Arquivos de neuro-psiquiatria最新文献

{"title":"Reply to: \"Assessment of heart rate variability and occurrence of falls in Alzheimer's disease: an exploratory study\".","authors":"Evelize Antunes Rodrigues, Aline Roberta Danaga, Etiene Farah Teixeira de Carvalho, Carlos Alberto Santos Filho, José Burgos Ponce, Alessandro Ferrari Jacinto","doi":"10.1055/s-0046-1829033","DOIUrl":"10.1055/s-0046-1829033","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 8","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenge of localizing hyperkinetic seizures: timing matters!","authors":"İrem İlgezdi Kaya, Gulshan Aliyeva, Nur Gülce İşkan, Ayşe Deniz Elmalı, Nerses Bebek","doi":"10.1055/s-0046-1827048","DOIUrl":"10.1055/s-0046-1827048","url":null,"abstract":"<p><strong>Background: </strong>Hyperkinetic seizures (HSs), which are generally associated with the frontal lobe (although they may indeed originate from other regions too), are characterized by complex motor movements with high amplitude and short duration.</p><p><strong>Objective: </strong>To differentiate HSs originating from the frontal and extrafrontal lobes via electroencephalographic (EEG) features, notably timing.</p><p><strong>Methods: </strong>Clinical and video-EEG data of patients with HS were examined retrospectively. The localization of the ictal and interictal discharges, the onset and duration of the hyperkinetic movements, as well as the ictal-postictal electrophysiological and semiological features, were reviewed. The patients were divided into two groups according to their HS onset timing: if the onset of hyperkinetic semiology was in the first 10 seconds, they were classified as <i>early-onset HS</i>; if later, as <i>late-onset HS</i>.</p><p><strong>Results: </strong>We included 29 patients (171 seizures); seizure onset was localized to the frontal region in 21 patients, and to the temporal and temporo-occipital regions in 6 patients, and it could not be determined in 2 patients. The HSs started in the early period in 21 patients, and in the late period in 8 patients; HSs originating from the frontal region started earlier than those originating from the temporal region (6.2 versus 25.7 seconds respectively; <i>p</i> = 0.002). Electrophysiological (35.4 versus 95.7 seconds respectively; <i>p</i> = 0.004) and clinical (34.3 versus 94.6 seconds respectively; <i>p</i> = 0.003) seizure durations were shorter in frontal-onset seizures compared with temporal-onset seizures.</p><p><strong>Conclusion: </strong>The timing of HS onset and the duration of the seizures are informative in terms of localization. Earlier onset of hyperkinetic semiology and shorter duration may point to a frontal origin.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 8","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebellitis in systemic lupus erythematosus: an elusive face of neurolupus.","authors":"Leonardo Furtado Freitas, Jeffrey S Ritter, Charif Sidani, Igor Mikityansky, Kevin J Abrams","doi":"10.1055/s-0046-1827161","DOIUrl":"https://doi.org/10.1055/s-0046-1827161","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 8","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging case of Down syndrome regression disorder.","authors":"Letícia Klabinske Marques Monteiro, Aimê de Paula Santos, Helena Santos de Moura Lima, Rejane de Souza Macedo Campos, Jesus Manoel Bernardez Gandara, Luziany Carvalho Araújo, Breno José Alencar Pires Barbosa","doi":"10.1055/s-0046-1819661","DOIUrl":"10.1055/s-0046-1819661","url":null,"abstract":"<p><strong>Abstract: </strong>Down syndrome regression disorder (DSRD) is a rare cause of neuropsychiatric regression observed in previously-healthy individuals with Down syndrome (DS). There have been reports of brain iron accumulation in the basal ganglia of patients with DS and DSRD, although the underlying etiology remains unclear. The current study aims to report, through detailed neuroimaging, laboratory tests, and clinical data findings, the case of a patient with DS who experienced a significant loss of abilities, accompanied by neuroimaging findings indicative of abnormal brain iron accumulation. While an extensive investigation with blood, cerebrospinal fluid (CSF), and genetic markers was unremarkable, magnetic resonance imaging (MRI) scans revealed abnormal iron deposition and calcifications in the globus pallidus. The abnormal iron accumulation in the basal ganglia of patients with DSRD could be a potential neuroimaging marker for this condition.