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de Gobbi Porto FH, Orsini M. Response letter: Neuropsychiatric presentation of Covid-19-related encephalitis: Case report. Psychiatry Research Communications 2022; 2:100031. [PMID: 35253009 PMCID: PMC8883672 DOI: 10.1016/j.psycom.2022.100031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 11/25/2022]
Abstract
Covid-19-related encephalitis is a heterogeneous syndrome characterized by a combination of clinical, laboratory, and imaging features related to inflammation of the brain, where the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presumably the causative agent. We reported a case of Covid-19-related encephalitis presenting with neuropsychiatric symptoms, including intense agitation. Reverse-transcriptase polymerase-chain-reaction in cerebrospinal fluid was positive for SARS-CoV-2. Our case expands the literature about neurologic manifestations of Covid-19 and emphasizes the possibility of prominent behavioral symptoms as the initial manifestation.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21) and Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marco Orsini
- Master's Program in Neurology - University of Vassouras and School of Medicine - University Iguaçu, RJ, Brazil
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Orsini M, Henrique de Gobbi Porto F, Fernandes do Nascimento J. Neuropsychiatric presentation of Covid-19-related encephalitis: Case report. Psychiatry Research Communications 2021; 1:100004. [PMID: 34977909 PMCID: PMC8552702 DOI: 10.1016/j.psycom.2021.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/23/2021] [Indexed: 11/25/2022]
Abstract
Covid-19-related encephalitis is a heterogeneous syndrome characterized by a combination of clinical, laboratory, and imaging features related to inflammation of the brain, where the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presumably the causative agent. We reported a case of Covid-19-related encephalitis presenting with neuropsychiatric symptoms, including intense agitation. Reverse-transcriptase polymerase-chain-reaction in cerebrospinal fluid was positive for SARS-CoV-2. Our case expands the literature about neurologic manifestations of Covid-19 and emphasizes the possibility of prominent behavioral symptoms as the initial manifestation.
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Cecchini MA, Yassuda MS, Squarzoni P, Coutinho AM, de Paula Faria D, Duran FLDS, Costa NAD, Porto FHDG, Nitrini R, Forlenza OV, Brucki SMD, Buchpiguel CA, Parra MA, Busatto GF. Deficits in short-term memory binding are detectable in individuals with brain amyloid deposition in the absence of overt neurodegeneration in the Alzheimer's disease continuum. Brain Cogn 2021; 152:105749. [PMID: 34022637 DOI: 10.1016/j.bandc.2021.105749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
The short-term memory binding (STMB) test involves the ability to hold in memory the integration between surface features, such as shapes and colours. The STMB test has been used to detect Alzheimer's disease (AD) at different stages, from preclinical to dementia, showing promising results. The objective of the present study was to verify whether the STMB test could differentiate patients with distinct biomarker profiles in the AD continuum. The sample comprised 18 cognitively unimpaired (CU) participants, 30 mild cognitive impairment (MCI) and 23 AD patients. All participants underwent positron emission tomography (PET) with Pittsburgh compound-B labelled with carbon-11 ([11C]PIB) assessing amyloid beta (Aβ) aggregation (A) and 18fluorine-fluorodeoxyglucose ([18F]FDG)-PET assessing neurodegeneration (N) (A-N- [n = 35]); A+N- [n = 11]; A+ N+ [n = 19]). Participants who were negative and positive for amyloid deposition were compared in the absence (A-N- vs. A+N-) of neurodegeneration. When compared with the RAVLT and SKT memory tests, the STMB was the only cognitive task that differentiated these groups, predicting the group outcome in logistic regression analyses. The STMB test showed to be sensitive to the signs of AD pathology and may represent a cognitive marker within the AD continuum.
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Affiliation(s)
- Mario Amore Cecchini
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Mônica Sanches Yassuda
- Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Gerontology, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
| | - Paula Squarzoni
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Artur Martins Coutinho
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil; Laboratory of Nuclear Medicine (LIM43), Centro de Medicina Nuclear, Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Daniele de Paula Faria
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil; Núcleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
| | - Fábio Luiz de Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Naomi Antunes da Costa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM43), Centro de Medicina Nuclear, Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil; Núcleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
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4
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Parra MA, Baez S, Sedeño L, Gonzalez Campo C, Santamaría‐García H, Aprahamian I, Bertolucci PHF, Bustin J, Camargos Bicalho MA, Cano‐Gutierrez C, Caramelli P, Chaves MLF, Cogram P, Beber BC, Court FA, de Souza LC, Custodio N, Damian A, de la Cruz M, Diehl Rodriguez R, Brucki SMD, Fajersztajn L, Farías GA, De Felice FG, Ferrari R, de Oliveira FF, Ferreira ST, Ferretti C, Figueredo Balthazar ML, Ferreira Frota NA, Fuentes P, García AM, Garcia PJ, de Gobbi Porto FH, Duque Peñailillo L, Engler HW, Maier I, Mata IF, Gonzalez‐Billault C, Lopez OL, Morelli L, Nitrini R, Quiroz YT, Guerrero Barragan A, Huepe D, Pio FJ, Suemoto CK, Kochhann R, Kochen S, Kumfor F, Lanata S, Miller B, Mansur LL, Hosogi ML, Lillo P, Llibre Guerra J, Lira D, Lopera F, Comas A, Avila‐Funes JA, Sosa AL, Ramos C, Resende EDPF, Snyder HM, Tarnanas I, Yokoyama J, Llibre J, Cardona JF, Possin K, Kosik KS, Montesinos R, Moguilner S, Solis PCL, Ferretti‐Rebustini REDL, Ramirez JM, Matallana D, Mbakile‐Mahlanza L, Marques Ton AM, Tavares RM, Miotto EC, Muniz‐Terrera G, Muñoz‐Nevárez LA, Orozco D, Okada de Oliveira M, Piguet O, Pintado Caipa M, Piña Escudero SD, Schilling LP, Rodrigues Palmeira AL, Yassuda MS, Santacruz‐Escudero JM, Serafim RB, Smid J, Slachevsky A, Serrano C, Soto‐Añari M, Takada LT, Grinberg LT, Teixeira AL, Barbosa MT, Trépel D, Ibanez A. Dementia in Latin America: Paving the way toward a regional action plan. Alzheimers Dement 2021; 17:295-313. [PMID: 33634602 PMCID: PMC7984223 DOI: 10.1002/alz.12202] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022]
