ORESTES VICENTE FORLENZA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- Cognitive Reserve Relates to Functional Network Efficiency in Alzheimer's Disease(2018) WEILER, Marina; CASSEB, Raphael Fernandes; CAMPOS, Brunno Machado de; TEIXEIRA, Camila Vieira de Ligo; CARLETTI-CASSANI, Ana Flavia Mac Knight; VICENTINI, Jessica Elias; MAGALHAES, Thamires Naela Cardoso; ALMEIRA, Debora Queiroz de; TALIB, Leda Leme; FORLENZA, Orestes Vicente; BALTHAZAR, Marcio Luiz Figueredo; CASTELLANO, GabrielaAlzheimer's disease (AD) is the most common form of dementia, with no means of cure or prevention. The presence of abnormal disease-related proteins in the population is, in turn, much more common than the incidence of dementia. In this context, the cognitive reserve (CR) hypothesis has been proposed to explain the discontinuity between pathophysiological and clinical expression of AD, suggesting that CR mitigates the effects of pathology on clinical expression and cognition. fMRI studies of the human connectome have recently reported that AD patients present diminished functional efficiency in resting-state networks, leading to a loss in information flow and cognitive processing. No study has investigated, however, whether CR modifies the effects of the pathology in functional network efficiency in AD patients. We analyzed the relationship between CR, pathophysiology and network efficiency, and whether CR modifies the relationship between them. Fourteen mild AD, 28 amnestic mild cognitive impairment (aMCI) due to AD, and 28 controls were enrolled. We used education to measure CR, cerebrospinal fluid (CSF) biomarkers to evaluate pathophysiology, and graph metrics to measure network efficiency. We found no relationship between CR and CSF biomarkers; CR was related to higher network efficiency in all groups; and abnormal levels of CSF protein biomarkers were related to more efficient networks in the AD group. Education modified the effects of tau-related pathology in the aMCI and mild AD groups. Although higher CR might not protect individuals from developing AD pathophysiology, AD patients with higher CR are better able to cope with the effects of pathology-presenting more efficient networks despite pathology burden. The present study highlights that interventions focusing on cognitive stimulation might be useful to slow age-related cognitive decline or dementia and lengthen healthy aging.
- Caregiver burden regarding elderly with bipolar disorder: An underrecognized problem(2018) SANTOS, Glenda D.; LADEIRA, Rodolfo B.; ALMEIDA, Jouce G.; APRAHAMIAN, Ivan; FORLENZA, Orestes V.; LAFER, Beny; NUNES, Paula V.
- Systemic Inflammation and Multimodal Biomarkers in Amnestic Mild Cognitive Impairment and Alzheimer's Disease(2018) MAGALHAES, T. N. C.; WEILER, M.; TEIXEIRA, C. V. L.; HAYATA, T.; MORAES, A. S.; BOLDRINI, V. O.; SANTOS, L. M. dos; CAMPOS, B. M. de; REZENDE, T. J. R. de; JOAQUIM, H. P. G.; TALIB, L. L.; FORLENZA, O. V.; CENDES, F.; BALTHAZAR, Marcio L. F.There is increasing evidence suggesting that one of the most relevant pathophysiological features of Alzheimer's disease (AD) is neuroinflammation, which plays an important role in the production and regulation of AD-related proteins (amyloid beta (A beta) and Tau) and exacerbates AD pathology. Neuroinflammation can also be induced by systemic influences (factors from outside the central nervous system). However, the role of systemic inflammation in AD pathophysiology is much less understood. Thus, our main objective in this study was to verify whether the presence of serum cytokines (IL-1 beta, IL-6, IL-10, IL-12, and TNF-alpha) affects different AD biomarkers: A beta(1-42) and Tau protein levels, hippocampal volumes (HV), and default mode network functional connectivity (DMN FC) in healthy elderly controls, amnestic mild cognitive impairment (aMCI) patients due to AD, and mild AD patients. To accomplish this, we acquired 3-T MRI, blood, and cerebrospinal fluid (CSF) samples from 42 healthy controls, 55 aMCI patients due to AD, and 33 mild AD patients. Comparing the groups, we found that the mild AD patients presented smaller HV, disrupted DMN FC, and proportionally less IL-1 beta than the controls. The aMCI patients only differed from the controls in DMN FC. In intra-group comparison, aMCI and mild AD with detectable levels of cytokines (TNF-alpha, IL-1 beta, IL-10, and IL-12) had decreased DMN FC. On the other hand, patients with detectable levels of IL-10 and IL-12 presented a more favorable AD biomarkers profile (larger HV, more CSF A beta(1-42), and less p-Tau), indicating a possible protective role of these ILs. Our findings indicate a possible relationship between systemic inflammation with DMN FC disruption, hippocampal atrophy, and CSF protein levels in the subjects with mild AD and aMCI.
