CASSIO MACHADO DE CAMPOS BOTTINO
Projetos de Pesquisa
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LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Neuropsychiatric Symptoms, Caregiver Burden and Distress in Behavioral-Variant Frontotemporal Dementia and Alzheimer's Disease(2015) LIMA-SILVA, Thais Bento; BAHIA, Valeria Santoro; CARVALHO, Viviane Amaral; GUIMARAES, Henrique Cerqueira; CARAMELLI, Paulo; BALTHAZAR, Marcio Luiz; DAMASCENO, Benito; BOTTINO, Cassio Machado; BRUCKI, Sonia Maria; NITRINI, Ricardo; YASSUDA, Monica SanchesBackground/Aims: We aimed to compare caregiver burden and distress in behavioral-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) and to investigate which factors contribute to caregivers' burden and distress. Methods: Fifty patients and their care-givers were invited to participate. Among the patients, 20 had a diagnosis of bvFTD and 30 had AD. Caregivers and patients were statistically equivalent for age, sex, education and dementia severity according to Clinical Dementia Rating. The protocol included the Short Zarit Burden Inventory, the Neuropsychiatric Inventory (NPI), Disability Assessment for Dementia (DAD), the Cornell Scale for Depression in Dementia (CSDD), Addenbrooke's Cognitive Examination-Revised, the Executive Interview with 25 Items, Direct Assessment of Functional Status and the Geriatric Anxiety Inventory (GAI). Results: In the NPI, caregivers of bvFTD patients reported a higher presence and severity of neuropsychiatric symptoms and caregiver distress compared to caregivers of AD patients. There was no significant difference in the perceived burden. In bvFTD, DAD and GAI scores were significantly correlated with burden, whereas in AD, burden was correlated with CSDD and NPI scores. Psychiatric symptoms were associated with distress in both groups. Conclusions: Caregivers of bvFTD patients experienced higher levels of distress than caregivers of AD patients. Patients' functional limitations were associated with burden of caregivers of bvFTD patients, whereas neuropsychiatric symptoms were associated with caregiver strain in both groups. (C) 2015 S. Karger AG, Basel
- Translation, cross-cultural adaptation and applicability of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS)(2013) LIMA-SILVA, Thais Bento; BAHIA, Valéria Santoro; CARVALHO, Viviane Amaral; GUIMARÃES, Henrique Cerqueira; CARAMELLI, Paulo; BALTHAZAR, Márcio; DAMASCENO, Benito; BOTTINO, Cássio Machado de Campos; BRUCKI, Sônia Maria Dozzi; MIOSHI, Eneida; NITRINI, Ricardo; YASSUDA, Mônica SanchesABSTRACT Background: Staging scales for dementia have been devised for grading Alzheimer's disease (AD) but do not include the specific symptoms of frontotemporal lobar degeneration (FTLD). Objective: To translate and adapt the Frontotemporal Dementia Rating Scale (FTD-FRS) to Brazilian Portuguese. Methods: The cross-cultural adaptation process consisted of the following steps: translation, back-translation (prepared by independent translators), discussion with specialists, and development of a final version after minor adjustments. A pilot application was carried out with 12 patients diagnosed with bvFTD and 11 with AD, matched for disease severity (CDR=1.0). The evaluation protocol included: Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), Executive Interview (EXIT-25), Neuropsychiatric Inventory (NPI), Frontotemporal Dementia Rating Scale (FTD-FRS) and Clinical Dementia Rating scale (CDR). Results: The Brazilian version of the FTD-FRS seemed appropriate for use in this country. Preliminary results revealed greater levels of disability in bvFTD than in AD patients (bvFTD: 25% mild, 50% moderate and 25% severe; AD: 36.36% mild, 63.64% moderate). It appears that the CDR underrates disease severity in bvFTD since a relevant proportion of patients rated as having mild dementia (CDR=1.0) in fact had moderate or severe levels of disability according to the FTD-FRS. Conclusion: The Brazilian version of the FTD-FRS seems suitable to aid staging and determining disease progression.
