Leite, Jorge
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Leite
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Jorge
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Jorge Leite
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Jorge Leite obtained his PhD in 2011 from the University of Minho, where he also completed his Psychology Degree in 2005. From 2013 to 2016, he underwent postdoctoral training at the Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School. Currently, he holds the positions of Vice-Rector for Research, Associate Professor, and Coordinator of the CINTESIS.UPT. Throughout his career, he has made significant contributions to the field, with over 70 peer-reviewed publications, including articles in journals, book chapters, and conference proceedings. According to Scopus data, over half of his publications are featured in the top 25% of journals, while 45% are among the top 25% most cited documents globally. He has also supervised numerous MSc dissertations and is currently overseeing four PhD theses. Furthermore, he actively participates in various research projects, taking on roles such as Principal Investigator, Researcher, and Supervisor. These projects have successfully secured over 6M euros in funding. His dedication to his work has been recognized with seven awards and/or honors. Furthermore, he has collaborated with 167 fellow researchers in various scientific endeavors.
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CINTESIS.UPT - Centro de Investigação em Tecnologias e Serviços de Saúde
Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS.UPT), former I2P, is an R&D unit devoted to the study of cognition and behaviour in context. With an interdisciplinary focus, namely on Education, Translational and Applied Psychology
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Publicação Acesso Aberto Digitalized transcranial electrical stimulation: a consensus statement2022-09-05 - Brunoni, André R.; Ekhtiari, Hamed; Antal, Andrea; Auvichayapat, Paradee; Baeken, Chris; Benseñor, Isabela M; Bikson, Marom; Boggio, Paulo; Borroni, Barbara; Brighina, Filippo; Brunelin, Erome; Carvalho, Sandra; Caumo, Wolnei; Ciechanski, Patrick; Charvet, Leigh; Clark, Vincent P; Kadosh, Roi Cohen; Cotelli, Maria; Datta, Abhishek; Deng, Zhi-De; Raedt, Rudi De; Ridder, Dirk De; Fitzgerald, Paul B; Floel, Agnes; Frohlich, Flavio; George, Mark S; Ghobadi-Azbari, Peyman; Goerigk, Stephan; Hamilton, Roy H; Jaberzadeh, Shapour J; Hoy, Kate; Kidgell, Dawson J; Zonoozi, Arash Khojasteh; Kirton, Adam; Laureys, Steven; Lavidor, Michal; Lee, Kiwon; Lisanby, Sarah H; Loo, Colleen; Martin, Donel M; Miniussi, Carlo; Mondino, Marine; Monte-Silva, Katia; Morales-Quezada, Leon; Nitsche, Michael A; Okano, Alexandre H; Oliveira, Claudia S; Onarheim, Balder; Pacheco-Barrios, Kevin; Padberg, Frank; Nakamura-Palacios, Ester M; Palm, Ulrich; Paulus, Walter; Plewnia, Christian; Priori, Alberto; Rajji, Tarek K; Razza, Lais B; Rehn, Erik M; Ruffini, Giuliov; Schellhorn, Klaus; Zare-Bidoky, Mehran; Simis, Marcel; Skorupinski, Pawel; Suen, Paulo; Thibaut, Aurore; Valiengo, Leandro C L; Vanderhasselt, Marie-Anne; Vanneste, Sven; Venkatasubramanian, Ganesan; Violante, Ines R; Wexler, Anna; Woods, Adam J; Fregni, Felipe; Leite, JorgeObjective: Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES. Methods: We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided. Results: The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/ threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity. Conclusions: Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. Significance: We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials.Publicação Acesso Restrito Modulation of the cognitive event-related potential P3 by transcranial direct current stimulation: Systematic review and meta-analysis2022-01 - Mendes, Augusto J.; Pacheco-Barrios, Kevin; Lema, Alberto; Gonçalves, Óscar F.; Fregni, Felipe; Carvalho, Sandra; Leite, JorgeTranscranial direct current stimulation (tDCS) has been widely used to modulate cognition and behavior. However, only a few studies have been probing the brain mechanism underlying the effects of tDCS on cognitive processing, especially throughout electrophysiological markers, such as the P3. This meta-analysis assessed the effects of tDCS in P3 amplitude and latency during an oddball, n-back, and Go/No-Go tasks, as well as during emotional processing. A total of 36 studies were identified, but only 23 were included in the quantitative analysis. The results show that the parietal P3 amplitude increased during oddball and n-back tasks, mostly after anodal stimulation over the left dorsolateral prefrontal cortex (p = 0.018, SMD = 0.4) and right inferior frontal gyrus (p < 0.001, SMD = 0.669) respectively. These findings suggest the potential