Navegando por Palavras-chave "cognitive impairment"
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- ItemAcesso aberto (Open Access)Depression increases in patients with Parkinson?s disease according to the increasing severity of the cognitive impairment(Academia Brasileira de Neurologia - ABNEURO, 2014-06-01) Chagas, Marcos Hortes N.; Moriyama, Tais Silveira [UNIFESP]; Felício, André Carvalho [UNIFESP]; Sosa, Ana Luisa; Bressan, Rodrigo Affonseca [UNIFESP]; Ferri, Cleusa Pinheiro [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert Einstein Instituto Israelita de Ensino e Pesquisa; National Institute of Neurology and Neurosurgery of MéxicoObjective : To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson’s disease (PD). Method : One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results : The mean age of the sample was 79.3 years old and most (69%) were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04). Conclusion : The association between depression and PD increases with the severity of the cognitive impairment.
- ItemAcesso aberto (Open Access)Duchenne muscular dystrophy: alpha-dystroglycan immunoexpression in skeletal muscle and cognitive performance(Academia Brasileira de Neurologia - ABNEURO, 2005-12-01) Pereira, Conceição Campanario da Silva [UNIFESP]; Kiyomoto, Beatriz Hitomi [UNIFESP]; Cardoso, Ricardo; Oliveira, Acary Souza Bulle [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); CeT Codificação e TabulaçãoThe Duchenne muscular systrophy (DMD) is a muscular dystrophy with cognitive impairment present in 20-30% of the cases. In the present study, in order to study the relationship between the alpha-dystroglycan (alpha-DG) immunostaining in skeletal muscle and cognitive performance in DMD patients, 19 were assessed. Twelve patients performed the intelligence quotient (IQ) below the average. Among the 19 patients, two were assessed by the Stanford-Binet test and 17 by Wechsler Intelligence Scale for Children-III (WISC-III). Nine patients performed a verbal IQ below the average, only three patients performed an average verbal IQ. The muscle biopsies immunostained with antibodies to alpha-DG showed that 17 patients presented a low expression, below 25% of the total fibers. Two patients presented alpha-DG immunostaining above 40% and an IQ within the average. No significant statistical relationship was demonstrated among total IQ, verbal IQ and execution IQ and alpha-DG immunostaining at these patients muscle samples.
- ItemAcesso aberto (Open Access)Generalized periodic EEG activity in two cases of neurosyphilis(Academia Brasileira de Neurologia - ABNEURO, 2006-03-01) Anghinah, Renato; Camargo, Érica C.s.; Braga, Nádia I. [UNIFESP]; Waksman, Simone; Nitrini, Ricardo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Neurosyphilis is a recognized cause of epileptic seizures and cognitive impairment, but is not usually associated with the finding of generalized periodic activity in the EEG. We report two similar cases characterized by progressive cognitive impairment followed by partial complex seizures, in whom the EEG showed generalized periodic activity. Both cerebrospinal fluid and the response to penicillin therapy confirmed the diagnoses of neurosyphilis in the two cases. The finding of EEG generalized periodic activity in patients with cognitive or behavioral disorders is usually associated with Creutzfeldt-Jakob disease, although there are other conditions, some of them potentially reversible, which may also present this EEG abnormality. Neurosyphilis has tended not to be included among them, and our present findings support the importance of first ruling out neurosyphilis in those patients with cognitive or behavioral disorders associated with generalized periodic epileptiform discharges.
- ItemSomente MetadadadosMelatonin attenuates tyrosine hydroxylase loss and hypolocomotion in MPTP-lesioned rats(Elsevier B.V., 2008-10-10) Capitelli, Caroline; Sereniki, Adriana; Santos Lima, Marcelo Meira [UNIFESP]; Reksidler, Angela Braga; Tufik, Sergio [UNIFESP]; Barbato Frazao Vital, Maria Aparecida; Univ Fed Parana; Universidade Federal de São Paulo (UNIFESP)Parkinson's disease is a chronic neurological disease characterized by dopaminergic neuron degeneration in the substantia nigra pars compacta. Melatonin is a powerful antioxidant agent secreted by the pineal gland which has numerous physiological functions and seems to exert an important neuroprotective effect. the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) model has been used to understand the pathophysiology of the disease because of its capacity to mimic biochemical and histological features observed in Parkinson's disease. This study investigated the effect of pretreatment with melatonin (50 mg/kg) on MPTP-lesioned animals 24 h and 7 days after neurotoxin infusion using the open-field test, two-way avoidance task and immunohistochemistry. Twenty-four hours after lesioning, the MPTP+vehicle group exhibited hypolocomotion and significant loss of tyrosine hydroxylase-immunoreactive cells, whereas no differences in these parameters were observed in lesioned animals receiving melatonin. Seven days after surgery, the MPTP-lesioned rats did not show hypolocomotion compared to control animals, while there was a significant dopaminergic neuronal loss. in the two-way avoidance task, MPTP-treated animals presented a cognitive deficit compared to the control groups and melatonin administration did not repair this defect. the present results suggest that melatonin reduces neuronal loss in the MPTP animal model of Parkinson's disease. (C) 2008 Published by Elsevier B.V.