Abstract
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
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Affiliation(s)
- Mario Alfredo Parra
- School of Psychological Sciences and HealthGraham Hills BuildingGlasgow, G1 1QE, UK, Universidad Autónoma del CaribePrograma de PsicologíaUniversity of StrathclydeBarranquillaColombia
| | | | - Lucas Sedeño
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center (CNC)Universidad de San AndresConsejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Hernando Santamaría‐García
- Pontificia Universidad JaverianaMedical School, Physiology and Psychiatry DepartmentsMemory and Cognition Center IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Ivan Aprahamian
- Department of Internal MedicineFaculty of Medicine of JundiaíGroup of Investigation on Multimorbidity and Mental Health in Aging (GIMMA)JundiaíState of São PauloBrazil
| | - Paulo HF Bertolucci
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Julian Bustin
- INECO FoundationInstitute of Cognitive and Translational Neuroscience (INCYT)Favaloro UniversityBuenos AiresArgentina
| | | | - Carlos Cano‐Gutierrez
- Medical SchoolGeriatric Unit, Memory and Cognition Center‐IntellectusAging InstituteHospital Universitario San IgnacioPontificia Universidad JaverianaBogotáColombia
| | - Paulo Caramelli
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Marcia L. F. Chaves
- Neurology ServiceHospital de Clínicas de Porto Alegre e Universidade Federal do Rio Grande do SulBrazil
| | - Patricia Cogram
- Laboratory of Molecular NeuropsychiatryINECO FoundationNational Scientific and Technical Research CouncilInstitute of Cognitive and Translational Neuroscience (INCyT)Favaloro UniversityBuenos AiresArgentina
| | - Bárbara Costa Beber
- Department of Speech and Language PathologyAtlantic Fellow for Equity in Brain HealthFederal University of Health Sciences of Porto Alegre (UFCSPA)Porto AlegreBrazil
| | - Felipe A. Court
- Center for Integrative BiologyFaculty of SciencesFONDAP Center for GeroscienceBrain Health and Metabolism, Santiago, Chile, The Buck Institute for Research on AgingUniversidad Mayor, ChileNovatoCAUSA
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM)Centro de Medicina Nuclear e Imagenología MolecularHospital de ClínicasUniversidad de la RepúblicaMontevideoUruguay
| | - Myriam de la Cruz
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
| | - Roberta Diehl Rodriguez
- Behavioral and Cognitive Neurology UnitDepartment of Neurology and LIM 22University of São PauloSão PauloBrazil
| | | | - Lais Fajersztajn
- Laboratory of Experimental Air Pollution (LIM05)Department of PathologySchool of MedicineGlobal Brain Health Institute, University of CaliforniaSan Francisco (UCSF)University of São PauloSão PauloSao PauloBrazil
| | - Gonzalo A. Farías
- Department Neurology and Neurosurgery North/Department of NeurosciencesCenter for Advanced Clinical Research (CICA)Faculty of MedicineUniversidad de ChileSantiagoChile
| | | | - Raffaele Ferrari
- Department of Neurodegenerative DiseaseUniversity College LondonLondonESUK
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Sergio T. Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis & Institute of Biophysics Carlos Chagas FilhoFederal University of Rio de JaneiroRio de JaneiroRJBrazil
| | - Ceres Ferretti
- Division of NeurologyUniversity of São PauloSão PauloBrazil
| | | | | | - Patricio Fuentes
- Geriatrics Section Clinical Hospital University of Chile, Santos Dumont 999 IndependenciaSantiagoChile
| | - Adolfo M. García
- Cognitive Neuroscience Center (CNC)Faculty of EducationNational University of Cuyo (UNCuyo)Universidad de San Andres. National Scientific and Technical Research Council (CONICET)MendozaArgentina
| | | | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Instituto de PsiquiatriaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloSao PauloBrazil
| | | | | | | | - Ignacio F. Mata
- Department of Genomic MedicineLerner Research InstituteCleveland ClinicOHUSA
| | - Christian Gonzalez‐Billault
- Center for GeroscienceBrain Health and Metabolism (GERO), Santiago, Chile, and Department of Biology, Faculty of SciencesUniversity of ChileSantiagoChile
| | - Oscar L. Lopez
- Alzheimer's Disease Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Laura Morelli
- Fundacion Instituto Leloir‐IIBBA‐CONICET. AveArgentina
| | - Ricardo Nitrini
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | | | - Alejandra Guerrero Barragan
- Trinity College Dublin, Dublin, Departamento de Neurologia Hospital Occidente de KennedyGlobal Brain Health InstituteUniversidad de la SabanaBogotaColombia
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN)School of PsychologyUniversidad Adolfo IbañezSantiagoChile
| | - Fabricio Joao Pio
- Department of NeurologyHospital Governador Celso RamosFlorianopolisBrazil
| | | | - Renata Kochhann
- Graduate Program in PsychologySchool of Health SciencesHospital Moinhos de VentoPontifical Catholic University of Rio Grande do Sul—PUCRS and Researcher OfficePorto AlegreBrazil
| | - Silvia Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | - Fiona Kumfor
- Brain and Mind Centre and School of PsychologyUniversity of SydneySydneyNSWAustralia
| | - Serggio Lanata
