RAQUEL CHACON RUIZ MARTINEZ

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Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 29
  • article 3 Citação(ões) na Scopus
    Long-Term Follow-Up on Bilateral Posterior Hypothalamic Deep Brain Stimulation for Treating Refractory Aggressive Behavior in a Patient with Cri du Chat Syndrome: Analysis of Clinical Data, Intraoperative Microdialysis, and Imaging Connectomics
    (2023) RIOS, Adriana Lucia Lopez; GERMANN, Jurgen; HUTCHISON, William D.; POSADA, Luis Fernando Botero; VELASQUEZ, Luisa Fernanda Ahunca; JIMENEZ, Francisco Aureliano Garcia; ESCOBAR, Jose Miguel Gloria; MARTINEZ, Raquel Chacon Ruiz; HAMANI, Clement; LEBRUN, Ivo; AUADA, Aline V. V.; BRAVO, Carlos Anibal Restrepo; GOUVEIA, Flavia Venetucci
    Posterior hypothalamic-deep brain stimulation (pHyp-DBS) has been reported as a successful treatment for reducing refractory aggressive behaviors in patients with distinct primary diagnoses. Here, we report on a patient with cri du chat syndrome presenting severe self-injury and aggressive behaviors toward others, who was treated with pHyp-DBS. Positive results were observed at long-term follow-up in aggressive behavior and quality of life. Intraoperative microdialysis and imaging connectomics analysis were performed to investigate possible mechanisms of action. Our results suggest the involvement of limbic and motor areas and alterations in main neurotransmitter levels in the targeted area that are associated with positive results following treatment.
  • article 72 Citação(ões) na Scopus
    Active vs. reactive threat responding is associated with differential c-Fos expression in specific regions of amygdala and prefrontal cortex
    (2013) MARTINEZ, Raquel C. R.; GUPTA, Nikita; LAZARO-MUNOZ, Gabriel; SEARS, Robert M.; KIM, Soojeong; MOSCARELLO, Justin M.; LEDOUX, Joseph E.; CAIN, Christopher K.
    Active avoidance (AA) is an important paradigm for studying mechanisms of aversive instrumental learning, pathological anxiety, and active coping. Unfortunately, AA neurocircuits are poorly understood, partly because behavior is highly variable and reflects a competition between Pavlovian reactions and instrumental actions. Here we exploited the behavioral differences between good and poor avoiders to elucidate the AA neurocircuit. Rats received Sidman AA training and expression of the activity-dependent immediate-early gene c-fos was measured after a shock-free AA test. Six brain regions with known or putative roles in AA were evaluated: amygdala, periaqueductal gray, nucleus accumbens, dorsal striatum, prefrontal cortex (PFC), and hippocampus. Good avoiders showed little Pavlovian freezing and high AA rates at test, the opposite of poor avoiders. Although c-Fos activation was observed throughout the brain, differential activation was found only in subregions of amygdala and PFC. Interestingly, c-Fos correlated with avoidance and freezing in only five of 20 distinct areas evaluated: lateral amygdala, central amygdala, medial amygdala, basal amygdala, and infralimbic PFC. Thus, activity in specific amygdala-PFC circuits likely mediates the competition between instrumental actions and Pavlovian reactions after AA training. Individual differences in AA behavior, long considered a nuisance by researchers, may be the key to elucidating the AA neurocircuit and understanding pathological response profiles.
  • conferenceObject
    Non-motor symptoms in PD candidates for DBS treatment
    (2016) GHILARDI, M. G. dos Santos; MARTINEZ, R. C. R.; CURY, R. G.; ARANHA, J. R.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.
  • conferenceObject
    Pallidal versus subthalamic stimulation for PD: Beyond the motor effects
    (2016) GHILARDI, M. G. dos Santos; CURY, R. G.; MARTINEZ, R. C. R.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.
