Fabricio Ferreira de Oliveira

Universidade Federal de São Paulo | UNIFESP · Departamento de Neurologia e Neurocirurgia

Background: More than 95% of right-handed individuals, as well as almost 80% of left-handed individuals, have left hemisphere dominance for language. The perisylvian networks of the dominant hemisphere tend to be the most important language systems in human brains, usually connected by bidirectional fibres originated from the superior longitudinal...

Frontotemporal dementia (FTD) covers a spectrum of neurodegenerative disorders with different phenotypes, genetic backgrounds, and pathological states. Its clinicopathological diversity challenges the diagnostic process and the execution of clinical trials, calling for specific diagnostic biomarkers of pathologic FTD types. There is also a need for...

Aim To explore associations of cerebrospinal fluid biomarkers of neurodegeneration and amyloidosis with caregiver burden, cognition and functionality in dementia with Lewy bodies (DLB) paired with late-onset Alzheimer’s disease (AD) and healthy older people. Methods Consecutive outpatients with DLB were matched with outpatients with AD according t...

Objective: In Alzheimer's disease (AD), angiotensin II receptor blockers (ARBs) could reduce cerebrovascular dysfunction, while angiotensin-converting enzyme inhibitors (ACEis) might increase brain amyloid-β by suppressing effects of the angiotensin-converting enzyme 1, an amyloid-β-degrading enzyme. However, ACEis could benefit patients with AD b...

Background Neurological manifestations frequently occur in individuals with COVID-19, manifesting during the acute phase, persisting beyond the resolution of acute symptoms, and appearing days or weeks after the initial onset of COVID-19 symptoms. However, predicting the incidence, course, and outcome of these neurological manifestations at the ind...

Background: Harmonisation of evidence-based neuropsychological protocols among different countries represents a priority for the benefit of researchers, clinicians and most importantly patients. Currently, no consensus on a uniform operationalization of socio-cognitive measures for neurocognitive disorders (NCDs) in memory clinics exists. The inter...

Amyloid-PET studies of neurodegenerative diseases may yield inconclusive findings due to lacking stratification according to genetic or demographic variants. APOE ɛ4 alleles are the major variants to increase disease susceptibility and cause earlier onset and more behavioral features in patients with late-onset Alzheimer’s disease, but have no line...

Aims: At present, there is no consensus on a uniform operationalization of social cognition measures for the diagnosis of neurocognitive disorders (NCDs) in memory clinics. To overcome this limitation, the international consortium "clinical use of SocIal coGNnition measures for the AssessmenT of neURocognitivE disorders'' (SIGNATURE) has been estab...

The brain changes of Alzheimer’s disease and other degenerative dementias begin long before cognitive dysfunction develops, and in people with subtle cognitive complaints, clinicians often struggle to predict who will develop dementia. The public increasingly sees benefits to accessing dementia risk evidence (DRE) such as biomarkers, predictive alg...

Objective: Neuropsychiatric syndromes have been associated with memory dysfunction and risk of and earlier onset of dementia, but how psychotropic drugs affect clinical changes in Alzheimer’s disease is not entirely clear. This study aimed to assess the prospective effects of psychotropic drugs on cognitive and functional changes in Alzheimer’s dis...

Psychotic phenomena are among the most severe and disruptive symptoms of dementias and appear in 30% to 50% of patients. They are associated with a worse evolution and great suffering to patients and caregivers. Their current treatments obtain limited results and are not free of adverse effects, which are sometimes serious. It is therefore crucial...

Background: The study of vascular cognitive impairment and dementia (VCID) risk factors must be reproduced in every community so that disparities may be addressed. In South America, diverse levels of education, mixed ethnicity, genetic and cultural heterogeneity, and the burden of cerebrovascular risk are important features to be investigated for p...

Background: Pharmacogenetic effects of statins on clinical changes in Alzheimer's disease (AD) could be mediated by epistatic interactions among relevant genetic variants involved in cholesterol metabolism. Objective: To investigate associations of HMGCR (rs3846662), NR1H2 (rs2695121), or CETP (rs5882&rs708272) with cognitive and functional chan...

The field of vascular contributions to cognitive impairment and dementia (VCID) is evolving rapidly. Research in VCID encompasses topics aiming to understand, prevent, and treat the detrimental effects of vascular disease burden in the human brain. In this perspective piece, early career researchers (ECRs) in the field provide an overview of VCID,...