- ItemAcesso aberto (Open Access)Midlife Hypertensive Status and Cognitive Function 20Years Later: the Southall and Brent Revisited Study(Wiley-Blackwell, 2013-09-01) Taylor, Clare; Tillin, Therese; Chaturvedi, Nish; Dewey, Michael; Ferri, Cleusa Pinheiro [UNIFESP]; Hughes, Alun; Prince, Martin; Richards, Marcus; Shah, Ajit; Stewart, Robert; Kings Coll London; Univ London Imperial Coll Sci Technol & Med; Universidade Federal de São Paulo (UNIFESP); Med Res Council Study Hlth & Dev; Univ Cent LancashireObjectivesTo investigate long-term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later.DesignCohort study.SettingTwo areas (Southall and Brent) of northwest London.ParticipantsSurvey samples of a multiethnic population (European, African Caribbean, South Asian) aged 40 to 67 were followed up 20 years later.MeasurementsComprehensive cardiovascular assessments were performed at baseline, including measurements of resting blood pressure (BP) and, in a subsample, ambulatory BP. At follow-up, a battery of cognitive assessments was administered, and a composite outcome was derived, with impairment defined as the lowest 10% within each ethnic group. Logistic regression models were used to investigate associations with prior measures of hypertensive status.ResultsIn 1,484 participants at follow-up, cognitive impairment showed significant U-shaped associations with baseline diastolic BP (DBP) and mean arterial pressure (MAP; strongest for those aged >= 50 at baseline), independent of a range of covariates, but no associations were found with systolic BP or pulse pressure. Cognitive impairment was also associated with antihypertensive medication use and higher evening ambulatory DBP at baseline. No substantial differences in strengths of association were found between ethnic groups.ConclusionLow and high DBP and MAP were associated with cognitive impairment 20 years later. Higher evening DBP on ambulatory monitoring was also associated with greater risk.
- ItemSomente MetadadadosMutations in the Human UBR1 Gene and the Associated Phenotypic Spectrum(Wiley-Blackwell, 2014-05-01) Sukalo, Maja; Fiedler, Ariane; Guzman, Celina; Spranger, Stephanie; Addor, Marie-Claude; Mcheik, Jiad N.; Benavent, Manuel Oltra; Cobben, Jan M.; Gillis, Lynette A.; Shealy, Amy G.; Deshpande, Charu; Bozorgmehr, Bita; Everman, David B.; Stattin, Eva-Lena; Liebelt, Jan; Keller, Klaus-Michael; Bertola, Debora Romeo; van Karnebeek, Clara D. M.; Bergmann, Carsten; Liu, Zhifeng; Dueker, Gesche; Rezaei, Nima; Alkuraya, Fowzan S.; Ogur, Gonul; Alrajoudi, Abdullah; Venegas-Vega, Carlos A.; Verbeek, Nienke E.; Richmond, Erick J.; Kirbiyik, Ozgur; Ranganath, Prajnya; Singh, Ankur; Godbole, Koumudi; Ali, Fouad A. M.; Alves, Cresio; Mayerle, Julia; Lerch, Markus M.; Witt, Heiko; Zenker, Martin; Univ Hosp Magdeburg; Univ Hosp Erlangen; Hosp Nacl Ninos Dr Carlos Saenz Herrera; Klinikum Bremen Mitte; CHU Vaudois; Univ Hosp; Hosp La Fe; AMC Univ Hosp; Vanderbilt Univ; Cleveland Clin; Guys Hosp; Kariminejad Najmabadi Pathol & Genet Ctr; Greenwood Genet Ctr; Umea Univ; Womens & Childrens Hosp; Stiftung Deutsch Klin Diagnost GmbH; Universidade Federal de São Paulo (UNIFESP); Univ British Columbia; Ctr Human Genet; Nanjing Med Univ; Univ Klinikum Bonn; Univ Tehran Med Sci; King Faisal Specialist Hosp & Res Ctr; Ondokuz Mayis Univ; Al Thawra Teaching Hosp; Hosp Gen Mexico City; Univ Med Ctr Utrecht; Natl Childrens Hosp; Sisli Etfal Res Hosp; Nizams Inst Med Sci; Maulana Azad Med Coll; Deenanath Mangeshkar Hosp & Res Ctr; Minist Hlth; Universidade Federal da Bahia (UFBA); Ernst Moritz Arndt Univ Greifswald; Tech Univ MunichJohanson-Blizzard syndrome (JBS) is a rare, autosomal recessive disorder characterized by exocrine pancreatic insufficiency, typical facial features, dental anomalies, hypothyroidism, sensorineural hearing loss, scalp defects, urogenital and anorectal anomalies, short stature, and cognitive impairment of variable degree. This syndrome is caused by a defect of the E3 ubiquitin ligase UBR1, which is part of the proteolytic N-end rule pathway. Herein, we review previously reported (n=29) and a total of 31 novel UBR1 mutations in relation to the associated phenotype in patients from 50 unrelated families. Mutation types include nonsense, frameshift, splice site, missense, and small in-frame deletions consistent with the hypothesis that loss of UBR1 protein function is the molecular basis of JBS. There is an association of missense mutations and small in-frame deletions with milder physical abnormalities and a normal intellectual capacity, thus suggesting that at least some of these may represent hypomorphic UBR1 alleles. the review of clinical data of a large number of molecularly confirmed JBS cases allows us to define minimal clinical criteria for the diagnosis of JBS. for all previously reported and novel UBR1 mutations together with their clinical data, a mutation database has been established at LOVD.
