Paula T Fernandes

University of Campinas, Conceição de Campinas, São Paulo, Brazil

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Publications (93)126.19 Total impact

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    ABSTRACT: Background: Tumor necrosis factor alpha (TNF-aα) is deeply related to pathogenesis of neurodevelopmental disorders, especially depression. The aim of this study was to explore potential relationships between sera TNF-aα levels and mood and anxiety disorders in systemic lupus erythematosus (SLE) patients. Methods: We included 153 consecutive SLE patients (women 148; median age 30; range 10-62) and 40 (women 37; mean age 28.5; range 12-59) age- and sex-matched healthy controls. Mood and anxiety disorders were determined through Beck Depression and Beck Anxiety Inventory. SLE patients were further assessed for clinical and laboratory SLE manifestations. TNF-aα levels were measured by enzyme-linked immunosorbent assay using commercial kits. Results: Depressive symptoms were identified in 70 (45.7 %) SLE patients and in 10 (25 %) healthy controls (p < 0.001). Anxiety symptoms were identified in 93 (60.7 %) SLE patients and in 16 controls (40 %) (p < 0.001). Sera TNF-aα levels were increased in SLE patients with depressive symptoms (p < 0.001) and with anxiety symptoms (p = 0.014). A direct correlation between the severity of depressive symptoms and sera TNF-aα levels (r = 0.22; p = 0.003) was observed. TNF-aα levels were significantly increased in patients with active disease (p = 0.012). In addition, we observed a correlation between sera TNF-aα levels and disease activity (r = 0.28; p = 0.008). In the multivariate analysis, sera TNF-aα levels were independently associated with depressive symptoms (t = 3.28; 95 % CI 1.08-2.2; p = 0.002). Conclusions: Sera TNF-aα levels are increased in SLE patients with mood and anxiety disorders. In SLE, sera TNF-aα levels are independently associated with mood disorders. The etiology of mood disorders is still debated in SLE, but our findings suggest the presence of immunological basis for depression in SLE.
    Preview · Article · Dec 2016 · Journal of Neuroinflammation
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    ABSTRACT: Objective. The aim of this study was to verify the effects of CH ingestion in the brain activation during different intensities of Motor Imagery (MI). Method. Nine subjects (eight men, 28±4.6 years) participated in this study and were submitted to a functional magnetic resonance paradigm based in MI block (running, with perceived exertion set as “light” and “intense”) interleaved with rest. Two acquisitions were made, and the solution (CH and placebo) was ingested between them. The image preprocessing and the statistical analysis were performed with SPM8 software (p<0.001 uncorrected) to compared changes in the pattern of brain activity as the intensity and the ingestion of substances. Results. At the light intensity, both substances similarly activated areas in the posterior and anterior cingulated cortex, temporal and fusiform. For high intensity, both substances activated the frontal, caudate and parahippocampal gyrus, thalamus, insula and posterior cingulated cortex. Conclusions. At the light intensity, the CH promoted similarly brain activation when compared to placebo, however, at the intense intensity, other areas involved in emotion and homeostatic regulation were identified. © 2015, Universidade Federal de Sao Paulo. All rights reserved.
