Dados do Trabalho

Título

Effect of non-invasive neuromodulation on language rehabilitation in acute stroke

RESUMO

CASE PRESENTATION: A 58-year-old male patient in the late postoperative period of mitral valve replacement associated with infective endocarditis. It evolved suddenly with motor and language alterations (onset of symptoms 14 days prior to hospital admission date). On examination, NIHSS 16 (right hemiplegia and motor aphasia). Brain imaging showed hypodensity in the left middle cerebral artery territory associated with ECASS 2 hemorrhagic transformation. The patient was clinically managed, and rehabilitation measures were initiated while in the hospital. There were 4 sessions of Transcranial Direct Current Stimulation - tDCS (20 minutes/session; 2mA; 35cm2)+ 8 sessions of speech therapy. Semantic and phonological processing were prioritized in a functional communicational context. After the interventions (discharge from hospital), an improvement in fluency, access to the lexicon, and spontaneous and written language was observed, affecting mood, adherence to other opportunistic therapies (psychology and physical therapy), and a reduction in the NIHSS to 12. DISCUSSION: Changes in neuroplasticity and cortical excitabilitymay contribute to regulating neural activity. Both could be modified by applying direct electrical current in the sensorimotor cortex, with results dependent on the type and modality of the polarity of the current, and it seffect would last for days after the end of the stimulation. To describe language skills achieved from hospital bedside language rehabilitation in acutestroke. The cascade effect on therapeutic improvement has been well documented in the literature; however, the use of tdcs in the acute phase of stroke isstill controversial, despite several studies having presented consistent data.In the hospital environment, it is highly relevant to provide therapies thatshorten rehabilitation since most patients come from accessible health networks(health prevention). CLOSING COMMENTS: The semantic and phonological networks were improved by using tDCS in the hospital environment, providing an opportunity to enhance mood and adherence to the proposed multidisciplinary therapies.

Palavras Chave

Hospitals, University; Humanization of Assistance; Health Communication; Rehabilitation; Transcranial Direct Current Stimulation.