132 Caregiver burden and neuropsychiatric symptoms Fialho PPA, et al. ... Patrícia Paes Araujo Fi... more 132 Caregiver burden and neuropsychiatric symptoms Fialho PPA, et al. ... Patrícia Paes Araujo Fialho1, Anne Marise Koenig1, Etelvina Lucas dos Santos2, Henrique Cerqueira Guimarães3, Rogério Gomes Beato3, Viviane Amaral Carvalho2, Thais Helena ...
Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determin... more Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education. We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ). Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales,...
Chorea is an abnormal movement characterized by a continuous flow of random muscle contractions. ... more Chorea is an abnormal movement characterized by a continuous flow of random muscle contractions. This phenomenon has several causes, such as infectious and degenerative processes. Chorea results from basal ganglia dysfunction. As the control of the eye movements is related to the basal ganglia, it is expected, therefore, that is altered in diseases related to chorea. Sydenham’s chorea, Huntington’s disease and neuroacanthocytosis are described in this review as basal ganglia illnesses that can present with abnormal eye movements. Ocular changes resulting from dysfunction of the basal ganglia are apparent in saccade tasks, slow pursuit, setting a target and anti-saccade tasks. The purpose of this article is to review the main characteristics of eye motion in these three forms of chorea.
A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of ... more A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State...
Revista brasileira de psiquiatria (São Paulo, Brazil : 1999), 2009
Sr. Editor, A doença de Huntington (DH) é uma doença genética neurodegenerativa transmitida por h... more Sr. Editor, A doença de Huntington (DH) é uma doença genética neurodegenerativa transmitida por herança autossômica dominante com penetrância completa. Sua gênese está na repetição exagerada do trinucleotídeo CAG no braço curto do cromossomo 4(4p16.3)1,2. Essa ...
Tremor and other hyperkinetic movements (New York, N.Y.), 2012
Takayasu's arteritis (TA) has been associated with many conditions. Herein described is a cas... more Takayasu's arteritis (TA) has been associated with many conditions. Herein described is a case of TA in a patient with rheumatic fever complicated with Sydenham's chorea. A 17-year-old female presented at age 6 with rheumatic fever followed by chorea a month later. At the age of 16, she developed a blood pressure discrepancy between the arms and faint pulses. Computed tomography angiography revealed diffuse aortic involvement and narrowing of the arteries. The presence of rheumatic fever and Sydenham's chorea in TA raises the possibility of an immunological basis for the pathogenesis of the disease.
Éditions du Conseil de l'Europe Regard éthique-Le clonage 2002, format A5, 200 pages-ISBN 92-871-... more Éditions du Conseil de l'Europe Regard éthique-Le clonage 2002, format A5, 200 pages-ISBN 92-871-4701-9-Prix : 15 € Des scientifiques, des philosophes, des juristes, des journalistes expliquent les questions éthiques liées aux différentes techniques de clonage et apportent leurs différents éclairages sur ces questions. Un glossaire, un rappel des concepts scientifiques de base, des illustrations et des références de sites Internet facilitent la lecture et la compréhension de l'ouvrage.
Journal of Epilepsy and Clinical Neurophysiology, 2009
OBJETIVO: Determinar a freqüência de epilepsia em uma amostra ambulatorial de pacientes idosos co... more OBJETIVO: Determinar a freqüência de epilepsia em uma amostra ambulatorial de pacientes idosos com demência e analisar possível associação da epilepsia a uma causa específica de demência. METODOLOGIA: Estudo retrospectivo com dados de 135 pacientes com demência acompanhados em ambulatório de Neurologia Cognitiva, no período de setembro de 2006 a novembro de 2007. Foi realizado levantamento de dados clínicos, laboratoriais, de neuroimagem e de eletroencefalograma. As etiologias das demências foram definidas de acordo com critérios diagnósticos específicos, a partir do quadro clínico, exame neurológico, avaliação neuropsicológica, exames laboratoriais e de neuroimagem. RESULTADOS: A freqüência de epilepsia foi 12%, sendo maior na demência mista (21,4%), seguida pela demência frontotemporal (18,6%), demência vascular (15,4%) e doença de Alzheimer (10,8%). No entanto, nenhuma diferença estatística foi observada entre essas freqüências (p = 0,817). Observou-se que 87,5% dos pacientes ini...