    Full-text · Article · Sep 2015 · Revista Neurociências
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    ABSTRACT: Background Mood and anxiety disorders are frequently observed in systemic lupus erythematosus (SLE) patients, and there are, probably due to physical disability and stress of living with chronic disease. However, these symptoms have not been evaluatedover time in childhood-onset SLE (cSLE) so far. Objectives To investigated mood and anxiety disorders pattern over time in cSLE. To explore potential relationships between mood and anxiety and clinical/laboratorial manifestations and treatment. Methods Consecutive cSLE patients recruited from the Pediatric Rheumatology Outpatient Clinic of State University of Campinas were included in this study. We followed up 51 cSLEpatients for two years (baseline (T0), 6 (T1), 12 (T2) and 18 months (T3). Three patients in use of antidepressants were excluded.Clinical visits were scheduled semiannuallywithinterval visits scheduled when necessary due to diseaseactivity or complications. Mood and anxiety disorderswere determined through Becks Depression and Becks Anxiety Inventory in all participants. For patients under sixteen years old, Children's Depression Inventory (CDI) was applied.These scales consist of 21 items, each describing a common symptom of depression/anxiety. The respondent is asked to rate how much he or she has been bothered by each symptom over the past month on a 4-point scale ranging from 0 to 3. The items are summed to obtain a total score that can range from 0 to 63. The cutoffs used for the BDI are: 0–13: no/minimal depression; 14–19: mild depression; 20–28: moderate depression; and 29–63: severe depression and for the BAI: 0-7: no/minimal level of anxiety; 8-15: mild anxiety; 16-25: moderate anxiety; 26-63: severe anxiety. The cutoff used for CDI is 17. SLE patients were further assessed for clinical and laboratory SLE manifestations, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. We used Mann-Whitney Test to compare the scores of BAI and BDI between the groups and to longitudinal analyses, we used Friedman Test. Results We included 51cSLE patients (46 girls) with mean age of mean age of 16.15 [Standard deviation (SD) ±3.03 years; range 10-23]. Disease duration was 3.66 (SD ±3.0; range 1-12 years).We observed a significant variation in anxiety scores (p=0.04) and depression scores (p=0.02) over time. Cumulative damage was associated with a worsening of anxiety (p=0.01). No association between mood and anxiety disorders and disease activity (p>0.05) and corticosteroid dose (p>0.05) was observed. In addition, no difference in mood disorders in patients with and without immunosuppressant medication was observed. Conclusions Mood and anxiety disorders have a significant variation over time in cSLEpatients. Cumulative damage is associated with worsening of anxiety incSLE patients. Acknowledgements Grants: Research Support Foundation of São Paulo –FAPESP (Simone 2008/02917-0, Mariana 2011/03788-2, Aline 2013/09480-5, Nailú 2010/13637-9) CNPQ (300447/2009-4 and 471343/2011-0; 302205/2012-8; 473328/2013-5) Disclosure of Interest None declared
    No preview · Article · Jun 2015 · Annals of the Rheumatic Diseases
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    ABSTRACT: Objectives To determine hippocampal and amigdala abnormalities in systemic sclerosis (SSc) and to determine the possible relationship with clinical, laboratory and treatment features of the disease. Methods A total of 41 SSc patients and sixty-six health age and sex matched volunteers. A complete clinical, laboratory and neurological evaluation was performed in all subjects. Cognitive evaluation was performed in all participants using the Montreal Cognitive Assessment (MoCA). Mood disorders were determined through Beck's Depression and Beck's Anxiety Inventories. SSc patients were further assessed for disease activity (Valentini Activity Index), severity activity (Medsger Severity Index) and current drug exposure. MRI scans were performed in a 3T Phillips® scanner. Coronal T1 weighted were used for manual volumetric measurements. Results We included 27 (65.9%) limited SSc (lSSc) and 14 (34.1%) diffuse SSc (dSSc) with mean disease duration of 10.4 (SD 6.9) years. Active disease was identified in 12 (29.3%) SSc patients. Abnormal neurological examination was observed in 27 (65.8%) and cognitive impairment in 36 (87.8%) SSc patients. Mood disorders were identified in 25 (60.9%) SSc patients. In dSSc, hippocampal (mean volume =2.95 cm3;; SD=0.13) and amigdala (mean volume =1.81 cm3;; SD=0.09) were significantly smaller when compared to hippocampal (mean volume =3.19 cm3;; SD=0.08; p=0.03) and amigdala (mean volume =2.12 cm3;; SD=0.09 p=0.02) volumes of lSSc and to hippocampal (mean volume =3.26 cm3;; SD=0.09; p=0.03) and amigdala (mean volume =2.15 cm3;; SD=0.10; p=0.02) volumes of healthy volunteers. No difference between hippocampal (p=0.08) and amigdala (p=0.12) volumes of lSSC and healthy controls were observed. Depression correlated with left hippocampal volume in dSSc (r=-0.51, p=0.003). No correlation between depression and amigdala volumes was observed. Anxiety correlated with hippocampal volume in dSSc (r=-0.38; p=0.03) and with amigdala volume in both dSSc (r=-0.29, p=0.04) and lSSc (r=-0.28, p=0.04).MoCA scores correlated with hippocampal volume in dSSc (r=0.44; p=0.03) and lSSc (r=0.32; p=0.04) and with amigdala volume in dSSc (r=0.36; p=0.04) and lSSc (r=0.35; p=0.03). No correlation was found between disease activity and hippocampal volume (r=-0.06; p=0.16) or amigdala volume (r=-0.09; p=0.19). No association was found between organic impairment and hippocampal volume (r=-0.05; p=0.11) or amigdala volume (r=-0.04; p=0.12). Conclusions This is the first study to analyze hippocampal and amigdala volume in SSc. We observed significant reduced hippocampal and amigdala volumes in dSSc when compared to lSSc and healthy volunteers. Hippocampal and amigdala volumes correlated with cognitive impairment and mood disorders in SSc. Disclosure of Interest None declared
