Joaquim Brasil-Neto

Centro Universitário Unieuro · Medicine

Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson's disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain,...

Este artigo descreve a estrutura do modelo Iniciação científica (IC) que vem sendo implantado no curso de graduação em medicina no Centro Universitário UNIEURO, em Brasília, DF, Brasil. A premissa básica deste modelo baseia-se na ideia originalmente desenvolvida por Alexander von Humboldt, responsável pela criação de um modelo emblemático de univer...

This English edition of "Estimulação Magnética Transcraniana: Manual Prático" by Dr. Joaquim Brasil-Neto, a pioneer in the field of transcranial magnetic stimulation (TMS), offers an authoritative and comprehensive overview of TMS. Dr. Brasil-Neto, one of the earliest researchers in transcranial magnetic stimulation, brings his extensive experience...

Aim To identify risk factors for falls in older adults with Type 2 Diabetes Mellitus (T2DM). Methods The eligible studies identified factors associated with the risk of falls in older adults with T2DM. We searched PubMed, Cinahl, Web of Science, Scopus, and the Cochrane Library databases. The review has been updated and the last review date was No...

Autism Spectrum Disorders (ASD) may significantly impact the well-being of patients and their families. The therapeutic use of cannabis for ASD has gained interest due to its promising results and low side effects, but a consensus on treatment guidelines is lacking. In this study, we conducted a retrospective analysis of 20 patients with autistic s...

Aim To identify risk factors for falls in the older adults with Type 2 Diabetes Mellitus (T2DM). Methods The eligible studies identified factors associated with the risk of falls in older adults with DM. We searched PubMed, Cinahl, Web of Science, Scopus, and the Cochrane Library databases for studies beginning April 2020 through July 2021 (CRD420...

A neuromodulação terapêutica não-invasiva é um dos campos mais dinâmicos e inovadores da medicina atual. As principais técnicas envolvidas são a estimulação magnética transcraniana (EMT) e a estimulação transcraniana por corrente contínua (ETCC). Esta nova edição do E-Book "Estimulação Magnética Transcraniana: Manual Prático" foi revista e atualiza...

Transcranial direct current stimulation (tDCS) has emerged as a promising intervention in clinical and behavioral neuroscience; however, the response variability to this technique has limited its impact, partly due to the widespread of current flow with conventional methods. Here, we investigate whether a more targeted, focal approach over the prim...

A medicina foi praticada, durante séculos, mais como arte do que como ciência. Uma longa estrada foi trilhada desde os tratamentos supersticiosos, mágico-religiosos e empiricos até os nossos dias, em que cada vez mais se preconiza a prática médica baseada em evidências científicas. Mas onde e como buscar as evidências científicas? O profissional de...

Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) has an antalgic effect on acute experimental pain in healthy volunteers. Many published studies have used online stimulation (i.e., tDCS performed during painful stimulation). On the other hand, daily tDCS sessions have been proposed as a therapy for chronic pain (off...

Introduction: Stuttering is characterized by abnormal speech rate and/or a significant amount of barriers to the natural course of speech. Transcranial Direct Current Stimulation (tDCS) is a noninvasive technique that causes temporary modulation of neuronal activity in particular cortical regions. This could be an interesting adjuvant for speech re...

The prefrontal cortices have been shown to be engaged in the perception of emotional faces, and imaging studies correlate activation of the left dorsolateral prefrontal cortex (l-DLPFC) with correct identification of emotional expressions. Transcranial direct current stimulation (tDCS)has been shown to modulate cortical function and might influence...

Background Anodal transcranial direct current stimulation (a-tDCS) has been shown to promote performance improvement of normal individuals in tests of executive function, including tasks that demand sustained attention and inhibitory control. The presumed mechanism is facilitation of prefrontal cortex activation, since a-tDCS is thought to increase...

Autism Spectrum Disorders comprise conditions that may affect cognitive development, motor skills, social interaction, communication, and behavior. This set of functional deficits often results in lack of independence for the diagnosed individuals, and severe distress for patients, families, and caregivers. There is a mounting body of evidence indi...

Background: Transcranial direct current stimulation (tDCS) has been investigated in movement disorders, making it a therapeutic alternative in clinical settings. However, there is still no consensus on the most appropriate treatment protocols in most cases, and the presence of deep brain stimulation (DBS) electrodes has been regarded as a contrain...

Background : Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique that has shown encouraging results regarding performance improvement of normal subjects in tests of executive functions. Moreover, when applied repeatedly in daily sessions, tDCS has shown therapeutic potential in various neuropsychiatric disorde...

