CLAUDIA DA COSTA LEITE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
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- Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial(2023) MEREGE-FILHO, Carlos A. A.; GIL, Saulo S.; KIRWAN, John P.; MURAI, Igor H.; DANTAS, Wagner S.; NUCCI, Mariana P.; PASTORELLO, Bruno; LIMA, Alisson Padilha de; BAZAN, Paulo R.; PEREIRA, Rosa M. R.; SA-PINTO, Ana L. de; LIMA, Fernanda R.; BRUCKI, Sonia M. D.; CLEVA, Roberto de; SANTO, Marco A.; LEITE, Claudia da Costa; OTADUY, Maria Concepcion Garcia; ROSCHEL, Hamilton; GUALANO, BrunoBackgroundObesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to investigate the possible synergistic effects of Roux-en-Y Gastric Bypass (RYGB) and exercise training on brain functional networks. MethodsThirty women eligible for bariatric surgery were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 15, age = 41.0 & PLUSMN; 7.3 years) or RYGB plus Exercise Training (RYGB + ET: n = 15, age = 41.9 & PLUSMN; 7.2 years). Clinical, laboratory, and brain functional connectivity parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6-month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). ResultsExercise superimposed on bariatric surgery (RYGB + ET) increased connectivity between hypothalamus and sensorial regions (seed-to-voxel analyses of hypothalamic connectivity), and decreased default mode network (DMN) and posterior salience (pSAL) network connectivity (ROI-to-ROI analyses of brain networks connectivity) when compared to RYGB alone (all p-FDR < 0.05). Increases in basal ganglia (BG) network connectivity were only observed in the exercised training group (within-group analyses). ConclusionExercise training is an important component in the management of post-bariatric patients and may improve the hypothalamic connectivity and brain functional networks that are involved in controlling food intake.
- Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease(2023) ARAUJO, Ana Luiza Vieira de; SANTOS, Raul D.; BITTENCOURT, Marcio Sommer; DANTAS, Roberto Nery; OSHIRO, Carlos Andre; NOMURA, Cesar Higa; BOR-SENG-SHU, Edson; OLIVEIRA, Marcelo de Lima; LEITE, Claudia da Costa; MARTIN, Maria da Graca Morais; ALVES, Maramelia Miranda; SILVA, Gisele Sampaio; SILVA, Victor Marinho; CONFORTO, Adriana BastosBackgroundThe coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis >= 50% in the carotid or vertebrobasilar territories (Group(athero)) and a control group (Group(control)). MethodsIn this cross-sectional study, Group(athero) included two subgroups: Group(ExtraorIntra), with stenoses in either cervical or intracranial arteries, and Group(Extra&Intra), with stenoses in at least one cervical and one intracranial artery. Group(control) had no history of prior stroke/transient ischemic attacks and no stenoses >= 50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC >= 100 and CAC > 0 were compared between Group(athero) and Group(control), as well as between Group(ExtraorIntr), Group(Extra&Intra), and Group(control), with bivariate logistic regressions. Multivariate analyses were also performed. ResultsA total of 120 patients were included: 80 in Group(athero) and 40 in Group(control.) CAC >0 was significantly more frequent in Group(athero) (85%) than Group(control) (OR, 4.19; 1.74-10.07; p = 0.001). Rates of CAC >= 100 were not significantly different between Group(athero) and Group(control) but were significantly greater in Group(Extra&Intra) (n = 13) when compared to Group(control) (OR 4.67; 1.21-18.04; p = 0.025). In multivariate-adjusted analyses, ""Group(athero)"" and ""Group(Extra&Intra)"" were significantly associated with CAC. ConclusionThe frequency of coronary calcification was higher in subjects with stroke caused by large-artery atherosclerosis than in controls.
- Postmortem chest computed tomography in COVID-19: A minimally invasive autopsy method(2024) SAVOIA, Paulo; SAWAMURA, Marcio Valente Yamada; MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; MARTIN, Maria da Graca Morais; DOLHNIKOFF, Marisa; MAUAD, Thais; SALDIVA, Paulo Hilario Nascimento; LEITE, Claudia da Costa; SILVA, Luiz Fernando Ferraz da; CARDOSO, Ellison FernandoObjectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology. Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis. Results: There was a positive correlation between patient mean CT and histopathological severity score indexesPearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground -glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between groundglass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p >= 0.10). Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground -glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.
