Artigos - Neurologia, Psicologia e Psiquiatria - FMB

URI Permanente para esta coleção

Navegar

Submissões Recentes

Agora exibindo 1 - 20 de 806
  • ItemArtigo
    Infant Temperament: Association with Maternal Depression Symptoms in Pregnancy and Postpartum
    (2022-01-01) Garcia, Natália Vanzo [UNESP]; Padovani, Flávia Helena Pereira [UNESP]; Perosa, Gimol Benzaquen [UNESP]; Universidade Estadual Paulista (UNESP)
    Research regarding the association between child temperament and maternal symptoms of depression remains inconclusive. This study aimed to compare the temperament of babies during their first year of life in relation to their mother's depression symptoms in pregnancy and/or postpartum. The study also identified risk factors for negative affectivity, extraversion, and effortful control. Fifty-four mother-infant dyads participated in the study, divided according to maternal depression symptoms into four groups: symptoms during pregnancy, postpartum, at both times, and without symptoms. The Edinburgh Postpartum Depression Scale and Infant Behavior Questionnaire were used. Children of mothers with depression symptoms had higher negative affectivity scores, activity levels, and lower effortful control scores. The prediction analysis revealed that negative affectivity and effortful control were explained by maternal postpartum depression symptoms, indicating that caring for the mother in her adaptation to motherhood can prevent impairment to infant temperament.
  • ItemArtigo
    Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study
    (2023-06-01) da Costa, Marcos Devanir Silva; Lima, Joao Vitor Fernades; Zanini, Marco Antonio [UNESP]; Filho, Pedro Tadao Hatamoto [UNESP]; Naufal, Rodrigo Ferrari Fernandes; Reys, Lorena; Goes, Pedro; Miguez, Camila Ahmed; Bastos, Francisco Azeredo; de Figueiredo Lopes, Dionisio; Dellaretti, Marcos; Buzartti, Israel; Machado Filho, Mario Alberto S.; Sako, Everson Akio; Wainberg, Ricardo Chmelnitsky; Ferreira, Danilo Santos; de Araujo Moura, Ana Laura; Chaddad-Neto, Feres; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual Paulista (UNESP); Hospital Regional de Presidente Prudente; Instituto Estadual do Cérebro Paulo Niemeyer; Hospital de Urgencias Governador Otavio Lage; Hospital de Neurologia Santa Monica; Santa Casa BH; Universidade Federal de Minas Gerais (UFMG); SECONCI; Hospital São Lucas da PUCRS; Hospital Beneficencia Portuguesa de São Paulo
    BACKGROUND: Aneurysms of the posterior communicating segment of carotid artery (PcomA) have a high risk of rupture; when these nonruptured aneurysms are associated with oculomotor nerve palsy (ONP), the risk of rupture increases compared with asymptomatic nonruptured PcomA. OBJECTIVE: To retrospectively analyze the risk factors involved in ONP secondary to PcomA aneurysm and to study the factors involved in the recovery time of ONP once it is established. METHODS: This was a retrospective study of patients from 10 neurosurgery centers from October 2008 to December 2020. We analyzed age at diagnosis, presence of compressive neuropathy of the oculomotor nerve, presence of aneurysm rupture, largest aneurysm diameter, aneurysm projection, smoking, hypertension, diabetes, time between diagnosis and surgical treatment, as well as the outcome. RESULTS: Approximately 1 in 5 patients (119/511 23.3%) with a PcomA presented with ONP. We found that patients with aneurysms measuring greater than or equal to 7.5 mm were 1.6 times more likely to have ONP than those with aneurysms smaller than 7.5 mm. In our study, the prevalence of smoking in the PcomA + ONP group was 57.76%, and we also found that smokers were 2.51 times more likely to develop ONP. A total of 80.7% showed some degree of improvement, and 45.4% showed complete improvement with a median recovery time of 90 days. CONCLUSION: This study showed that 80.7% of patients with PcomA aneurysms undergoing surgical treatment with aneurysm clipping showed some degree of improvement of the ONP, with a median time to recovery between 90 and 120 days.
