase 2 (3.8±0.6 a.u.), but not to phase 3 (4.37±0.79 a.u.). Motivation was higher in phase 1 (3.6±0.3 a.u.) compared to phase 2 (2.3±0.6 a.u.) and phase 3 (2.4±0.5 a.u.). CONCLUSIONS: The results of the study demonstrated that extra-activities involving online athletes' socialization were implemented to rouse the motivation, but the quarantine period induced a reduction in ITL and influenced the player's training motivation.

Transcranial Direct Current Stimulation Associated With Functional Exercise Program for Treating Fibromyalgia: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of transcranial direct current stimulation (tDCS) associated with functional exercise on pain, functional performance, psychological symptoms, and quality of life of patients with fibromyalgia (FM). DESIGN: Randomized controlled trial. Participants were randomized by blocks into 2 groups: tDCS associated with functional exercise (n=17) and sham-tDCS associated with functional exercise (n=14). SETTING: Laboratory of neuromuscular performance in the department of physical therapy. PARTICIPANTS: Women with FM (N=31) according to American College of Rheumatology-2010 criteria. INTERVENTIONS: Anodal tDCS or sham-tDCS was applied over the left motor cortex for 5 consecutive days during the first week of intervention (2 mA; 20min). All volunteers also engaged in 8 weeks of functional exercises 3 times per week. MAIN OUTCOME MEASURES: Pain intensity, functional performance, psychological symptoms, and quality of life were assessed pre-exercise and immediately after the first, fourth, and eighth weeks of intervention. RESULTS: Pain intensity, functional performance, psychological symptoms, and quality of life increased significantly in both groups (P<.05); however, no significant differences between groups were found in all outcomes (P>.05). CONCLUSION: tDCS associated with functional exercises did not enhance the effects of physical exercise on pain, functional performance, psychological symptoms, and quality of life of patients with FM.

Does high-definition transcranial direct current stimulation change brain electrical activity in professional female basketball players during free-throw shooting?

Differentiated brain activation in high-performance athletes supports neuronal mechanisms relevant to sports performance. Preparation for the motor action involves cortical and sub-cortical regions that can be non-invasively modulated by electrical current stimulation. This study aimed to investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) on electrical brain activity in professional female basketball players during free-throw shooting. Successful free-throw shooting (n = 2,361) from seven professional female basketball players was analyzed during two experimental conditions (HD-tDCS cathodic and sham) separated by 72 h. Three spectral bio-markers, Power Ratio Index (PRI), Delta Alpha Ratio (DAR), and Theta Beta Ratio (TBR) were measured (electroencephalography [EEG] Brain Products). Multi-channel HD-tDCS was applied for 20 min, considering current location and intensity for cathodic stimulation: FCC1h, AFF5h, AFF1h (-0.5 mA each), and FCC5h (ground). The within EEG analyses (pre and post HD-tDCS) of frontal channels (Fp1, Fp2, F3, F4, FC1, FC3) for 1 second epoch pre-shooting, showed increases in PRI (p < 0.001) and DAR (p < 0.001) for HD-tDCS cathodic condition, and in TBR for both conditions (cathodic, p = 0.01; sham, p = 0.002). Sub-group analysis divided the sample into less (n = 3; LSG) and more (n = 4; MSG) stable free-throw-shooting performers and revealed that increases in pre to post HD-tDCS in PRI only occurred for the LSG. These results suggest that the effect of HD-tDCS may induce changes in slow frontal frequency brain activities and that this alteration seems to be greater for players demonstrating a less stable free-throw shooting performance.

Acute effect of high-definition and conventional tDCS on exercise performance and psychophysiological responses in endurance athletes: a randomized controlled trial.