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 8","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training neurologists for Brazil: from geographic imbalance to national responsibility.","authors":"Eduardo Boiteux Uchôa Cavalcanti, Eduardo Genaro Mutarelli","doi":"10.1055/s-0046-1827823","DOIUrl":"10.1055/s-0046-1827823","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 8","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocturnal polygraphy in neuromuscular disorders: is it a useful diagnostic tool?","authors":"Aleciane Cristine de Oliveira, Thayanne Dos Santos Corrêa, Lucas Figueira Vieira, Iago Resende Carvalho, Daniela Name Chaul, Ana Elizabeth Cunha Guimarães de Almeida, Vitor Laguardia Guido Faria, Paulo Cézar Simamoto Júnior, José Fausto de Morais, Fernando Gustavo Stelzer, Isabela Maria Bernardes Goulart, Diogo Fernandes Dos Santos","doi":"10.1055/s-0046-1825767","DOIUrl":"10.1055/s-0046-1825767","url":null,"abstract":"<p><strong>Background: </strong>Patients with neuromuscular diseases (NMDs) have a high incidence of sleep-related breathing disorders. These include obstructive sleep apnea (OSA), which is characterized by recurrent episodes of upper airway obstruction during sleep, resulting in intermittent hypoxemia and sleep fragmentation. Obstructive sleep apnea may be more common in patients with NMDs than in the general population.</p><p><strong>Objective: </strong>To assess the prevalence of OSA through home polygraphy at a public university hospital during respiratory evaluations of patients with NMDs, and its contribution to the indication of non-invasive ventilation. It did not aim to validate a model for early indication.</p><p><strong>Methods: </strong>The present prospective study collected data over the period from May 2021 to June 2024, using medical records and tests such as spirometry to evaluate pulmonary respiratory function, home polygraphy, and sleep assessments using the Epworth Sleepiness Scale (ESS) and a symptom questionnaire.</p><p><strong>Results: </strong>A total of 74 patients were included, 64.7% (n = 48) of whom had OSA. The most prevalent NMDs were muscular dystrophy (n = 22; 29.7%), myasthenia gravis (n = 13; 17.6%), and amyotrophic lateral sclerosis (ALS) (n = 11; 14.9%). Apnea-hypopnea index (AHI) values were higher in the supine position (11.6 ± 12.6) compared to the AHI in the non-supine position (7.0 ± 14.1), which indicates, on average, a mild degree of OSA. The ESS revealed that 40.5% of patients had scores indicating excessive daytime sleepiness (EDS).</p><p><strong>Conclusion: </strong>The findings reinforce the importance of early OSA diagnosis in patients with NMDs.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 7","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost and clinical outcomes of epilepsy surgery in a Brazilian public hospital: a health economic evaluation.","authors":"Raíssa Mansilla Cabrera Rodrigues, Tayla Taynan Romão Bastos, Lizen Clare André Moreira, Vânia de Matos Fonseca, José Alberto Landeiro, Bruno Lima Pessôa","doi":"10.1055/s-0046-1827047","DOIUrl":"10.1055/s-0046-1827047","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy surgery is an established therapy for drug-resistant epilepsy, but it remains underused in Brazil. Assessing direct costs and outcomes is key for planning in low- and middle-income countries (LMICs).</p><p><strong>Objective: </strong>To estimate surgery costs in a Brazilian public hospital and evaluate seizure and medication outcomes.</p><p><strong>Methods: </strong>A retrospective economic evaluation was conducted among patients aged ≥ 16 years who underwent epilepsy surgery at a Brazilian tertiary public hospital between 2014 and 2019. A micro-costing (bottom-up) approach from the healthcare provider perspective was used to estimate actual resource consumption based on hospital administrative records. Costs were stratified by surgical technique, and clinical outcomes were assessed using seizure frequency, antiseizure medication use, and standardized Engel and International League Against Epilepsy (ILAE) classifications.</p><p><strong>Results: </strong>Twenty patients were included, predominantly with temporal lobe epilepsy, and were mainly treated with resective procedures. Average direct costs varied according to the surgical technique, ranging from approximately US$ 4,200 for resective procedures to US$ 6,800 for disconnective surgeries. Hospital length of stay was the primary cost driver, followed by expenditures on materials and human resources. Overall, the observed costs were proportional to the clinical benefits, as most patients demonstrated favorable seizure control at 2-year follow-up, with consistent reductions in seizure frequency and antiseizure medication use.</p><p><strong>Conclusion: </strong>The current study presents a transparent hospital-based micro-costing approach to estimate the direct costs of epilepsy surgery in a tertiary public setting of a middle-income country. By focusing on actual resource consumption and standardized clinical outcomes, it supports the clinical effectiveness and economic plausibility of epilepsy surgery within the Brazilian Public Healthcare System and informs future economic evaluations in similar contexts.