  • ItemCapítulo de livro
    History Taking and Assessment
    (2019-01-01) Forlenza, Orestes V.; Pereira, Marta L.G.F.; Canineu, Paulo R.; Stella, Florindo [UNESP]; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
    The clinical history is a fundamental part of the medical semiology. It requires assessing the patient with a holistic approach and demands special attention to specific elements that may allow a deeper understanding of disease process and its progression over time. In the present text, we emphasize some of the most relevant aspects of history taking in geriatric psychiatry, including the characterization of premorbid features, personal and family history, and the establishment of an accurate estimate of cognitive/functional status and behavioral symptoms both in primary (functional) and secondary (organic) psychiatric disorders. The identification of risk factors for neuropsychiatric disorders associated to general medical conditions is another important element, for the modification of these factors (whenever possible) may be crucial for overall response and prognosis. We further propose that use of psychometric scales in clinical practice not only yields the objective measurement of baseline cognitive/functional state for diagnostic purposes but also enables the clinician to monitor changes during follow-up, particularly those related to treatment response.
  • ItemArtigo
    Analysis of Progressive Muscle Relaxation on Psychophysiological Variables in Basketball Athletes
    (2022-12-01) Battaglini, Marina Pavão [UNESP]; Pessôa Filho, Dalton Müller [UNESP]; Calais, Sandra Leal [UNESP]; Miyazaki, Maria Cristina Oliveira Santos; Neiva, Cassiano Merussi [UNESP]; Espada, Mário C.; de Moraes, Mayra Grava [UNESP]; Verardi, Carlos Eduardo Lopes [UNESP]; Universidade Estadual Paulista (UNESP); São José do Rio Preto Medical School; Ribeirão Preto University; ESTSetúbal-CDP2T); Life Quality Research Centre (CIEQV-Leiria)
    The purpose of this study was to evaluate the effects of a progressive muscle relaxation program on psychological (stress levels, anxiety, and mood states) and physiological (blood pressure and heart rate) variables in basketball athletes. Fifty-nine basketball players, aged 14 to 19 years, and members of Bauru Basket team, were recruited for this study and grouped into control group (CG, n = 30) and intervention group (IG, n = 29). The participants were evaluated, before and after the intervention, by the following means: Competitive State Anxiety Inventory-2 (CSAI-2), to measure the pre-competitive anxiety state, i.e., how anxious each athlete felt just before the competition; Brunel Mood Scale (BRUMS), an instrument for early detection of overtraining syndrome; Recovery-Stress Questionnaire for Athletes (RESTQ-Sport), to identify the extent to which each athlete was physically or mentally stressed and the athlete’s current capability for recovery; Athlete Burnout Questionnaire (ABQ), specifically developed for athletes. The IG athletes participated in 12 progressive muscle relaxation sessions, a practice for tensing or tightening a specific muscle until an ideal state of relaxation is reached. Each participant had blood pressure and heart rate measured before and after every session. The CG athletes were evaluated similarly to those in the IG but without relaxation. The results showed statistically significant differences in cognitive anxiety (p = 0.039) and specific stress (p = 0.016) between CG and IG before the intervention; in addition, a significant heart rate decrease (p < 0.01) between IG and CG was noted.
