Arquivos de neuro-psiquiatria最新文献

{"title":"Cardiovascular autonomic dysfunction in Parkinson's disease: associations with disease severity and the modulatory role of dopaminergic therapy.","authors":"Yogesh Kumar, Gunjan Kumar, Nirangjhana Sivasubramanian","doi":"10.1055/s-0046-1825525","DOIUrl":"10.1055/s-0046-1825525","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by both motor and non-motor symptoms, with autonomic dysfunction significantly impacting patients' quality of life. Despite its recognized importance, comprehensive evaluation of autonomic dysfunction in PD remains limited.</p><p><strong>Objective: </strong>To assess cardiovascular autonomic dysfunction in PD, explore its association with disease severity, and examine the modulatory effects of dopaminergic therapy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 60 PD patients and 30 age- and sex-matched healthy controls. Autonomic function was evaluated using standardized cardiovascular tests, including deep breathing, the Valsalva maneuver, and head-up tilt. Heart rate variability, baroreflex sensitivity, and orthostatic blood pressure responses were measured. Parkinson's disease patients were evaluated in both dopaminergic medication ON and OFF states. Correlations between autonomic parameters and disease severity were analyzed.</p><p><strong>Results: </strong>Parkinson's disease patients demonstrated significant autonomic impairment compared to controls (<i>p</i> < 0.001). Standard deviation of NN intervals (SDNN) (21.3 ± 8.7 vs. 32.5 ± 10.2 ms), baroreflex sensitivity (4.2 ± 1.8 vs. 7.1 ± 2.3 ms/mmHg), and heart rate response to deep breathing (8.3 ± 3.2 vs. 13.7 ± 4.1 bpm) were reduced, while systolic blood pressure drop on tilt increased (22.5 ± 12.8 vs. 8.3 ± 5.7 mmHg). Autonomic impairment correlated with disease severity. Dopaminergic medication showed modest but significant improvements in heart rate variability (<i>p</i> = 0.032), baroreflex sensitivity (<i>p</i> = 0.041), and orthostatic response (<i>p</i> = 0.025).</p><p><strong>Conclusion: </strong>Parkinson's disease patients exhibit marked cardiovascular autonomic dysfunction correlating with disease severity. The modest modulatory effects of dopaminergic medication on autonomic parameters suggest complex dopaminergic-autonomic interactions and supports autonomic parameters as potential markers of disease progression.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444173","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":"Letter on: \"Electrophysiological and Biochemical Evaluations of Neuropathy Risk in Oral Levodopa versus Levodopa/Carbidopa Intestinal Gel Treatment\".","authors":"Osheen Bhandari, Prishita Kumar, Sajjan Pal, Sandeep Singh Saini","doi":"10.1055/s-0046-1825516","DOIUrl":"10.1055/s-0046-1825516","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618293","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":"Jean-Ovide Decroly (1871-1932): neurologist and pedagogue.","authors":"Sylvain Wagnon, Norberto Dallabrida, Léo Coutinho, Hélio A Ghizoni Teive","doi":"10.1055/s-0046-1825518","DOIUrl":"10.1055/s-0046-1825518","url":null,"abstract":"<p><strong>Abstract: </strong>The present article aims to understand Ovide Decroly1s intervention in the pedagogical field considering his medical-neurological training. Thus, it shows that, in 1901, Decroly founded an institute of special education and, 6 years later, created the Hermitage School, for disabled and so-called <i>normal children</i> respectively. In these educational endeavors, Decroly used the mental tests of the Binet-Simon scale, but indicating their limits; and in the light of the experience of American psychology, in the 1920s, he developed, with Raymond Buyse, the Decroly-Buyse tests.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444195","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 past, present, and future of Alzheimer's disease-part 3: the future.","authors":"Ricardo Nitrini, Leonel Tadao Takada, Sonia Maria Dozzi Brucki","doi":"10.1055/s-0046-1824435","DOIUrl":"10.1055/s-0046-1824435","url":null,"abstract":"<p><strong>Abstract: </strong>Predicting future advances in science is practically impossible because unexpected discoveries can radically change the march of ongoing processes. Predicting the nearest future may have a slightly greater chance of success. First, the diagnosis of risk factors for Alzheimer's disease (AD), based on the preponderant role of genetics, will be made very early. Diagnosis will be made with biomarkers prior to clinical manifestations. Furthermore, the prevention of AD and of dementia due to AD will be possible with better control