- Lung ultrasound versus chest computed tomography for pregnant inpatients with COVID-19(2023) BIANCOLIN, Sckarlet Ernandes; FERNANDES, Hermann dos Santos; SAWAMURA, Marcio Valente Yamada; QUEIROZ, Joelma; CENTOFANTI, Sandra Frankfurt; LIAO, Adolfo Wenjaw; LEITE, Claudia da Costa; FRANCISCO, Rossana Pulcineli Vieira; BRIZOT, Maria de Lourdes; BASSI, Aline Scalisse; FABRI, Amanda Wictky; SOUZA, Ana Claudia Rodrigues Lopes Amaral de; FARCHE, Ana Claudia Silva; IGAI, Ana Maria Kondo; OLIVEIRA, Ana Maria da Silva Sousa; WAISSMAN, Adriana Lippi; MARTINS, Carlos Eduardo do Nascimento; PAGANOTI, Cristiane de Freitas; DOMINGUES, Danielle Rodrigues; MIKAMI, Fernanda Cristina Ferreira; BAPTISTA, Fernanda Spadotto; CIPPICIANI, Jacqueline Kobayashi; ALBERTINI, Jessica Gorrao Lopes; NIIGAKI, Juliana Ikeda; GALLETTA, Marco Aurelio Knippel; MIYADAHIRA, Mariana Yumi; BARBOSA, Mariana Vieira; MAEDA, Mariane de Fatima Yukie; BARROS, Monica Fairbanks de; TAKIUTI, Nilton Hideto; MARTINELLI, Silvio; ARRYM, Tiago Pedromonico; GOMEZ, Ursula Trovato; FRANCO, Veridiana FreirePurpose To compare lung ultrasound (US) and computed tomography (CT) in the assessment of pregnant women with COVID-19. Methods Prospective study comprising 39 pregnant inpatients with COVID-19 who underwent pulmonary assessment with CT and US with a maximum span of 48 h between the exams. The thorax was divided into 12 regions and assessed in terms of the following: the presence of B-lines (>2), coalescent B-lines, consolidation on US; presence of interlobular thickening, ground glass, consolidation on CT. The two methods were scored by adding up the scores from each thoracic region. Results A significant correlation was found between the scores obtained by the two methods (rICC = 0.946; p < 0.001). They were moderately in agreement concerning the frequency of altered pulmonary regions (weighted kappa = 0.551). In US, a score over 15, coalescent B-lines, and consolidation were predictors of the need for oxygen, whereas the predictors in CT were a lung score over 16 and consolidation. The two methods, US (p < 0.001; AUC = 0.915) and CT (p < 0.001; AUC = 0.938), were fairly accurate in predicting the need for oxygen. Conclusion In pregnant women, lung US and chest CT are of similar accuracy in assessing lungs affected by COVID-19 and can predict the need for oxygen.
- The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study(2023) SOBREIRO, Matildes F. M.; TERRONI, Luisa; GUAJARDO, Valeri Delgado; MATTOS, Patricia Ferreira; LEITE, Claudia da Costa; JR, Edson Amaro; TINONE, Gisela; IOSIFESCU, Dan V.; FRAGUAS, RenerioBackground: Depressive symptoms have been associated with cognitive impairment after stroke, and women may be specifically affected. Objective: The aim of this study was to investigate gender-specific characteristics in the relationship between changes in depression severity and changes in cognitive performance after stroke. Methods: We prospectively evaluated 73 patients without a previous history of depression in the first and fourth months after a first ischemic stroke. The severity of depressive symptoms was assessed using the 31-item version of the Hamilton Rating Scale for Depression, and executive function, attention, working memory, and verbal fluency were assessed using a neuropsychological battery. Results: We included 46 (63.0%) men and 27 (36.9%) women, with mean ages of 55.2 (SD & PLUSMN; 15.1) and 46.8 (SD & PLUSMN; 14.7) years, respectively. We found significant improvement in the digit span forward and Stroop dots from month 1 to month 4 post stroke for both men and women. Women, but not men, presented a correlation between changes in phonemic verbal fluency and changes in the 31-item version of the Hamilton Rating Scale for Depression scores. Improvement in depression was correlated with improvement in verbal fluency, and worsening in depression was correlated with worsening in verbal fluency. Conclusions: Our results suggest that women might be more vulnerable to the relationship between depressive symptoms and cognitive performance, and improvement of depression may be necessary for women's improvement in phonemic verbal fluency from the first to the fourth month after a stroke. We did not adjust the results for multiple comparisons. Thus, our findings might be considered preliminary, and confirmatory studies, also focusing on specific characteristics of women that could explain these differences, are warranted.