Alguns estudos sugerem que infartos cerebrais possam agravar a demência em pacientes com doença d... more Alguns estudos sugerem que infartos cerebrais possam agravar a demência em pacientes com doença de Alzheimer (DA) e que sintomas neuropsiquiátricos sejam comuns tanto na DA quanto na demência vascular (DV). Doença cerebrovascular concomitante à DA incorre na chamada demência mista (DM). OBJETIVOS: Comparar a freqüência e o perfil dos sintomas neuropsiquiátricos em uma amostra de pacientes com DA e DM. MÉTODOS: Análise retrospectiva dos prontuários de 70 pacientes com diagnóstico de DA provável e 14 com DM. Informações sobre sintomatologia neuropsiquiátrica foram obtidas por meio dos relatos de familiares e cuidadores. RESULTADOS: A média etária foi de 74,5 anos na DA e 75,1 na DM. O sintoma mais comum na DA foi agitação (61,4%), enquanto na DM foi apatia (71,7%). Na DM, nove (64,3%) pacientes apresentavam > 5 sintomas, enquanto na DA, 40 (57,1%) apresentavam < 4. Quarenta e cinco (64,3%) pacientes com DA tinham > 4 anos de doença; na DM, 10 (71,4%) tinham < 3 anos. Pacie...
OBJECTIVES: To present the methods and baseline characteristics of the Pietà study, a population-... more OBJECTIVES: To present the methods and baseline characteristics of the Pietà study, a population-based survey investigating successful brain aging in the oldest-old. METHOD: The study was conducted in Caeté (MG), Brazil. In 2007, 1,251 individuals aged 75+ years were living in the city and were invited to participate. Participants responded to a general health questionnaire and were submitted to clinical, neurological, cognitive, psychiatric and functional evaluations. A subgroup was submitted to neuropsychological testing, blood tests and magnetic resonance of the skull. Individuals were classified as having cognitive impairment-no dementia, dementia, parkinsonism, psychiatric disorders or successful brain aging. RESULTS: We evaluated 639 individuals (51.1% of the target population; 64% women), aged 81.4±5.2 years and with 2.7±2.6 years of schooling. Almost 30% of the elderly were illiterates and 82.1% belonged to middle/middle-low socioeconomic levels. Almost 50% were widows, but ...
Arquivos De Neuro-psiquiatria - ARQ NEURO-PSIQUIAT, 2008
Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome i... more Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome is generally deleterious. Apathy can be related to a dysfunction of the anatomical-system that supports the generation of voluntary actions, namely the prefrontal cortex and/or the prefrontal-subcortical circuits. In Alzheimer's disease, pathological and neuroimaging data indicate that apathy is likely due to a dysfunction of the medial prefrontal cortex. Accordingly, in this review article, we propose a pathophysiological model to explain apathetic behavior in Alzheimer's disease, combining data from neuroimaging, neuropathology and experimental research on the role of orbito-frontal cortex, anterior cingulate cortex, basal ganglia and dopamine in decision-making neurobiology.
‐ The Frontal Assessment Battery (FAB) has been proposed,as a diagnostic tool for patients with f... more ‐ The Frontal Assessment Battery (FAB) has been proposed,as a diagnostic tool for patients with frontal lobe syndrome. Objectives: To present the Brazilian version of the FAB and to show preliminary data on the performance of healthy elderly in the battery, correlating with age, education and scores in the Mini- Mental State Examination (MMSE). Methods: Forty-eight healthy elderly individuals
The Frontal Assessment Battery (FAB) has been proposed as a diagnostic tool for patients with fro... more The Frontal Assessment Battery (FAB) has been proposed as a diagnostic tool for patients with frontal lobe syndrome. Objectives: To present the Brazilian version of the FAB and to show preliminary data on the performance of healthy elderly in the battery, correlating with age, education and scores in the Mini- Mental State Examination (MMSE). Methods: Forty-eight healthy elderly individuals (34
132 Caregiver burden and neuropsychiatric symptoms Fialho PPA, et al. ... Patrícia Paes Araujo Fi... more 132 Caregiver burden and neuropsychiatric symptoms Fialho PPA, et al. ... Patrícia Paes Araujo Fialho1, Anne Marise Koenig1, Etelvina Lucas dos Santos2, Henrique Cerqueira Guimarães3, Rogério Gomes Beato3, Viviane Amaral Carvalho2, Thais Helena ...
Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determin... more Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education. We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ). Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales,...
Chorea is an abnormal movement characterized by a continuous flow of random muscle contractions. ... more Chorea is an abnormal movement characterized by a continuous flow of random muscle contractions. This phenomenon has several causes, such as infectious and degenerative processes. Chorea results from basal ganglia dysfunction. As the control of the eye movements is related to the basal ganglia, it is expected, therefore, that is altered in diseases related to chorea. Sydenham’s chorea, Huntington’s disease and neuroacanthocytosis are described in this review as basal ganglia illnesses that can present with abnormal eye movements. Ocular changes resulting from dysfunction of the basal ganglia are apparent in saccade tasks, slow pursuit, setting a target and anti-saccade tasks. The purpose of this article is to review the main characteristics of eye motion in these three forms of chorea.
A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of ... more A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State...
Revista brasileira de psiquiatria (São Paulo, Brazil : 1999), 2009
Sr. Editor, A doença de Huntington (DH) é uma doença genética neurodegenerativa transmitida por h... more Sr. Editor, A doença de Huntington (DH) é uma doença genética neurodegenerativa transmitida por herança autossômica dominante com penetrância completa. Sua gênese está na repetição exagerada do trinucleotídeo CAG no braço curto do cromossomo 4(4p16.3)1,2. Essa ...
Tremor and other hyperkinetic movements (New York, N.Y.), 2012
Takayasu's arteritis (TA) has been associated with many conditions. Herein described is a cas... more Takayasu's arteritis (TA) has been associated with many conditions. Herein described is a case of TA in a patient with rheumatic fever complicated with Sydenham's chorea. A 17-year-old female presented at age 6 with rheumatic fever followed by chorea a month later. At the age of 16, she developed a blood pressure discrepancy between the arms and faint pulses. Computed tomography angiography revealed diffuse aortic involvement and narrowing of the arteries. The presence of rheumatic fever and Sydenham's chorea in TA raises the possibility of an immunological basis for the pathogenesis of the disease.
Éditions du Conseil de l'Europe Regard éthique-Le clonage 2002, format A5, 200 pages-ISBN 92-871-... more Éditions du Conseil de l'Europe Regard éthique-Le clonage 2002, format A5, 200 pages-ISBN 92-871-4701-9-Prix : 15 € Des scientifiques, des philosophes, des juristes, des journalistes expliquent les questions éthiques liées aux différentes techniques de clonage et apportent leurs différents éclairages sur ces questions. Un glossaire, un rappel des concepts scientifiques de base, des illustrations et des références de sites Internet facilitent la lecture et la compréhension de l'ouvrage.
Journal of Epilepsy and Clinical Neurophysiology, 2009
OBJETIVO: Determinar a freqüência de epilepsia em uma amostra ambulatorial de pacientes idosos co... more OBJETIVO: Determinar a freqüência de epilepsia em uma amostra ambulatorial de pacientes idosos com demência e analisar possível associação da epilepsia a uma causa específica de demência. METODOLOGIA: Estudo retrospectivo com dados de 135 pacientes com demência acompanhados em ambulatório de Neurologia Cognitiva, no período de setembro de 2006 a novembro de 2007. Foi realizado levantamento de dados clínicos, laboratoriais, de neuroimagem e de eletroencefalograma. As etiologias das demências foram definidas de acordo com critérios diagnósticos específicos, a partir do quadro clínico, exame neurológico, avaliação neuropsicológica, exames laboratoriais e de neuroimagem. RESULTADOS: A freqüência de epilepsia foi 12%, sendo maior na demência mista (21,4%), seguida pela demência frontotemporal (18,6%), demência vascular (15,4%) e doença de Alzheimer (10,8%). No entanto, nenhuma diferença estatística foi observada entre essas freqüências (p = 0,817). Observou-se que 87,5% dos pacientes ini...