  • ItemArtigo
    Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol
    (2022-10-01) de Oliveira Cacho, Roberta; Cabral Moro, Carla Heloisa; Bazan, Rodrigo [UNESP]; da Guarda, Suzete Nascimento Farias; Pinto, Elen Beatriz; dos Santos Andrade, Suellen Mary Marinho; Valler, Lenise; Almeida, Kelson James; Ribeiro, Tatiana Souza; de Moura Jucá, Renata Viana Brígido; Minelli, Cesar; Pimentel Piemonte, Maria Elisa; Albuquerque Paschoal, Eric Homero; Araújo Pedatella, Marco Túlio; Pontes-Neto, Octávio Marques; Fontana, Ana Paula; de Souza Pagnussat, Aline; Conforto, Adriana Bastos; Faculdade de Ciências da Saúde do Trairi; Hospital Municipal de São José; Universidade Estadual Paulista (UNESP); Universidade Federal da Bahia (UFBA); Fundação para o Desenvolvimento das Ciências; Universidade Federal da Paraíba (UFPB); Universidade Estadual de Campinas (UNICAMP); Centro Universitário UniFacid; Universidade Federal do Rio Grande do Norte; Hospital Universitário Walter Cantídio; Instituto “Você sem AVC”; Universidade de São Paulo (USP); Hospital Ophir Loyola; Hospital Estadual de Urgência de Goiânia Dr Valdemiro Cruz; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de Ciências da Saúde de Porto Alegre; Hospital Israelita Albert Einstein
    Background Most of the Brazilian population relies on public healthcare and stroke is a major cause of disability in this country of continental dimensions. There is limited information about access to rehabilitation after stroke in Brazil. Objective To provide comprehensive information about Access to Rehabilitation After discharge from public hospitals in Brazil (AReA study), up to 6 months after stroke. Methods The present study intends to collect information from 17 public health centers in 16 Brazilian cities in the 5 macroregions of the country. Each center will include 36 participants (n ¼ 612). The inclusion criteria are: age ≥ 18 years old; ischemic or hemorrhagic stroke, from 6 months to 1 year prior to the interview; admission to a public hospital in the acute phase after stroke; any neurological impairment poststroke; patient or caregiver able to provide informed consent and answer the survey. Patients can only be recruited in public neurology or internal medicine outpatient clinics. Outcomes will be assessed by a standard questionnaire about rehabilitation referrals, the rehabilitation program (current status, duration in months, number of sessions per week) and instructions received. In addition, patients will be asked about preferences for locations of rehabilitation (hospitals, clinics, or at home). Trial Status The study is ongoing. Recruitment started on January 31st, 2020 and is planned to continue until June 2022. Conclusion The AReA study will fill a gap in knowledge about access to stroke rehabilitation in the public health system in different Brazilian regions.
  • ItemArtigo
    Neostriatum neuronal TRPV1-signalling mediates striatal anandamide at high concentration facilitatory influence on neostriato-nigral dishinhibitory GABAergic connections
    (2023-01-01) da Silva, Juliana Almeida; Almada, Rafael Carvalho [UNESP]; Falconi-Sobrinho, Luiz Luciano; Pigatto, Glauce Regina; Hernandes, Paloma Molina [UNESP]; Coimbra, Norberto Cysne; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Behavioural Neuroscience Institute (INeC)
    Rationale: Several lines of evidence have demonstrated that the cannabinoid type 1 receptor (CB1) is found in the caudate nucleus and putamen (CPu) in addition to the substantia nigra pars reticulata (SNpr). Here, we investigated the role of endocannabinoid neuromodulation of striato-nigral disinhibitory projections on the activity of nigro-collicular GABAergic pathways that control the expression of unconditioned fear-related behavioural responses elicited by microinjections of the GABAA receptor selective antagonist bicuculline (BIC) in the deep layers of the superior colliculus (dlSC). Methods: Fluorescent neural tract tracers were deposited in either CPu or in SNpr. Wistar rats received injection of vehicle, anandamide (AEA), either at low (50 pmol) or high (100 pmol) concentrations in CPu followed by bicuculline microinjections in dlSC. Results: Connections between CPu, the SNpr and dlSC were demonstrated. The GABAA receptor blockade in dlSC elicited panic-like behaviour. AEA at the lowest concentration caused a panicolytic-like effect that was antagonised by the CPu pretreatment with AM251 at 100 pmol. AEA at the highest concentration caused a panicogenic-like effect that was antagonised by the CPu pretreatment with 6-iodonordihydrocapsaicin (6-I-CPS) at different concentrations (0.6, 6, 60 nmol). Conclusion: These findings suggest that while pre-synaptic CB1-signalling subserves an indirect facilitatory effect of AEA on striato-nigral pathways causing panicolytic-like responses through midbrain tectum enhanced activity, post-synaptic TRPV1-signalling in CPu mediates AEA direct activation of striato-nigral disinhibitory pathways resulting in increasing dlSC neurons activity and a panicogenic-like response. All these actions seem to depend on the interface with the nigro-collicular inhibitory GABAergic pathways.