usefulness of the parietal P3 ERP as a marker of tDCS-induced effects during task performance. Nonetheless, this study had a low number of studies and the presence of considerable risk of bias, highlighting issues to be addressed in the future.Publicação Acesso Aberto Editorial: Optimization strategies for pain management with neuromodulation2022-09-15 - Pacheco-Barrios, Kevin; Carvalho, Sandra; Caumo, Wolnei; Fregni, Felipe; Leite, JorgeChronic pain is a high-priority global health issue due to its high prevalence, impact on quality of life, and cost (1). In most cases, chronic pain is challenging to manage, and the existing treatment modalities have reported frequent and severe adverse events, including gastritis (2), cardiovascular complications [...]Publicação Acesso Aberto Cognitive effects of transcranial direct current stimulation combined with working memory training in fibromyalgia: A randomized clinical trial2018-08-20 - Santos, Vinicius Souza dos Souza dos; Zortea, Maxciel; Alves, Rael Lopes; Naziazeno, Cátia Cilene dos Santos; Saldanha, Júlia Schirmer; Carvalho, Sandra da Conceição Ribeiro; Torres, Iraci Lucena da Silva; Souza, Andressa; Calvetti, Prisla Ücker; Fregni, Felipe; Caumo, Wolnei; Leite, JorgeCognitive dysfunction in fibromyalgia has been reported, especially memory. Anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) has been effective in enhancing this function. We tested the effects of eight sessions of tDCS and cognitive training on immediate and delayed memory, verbal fluency and working memory and its association with brain-derived neurotrophic factor (BDNF) levels. Forty females with fibromyalgia were randomized to receive eight sessions of active or sham tDCS. Anodal stimulation (2 mA) was applied over the DLPFC and online combined with a working memory training (WMT) for 20 minutes. Pre and post-treatment neurocognitive tests were administered. Data analysis on deltas considering years of education and BDNF as covariates, indicated active-tDCS + WMT significantly increased immediate memory indexed by Rey Auditory Verbal Learning Test score when compared to sham. This effect was dependent on basal BDNF levels. In addition, the model showed active stimulation increased orthographic and semantic verbal fluency scores (Controlled Oral Word Association Test) and short-term memory (Forward Digit Span). The combination of both techniques seemed to produce effects on specific cognitive functions related to short-term and long-term episodic memory and executive functions, which has clinical relevance for top-down treatment approaches in FM.Publicação Acesso Aberto Longitudinal Clinical Trial Recruitment and Retention Challenges in the Burn Population: Lessons Learned from a Trial Examining a Novel Intervention for Chronic Neuropathic Symptoms2019 - Ohrtman, Emily A.; Zaninotto, Ana Luiza; Carvalho, Sandra; Shie, Vivian L.; Ianni, Corinne Rose; Kazis, Lewis E.; Ross Zafonte, Ross Zafonte; Ryan, Colleen M.; Schneider, Jeffrey C.; Fregni, Felipe; Leite, JorgeLong-term trials are key to understanding chronic symptoms such as pain and itch. However, challenges such as high attrition rates and poor recruitment are common when conducting research. The aim of this work was to explore these issues within a long-term randomized control trial using transcranial direct current stimulation to treat pain and itch. This parallel double blinded, placebo-controlled randomized trial was comprised of 15 transcranial direct current stimulation visits and 7 follow-up visits. Participants were over the age of 18, had a burn injury that occurred at least 3 weeks before enrollment, and reported having pain and/or itch that was moderate to severe in intensity. A total of 31 subjects were randomized into either an active or sham transcranial direct current stimulation groups. There were no significant differences between the groups in terms of age, race, education, baseline depression, or anxiety. The median dropout time was at visit 19 (visit 16 [SE = 1.98] for the sham group and visit 19 [SE = 1.98] for the active group). Analysis showed no differences in the dropout rate between groups [χ2(1) = 0.003, P = .954]. The dropout rate was 46.7% for the sham group and 43.8% for the active group. Overall, 45.2% of the subjects dropped out of the trial. Long-term clinical trials are an essential part of evaluating interventions for symptoms such as chronic pain and itch. However, as seen in this trial, long-term studies in the burn population often face recruitment and adherence challenges.Publicação Acesso Restrito Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation (tDCS) in neurological and psychiatric disorders2021-04 - Fregni, Felipe; El-Hagrassy, Mirret M.; Pacheco-Barrios, Kevin; Carvalho, Sandra; Simis, Marcel; Brunelin, Jerome; Nakamura-Palacios, Ester