Alguns estudos sugerem que infartos cerebrais possam agravar a demência em pacientes com doença d... more Alguns estudos sugerem que infartos cerebrais possam agravar a demência em pacientes com doença de Alzheimer (DA) e que sintomas neuropsiquiátricos sejam comuns tanto na DA quanto na demência vascular (DV). Doença cerebrovascular concomitante à DA incorre na chamada demência mista (DM). OBJETIVOS: Comparar a freqüência e o perfil dos sintomas neuropsiquiátricos em uma amostra de pacientes com DA e DM. MÉTODOS: Análise retrospectiva dos prontuários de 70 pacientes com diagnóstico de DA provável e 14 com DM. Informações sobre sintomatologia neuropsiquiátrica foram obtidas por meio dos relatos de familiares e cuidadores. RESULTADOS: A média etária foi de 74,5 anos na DA e 75,1 na DM. O sintoma mais comum na DA foi agitação (61,4%), enquanto na DM foi apatia (71,7%). Na DM, nove (64,3%) pacientes apresentavam > 5 sintomas, enquanto na DA, 40 (57,1%) apresentavam < 4. Quarenta e cinco (64,3%) pacientes com DA tinham > 4 anos de doença; na DM, 10 (71,4%) tinham < 3 anos. Pacie...
OBJECTIVES: To present the methods and baseline characteristics of the Pietà study, a population-... more OBJECTIVES: To present the methods and baseline characteristics of the Pietà study, a population-based survey investigating successful brain aging in the oldest-old. METHOD: The study was conducted in Caeté (MG), Brazil. In 2007, 1,251 individuals aged 75+ years were living in the city and were invited to participate. Participants responded to a general health questionnaire and were submitted to clinical, neurological, cognitive, psychiatric and functional evaluations. A subgroup was submitted to neuropsychological testing, blood tests and magnetic resonance of the skull. Individuals were classified as having cognitive impairment-no dementia, dementia, parkinsonism, psychiatric disorders or successful brain aging. RESULTS: We evaluated 639 individuals (51.1% of the target population; 64% women), aged 81.4±5.2 years and with 2.7±2.6 years of schooling. Almost 30% of the elderly were illiterates and 82.1% belonged to middle/middle-low socioeconomic levels. Almost 50% were widows, but ...
Arquivos De Neuro-psiquiatria - ARQ NEURO-PSIQUIAT, 2008
Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome i... more Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome is generally deleterious. Apathy can be related to a dysfunction of the anatomical-system that supports the generation of voluntary actions, namely the prefrontal cortex and/or the prefrontal-subcortical circuits. In Alzheimer's disease, pathological and neuroimaging data indicate that apathy is likely due to a dysfunction of the medial prefrontal cortex. Accordingly, in this review article, we propose a pathophysiological model to explain apathetic behavior in Alzheimer's disease, combining data from neuroimaging, neuropathology and experimental research on the role of orbito-frontal cortex, anterior cingulate cortex, basal ganglia and dopamine in decision-making neurobiology.
‐ The Frontal Assessment Battery (FAB) has been proposed,as a diagnostic tool for patients with f... more ‐ The Frontal Assessment Battery (FAB) has been proposed,as a diagnostic tool for patients with frontal lobe syndrome. Objectives: To present the Brazilian version of the FAB and to show preliminary data on the performance of healthy elderly in the battery, correlating with age, education and scores in the Mini- Mental State Examination (MMSE). Methods: Forty-eight healthy elderly individuals
The Frontal Assessment Battery (FAB) has been proposed as a diagnostic tool for patients with fro... more The Frontal Assessment Battery (FAB) has been proposed as a diagnostic tool for patients with frontal lobe syndrome. Objectives: To present the Brazilian version of the FAB and to show preliminary data on the performance of healthy elderly in the battery, correlating with age, education and scores in the Mini- Mental State Examination (MMSE). Methods: Forty-eight healthy elderly individuals (34
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