  • article 16 Citação(ões) na Scopus
    Fully Automated Habenula Segmentation Provides Robust and Reliable Volume Estimation Across Large Magnetic Resonance Imaging Datasets, Suggesting Intriguing Developmental Trajectories in Psychiatric Disease
    (2020) GERMANN, Juergen; GOUVEIA, Flavia Venetucci; MARTINEZ, Raquel C. R.; ZANETTI, Marcus Vinicius; DURAN, Fabio Luis de Souza; CHAIM-AVANCINI, Tiffany M.; SERPA, Mauricio H.; CHAKRAVARTY, M. Mallar; DEVENYI, Gabriel A.
    Studies of habenula (Hb) function and structure provided evidence of its involvement in psychiatric disorders, including schizophrenia and bipolar disorder. Previous studies using magnetic resonance imaging (manual/semi-automated segmentation) have reported conflicting results. Aiming to improve Hb segmentation reliability and the study of large datasets, we describe a fully automated protocol that was validated against manual segmentations and applied to 3 datasets (childhood/adolescence and adult bipolar disorder and schizophrenia). It achieved reliable Hb segmentation, providing robust volume estimations across a large age range and varying image acquisition parameters. Applying it to clinically relevant datasets, we found smaller Hb volumes in the adult bipolar disorder dataset and larger volumes in the adult schizophrenia dataset compared with healthy control subjects. There are indications that Hb volume in both groups shows deviating developmental trajectories early in life. This technique sets a precedent for future studies, as it allows for fast and reliable Hb segmentation and will be publicly available.
  • article 7 Citação(ões) na Scopus
    Bilateral Amygdala Radio-Frequency Ablation for Refractory Aggressive Behavior Alters Local Cortical Thickness to a Pattern Found in Non-refractory Patients
    (2021) GOUVEIA, Flavia Venetucci; GERMANN, Jurgen; DEVENYI, Gabriel A.; FONOFF, Erich T.; MORAIS, Rosa M. C. B.; BRENTANI, Helena; CHAKRAVARTY, M. Mallar; MARTINEZ, Raquel C. R.
    Aggressive behaviors comprise verbal and/or physical aggression directed toward oneself, others, or objects and are highly prevalent among psychiatric patients, especially patients diagnosed with autism spectrum disorder and severe intellectual disabilities. Some of these patients are considered refractory to treatment, and functional neurosurgery targeting the amygdala can result in widespread plastic brain changes that might reflect ceasing of some abnormal brain function, offering symptom alleviation. This study investigated cortical thickness changes in refractory aggressive behavior patients that were treated with bilateral amygdala ablation and compared to control patients presenting non-refractory aggressive behavior [three refractory and seven non-refractory patients, all males diagnosed with autism spectrum disorder (ASD) and intellectual disabilities]. The Overt Aggression Scale (OAS) was used to quantify behavior and magnetic resonance imaging was performed to investigate cortical thickness. Before surgery, both groups presented similar total OAS score, however refractory patients presented higher physical aggression against others. After surgery the refractory group showed 88% average reduction of aggressive behavior. Imaging analysis showed that while refractory patients present an overall reduction in cortical thickness compared to non-refractory patients across both timepoints, the local pattern of thickness difference found in areas of the neurocircuitry of aggressive behavior present before surgery is diminished and no longer detected after surgery. These results corroborate the hypotheses on induction of widespread neuronal plasticity following functional neurosurgical procedures resulting in modifications in brain morphology and improvement in behavior. Further studies are necessary to determine the underlying cause of these morphological changes and to better understand and improve treatment options.
  • article 1 Citação(ões) na Scopus
    Does TRODAT-1 SPECT Uptake Correlate with Cerebrospinal Fluid alpha-Synuclein Levels in Mid-Stage Parkinson's Disease?
    (2023) COUTINHO, Artur M.; GHILARDI, Maria Gabriela; CAMPOS, Ana Carolina P.; ETCHEBEHERE, Elba; FONOFF, Fernanda C.; CURY, Rubens G.; PAGANO, Rosana L.; MARTINEZ, Raquel C. R.; FONOFF, Erich T.
