Arquivos de neuro-psiquiatria最新文献

{"title":"Levodopa-induced dyskinesia is still a major clinical problem in Brazilian movement disorder clinics.","authors":"Vitor Tumas, Manuelina Mariana Capellari Macruz Brito, Vanderci Borges, Henrique Ballalai Ferraz, Cyrus P Zabetian, Ignacio F Mata, Bruno Lopes Santos-Lobato","doi":"10.1055/s-0045-1806922","DOIUrl":"10.1055/s-0045-1806922","url":null,"abstract":"<p><p>Levodopa-induced dyskinesia (LID) remains a significant motor complication in Parkinson's disease (PD), although opinions differ on its clinical relevance.To explore the current prevalence and impact of LID, we analyzed two cohorts from the Latin American Research Consortium on the Genetics of Parkinson's Disease from movement disorder clinics in the city of São Paulo, Brazil, recruited 10 years apart.The cohorts included 187 individuals diagnosed with PD in phase 1 (2007-2014) and 224 in phase 2 (2021-2022). The presence and functional impact of LID were measured using part IV (items 4.1 and 4.2 respectively) of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).The analysis revealed that LID frequency increased from 34.7 in phase 1 to 54.9% in phase 2 (more recent), with functional impact rising from 25.1 to 38.8%.The findings suggest that LID remains a relevant clinical issue in clinics specialized in movement disorders in Brazil, with no reduction in prevalence throughout the last decade. Further studies from other regions and less specialized neurology centers may help understand this motor complication in Brazil and in other developing countries.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-5"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109532","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 prevalence of myasthenia gravis is increased in inflammatory bowel disease.","authors":"Antônio Miguel Furtado Leitão, Florian P Thomas, Marcellus Henrique Loiola Ponte de Souza, Lúcia Libanez Bessa Campelo Braga, Francisco de Assis Aquino Gondim","doi":"10.1055/s-0045-1807717","DOIUrl":"10.1055/s-0045-1807717","url":null,"abstract":"<p><p>Comorbid autoimmune disorders affect approximately 0.2% of the population. A second autoimmune disease occurs in up to 15% of myasthenia gravis (MG) patients.To evaluate the association between MG and inflammatory bowel disease (IBD).We conducted a cross-sectional study involving a Brazilian cohort of IBD patients and a literature review.In 2022, we found 1 MG patient with ulcerative colitis and 3 with Crohn's disease out of 606 IBD patients (0.66% prevalence). The patient with UC and MG died in April 2024. The mean IBD onset age was 33.5 ± 2.7; patients were 45.8 ± 7.3-years-old at evaluation. Further, 2 patients were acetylcholine receptor antibody positive, 1 was anti-muscle specific kinase positive, and 1 seronegative. Also, 3 had abnormal repetitive nerve stimulation, all had normal nerve conduction studies, abnormal skin wrinkling test, and mild small fiber neuropathy. None had thymoma and/or underwent thymectomy. According to the MG Foundation's classification, one was class V, one IVb, and two IIa. The MG diagnosis was masked by immunotherapy in all. The prevalence ratio of MG in IBD patients versus the proportion of MG among all patients in our center was 8.56 (<i>p</i> < 0.0001, CI = 3.1-23.5). Considering the lowest and highest prevalence of this condition reported in the literature, the ratio is 44.0 (<i>p</i> < 0.0001, CI: 16.3-118.4) and 26.4 (<i>p</i> < 0.0001, CI: 9.8-70.6), respectively.The prevalence of MG is higher in IBD, may include muscle specific kinase positive disease (first report in the literature) and frequently overlaps with other autoimmune conditions and small fiber neuropathy.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957394","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 physiotherapy protocol* for stroke patients in acute hospital settings: expert consensus from the Brazilian early stroke rehabilitation task force.","authors":"Iara Maso, Gustavo José Luvizutto, Jéssica Mariana de Aquino Miranda, Carla Ferreira do Nascimento, Luana Aparecida Miranda Bonome, Elen Beatriz Pinto, Fabiane Maria Klitzke, Ricardo Machado Souza, Carla Heloisa Cabral Moro, Rodrigo Bazan, Pedro Antonio Pereira de Jesus, Eduardo de Melo Carvalho Rocha, Cesar Minelli, Sheila Ouriques Martins, Jussara Almeida de Oliveira Baggio","doi":"10.1055/s-0045-1806924","DOIUrl":"10.1055/s-0045-1806924","url":null,"abstract":"<p><p>The present protocol provides general recommendations based on the best evidence currently available for physiotherapists to use as a guide for the care of stroke patients during hospitalization. The Brazilian Early Stroke Rehabilitation Task Force, comprising physical therapy experts and researchers from different Brazilian states, was organized to develop this care protocol based on a bibliographical survey, including meta-analyses, systematic reviews, clinical trials, and other more recent and relevant scientific publications. Professionals working in stroke units were also included in the task force to ensure the practicality of the protocol in different contexts. This protocol provides guidance on assessment strategies, safety criteria for the mobilization of patients with stroke, recommendations for mobilization and proper positioning, as well as evidence-based practices for treatment during hospitalization, including preventive measures for shoulder pain and shoulder-hand syndrome. The protocol also provides information on the organization of the physiotherapy service at stroke units, guidelines for hospital discharge, and quality indicators for physiotherapy services. We have included detailed activities that can be performed during mobilization in the supplementary material, such as postural control training, sensory and perceptual stimulation, task-oriented training, and activities involving an enriched environment. The protocol was written in a user-friendly format to facilitate its application in different social and cultural contexts, utilizing resources readily available in most clinical settings.