VALQUIRIA APARECIDA DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Effects of dentate nucleus stimulation in spinocerebellar ataxia type 3(2019) CURY, Rubens Gisbert; FRANCA, Carina; SILVA, Valquiria; BARBOSA, Egberto Reis; CAPATO, Tamine T. C.; LEPSKI, Guilherme; DUARTE, Kleber Paiva; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de
- Effects of cerebellar neuromodulation in movement disorders: A systematic review(2018) FRANCA, Carina; ANDRADE, Daniel Ciampi de; TEIXEIRA, Manoel Jacobsen; GALHARDONI, Ricardo; SILVA, Valquiria; BARBOSA, Egberto Reis; CURY, Rubens GisbertBackground: The cerebellum is involved in the pathophysiology of many movement disorders and its importance in the field of neuromodulation is growing. Objectives: To review the current evidence for cerebellar modulation in movement disorders and its safety profile. Methods: Eligible studies were identified after a systematic literature review of the effects of cerebellar modulation in cerebellar ataxia, Parkinson's disease (PD), essential tremor (ET), dystonia and progressive supranuclear palsy (PSP). Neuromodulation techniques included transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS). The changes in motor scores and the incidence of adverse events after the stimulation were reviewed. Results: Thirty-four studies were included in the systematic review, comprising 431 patients. The evaluation after stimulation ranged from immediately after to 12 months after. Neuromodulation techniques improved cerebellar ataxia due to vascular or degenerative etiologies (TMS, tDCS and DBS), dyskinesias in PD patients (TMS), gross upper limb movement in PD patients (tDCS), tremor in ET (TMS and tDCS), cervical dystonia (TMS and tDCS) and dysarthria in PSP patients (TMS). All the neuromodulation techniques were safe, since only three studies reported the existence of side effects (slight headache after TMS, local skin erythema after tDCS and infectious complication after DBS). Eleven studies did not mention if adverse events occurred. Conclusions: Cerebellar modulation can improve specific symptoms in some movement disorders and is a safe and well-tolerated procedure. Further studies are needed to lay the groundwork for new researches in this promising target.
conferenceObject Effects of Cerebellar Neuromodulation in Movement Disorders: A Systematic Review(2018) FRANCA, Carina; ANDRADE, Daniel De; TEIXEIRA, Manoel; GALHARDONI, Ricardo; SILVA, Valquiria; BARBOSA, Egberto; CURY, Rubens- Abnormal sensory thresholds of dystonic patients are not affected by deep brain stimulation(2021) LISTIK, Clarice; CURY, Rubens Gisbert; SILVA, Valquiria Aparecida da; CASAGRANDE, Sara Carvalho Barbosa; LISTIK, Eduardo; LINK, Naira; GALHARDONI, Ricardo; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deBackground Unlike motor symptoms, the effects of deep brain stimulation (DBS) on non-motor symptoms associated with dystonia remain unknown. Methods The objective of this study was to assess the effects of DBS on evoked experimental pain and cutaneous sensory thresholds in a crossover, double-blind on/off study and compare these results with those of healthy volunteers (HV). Results Sixteen patients with idiopathic dystonia (39.9 +/- 13 years old, n = 14 generalized) with DBS of the globus pallidus internus underwent a battery of quantitative sensory testing and assessment using a pain top-down modulation system (conditioned pain modulation, CPM). Results for the more and less dystonic body regions were compared in on and off stimulation. The patients' results were compared to age- and sex-matched HV. Descending pain modulation CPM responses in dystonic patients (on-DBS, 11.8 +/- 40.7; off-DBS, 1.8 +/- 22.1) was abnormally low (defective) compared to HV (-15.6 +/- 23.5, respectively p = .006 and p = .042). Cold pain threshold and cold hyperalgesia were 54.8% and 95.7% higher in dystonic patients compared to HV. On-DBS CPM correlated with higher Burke-Fahn-Marsden disability score (r = 0.598; p = .014). While sensory and pain thresholds were not affected by DBS on/off condition, pain modulation was abnormal in dystonic patients and tended to be aggravated by DBS. Conclusion The analgesic effects after DBS do not seem to depend on short-duration changes in cutaneous sensory thresholds in dystonic patients and may be related to changes in the central processing of nociceptive inputs.
