Pedro Renato de Paula Brandão

• MD PhD
• Neurologist at Hospital Sírio Libanes (Brasilia)

Cognitive dysfunction in Parkinson's disease (PD) has received increasing attention, and, together with other non-motor symptoms, exert a significant functional impact in the daily lives of patients. This article aims to compile and briefly summarize selected published data about clinical features, cognitive evaluation, biomarkers, and pathophysiol...

A 35‐year‐old previously healthy female presented with fever, cough, sneezing, rhinorrhea, diarrhea, myalgia, anosmia, and hypogeusia. She was diagnosed with mild coronavirus disease 2019 (COVID‐19) infection (positive quantitative reverse transcription polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 [SARS‐COV‐2]...

ABSTRACT Parkinson’s disease can be treated surgically in patients who present with motor complications such as fluctuations and dyskinesias, or medically-refractory disabling tremor. In this review, a group of specialists formulated suggestions for a preoperative evaluation protocol after reviewing the literature published up to October 2017. In t...

Transcranial sonography (TCS) is an emerging ancillary examination for diagnosing Parkinson’s disease (PD). Objective To evaluate TCS features in patients with PD and its mimics, and establish their accuracy in predicting the final clinical diagnosis after follow-up. Methods We retrospectively studied 85 patients with an initial clinical suspic...

Non-motor symptoms are common in Parkinson's disease (PD) and they include dysregulation of cardiovascular system, which adversely affects quality of life. Recent studies provide indirect evidence that baroreflex dysfunction may be one of the mechanisms of cardiovascular dysregulation in PD. Herein, we tested the hypothesis that the baroreflex gain...

Background: The Movement Disorder Society Non-Motor Rating Scale (MDS-NMS) serves as a comprehensive clinical assessment tool for non-motor symptoms in Parkinson’s disease (PD) Objectives: This study aims to validate the Portuguese version of the MDS-NMS, addressing the critical need for culturally adapted rating scales in Portuguese-speaking popul...

Here, we report the case of a 29-year-old male with classic Pelizaeus-Merzbacher disease (PMD) harboring the PLP1 variant NM_000533.5:c.62 C > T, leading to an NP_000524.3:p.(Ala21Val) alteration in the first transmembrane domain of the protein. He presented with developmental delays, nystagmus, spastic paraparesis, optic atrophy, dysphagia, append...

Background: The Montreal Cognitive Assessment (MoCA) is widely used to evaluate global cognitive function in older Brazilian adults. However, concerns persist regarding its applicability in non-homogeneous socio-demographic groups. This study scrutinizes the Brazilian version of the MoCA, focusing on its measurement properties in a diverse cohort o...

Background Parkinson’s disease (PD) is characterized by dopaminergic neuron degeneration, leading to motor and neuropsychological symptoms. PD is clinically divided into tremor-dominant (TD) and postural instability-gait disorder (PIGD) subtypes, which may differ in neuroanatomical changes. Neuroimaging explores these differences, enhancing underst...

Parkinson’s disease (PD) is a common neurodegenerative disease that is a growing public health challenge. Estimates of the burden of PD have focused on data from high-income countries, with lower-income countries poorly described. We reviewed and examined the prevalence of PD reported by studies in low- to upper-middle-income countries. A systemati...

Background: The Parkinson’s Disease-Cognitive Rating Scale (PD-CRS) is a widely used tool for detecting mild cognitive impairment (MCI) in Parkinson’s Disease (PD) patients, however, the neuroanatomical underpinnings of this test’s outcomes require clarification. This study aims to: (a) investigate cortical volume (CVol) and cortical thickness (CTh...

Although validated and reliable psychophysical tests of olfactory function are available, an easy-to-use and feasible test has yet to be developed. This study aimed to design a digital odour identification test, evaluate its validity, assess its reliability, establish a normative curve, and explore the impact of demographic factors. The odour ident...

Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson's disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain,...

The rise of artificial intelligence (AI) has catalyzed transformative changes across various domains, with neurology emerging as a particularly affected field. This essay delves into a comprehensive analysis of how AI's integration into medicine and neurology revolutionizing diagnostic and therapeutic practices is while simultaneously posing challe...

Multiple Sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS) characterized by damage to the myelin sheaths of oligodendrocytes. Currently, there is no specific biomarker to identify the disease; however, a diagnostic criterion has been established based on patient's clinical, laboratory, and imaging characteris...

This study evaluated clinical features of individuals with long COVID (5–8 months after diagnosis) who reported sleep and memory problems (62 cases) compared to those without (52 controls). Both groups had a similar mean age (41 vs. 39 years). Around 86% of the participants were non-hospitalized at the time of infection, and none of them were vacci...