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 7","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The skin-wrinkling test: principles and clinical applications.","authors":"Otto Jesus Hernández Fustes, Cláudia Suemi Kamoi Kay, Paulo José Lorenzoni, Renata Dal-Prá Ducci, Paula Raquel do Vale Pascoal Rodrigues, Orlando Graziani Povoas Barsottini, Rosana Herminia Scola","doi":"10.1055/s-0046-1827046","DOIUrl":"10.1055/s-0046-1827046","url":null,"abstract":"<p><strong>Abstract: </strong>Cutaneous wrinkling is a normal phenomenon that occurs on the palms in a reversible manner and results from vasoconstriction influenced by vasomotor function. It can be assessed through the skin-wrinkling test following water immersion, with the absence or reduction of wrinkling being associated with disorders affecting the dense network of sympathetic nerves in these regions. The literature suggests that this test may serve as a screening tool for small-fiber neuropathy, particularly in settings in which biopsy is not available. It is a rapid, inexpensive, and easily-accessible test. We herein review the principles of the skin-wrinkling test, its pathophysiology, and its clinical indications as a tool to evaluate the sympathetic component of the autonomic nervous system.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 7","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amyotrophic lateral sclerosis (ALS): new insights 156 years after Charcot's masterful description.","authors":"Otto Jesus Hernandez Fustes, Hélio Afonso Ghizoni Teive","doi":"10.1055/s-0046-1827042","DOIUrl":"10.1055/s-0046-1827042","url":null,"abstract":"<p><strong>Abstract: </strong>In 1869, Charcot and Alix Joffroy published the first detailed clinical and neuropathological description of amyotrophic lateral sclerosis (ALS), establishing the correlation involving muscle weakness, atrophy, spasticity, and degeneration of the lateral corticospinal tracts. Charcot unified the involvement of upper and lower motor neurons into a single clinical entity. His pioneering description was limited to the motor system, reflecting the scientific constraints of his time. Charcot interpreted ALS primarily as a disorder of the motor system, a conclusion consistent with the clinical and pathological methods available in the late nineteenth century. Neurological investigation at that time relied mainly on detailed clinical observation, anatomical correlation at autopsy, and relatively-simple physiological techniques. These approaches were well suited to identify motor dysfunction but were far less capable of revealing subtle cognitive or behavioral alterations. Currently, ALS is recognized as a multisystem neurodegenerative disorder. Thus, Charcot's historical contribution was crucial for the initial understanding of ALS, while modern perspectives acknowledge its broader clinical complexity beyond the motor system.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 7","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular rehabilitation in hereditary spastic paraplegia: a randomized pilot study.","authors":"Geslaine Janaina Bueno Dos Santos, Maria Izabel Rodrigues Severiano, Flávio Magno Gonçalves, Cristiano Miranda de Araujo, Bianca Simone Zeigelboim, Hélio Afonso Ghizoni Teive","doi":"10.1055/s-0046-1827050","DOIUrl":"10.1055/s-0046-1827050","url":null,"abstract":"<p><strong>Background: </strong>Hereditary spastic paraplegia (HSP) is a neurodegenerative disorder characterized by spasticity, lower limb weakness, impaired balance, and increased risk of falls.</p><p><strong>Objective: </strong>To evaluate the effect of vestibular rehabilitation associated with virtual reality (VRi) on functional balance in patients with HSP.</p><p><strong>Methods: </strong>A randomized pilot clinical trial was conducted with 16 patients who were diagnosed with HSP and divided into two groups: GI (balance games) and GII (balance + strength games). Interventions were performed via the Wii console and the Wii Balance Board platform (Nintendo Co, Ltd.). The Berg balance scale (BBS) and physiological profile assessment (PPA) were administered at T0 (prerehabilitation), T1 (after 10 sessions), and T2 (after 20 sessions). The Friedman test and Wilcoxon test were used to analyze temporal changes, the Mann-Whitney test was used to compare the groups.</p><p><strong>Results: </strong>All patients reported imbalance and muscle fatigue, whereas heaviness in the lower limbs and weakness were more common in GII. The visual contrast domain showed a significant change from T0 to T2, with scores increasing by a median of 2.0 (18.5-20.5) units.</p><p><strong>Conclusion: </strong>The use of VRi showed potential as a therapeutic adjunct in HSP rehabilitation, with improvements in balance and fall risk. However, larger studies are needed to corroborate these results.</p><p><strong>Clinical trial registration: </strong>ReBEC (RBR-3JMX67, 01/29/2020). https://ensaiosclinicos.gov.br/rg/RBR-3jmx67.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 7","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}