Exploring the Role of Prefrontal Cortex tDCS in Hypertension: A Mini-Review.

Olívia Moraes Ruberti, Heitor Moreno Junior, Bruno Rodrigues
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Abstract

Arterial Hypertension (HTN) is the leading cause of cardiovascular diseases, which, in turn, are the primary cause of mortality worldwide. The success rates in Blood Pressure (BP) control among the general population remain unacceptably low. HTN etiology is multifactorial, but ample evidence has shown an essential role of the Autonomic Nervous System (ANS) dysfunction in its physiopathology. Concurrently, studies have pointed to the promising effect of non-invasive cortical stimulation techniques, such as transcranial Direct Current Stimulation (tDCS), on modulating blood pressure and the ANS. tDCS involves the application of a direct low-intensity electric current between two electrodes (cathode and anode) placed on the scalp and skull over areas of interest in the cerebral cortex. The impacts of this technique on regulating BP levels and cardiovascular autonomic modulation have excellent potential to be explored in hypertension. This study aimed to review and discuss the existing evidence concerning the efficacy of tDCS in modulating BP and ANS, focusing on its potential as a therapeutic intervention for HTN. This narrative mini-review presents and discusses critical findings regarding using tDCS to modulate BP and the ANS. Data obtained from clinical and preclinical studies have been addressed in this work. The evidence gathered and discussed in this mini-review suggests the promising role of tDCS as a non-invasive intervention for HTN; however, the underlying mechanisms through which it exerts its effects remain poorly understood. More mechanistic studies must be carried out to draw definitive conclusions regarding the effectiveness and safety of tDCS as a treatment for HTN.

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探索前额皮质 tDCS 在高血压中的作用:微型综述。
动脉高血压(HTN)是导致心血管疾病的主要原因,而心血管疾病又是全球死亡的主要原因。普通人群的血压控制成功率仍然低得令人无法接受。高血压的病因是多因素的,但大量证据表明,自律神经系统(ANS)功能障碍在其生理病理中起着至关重要的作用。经颅直流电刺激(transcranial Direct Current Stimulation,tDCS)等非侵入性皮层刺激技术对调节血压和自律神经系统具有良好效果。tDCS 是指在头皮和头骨上的大脑皮层相关区域的两个电极(阴极和阳极)之间施加直接的低强度电流。这种技术对调节血压水平和心血管自律神经调节的影响极具潜力,可用于高血压的治疗。本研究旨在回顾和讨论有关 tDCS 调节血压和自律神经系统疗效的现有证据,重点关注其作为高血压治疗干预措施的潜力。这篇叙事性微型综述介绍并讨论了有关使用 tDCS 调节血压和自律神经系统的重要发现。本研究讨论了从临床和临床前研究中获得的数据。本小综述中收集和讨论的证据表明,tDCS 作为一种非侵入性干预手段,在治疗高血压和心律失常方面具有广阔的前景。必须开展更多的机制研究,才能就 tDCS 治疗高血压的有效性和安全性得出明确结论。
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