In Alzheimer’s disease, amyloid-β biomarkers become abnormal decades before cognition starts to decline and also before detectable biomarkers of neurodegeneration. Reduced levels of acetylcholine receptors and loss of cholinergic neurons are among the major neuropathological events, usually precipitated by the accumulation of extracellular amyloid-...

Introduction: Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. Methods: To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeho...

Background/purpose: Sleep disorders (SD) have a complex etiology and socioeconomic status (SES) as determined by income and education plays an important role in their development. SES also influences allostatic load caused by chronic accumulation of stress throughout life. Environmental and psychological stressors have a direct effect on SD, and th...

Introduction: The inherited risk of late-onset Alzheimer’s disease (AD) is genetically determined. We aimed to examine associations of genetic variants of APOE and ACE with age at AD onset and with neuropsychiatric symptoms according to each dementia stage. Methods: Consecutive outpatients with AD were assessed for demographic features, Clinical De...

Background: Behavioral features may reflect proteinopathies predicting pathophysiology in neurodegenerative diseases. Objective: We aimed to investigate associations of cerebrospinal fluid biomarkers of amyloidogenesis and neurodegeneration with neuropsychiatric features in dementia with Lewy bodies (DLB) compared with late-onset Alzheimer's dis...

Objective: To study associations of cerebrospinal fluid biomarkers with cognition and functionality in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD) and cognitively healthy people. Background: Amyloidosis and neurodegeneration may correlate with cognition and functionality, reflecting degrees of neuropathology in dementia...

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...

Background: Swallowing and feeding problems may occur with the progression of behavioral variant frontotemporal dementia (bvFTD) and can impair the anticipatory and oral preparatory phases of swallowing. Objective: To characterize swallowing problems and the feeding situation of patients with bvFTD and to correlate the swallowing problems with fun...

The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we unders...

Effects of statins over clinical changes in Alzheimer’s disease (AD) are usually non-significant, but epistatic interactions between genetic variants involved in cholesterol metabolism could be important for such effects. We aimed to investigate whether LDLR single-nucleotide polymorphisms rs11669576 (LDLR8), rs5930 (LDLR10), and rs5925 (LDLR13) ar...

To identify knowledge gaps regarding new‐onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre‐dementia risk synd...

Background Klüver‐Bucy syndrome (KBS) comprises: 1) hyperorality, 2) hypermetamorphosis, 3) hypersexuality, 4) eating disorder, 5) placidity, 6) visual agnosia (psychic blindness) and 7) amnesia (at least three components are described as partial KBS). The classic description involves bilateral injuries to the anterior temporal lobes, but it has be...

Background Anatomical studies in animals have described multiple striatal circuits and suggested that sub‐components of the striatum project to distinct cortical areas. Researchers that reconstructed tracts of the left and right putamen have shown ipsilateral projections to the primary motor area, primary somatosensory area, supplementary motor are...

Objective Differential diagnosis between Parkinson’s disease (PD) dementia and dementia with Lewy bodies (DLB) is difficult due to common features, whereas management decisions and research endpoints depend upon knowledge of dementia severity. We aimed to assess risk factors for age at dementia onset, as well as which neuropsychiatric features are...

Background Lewy body dementia (LBD) impairs performance in daily activities and affects motor, language and visuospatial tasks. Objective We aimed to correlate neuropsychiatric and motor assessments with language and visual organization tests in LBD. Methods Twenty-two patients with dementia with Lewy bodies and ten patients with Parkinson’s dise...

Background: Neurofibrillary tangles are usually ubiquitinated, whereas Lewy bodies might decrease cerebrospinal fluid concentrations of ubiquitin; thus, tau isoforms and ubiquitin in the cerebrospinal fluid might correlate with behavioral dysfunction in dementia syndromes. Methods: Consecutive outpatients with probable dementia with Lewy bodies (D...

Background & objectives: Neurodegeneration affects blood pressure variations, while renal function and cerebral perfusion are impaired by vascular risk factors. This study was aimed to estimate variations of measures of cardiovascular risk in Alzheimer's dementia by pharmacogenetic analyses of the effects of angiotensin-converting enzyme (ACE) inhi...