  • ItemResenha
    The carotid body: A novel key player in neuroimmune interactions
    (2022-10-24) Katayama, Pedro L. [UNESP]; Leirão, Isabela P. [UNESP]; Kanashiro, Alexandre; Menani, José V. [UNESP]; Zoccal, Daniel B. [UNESP]; Colombari, Débora S. A. [UNESP]; Colombari, Eduardo [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
    The idea that the nervous system communicates with the immune system to regulate physiological and pathological processes is not new. However, there is still much to learn about how these interactions occur under different conditions. The carotid body (CB) is a sensory organ located in the neck, classically known as the primary sensor of the oxygen (O2) levels in the organism of mammals. When the partial pressure of O2 in the arterial blood falls, the CB alerts the brain which coordinates cardiorespiratory responses to ensure adequate O2 supply to all tissues and organs in the body. A growing body of evidence, however, has demonstrated that the CB is much more than an O2 sensor. Actually, the CB is a multimodal sensor with the extraordinary ability to detect a wide diversity of circulating molecules in the arterial blood, including inflammatory mediators. In this review, we introduce the literature supporting the role of the CB as a critical component of neuroimmune interactions. Based on ours and other studies, we propose a novel neuroimmune pathway in which the CB acts as a sensor of circulating inflammatory mediators and, in conditions of systemic inflammation, recruits a sympathetic-mediated counteracting mechanism that appears to be a protective response.
  • ItemArtigo
    TREATMENT OF DEMENTIA: RECOMMENDATIONS OF THE SCIENTIFIC DEPARTMENT OF COGNITIVE NEUROLOGY AND AGING OF THE BRAZILIAN ACADEMY OF NEUROLOGY
    (2022-01-01) Caramelli, Paulo; Marinho, Valeska; Laks, Jerson; Coletta, Marcus Vinicius Della; Stella, Florindo [UNESP]; Camargos, Einstein Francisco; Smid, Jerusa; Barbosa, Breno José Alencar Pires; Schilling, Lucas Porcello; Balthazar, Marcio Luiz Figueredo; Frota, Norberto Anízio Ferreira; de Souza, Leonardo Cruz; Vale, Francisco Assis Carvalho; Chaves, Márcia Lorena Fagundes; Brucki, Sonia Maria Dozzi; Nitrini, Ricardo; Durgante, Helen Bedinoto; Bertolucci, Paulo Henrique Ferreira; Universidade Federal de Minas Gerais (UFMG); Universidade Federal do Rio de Janeiro (UFRJ); Universidade do Estado do Rio de Janeiro (UERJ); Universidade do Estado do Amazonas; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Centro de Medicina do Idoso; Universidade de Brasília (UnB); Universidade Federal de Pernambuco (UFPE); Fernando Figueira; Serviço de Neurologia; Instituto do Cérebro do Rio Grande do Sul; Programa de Pós-Graduação em Gerontologia Biomédica; Universidade Estadual de Campinas (UNICAMP); Universidade de Fortaleza; Universidade Federal de São Carlos (UFSCar); Faculdade de Medicina; Universidade Federal de Pelotas; Universidade Federal de São Paulo (UNIFESP)
    There is currently no cure for neurodegenerative or vascular dementias, but some pharmacological and non-pharmacological interventions may contribute to alleviate symptoms, to slow disease progression and improve quality of life. Current treatment approaches are based on etiology, symptoms’ profile and stage of dementia. In this manuscript we present recommendations about the pharmacological and non-pharmacological treatments of dementia due to Alzheimer’s disease, vascular cognitive impairment, frontotemporal dementia, Parkinson’s disease dementia and dementia with Lewy bodies.