    No preview · Article · Jun 2015 · Annals of the Rheumatic Diseases
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    ABSTRACT: To determine the serum interleukin-17 (IL-17) levels in childhood-onset systemic lupus erythematosus patients and to evaluate the association between IL-17 and clinical manifestations, disease activity, laboratory findings and treatment. We included 67 consecutive childhood-onset systemic lupus erythematosus patients [61 women; median age 18 years (range 11-31)], 55 first-degree relatives [50 women; median age 40 years (range 29-52)] and 47 age- and sex-matched healthy controls [42 women; median age 19 years (range 6-30)]. The childhood-onset systemic lupus erythematosus patients were assessed for clinical and laboratory systemic lupus erythematosus manifestations, disease activity [Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)], cumulative damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index] and current drug use. Serum IL-17 levels were measured by an enzyme-linked immunosorbent assay using commercial kits. The median serum IL-17 level was 36.3 (range 17.36-105.92) pg/mL in childhood-onset systemic lupus erythematosus patients and 29.47 (15.16-62.17) pg/mL in healthy controls (p=0.009). We observed an association between serum IL-17 levels and active nephritis (p=0.01) and migraines (p=0.03). Serum IL-17 levels were not associated with disease activity (p=0.32), cumulative damage (p=0.34), or medication use (p=0.63). IL-17 is increased in childhood-onset systemic lupus erythematosus and may play a role in the pathogenesis of neuropsychiatric and renal manifestations. Longitudinal studies are necessary to determine the role of IL-17 in childhood-onset systemic lupus erythematosus.
    Full-text · Article · May 2015 · Clinics (São Paulo, Brazil)
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    ABSTRACT: Chronic pain is commonly associated with disability and poor quality of life (QOL). This condition has a significant impact on the physical, psychological, and social well-being of older adults. However, the studies carried out in Brazil are insufficient to represent the multicultural characteristics of the country. It is believed that cultural/environmental differences may influence health management quality, with implications for older adults' health and QOL. Therefore, the aim of this study was to assess the factors related to bodily pain in older female participants in a recreational program in Brazil.
    Full-text · Article · Apr 2015 · Journal of Clinical Gerontology and Geriatrics
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    ABSTRACT: Objective: This study intended to compare the circadian rhythm and circadian profile between patients with juvenile myoclonic epilepsy (JME) and patients with temporal lobe epilepsy (TLE). Method: We enrolled 16 patients with JME and 37 patients with TLE from the Outpatient Clinic of UNICAMP. We applied a questionnaire about sleep-wake cycle and circadian profile. Results: Fourteen (87%) out of 16 patients with JME, and 22 out of 37 (59%) patients with TLE reported that they would sleep after seizure (p < 0.05). Three (19%) patients with JME, and 17 (46%) reported to be in better state before 10:00 AM (p < 0.05). Conclusion: There is no clear distinct profile and circadian pattern in patients with JME in comparison to TLE patients. However, our data suggest that most JME patients do not feel in better shape early in the day.
    Preview · Article · Jan 2015 · Arquivos de Neuro-Psiquiatria
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    ABSTRACT: Unlabelled: The two-arm Clinical Decisions/Diagnostic Workshop (CD/DW) approach to undergraduate medical education has been successfully used in Brazil. Objective: Present the CD/DW approach to the teaching of stroke, with the results of its pre-experimental application and of a comparative study with the traditional lecture-case discussion approach. Method: Application of two questionnaires (opinion and Knowledge-Attitudes-Perceptions-KAP) to investigate the non-inferiority of the CD/DW approach. Results: The method was well accepted by teachers and students alike, the main drawback being the necessarily long time for its completion by the students, a feature that may better cater for different educational needs. The comparative test showed the CD/DW approach to lead to slightly higher cognitive acquisition as opposed to the traditional method, clearly showing its non-inferiority status. Conclusion: The CD/DW approach seems to be another option for teaching neurology in undergraduate medical education, with the bonus of respecting each learner`s time.