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-18"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976477","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":"Immune-mediated insights into clinical and specific autoantibodies in acute and chronic immune-mediated nodo-paranodopathies.","authors":"Marcus Vinícius Magno Gonçalves, Pedro José Tomaselli, Wilson Marques Junior","doi":"10.1055/s-0045-1805073","DOIUrl":"10.1055/s-0045-1805073","url":null,"abstract":"<p><p>The recognition of the molecular structures, namely the node of Ranvier and the axonal regions surrounding it (the paranode and juxtaparanode), as the primary target for specific autoantibodies has introduced a new site for neurological location (microtopographic structures), in contrast to the prevailing understanding, in which lesions to neural macrostructures (roots, nerves, and/or plexus) were the focus of semiologists and electrophysiologists for topographic, syndromic, and nosological diagnoses. Therefore, there was a need to understand and characterize the components of these neural microstructures that are grouped in small regions within the nerve to optimize clinical and therapeutic reasoning.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662313","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":"Pointing the trident in the right direction: recognizing spinal neurosarcoidosis through a specific MRI pattern.","authors":"Alena Khalil, Kevin J Abrams, Márcio Luís Duarte, Leonardo Furtado Freitas","doi":"10.1055/s-0045-1807720","DOIUrl":"10.1055/s-0045-1807720","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960059","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":"Impulsiveness levels among patients with medication-overuse headache accompanying chronic migraine or tension-type headache.","authors":"Ruken Simsekoglu, Nestug Keskin, Tugba Cankay, Sumeyye Cakmak, Temel Tombul","doi":"10.1055/s-0045-1807716","DOIUrl":"10.1055/s-0045-1807716","url":null,"abstract":"<p><p>Impulsiveness in primary headaches is not well understood.To analyze impulsiveness in patients with medication-overuse headache (MOH) and either chronic migraines or chronic tension-type headaches (TTHs).This cross-sectional study included 119 participants (96 female) divided into 3 groups: the migraine with MOH (M-O, <i>n</i> = 44, age = 36.6 ± 11.1), the tension-type headache with MOH group (TTH-O, <i>n</i> = 38, age = 42.6 ± 11.8), and the healthy control group (HC, <i>n</i> = 37, age = 36.9 ± 13.1). The Barratt Impulsiveness Scale-11 Short Form (BIS-11 SF), Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used to assess impulsiveness, depression, anxiety, and sleep quality, respectively.Impulsiveness levels were significantly higher in the M-O (<i>p</i> < 0.01) and TTH-O (<i>p</i> < 0.01) groups compared with the HC. However, no significant difference in impulsiveness was found between the M-O and TTH-O (<i>p</i> > 0.05). The PSQI scores were significantly higher in the M-O and TTH-O compared with the HC (<i>p</i> < 0.01). Additionally, anxiety scores were notably higher in the M-O compared with both the TTH-O and HC (<i>p</i> < 0.01).The present study, which compared the M-O and TTH-O groups with HC in terms of impulsiveness, with no significant differences in parameters such as age, gender, schooling, frequency of headache attacks, and disease onset duration, concluded that both patient groups exhibited higher impulsiveness compared with the controls. Furthermore, the lack of difference in impulsiveness between MO and chronic TTH-O patients with a common denominator of MOH suggests that it may be associated with MOH, which is a shared subset of two distinct headache disorders.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953445","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":"EGR2 gene mutations: lessons learned from 4 cases.","authors":"Wilson Marques","doi":"10.1055/s-0045-1809331","DOIUrl":"10.1055/s-0045-1809331","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149025","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":"Efficacy and safety of glucagon-like peptide 1 agonists for Parkinson's disease: a systematic review and meta-analysis.","authors":"Luis O S Nogueira, Roberto A S V Mazetto, Maria L R Defante, Vânio L J Antunes, Ocílio Ribeiro Gonçalves, Angela Maria Sandini Corso, Marcus V Della Coletta, Dayany Leonel Boone, Walderico Silva Machado Filho, Vanderci Borges, Henrique Ballalai Ferraz","doi":"10.1055/s-0045-1806824","DOIUrl":"10.1055/s-0045-1806824","url":null,"abstract":"<p><strong>Background: </strong> Recent research on Parkinson's disease (PD) therapy has highlighted glucagon-like peptide 1 (GLP-1) agonists as potential therapeutic agents. However, recent randomized controlled trials (RCTs) have shown mixed results regarding the use of this medication.</p><p><strong>Objective: </strong> To perform a meta-analysis comparing GLP-1 agonists with placebo or standard PD treatment in adult PD patients.