Miyuki; Marangolo, Paola; Venkatasubramanian, Ganesan; San-Juan, Daniel; Caumo, Wolnei; Bikson, Marom; Brunoni, André R.; Leite, JorgeTranscranial direct current stimulation (tDCS) has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. Objective We convened a team of tDCS experts to conduct a systematic review of clinical trials with more than one session of stimulation testing: Pain, Parkinson’s Disease Motor Function and Cognition, Stroke Motor Function and Language, Epilepsy, Major Depressive Disorder, Obsessive-Compulsive Disorder, Tourette Syndrome, Schizophrenia and Drug Addiction. Methods Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into: Levels A (definitely effective), B (probably effective), C (possibly effective) or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. Results Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A) such as depression, probably effective (Level B) such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson´s disease (motor and cognition), stroke (motor), epilepsy, schizophrenia and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with largest effect size being in postoperative acute pain, and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy). Conclusion All recommendations listed here are based on current published Pubmed-indexed data. Despite high level of evidence in some conditions, it needs to be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.Publicação Acesso Aberto Working memory training coupled with transcranial direct current stimulation in older adults: A randomized controlled experiment2022-04-12 - Teixeira-Santos, Ana C.; Moreira, Célia S.; Pereira, Diana R.; Pinal, Diego; Fregni, Felipe; Carvalho, Sandra; Sampaio, Adriana; Leite, JorgeBackground: Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects. Methods: In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven’s Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis. Results: Working memory training improved dual n-back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim. Conclusion: This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up.Publicação Acesso Restrito Transcranial direct current stimulation as an add-on treatment to cognitive-behavior therapy in first episode drug-naïve major depression patients: The ESAP Study Protocol2020-11-03 - Carvalho, Sandra; Gonçalves, Óscar F.; Brunoni, André R.; Fernandes-Gonçalves, Ana; Fregni, Felipe; Leite, JorgeMajor Depressive Disorder (MDD) affects more than 264 million people worldwide. Current treatments include the use of psychotherapy and/or drugs, however ∼30% of patients either do not respond to these treatments, or do not tolerate the side effects associated to the use of pharmacological interventions. Thus, it is important to study non-pharmacological interventions targeting mechanisms not directly involved with the regulation of neurotransmitters. Several studies demonstrated that transcranial Direct Current Stimulation (tDCS) can be effective for symptoms relief in MDD. However, tDCS seems to have a better effect when used as an add-on treatment to other interventions.Publicação Acesso Aberto The effects of direct current stimulation and random noise stimulation on attention networks2021-03-18 - Lema, Alberto; Carvalho, Sandra; Fregni, Felipe; Gonçalves, Óscar F.; Leite, JorgeAttention is a complex cognitive process that selects specific stimuli for further processing. Previous research suggested the existence of three attentional networks: alerting, orienting and executive. However, one important topic is how to enhance the efficiency of attentional networks. In this context, understanding how this system behaves under two different modulatory conditions, namely transcranial direct current stimulation (tDCS) and transcranial Random Noise Stimulation (tRNS), will provide important insights towards the understanding of the attention network system. Twenty-seven healthy students took part on a randomized single-blinded crossover study, testing the effects that involved three modalities of unilateral stimulation (tRNS, anodal tDCS, and sham) over the DLPFC, during the performance of the attention network test (ANT) in three different conditions: standard, speed and accuracy. Results showed that tRNS was able to increase attention during more complex situations, namely by increasing alerting and decreasing conflict effect in the executive network. Under the Speed condition, tRNS increased efficiency of the alerting network, as well as under the more demanding conflict network, tRNS overall increased the performance when comparing to sham. No statistical significant effects of tDCS were observed. These results are compatible with the attention requiring the synchronization of pre-existing networks, rather the reinforcement or creation of new pathways.