Transcranial direct current stimulation (tDCS) has been used aiming to boost exercise performance and inconsistent findings have been reported. One possible explanation is related to the limitations of the so-called "conventional" tDCS, which uses large rectangular electrodes, resulting in a diffuse electric field. A new tDCS technique called high-definition tDCS (HD-tDCS) has been recently developed. HD-tDCS uses small ring electrodes and produces improved focality and greater magnitude of its aftereffects. This study tested whether HD-tDCS would improve exercise performance to a greater extent than conventional tDCS. Twelve endurance athletes (29.4 ± 7.3 years; 60.15 ± 5.09 ml kg-1 min-1) were enrolled in this single-center, randomized, crossover, and sham-controlled trial. To test reliability, participants performed two time to exhaustion (TTE) tests (control conditions) on a cycle simulator with 80% of peak power until volitional exhaustion. Next, they randomly received HD-tDCS (2.4 mA), conventional (2.0 mA), or active sham tDCS (2.0 mA) over the motor cortex for 20-min before performing the TTE test. TTE, heart rate (HR), associative thoughts, peripheral (lower limbs), and whole-body ratings of perceived exertion (RPE) were recorded every minute. Outcome measures were reliable. There was no difference in TTE between HD-tDCS (853.1 ± 288.6 s), simulated conventional (827.8 ± 278.7 s), sham (794.3 ± 271.2 s), or control conditions (TTE1 = 751.1 ± 261.6 s or TTE2 = 770.8 ± 250.6 s) [F(1.95; 21.4) = 1.537; P = 0.24; η2p = 0.123]. There was no effect on peripheral or whole-body RPE and associative thoughts (P > 0.05). No serious adverse effect was reported. A single session of neither HD-tDCS nor conventional tDCS changed exercise performance and psychophysiological responses in athletes, suggesting that a ceiling effect may exist.

Effect of Transcranial Direct Current Stimulation on Professional Female Soccer Players' Recovery Following Official Matches.

This study investigated the effect of transcranial direct current stimulation (tDCS) combined with a recovery training session on the well-being and self-perceived recovery of professional female soccer players after official matches. Data from 13 world-class players were analyzed after participating in four official soccer matches of the first division of the Brazilian Women's Soccer Championship (7-, 10-, and 13-day intervals). We applied anodal tDCS (a-tDCS) over the left dorsolateral prefrontal cortex with 2 mA for 20 minutes (+F3/-F4 montage) the day after each match. Participants underwent two randomly ordered sessions of a-tDCS or sham. Players completed the Well-Being Questionnaire (WBQ) and the Total Quality Recovery (TQR) scale before each experimental condition and again the following morning. A two-way repeated-measures ANOVA showed a significant time x condition interaction on the WBQ (F(1,11)=5.21; p=0.043; ηp2=0.32), but not on the TQR (F(1,12) = 0.552; p = 0.47; ηp2 = 0.044). There was a large effect size (ES) for a-tDCS for the WBQ score (ES = 1.02; 95%CI = 0.17;1.88), and there was a moderate WBQ score increase (ES = 0.53; 95%CI = -0.29;1.34) for the sham condition. We found similar increases in the TQR score for a-tDCS (ES = 1.50; 95%CI = 0.63-2.37) and the sham condition (ES = 1.36; 95%CI = 0.51-2.22). These results suggest that a-tDCS (+F3/-F4 montage) combined with a recovery training session may slightly improve perceived well-being beyond the level of improvement after only the recovery training session among world-class female soccer players. Prior to widely adopting this recovery approach, further study is needed with larger and more diverse samples, including for female teams of different performance levels.

Aerobic Exercise Combined With Transcranial Direct Current Stimulation Over the Prefrontal Cortex in Parkinson Disease: Effects on Cortical Activity, Gait, and Cognition.

BACKGROUND: Since people with Parkinson disease (PD) rely on limited prefrontal executive resources for the control of gait, interventions targeting the prefrontal cortex (PFC) may help in managing PD-related gait impairments. Transcranial direct current stimulation (tDCS) can be used to modulate PFC excitability and improve prefrontal cognitive functions and gait. OBJECTIVE: We investigated the effects of adding anodal tDCS applied over the PFC to a session of aerobic exercise on gait, cognition, and PFC activity while walking in people with PD. METHODS: A total of 20 people with PD participated in this randomized, double-blinded, sham-controlled crossover study. Participants attended two 30-minute sessions of aerobic exercise (cycling at moderate intensity) combined with different tDCS conditions (active- or sham-tDCS), 1 week apart. The order of sessions was counterbalanced across the sample. Anodal tDCS (2 mA for 20 minutes [active-tDCS] or 10 s [sham-tDCS]) targeted the PFC in the most affected hemisphere. Spatiotemporal gait parameters, cognitive functions, and PFC activity while walking were assessed before and immediately after each session. RESULTS: Compared with the pre-assessment, participants decreased step time variability (effect size: -0.4), shortened simple and choice reaction times (effect sizes: -0.73 and -0.57, respectively), and increased PFC activity in the stimulated hemisphere while walking (effect size: 0.54) only after aerobic exercise + active-tDCS. CONCLUSION: The addition of anodal tDCS over the PFC to a session of aerobic exercise led to immediate positive effects on gait variability, processing speed, and executive control of walking in people with PD.