of the many risk factors for dementia, healthier lifestyles, multi-target drugs, and genetic therapy. The relationship between AD and aging will be better understood, opening possibilities for intervention in aging itself. As the pathophysiology of AD is not unique, treatment will be individualized, according to the stage and characteristics of the disease. Most clinical trials will have surrogate markers as primary outcomes. Treatments to decrease the velocity or arrest the evolution of mild cognitive impairment (MCI) and mild dementia caused by AD will be available. Additionally, artificial intelligence (AI) will aid in the diagnosis and selection of the best treatments. Access to the new methods for diagnosing and treating AD is currently limited to a small parcel of the population, especially in low- and middle-income countries, because of their high costs. Due to the high prevalence of AD, it is possible these will become less expensive in the future. The possibility of reversing dementia once it has set in will probably have to wait for longer.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444211","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":"Andersen-Tawil syndrome: visual clues to the diagnosis.","authors":"João Victor Cabral Correia Férrer, Gabriel Keller Guimarães, Stefano Machado, Carlos Otto Heise, Andre Macedo Serafim da Silva, Edmar Zanoteli","doi":"10.1055/s-0046-1820534","DOIUrl":"10.1055/s-0046-1820534","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926003","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":"Clinical efficacy of electroacupuncture stimulation based on mismatch negativity in patients with prolonged disorders of consciousness.","authors":"Xiaoguang Lang, Nuan Yang, Linxi Li, Zhengmao Xiang, Yuqin Zhao, Yuemin Gao, Zhixing Yao, Ying Lv, Sui Tian, Fang Hu, Xuehai Lv","doi":"10.1055/s-0046-1825520","DOIUrl":"10.1055/s-0046-1825520","url":null,"abstract":"<p><strong>Background: </strong>The use of electroacupuncture can regulate brain activity, facilitating consciousness recovery.</p><p><strong>Objective: </strong>To investigate the clinical effectiveness of electroacupuncture at the Cuanzhu (BL2) and Sibai (ST2) accupoints on patients with prolonged disorders of consciousness (DOCs), and evaluate its awakening value.</p><p><strong>Methods: </strong>A total of 48 patients with prolonged DOCs were randomly divided into the control and electroacupuncture groups by the random number table method. The electroacupuncture group underwent treatment at the Cuanzhu (BL2) and Sibai acupoints (ST2) and was given electrical stimulation (2/100 Hz), while the control group received sham electroacupuncture stimulation for 3 weeks. Mismatch negativity (MMN) tests were administered to both groups before and after the intervention. Comprehensive assessments were performed using the Coma Recovery Scale-Revised (CRS-R) and the Glasgow Coma Scale (GCS) to compare the arousal rate and prognosis between the groups.</p><p><strong>Results: </strong>After treatment, both groups of patients showed a significant increase in MMN amplitudes and a reduction in latency (<i>p</i> < 0.05). There was no statistically significant difference in MMN amplitudes and latency between groups after treatment. The awakening rate in the electroacupuncture group was 70.8%, and 54.2% in the control group. The difference between groups was not statistically significant (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Electroacupuncture at Cuanzhu (BL2) and Sibai (ST2) may improve consciousness in patients with prolonged DOCs, but its therapeutic effect is not statistically superior to sham electroacupuncture. Due to the present study's small sample size and population heterogeneity, the findings should be interpreted cautiously.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547785","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":"Distinct thalamic volumetric profiles in cervical and upper limb dystonia.","authors":"Hüseyin Yiğit, Abdulkerim Gökoğlu","doi":"10.1055/s-0046-1825521","DOIUrl":"10.1055/s-0046-1825521","url":null,"abstract":"<p><strong>Background: </strong>Dystonia is a large-scale motor network disorder involving the basal ganglia, cerebellum, and thalamus.</p><p><strong>Objective: </strong>This study investigated the volumetric characteristics of thalamic subnuclei in patients with isolated cervical (CD) and upper limb (ULD) dystonias, and their relationship with disease severity.