conferenceObject Effects of deep transcranial magnetic stimulation of the cerebellum on cerebellar ataxias: A randomized, double-blind, cross-over clinical trial(2020) FRANCA, C.; ANDRADE, D. de; SILVA, V.; GALHARDONI, R.; BARBOSA, E.; TEIXEIRA, M.; CURY, R.conferenceObject Deep brain stimulation of the dentate nucleus improves ataxia and modulates cortical excitability(2016) FRANCA, C. C.; TEIXEIRA, M. J.; ANDRADE, D. Ciampi de; GALHARDONI, R.; BARBOZA, V. R.; SILVA, V.; LEPSKI, G.; BARBOSA, E. R.; CURY, R. G.- Improvement of Non-motor Symptoms and Quality of Life After Deep Brain Stimulation for Refractory Dystonia: A 1-Year Follow-Up(2021) LISTIK, Clarice; CURY, Rubens Gisbert; CASAGRANDE, Sara Carvalho Barbosa; LISTIK, Eduardo; ARNAUT, Debora; SANTIAGO, Natally; SILVA, Valquiria Aparecida Da; GALHARDONI, Ricardo; MACHADO, Julia de Lima Arantes; ALMEIDA, Jessica Campelo de; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi DeIntroduction: Deep brain stimulation (DBS) is a treatment option for refractory dystonia's motor symptoms, while its non-motor symptoms (NMS) have been less systematically assessed. We aimed to describe the effects of DBS on NMS in refractory generalized inherited/idiopathic dystonia prospectively. Methods: We evaluated patients before and 1 year after DBS surgery and applied the following scales: Burke-Fahn-Marsden Rating Scale (BFMRS), NMS Scale for Parkinson's Disease (NMSS-PD), Parkinson's Disease Questionnaire-8, short-form Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI), and short-form McGill Pain Questionnaire (MPQ). Results: Eleven patients (38.35 +/- 11.30 years) underwent surgery, all with generalized dystonia. Motor BFMRS subscore was 64.36 +/- 22.94 at baseline and 33.55 +/- 17.44 1 year after DBS surgery (47.9% improvement, p = 0.003). NMSS-PD had a significant change 12 months after DBS, from 70.91 +/- 59.07 to 37.18 +/- 55.05 (47.5% improvement, p = 0.013). NMS changes were mainly driven by changes in the gastrointestinal (p = 0.041) and miscellaneous domains (p = 0.012). Seven patients reported chronic pain before DBS and four after it. BPI's severity and interference scores were 4.61 +/- 2.84 and 4.12 +/- 2.67, respectively, before surgery, and 2.79 +/- 2.31 (0.00-6.25) and 1.12 +/- 1.32 (0.00-3.00) after, reflecting a significant improvement (p = 0.043 and p = 0.028, respectively). NPSI score was 15.29 +/- 13.94 before, while it was reduced to 2.29 +/- 2.98 afterward (p = 0.028). MPQ's total score was 9.00 +/- 3.32 before DBS, achieving 2.71 +/- 2.93 after (p = 0.028). Conclusions: DBS improves NMS in generalized inherited/idiopathic dystonia, including chronic pain.