    Preview · Article · Oct 2014 · Arquivos de Neuro-Psiquiatria
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    Preview · Article · Sep 2014 · Pediatric Rheumatology
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    Preview · Article · Sep 2014 · Pediatric Rheumatology
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    ABSTRACT: Objectives To investigate the prevalence of the anti-ribosomal P (anti-P) antibodies in childhood-onset systemic lupus erythematosus patients (cSLE) and to elucidate the association between anti-P and disease activity, laboratory and treatment features in cSLE patients Methods We included consecutive SLE patients with disease onset before the age of 16 (cSLE), first-degree relatives and age and healthy age and sex matched controls. cSLE patients were assessed for disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. Mood disorders were determined through Becks Depression and Becks Anxiety Inventory (BDI and BAI). Anti-P was measured by enzyme-linked immunosorbent assay using commercial kits. Clinical/laboratorial manifestations, disease activity, cumulative damage and drugs undertaken were assessed at time of blood withdrawal Results We included 50 cSLE patients (mean age 16.82±3.46), 35 first-degree relatives (mean age 38.73±3.89) and 20 health controls (mean age 18.3±4.97). Anti-P was present in 13 (26%) cSLE patients. No first-degree relatives or controls presented anti-P (p<0.01). The presence of anti-P was associated with anxiety on cSLE (p<0,002). No other clinical/laboratorial manifestations or treatment were associated with anti-P in cSLE. Conclusions Anti-P is frequently observed in cSLE patients and was associated with anxiety in this cohort. Grants FAPESP: 2008/02917-0; 2009/13046-3 Disclosure of Interest H. Aldar Grant/Research support from: FAPESP 2009/13046-3, A. Lapa Grant/Research support from: FAPESP 2010/13639-1, B. Belini Grant/Research support from: FAPESP 2009/12343-4, N. Sinicato Grant/Research support from: FAPESP 2010/13637-9, M. Postal Grant/Research support from: FAPESP 2009/10744-1, P. Fernandes: None Declared, L. Costallat: None Declared, R. Marini: None Declared, S. Appenzeller Grant/Research support from: FAPESP 2008/02917-0; Conselho Nacional Pesquisa Desenvolvimento-Brasil CNPq (300447/2009-4)
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Objectives To determine clinical and laboratorial manifestations associated with S100β protein in childhood-onset systemic lupus erythematosus (cSLE) patients Methods We included consecutive cSLE patients with disease onset before the age of 16 and healthy controls and age and healthy age and sex matched controls. All subjects underwent a standardized neuropsychological evaluation assessing the following: simple attention, complex attention, memory, visuospatial processing, language, reasoning/problem solving, psychomotor speed, and executive functions. Individual results were converted into standard scores and compared to normative data. Subjects with a total score in any of the 8 domains ≤-2 SD below the normative value were considered impaired. Mood disorders were determined through Becks Depression and Becks Anxiety Inventory (BDI and BAI) in all subjects. cSLE patients were assessed for disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. S100β protein levels were measured by enzyme-linked immunosorbent assay using commercial kits. Clinical/laboratorial manifestations, disease activity, cumulative damage and drugs undertaken were assessed at time of blood withdrawal. Results We included 42 cSLE patients (mean age 16.56±3.68) and 20 healthy controls (mean age 19.9±5.31). Cognitive impairment was observed in 25 (60%) cSLE patients and in 3 (15%) healthy controls (p<0.05). Patients with cognitive impairment presented significantly higher levels of the S100β protein (median 38.64) compared to patients without cognitive impairment (median 25.49; p=0.001) and controls (median 23.62; p<0.001). No other clinical/laboratorial manifestations and drugs undertaken were associated to S100β protein levels in cSLE. Conclusions Cognitive impairment was associated with higher levels of the S100β protein, suggesting the presence of neuronal lesions in this cSLE patients cohort. Disclosure of Interest H. Aldar Grant/Research support from: FAPESP 2009/13046-3, A. Lapa Grant/Research support from: FAPESP 2010/13639-1, B. Belini Grant/Research support from: FAPSEP 2009/12343-4, N. Sinicato Grant/Research support from: FAPESP 2010/13637-9, M. Postal Grant/Research support from: FAPESP 2009/11076-2, P. Fernandes: None Declared, R. Marini: None Declared, S. Appenzeller Grant/Research support from: FAPESP 2008/02917-0; Conselho Nacional Pesquisa Desenvolvimento-Brasil CNPq (300447/2009-4)
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
  • C.M. Genari · B.S. Bellini · P.T. Fernandes · C. Gabriela · F.O. Lima · Li Min Li