bookPart Transtormo neurocognitivo maior e menor no doença de Alzheimer(2018) BOTTINO, Cássio Machado de Campos; APRAHAMIAN, Ivan; PERROCO, Tibor Rilho; FORLENZA, Orestes Vicente- Chronic Lithium Treatment Increases Telomere Length in Parietal Cortex and Hippocampus of Triple-Transgenic Alzheimer's Disease Mice(2018) CARDILLO, Giancarlo de Mattos; DE-PAULA, Vanessa de Jesus Rodrigues; IKENAGA, Eliza Hiromi; COSTA, Luciana Rodrigues; CATANOZI, Sergio; SCHAEFFER, Evelin Lisete; GATTAZ, Wagner Farid; KERR, Daniel Shikanai; FORLENZA, Orestes VicenteTelomere length (TL) is a biomarker of cell aging, and its shortening has been linked to several age-related diseases. In Alzheimer's disease (AD), telomere shortening has been associated with neuroinflammation and oxidative stress. The majority of studies on TL in AD were based on leucocyte DNA, with little information about its status in the central nervous system. In addition to other neuroprotective effects, lithium has been implicated in the maintenance of TL. The present study aims to determine the effect of chronic lithium treatment on TL in different regions of the mouse brain, using a triple-transgenic mouse model (3xTg-AD). Eighteen transgenic and 22 wild-type (Wt) male mice were treated for eight months with chow containing 1.0 g (Li1) or 2.0 g (Li2) of lithium carbonate/kg, or standard chow (Li0). DNA was extracted from parietal cortex, hippocampus and olfactory epithelium and TL was quantified by real-time PCR. Chronic lithium treatment was associated with longer telomeres in the hippocampus (Li2, p = 0.0159) and in the parietal cortex (Li1, p = 0.0375) of 3xTg-AD compared to Wt. Our findings suggest that chronic lithium treatment does affect telomere maintenance, but the magnitude and nature of this effect depend on the working concentrations of lithium and characteristics of the tissue. This effect was observed when comparing 3xTg-AD with Wt mice, suggesting that the presence of AD pathology was required for the lithium modulation of TL.
bookPart Delinim(2018) FORLENZA, Orestes Vicente; SANTOS, Franklin Santana- Sensitivity and specificity of a briefer version of the Cambridge Cognitive Examination (CAMCog-Short) in the detection of cognitive decline in the elderly: An exploratory study(2018) RADANOVIC, Marcia; FACCO, Giuliana; FORLENZA, Orestes V.ObjectiveTo create a reduced and briefer version of the widely used Cambridge Cognitive Examination (CAMCog) battery as a concise cognitive test to be used in primary and secondary levels of health care to detect cognitive decline. Our aim was to reduce the administration time of the original test while maintaining its diagnostic accuracy. MethodsOn the basis of the analysis of 835 CAMCog tests performed by 429 subjects (107 controls, 192 mild cognitive impairment [MCI], and 130 dementia patients), we extracted items that most contributed to intergroup differentiation, according to 2 educational levels (8 and >8y of formal schooling). ResultsThe final 33-item low education and 24-itemhigh education CAMCog-Short correspond to 48.5% and 35% of the original version and yielded similar rates of accuracy: area under ROC curves (AUC)>0.9 in the differentiation between controlsxdementia and MCIxdementia (sensitivities>75%; specificities>90%); AUC>0.7 for the differentiation between controls and MCI (sensitivities>65%; specificities>75%). ConclusionsThe CAMCog-Short emerges as a promising tool for a brief, yet sufficiently accurate, screening tool for use in clinical settings. Further prospective studies designed to validate its diagnostic accuracy are needed.
- Relevance of gutmicrobiota in cognition, behaviour and Alzheimer's disease(2018) DE-PAULA, Vanessa de J. R.; FORLENZA, Andrea S.; FORLENZA, Orestes V.Approximately 95% of the symbiotic microbes in human body are located in the gut. This microbioma is involved in important homeostatic processes, not only related to gastrointestinal function but also to several complex modulatory processes, such as glucose and bone metabolism, inflammation and immune response, peripheral (enteric) and central neurotransmission. For that reason, recent studies proposed that abnormalities in gut microbiota may play a role in systemic and central nervous system (CNS) conditions. Therefore, the integrity of gut microbiota be relevant to the pathophysiology and control of important medical diseases like diabetes mellitus, inflammatory and autoimmune diseases, and even neuropsychiatric disorders such as depression, autism spectrum disorder, Parkinson's and Alzheimer disease. Gut microbiota may affect brain function and behaviour through the microbiota-gut-brain axis, in bidirectional interplay with top-down and bottom-up regulations. Through metabolic activity of non- pathogenical microorganisms and secretion of functional by-products that increase the permeability of the intestinal mucosa, the gut microbiota influences both the production and absorption of neurotransmitters (e.g., serotonin and GABA), increasing their bioavailability to the CNS. It has been further shown some components of the gut microbiota predominantly bacteria synthesize and release amyloid peptides and lipopolysaccharides, which in turn activate inflammatory signalling through the release of cytokines, with potential effects on the pathophysiological cascade of Alzheimer disease.
- Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial(2018) CIASCA, Eliana C.; FERREIRA, Rita C.; SANTANA, Carmen L. A.; FORLENZA, Orestes V.; SANTOS, Glenda D. dos; BRUM, Paula S.; NUNES, Paula V.Objective: There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly. Methods: A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures. Results: Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures. Conclusion: Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms.
bookPart Particulariedades da avaliação neuropsiquiátrica de idosos(2018) STELLA, Florindo; FORLENZA, Orestes Vicente