- Parkinson's Disease-related Pains are Not Equal: Clinical, Somatosensory and Cortical Excitability Findings in Individuals With Nociceptive Pain(2023) BARBOZA, Victor Rossetto; KUBOTA, Gabriel Taricani; SILVA, Valquiria Aparecida da; BARBOSA, Luciana Mendonca; ARNAUT, Debora; RODRIGUES, Antonia Lilian de Lima; GALHARDONI, Ricardo; CURY, Rubens Gisbert; BARBOSA, Egberto Reis; BRUNONI, Andre Russowsky; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deChronic pain is a frequent and burdensome nonmotor symptom of Parkinson's disease (PD). PD-related chronic pain can be classified as nociceptive, neuropathic, or nociplastic, the former being the most frequent subtype. However, differences in neurophysiologic profiles between these pain subtypes, and their potential prognostic and therapeutic implications have not been explored yet. This is a cross-sectional study on patients with PD (PwP)-related chronic pain (ie, started with or was aggravated by PD). Subjects were assessed for clinical and pain characteristics through ques-tionnaires and underwent quantitative sensory tests and motor corticospinal excitability (CE) eva-luations. Data were then compared between individuals with nociceptive and non-nociceptive (ie, neuropathic or nociplastic) pains. Thirty-five patients were included (51.4% male, 55.7 +/- 11.0 years old), 20 of which had nociceptive pain. Patients with nociceptive PD-related pain had lower warm detection threshold (WDT, 33.34 +/- 1.39 vs 34.34 +/- 1.72, P = .019) and mechanical detection threshold (MDT, 2.55 +/- 1.54 vs 3.86 +/- .97, P = .007) compared to those with non-nociceptive pains. They also presented a higher proportion of low rest motor threshold values than the non-nociceptive pain ones (64.7% vs 26.6%, P = .048). In non-nociceptive pain patients, there was a negative corre-lation between WDT and non-motor symptoms scores (r = -.612, P = .045) and a positive correlation between MDT and average pain intensity (r = .629, P = .038), along with neuropathic pain symptom scores (r = .604, P = .049). It is possible to conclude that PD-related chronic pain subtypes have dis-tinctive somatosensory and CE profiles. These preliminary data may help better frame previous contradictory findings in PwP and may have implications for future trial designs aiming at developing individually-tailored therapies. Perspective: This work showed that PwP-related nociceptive chronic pain may have distinctive somatosensory and CE profiles than those with non-nociceptive pain subtypes. These data may help shed light on previous contradictory findings in PwP and guide future trials aiming at developing individually-tailored management strategies. (c) 2023 The Author(s).
- Connectivity Patterns of Subthalamic Stimulation Influence Pain Outcomes in Parkinson's Disease(2020) CURY, Rubens Gisbert; TEIXEIRA, Manoel Jacobsen; GALHARDONI, Ricardo; SILVA, Valquiria; IGLESIO, Ricardo; FRANCA, Carina; ARNAUT, Debora; FONOFF, Erich Talamoni; BARBOSA, Egberto Reis; ANDRADE, Daniel Ciampi deBackground: Pain is highly prevalent in Parkinson's disease and is associated with significant reduction in health-related quality of life. Subthalamic deep brain stimulation can produce significant pain relief in a subset of patients after surgery. However, the mechanism by which deep brain stimulation modulates sensory function in Parkinson's disease remains uncertain. Objective: To describe the motor and pain outcomes of deep brain stimulation applied to a series of patients with Parkinson's disease and to determine whether the structural connectivity between the volume of tissue activated and different regions of the brain was associated with the changes of these outcomes after surgery. Methods: Data from a long-term prospective cohort of 32 Parkinson's disease patients with subthalamic stimulation were combined with available human connectome to identify connections consistently associated with clinical improvement (Unified Parkinson Disease Rating Scale), pain intensity, and experimental cold pain threshold after surgery. Results: The connectivity between the volume of tissue activated and a distributed network of sensory brain regions (prefrontal, insular and cingulate cortex, and postcentral gyrus) was inversely correlated with pain intensity improvement and reduced sensitivity to cold pain after surgery (p < 0.01). The connectivity strength with the supplementary motor area positively correlated with motor and pain threshold improvement (p < 0.05). Conclusions: These data suggest that the pattern of the connectivity between the region stimulated and specific brain cortical area might be responsible, in part, for the successful control of motor and pain symptoms by subthalamic deep brain stimulation in Parkinson's disease.