  • ItemArtigo
    Metabolomics Approach Reveals Important Glioblastoma Plasma Biomarkers for Tumor Biology
    (2023-05-01) Ferrasi, Adriana C. [UNESP]; Puttini, Ricardo [UNESP]; Galvani, Aline F. [UNESP]; Hamamoto Filho, Pedro T. [UNESP]; Delafiori, Jeany; Argente, Victoria D. [UNESP]; de Oliveira, Arthur N.; Dias-Audibert, Flávia L.; Catharino, Rodrigo R.; Silva, Octavio C. [UNESP]; Zanini, Marco A. [UNESP]; Kurokawa, Gabriel A. [UNESP]; Lima, Estela O. [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
    Glioblastoma (GB) is the most aggressive and frequent primary malignant tumor of the central nervous system and is associated with poor overall survival even after treatment. To better understand tumor biochemical alterations and broaden the potential targets of GB, this study aimed to evaluate differential plasma biomarkers between GB patients and healthy individuals using metabolomics analysis. Plasma samples from both groups were analyzed via untargeted metabolomics using direct injection with an electrospray ionization source and an LTQ mass spectrometer. GB biomarkers were selected via Partial Least Squares Discriminant and Fold-Change analyses and were identified using tandem mass spectrometry with in silico fragmentation, consultation of metabolomics databases, and a literature search. Seven GB biomarkers were identified, some of which were unprecedented biomarkers for GB, including arginylproline (m/z 294), 5-hydroxymethyluracil (m/z 143), and N-acylphosphatidylethanolamine (m/z 982). Notably, four other metabolites were identified. The roles of all seven metabolites in epigenetic modulation, energy metabolism, protein catabolism or folding processes, and signaling pathways that activate cell proliferation and invasion were elucidated. Overall, the findings of this study highlight new molecular targets to guide future investigations on GB. These molecular targets can also be further evaluated to derive their potential as biomedical analytical tools for peripheral blood samples.
  • ItemResenha
    Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment
    (2023-01-01) de Oliveira, Marcos Vinícius Sousa; de Barros, Pedro Macul Ferreira; de Mathis, Maria Alice; Boavista, Rodrigo; Chacon, Priscila; Echevarria, Marco Antonio Nocito; Ferrão, Ygor Arzeno; de Queiroz Vattimo, Edoardo Felippo; Lopes, Antônio Carlos; Torres, Albina Rodrigues [UNESP]; Diniz, Juliana Belo; Fontenelle, Leonardo F.; Dorosário, Maria Conceição; Shavitt, Roseli Gedanke; Miguel, Eurípedes Constantino; da Silva, Renata de Melo Felipe; Costa, Daniel Lucas da Conceição; Universidade de São Paulo (USP); Consórcio Brasileiro de Pesquisa em Transtornos do Espectro Obsessivo-Compulsivo; Universidade Federal de Ciências da Saúde de Porto Alegre; Universidade Estadual Paulista (UNESP); Universidade Federal do Rio de Janeiro (UFRJ); Instituto D’Or de Pesquisa e Ensino; Monash University; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the firstline treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.
  • ItemArtigo
    Computational methods of EEG signals analysis for Alzheimer’s disease classification
    (2023-12-01) Vicchietti, Mário L. [UNESP]; Ramos, Fernando M.; Betting, Luiz E. [UNESP]; Campanharo, Andriana S. L. O. [UNESP]; Universidade Estadual Paulista (UNESP); Earth System Science Center
    Computational analysis of electroencephalographic (EEG) signals have shown promising results in detecting brain disorders, such as Alzheimer’s disease (AD). AD is a progressive neurological illness that causes neuron cells degeneration, resulting in cognitive impairment. While there is no cure for AD, early diagnosis is critical to improving the quality of life of affected individuals. Here, we apply six computational time-series analysis methods (wavelet coherence, fractal dimension, quadratic entropy, wavelet energy, quantile graphs and visibility graphs) to EEG records from 160 AD patients and 24 healthy controls. Results from raw and wavelet-filtered (alpha, beta, theta and delta bands) EEG signals show that some of the time-series analysis methods tested here, such as wavelet coherence and quantile graphs, can robustly discriminate between AD patients from elderly healthy subjects. They represent a promising non-invasive and low-cost approach to the AD detection in elderly patients.