</p><p><strong>Methods: </strong> We systematically searched the PubMed, Embase and Cochrane Central databases. The efficacy outcomes were assessed through the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39). We also assessed adverse events. Dichotomous data were compared using the risk ratio (RR), and continuous endpoints were pooled using the mean difference (MD).</p><p><strong>Results: </strong> We included 4 RCTs, with a total of 514 patients. In every study, the Hoehn and Yahr stage was < 3. The pooled analysis demonstrated that the use of GLP-1 agonists was not associated with an improvement in the scores on parts I, II, III, and IV of the MDS-UPDRS at 6 and 12 months of follow-up. Neither did quality of life (PDQ-39) show significant differences among the groups, and a higher risk of gastrointestinal adverse events and weight loss was observed with the use of GLP-1 agonists. A subgroup analysis further confirmed the lack of clinical benefits of the intervention regarding all of these efficacy outcomes, and the intervention also significantly reduced result heterogeneity.</p><p><strong>Conclusion: </strong> In 1 year, GLP-1 agonists failed to improve motor and non-motor features of PD. Additional high-quality studies are needed to draw more robust conclusions about this treatment.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966566","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":"Brás Cubas, Quincas Borba, and Rubião: portraits of neuropsychiatry in the novels of Machado de Assis.","authors":"Juliana de Castro Vilanova, Antonione Santos Bezerra Pinto, Giuliano da Paz Oliveira","doi":"10.1055/s-0045-1806828","DOIUrl":"10.1055/s-0045-1806828","url":null,"abstract":"<p><p>The intersection of literature and neuroscience provides a fascinating way to explore human behavior through fictional narratives. Brazilian literature, particularly the work of Machado de Assis, excels in portraying characters with neuropsychiatric conditions. This work aims to establish connections between the fictional representations of human behavior in Machado's classic works and neurological conditions described by contemporary neuroscience. In <i>The Posthumous Memoirs of Brás Cubas</i> and <i>Quincas Borba</i>, Machado's characters exhibit behaviors that align with modern neurological diagnoses. For example, Brás Cubas experiences episodes resembling delirium, characterized by mental confusion and altered cognition, while Quincas Borba shows traits of attention deficit hyperactivity disorder (ADHD) and bipolar disorder. Rubião, the protagonist of Quincas Borba, meets certain criteria for dementia, displaying visual hallucinations and cognitive fluctuations. By analyzing Machado's characters through a neuropsychiatric lens, we can appreciate his remarkable ability to depict complex mental conditions, many of which were not fully understood by medicine at the time.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-5"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952717","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":"Oxford Cognitive Screen - Brazilian Portuguese version (OCS-Br): assessment of vascular cognitive impairment.","authors":"Claudia Cristina Ferreira Ramos, Marcelo Vilela Machado João, Caroline Suemi Ogusuku, Sonia Maria Dozzi Brucki","doi":"10.1055/s-0045-1806919","DOIUrl":"10.1055/s-0045-1806919","url":null,"abstract":"<p><p>Cognitive impairment is prevalent in stroke patients and is rarely diagnosed. Cognitive deficits involving language functions, praxis, visuospatial and visuoconstructive skills, as well as memory, are prominent. The cognitive assessment tests available do not address some specific characteristics of stroke patients and present essential limitations concerning the most compromised cognitive domains.To determine the performance profile of the Oxford Cognitive Screen - Brazilian Portuguese version (OCS-Br) in cognitively-healthy individuals and to evaluate its ability to screen for cognitive impairment in individuals after ischemic stroke.We conducted an observational and descriptive study with cognitively-healthy individuals and patients with a history of stroke. The healthy individuals were recruited at the Neurology Clinic of the Outpatient Center of Universidade de São Caetano do Sul and the João Castaldelli Integrated Center for Health and Education for the Elderly, in the city of São Caetano do Sul, state of São Paulo. The stroke patients were recruited at the same Neurology Clinic and among subjects referred from Hospital Municipal de Emergências Albert Sabin and admitted to the Stroke Unit of Hospital Santa Marcelina, in the city of São Paulo, from September 2021 to July 2023.The study included 108 participants, 50 (46.3%) in the stroke group and 58 (53.7%) in the healthy group. When comparing the OCS-Br scores between the groups, we found a significant difference in writing tasks, executive functions (attention, change of strategy), and memory.Our results show the need for adequate monitoring and rehabilitation of poststroke patients. The advantages of the OCS-Br are: its focus on specific cognitive aspects of stroke, such as visual inattention and visual field testing; the assessment of patients with aphasia and visual impairment; and its prognostic value to predict long-term functioning.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 4","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109536","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}