This chapter offers a comprehensive review of Parkinson's disease (PD), spanning from epidemiology to advanced treatment options. It delves into the neuropathology and the evolution of etiological theories, elucidating the genetic mechanisms and clinical subtypes of PD. The text outlines criteria for clinical diagnosis, including essential markers...

Parkinson’s disease (PD) is a common neurodegenerative disease associated with cognitive impairment. The Montreal Cognitive Assessment (MoCA) has been used as a recommended global cognition scale for patients with PD, but there are some concerns about its application, partially due to the floor and ceiling effects. Objectives: To explore the floor...

We aimed to investigate changes in olfactory bulb volume and brain network in the white matter (WM) in patients with persistent olfactory disfunction (OD) following COVID-19. A cross-sectional study evaluated 38 participants with OD after mild COVID-19 and 24 controls, including Sniffin' Sticks identification test (SS-16), MoCA, and brain magnetic...

Although validated and reliable psychophysical tests of olfactory function are available, an easy-to-use and feasible test has yet to be developed. This study aimed to design a digital odour identification test, evaluate its validity, establish a normative curve, and explore the impact of demographic factors. The odour identification test was prese...

We aimed to investigate changes in olfactory bulb volume and brain network in the white matter (WM) in patients with persistent olfactory disfunction (OD) following COVID-19. A cross-sectional study evaluated 38 participants with OD after mild COVID-19 and 24 controls, including Sniffin' Sticks identification test (SS-16), MoCA, and brain magnetic...

Background: The Parkinson's Disease-Cognitive Rating Scale (PD-CRS) assesses posterior-cortical and frontal-subcortical cognitive functioning and distinguishes mild cognitive impairment in Parkinson's disease (PD-MCI); however, it was not evaluated in Brazil. Objectives: To investigate PD-CRS's reliability, validity, normative data, and accuracy...

A DP idiopática consiste na segunda doença neurodegenerativa mais frequente, diagnosticada em cerca de 1% dos indivíduos com idade superior a 60 anos.1 No Brasil, o único estudo populacional a esse respeito provém de Bambuí/MG, em que se estimou a prevalência da DP em 3% da população com idade superior a 64 anos.2 O diagnóstico da DP é fundamental...

Background Fatigue and cognitive complaints are the most frequent persistent symptoms in patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to assess fatigue and neuropsychological performance and investigate changes in the thickness and volume of gray matter (GM) and microstructural abnormalitie...

Background Fatigue and cognitive complaints are the most frequent persistent symptoms in patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to assess fatigue and neuropsychological performance and investigate changes in the thickness and volume of gray matter (GM) and microstructural abnormalitie...

Purpose: To establish cutaneous silent period (CSP) normative values and investigate the variables that may influence them. Methods: We tested 41 healthy subjects. All subjects underwent nerve conduction studies, and we evaluated the CSP in both arms. Results: Four subjects did not have CSP and were excluded. The analyses were performed in the...

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections lead to acute- and chronic Long COVID (LC) symptoms. However, few studies have addressed LC sequelae on brain functions. This study was aimed to examine if acute symptoms of coronavirus disease 2019 (COVID-19) would persist during LC, and if memory problems would be...

A Escala de Avaliação Cognitiva da Doença de Parkinson (PD-CRS) é um teste de triagem cognitiva global que abrange a maioria dos domínios cognitivos comprometidos na DP (Pagonabarraga et al., 2008; Fernández de Bobadilla et al., 2013). Os nove itens cobertos pela PD-CRS incluem a avaliação de ambos os domínios cognitivos "frontal-subcortical" e "co...

Cognitive decline is one of the most disabling manifestations of Parkinson's disease (PD). Despite advances in the description of its natural history, there are still difficulties in defining state biomarkers that are robustly correlated with clinical and cognitive manifestations. The study sought to describe the clinical, neuropsychological and ne...

Background: Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. Objective: In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinical t...

Background: Increasing numbers of mutations causing monogenic forms of Parkinson's disease (PD) have been described, mostly among patients in Europe and North America. Since genetic architecture varies between different populations, studying the specific genetic profile of Brazilian patients is essential for improving genetic counseling and for se...

Introduction: Movement disorders are increasingly described in hospitalized and milder cases of SARS-CoV-2 infection, despite a very low prevalence compared to the total patients. Methods: We reviewed the scientific literature published in English, spanning from the initial descriptions of COVID-19 until January 25, 2021, in the PubMed/MEDLINE data...