</p><p><strong>Methods: </strong>We analyzed high-resolution T1-weighted MR-images from the OpenNeuro database. The sample included 37 healthy controls, 25 CD, and 29 ULD patients. Thalamic nuclei were automatically segmented using the DeepThalamus pipeline. Group differences were analyzed using analysis of covariance (ANCOVA), controlling for age, sex, and total intracranial volume (TIV). Relationships between disease severity and volumetry were assessed using Spearman's correlation.</p><p><strong>Results: </strong>A volumetric reduction trend was observed in the CD group compared with controls, particularly in the left lateral geniculate, right ventral lateral posterior, and right intermediate nuclei. Although statistical significance remained borderline after FDR correction (<i>p</i> = 0.078), high Cohen's values (d > 1.4) were detected. In contrast, thalamic volumes were largely preserved in the ULD group. Correlation analyses showed that increased disease severity was associated with decreased volumes of the mammillothalamic tract in the CD group and the anterior ventral nuclei in the ULD group.</p><p><strong>Conclusion: </strong>Observed volumetric trends may provide preliminary insights into the role of specific thalamic substructures in cervical dystonia pathophysiology. Further studies in larger cohorts, supported by functional and diffusion imaging, are needed to clarify these findings.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 6","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547776","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":"Between the invisible and the measurable: what GBD 2023 data reveal (and conceal) about neurodevelopmental disorders in South America.","authors":"Erasmo Barbante Casella","doi":"10.1055/s-0046-1823679","DOIUrl":"10.1055/s-0046-1823679","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 5","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547766","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":"Nusinersen for type-III spinal muscular atrophy: a 12-month retrospective study in a Brazilian cohort.","authors":"Vanessa Van Der Linden, Alessandra Paula de Melo Calado, Gabriela Van Der Linden, João Vitor Duque Porto Valença, Mateus Alves Garrido, Karina Lúcia Soares de Oliveira, Marcelo Soares Kerstenetzky, Thiago Oliveira","doi":"10.1055/s-0046-1824578","DOIUrl":"10.1055/s-0046-1824578","url":null,"abstract":"<p><strong>Background: </strong>Spinal muscular atrophy (SMA) is a progressive, autosomal recessive motor neuron disorder caused by mutations in the <i>SMN1</i> gene. While clinical trials in type-I and -II SMA led to the approval of nusinersen for all SMA types, evidence on its long-term efficacy and safety in type-III patients is still scarce.</p><p><strong>Objective: </strong>The present study investigated treatment responses in SMA type-III patients subjected to nusinersen therapy.</p><p><strong>Methods: </strong>Pediatric and adult patients with genetically confirmed 5q SMA type III on nusinersen treatment for at least 12 months were included in the current retrospective study. We collected data on demographics, genetics, nutritional status, swallowing function, and adverse events associated with nusinersen treatment. Motor function was assessed in all patients using the Hammersmith Functional Motor Scale-Expanded (HFMSE), and respiratory function was evaluated through forced vital capacity in patients aged 6 and older.</p><p><strong>Results: </strong>Nineteen patients (12 males; 63.2%) were included in the study. Most patients (94.7%) had a homozygous <i>SMN1</i> exon 7 deletion, and 63.2% had 3 <i>SMN2</i> copies. At baseline, 68.4% of patients were ambulant, 21.1% had scoliosis, and 36.8% had lower limb deformities. One patient required non-invasive ventilation, which was discontinued after treatment with nusinersen. Hammersmith Functional Motor Scale-Expanded scores improved in 94.7% of patients after 12 months of treatment, with gains of 1 to 9 points (mean 4.0 points; <i>p</i> < 0.001). Adverse events were mild and resolved within 24 hours.</p><p><strong>Conclusion: </strong>Nusinersen was well tolerated and improved motor function in SMA type-III patients, supporting its potential benefits in real-world settings.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 5","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468597","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":"Letter regarding \"Impact of screen use on behavior and sleep in patients with autism spectrum disorder\".","authors":"Marcos Vinicius Sousa Varão, Guilherme Nobre Nogueira","doi":"10.1055/s-0046-1820104","DOIUrl":"10.1055/s-0046-1820104","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 5","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306745","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}