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La estimulación transcraneal con corriente continua es segura y factible en el ictus isquémico hiperagudo (ensayo
Matej Slovak1, David Kemlink1, Pavel Dusek1
1Department of Neurology and Center for Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
Resumen
La estimulación transcraneal con corriente continua catodal (C-tDCS) es segura y factible en pacientes con ictus isquémico agudo. Este método neuroprotector mostró buena tolerabilidad, lo que apoya futuros ensayos para el tratamiento del ictus.
Área de la Ciencia:
- Neurología
- Neurociencia
- Dispositivos Médicos
Sus antecedentes:
- El ictus isquémico requiere neuroprotección urgente en la fase hiperaguda.
- La estimulación transcraneal con corriente continua catodal (C-tDCS) es una intervención neuroprotectora potencial.
- Es crucial evaluar la C-tDCS en pacientes con ictus con penumbra salvable.
Objetivo del estudio:
- Evaluar la seguridad, tolerabilidad y factibilidad de la C-tDCS.
- Explorar la posible eficacia de la C-tDCS en el ictus isquémico agudo.
- Determinar los parámetros de C-tDCS en un ensayo de escalada de dosis.
Principales métodos:
- Ensayo aleatorizado, doble ciego, controlado con placebo y de escalada de dosis (DICAST-SF).
- Inclusión de pacientes con ictus por oclusión de la arteria carótida interna/arteria cerebral media, dentro de las 24 horas y con penumbra salvable.
- Aplicación de C-tDCS sobre la corteza motora primaria afectada en seis niveles de dosis.
Principales resultados:
- No se produjo hemorragia intracraneal sintomática (HICS) en el grupo de C-tDCS activo.
- La C-tDCS fue bien tolerada y factible, con un tiempo medio de aleatorización a inicio de la estimulación de 8 minutos.
- La hemorragia intracraneal asintomática (HICA) y otros eventos adversos fueron comparables entre los grupos activo y placebo.
Conclusiones:
- La C-tDCS es un tratamiento seguro, bien tolerado y factible para el ictus isquémico hiperagudo.
- Los hallazgos respaldan una mayor investigación de la C-tDCS en ensayos clínicos más amplios para la eficacia en el ictus.
- La C-tDCS demuestra ser una estrategia neuroprotectora prometedora en el manejo del ictus agudo.
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