Alternate sessions of transcranial direct current stimulation (tDCS) reduce chronic pain in women affected by chikungunya. A randomized clinical trial.

CONTEXT: Thousands of people worldwide have been infected by the chikungunya virus (CHIKV), and the persistence of joint pain symptoms has been considered the main problem. Neuromodulation techniques such as transcranial direct current stimulation (tDCS) act on brain areas involved in the processing of chronic pain. It was previously demonstrated that tDCS for five consecutive days significantly reduced pain in the chronic phase of chikungunya (CHIK). OBJECTIVE: To analyze the effect of alternate tDCS sessions on pain and functional capacity in individuals affected by CHIK. METHODS: In a randomized clinical trial, 58 women in the chronic phase of CHIK were divided into two groups: active-tDCS (M1-S0, 2 mA, 20 min) and sham-tDCS. The Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI) were used to assess pain, while the Health Assessment Questionnaire (HAQ) assessed functional capacity. These scales were used before and after six sessions of tDCS in nonconsecutive days on the primary motor cortex, and at follow-up consultation 7 and 15 days after the last session. A repeated measures mixed-model ANOVA was used for comparison between groups (significant p-values < 0.05). RESULTS: A significant pain reduction (Z [3, 171] = 14.303; p < 0.0001) was observed in the tDCS group compared to the sham group; no significant difference in functional capacity was observed (Z [1.57] = 2.797; p = 0.1). CONCLUSION: Our results suggest that six nonconsecutive sessions of active tDCS on M1 reduce pain in chronic CHIKV arthralgia.

Effect of tDCS on well-being and autonomic function in professional male players after official soccer matches.

This study aimed to examine the effect of transcranial direct current stimulation (tDCS) used as a recovery strategy, on heart rate (HR) measures and perceived well-being in 12 male professional soccer players. tDCS was applied in the days after official matches targeting the left dorsolateral prefrontal cortex (DLPFC) with 2 mA for 20 min (F3-F4 montage). Participants were randomly assigned to anodal tDCS (a-tDCS) or sham tDCS sessions. Players completed the Well-Being Questionnaire (WBQ) and performed the Submaximal Running Test (SRT) before and after tDCS. HR during exercise (HRex) was determined during the last 30 s of SRT. HR recovery (HRR) was recorded at 60 s after SRT. The HRR index was calculated from the absolute difference between HRex and HRR. A significant increase was observed for WBQ (effect of time; p<0.001; ηp2=0.417) with no effect for condition or interaction. A decrease in HRR (p = 0.014; ηp2=0.241), and an increase in HRR index were observed (p = 0.045; ηp2=0.168), with no effect for condition or interaction. No change for HRex was evident (p>0.05). These results suggest that a-tDCS over the DLPFC may have a positive effect on enhancing well-being and parasympathetic autonomic markers, which opens up a possibility for testing tDCS as a promising recovery-enhancing strategy targeting the brain in soccer players. The findings suggest that brain areas related to emotional and autonomic control might be involved in these changes with a possible interaction effect of tDCS by placebo-related effects, but more research is needed to verify this effect.

Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis.

Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD. Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms. Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included. Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III - motor aspects (MD = -0.98%, 95% CI = -10.03 to 8.07, p = 0.83, I 2 = 0%), UPDRS IV - dyskinesias (MD = -0.89%, CI 95% = -3.82 to 2.03, p = 0.55, I 2 = 0%) and motor fluctuations (MD = -0.67%, CI 95% = -2.45 to 1.11, p = 0.46, I 2 = 0%), timed up and go - gait (MD = 0.14%, CI 95% = -0.72 to 0.99, p = 0.75, I 2 = 0%), Berg Balance Scale - balance (MD = 0.73%, CI 95% = -1.01 to 2.47, p = 0.41, I 2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III - motor aspects (MD = 2.05%, CI 95% = -1.96 to 6.06, p = 0.32, I 2 = 0%) and gait (SMD = -0.05%, 95% CI = -0.28 to 0.17, p = 0.64, I 2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = -1.7, SE = 1.51, z-score = -1.18, p = 0.2, IC = -4.75 to 1.17) and cumulative time (estimate = -0.07, SE = 0.07, z-score = -0.99, p = 0.31, IC = -0.21 to 0.07) had no significant association. Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.