conferenceObject Cross-cultural Adaptation and Validity of the Brazilian version of the Clinical staging scale and disease progression in frontotemporal dementia(2016) SILVA, T. Bento Lima da; BAHIA, V.; CECCHINI, M. Amore; CASSIMIRO, L.; CARVALHO, V. Amaral; GUIMARAES, H. Cerqueira; CARAMELLI, P.; BALTHAZAR, M.; DAMASCENO, B.; BOTTINO, C.; BRUCKI, S.; SOUZA, L. Cruz de; MIOSHI, E.; NITRINI, R.; YASSUDA, M.- Peripheral Oxidative Stress Biomarkers in Mild Cognitive Impairment and Alzheimer's Disease(2011) TORRES, Larissa Lobo; QUAGLIO, Nathalia Barbosa; DE SOUZA, Gisele Tavares; GARCIA, Raphael Tamborelli; MUNHOZ DATI, Livia Mendonca; MOREIRA, Wallace Luiz; DE MELO LOUREIRO, Ana Paula; DE SOUZA-TALARICO, Juliana Nery; SMID, Jerusa; PORTO, Claudia Selito; DE CAMPOS BOTTINO, Cassio Machado; NITRINI, Ricardo; DE MORAES BARROS, Silvia Berlanga; CAMARINI, Rosana; MARCOURAKIS, TaniaOxidative stress has been associated with normal aging and Alzheimer's disease (AD). However, little is known about oxidative stress in mild cognitive impairment (MCI) patients who present a high risk for developing AD. The aim of this study was to investigate plasma production of the lipid peroxidation marker, malonaldehyde (MDA) and to determine, in erythrocytes, the enzymatic antioxidant activity of catalase, glutathione peroxidase (GPx), glutathione reductase (GR), and glutathione S-transferase (GST) in 33 individuals with MCI, 29 with mild probable AD and 26 healthy aged subjects. GR/GPx activity ratio was calculated to better assess antioxidant defenses. The relationship between oxidative stress and cognitive performance was also evaluated by the Mini Mental State Examination (MMSE). AD patients showed higher MDA levels than both MCI and healthy elderly subjects. MCI subjects also exhibited higher MDA levels compared to controls. Catalase and GPx activity were similar in MCI and healthy individuals but higher in AD. GR activity was lower in MCI and AD patients than in healthy aged subjects. Additionally, GR/GPx ratio was higher in healthy aged subjects, intermediate in MCI and lower in AD patients. No differences in GST activity were detected among the groups. MMSE was negatively associated with MDA levels (r = -0.31, p = 0.028) and positively correlated with GR/GPx ratio in AD patients (r = 0.68, p < 0.001). MDA levels were also negatively correlated to GR/GPx ratio (r = -0.31, p = 0.029) in the AD group. These results suggest that high lipid peroxidation and decreased antioxidant defenses may be present early in cognitive disorders.