- Phenotyping Superagers Using Resting-State fMRI(2023) GODOY, L. L. de; STUDART-NETO, A.; PAULA, D. R. de; GREEN, N.; HALDER, A.; ARANTES, P.; CHAIM, K. T.; MORAES, N. C.; YASSUDA, M. S.; NITRINI, R.; DRESLER, M.; LEITE, C. da Costa; PANOVSKA-GRIFFITHS, J.; SODDU, A.; BISDAS, S.BACKGROUND AND PURPOSE: Superagers are defined as older adults with episodic memory performance similar or superior to that in middle-aged adults. This study aimed to investigate the key differences in discriminative networks and their main nodes between superagers and cognitively average elderly controls. In addition, we sought to explore differences in sensitivity in detecting these functional activities across the networks at 3T and 7T MR imaging fields. MATERIALS AND METHODS: Fifty-five subjects 80 years of age or older were screened using a detailed neuropsychological protocol, and 31 participants, comprising 14 superagers and 17 cognitively average elderly controls, were included for analysis. Participants underwent resting-state-fMRI at 3T and 7T MR imaging. A prediction classification algorithm using a penalized regression model on the measurements of the network was used to calculate the probabilities of a healthy older adult being a superager. Additionally, ORs quantified the influence of each node across preselected networks. RESULTS: The key networks that differentiated superagers and elderly controls were the default mode, salience, and language networks. The most discriminative nodes (ORs > 1) in superagers encompassed areas in the precuneus posterior cingulate cortex, prefrontal cortex, temporoparietal junction, temporal pole, extrastriate superior cortex, and insula. The prediction classification model for being a superager showed better performance using the 7T compared with 3T resting-state-fMRI data set. CONCLUSIONS: Our findings suggest that the functional connectivity in the default mode, salience, and language networks can provide potential imaging biomarkers for predicting superagers. The 7T field holds promise for the most appropriate study setting to accurately detect the functional connectivity patterns in superagers.
- Brain glucose metabolism and gray matter volume in retired professional soccer players: a cross-sectional [F-18]FDG-PET/MRI study(2023) ARANHA, Mateus Rozalem; COUTINHO, Artur Martins; CARNEIRO, Camila de Godoi; PASTORELLO, Bruno Fraccini; STUDART-NETO, Adalberto; GUARIGLIA, Carla Cristina; TSUNEMI, Miriam Harumi; MOREIRA, Everton Luis Santos; IANOF, Jessica Natuline; ANGHINAH, Renato; NITRINI, Ricardo; CERRI, Giovanni Guido; FORTEA, Juan; BUCHPIGUEL, Carlos Alberto; LEITE, Claudia CostaBackground Professional soccer athletes are exposed to repetitive head impacts and are at risk of developing chronic traumatic encephalopathy. Objective To evaluate regional brain glucose metabolism (rBGM) and gray matter (GM) volume in retired soccer players (RSPs). Methods Male RSPs and age and sex-matched controls prospectively enrolled between 2017 and 2019 underwent neurological and neuropsychological evaluations, brain MRI and [F-18]FDG-PET in a 3.0-Tesla PET/MRI scanner. Visual analysis was performed by a blinded neuroradiologist and a blinded nuclear physician. Regional brain glucose metabolism and GM volume were assessed using SPM8 software. Groups were compared using appropriate statistical tests available at SPM8 and R. Results Nineteen RSPs (median [IQR]: 62 [50-64.5] years old) and 20 controls (60 [48-73] years old) were included. Retired soccer players performed worse on mini-mental state examination, digit span, clock drawing, phonemic and semantic verbal fluency tests, and had reduced rBGM in the left temporal pole (pFDR = 0.008) and the anterior left middle temporal gyrus (pFDR = 0.043). Semantic verbal fluency correlated with rBGM in the right hippocampus, left temporal pole, and posterior left middle temporal gyrus (p <= 0.042). Gray matter volume reduction was observed in similar anatomic regions but was less extensive and did not survive correction for multiple comparisons (pFDR >= 0.085). Individual [18F]FDG-PET visual analysis revealed seven RSPs with overt hypometabolism in the medial and lateral temporal lobes, frontal lobes, and temporoparietal regions. Retired soccer players had a higher prevalence of septum pellucidum abnormalities on MRI. Conclusion Retired soccer players had reduced rBGM and GM volume in the temporal lobes and septum pellucidum abnormalities, findings possibly related to repetitive head impacts.