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Bruce Miller
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | - Mirna Lie Hosogi
- Behavioral and Cognitive Unit of Department of NeurologyUniversity of São Paulo School of MedicineSao PauloBrazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile, Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | | | - David Lira
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Francisco Lopera
- Neuroscience Research GroupUniversidad de AntioquiaMedellínColombia
| | - Adelina Comas
- Department of Health Policy at the London School of Economics and Political ScienceLondonUK
| | | | - Ana Luisa Sosa
- Instituto Nacional de Neurología y NeurocirugíaCiudad de MéxicoMéxico
| | - Claudia Ramos
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | | | - Ioannis Tarnanas
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
- Altoida Inc.HoustonTexasUSA
| | - Jenifer Yokoyama
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | | | - Kate Possin
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Kenneth S. Kosik
- Neuroscience Research Institute and Dept of Molecular Cellular and Developmental BiologyUniversity of California SantaBarbaraCaliforniaUSA
| | - Rosa Montesinos
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Patricia Cristina Lourdes Solis
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | | | - Jeronimo Martin Ramirez
- Departamen de Admision Continua Adultos Hospital General La Raza Instituto Mexicano del Seguro SocialGlobal Brain Health Institute, Trinity College Dublin, DublinCiudad de MexicoMexico
| | - Diana Matallana
- Medical SchoolAging Institute and Psychiatry DepartmentPontificia Universidad Javeriana. Memory and Cognition Center‐IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Lingani Mbakile‐Mahlanza
- Global Brain Health InstituteUniversity of California San Francisco, University of BotswanaGaboroneBotswana
| | | | | | - Eliane C Miotto
- Department of NeurologyUniversity of Sao PauloSao PauloBrazil
| | | | | | - David Orozco
- Cognitive Neuroscience Development LaboratoryAxis NeurocienciasUniversidad Nacional del Sur, Cognitive Impairment and Behavior Disorders UnitBahía BlancaArgentina
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Olivier Piguet
- School of Psychology and Brain and Mind CentreUniversity of SydneyCamperdownNSWAustralia
| | - Maritza Pintado Caipa
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | - Lucas Porcello Schilling
- Department of NeurologyPontificia Universidade Catolica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
| | - André Luiz Rodrigues Palmeira
- Santa Casa de Misericórdia de Porto Alegre, Serviço de Neurologia, Porto Alegre, BrazilHospital Ernesto DornellesServiço de Neurologia e NeurocirurgiaPorto AlegreBrazil
| | | | - Jose Manuel Santacruz‐Escudero
- Medical School and Psychiatry DepartmentMemory and Cognition Center‐ IntellectusPontificia Universidad JaverianaHospital Universitario San IgnacioBogotáColombia
| | | | - Jerusa Smid
- Department of NeurologyUniversity of Sao PauloSão PauloBrazil
| | - Andrea Slachevsky
- Neurology DepartmentGeroscience Center for Brain Health and Metabolism, Santiago, Chile, Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program‐ICBM, East Neurologic and Neurosciences Departments, Faculty of MedicineHospital del Salvador and Faculty of Medicine University of Chile. Servicio de NeurologíaDepartamento de MedicinaClínica Alemana—Universidad del DesarrolloUniversity of Chile, Neuropsychiatry and Memory Disorders clinic (CMYN)SantiagoChile
| | | | | | | | - Lea Tenenholz Grinberg
- Departments of NeurologyPathology and Global Brain Health InstituteUCSF ‐ USA, Department of PathologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Antonio Lucio Teixeira
- Laboratório Interdisciplinar de Investigação MédicaFaculdade de MedicinaAv. Alfredo Balena, 110Universidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais e Faculdade deCiências Médicas de Minas GeraisBelo HorizonteBrazil
| | - Dominic Trépel
- Global Brain Health Institute (GBHI)Trinity College DublinDublin
| | - Agustin Ibanez
- Cognitive Neuroscience Center (CNC) Buenos Aires, Argentina; Universidad Autonoma del Caribe, Barranquilla, Colombia; Global Brain Health Institute (GBHI), USUniversidad de San AndresCONICETUniversidad Autonoma del CaribeUniversidad Adolfo IbanezUCSFUSA
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Maia da Silva MN, Porto FHDG, Lopes PMG, Sodré de Castro Prado C, Frota NAF, Alves CHL, Alves GS. Frontotemporal Dementia and Late-Onset Bipolar Disorder: The Many Directions of a Busy Road. Front Psychiatry 2021; 12:768722. [PMID: 34925096 PMCID: PMC8674641 DOI: 10.3389/fpsyt.2021.768722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022] Open
Abstract
It is a common pathway for patients with the behavioral variant of frontotemporal dementia (bvFTD) to be first misdiagnosed with a primary psychiatric disorder, a considerable proportion of them being diagnosed with bipolar disorder (BD). Conversely, not rarely patients presenting in late life with a first episode of mania or atypically severe depression are initially considered to have dementia before the diagnosis of late-onset BD is reached. Beyond some shared features that make these conditions particularly prone to confusion, especially in the elderly, the relationship between bvFTD and BD is far from simple. Patients with BD often have cognitive complaints as part of their psychiatric disorder but are at an increased risk of developing dementia, including FTD. Likewise, apathy and disinhibition, common features of depression and mania, respectively, are among the core features of the bvFTD syndrome, not to mention that depression may coexist with dementia. In this article, we take advantage of the current knowledge on the neurobiology of these two nosologic entities to review their historical and conceptual interplay, highlighting the clinical, genetic and neuroimaging features that may be shared by both disorders or unique to each of them.