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    ABSTRACT: Stroke is the leading cause of acquired physical impairment in adult in the world. One person in six seconds is having a stroke somewhere in the world. It is estimated that one-third of stroke victims will be handicapped, and will require assistive technology of some sort. There are many BCI therapeutic resources in development that can be used for treating patients who have any physical challenge. The objective of this study is to explore the perception of BCI assistive technology by the post-stroke patients that have sequelae. We applied a home developed questionnaire and conducted a semi-structured interview by phone to explore the perception of patients towards BCI procedures. We studied seven post-ischemic stroke patients (4 men) with a mean age of 63 years (range 34-80 years). Six subjects had incomplete basic education and only one subject had completed high school. The median Rankin score was 3 (range 2-4). We found positive to very positive perception on the usage of BCI. A pleasant experience was described by all patients and no complaints were reported. Most subjects misinterpreted the research procedures regarding them as part of their treatment. In conclusion, the overall perception of BCI by the stroke patients was positive, and there is a willingness of trying this type of technology in particular when physicians are part of the BCI implementation process.
    No preview · Conference Paper · Jan 2013
  • G.C. Monteiro · F.O. Lima · W. Susan · P.T. Fernandes · B. Flavio · C. Gabriela · Li Li Min
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    ABSTRACT: The number of research papers in the area of Brain Computer Interface (BCI) assistive technologies is increasing rapidly. In addition, there is a possibility that some prosthetic models based on BCI will soon be available on the market. However, the acceptance and the degree of information that lay people have about this kind of technology is still unclear. The objective of this study was to investigate the diffusion of this top-of-the-edge technology and its acceptance by society. We developed a structured questionnaire and we applied it, in a single day, to passersby in downtown of an urban city with over one million people in Southeastern Brazil. The results showed that almost a third of 336 interviewees (mean age of 37 year-old, range from 15 to 89 years) had never heard about such technology. Most (89 %) of the other two thirds that had already heard of it affirmed that BCI based technologies would help in cases of incapacitating physical disabilities. No association was found when confronting the pattern of the answers with demographical data (p>O.05). We conclude that there is a positive attitude towards assistive technology by the society. The majority of the interviewees claimed to know about it, but it seems that the knowledge is superficial and based on broad science diffusion media. The literature on BCI acceptance is still very limited. Approximation between the scientific community and the end users is advised to bring adequate information and to decrease the degree of fantasy naturally related to this area, avoiding future false expectations.
    No preview · Conference Paper · Jan 2013
  • C.B.O. Santos · P.T. Fernandes · L.L. Min · E.R. Turato
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    ABSTRACT: Delimited object of this study considers emotional meanings of stigma epilepsy related to the establishment / or the achievement of love relationships. Stigma brings potential adverse consequences to the quality of life for ill persons.Objective To discuss psychological and possible cultural meanings that patients with epilepsy, recognizing their stigma, attributed to issues experienced regarding to love relationships.Methodqualitative method using of semidirected interviews and observing manifestations of respondents. Sample closed when informants' speech became repetitive.ResultsPatients with epilepsy who are on their way there is less time-controlled are more emotional vulnerability, accompanied by the development of psychological distress. Some patients became during the treatment dependent on any kind of help of caregivers. There is an age difference between respondents who ranged from 20 to 40 years. There was that time with patient already dealing with illness and age at which symptoms began differentiate how vulnerable they feel.Conclusions Despite the condition of life at stake, they seemed not to feel emotionally or socially exposed. Those who were already in a stable relationship before the table of epilepsy, reported that over a life challenge to be faced by the couple and still had the vision of strengthening the relationship of certain complicity. Those who started a relationship that became permanent after the onset of epilepsy, faced uncertainty, fear of rejection and some embarrassment, at least initially. For those who find themselves loving relationship we find a profile of persons imprisoned the idea of not building links.