- Headache at the chronic stage of cerebral venous thrombosis(2022) BOSSONI, Alexandre Souza; PERES, Mario Fernando Prieto; LEITE, Claudia da Costa; FORTINI, Ida; CONFORTO, Adriana BastosBackground Headache is the most frequent symptom of cerebral venous thrombosis (CVT) but there is limited information about the frequency and phenotype of headache, weeks to months after cerebral venous thrombosis (post-cerebral venous thrombosis headache, post cerebral venous thrombosis headache). Objective To assess the frequency, characteristics and predictors of PCH. Methods In this cross-sectional study, the frequency and characteristics of PCH were assessed in cerebral venous thrombosis survivors. Patients were interviewed between six months and five years after the cerebral venous thrombosis diagnosis. Clinical and imaging characteristics at the time of cerebral venous thrombosis diagnosis, as well as history of headache prior to cerebral venous thrombosis were compared in subjects with (Group(PCH)) and without PCH (Group(control)). Results Subjects (n = 100; 82% women) were assessed, on average, at 1.1 +/- 1.6 years of follow-up. PCH was present in 59% of the patients, phenotypes of tension-type-like headache were present in 31/59 (52.6%) and of migraine-like headache in 16/59 (27.1%). History of primary headache prior to cerebral venous thrombosis was significantly more common (OR: 6.4; 95% CI: 1.7-36.3) in Group(PCH) (33.9%) than in Group(control) (7.3%). Conclusion Post cerebral venous thrombosis headache was present in more than half of the patients. History of prior headache may be a risk factor for post cerebral venous thrombosis headache. Prospective studies are required to confirm these findings and determine mechanisms, as well as interventions for prevention and treatment of post cerebral venous thrombosis headache.
- Brain Spectroscopy Analysis in Retired Soccer Players With Chronic Exposure to Mild Traumatic Brain Injuries(2023) RESENDE, Lucas Lopes; LEITE, Claudia da Costa; PASTORELLO, Bruno Fraccini; SOLLA, Davi Jorge Fontoura; MARTINS, Pedro Nascimento; COSTA, Bernardo Fernandes Pelinca da; ARANHA, Mateus Rozalem; FERRACIOLLI, Suely Fazio; OTADUY, Maria Concepcion GarciaSoccer players are at risk of suffering cranial injuries in the short and long term. There is growing concern that this may lead to traumatic brain injury in soccer players. Magnetic resonance spectroscopy (MRS) is an analytical method that enables the measurement of changes in brain metabolites that usually occur before significant structural changes. This study aimed to use MRS to compare variations in brain metabolite levels between retired soccer players and a control group. Twenty retired professional soccer players and 22 controls underwent magnetic resonance imaging, including MRS sequences and Mini-Mental State Examination (MMSE). Metabolite analysis was conducted based on absolute concentration and relative ratios. N-acetyl-aspartate, choline, glutamate, glutamine, and myoinositol were the metabolites of interest for the statistical analysis. Retired soccer players had an average age of 57.8 years, whereas the control group had an average age of 63.2 years. Median cognitive evaluation score, assessed using the MMSE, was 28 [26-29] for athletes and 29 [28-30] for controls (p = 0.01). Uni- and multi-variate analyses of the absolute concentration of metabolites (mM) between former athletes and controls did not yield any statistically significant results. Comparison of metabolites to creatine ratio concentrations did not yield any statistically significant results. There were no changes in concentrations of brain metabolites that indicated brain metabolic changes in retired soccer players compared with controls.
- Contrast phase recognition in liver computer tomography using deep learning(2022) ROCHA, Bruno Aragao; FERREIRA, Lorena Carneiro; VIANNA, Luis Gustavo Rocha; FERREIRA, Luma Gallacio Gomes; CICONELLE, Ana Claudia Martins; NORONHA, Alex Da Silva; CORTEZ FILHO, Joao Martins; NOGUEIRA, Lucas Salume Lima; LEITE, Jean Michel Rocha Sampaio; SILVA FILHO, Mauricio Ricardo Moreira da; LEITE, Claudia da Costa; FELIX, Marcelo de Maria; GUTIERREZ, Marco Antonio; NOMURA, Cesar Higa; CERRI, Giovanni Guido; CARRILHO, Flair Jose; ONO, Suzane KiokoHepatocellular carcinoma (HCC) has become the 4th leading cause of cancer-related deaths, with high social, economical and health implications. Imaging techniques such as multiphase computed tomography (CT) have been successfully used for diagnosis of liver tumors such as HCC in a feasible and accurate way and its interpretation relies mainly on comparing the appearance of the lesions in the different contrast phases of the exam. Recently, some researchers have been dedicated to the development of tools based on machine learning (ML) algorithms, especially by deep learning techniques, to improve the diagnosis of liver lesions in imaging exams. However, the lack of standardization in the naming of the CT contrast phases in the DICOM metadata is a problem for real-life deployment of machine learning tools. Therefore, it is important to correctly identify the exam phase based only on the image and not on the exam metadata, which is unreliable. Motivated by this problem, we successfully created an annotation platform and implemented a convolutional neural network (CNN) to automatically identify the CT scan phases in the HCFMUSP database in the city of SAo Paulo, Brazil. We improved this algorithm with hyperparameter tuning and evaluated it with cross validation methods. Comparing its predictions with the radiologists annotation, it achieved an accuracy of 94.6%, 98% and 100% in the testing dataset for the slice, volume and exam evaluation, respectively.