Background: Pharmacologically treatable behavioral features may reflect underlying amyloidogenesis and neurodegeneration in dementia syndromes. Methods: Consecutive outpatients with probable dementia with Lewy bodies (DLB) were paired with outpatients with late-onset Alzheimer’s dementia (AD) by sex, Clinical Dementia Rating (CDR) and Mini-Mental...

Background: Given some of the current limitations in implementing gait assessment for mild cognitive impairment (MCI), we aimed to investigate how much Montreal Cognitive Assessment (MoCA) score was correlated with step height (SH) changes during a repetitive stepping-in-place (SIP) task in patients with MCI. Methods: Whilst Montreal Cognitive Ass...

Background: Earlier evidence showed that Memantine antagonizes the N-methyl-D-aspartate (NMDA) type of glutamate receptor leading to possible behavioral improvement and a synergistic effect with cholinesterase inhibitors over slower functional and cognitive decline in Alzheimer’s dementia (AD). Variations in some receptor genes can contribute to AD...

Background: Amyloidogenesis may cause earlier onset of dementia with Lewy bodies (DLB) as well as Alzheimer’s dementia (AD), whereas the angiotensin-converting enzyme (ACE-1) is an amyloid-β-degrading enzyme. Methods: Consecutive outpatients with probable DLB (fourth consensus report of the DLB Consortium) were paired with outpatients with late-on...

Background: Primary Progressive Aphasia (PPA) is characterized by a progressive loss of specific language functions with relative sparing of other cognitive domains. Among the three recognized variants of PPA, we would like to share an interesting case that resembles an animated episode of Dungeons and Dragons written by Steve Gerber and released i...

Influence of socioeconomic status-stress induced on sleep quality: a systematic review. Preprints 2018 SUMMARY Sleep disorders (SD) have a complex aetiology, and socioeconomic status (SES) as determined by social class, household income, ethnicity and education plays an important role in their development. As SD are associated with cognitive impair...

Objective: To assess whether angiotensin-converting enzyme (ACE) inhibitors modulate associations of biofluid concentrations and activity of ACE with motor and non-motor experiences in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD) and cognitively healthy people. Background: Amyloidogenesis is pathogenically important in D...

Objective: To study associations of cerebrospinal fluid (CSF) amino acids and monoamine metabolites with motor and non-motor features in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD) and healthy controls. Background: Motor and non-motor aspects of daily experiences may reflect amino acid and monoamine metabolism in dement...

Objective: To study associations of cerebrospinal fluid biomarkers of amyloidogenesis and neurodegeneration with motor and non-motor aspects of daily experiences in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD) and cognitively healthy people. Background: Motor and non-motor aspects of daily experiences may reflect amyloid...

Lifetime risk factors for cognitive and functional decline in Alzheimer’s disease (AD) are not fully understood, and were prospectively evaluated in patients with low mean schooling from São Paulo, Brazil. Consecutive outpatients with late-onset AD were assessed for APOE haplotypes and the following potential baseline predictors: gender, schooling,...

Background: Illiteracy, midlife cerebrovascular risk and copies of APOE-e4 are risk factors for Alzheimer's dementia (AD). This study aimed to explore the impacts of risk factors for progression of AD in São Paulo, Brazil. Methods: Outpatients with late-onset AD were assessed for APOE haplotypes (rs7412&rs429358 genotyped by TaqMan® Real-Time PCR t...

Background: Neuropsychiatric syndromes have been associated with risk and earlier onset of dementia, but it is unclear whether neuropsychiatric treatment may affect clinical changes in Alzheimer's disease dementia (AD). This study aimed to investigate whether psychotropics may affect cognitive or functional changes in AD. Methods: Consecutive outpa...

Background: Brain monoamine activity and aminoacid concentrations may correlate with cognition, reflecting their metabolism in dementia. Methods: Consecutive outpatients with probable dementia with Lewy bodies (DLB, fourth consensus report of the DLB Consortium) were paired with outpatients with late-onset Alzheimer's dementia (AD, NIA-AA workgroup...

Background: The angiotensin-converting enzyme is an amyloid-ß-degrading enzyme; therefore, angiotensin-converting enzyme inhibitors (ACEis) may increase amyloid-ß concentrations. Contrariwise, ACEis may improve cognitive function by affecting the angiotensin-II-mediated inhibition of acetylcholine release, and also by increasing brain substance P (...

