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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Publication Open Access Efficacy and safety of TMS and tDCS in memory deficits Alzheimer's disease2024-06-01 - Mendes, Augusto J.; Rocha, Magda; Rodrigues, Pedro F. S.; Fernandes, Sara M.; Conde, Ana; Leite, JorgeTranscranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are promising non-pharmacological therapeutic options for Alzheimer’s´ Disease (AD). The aim of this meta-analysis is to assess which intervention (i.e., TMS or tDCS) is more effective for memory losses in people with AD. As secondary outcome, safety will be addressed. [...]Publication Open Access Executive impairments in obsessive compulsive disorder: A systematic review with emotional and non-emotional paradigms2020-02 - Tubío Fungueiriño, Maria; Fernandez Prieto, Montse; Carvalho, Sandra; Carracedo, Angel; Gonçalves, Óscar F.; Leite, JorgePrecedent: Impairments in executive functioning may be associated with compulsive symptoms in Obsessive Compulsive Disorder (OCD). The aim of this study was to conduct a systematic review of cognitive flexibility, inhibitory control and working memory in OCD patients. using emotional and non-emotional paradigms. Method: we reviewed research published in PubMed, Web of Science, PsychInfo, Scopus, Scielo, and ProQuest Psychology databases, from January 2008 to April 2019. The review followed a two-stage process. In the first stage, we selected only studies using neutral stimuli paradigms, while in the second we selected executive-emotional paradigms. Results: The first stage of the review provided 16 final results, while the second stage, with emotional stimuli, provided 3 results. Conclusions: There is some initial evidence for the existence of executive impairments in OCD, as expressed in the performance and/or processing of working memory inhibitory control and cognitive flexibility. There is also initial evidence that these latter two could be modulated by the presentation or mental representation of negative valence stimuli or images, as well as the presence of aversive contingencies.Publication Open Access Tailoring transcranial alternating current stimulation based on endogenous event-related P3 to modulate premature responses: A feasibility study2024-04-03 - Mendes, Augusto; Lema, Alberto; Carvalho, Sandra; Leite, JorgeBackground Transcranial alternating current stimulation (tACS) is a brain stimulation method for modulating ongoing endogenous oscillatory activity at specified frequency during sensory and cognitive processes. Given the overlap between event-related potentials (ERPs) and event-related oscillations (EROs), ERPs can be studied as putative biomarkers of the effects of tACS in the brain during cognitive/sensory task performance. Objective This preliminary study aimed to test the feasibility of individually tailored tACS based on individual P3 (latency and frequency) elicited during a cued premature response task. Thus, tACS frequency was individually tailored to match target-P3 ERO for each participant. Likewise, the target onset in the task was adjusted to match the tACS phase and target-P3 latency. Methods Twelve healthy volunteers underwent tACS in two separate sessions while performing a premature response task. Target-P3 latency and ERO were calculated in a baseline block during the first session to allow a posterior synchronization between the tACS and the endogenous oscillatory activity. The cue and target-P3 amplitudes, delta/theta ERO, and power spectral density (PSD) were evaluated pre and post-tACS blocks. Results Target-P3 amplitude significantly increased after activetACS, when compared to sham. Evoked-delta during cue-P3 was decreased after tACS. No effects were found for delta ERO during target-P3 nor for the PSD and behavioral outcomes. Conclusion The present findings highlight the possible effect of phase synchronization between individualized tACS parameters and endogenous oscillatory activity, which may result in an enhancement of the underlying process (i.e., an increase of target-P3). However, an unsuccessful synchronization between tACS and EEG activity might also result in a decrease in the evoked-delta activity during cue-P3. Further studies are needed to optimize the parameters of endogenous activity and tACS synchronization. The implications of the current results for future studies, including clinical studies, are further discussed since transcranial alternating current stimulation can be individually tailored based on endogenous event-related P3 to modulate responses.Publication Open Access Efficacy and safety of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in memory deficits in patients with Alzheimer's disease: Meta-analysis and systematic review2024-03-01 - Mendes, Augusto J.; Leite, Jorge; Fernandes, Sara M.; Rodrigues, Pedro F. S.; Conde, Ana; Rocha, MagdaRepetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are two of the most used non-pharmacological interventions for Alzheimer's Disease (AD). However, most of the clinical trials have focused on evaluating the effects on global cognition and not on specific cognitive functions. Therefore, considering that memory loss is one of the hallmark symptoms of AD, we aim to assess the efficacy and safety of tDCS and rTMS in memory deficits. For that, multilevel random effect models were performed considering the standardized mean difference (SMD) between active and sham stimulation. A total of 19 studies with 411 participants demonstrated positive effects in memory after tDCS (SMD=0.20, p = 0.04) and rTMS (SMD=0.44, p = 0.001). Subgroup analysis revealed that tDCS had greater efficacy when administered in temporal regions (SMD=0.32, p = 0.04), whereas rTMS was superior when applied in frontal regions (SMD=0.61, p < 0.001). Therefore, depending on the brain region of stimulation, both interventions produced a positive effect on memory symptoms in AD patients. Finally, the safety of both techniques was observed in the AD population after the reporting of almost no serious events.Publication Open Access Transcranial direct current stimulation decreases P3 amplitude and inherent Delta activity during a waiting impulsivity paradigm: Crossover