Transcranial direct current stimulation (tDCS) applied over the dorsolateral prefrontal cortex (DLPFC) has been shown to reduce cravings in tobacco addiction; however, results have been somewhat mixed. In this study, we hypothesized that motivation to quit smoking is a critical factor of tDCS effects in smokers. Therefore, we conducted a double-bli...

Although growing evidence points to the potential therapeutic effects of transcranial Direct Current Stimulation (tDCS), there is still no consensus on the most appropriate protocol to be used in specific neurological and neuropsychological symptoms. This case report evaluated the neuromodulatory therapeutic effects of two 15-day courses of tDCS on...

Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely exp...

Both invasive and non-invasive motor cortex stimulation techniques have been successfully employed in the treatment of chronic pain, but the precise mechanism of action of such treatments is not fully understood. It has been hypothesized that a mismatch of normal interaction between motor intention and sensory feedback may result in central pain. S...

Both invasive and non-invasive motor cortex stimulation techniques have been successfully employed in the treatment of chronic pain, but the precise mechanism of action of such treatments is not fully understood. It has been hypothesized that a mismatch of normal interaction between motor intention and sensory feedback may result in central pain. S...

Background: Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique that has shown encouraging results regarding performance improvement of normal subjects in tests of executive functions. Moreover, when applied repeatedly in daily sessions, tDCS has shown therapeutic potential in various neuropsychiatric disorder...

Background : Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique that has shown encouraging results regarding performance improvement of normal subjects in tests of executive functions. Moreover, when applied repeatedly in daily sessions, tDCS has shown therapeutic potential in various neuropsychiatric disorde...

Cerebral plasticity plays an important role in learning and in neurological recovery after nervous lesions. However, in certain nervous diseases that same plasticity may lead to nervous system malfunction. Nowadays there are new methods that seem to be able to modulate nervous system function, namely transcranial magnetic stimulation and transcrani...

Sir, We have read with great interest the article published by Gallea et al. (2013), in the November 2013 issue of Brain , regarding the pathophysiological basis of the rare disease named congenital mirror movements (Srour et al. , 2010; Depienne et al. , 2012), that might serve as a model to recognize new aspects of bimanual motor control (Gallea...

OBJETIVO: Avaliar a qualidade de vida através dos domínios do Instrumento SF-36 em portadores de lombalgia crônica inespecífica. MÉTODOS: Trinta portadores de lombalgia crônica inespecífica foram aleatorizados para três grupos (grupo Iso (Isostretching), grupo RPG (Reeducação Postural Global) e Iso+RPG), e avaliados quanto à dor e qualidade de vida...

The objective of this study was to evaluate the quality of life (QL) with the use of the SF-36 Questionnaire in patients with chronic nonspecific low back pain (CNLBP). Thirty patients with CNLBP were randomly assigned to one of three groups (Iso group (Isostretching), GPR group (Global Postural Reeducation), and the Iso+GPR group. Patients underwe...

Desde a sua introdução, em 1985, por Barker et al. (1985), a estimulação magnética transcraniana (EMT) por pulsos únicos tem se mostrado uma ferramenta útil para o estudo das vias motoras no homem (Amassian et al., 1987; Cohen et al., 1988; Day et al., 1989). A estimulação magnética transcraniana tornou‑se possível com o desenvolvimento de bobinas...

Introduction - The modulation of cortical excitability by transcranial direct current stimulation (tDCS), acting through cortico-subcortical connections, has the potential to produce side effects on the autonomic nervous system.Objective - Our research aimed at evaluating possible acute effects o tDCS on blood pressure, respiratory rate and VO2 and...

Transcranial direct current stimulation (tDCS) has been the subject of many studies concerning its possible cognitive effects. One of the proposed mechanisms of action for neuromodulatory techniques, such as transcranial magnetic stimulation and tDCS is induction of long-term potentiation (LTP) and long-term depression (LTD)-like phenomena. LTP and...

Recent findings indicate that the motor and premotor cortices are hyperexcitable in obsessive-compulsive disorder (OCD). The authors have performed the first randomized, double-blind clinical trial of repetitive transcranial magnetic stimulation (rTMS) in OCD, with a 3-month follow-up. OCD patients (N=22) were assigned to either 2 weeks of active o...

We analysed cortical muscle representation areas during single muscle activation and during the co-activation of several upper arm muscles in the patients with writer's cramp to determine the possible occurrence of abnormal dynamic somatotopic changes in M1, in addition to the static map abnormalities already described in this form of dystonia. Usi...

Neuromodulatory techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have been increasingly studied as possible treatments for many neurological and psychiatric disorders. tDCS is capable of inducing changes in regional cerebral blood flow in both cortical and subcortical structures, as sho...

