Fábio H.G Porto

• MD, PhD.
• Cognitive and Behavioral Neurologist, MD, PhD. at University of São Paulo

A 62-year-old previously cognitively intact man presented to the emergency department with acute impairment of anterograde memory (ability to form new memories). 1 Head CT did not show acute changes; however, amnesia persisted. MRI disclosed an acute infarct in the left posterior hippocampus and a nonacute lacunar stroke in the right anterior thala...

We describe the case of a patient who developed an episode of catatonia during the course of her life-long obsessive-compulsive disorder (OCD) and discuss issues related to the etiopathogenesis, differential diagnosis, and therapeutic management of this association. Catatonia is conventionally considered a heterogeneous syndrome of motor dysregulat...

Background: Aerobic training (AT) is a promising intervention for mild cognitive impairment (MCI). Objective: To evaluate the effects of AT on cognition and regional brain glucose metabolism (rBGM) in MCI patients. Methods: Subjects performed a twice-a-week, moderate intensity, AT program for 24 weeks. Assessment with ADAS-cog, a comprehensive neur...

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 neuroplastici...

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 neu...

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 depr...

Background Parkinson’s disease is incurable, idiopathic, degenerative, and progressive, and affects about 1% of the elderly population. Multidisciplinary clinical treatment is the best and most adopted therapeutic option, while surgical treatment is used in less than 15% of those affected. In practice, there is a lack of reliable and validated scal...

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 neu...

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 t...

Covering the spectrum of cognitive decline in aging using illustrative cases, from mild impairment to dementia, this set of case studies offers a wide-ranging guide for trainees and clinicians. This second volume includes updated research diagnostic criteria and details of new imaging technology, including novel biomarkers such as PET amyloid and t...

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...

Objectives: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain. Methods: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic...

Introduction: Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low-middle income environments, leading to decreased cognitive resilience (RES) to Alzheimer´s disease (AD) pathology. However, in vivo findings in VLE groups confirming this prediction are lacking. Methods: Cognitively impa...

Background Previous research showed that mnemonic strategy training (MST) improves cognitive performance in people with MCI, and has been associated with increased brain activation consonant with the cognitive processes engaged by the training, such as, semantic memory, decision‐making, cognitive control, face processing and social cognition. Despi...

A thorough investigation is necessary for the diagnosis of Alzheimer’s disease (AD). An ideal treatment is composed of drug treatment and neuropsychological rehabilitation (NR). AD still has no cure, but its adequate treatment can delay the evolution of the disease and make the patient and family live with more quality. The purpose of this case rep...

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, analyt...

Abstract Introduction: Mnemonic strategy training (MST) has been shown to improve cognitive performance and increase brain activation in those with mild cognitive impairment (MCI). However, little is known regarding the effects of MST on functional connectivity (FC) at rest. The aim of the present study was to investigate the MST focused on face-na...

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),...

In the last paragraph of the subsession "Recruitment of the study population and clinical Evaluation" (Material and methods session).

Changes in hippocampal subfield volumes (HSV) along the Alzheimer's disease (AD) continuum have been scarcely investigated to date in elderly subjects classified based on the presence of β‐amyloid aggregation and signs of neurodegeneration. We classified patients (either sex) with mild dementia compatible with AD (n = 35) or amnestic mild cognitive...

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...

Background The purpose of this study was to determine whether whole-body MRI (WBMRI) with diffusion-weighted sequences, which is free of ionizing radiation, can perform as well as traditional methods when used alone for staging or follow-up of pediatric cancer patients. Methods After obtaining approval from our institutional research ethics commit...

Our objective was to find a mean flow velocity (MFV) cut-off point to differentiate between normal and cognitive impaired patients using Clinical Dementia Rating (CDR) as a comparison method. To evaluate MFV (in cm/s) and pulsatility index (PI) from the left middle cerebral artery (MCA) and basilar artery using transcranial Doppler in a pilot study...

Introduction: The Montreal Cognitive Assessment (MoCA) has been described as a good tool to detect cognitive impairment. The ideal MoCA cutoff score is still under debate. The aim was to provide MoCA norms and accuracy data for seniors with a lower education level, including illiterates. Methods: Data originated from an epidemiological study con...

Prior work has revealed that mnemonic strategy training (MST)can enhance memory for specific content and engages regions in the frontoparietal cognitive control network. Evidence of transfer to novel content is less clear. Here, we provide secondary analysis of functional magnetic resonance imaging (fMRI)data acquired during a randomized controlled...

