Prática do exercício físico aeróbico em diferentes momentos da aplicação da estimulação transcraniana por corrente contínua e seus efeitos sobre o desejo de fumar em tabagistas

Abstract

Tobacco use with a sedentary lifestyle is among the main behavioral causes of mortality worldwide. Studies have reported a series of changes in behavior related to aerobic exercise (AE) in smokers, has a positive effect on cognitive functioning, especially in the cognitive domains dependent on the prefrontal cortex. Another method that has been shown to be a promising to reduce the desire to smoke is Transcranial Direct Current Stimulation (TDCS). Since the cognitive benefits of AE and TDCS activate common brain areas such as the prefrontal cortex, in addition, they are two techniques that can be used in combinations, for these reasons it is plausible that they may have additive effects. Given the above, the main objective of this study is to verify whether the association of AE with TDCS has an additive effect on the desire to smoke in smokers when compared to the use of isolated TDCS and to identify when (before, during or after) AE must be applied, associated with TDCS. We conducted a randomized clinical trial, with pre- and post-test design of four groups: G1 (TDCS); G2 (1st TDCS 2nd AE); G3 (1st AE 2nd TDCS) and G4 (AE and TDCS concurrently), with altogether 39 participants. The volunteers received anodal TDCS in the area of the prefrontal cortex (F4) and cathodal TDCS in the temporal region (T3) at an intensity of 2.0 mA for 20 minutes for five consecutive days. Groups G2, G3 and G4 in addition to TDCS were submitted to moderate intensity AE on a treadmill for 40 minutes (5 minutes of warm-up, 30 minutes of moderate exercise and 5 minutes of calm back) before, after or during TDCS depending on the group. The level of dependence, exhaled carbon monoxide, degree of motivation, number of cigarettes smoked, and level of desire were evaluated. The results were analyzed statistically by the Student test or by the Wilcoxon test and one-way ANOVA or by the Kruskal-Wallis test, they were considered significant when p <0.05. Groups G2 and G4 showed a significant

reduction of 32.95% and 50.13% respectively in the desire to smoke, when comparing the pre- and post-test moments. For the level of dependence, the groups showed a significant reduction

of 23.08%, 31.38%, 43.19% and 39.54% respectively when comparing the pre- and post-test moments. Exhaled carbon monoxide showed significant reductions of 46.78%, 42.17% and 44.50% for groups G2, G3 and G4 respectively when comparing the pre- and post-test moments. For the variable number of cigarettes smoked, there was a significant reduction over time in consumption for all groups. Although we found a more accentuated decrease profile in the groups where there is an association, there was no significant difference between these groups and the TDCS for any evaluated variable. The results demonstrate that five AE sessions performed during or after TDCS can reduce the desire to smoke, the level of dependence, the levels of exhaled carbon monoxide and the number of cigarettes smoked between the pre- and post-test moments, and the more accentuated decrease profile in groups where there is an association, suggests AE as a probable enhancer of the positive modulators effects of TDCS in smokers.