Bruno Schein Cavalheiro Correa

EDUCATION

Bachelor of Psychology from the Pontifical Catholic University of Rio Grande do Sul

RESEARCH INTERESTS

Neurosciences, Neuromodulation, Chronic painCognitive Behavioral Therapy, Hypnosis, Hypnotic Analgesia

Scopus Publications

Effects of Hypnotic Analgesia and Transcranial Direct Current Stimulation on Pain Tolerance and Corticospinal Excitability in Individuals with Fibromyalgia: A Cross-Over Randomized Clinical Trial
Bruno Schein, Gerardo Beltran, Bárbara Regina França, Paulo RS Sanches, Danton P Silva Jr, Iraci Lucena Torres, Felipe Fegni, Wolnei Caumo
Journal of Pain Research, 2023
Objective We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Methods This randomized, blind, crossover trial included 18 women with fibromyalgia, aged from 18 to 65 years old. They received at random and in a crossover order a-tDCS over the l-DLPFC (2mA), HAS, or a rest-testing. Results HAS compared to a-tDCS increased the pain tolerance with a moderate effect size (ES) [Cohen’s f=−0.78; (CI 95%; −1.48 to −0.12)]. While compared to rest-testing, HAS increased the CPT with a large ES [Cohen’s f=−0.87; (CI 95%; −1.84 to −0.09)]. The a-tDCS compared to HAS increased the MEP amplitude with large ES [Cohen’s f=−1.73 (CI 95%; −2.17 to −0.17)]. Likewise, its ES compared to rest-testing in the MEP size was large [Cohen’s f=−1.03; (CI 95%; −2.06 to −0.08)]. Conclusion These findings revealed that HAS affects contra-regulating mechanisms involved in perception and pain tolerance, while the a-tDCS increased the excitability of the corticospinal pathways. They give a subsidy to investigate their effect as approaches to counter regulate the maladaptive neuroplasticity involved in fibromyalgia. Clinical Trial Registration www.ClinicalTrials.gov, identifier – NCT05066568.
The hypnotic analgesia suggestion mitigated the effect of the transcranial direct current stimulation on the descending pain modulatory system: A proof of concept study
Gerardo Beltran Serrano, Laura Pooch Rodrigues, Bruno Schein, Maxciel Zortea, Iraci Lucena da Silva Torres, Felipe Fregni, Wolnei Caumo
Journal of Pain Research, 2020
Objective We evaluated whether active(a)-tDCS combined with hypnotic analgesia suggestion (HS) would be more effective than a single active(a)-tDCS, and/or sham-(s)-tDCS and s-tDCS/HS on the following outcomes: function of descending pain modulatory system (DPMS) during the conditioned pain modulation test (CPM-test) (primary outcome), heat pain threshold (HPT), heat pain tolerance (HPTo) and cold pressor test (CPT) (secondary outcomes). We also examined whether their effects are related to neuroplasticity state evaluated by serum brain-derived-neurotropic factor (BDNF). Materials and Methods Forty-eight females received one session of one of the four interventions (a-tDCS/HS, s-tDCS/HS, a-tDCS, and s-tDCS) in an incomplete randomized crossover sequence. The a-tDCS or s-tDCS was applied over the left dorsolateral prefrontal cortex (DLPFC) for 30 minutes at 2mA. Results A generalized linear model revealed a significant main effect for the intervention group (P <0.032). The delta-(Δ) pain score on the Numerical Pain Scale (NPS0-10) during CPM-test in the a-tDCS/HS group was −0.25 (0.43). The (Δ) pain score on NPS (0–10) during CPM-test in the other three groups was a-tDCS=−0.54 (0.41), HS −0.01 (0.41) and s-tDCS/HS=−0.19 (0.43). A-tDCS/HS intervention increased the CPT substantially compared to all other interventions. Also, higher baseline levels of BDNF were associated with a larger change in CPT and HPTo. Conclusion These findings indicate that the HS combined with a-tDCS mitigated the effect of the a-tDCS on the DPMS. The a-tDCS up-regulates the inhibition on DPMS, and the HS improved pain tolerance. And, together they enhanced the reaction time substantially upon the CPT. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03744897.
Comparison of hypnotic suggestion and transcranial direct-current stimulation effects on pain perception and the descending pain modulating system: A crossover randomized clinical trial
Gerardo Beltran Serrano, Laura Pooch Rodrigues, Bruno Schein, Andressa Souza, Iraci L. S. Torres, Luciana da Conceição Antunes, Felipe Fregni, Wolnei Caumo
Frontiers in Neuroscience, 2019
Objectives: This paper aims to determine if hypnotic analgesia suggestion and transcranial direct-current stimulation (tDCS) have a differential effect on pain perception. We hypothesized that transcranial direct-current stimulation would be more effective than hypnotic analgesia suggestion at changing the descending pain modulating system, whereas the hypnotic suggestion would have a greater effect in quantitative sensory testing. Design: This is a randomized, double blind and crossover trial. Settings: All stages of this clinical trial were performed at the Laboratory of Pain and Neuromodulation of the Hospital de Clínicas de Porto Alegre. Subjects: Were included 24 healthy females aged from 18 to 45 years old, with a high susceptibility to hypnosis, according to the Waterloo-Stanford Group Scale of Hypnotic Susceptibility, Form C (15). Methods: The subjects received a random and crossover transcranial direct-current stimulation over the dorsolateral prefrontal cortex (2 mA for 20 min) and hypnotic analgesia (20 min). Results: Only hypnotic suggestion produced changes that are statistically significant from pre- to post-intervention in the following outcomes measures: heat pain threshold, heat pain tolerance, cold pressure test, and serum brain-derivate-neurotrophic-factor. The analysis showed a significant main effect for treatment (F = 4.32; P = 0.04) when we compared the delta-(Δ) of conditioned pain modulation task between the transcranial direct-current stimulation and hypnotic suggestion groups. Also, the change in the brain-derivate-neurotrophic-factor was positively correlated with the conditioned pain modulation task. Conclusion: The results confirm a differential effect between hypnotic suggestion and transcranial direct-current stimulation on the pain measures. They suggest that the impact of the interventions has differential neural mechanisms, since the hypnotic suggestion improved pain perception, whereas the transcranial direct-current stimulation increased inhibition of the descending pain modulating system. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03744897. Perspective: These findings highlight the effect of hypnotic suggestion on contra-regulating mechanisms involved in pain perception, while the transcranial direct-current stimulation increased inhibition of the descending pain modulating system. They could help clinicians comprehend the mechanisms involved in hypnotic analgesia and transcranial direct-current stimulation and thus may contribute to pain and disability management.