Centros nacionais e internacionais de pesquisa em reabilitação neurológica vêm realizando e fundamentando estudos sobre os efeitos de programas fisioterapêuticos no nível de independência funcional e qualidade de vida de portadores de lesão medular. Relatamos o caso de um paciente de 63 anos, vítima de lesão traumática da medula espinhal em nível l...

Background: Mnemonic strategy training (MST) has been shown to improve cognitive performance in amnestic mild cognitive impairment (a-MCI), however, several questions remain unresolved. The goal of the present study was to replicate earlier pilot study findings using a randomized controlled design and to evaluate transfer effects and changes in bra...

Results of scores of the ADAS-Cog scale and neuropsychological battery of subjects with mild cognitive impairment before and after aerobic training program.

Regions with reduction and increased rBGM after aerobic training with age, sex, education, number of trained sessions and mini-mental state examination scores as covariates. The results were obtained at peak voxel level (global analysis, minimum of 50 voxels) (N = 65).

Ergospirometric test score results.

Aerobic training (AT) is a promising intervention to improve cognitive functioning.However, its modulatory effects on brain networks are not yet entirely understood.Sixty-five subjects with mild cognitive impairment performed a moderate intensity, 24- week AT program. Differences in resting regional brain glucose metabolism (rBGM) with FDG-PET were...

Background:Despite being a promising intervention for mild cognitive impairment (MCI), the effects of AT on brain glucose metabolism (rBGM) are not yet entirely understood. Objective: To evaluate the effects of aerobic training (AT) on cognition and regional brain glucose metabolism (rBGM) in mild cognitive impairment (MCI) with a resting-state net...

Background: Historically, mild cognitive impairment was considered the first clinical manifestation of Alzheimer’s disease. However, several epidemiological studies have shown that individuals with subjective decline experience a higher risk of progression to dementia due to Alz- heimer’s disease. In addition, there is evidence of a higher prevalen...

Background: Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination - Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lowe...

Objective: To evaluate the effects of aerobic training (AT) on cognition and regional brain glucose metabolism (rBGM) in mild cognitive impairment (MCI). Background: Despite being a promising intervention for MCI, the effects of AT on rBGM are not yet entirely understood. Methods: Subjects performed a twice-a-week moderate intensity AT program for...

Objective: Olfaction-related symptoms accompany migraine attacks and some, such as osmophobia, may be useful in differentiating migraine from other types of headaches. However, the types and frequencies of olfactory symptoms associated with migraine have not been well characterized. The goal of this study was to better characterize the olfactory s...

We read this paper with great interest. We considered of particular interest the results showing preservation of cortical thickness in specific regions that play a role as hubs of the salience and default mode networks in "superagers", in comparison with older adults with typical age-related expected decline in cognition. As physical activity is a...

Apresentação sobre os efeitos da atividade física aeróbia na cognição e em biomarcadores de doença de Alzheimer.

The atypical form of Pantothenate Kinase-Associated Neurodegeneration (PKAN) tends to present at around the age of 14 years, has a heterogeneous presentation with extrapyramidal symptoms, and approximately one third of patients exhibit psychiatric problems. This paper reports the case of a patient with apparent typical symptoms of Tourette syndrome...

Examination of a 57-year-old woman with a 3-year history of progressive right-sided weakness (first arm, then leg) and dysarthria disclosed right-sided weakness, spasticity, hyperreflexia, and Babinski sign. There were no signs of lower motor neuron disease or sensory involvement on clinical and electroneuromyographic examinations. MRI and [18F]FDG...

Discussion. • The rBGM changes may be influenced by APOE status. • rBGM increment in precuneus was more pronounced in carriers of the APOE Ɛ4 allele, while non-carriers, in inferior frontal gyrus. Metabolic decreases were independent of APOE status.

Objectives To access possible differences of the findings in [18F]FDG-PET and the NAA/mI ratio in the Posterior Cingulate Cortex (PCC) while evaluating subjects with AD, MCI and cognitively normal volunteers, and also to evaluate possible correlations between both methods in the PCC of these subjects. Methods Subjects with the clinical diagnosis o...