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Affiliation(s)
- Mari N Maia da Silva
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21) and Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Norberto Anízio Ferreira Frota
- University of Fortaleza (UNIFOR) School of Medicine, Cognitive and Behavioral Neurology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil
| | | | - Gilberto Sousa Alves
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil.,Post Graduation in Psychiatry and Mental Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Andrade SKDDRES, Melo MCSD, Lima Filho BFD, Porto FHDG, Peixoto VGDMNP, Gazzola JM. Loss of functional capacity in elderly individuals with Alzheimer disease. Dement Neuropsychol 2020; 14:387-393. [PMID: 33354292 PMCID: PMC7735045 DOI: 10.1590/1980-57642020dn14-040009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT. Background: The functional capacity of elderly individuals with Alzheimer disease (AD) progressively declines. Objective: To verify the influence of sociodemographic, clinical, staging, mobility, and postural and cognitive balance data on the impairment of the functional capacity of elderly individuals with AD. Methods: This observational, analytical, cross-sectional study was performed at the Physiotherapy Department of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. The study consisted of forty elderly individuals aged ≥60 years old with mild or moderate AD, who could ambulate independently. The instruments used included a questionnaire to assess sociodemographic and anthropometric data; the Mini-Mental Health State Examination (MMSE); the Clinical Dementia Rating (CDR); a clock drawing test (CDT); a verbal fluency test (VFT); the Timed Up and Go Test (TUG); and the Clinical Test of Sensory Organization and Balance (CTSIB). Simple descriptive analyses, Mann-Whitney test, Spearman's correlation test, linear regression modeling, and prediction equation (p<0.05, 95% confidence interval [95%CI]) were performed. Results: Fifteen linear regression models were generated, with the final model chosen for analysis. The variables assumed in that model were CDR, MMSE score, and condition 3 of the CTSIB, which explained 60.1% of the outcome. Conclusions: Impairment of functional capacity in elderly individuals with AD was influenced by disease progression, which was due to cognitive deficits and deficits in postural balance, which are related to the inaccuracy of the somatosensory system in performing sensory integration.
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Squarzoni P, Faria DDP, Yassuda MS, Porto FHDG, Coutinho AM, Costa NAD, Nitrini R, Forlenza OV, Duran FLDS, Brucki SMD, Buchpiguel CA, Busatto GF. Relationship Between PET-Assessed Amyloid Burden and Visual and Verbal Episodic Memory Performance in Elderly Subjects. J Alzheimers Dis 2020; 78:229-244. [PMID: 32986673 DOI: 10.3233/jad-200758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Studies of elderly subjects using biomarkers that are proxies for Alzheimer's disease (AD) pathology have the potential to document meaningful relationships between cognitive performance and biomarker changes along the AD continuum. OBJECTIVE To document cognitive performance differences across distinct AD stages using a categorization based on the presence of PET-assessed amyloid-β (Aβ) burden and neurodegeneration. METHODS Patients with mild dementia compatible with AD (n = 38) or amnestic mild cognitive impairment (aMCI; n = 43) and a cognitively unimpaired group (n = 27) underwent PET with Pittsburgh compound-B (PiB) assessing Aβ aggregation (A+) and [18F]FDG-PET assessing neurodegeneration ((N)+). Cognitive performance was assessed with verbal and visual episodic memory tests and the Mini-Mental State Examination. RESULTS The A+(N)+ subgroup (n = 32) showed decreased (p < 0.001) cognitive test scores compared to both A+(N)-(n = 18) and A-(N)-(n = 49) subjects, who presented highly similar mean cognitive scores. Despite its modest size (n = 9), the A-(N)+ subgroup showed lower (p < 0.043) verbal memory scores relative to A-(N)-subjects, and trend lower (p = 0.096) scores relative to A+(N)-subjects. Continuous Aβ measures (standard uptake value ratios of PiB uptake) were correlated most significantly with visual memory scores both in the overall sample and when analyses were restricted to dementia or (N)+ subjects, but not in non-dementia or (N)-groups. CONCLUSION These results demonstrate that significant Aβ-cognition relationships are highly salient at disease stages involving neurodegeneration. The fact that findings relating Aβ burden to memory performance were detected only at (N)+ stages, together with the similarity of test scores between A+(N)-and A-(N)-subjects, reinforce the view that Aβ-cognition relationships during early AD stages may remain undetectable unless substantially large samples are evaluated.
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Affiliation(s)
- Paula Squarzoni
- Laboratory of Psychiatric Neuroimaging (LIM 21), Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Daniele de Paula Faria
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Mônica Sanches Yassuda
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fábio Henrique de Gobbi Porto
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Artur Martins Coutinho
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Naomi Antunes da Costa
- Laboratory of Psychiatric Neuroimaging (LIM 21), Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27), Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fabio Luiz de Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM 21), Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM 21), Departament of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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8
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Coutinho AM, Busatto GF, de Gobbi Porto FH, de Paula Faria D, Ono CR, Garcez AT, Squarzoni P, de Souza Duran FL, de Oliveira MO, Tres ES, Brucki SMD, Forlenza OV, Nitrini R, Buchpiguel CA. Correction to: Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual approach exploring clinical-biomarker mismatches and sociodemographic parameters. Eur J Nucl Med Mol Imaging 2020; 47:2715-2716. [PMID: 32592039 DOI: 10.1007/s00259-020-04933-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the last paragraph of the subsession "Recruitment of the study population and clinical Evaluation" (Material and methods session).