- Support vector machine-based classification of neuroimages in Alzheimer's disease: direct comparison of FDG-PET, rCBF-SPECT and MRI data acquired from the same individuals(2018) FERREIRA, Luiz K.; RONDINA, Jane M.; KUBO, Rodrigo; ONO, Carla R.; LEITE, Claudia C.; SMID, Jerusa; BOTTINO, Cassio; NITRINI, Ricardo; BUSATTO, Geraldo F.; DURAN, Fabio L.; BUCHPIGUEL, Carlos A.Objective: To conduct the first support vector machine (SVM)-based study comparing the diagnostic accuracy of T1-weighted magnetic resonance imaging (T1-MRI), F-fluorodeoxyglucose-positron emission tomography (FDG-PET) and regional cerebral blood flow single-photon emission computed tomography (rCBF-SPECT) in Alzheimer's disease (AD). Method: Brain T1-MRI, FDG-PET and rCBF-SPECT scans were acquired from a sample of mild AD patients (n=20) and healthy elderly controls (n=18). SVM-based diagnostic accuracy indices were calculated using whole-brain information and leave-one-out cross-validation. Results: The accuracy obtained using PET and SPECT data were similar. PET accuracy was 68 similar to 71% and area under curve (AUC) 0.77 similar to 0.81; SPECT accuracy was 68 similar to 74% and AUC 0.75 similar to 0.79, and both had better performance than analysis with T1-MRI data (accuracy of 58%, AUC 0.67). The addition of PET or SPECT to MRI produced higher accuracy indices (68 similar to 74%; AUC: 0.74 similar to 0.82) than T1-MRI alone, but these were not clearly superior to the isolated neurofunctional modalities. Conclusion: In line with previous evidence, FDG-PET and rCBF-SPECT more accurately identified patients with AD than T1-MRI, and the addition of either PET or SPECT to T1-MRI data yielded increased accuracy. The comparable SPECT and PET performances, directly demonstrated for the first time in the present study, support the view that rCBF-SPECT still has a role to play in AD diagnosis.
- Brazilian research on cognitive impairment and dementia from 1999 to 2013(2014) TOLEDO, André Aguiar Souza Furtado de; NITRINI, Ricardo; BOTTINO, Cássio Machado de Campos; CARAMELLI, PauloThe phenomenon of demographic transition in recent decades has increased the number of elderly people in Brazil, promoting an escalation in chronic-degenerative conditions, particularly dementia and cognitive related disorders. OBJECTIVE: The aim of this study was to assess the evolution of the Brazilian scientific publications on dementia and related conditions from 1999 to 2013. METHODS: Articles published during the analysis period were searched on three electronic databases: Scopus, Medline (via PubMed) and Lilacs (via BVS). The keywords used were Alzheimer's disease, dementia and mild cognitive impairment, with Brazil as the country of affiliation. RESULTS: A total of 1,657 articles met the conditions for inclusion in the study. The output of Brazilian researchers in the area of cognitive disorders increased 11.38-fold in the fifteen-year period of analysis and 4.98-fold from 2003 to 2013. More than half of the articles (53%) were published in international journals. The majority of institutions involved in publications were public universities while 19% were collaborative studies involving Brazilian and international institutions. CONCLUSION: Despite marked growth, the number of Brazilian scientific publications in the area of cognitive impairment and dementia is still low. More effort is required to improve the output of Brazilian researchers and institutions. Possible strategies to accomplish this increase could be to encourage residents to participate in publications of scientific papers during their residence program and to increase the collaborations between different institutions within Brazil and with the international scientific community.
- Direct and Indirect Assessments of Activities of Daily Living in Behavioral Variant Frontotemporal Dementia and Alzheimer Disease(2015) LIMA-SILVA, Thais Bento; BAHIA, Valeria Santoro; CARVALHO, Viviane Amaral; GUIMARAES, Henrique Cerqueira; CARAMELLI, Paulo; BALTHAZAR, Marcio Luiz Figueredo; DAMASCENO, Benito; BOTTINO, Cassio Machado de Campos; BRUCKI, Sonia Maria Dozzi; NITRINI, Ricardo; YASSUDA, Monica SanchesBackground: There is limited information about the functional profile of behavioral variant frontotemporal dementia (bvFTD). Objective: To compare direct and indirect assessments of activities of daily living (ADLs) in bvFTD and Alzheimer disease (AD) and their relationship with cognitive performance. Methods: In all, 20 patients with bvFTD, 30 patients with AD, and 34 normal controls (NCs), matched for age, education, and severity of dementia, completed the Direct Assessment of Functional Performance (DAFS-BR) and usual cognitive measures. The Disability Assessment for Dementia (DAD) was completed by caregivers. Results: In DAFS-BR, patients with bvFTD and AD had similar performance but lower than NCs. In DAD, there were no significant differences for effective performance, but patients with bvFTD had lower scores for initiation and planning/organization. Patients with bvFTD were less impaired than AD in cognition. Conclusion: Functional changes in bvFTD seem to be better documented by indirect measures.