Background: Illiteracy, high cerebrovascular risk and copies of APOE-ϵ4 are risk factors for Alzheimer's disease dementia (AD). We aimed to investigate the impacts of gender, education, coronary heart disease (CHD) risk and creatinine clearance variations, body mass index (BMI) and APOE haplotypes over the rates of cognitive and functional decline...

Objective: To study associations of cerebrospinal fluid aminoacids and monoamine metabolites with behavior in dementia with Lewy bodies (DLB) compared with Alzheimer’s dementia (AD) and cognitively healthy people. Background: Brain monoamine activity and aminoacid concentrations may correlate with behavioral features, reflecting their metabolism i...

Background: While the angiotensin-converting enzyme degrades amyloid-β, angiotensin-converting enzyme inhibitors (ACEis) may slow cognitive decline by way of cholinergic effects, by increasing brain substance P and boosting the activity of neprilysin, and by modulating glucose homeostasis and augmenting the secretion of adipokines to enhance insul...

Background and aims: The angiotensin-converting enzyme is an amyloid-β-degrading enzyme. Angiotensin receptor blockers have been implicated in the modulation of glucose homeostasis and in the boosted secretion of adipocytokines, thus improving insulin sensitivity and potentially slowing cognitive decline in patients with dementia due to Alzheimer’s...

Background and aims: Associations of the insertion allele of an Alu repeat insertion/deletion (I/D) polymorphism in intron 16 of ACE with dementia due to Alzheimer’s disease (AD) are not consistent in all studies. We sought to examine associations of APOE haplotypes and the ACE I/D polymorphism with neuropsychiatric symptoms according to each stage...

Background and aims: Lewy body dementia syndromes present motor impairment and neuropsychiatric symptoms among their main manifestations. It is unclear how motor experiences are associated with behaviour in these patients. Methods: Participants with Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB) were screened with the Movemen...

Background: When in combination with other cerebrovascular risk factors, midlife hypercholesterolemia is usually associated with earlier onset of Alzheimer’s disease dementia, particularly regarding higher levels of LDL-cholesterol inducing cortical amyloid-β deposition. Contrariwise, late life hypercholesterolemia might slow cognitive decline, pos...

Hypercholesterolemia and statin use have been unevenly associated with clinical change in Alzheimer's disease dementia. In this longitudinal study, 192 consecutive outpatients with late-onset Alzheimer's disease dementia were stratified according to APOE haplotypes, and followed for one year to investigate associations of lipid profile variations a...

Objective:: To study associations of cerebrovascular metabolism genotypes and haplotypes with age at Alzheimer's disease dementia (AD) onset and with neuropsychiatric symptoms according to each dementia stage. Methods:: Consecutive outpatients with late-onset AD were assessed for age at dementia onset and Neuropsychiatric Inventory scores accord...

Transtornos do sono são frequentes em pacientes com demências por corpos de Lewy, em particular o distúrbio comportamental do sono REM (RBD), com valor prognóstico nas sinucleinopatias. OBJETIVO: Analisar padrões qualitativos e quantitativos do sono nas demências por corpos de Lewy. MÉTODO: Pacientes consecutivos com demência com corpos de Lewy (DC...

Little is known on how risk factors for Alzheimer disease (AD) dementia affect disease progression, much less for populations with low mean schooling, whereas the transcription of APOE may be regulated by nongenetic factors. In this 44-month cohort study, 214 consecutive outpatients with late-onset AD were assessed for rates of cognitive and functi...

Background: Midlife hypertension followed by late life hypotension resulting from neurodegeneration increases amyloidogenesis and tauopathy. Methods: Consecutive outpatients with late-onset Alzheimer's disease (AD) at various stages and their respective caregivers were assessed for score variations in 1 year of tests assessing caregiver burden,...

Background: Lewy body dementia syndromes present motor impairment and neuropsychiatric symptoms among their main manifestations. It is unclear how motor signs are associated with behavioural and functional status in these patients. Methods:Participants with Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB) were screened with the...

Background: Low schooling, high cerebrovascular risk and APOE4+ haplotypes are risk factors for Alzheimer’s disease dementia (AD). We aimed to investigate the impacts of gender, education, coronary heart disease (CHD) risk and creatinine clearance variations, body mass index (BMI) and APOE haplotypes over the rates of cognitive and functional decli...