  • ItemArtigo
    Influence of CReatine supplementation on mUScle mass and strength after stroke (ICaRUS Stroke Trial): study protocol for a randomized controlled trial
    (2023-12-01) de Souza, Juli Thomaz [UNESP]; Minicucci, Marcos F. [UNESP]; Ferreira, Natália C. [UNESP]; Polegato, Bertha F. [UNESP]; Okoshi, Marina Politi [UNESP]; Modolo, Gabriel P. [UNESP]; Phillips, Bethan E.; Atherton, Philip J.; Smith, Kenneth; Wilkinson, Daniel; Gordon, Adam; Tanni, Suzana E. [UNESP]; Costa, Vladimir Eliodoro [UNESP]; Fernandes, Maria Fernanda P. [UNESP]; Bazan, Silméia G. Zanati [UNESP]; Zornoff, Leonardo A. M. [UNESP]; Bazan, Rodrigo [UNESP]; de Paiva, Sérgio A. Rupp [UNESP]; Azevedo, Paula Schmidt [UNESP]; Universidade Estadual Paulista (UNESP); University of Nottingham
    Background: Stroke is a leading cause of mortality and disability, and its sequelae are associated with inadequate food intake which can lead to sarcopenia. The aim of this study is to verify the effectiveness of creatine supplementation on functional capacity, strength, and changes in muscle mass during hospitalization for stroke compared to usual care. An exploratory subanalysis will be performed to assess the inflammatory profiles of all participants, in addition to a follow-up 90 days after stroke, to verify functional capacity, muscle strength, mortality, and quality of life. Methods: Randomized, double-blind, unicenter, parallel-group trial including individuals with ischemic stroke in the acute phase. The duration of the trial for the individual subject will be approximately 90 days, and each subject will attend a maximum of three visits. Clinical, biochemical, anthropometric, body composition, muscle strength, functional capacity, degree of dependence, and quality of life assessments will be performed. Thirty participants will be divided into two groups: intervention (patients will intake one sachet containing 10g of creatine twice a day) and control (patients will intake one sachet containing 10g of placebo [maltodextrin] twice a day). Both groups will receive supplementation with powdered milk protein serum isolate to achieve the goal of 1.5g of protein/kg of body weight/day and daily physiotherapy according to the current rehabilitation guidelines for patients with stroke. Supplementation will be offered during the 7-day hospitalization. The primary outcomes will be functional capacity, strength, and changes in muscle mass after the intervention as assessed by the Modified Rankin Scale, Timed Up and Go test, handgrip strength, 30-s chair stand test, muscle ultrasonography, electrical bioimpedance, and identification of muscle degradation markers by D3-methylhistidine. Follow-up will be performed 90 days after stroke to verify functional capacity, muscle strength, mortality, and quality of life. Discussion: The older population has specific nutrient needs, especially for muscle mass and function maintenance. Considering that stroke is a potentially disabling event that can lead the affected individual to present with numerous sequelae, it is crucial to study the mechanisms of muscle mass loss and understand how adequate supplementation can help these patients to better recover. Trial registration: The Brazilian Clinical Trials Registry (ReBEC) RBR-9q7gg4. Registered on 21 January 2019.
  • ItemArtigo
    Electrophysiological and neuroimaging tools to evaluate neurological symptoms, manifestations, and complications in patients with long COVID-19
    (2023-01-01) Luvizutto, Gustavo José; Bazan, Rodrigo [UNESP]; Federal University of Triangulo Mineiro; Universidade Estadual Paulista (UNESP)
  • ItemResenha
    Advances in the Molecular Landscape of Lung Cancer Brain Metastasis
    (2023-02-01) Souza, Vanessa G. P. [UNESP]; de Araújo, Rachel Paes [UNESP]; Santesso, Mariana R. [UNESP]; Seneda, Ana Laura [UNESP]; Minutentag, Iael W. [UNESP]; Felix, Tainara Francini [UNESP]; Hamamoto Filho, Pedro Tadao [UNESP]; Pewarchuk, Michelle E.; Brockley, Liam J.; Marchi, Fábio A.; Lam, Wan L.; Drigo, Sandra A. [UNESP]; Reis, Patricia P. [UNESP]; Universidade Estadual Paulista (UNESP); British Columbia Cancer Research Institute; Universidade de São Paulo (USP)
    Lung cancer is one of the most frequent tumors that metastasize to the brain. Brain metastasis (BM) is common in advanced cases, being the major cause of patient morbidity and mortality. BMs are thought to arise via the seeding of circulating tumor cells into the brain microvasculature. In brain tissue, the interaction with immune cells promotes a microenvironment favorable to the growth of cancer cells. Despite multimodal treatments and advances in systemic therapies, lung cancer patients still have poor prognoses. Therefore, there is an urgent need to identify the molecular drivers of BM and clinically applicable biomarkers in order to improve disease outcomes and patient survival. The goal of this review is to summarize the current state of knowledge on the mechanisms of the metastatic spread of lung cancer to the brain and how the metastatic spread is influenced by the brain microenvironment, and to elucidate the molecular determinants of brain metastasis regarding the role of genomic and transcriptomic changes, including coding and non-coding RNAs. We also present an overview of the current therapeutics and novel treatment strategies for patients diagnosed with BM from NSCLC.
