MARCIA RADANOVIC
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
17 resultados
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Agora exibindo 1 - 10 de 17
- Cognitive-communication disorder following right hemisphere damage: Narrative production(2022) RODRIGUEZ, E.; BELAN, A. F. R.; RADANOVIC, M.Background: Cognitive-communication disorder (CCD) results from the association of language and cognition impairment that may follow right hemisphere (RH) damage and impair the quality of life of affected persons. Objective: We studied a set of 1,625 narratives produced by a cohort of 125 individuals (50 with a single right vascular lesion in the MCA territory and 75 cognitively healthy controls) using a task of picture-based discourse production. Discourse production was analyzed in its macro-and microlinguistic aspects to characterize better the linguistic mechanisms underlying RH patients' performance. Results: The RH group produced more words and elocutions than controls, with a lower rate of informational content and a higher percentage of global coherence errors (all p-values <0.0001). Conclusion: Individuals with RH lesions showed formal lexical and syntactic aspects of discourse mostly preserved. Alterations in the macrostructure of discourse prevailed over microstructural alterations in our sample, according to most literature studies. The group of individuals with RH lesions produced narratives containing more words and utterances, with a lesser degree of lexical information and more global coherence errors. © 2022
- screening for cognitive impairment in late onset depression in a Brazilian sample using the BBRC-edu(2012) NOVARETTI, Tânia Maria da Silva; RADANOVIC, Marcia; NITRINI, RicardoABSTRACT Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.
conferenceObject COGNITIVE PROFILE OF ADULTS AND SENIORS WITH DOWN'S SYNDROME: DATA FROM THE CAMBRIDGE EXAMINATION FOR MENTAL DISORDERS OF OLDER PEOPLE WITH DOWN SYNDROME BRAZILIAN VERSION - CAMDEX-DS ADAPTED AND VALIDATED FOR THE BRAZILIAN POPULATION(2019) CARVALHO, C. L.; ARAUJO, M. C. Cristianini; NOGUEIRA, C.; GONCALVES, A.; BELAN, A.; BRAM, J.; SANTANA, L.; BECKER, A.; RADANOVIC, M.; FORLENZA, O.- Sentence processing in mild cognitive impairment(2022) PEREIRA, Diana Nakamura; SOUZA, Wellington da Cruz; BELAN, Ariella Fornachari Ribeiro; CAMARGO, Marina von Zuben de Arruda; FORLENZA, Orestes Vicente; RADANOVIC, MarciaDifficulties in sentence processing have been reported in patients with Mild Cognitive Impairment (MCI), which may be due to impairment in primary syntactic abilities or short-term memory. In the present study, we investigated the relationship between overt sentence production (SP) and comprehension (SC) with short-term memory performance in MCI. Cognitively healthy elderly (n = 34), amnestic MCI (aMCI,n = 22), non-amnestic MCI (naMCI,n = 45), and Alzheimer's disease (AD,n = 18) patients were asked to complete tests of constrained SP and oral SC. We tested the association between performance in SP and SC with memory tasks and performed a qualitative analysis of the frequency and type of errors in SC. Our results showed that there were no intergroup differences in SC and SP performances. SC scores were associated with delayed recall for words in the naMCI group (p = 0.003), and immediate (p = 0.001) and delayed recall for shapes (p = 0.031) in AD. There were no predictors for NAT scores in any group. In conclusion, the three groups performed similarly in SC and SP tasks. Short-term memory was not associated with performance in the SP task. There was an association between performance in the SC task and verbal memory in naMCI and non-verbal memory in AD; the latter may reflect visuospatial processing demands embedded in the SC task.
- Diagnostic Performance of an Eye-Tracking Assisted Visual Inference Language Test in the Assessment of Cognitive Decline due to Alzheimer's Disease(2023) BELAN, Ariella Fornachari Ribeiro; PAIS, Marcos Vasconcelos; CAMARGO, Marina von Zuben de Arruda; ANA, Livea Carla Fidalgo Garcez Sant'; RADANOVIC, Marcia; FORLENZA, Orestes VicenteBackground: The assessment of language changes associated with visual search impairment can be an important diagnostic tool in the Alzheimer's disease (AD) continuum. Objective: Investigate the performance of an eye-tracking assisted visual inference language task in differentiating subjects with mild cognitive impairment (MCI) or AD dementia from cognitively unimpaired older adults (controls). Methods: We assessed a group of 95 older adults (49 MCI, 18 mild dementia due to AD, and 28 controls). The subjects performed the same task under multiple experimental conditions which generate correlated responses that need to be taken into account. Thus, we performed a non-parametric repeated measures ANOVA model for verbal answers, and a linear mixed model (LMM) or its generalized version for the analysis of eye tracking variables. Results: Significant differences were found in verbal answers across all diagnostic groups independently of type of inference, i.e., logic or pragmatic. Also, eye-tracking parameters were able to discriminate AD from MCI and controls. AD patients did more visits to challenge stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011), more visits to the correct response stimulus (Control-AD, -1.363, SE = 0.383, p = 0.002; MCI-AD, -0.946, SE = 0.349, p = 0.022), more fixations on distractors (Control-AD, -4.580, SE = 1.172, p = 0.001; MCI-AD, -2.940, SE = 1.070, p = 0.020), and a longer time to first fixation on the correct response stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011). Conclusion: The analysis of oculomotor behavior along with language assessment protocols may increase the sensitivity for detection of subtle deficits in the MCI-AD continuum, representing an important diagnostic tool.