Background: Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. Objective: In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinica...

The flow of gene expression or “The central dogma of molecular biology”: DNA – RNA – protein, proposed by Watson & Crick sixty years ago, is a tightly controlled cell process. In the middle of this journey, the mRNA molecule is regulated by “RNA interference” (RNAi), a posttranscriptional gene silencing mechanism. A microRNA is an endogenous short...

O parkinsonismo é uma síndrome clínica caracterizada por bradicinesia, rigidez, tremor de repouso e instabilidade postural. Sua principal etiologia é a doença de Parkinson (DP) idiopática. Os estudos de autópsia demonstraram que a imprecisão diagnóstica é relativamente comum, especialmente em estágios iniciais. O capítulo propõe realizar uma revisã...

Background: Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phen...

Parkinson’s disease (PD) is a neurodegenerative disorder that is known for its motor dysfunction. Moreover, PD also causes non‐motor impairments, and approximately 40% of the patients experience coexistent abnormalities, like orthostatic hypotension (OH). The OH induces incapacitating symptoms that can contribute to an increased risk of falls, whic...

In November 2019 givosiran became the second small interfering RNA (siRNA)-based drug to receive US Food and Drug Administration (FDA) approval, it has been developed for the treatment of acute intermittent porphyria (AIP), a disorder characterized by life-threatening acute neurovisceral attacks. The porphyrias are a group of disorders in which enz...

In 2018, patisiran was the first-ever RNA interference (RNAi)-based drug approved by the US Food and Drug Administration. Now pharmacology textbooks may include a new drug class that results in the effect first described by Fire and Mello 2 decades ago: post-transcriptional gene silencing by a small-interfering RNA (siRNA). Patients with hereditary...

The following study protocol describes the rationale and methods of a cohort with a nested case-control study, which aims to identify risk factors and predictors of cognitive dysfunction in Parkinson's disease (PD). It is a study that will follow PD every 18 months with a comprehensive neuropsychological, clinical (motor and non-motor symptoms) and...

The following study protocol describes the rationale and methods of a cohort with a nested case-control study, which aims to identify risk factors and predictors of cognitive dysfunction in Parkinson's disease (PD). It is a study that will follow PD every 18 months with a comprehensive neuropsychological, clinical (motor and non-motor symptoms) and...

Discussion regarding indications of deep brain stimulation therapy in Parkinson's disease, which includes considerations regarding pre- and postoperative care

ABSTRACT Introduction: Several studies have shown that cerebral venous sinus stenosis may be a potential cause or aggravation for idiopathic intracranial hypertension (IIH). Endovascular therapy for angioplasty of brain sinus stenosis is emerging as a potential alternative to IIH treatment. Here, we present the results of our case series. Methods:...

INTRODUÇÃO No ano de 2017 se completam 200 anos da publicação da descrição original da "paralisia tremulante" por James Parkinson, em Londres. Ao reler as impressionantes observações agrupadas por Parkinson em 1817, vê-se que ele já reconhecia a nova doença como uma mistura de sintomas motores e não motores. Prontamente citava a ocorrência de dor,...

http://n.neurology.org/content/90/15_Supplement/P3.078

Abstract Objective: Describe the prevalence of specific motor and non-motor symptoms in a sample that includes patients with long-term disease duration and to highlight possible risk factors for motor complications and specific non-motor symptoms in a retrospective cohort of Parkinson's diseases patients.

Sir, We have read with great interest the article published by Gallea et al. (2013), in the November 2013 issue of Brain , regarding the pathophysiological basis of the rare disease named congenital mirror movements (Srour et al. , 2010; Depienne et al. , 2012), that might serve as a model to recognize new aspects of bimanual motor control (Gallea...

To know the opinion of Medical interns, University of Brasilia on the preparatory courses for medical residency. Application of a standardized questionnaire to students if the first year of internship. Sixty-seven of the 74 students (90.5%) of the first two semesters of internship participated. Among them, 57 (85.1%) are enrolled or intend to enrol...

Reduction of excitability of the dominant primary motor cortex (M1) improves ipsilateral hand function in healthy subjects. In analogy, inhibition of non-dominant M1 should also improve ipsilateral performance. In order to investigate this hypothesis, we have used slow repetitive transcranial magnetic stimulation (rTMS) and the Purdue Pegboard test...

To evaluate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the symptoms of a patient with primary segmental dystonia (PSD). 1200 TMS pulses at a frequency of 1Hz, over the premotor cortex, with an intensity of 90% of the motor threshold (MT), using an eight-shaped coil; a total of 5 sessions were carried out. A r...