- Effects of galantamine and galantamine combined with nimodipine on cognitive speed and quality of life in mixed dementia: a 24-week, randomized, placebo-controlled exploratory trial (the REMIX study)(2014) CARAMELLI, Paulo; LAKS, Jerson; PALMINI, Andre Luis Fernandes; NITRINI, Ricardo; CHAVES, Marcia Lorena Fagundes; FORLENZA, Orestes Vicente; VALE, Francisco de Assis Carvalho do; BARBOSA, Maira Tonidandel; BOTTINO, Cassio Machado de Campos; MACHADO, Joao Carlos; CHARCHAT-FICHMAN, Helenice; LAWSON, Fabio LoreaThe effects of galantamine (GAL) on quality of life (QoL) and cognitive speed, as well its effects combined with nimodipine (NIM) in Alzheimer disease (AD) with cerebrovascular disease (mixed dementia), have not been explored. Method: Double-blind, placebo-controlled, multicenter Brazilian trial, studying the effects of GAL/NIM vs. GAL/placebo (PLA) in mild to moderate mixed dementia. Patients were randomized to receive GAL/NIM or GAL/PLA for 24 weeks. Primary efficacy measures were changes on a computerized neuropsychological battery (CNTB) and QoL Scale in Alzheimer's Disease (QoL-AD) from baseline to week 24. Results: Twenty-one patients received at least one drug dose (9 GAL/NIM and 12 GAL/PLA). Groups were matched for age, sex, education, cognitive and QoL scores at baseline. No significant differences were observed between groups on primary or secondary measures. QoL and cognitive performance showed significant improvement (p<0.05) from baseline when all GAL-treated patients were analyzed. Adverse events were predominantly mild to moderate. Conclusion: GAL treatment improved QoL in mixed dementia, in addition to its previously known cognitive benefits. The combination GAL/NIM was not advantageous. However, the small sample size precludes any definitive conclusions.
- Functional profile of patients with behavioral variant frontotemporal dementia (bvFTD) compared to patients with Alzheimer's disease and normal controls(2013) LIMA-SILVA, Thais Bento; BAHIA, Valéria Santoro; CARVALHO, Viviane Amaral; GUIMARÃES, Henrique Cerqueira; CARAMELLI, Paulo; BALTHAZAR, Márcio; DAMASCENO, Benito; BOTTINO, Cássio Machado de Campos; BRUCKI, Sônia Maria Dozzi; NITRINI, Ricardo; YASSUDA, Mônica SanchesABSTRACT There are few studies describing the functional changes in behavioral variant frontotemporal dementia (bvFTD) and it is not clear which aspects of functionality are affected by the disease. Objective: The aim of the present investigation was to characterize the functional profile of patients previously diagnosed with bvFTD. Methods: The sample consisted of 31 patients diagnosed with bvFTD, who were compared to patients with Alzheimer's disease (AD) (n=31) and to healthy control subjects (NC) (n=34), matched for schooling and age. bvFTD and AD patients were matched by severity of dementia. The protocol included the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Direct Assessment of Functional Status (DAFS-BR), Functional Activities Questionnaire (PFAQ), Disability Assessment for Dementia (DAD) and the Clinical Dementia Rating scale (CDR). Results: The group with bvFTD showed worse performance on Initiation and Planning/Organization in the DAD and on ability to feed oneself in the DAFS-BR, as well as higher scores on the PFAQ, suggesting greater dependence in the bvFTD group. Conclusion: The results suggest that individuals with bvFTD display greater functional impairment compared to AD patients with a similar degree of dementia severity and to healthy controls. Direct assessment of functionality proved unable to clearly differentiate between the dementia subtypes.