    Background: Parkinson's disease (PD) is characterized by a progressive loss of nigrostriatal dopaminergic neurons with impaired motor and non-motor symptoms. It has been suggested that motor asymmetry could be caused due to an imbalance in dopamine levels, as visualized by dopamine transporter single emission computed tomography test (DAT-SPECT), which might be related to indirect measures of neurodegeneration, evaluated by the Montreal Cognitive Assessment (MOCA) and alpha-synuclein levels in the cerebrospinal fluid (CSF). Therefore, this study aimed to understand the correlation between disease laterality, DAT-SPECT, cognition, and alpha-synuclein levels in PD. Methods: A total of 28 patients in the moderate-advanced stage of PD were subjected to neurological evaluation, TRODAT-1-SPECT/CT imaging, MOCA, and quantification of the levels of alpha-synuclein. Results: We found that alpha-synuclein in the CSF was correlated with global cognition (positive correlation, r(2) = 0.3, p = 0.05) and DAT-SPECT concentration in the putamen (positive correlation, r(2) = 0.4, p = 0.005), and striatum (positive correlation, r(2) = 0.2, p = 0.03), thus working as a neurodegenerative biomarker. No other correlations were found between DAT-SPECT, CSF alpha-synuclein, and cognition, thus suggesting that they may be lost with disease progression. Conclusions: Our data highlight the importance of understanding the dysfunction of the dopaminergic system in the basal ganglia and its complex interactions in modulating cognition.
  • article 5 Citação(ões) na Scopus
    Case report: 5 Years follow-up on posterior hypothalamus deep brain stimulation for intractable aggressive behaviour associated with drug-resistant epilepsy
    (2021) GOUVEIA, Flavia Venetucci; GERMANN, Jurgen; ELIAS, Gavin JB.; HAMANI, Clement; FONOFF, Erich Talamoni; MARTINEZ, Raquel Chacon Ruiz
  • conferenceObject
    Rat brain basal ganglia imaged with optical coherence tomography: Feasibility and future perspectives
    (2015) ANGELOS, J. S. dos; LOPEZ, W. O. C.; MARTINEZ, R. C. R.; REIS, P. R.; TAKIMURA, C. K.; TEIXEIRA, M. J.; LEMOS NETO, P. A.; FONOFF, E. T.
  • article 7 Citação(ões) na Scopus
    Habenula activation patterns in a preclinical model of neuropathic pain accompanied by depressive-like behaviour
    (2022) ANTUNES, Geiza Fernanda; CAMPOS, Ana Carolina Pinheiro; ASSIS, Danielle Varin de; GOUVEIA, Flavia Venetucci; SENO, Midia Dias de Jesus; PAGANO, Rosana Lima; MARTINEZ, Raquel Chacon Ruiz
    Pain and depression are complex disorders that frequently co-occur, resulting in diminished quality of life. The habenula is an epithalamic structure considered to play a pivotal role in the neurocircuitry of both pain and depression. The habenula can be divided into two major areas, the lateral and medial habenula, that can be further subdivided, resulting in 6 main subregions. Here, we investigated habenula activation patterns in a rat model of neuropathic pain with accompanying depressive-like behaviour. Wistar rats received active surgery for the development of neuropathic pain (chronic constriction injury of the sciatic nerve; CCI), sham surgery (surgical control), or no surgery (behavioural control). All animals were evaluated for mechanical nociceptive threshold using the paw pressure test and depressive-like behaviour using the forced swimming test, followed by evaluation of the immunoreactivity to cFos-a marker of neuronal activity-in the habenula and subregions. The Open Field Test was used to evaluate locomotor activity. Animals with peripheral neuropathy (CCI) showed decreased mechanical nociceptive threshold and increased depressive-like behaviour compared to control groups. The CCI group presented decreased cFos immunoreactivity in the total habenula, total lateral habenula and lateral habenula subregions, compared to controls. No difference was found in cFos immunoreactivity in the total medial habenula, however when evaluating the subregions of the medial habenula, we observed distinct activation patterns, with increase cFos immunoreactivity in the superior subregion and decrease in the central subregion. Taken together, our data suggest an involvement of the habenula in neuropathic pain and accompanying depressive-like behaviour.