Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-23T00:12:01Z No. of bitstreams: 1 FabianaTenorioGomesDaSilva_DISSERT.pdf: 1184676 bytes, checksum: 9d03e59733d51511aa0eec704401ade1 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-02-26T22:56:55Z (GMT) No. of bitstreams: 1 FabianaTenorioGomesDaSilva_DISSERT.pdf: 1184676 bytes, checksum: 9d03e59733d51511aa0eec704401ade1 (MD5) / Made available in DSpace on 2016-02-26T22:56:55Z (GMT). No. of bitstreams: 1 FabianaTenorioGomesDaSilva_DISSERT.pdf: 1184676 bytes, checksum: 9d03e59733d51511aa0eec704401ade1 (MD5) Previous issue date: 2014-12-08 / Introdu??o: Estimula??o transcraniana por corrente continua (ETCC) tem sido usada em estudos voltados para o tratamento da dor perif?rica cr?nica em pessoas com les?o medular (LM), mas seus efeitos sobre o sistema nervoso auton?mico (SNA) nestes indiv?duos s?o inexistentes e, portanto a necessidade de estudos ? de fundamental import?ncia, pois estes indiv?duos apresentam desbalan?o auton?mico, e sua intensidade ? dependente do grau e n?vel da les?o. Objetivo: Investigar se a ETCC sobre o c?rtex motor prim?rio ir? modular o controle do SNA em pessoas com LM e se estas altera??es s?o dependentes do grau e n?vel de les?o. M?todos: Estudo randomizado, placebo controlado, aplicou ETCC an?dica ou sham sobre o c?rtex motor prim?rio (M1), bilateralmente, com o eletrodo de refer?ncia sendo colocado na protuber?ncia occipital. Dezenove sujeitos (les?o incompleta baixa (n=7), completa baixa (n=9) e completa alta (n=3)) visitaram o laborat?rio tr?s vezes e receberam ETCC ativa ou sham por 13min. A variabilidade da frequ?ncia card?aca (VFC) foi medida antes, durante e p?s-estimula??o. A VFC foi calculada usando a analise espectral batimento a batimento dos intervalos derivados das ondas r-r. Resultados: A ETCC modulou o sistema nervoso auton?mico de forma divergente nos grupos analisados. Nos indiv?duos com LM completa alta a ETCC n?o alterou a VFC. Para os indiv?duos com LM incompleta baixa a ETCC alterou a VFC no sentido de aumentar o simp?tico e reduzir o parassimp?tico e para os indiv?duos com LM completa baixa a ETCC reduziu o simp?tico e aumentou o parassimp?tico. Conclus?o: O presente estudo observou que a ETCC an?dica aplicada sobre o c?rtex motor prim?rio de forma bilateral, conseguiu modular o balan?o do SNA em pessoas com les?o medular e este efeito ? dependente do grau e n?vel de les?o. Palavras-chave: Estimula??o Transcraniana; Sistema nervoso auton?mico; Variabilidade da frequ?ncia card?aca; Les?o medular. / Introduction: Transcranial Direct Current Stimulation (tDCS) has been used in studies for the treatment of chronic pain, but their effects on the autonomic nervous system (ANS) are non-existent. Therefore, the need for studies is of fundamental importance, as these individuals have autonomic imbalance and the intensity of this is dependent on the degree and level of injury. Objective: We investigated the effect of tDCS on the ANS in people with spinal cord injury (SCI) with different degrees and levels of injury. Methods: Randomized, placebo-controlled, double-blind, applied anodal tDCS or sham on the primary motor cortex (M1), bilaterally. The subjects (lower incomplete injury, n = 7; lower complete injury, n = 9; and high complete thoracic injury, n = 3) visited the laboratory three times and received active or sham tDCS for 13min. The heart rate variability (HRV) was measured before, during and after stimulation and analyzed the variables LF, HF and LF / HF. Results: The tDCS modulated the ANS in different ways among the groups. In individuals with SCI high complete thoracic the tDCS did not change the HRV. However, for individuals with SCI low incomplete, tDCS changed the HRV in order to increase sympathetic (LF, p = 0.046) and reduced parasympathetic (HF, p = 0.046). For individuals SCI low complete to tDCS changed the HRV reduction sympathetic (LF, p = 0.017) and increased parasympathetic (HF, p = 0.017). Conclusions: The present study suggests that anodal tDCS applied on the motor cortex bilaterally could modulate the ANS balance in people with spinal cord injury and that this effect is dependent on the degree and level of injury.