- ItemAcesso aberto (Open Access)Neurological manifestations of celiac disease(Academia Brasileira de Neurologia - ABNEURO, 2004-12-01) Siqueira Neto, José Ibiapina; Costa, Ana Carolina Leite Vieira; Magalhães, Francisco George; Silva, Gisele Sampaio [UNIFESP]; Federal University of Ceará Department of Internal Medicine; Federal University of Ceará Hospital Universitário Walter; Universidade Federal de São Paulo (UNIFESP)Celiac disease (CD/ Nontropicalsprue, gluten-sensitive enteropathy) is a malabsortive condition in which an allergic reaction to the cereal grain-protein gluten (present in wheat, rye and barley) causes small intestine mucosal injury. The onset is in the first four decades of life, with a female to male ratio of 2:1. It may be associated with a wide spectrum of neurological manifestations including cerebellar ataxia, epileptic seizures, dementia, neuropathy, myopathy and multifocal leucoencephalopathy. We report three patients with neurological manifestations related with CD: one with cerebellar ataxia, one with epilepsy and one with cognitive impairment. The diagnosis of CD was confirmed by serologic tests (antiendomysial and antigliadin antibodies) and biopsy of the small intestine. In two patients the neurological symptoms preceded the gastrointestinal abnormalities and in all of them gluten restriction failed to improve the neurological disability. Conclusion: CD should be ruled out in the differential diagnosis of neurological dysfunction of unknown cause, including ataxia, epilepsy and dementia. A gluten free diet, the mainstay of treatment, failed to improve the neurological disability.
- ItemAcesso aberto (Open Access)Neuropsychological performance in patients with subcortical stroke(Academia Brasileira de Neurologia - ABNEURO, 2012-05-01) Andrade, Silviane Pinheiro Campos de [UNIFESP]; Brucki, Sônia Maria Dozzi; Bueno, Orlando Francisco Amodeo [UNIFESP]; Siqueira Neto, José Ibiapina; Universidade Federal de São Paulo (UNIFESP)Vascular cognitive impairment (VCI) is characterized by cognitive compromise predominantly of executive dysfunction. OBJECTIVES: To assess cognitive functions in VCI, focusing on executive functions, to observe functional losses in relation to activities of daily living (ADLs) and to detect early symptoms prior to the onset of dementia. METHODS: We evaluated healthy subjects matched for gender, education and age to patients with diagnosis of subcortical vascular disease who had a stroke classified into three groups: 1) vascular lesions and no impairment; 2) vascular cognitive impairment with no dementia (VCIND); 3) vascular dementia (VaD). RESULTS AND DISCUSSION: The performance on neuropsychological tests differed among groups, worsening with increased impairment level. The probable VaD group demonstrated impaired performance in memory, processing speed and verbal production, while the VCIND group showed attention deficits. CONCLUSION: Impairment in executive functions and difficulties in ADLs allow us to differentiate levels of impairment in groups of subcortical vascular disease.