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Affiliation(s)
- Artur Martins Coutinho
- Laboratory of NuclearMedicine (LIM43), Department of Radiology and Oncology, Faculdade deMedicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. .,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil. .,Centro deMedicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Geraldo F Busatto
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fábio Henrique de Gobbi Porto
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Daniele de Paula Faria
- Laboratory of NuclearMedicine (LIM43), Department of Radiology and Oncology, Faculdade deMedicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carla Rachel Ono
- Laboratory of NuclearMedicine (LIM43), Department of Radiology and Oncology, Faculdade deMedicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Centro deMedicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil
| | - Alexandre Teles Garcez
- Laboratory of NuclearMedicine (LIM43), Department of Radiology and Oncology, Faculdade deMedicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Paula Squarzoni
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fábio Luiz de Souza Duran
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maira Okada de Oliveira
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eduardo Sturzeneker Tres
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of NuclearMedicine (LIM43), Department of Radiology and Oncology, Faculdade deMedicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Centro deMedicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil
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Coutinho AM, Busatto GF, de Gobbi Porto FH, de Paula Faria D, Ono CR, Garcez AT, Squarzoni P, de Souza Duran FL, de Oliveira MO, Tres ES, Brucki SMD, Forlenza OV, Nitrini R, Buchpiguel CA. Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual approach exploring clinical-biomarker mismatches and sociodemographic parameters. Eur J Nucl Med Mol Imaging 2020; 47:2666-2680. [PMID: 32055966 DOI: 10.1007/s00259-020-04714-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE [18F]FDG-PET and [11C]PIB-PET are validated as neurodegeneration and amyloid biomarkers of Alzheimer's disease (AD). We used a PET staging system based on the 2018 NIA-AA research framework to compare the proportion of amyloid positivity (A+) and hypometabolism ((N)+) in cases of mild probable AD, amnestic mild cognitive impairment (aMCI), and healthy controls, incorporating an additional classification of abnormal [18F]FDG-PET patterns and investigating the co-occurrence of such with A+, exploring [18F]FDG-PET to generate hypotheses in cases presenting with clinical-biomarker "mismatches." METHODS Elderly individuals (N = 108) clinically classified as controls (N = 27), aMCI (N = 43) or mild probable AD (N = 38) were included. Authors assessed their A(N) profiles and classified [18F]FDG-PET neurodegenerative patterns as typical or non-typical of AD, performing re-assessments of images whenever clinical classification was in disagreement with the PET staging (clinical-biomarker "mismatches"). We also investigated associations between "mismatches" and sociodemographic and educational characteristics. RESULTS AD presented with higher rates of A+ and (N)+. There was also a higher proportion of A+ and (N)+ individuals in the aMCI group in comparison to controls, however without statistical significance regarding the A staging. There was a significant association between amyloid positivity and AD (N)+ hypometabolic patterns typical of AD. Non-AD (N)+ hypometabolism was seen in all A- (N)+ cases in the mild probable AD and control groups and [18F]FDG-PET patterns classified such individuals as "SNAP" and one as probable frontotemporal lobar degeneration. All A- (N)- cases in the probable AD group had less than 4 years of formal education and lower socioeconomic status (SES). CONCLUSION The PET-based staging system unveiled significant A(N) differences between AD and the other groups, whereas aMCI and controls had different (N) staging, explaining the cognitive impairment in aMCI. [18F]FDG-PET could be used beyond simple (N) staging, since it provided alternative hypotheses to cases with clinical-biomarker "mismatches." An AD hypometabolic pattern correlated with amyloid positivity. Low education and SES were related to dementia in the absence of biomarker changes.
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Affiliation(s)
- Artur Martins Coutinho
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. .,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil. .,Centro de Medicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Geraldo F Busatto
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fábio Henrique de Gobbi Porto
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carla Rachel Ono
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Centro de Medicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil
| | - Alexandre Teles Garcez
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Paula Squarzoni
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fábio Luiz de Souza Duran
- Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maira Okada de Oliveira
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eduardo Sturzeneker Tres
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Centro de Medicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 2° andar, Rua Doutor Ovídio Pires de Campos, 872, Cerqueira Cesar, São Paulo, SP, Brazil
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10
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Porto FHDG, Porto GCLM, Brotto MWL. Additional tests to investigate neuropathic pain. The value of electroneuromyography for neuropathic pain. Revista Dor 2016. [DOI: 10.5935/1806-0013.20160042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Henrique de Gobbi Porto F, Martins Novaes Coutinho A, Lucia de Sá Pinto A, Gualano B, Luís de Souza Duran F, Prando S, Rachel Ono C, Spíndola L, Okada de Oliveira M, Helena Figuerêdo do Vale P, Nitrini R, Alberto Buchpiguel C, Maria Dozzi Brucki S. Effects of Aerobic Training on Cognition and Brain Glucose Metabolism in Subjects with Mild Cognitive Impairment. J Alzheimers Dis 2015; 46:747-60. [DOI: 10.3233/jad-150033] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Artur Martins Novaes Coutinho
- Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Lucia de Sá Pinto
- Laboratory of Assessment and Conditioning in Rheumatology (LACRE), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Gualano
- Laboratory of Assessment and Conditioning in Rheumatology (LACRE), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabio Luís de Souza Duran
- Department of Psychiatry and LIM21, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvana Prando
- Department of Psychiatry and LIM21, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carla Rachel Ono
- Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lívia Spíndola
- Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maira Okada de Oliveira
- Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Patrícia Helena Figuerêdo do Vale
- Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ricardo Nitrini
- Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Porto FHDG, Fox AM, Tusch ES, Sorond F, Mohammed AH, Daffner KR. In vivo evidence for neuroplasticity in older adults. Brain Res Bull 2015; 114:56-61. [PMID: 25857946 PMCID: PMC4666311 DOI: 10.1016/j.brainresbull.2015.03.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/27/2015] [Accepted: 03/28/2015] [Indexed: 12/11/2022]
Abstract
Neuroplasticity can be conceptualized as an intrinsic property of the brain that enables modification of function and structure in response to environmental demands. Neuroplastic strengthening of synapses is believed to serve as a critical mechanism underlying learning, memory, and other cognitive functions. Ex vivo work investigating neuroplasticity has been done on hippocampal slices using high frequency stimulation. However, in vivo neuroplasticity in humans has been difficult to demonstrate. Recently, a long-term potentiation-like phenomenon, a form of neuroplastic change, was identified in young adults by differences in visual evoked potentials (VEPs) that were measured before and after tetanic visual stimulation (TVS). The current study investigated whether neuroplastic changes in the visual pathway can persist in older adults. Seventeen healthy subjects, 65 years and older, were recruited from the community. Subjects had a mean age of 77.4 years, mean education of 17 years, mean MMSE of 29.1, and demonstrated normal performance on neuropsychological tests. 1Hz checkerboard stimulation, presented randomly to the right or left visual hemi-field, was followed by 2min of 9Hz stimulation (TVS) to one hemi-field. After 2min of rest, 1Hz stimulation was repeated. Temporospatial principal component analysis was used to identify the N1b component of the VEPs, at lateral occipital locations, in response to 1Hz stimulation pre- and post-TVS. Results showed that the amplitude of factors representing the early and late N1b component was substantially larger after tetanic stimulation. These findings indicate that high frequency visual stimulation can enhance the N1b in cognitively high functioning old adults, suggesting that neuroplastic changes in visual pathways can continue into late life. Future studies are needed to determine the extent to which this marker of neuroplasticity is sustained over a longer period of time, and is influenced by age, cognitive status, and neurodegenerative disease.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology and Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Anne Murphy Fox
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology and Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Erich S Tusch
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology and Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Farzaneh Sorond
- Division of Stroke and Cerebrovascular Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Abdul H Mohammed
- Department of Psychology, Linnaeus University, Växjö, Sweden; Center for Alzheimer Research, Department of NVS, Karolinska Institutet, Huddinge, Sweden.
| | - Kirk R Daffner
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology and Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Machado-Porto GCL, Lucato LT, Porto FHDG, de Souza EC, Nitrini R. Reversible dementia due to neurocysticercosis: Improvement of the racemose type with antihistamines. Dement Neuropsychol 2015; 9:85-90. [PMID: 29213947 PMCID: PMC5618997 DOI: 10.1590/s1980-57642015dn91000014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Infection of the human central nervous system (CNS) by the larvae of
Taenia solium, termed neurocysticercosis (NCC), is endemic
in most developing countries, where it is a major cause of acquired seizures and
other neurological morbidity, including neuropsychiatric symptoms. However,
despite its frequent manifestation, some findings, such as cognitive impairment
and dementia, remain poorly understood. Less commonly, NCC may affect the
ventricular system and subarachnoid spaces and this form is known as
extraparenchymal neurocysticercosis. A particular presentation of the
subarachnoid form is called racemose cysticercosis, which has a progressive
pattern, frequently leads to hydrocephalus and can be life-threatening. Here we
review a case of the racemose variety of cysticercosis, complicated by
hydrocephalus and reversible dementia, with remission of symptoms after
derivation and that remained stable with use of dexchlorpheniramine. We discuss
the challenges in diagnosis, imaging findings, treatment and follow-up of this
disease.
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Affiliation(s)
- Gislaine Cristina Lopes Machado-Porto
- MD, PhD student, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil. Department of Radiology, A.C.Camargo Cancer Center, São Paulo SP, Brazil
| | - Leandro Tavares Lucato
- MD, PhD, Neuroradiologist, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil. Centro de Diagnóstico Brasil, São Paulo SP, Brazil
| | - Fábio Henrique de Gobbi Porto
- MD, PhD student, Behavioral and Cognitive Neurology Unit, Department of Neurology Cognitive Disorders Reference Center (CEREDIC), HC/FMUSP, São Paulo, Brazil
| | - Evandro Cesar de Souza
- MD, PhD, Medical Assistant, Head of Neurological Radiosurgery Group, HC/FMUSP, São Paulo SP, Brazil
| | - Ricardo Nitrini
- MD, PhD, Full Professor, Behavioral and Cognitive Neurology Unit, Department of Neurology Cognitive Disorders Reference Center (CEREDIC), HC/FMUSP, São Paulo SP, Brazil
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Figueirêdo do Vale Capucho PH, Dozzi Rabin LM, Spíndola L, Henrique de Gobbi Porto F, Porto C, Nitrini R, Dozzi Brucki SM. P2‐244: JUDGMENT IN COGNITIVELY HEALTHY ELDERLY AND MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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de Gobbi Porto FH, Spíndola L, de Oliveira MO, Figuerêdo do Vale PH, Orsini M, Nitrini R, Dozzi Brucki SM. A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints. Neurol Int 2013; 5:e16. [PMID: 24147213 PMCID: PMC3794451 DOI: 10.4081/ni.2013.e16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 04/03/2013] [Accepted: 05/06/2013] [Indexed: 12/12/2022] Open
Abstract
It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, das Clínicas Hospital, University of São Paulo
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Abstract
Although not evident clinically, lesions to the prefrontal cortex cause great
social and functional impairment to patients. The anterior cingulate cortex is
intimately involved with motivational behavior and after injury to this area the
onset of an apathetic state can be observed. This paper describes the case of a
patient with traumatic brain injury to the prefrontal lobe presenting with a
depressive syndrome associated with apathetic symptoms. After appropriate
treatment for depression, intense apathy was revealed, an irreversible sequelae
of the traumatic brain injury, constituting the main barrier to the patient's
return of lifestyle and independence.