Background: Earlier evidence showed that Memantine antagonises the N-methyl-D-aspartate (NMDA) type of glutamate receptor leading to possible behavioural improvement and a synergistic effect with cholinesterase inhibitors over slower cognitive and functional decline in Alzheimer’s disease dementia (AD). Variations in some receptor genes can contrib...

Antecedentes: El deterioro de la función renal depende de la edad y los factores vasculares. La literatura sobre los efectos de fármacos antihipertensivos mediada genéticamente en la función renal es pobre. Objetivo: Estimar las variaciones de urea y creatinina a través del análisis farmacogenético de los efectos antihipertensivos de los inhibidore...

Background: Renal function declines according to age and vascular risk factors, whereas few data are available regarding genetically-mediated effects of anti-hypertensives over renal function. Objective: To estimate urea and creatinine variations in dementia due to Alzheimer disease (AD) by way of a pharmacogenetic analysis of the anti-hypertens...

Objectives: To assess correlations among gait apraxia, balance impairment and cognitive performance in mild (AD1, n = 30) and moderate (AD2, n = 30) AD. Method: The following evaluations were undertaken: gait apraxia (Assessment Walking Skills); balance performance (Berg Balance Scale); Clinical Dementia Rating and Mini-mental State Examination...

Background: Few studies have described characteristics of swallowing in primary progressive aphasia (PPA) and its variants. Objective: To describe and characterize swallowing and eating behaviors of patients with PPA, as well as their correlates with neuropsychiatric symptoms and patterns of communication. Methods: We studied 16 patients with...

Background: Genotypes of LDLR and CETP have been associated with risk of Alzheimer’s disease dementia (AD). Regardless of APOE haplotypes, it is unknown whether these genes may modify the age at onset of AD. Objectives: To investigate the effects of APOE haplotypes and polymorphisms of LDLR and CETP over the age at onset of AD. Methods: Participant...

Midlife cerebrovascular risk, low cognitive reserve and APOE4+ haplotypes are risk factors for Alzheimer's disease dementia (AD). We prospectively searched for factors that might be associated with yearly changes in caregiver burden, cognition, basic and instrumental functionality in 193 consecutive outpatients with late-onset AD, namely gender, AP...

Introduction: Neuropsychiatric and epidemiological patterns may compensate for insufficient specificity of diagnostic criteria of Lewy body dementia (LBD) syndromes in differential analysis with Alzheimer disease (AD) dementia. We aimed to compare and distinguish demographic and neuropsychiatric features between LBD and APOE-ε3/ε3 late-onset AD. Me...

Primarily, we sought to verify correlations among assessments for cognition, behaviour and functional independence in a sample of patients with dementia due to Alzheimer's disease (AD). Secondarily, impacts of education, APOE haplotypes, length of dementia, age and alcohol use over the neuropsychiatric assessment were estimated. Patients with AD we...

IntroductionThere are three recognized subtypes of primary progressive aphasia syndromes [1]: the logopenic variant, the agrammatic (or non-fluent) variant, and semantic dementia. The logopenic variant of primary progressive aphasia, with hesitant anomic speech, word retrieval and sentence repetition deficits, features left posterior perisylvian or...

The aims of this study were to investigate risk factors for cognitive and functional decline among 193 patients with Alzheimer's disease dementia (AD), and to conduct pharmacogenetic analysis on cerebrovascular metabolism modulators, taking into account APOE haplotypes and the genotypes of ACE, CETP, LDLR and the LXR-β gene. For all patients, later...

Aims: Due to insufficient specificity of current diagnostic criteria for Lewy body dementia (LBD) syndromes, we sought to compare clinical and epidemiological features between LBD and dementia due to Alzheimer's disease (AD). Methods: According to gender and Mini-Mental State Examination scores, 39 consecutive patients with diagnoses of dementia wi...

Sleep length and architecture are potential markers of progressive cognitive impairment, while neuropsychiatric symptoms and APOE4− haplotypes have been associated with more sleep complaints in patients with dementia due to Alzheimer’s disease (AD). In this cross-sectional study, we sought to investigate which factors might be related to sleep sati...

Objective: Besides significant cognitive decline, patients in later stages of Alzheimer's disease (AD) also present global functional impairment, usually reported by their caregivers. This study searched for preserved activities of daily living by investigating correlations among specific instruments for severe dementia with a performance-based fu...