Banca de DEFESA: WESLEY RIBEIRO COSTA MENESES

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : WESLEY RIBEIRO COSTA MENESES
DATE: 05/03/2026
TIME: 08:30
LOCAL: remoto
TITLE:

Non-Invasive Evaluation by Transcranial Magnetic Stimulation (TMS) of the Contraction and Relaxation Properties of the Respiratory Muscles in Subjects with Amyotrophic Lateral Sclerosis.

KEY WORDS:

Amyotrophic Lateral
Sclerosis; Transcranial Magnetic Stimulation; Respiratory Muscles;
Diaphragm; Neurophysiology.

 

PAGES: 39
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Amyotrophic Lateral Sclerosis (ALS)
promotes a progressive neuromuscular degeneration that culminates in
ventilatory failure. Limitations in conventional effort-dependent tests hinder
the detection of dysfunctions in subclinical stages. Transcranial Magnetic
Stimulation (TMS) integrated with pressure assessments creates a more
objective approach to quantify neural drive and muscular mechanical
efficiency. Objectives: To evaluate respiratory contraction and relaxation
properties in ALS patients, comparing them before and in conjunction with
TMS, while establishing the relationship between neurophysiological markers
and functional performance. Methodology: A cross-sectional study involving
individuals with ALS. Maximum pressure maneuvers (MIP/MEP/SNIP/SNEP)
were performed in association with surface electromyography (sEMG). TMS
was applied to the cervical and thoracic nerve roots to capture the
diaphragmatic Motor Evoked Potential (MEP), analyzing contraction rates
(MRPD) and relaxation rates (MRR, Tau, and ½ RT). Results and
Discussion: The findings reveal alterations that impair corticospinal
excitability, characterized by neural conduction delays (increased latencies)
and a reduction in the magnitude of the motor response (lower MEP
amplitudes). Regarding contraction and relaxation properties, a marked
slowing of muscle relaxation kinetics was identified, even in patients who still
maintained preserved lung function. These patterns evidence an early failure
in the neuromuscular response. Conclusion: The integration of TMS with
pressure kinetics allows for the early identification of the brain-muscle
interface decline. This methodology establishes itself as a sensitive biomarker
for more precise clinical monitoring, potentially enabling a more accurate
neurophysiological and respiratory muscle prognosis in ALS.

 

COMMITTEE MEMBERS:
Presidente - 1545315 - GUILHERME AUGUSTO DE FREITAS FREGONEZI
Interna - 2211046 - LUCIEN PERONI GUALDI
Externa à Instituição - JESSICA DANIELLE MEDEIROS DA FONSECA - EBSERH