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Affiliation(s)
- Raquel Quimas Molina da Costa
- MD. Universidade Federal do Estado do Rio de Janeiro (Unirio). Escola de Medicina e Cirurgia (EMC). Hospital Universitário Gaffrée e Guinle (HUGG). Departamento de Medicina Especializada. Disciplina de Psiquiatria. Serviço de Psiquiatria
| | - Fábio Henrique de Gobbi Porto
- MD. Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC). Hospital das Clínicas of the University of São Paulo, São Paulo, SP, Brazil
| | - Rogério Paysano Marrocos
- MD, MSc. Universidade Federal do Estado do Rio de Janeiro (Unirio). Hospital Universitário Gaffrée e Guinle (HUGG)
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17
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Heluani AS, Porto FHDG, Listik S, de Campos AW, Machado AAC, Cukiert A, de Oliveira JO. Neuropsychological and quality of life assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus. Dement Neuropsychol 2012; 6:260-265. [PMID: 29213806 PMCID: PMC5619338 DOI: 10.1590/s1980-57642012dn06040010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Deep brain stimulation (DBS) has been widely used to control motor symptoms and improve quality of life in patients with Parkinsons disease (PD). Recently, DBS in the subthalamic nucleus (STN) has become the preferred target for patients with mixed motor symptoms. Despite resultant motor and quality of life improvements, the procedure has been associated with cognitive decline, mainly in language skills, and also with psychiatric symptoms. Objective To evaluate the influence of DBS in the STN on cognition, mood and quality of life. Methods We studied 20 patients with PD submitted to DBS in the STN from May 2008 to June 2012 with an extensive battery of cognitive tests including memory, language, praxis, executive functions and attention assessments; the Parkinson's Disease Quality of Life Questionnaire (PDQ-39); and the Hospital Anxiety and Depression Scale (HAD), were applied both before and after the surgery. Data was analyzed using SPSS version 17.0 and results compared using the paired Student's t test. Results A total of 20 patients with pre and post-operative assessments were included. A statistically significant improvement was found in total score and on subscales of mobility, activities of daily living and emotional well-being from the PDQ-39 (P=0.009, 0.025, 0.001 and 0.034, respectively). No significant difference was found on the cognitive battery or mood scale. Conclusion DBS in the SNT improved quality of life in PD with no negative impact on cognitive skills and mood.
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Affiliation(s)
| | - Fábio Henrique de Gobbi Porto
- MD, Neurologist. Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC). Hospital das Clínicas of the University of São Paulo. Department of Neurosurgery of Hospital "Euriclydes de Jesus Zerbini", São Paulo SP, Brazil
| | - Sergio Listik
- MD, Neurosurgeon. Department of Neurosurgery of Hospital "Euriclydes de Jesus Zerbini", São Paulo SP, Brazil. Movement Disorders Unit
| | - Alexandre Walter de Campos
- MD, Neurosurgeon. Department of Neurosurgery of Hospital "Euriclydes de Jesus Zerbini", São Paulo SP, Brazil. Movement Disorders Unit
| | | | | | - José Oswaldo de Oliveira
- MD, Neurosurgeon in Chief-Movement Disorders Unit - Department of Neurosurgery of Hospital "Euriclydes de Jesus Zerbini", São Paulo SP, Brazil
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18
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Abstract
A 35-year-old, previously healthy man presented psychiatric symptoms lasting four
years, receiving treatment with neuroleptics. One year later he evolved with
gait disequilibrium. After a further six months, cognitive symptoms were
characterized with rapid evolution to a profound demented state. MRI showed
signal changes in cerebral white matter and very long-chain fatty acids were
detected in blood.
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Affiliation(s)
- Antonio Cézar Ribeiro Galvão
- MD, PhD, Assistant Professor. Department of Neurology, Hospital das Clínicas of the University of São Paulo (HC/FMUSP), São Paulo SP, Brazil
| | | | - Fábio Henrique de Gobbi Porto
- MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC), HC/FMUSP
| | | | - Ricardo Nitrini
- MD, PhD, Full Professor, Behavioral and Cognitive Neurology Unit, Department of Neurology, and CEREDIC, HC/FMUSP
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19
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Porto FHDG, Silva MNMD, Domingues JRS, Porto GCLM, Davagnaman I, Nitrini R. The missed missing hole. Arq Neuropsiquiatr 2012; 70:467-469. [PMID: 22699546 DOI: 10.1590/s0004-282x2012000600015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 04/16/2012] [Indexed: 06/01/2023]
Abstract
At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT) scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Behavorial and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
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20
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de Gobbi Porto FH, d'Ávila Freitas MI, de Oliveira MO, Lucato LT, Orsini M, de Menezes SLS, Magaldi RM, Porto CS, Dozzi Brucki SM, Nitrini R. Thalamic alexia with agraphia. Neurol Int 2012; 4:e4. [PMID: 22593808 PMCID: PMC3349959 DOI: 10.4081/ni.2012.e4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 12/05/2011] [Indexed: 12/03/2022] Open
Abstract
Alexia with agraphia is defined as an acquired impairment affecting reading and writing ability. It can be associated with aphasia, but can also occur as an isolated entity. This impairment has classically been associated with a left angular gyrus lesion In the present study, we describe a case involving a patient who developed alexia with agraphia and other cognitive deficits after a thalamic hemorrhage. In addition, we discuss potential mechanisms of this cortical dysfunction syndrome caused by subcortical injury. We examined a patient who presented with alexia with agraphia and other cognitive deficits due to a hemorrhage in the left thalamus. Neuropsychological evaluation showed attention, executive function, arithmetic and memory impairments. In addition, language tests revealed severe alexia with agraphia in the absence of aphasia. Imaging studies disclosed an old thalamic hemorrhage involving the anterior, dorsomedial and pulvinar nuclei. Tractography revealed asymmetric thalamocortical radiations in the parietal region (left
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Affiliation(s)
| | - Maria Isabel d'Ávila Freitas
- Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC)
| | - Maira Okada de Oliveira
- Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC)
| | | | - Marco Orsini
- Neurology Department, Fluminense Federal University and Masters Program in Science Rehabilitation, UNISUAM, Rio de Janeiro
| | | | - Regina Miksian Magaldi
- Memory and Aging Unit, Geriatric Service, Department of Clinical Medicine and Cognitive Disorders Reference Center, University of São Paulo School of Medicine, São Paulo SP, Brazil
| | - Cláudia Sellitto Porto
- Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC)
| | - Sonia Maria Dozzi Brucki
- Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC)
| | - Ricardo Nitrini
- Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC)
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21
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Abstract
Acquired hepatocerebral degeneration is an underdiagnosed neurologic syndrome characterized by parkinsonism, ataxia or other movement disorders and by neuropsychiatric and cognitive symptoms. It occurs in patients with chronic liver disease, especially those who develop portosystemic shunting and is often unrecognized as a cause of cognitive decline. Recently, its pathogenesis has been associated with manganese accumulation in basal ganglia and some treatments proposed. The aim of this article was to report a case and discuss some discoveries in connection with the disease.