- ItemSomente MetadadadosNeuropsychological profile of patients with juvenile myoclonic epilepsy: A controlled study of 50 patients(Elsevier B.V., 2007-03-01) Frascareli Pascalicchio, Tatiana; Araujo Filho, Gerardo M. de; Helena da Silva Noffs, Maria; Lin, Katia; Otavio S. F. Caboclo, Luis; Vidal-Dourado, Marcos; Ferreira Guilhoto, Laura M. F.; Marcia Targas Yacubian, Elza; Universidade Federal de São Paulo (UNIFESP)The purpose of this study was to verify possible cognitive dysfunction in patients with juvenile myoclonic epilepsy (JME) and its relationship to factors related to epilepsy and schooling. Fifty subjects diagnosed with JME and 50 controls underwent neuropsychological assessment evaluating intellectual functions, attention, memory, executive functions, and language. the patients were further divided into two subgroups on the basis of educational level: <= 11 and >11 years of formal education. Participants diagnosed with JME scored significantly below age-, education-, and gender-matched controls on neuropsychological measures of attention, immediate verbal memory, mental flexibility, control of inhibition, working memory, processing speed, verbal delayed memory, visual delayed memory, naming, and verbal fluency. A positive correlation was observed between duration of epilepsy and cognitive decline. However, in the group of patients with >11 years of education, this correlation was not significant. in this series of patients with JME, neuropsychological evaluation suggests widespread cognitive dysfunction outside the limits of the frontal lobes. the duration of epilepsy correlated with cognitive decline, and patients with higher education manifested less progression of deficits. (c) 2006 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosSubjective memory complaints in an elderly sample: a cross-sectional study(Wiley-Blackwell, 2008-01-01) Minett, Thais Soares Cianciarullo [UNIFESP]; Silva, Rosirneire Vieira da [UNIFESP]; Ortiz, Karin Zazo [UNIFESP]; Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background Community based studies show that neurological or psychiatric symptoms are very frequent among the elderly population, with poor memory complaints being the most common. However, the relationship between poor memory complaints and objective memory performance is unclear. We designed this study to evaluate whether subjective memory complaints (SMC) are associated with objective cognitive performance or depression amongst the elderly Brazilian generation.Methods A cross-sectional study was carried out in 114 patients who were 50+, with or without SMC having no obvious cognitive impairment at its baseline (this was screened by the Mini-Mental State Examination with cut-off values adapted according to the subjects' educational background). Subjects were assessed regarding memory difficulty complaints, demographic data and underwent a neuropsychological assessment made up of nine cognitive tests (Rey Auditory Verbal Learning Test, Visual Reproduction Test, Logic Memory-History A, Free and Cued Selective Reminding Test, Stroop Test, Digit Span, Digit Symbol, Trail Making Test, fluency tests: naming animals and fruits) and the Geriatric Depression Scale.Results Twenty-one percent of the subjects had subjective memory complaints. the scores in the. cognitive assessment of subjects with SMC did not differ from the scores of subjects without SMC. However, patients with subjective memory complaints had lower scores in the fluency test - category animals and the Geriatric Depression Scale.Conclusions These results support the finding from other cross-sectional studies showing that subjective memory complaints are associated with depressive symptoms rather than objective cognitive performance. Copyright (C) 2007 John Wiley & Sons, Ltd.
- ItemSomente MetadadadosSuggested instruments for General Practitioners in countries with low schooling to screen for cognitive impairment in the elderly(Cambridge Univ Press, 2014-07-01) Jacinto, Alessandro Ferrari [UNIFESP]; Dozzi Brucki, Sonia Maria; Porto, Claudia Sellitto; Martins, Milton de Arruda; Citero, Vanessa de Albuquerque [UNIFESP]; Nitrini, Ricardo; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background: General Practitioners (GPs) from underdeveloped countries apply cognitive impairment (CI) assessment tools translated and adapted to cultural setting from other idioms, mainly English. As schooling in elderly from underdeveloped countries tends to be relatively heterogeneous, it is necessary to establish normative and cut-off scores for these CI instruments that are based on studies conducted locally. Some CI screening instruments frequently used by Brazilian specialists in dementia were analyzed to determine which could be most useful to GPs in their working sets.Method: Two hundred forty-eight patients aged 65 years or older that had been assisted by GPs in a tertiary hospital in Brazil were evaluated. Based on the MMSE and/or Short-IQCODE scores, 52 probable cases were identified on the basis of clinical data, performances on the neuropsychological tests and questionnaires (Functional Assessment Questionnaire/FAQ, Category Verbal Fluency/CVF, Clock Drawing Test /CDT) and blood tests and brain CT.Results: the combination of a functional questionnaire with a cognitive instrument had higher sensitivity and specificity than using the instruments alone. A FAQ cut-off of 3 in conjunction with a CDT cut-off of 6 proved optimal (93% sensitivity and 92.5% specificity). A higher specificity (93.5%) was attained using a combination of the FAQ (cut-off of 3) with the CVF (cut-off of 10).Conclusions: for low schooling elderly, the combination of the FAQ and CVF represented a very simple method of increasing the chances of correct screening. for those with higher schooling, the combination of the FAQ and CDT was more suitable.