study2024-02-07 - Mendes, Augusto J.; Galdo-Álvarez, Santiago; Lema, Alberto; Carvalho, Sandra; Leite, JorgeThe inability to wait for a target before initiating an action (i.e., waiting impulsivity) is one of the main features of addictive behaviors. Current interventions for addiction, such as transcranial Direct Current Stimulation (tDCS), have been suggested to improve this inability. Nonetheless, the effects of tDCS on waiting impulsivity and underlying electrophysiological (EEG) markers are still not clear. Therefore, this study aimed to evaluate the effects of neuromodulation over the right inferior frontal gyrus (rIFG) on the behavior and EEG markers of reward anticipation (i.e., cue and target-P3 and underlying delta/theta power) during a premature responding task. For that, forty healthy subjects participated in two experimental sessions, where they received active and sham tDCS over the rIFG combined with EEG recording during the task. To evaluate transfer effects, participants also performed two control tasks to assess delay discounting and motor inhibition. The active tDCS decreased the cue-P3 and target-P3 amplitudes, as well as delta power during target-P3. While no tDCS effects were found for motor inhibition, active tDCS increased the discounting of future rewards when compared to sham. These findings suggest a tDCS-induced modulation of the P3 component and underlying oscillatory activity during waiting impulsivity and the discounting of future rewards.Publication Open Access Maternal mental health in refugees and migrants: a comprehensive systematic review2023-08-17 - Almeida, Lígia Moreira; Moutinho, Ana Raquel; Siciliano, Florência; Caldas, José Peixoto; Leite, JorgeThe first years of motherhood are often difficult for women, requiring large emotional and biophysical adjustments and increased health risks that may combine with social disadvantage and psychosocial conditions towards decreased maternal wellbeing. Those outcomes are usually worse in vulnerable populations, as refugee and migrants. Comprehending mothers’ needs regarding mental health and psychological well-being must be prioritized. A systematic review using MEDLINE, EBSCO, and SCOPUS databases was carried out, searching for population-based studies published between 2012 and 2022 reporting on maternal mental health in displaced populations. A total of 2881 articles were retrieved; 35 publications met the inclusion criteria, being included in the final evaluation. Displaced women tend to be at higher risks of maternal mental distress, due to life stressors, isolation, intrapersonal and background characteristics, mental health stigma, discrimination, and barriers in accessing adequate healthcare. Refugee and asylum-seekers are at the most vulnerable positions. Postpartum depression is the most assessed condition regarding mental health but is manifestly insufficient for public health systems in assuring an adequate state of maternal well-being. Maternal mental healthcare must be patient-centered, more accessible, and available to both native and displaced mothers. PROSPERO Registration Number: CRD42022335343.Publication Open Access 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.Publication Restricted Access Functional neuroimaging and behavioral correlates of multisite tDCS as an add-on to language training in a person with post-stroke non-fluent aphasia: A year-long case study2024-05-03 - Mendes, Augusto; Lema, Alberto; Soares, José Miguel; Sampaio, Adriana; Carvalho, Sandra; Leite, JorgeMary, who experienced non-fluent aphasia as a result of an ischemic stroke, received 10 years of personalized language training (LT), resulting in transient enhancements in speech and comprehension. To enhance these effects, multisite transcranial Direct Current Stimulation (tDCS) was added to her LT regimen for 15 sessions. Assessment using the Reliable Change Index showed that this combination improved her left inferior frontal connectivity and speech production for two months and significantly improved comprehension after one month. The results indicate that using multisite transcranial direct current stimulation (tDCS) can improve the effectiveness of language therapy (LT) for individuals with non-fluent aphasia.Publication Restricted Access 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.Publication Restricted Access Non-pharmacological treatment-related changes of molecular biomarkers in major depressive disorder: A systematic review and meta-analysisTagedEnd2023-01-24 - Irwin, Courtney L.; Coelho, Patrícia S.; Kluwe-Schiavon, Bruno; Silva-Fernandes, Anabela; Gonçalves, Óscar F.; Carvalho, Sandra; Leite, JorgeBackground: Major depressive disorder (MDD) is a serious mood disorder and leading cause of disability. Despite treatment advances, approximately 30% of individuals with MDD do not achieve adequate clinical response. Better understanding the biological mechanism(s) underlying clinical response to specific psychopharmacological interventions may help fine tune treatments in order to further modulate their underlying mechanisms of action. However, little is known regarding the effect of non-pharmacological treatments (NPTs) on candidate molecular biomarker levels in MDD. This review aims to identify molecular biomarkers that may elucidate NPT response for MDD. Methods: We performed a systematic review and a multilevel linear mixed-effects meta-analyses, and a metaregression. Searches were performed in PubMed, Scopus, and PsycINFO in October 2020 and July 2021. Results: From 1387 retrieved articles, 17 and six studies were included in the systematic review and meta-analyses, respectively. Although there was little consensus associating molecular biomarker levels with symptomology and/or treatment response, brain metabolites accessed via molecular biomarker-focused neuroimaging techniques may provide promising information on whether an individual with MDD would respond positively to NPTs. Furthermore, non-invasive brain stimulation interventions significantly increased the expression of neurotrophic factors (NTFs) compared to sham/placebo, regardless of add-on pharmacological treatment. Conclusions: NTFs are candidate biomarkers to fine-tune NIBS for MDD treatment.