The aim of this work was to analyse how writer's cramp patients coordinate each element of the proximal to distal upper arm muscle chain during voluntary movement. Using transcranial magnetic stimulation, we have assessed motor cortex excitability properties in patients by recording motor-evoked potentials and silent periods in both the extensor ca...

Introduction. Recent evidence has shown that the motor deficit after unilateral stroke may be compounded by excessive transcallosal inhibition from a hyperexcitable intact cerebral hemisphere. We hypothesize that EMG biofeedback relaxation training (EBRT) of the non-paretic upper limb (NPUL) might be able to decrease the excitability of the intact...

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vag...

The visual capture phenomenon has recently been explored, especially in the context of the rubber-hand illusion (RHI)--an illusion in which tactile sensations are referred to an illusory limb. We have induced the RHI with the difference that tactile-painful stimuli were added in order to verify the interaction between vision, touch, proprioception,...

To evaluate sensory function in the unaffected hand of unilateral stroke patients. Ipsilateral motor deficits have been described in stroke patients, but sensory function has usually been reported to be normal in the unaffected limbs. Twenty-five patients (19 males, 6 females, 58.24+/-11.11 y old) with first-ever stroke, in the chronic phase (mean...

Reduction of excitability of the dominant primary motor cortex (M1) improves ipsilateral hand function in healthy subjects. In analogy, inhibition of non-dominant M1 should also improve ipsilateral performance. In order to investigate this hypothesis, we have used slow repetitive transcranial magnetic stimulation (rTMS) and the Purdue Pegboard test...

Human and primate studies have demonstrated that performance of tasks that induce asymmetrical physiological activation of the cerebral hemispheres leads to a reduction of tympanic temperature (TT) ipsilateral to the most active hemisphere. It is possible that diseases that interfere in an asymmetrical fashion with the degree of cerebral activity c...

To evaluate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the symptoms of a patient with primary segmental dystonia (PSD). 1200 TMS pulses at a frequency of 1Hz, over the premotor cortex, with an intensity of 90% of the motor threshold (MT), using an eight-shaped coil; a total of 5 sessions were carried out. A r...

To report the effects of local injections of botulinum toxin type A regarding pain relief and long-term control in a patient with intractable trigeminal neuralgia. The patient was a 75-year-old man with trigeminal neuralgia in the left hemifacial region. His pain was unbearable and could not be controlled by carbamazepine, amitriptyline, or blocked...

The aim of this study was to verify whether botulinum toxin (BTX)-induced clinical improvement of cranial dystonia is associated with changes in the cortical silent period (SP), a measure of cortical excitability. By transcranial magnetic stimulation (TMS), high-intensity stimuli were delivered with a round coil centered at the vertex during a maxi...

Transcranial Magnetic Stimulation (TMS) has been shown to be a useful therapy for depression. This paper evaluates the results of bi-weekly low-frequency TMS of 4 weeks duration, in 10 patients with depression who do not respond or are intolerant to antidepressive medication. This is a case series study. DMS-IV criteria were used to diagnose depres...

To investigate the effect of three months of low-frequency repetitive transcranial magnetic stimulation (rTMS) treatment in intractable epilepsy. Five patients (four males, one female; ages 6 to 50 years), were enrolled in the study; their epilepsy could not be controlled by medical treatment and surgery was not indicated. rTMS was performed twice...

This article describes the discovery of transcranial magnetic stimulation (TMS) since early studies concerning the effects of magnetism in animals and humans, as a research tool as well as a therapeutic agent, to this day, when applications to psychiatric illnesses are being suggested.

An old biological dogma states that a potencial for cortical reorganization (neuroplasticity) exists nly in young animals, being lost in adlt life. Here we review studies carried out both in animals and humans, whixh demonstrate cortical reorganization in sensory and motor systems in adult subjects. We particulary emphasiza human studies carried ou...

This paper reports the use of slow frequency transcranial magnetic stimulation of the right pre-frontal cortex in three patients with a diagnosis of major depressive episode according to the DSM-IV classification. There was a significant improvement in two patients, with a decrease of over 50% in the Hamilton Scale scores- 17 items. Possible indica...

O presente estudo relata o uso da estimulação magnética transcraniana de baixa frequência sobre o córtex pré-frontal direito em três pacientes com diagnóstico de episódio depressivo maior, de acordo com o DSM - IV. Houve melhora significativa em dois pacientes, com diminuição de mais de 50% na pontuação da escala de Hamilton - 17 itens. São feitas...