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Affiliation(s)
- Clarice Listik
- Fifth year Medical Student at the University of São Paulo,
São Paulo SP, Brazil
| | | | - Maira Okada de Oliveira
- Psych, M.Sc. Behavioral and Cognitive Neurology Unit, Department of
Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das
Clínicas of the University of São Paulo (HC/USP), São Paulo SP,
Brazil
| | - Fábio Henrique de Gobbi Porto
- MD, Behavioral and Cognitive Neurology Unit, Department of
Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das
Clínicas of the University of São Paulo, São Paulo SP,
Brazil
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22
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Abstract
Progressive posterior cortical dysfunction (PPCD) is an insidious syndrome
characterized by prominent disorders of higher visual processing. It affects
both dorsal (occipito-parietal) and ventral (occipito-temporal) pathways,
disturbing visuospatial processing and visual recognition, respectively. We
report a case of a 67-year-old woman presenting with progressive impairment of
visual functions. Neurologic examination showed agraphia, alexia, hemispatial
neglect (left side visual extinction), complete Balint’s syndrome and visual
agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the
bilateral parieto-occipital regions, slightly more predominant to the right. Our
aim was to describe a case of this syndrome, to present a video showing the main
abnormalities, and to discuss this unusual presentation of dementia. We believe
this article can contribute by improving the recognition of PPCD.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC); Hospital das Clínicas of the University of São Paulo, São Paulo SP, Brazil
| | | | - Lilian Schafirovits Morillo
- MD, MSc, Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC); Hospital das Clínicas of the University of São Paulo, School of Medicine, São Paulo SP, Brazil. Discipline of Geriatric Medicine, Hospital das Clínicas of the University of São Paulo, School of Medicine, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- MD, PhD, Neurologist from the Cognitive and Behavioral Neurology Group (University of São Paulo); Psychobiology Department (Federal University of São Paulo); Hospital Santa Marcelina, São Paulo SP, Brazil
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23
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Henrique de Gobbi Porto F, Orsini M, Antônio Araújo Leite M, Moreira Dos Santos J, Pulier S, Mello M, Nascimento OJM. Mills' syndrome: case report. Neurol Int 2009; 1:e15. [PMID: 21577352 PMCID: PMC3093238 DOI: 10.4081/ni.2009.e15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 10/19/2009] [Accepted: 10/26/2009] [Indexed: 11/23/2022] Open
Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Neuromuscular Disease Outpatient Division, Federal Fluminense University, UFF Department of Neurology, UFF, Antônio Pedro University Hospital (HUAP)
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24
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Porto FHDG, Machado GCL, da Silva MNM, de Freitas GR. The "eye sign" due to hemispatial neglect: A case report. Dement Neuropsychol 2009; 3:256-259. [PMID: 29213637 PMCID: PMC5618982 DOI: 10.1590/s1980-57642009dn30300013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 08/14/2009] [Indexed: 11/22/2022] Open
Abstract
Conjugate eye deviation is characterized by a sustained shift in horizontal gaze, usually toward the affected brain hemisphere. When detected on neuroimaging, it is called the "eye sign". It is classically associated with lesions involving the frontal eye fields, ipsilateral to the side of the deviation. Neglect may be conceptualized as a spatially addressed bias of the sensory events in explicit behaviors and in the absence of perceptual and motor deficits. Hemispatial neglect is a common disabling condition that occurs following acute unilateral brain damage, usually to the right side. We report a case of a patient presenting with the "eye sign" on tomography, following an acute subinsular stroke, in the absence of conjugated eyes deviation. Our hypothesis was that the sign may have been due to hemispatial neglect in this patient. The aim of this article was to discuss the mechanisms involved in the attention network and its neuroanatomic correlates.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- MD, Behavioral and Cognitive Neurology Unit, Department
of Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das
Clínicas of the University of São Paulo, São Paulo, SP,
Brazil
| | | | - Mari-Nilva Maia da Silva
- MD, Behavioral and Cognitive Neurology Unit, Department
of Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das
Clínicas of the University of São Paulo, São Paulo, SP,
Brazil
| | - Gabriel Rodriguez de Freitas
- MD, PhD, Cerebrovascular Unit, Department of Neurology,
Hospital Antônio Pedro of the Federal Fluminense University (UFF), Rio de
Janeiro, RJ, Brazil
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