  • ItemCapítulo de livro
    Interlinking dementia in Parkinson’s disease: Nutritional correlates of body composition
    (2020-01-01) Schelp, Arthur Oscar [UNESP]; Komuro, Jéssica Emy; Corrente, José Eduardo; Papini, Silvia Justina; Universidade Estadual Paulista (UNESP); Medicine School; Bioscience Institute
    Little evidence showed that body composition has a primary role in the development of dementia in Parkinson’s disease (PD). However, several studies indicated that metabolic and nutritional dysfunctions have a relevant influence on disease outcome. The confluence of several disturbances, including disruption in fat and glucose metabolism, with nutritional component abnormalities, could be a crucial event when associated with dopamine depletion in the striatum of patients with PD. It was discussed that there may be a relationship between decreased insulin resistance and cholesterol lower levels as a possible risk factor to dementia associated with PD (PDD). The possibility that nutritional habits, metabolic disturbances, and dopamine depletion in the striatum could have a synergic action on PDD is taken into consideration. Thus, future studies should establish dietary measures for elderly patients with PD, associated or not with dementia.
  • ItemArtigo
    Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil
    (2023-01-01) da Silva, T. R. [UNESP]; Luvizutto, G. J.; Martins, L. G. [UNESP]; da Costa, R. D.M. [UNESP]; de Souza, J. T. [UNESP]; Winckler, F. C. [UNESP]; Sartor, L. C.A. [UNESP]; Modolo, G. P. [UNESP]; Ferreira, N. C. [UNESP]; Rodrigues, J. C.S. [UNESP]; Kanda, R. G. [UNESP]; Fogaroli, M. O. [UNESP]; Borges, G. F. [UNESP]; Rizzatti, G. R.S. [UNESP]; Ribeiro, P. W. [UNESP]; Pires, D. S.; Favoretto, D. B.; Aguiar, L. R.; Bazan, S. G.Z. [UNESP]; Betting, L. E.G. [UNESP]; Antunes, L. C.O. [UNESP]; Nunes, H. R.C. [UNESP]; Pereira, V. M.; Edwards, T. G.S.; Pontes-Neto, O.; Conforto, A. B.; Bazan, R. [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal do Triângulo Mineiro; Universidade de São Paulo (USP); University of Toronto
    There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.
  • ItemCarta
    Addressing expectations of therapeutic options for children with hydrocephalus—A comment on “Fetal Cerebral Ventriculomegaly. What do we tell the prospective parents?”