    No preview · Article · Dec 2012 · European Psychiatry
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    ABSTRACT: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization.
    Preview · Article · Mar 2012 · Clinics (São Paulo, Brazil)
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    ABSTRACT: Studies have suggested that the thalamus is a key structure in the pathophysiology of juvenile myoclonic epilepsy. The objective of the present investigation was to examine the thalami of patients with juvenile myoclonic epilepsy using a combination of multiple structural neuroimaging modalities. The association between these techniques may reveal the mechanisms underlying juvenile myoclonic epilepsy and help to identify the neuroanatomical structures involved. Twenty-one patients with juvenile myoclonic epilepsy (13 women, mean age=30±9 years) and a control group of 20 healthy individuals (10 women, mean age=31±8 years) underwent MRI in a 2-T scanner. The volumetric three-dimensional sequence was used for structural investigation. Evaluation of the thalamus comprised voxel-based morphometry, automatic volumetry, and shape analysis. Comparisons were performed between patient and control groups. Voxel-based morphometry analysis identified areas of atrophy located in the anterior portion of the thalamus. Post hoc analysis of automatic volumetry did not reveal significant differences between the groups. Shape analysis disclosed differences between patients and controls in the anterior and inferior portions of the right thalamus and in the anterior portion of the left thalamus. The present investigation confirms that thalami of patients with juvenile myoclonic epilepsy are structurally abnormal with impairments located mainly in the anterior and inferior sections.
    Full-text · Article · Jun 2011 · Epilepsy & Behavior
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    ABSTRACT: Inflammation and dysfunction of the hypothalamus are common features of experimental obesity. However, it is unknown whether obesity and massive loss of body mass can modify the immunologic status or the functional activity of the human brain. Therefore, the aim of this study was to determine the effect of body mass reduction on brain functionality. In humans, changes in hypothalamic activity after a meal or glucose intake can be detected by functional magnetic resonance imaging (fMRI). Distinct fMRI analytic methods have been developed to explore changes in the brain's activity in several physiologic and pathologic conditions. We used two analytic methods of fMRI to explore the changes in the brain activity after body mass reduction. Obese patients present distinct functional activity patterns in selected brain regions compared with lean subjects. On massive loss of body mass, after bariatric surgery, increases in the cerebrospinal fluid (CSF) concentrations of interleukin (IL)-10 and IL-6 are accompanied by changes in fMRI patterns, particularly in the hypothalamus. Massive reduction of body mass promotes a partial reversal of hypothalamic dysfunction and increases anti-inflammatory activity in the CSF.
    Full-text · Article · Jun 2011 · Diabetes
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    ABSTRACT: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.
    Preview · Article · Apr 2011 · Arquivos de neuro-psiquiatria
  • Paula T Fernandes · Dee A Snape · Roy G Beran · Ann Jacoby
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    ABSTRACT: Stigma is a major issue for people who develop epilepsy. Reducing stigma is a major focus of activity for the epilepsy patient support groups globally. In this paper, we introduce some key ideas and debates about the nature of and drivers for the stigma of epilepsy, including recent arguments about the need to frame analyses of the nature of epilepsy stigma within sociological debates about conflict and power. We then consider the role of the legislative process for redressing power imbalances that promote or maintain epilepsy stigma; and the value of tailored educational campaigns and programmes directed at stigma reduction. Finally, we consider the nature of 'difference' as experienced by people with epilepsy and how that difference translates into stigma; and provide evidence from a specific targeted intervention to combat epilepsy stigma that its reduction is an achievable goal.
    No preview · Article · Mar 2011 · Epilepsy & Behavior

Publication Stats

712 Citations
126.19 Total Impact Points

Institutions

  • 2001-2015
    • University of Campinas
      • • Departamento de Ciências do Esporte (DCE)
      • • Institute of Language Studies
      • • Faculty of Medical Sciences
      Conceição de Campinas, São Paulo, Brazil
  • 2009
    • EPI-Q
      QHO, Illinois, United States