Background: Mutations in GRN (progranulin) and MAPT (microtubule-associated protein tau) are among the most frequent causes of monogenic frontotemporal dementia (FTD), but data on the frequency of these mutations in regions such as Latin America are still lacking. Objective: We aimed to investigate the frequencies of GRN and MAPT mutations in FT...

BACKGROUND AND OBJECTIVES: Neuropathic pain is defined as pain induced by injury or disease involving the somatosensory system. Dysfunctions in anatomic regions responsible for the processing of pain may involve peripheral and central nervous system components. A careful history and clinical evaluation with special attention to neurologic propaedeu...

Reduction of regional brain glucose metabolism (rBGM) measured by [18F]FDG-PET in the posterior cingulate cortex (PCC) has been associated with a higher conversion rate from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). Magnetic Resonance Spectroscopy (MRS) is a potential biomarker that has disclosed Naa/mI reductions within the PCC...

Background: The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in a community-dwelling elderly in Brazil. Methods: This was a single-phase epidemiological study with the elderly (aged 60 years and...

A 75-year-old man was evaluated for cogni-tive dysfunction noticed by his daughter during a telephone call. The patient had a past history of hypertension, dyslipidemia, depression , blindness in the right eye due to trauma, alcohol abuse and smoking. He lived alone and was totally independent. There was no previous cognitive dysfunction reported....

Background: The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in a community-dwelling elderly in Brazil. Methods: This was a single-phase epidemiological study with the elderly (aged 60 years and abo...

Introduction Mild cognitive impairment (MCI) is classically considered a transitional stage between normal aging and dementia. Non-amnestic MCI (naMCI) patients, however, typically demonstrate cognitive deficits other than memory decline. Furthermore, as a group, naMCI have a lower rate of an eventual dementia diagnosis as compared to amnestic subt...

Background: Dementia is one of the major health issues due to the rapidly growing elderly population, with an estimated prevalence of 8.5% in Latin American studies. The aim of this study was to ascertain the prevalence of cognitive impairment no dementia (CIND) and dementia in a community-dwelling elderly in Brazil. Methods: This was a single phas...

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 neuroplastici...

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 cognit...

Introduction: The increasing prevalence of cognitive impairment in older adults is a major concern nowadays. Interventions able to change the natural history of the most common cause of cognitive impairment in older adults, Alzheimer’s disease (AD), are needed. Physical inactivity is considered one of the most important modifiable risk factors for...

OBJECTIVE: To establish the correlation between the Visual Analogue Scale of Happiness and the Cornell Scale for Depression in Dementia in the population aged 60 years or over in the city of Tremembé, state of São Paulo, Brazil. METHODS: An epidemiological survey involving home visits was carried out in the city of Tremembé. The sample was randoml...

Fasciculations are visible, fine and fast, sometimes vermicular contractions of fine muscle fibers that occur spontaneously and intermittently. The aim of this article is to discuss the main causes for fasciculations and their pathophysiology in different sites of the central/peripheral injury and in particular to disprove that the presence of this...

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...

Objective To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the...

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...

Background: Amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) are believed to be a continuum of the same process, in which aMCI is a symptomatic pre-dementia stage. There is a growing need to early diagnosis and neuroimaging methods may help it. Nevertheless, there is a relative lack of studies which correlate findings in magne...

RESUMO Introdução. Cuidar é essencial. Da concepção à finitude faz-se necessário cuidar – sempre. O cuidar médico pode ser caracterizado como um mistura de arte e ciência, algo dinâmico, que busca continuamente a tomada de decisões que visam a restauração ou controle do corpo e da mente. Objetivo. Promover uma discussão provocativa à respeito da ar...

Introdução. Cuidar é essencial. Da concepção à finitude faz-se neces­sário cuidar – sempre. O cuidar médico pode ser caracterizado como um mistura de arte e ciência, algo dinâmico, que busca continuamente a tomada de decisões que visam a restauração ou controle do corpo e da mente. Objetivo. Promover uma discussão provocativa à respei­to da arte de...

The spectrum of paraneoplastic neurologic syndromes has increased with the description of encephalitis associated with antibodies against cell surface and synaptic proteins. Subacute cognitive impairment, movement disorders, late onset epilepsy and neuropsychiatric syndromes were recently linked to paraneoplastic encephalitis. Despite that, probabl...

Background: A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis – Syndrome, Moto...

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...

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 an...

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...

Background: A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis-Syndrome, Motor...

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 cognit...

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...