    (2023-03-01) Poliseli, Gianfelipe Belini [UNESP]; Hamamoto, Juliana Fattori [UNESP]; Rugolo, Ligia Maria Suppo de Souza [UNESP]; Zanini, Marco Antonio [UNESP]; Hamamoto Filho, Pedro Tadao [UNESP]; Universidade Estadual Paulista (UNESP)
  • ItemArtigo
    Differential Plasma Metabolites between High- and Low-Grade Meningioma Cases
    (2023-01-01) Kurokawa, Gabriel A. [UNESP]; Hamamoto Filho, Pedro T. [UNESP]; Delafiori, Jeany; Galvani, Aline F. [UNESP]; de Oliveira, Arthur N.; Dias-Audibert, Flávia L.; Catharino, Rodrigo R.; Pardini, Maria Inês M. C. [UNESP]; Zanini, Marco A. [UNESP]; Lima, Estela de O. [UNESP]; Ferrasi, Adriana C. [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
    Meningiomas (MGMs) are currently classified into grades I, II, and III. High-grade tumors are correlated with decreased survival rates and increased recurrence rates. The current grading classification is based on histological criteria and determined only after surgical tumor sampling. This study aimed to identify plasma metabolic alterations in meningiomas of different grades, which would aid surgeons in predefining the ideal surgical strategy. Plasma samples were collected from 51 patients with meningioma and classified into low-grade (LG) (grade I; n = 43), and high-grade (HG) samples (grade II, n = 5; grade III, n = 3). An untargeted metabolomic approach was used to analyze plasma metabolites. Statistical analyses were performed to select differential biomarkers among HG and LG groups. Metabolites were identified using tandem mass spectrometry along with database verification. Five and four differential biomarkers were identified for HG and LG meningiomas, respectively. To evaluate the potential of HG MGM metabolites to differentiate between HG and LG tumors, a receiving operating characteristic curve was constructed, which revealed an area under the curve of 95.7%. This indicates that the five HG MGM metabolites represent metabolic alterations that can differentiate between LG and HG meningiomas. These metabolites may indicate tumor grade even before the appearance of histological features.
  • ItemArtigo
    Eastchester clapping sign and networks related to spatial attention
    (2022-10-01) Luvizutto, Gustavo José; Braga, Gabriel Pereira; Garcia Betting, Luiz Eduardo Gomes [UNESP]; Bazan, Rodrigo [UNESP]; Universidade Federal do Triângulo Mineiro; Hospital Universitário Maria Aparecida Pedrossian; Universidade Estadual Paulista (UNESP)
  • ItemArtigo
    Evaluating the performance of the PRISMA-7 frailty criteria for predicting disability and death after acute ischemic stroke: PRISMA-7 - Disability or Death after Stroke
    (2022-12-01) Miranda, Luana Aparecida [UNESP]; Luvizutto, Gustavo José; Stephan, Blossom Christa Maree; Souza, Juli Thomaz de [UNESP]; Silva, Taís Regina da [UNESP]; Winckler, Fernanda Cristina [UNESP]; Ferreira, Natalia Cristina [UNESP]; Antunes, Leticia Claudia de Oliveira [UNESP]; Bessornia, Pedro Augusto Cândido [UNESP]; Bazan, Silméia Garcia Zanati [UNESP]; Fukushima, Fernanda Bono [UNESP]; Costa, Rafael Dalle Molle da [UNESP]; Modolo, Gabriel Pinheiro [UNESP]; Minicucci, Marcos Ferreira [UNESP]; Bazan, Rodrigo [UNESP]; Vidal, Edison Iglesias de Oliveira [UNESP]; Universidade Estadual Paulista (UNESP); Federal University of Triângulo Mineiro (UFTM); University of Nottingham Medical School
    Objectives: We aimed to evaluate the predictive performance of the PRISMA-7 frailty criteria regarding the composite outcome of disability or death in patients with an acute ischemic stroke, and to compare it with the Frailty Index and the National Institutes of Health Stroke Scale (NIHSS). Materials and methods: This prospective cohort study involved all patients aged ≥ 40 years admitted with an acute ischemic stroke between March 2019 and January 2020. We performed survival analyses, calculated risk ratios, sensitivity, specificity, and predictive values for the combined outcome of disability or death according to the presence of frailty as determined by the PRISMA-7 and the Frailty Index, and stroke severity based on the NIHSS. Results: In 174 patients with acute ischemic stroke, being frail in the week before the stroke according to the PRISMA-7 was associated with a Risk Ratio of 4·50 (95%CI 1·77-11·43, P <0·001) and a Positive Predictive Value of 89% (95%CI 77-99%) for being disabled or dead 90 days after the stroke, and a Hazard Ratio of 3·33 (95%CI 1·48-7·51, P = 0·004) for the survival outcome. The predictive performance of the PRISMA-7 was not significantly different from the Frailty Index or the NIHSS. Conclusions: We provide evidence that the PRISMA-7 frailty criteria may be a useful prognostication tool in acute ischemic stroke.