Introdução. Estudos recentes têm demonstrado que após acidente vascular encefálico (AVC) unilateral, o déficit motor parece ser acentuado por uma atividade inibitória excessiva exercida pelo hemisfério cerebral não afetado, que se torna hiperexcitável. Propomos o Biofeedback Eletromiográfico para treino de relaxamento do membro superior não-parétic...

Motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) increase in amplitude when obtained immediately after a period of exercise of the target muscle (postexercise facilitation). We studied postexercise facilitation of MEPs to TMS after periods of voluntary activation of either the ipsilateral or contralateral primary motor cort...

We activated the sciatic nerve afferents by either the discharge of a magnetic coil or a needle inserted near the nerve. Both types of stimulation induced facilitation of the vastus medialis (VM) H reflex, and of the VM response to transcranial magnetic stimulation, at the joint time of arrival of conditioning and test volleys, while a subsequent i...

Sympathetic skin responses (SSRs) have been increasingly used as tests for autonomic function in the clinical setting. In spite of the known circadian rhythmicity of sympathetic function, however, normative studies have not addressed the possibility of circadian variability of SSR parameters. Ten normal volunteers (7 men, 3 women, aged 19 to 43) ha...

We have developed a computer-based method for measuring the speed of human visual depth perception (stereolatency). Since it needs only a personal computer and special glasses, our method is easier to use than other techniques, which require electromechanical devices. We have tested 25 normal subjects and have found a mean stereolatency of 258.3 ms...

Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) of the human motor cortex produce a silent period (SP) following motor evoked potentials (MEPs). The early part of the SP can be explained by decreased alpha motor neuron excitability, whereas the late part is presumably due to suprasegmental mechanisms. In order...

1. We used transcranial magnetic stimulation (TMS) to study the role of plastic changes of the human motor system in the acquisition of new fine motor skills. We mapped the cortical motor areas targeting the contralateral long finger flexor and extensor muscles in subjects learning a one-handed, five-finger exercise on the piano. In a second experi...

We have previously shown that the amplitudes of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) were transiently decreased after exercise, indicating fatigue of motor pathways in the central nervous system. The responsible mechanism is apparently decreased efficiency in the generation of the descending volleys in...

Transcranial magnetic stimulation (TMS) of the sensorimotor cortex can evoke motor evoked potentials (MEPs), attenuation in detection of somatosensory stimuli (ADSS), and sensation of movement (SOM) referred to the same body part. In this study we tried to differentiate the substrates responsible for these effects. In 6 normal volunteers, TMS was a...

We studied the effects of transcranial magnetic stimulation (TMS) of the motor cortex on simple reaction time (RT) in 10 patients with Parkinson's disease compared with 10 age-matched normal controls. The subjects flexed their right elbow rapidly in response to a visual go-signal. In random trials, TMS was applied to the left motor cortex at varyin...

We studied the effects of repetitive transcranial stimulation of the motor cortex (rTMS) on choice reaction time (cRT), movement time (MT), and error rate (ER) in a serial reaction-time task in six medicated patients with Parkinson's disease (PD) and 10 age-matched normal controls. In normal subjects, subthreshold 5-Hz rTMS did not significantly ch...

We studied the facilitation of the motor evoked potential (MEP) elicited with transcranial magnetic stimulation by increasing the stimulus intensity and the degree of voluntary activation of the target muscle in patients with Parkinson's disease (PD) and in normal volunteers. The threshold intensity for eliciting MEPs with the muscle at rest did no...

Non-invasive mapping of human motor cortex by stimulating different scalp positions with a magnetic coil held at a constant orientation allows differentiation of proximal and distal arm muscles. This study describes a technique for more precise mapping of closely represented muscles using different orientations of a coil that delivers nearly monopo...

We used focal transcranial magnetic stimulation to map the motor cortical areas targeting the first dorsal interosseous and the abductor digiti minimi muscles bilaterally in 10 proficient braille readers and 10 blind controls who were matched for age (mean, 50.6 yr) and age at time of blindness (mean, 7.5 yr). The proficient braille readers had lea...

The amplitudes of motor evoked potentials to transcranial magnetic stimulation from muscles immediately proximal to a temporarily anaesthetized (Bier's block) human forearm increase in minutes after the onset of anaesthesia and return to control values after the anaesthesia subsides. In order to determine the level at which the early modulation of...

In 9 normal volunteers, we studied the safety of rapid-rate transcranial magnetic stimulation (rTMS) applied to different scalp positions at various frequencies and intensities. Pure tone threshold audiometry showed temporary threshold shifts in 3 subjects. In the subject stimulated at the highest intensity, rTMS induced a focal, secondarily genera...