- Increased CSF levels of total Tau in patients with subcortical cerebrovascular pathology and cognitive impairment(2017) RADANOVIC, Márcia; STELLA, Florindo; SILVA, Lis Gomes; TALIB, Leda L.; FORLENZA, Orestes V.ABSTRACT. Cognitive impairment includes mild cognitive decline and dementia, such as Alzheimer's disease (AD) and cerebrovascular-related pathologies. Objective: To investigate the profile of AD-related CSF biomarkers in a sample of cognitively impaired and unimpaired older adults with concomitant subcortical cerebrovascular burden. Methods: Seventy-eight older adults attending an outpatient psychogeriatric clinic were enrolled. Diagnoses were based on clinical, neuropsychological, laboratory, and neuroimaging data. Participants were classified into: cognitively normal (controls, n = 30), mild cognitive impairment (MCI, n = 34), and dementia (AD, n = 14). All subjects were submitted to CSF analyses for determination of amyloid-beta (Aβ1-42), total tau (t-tau), phosphorylated tau (p-tau) and Aβ1-42/p-tau ratio according to the Luminex method. MRI was performed in all individuals, and was scored independently by two experts according to Fazekas scale. Statistical analyses were conducted with the aid of general linear model procedures, and the Chi-squared test. Results: T-tau levels were significantly associated with subcortical lesion pattern when Fazekas was considered as a group factor. CSF biomarkers were not associated with MCI, AD, or controls when considered separately. There was a tendency for reduction in CSF Aβ1-42 together with increasing Fazekas scores, but without statistical significance. Comparisons of Aβ1-42 and t-tau with each clinical group or with each neuroimaging pattern did not reach statistical differences. Likewise, Fazekas scores had no impact on CAMCOG scores. Conclusion: We found a significant association between t-tau levels and subcortical lesions when all Fazekas classifications were considered as a single group; comparisons of Fazekas subgroups and CSF biomarkers did not reach significance.
- Electroconvulsive therapy for treating patients with agitation and related behavioral disorders due to dementia: a systematic review(2023) STELLA, Florindo; RADANOVIC, Márcia; GALLUCCI-NETO, José; FORLENZA, Orestes VicenteABSTRACT Behavioral disturbances are clinically relevant in patients with dementia, and pharmacological regimens to mitigate these symptoms have provided limited results. Proven to be effective in several psychiatric conditions, electroconvulsive therapy is a potentially beneficial strategy for treating severe agitation due to dementia. Objective: This review aimed to examine the publications on the efficacy, safety and tolerability of electroconvulsive therapy in treating patients with agitation due to dementia. Methods: We performed a systematic analysis on the electroconvulsive therapy to treat patients with dementia and coexisting severe agitation. Articles were classified according to the level of evidence based on methodological design. Patients received an acute course of electroconvulsive therapy, often followed by maintenance intervention. Results: We selected 19 studies (156 patients; 64.1% women; 51–98 years old), which met the inclusion criteria: one case-control study by chart analysis (level of evidence 2); one open-label study (level of evidence 3); three historical/retrospective chart analyses (level of evidence 4); and 14 case series/reports (level of evidence 5). No randomized, sham-controlled clinical trials (level of evidence 1) were identified, which represents the main methodological weakness. Some patients had postictal delirium, cardiovascular decompensation and cognitive changes, lasting for a short time. Conclusions: Overall, patients achieved significant improvement in agitation. However, the main finding of the present review was the absence of methodological design based on randomized and sham-controlled clinical trials. Despite methodological limitations and side effects requiring attention, electroconvulsive therapy was considered a safe and effective treatment of patients with severe agitation and related behavioral disorders due to dementia.
conferenceObject SYMPTOMS OF DEPRESSION IN ADULTS AND ELDERS WITH DOWN SYNDROME: DATA FROM A PILOT STUDY IN BRAZIL(2019) NOGUEIRA, C.; CARVALHO, C. L.; GONCALVES, A.; BELAN, A.; BRAM, J.; SANTANA, L.; RADANOVIC, M.; BECKER, A.; FORLENZA, O.- Textual Inference Comprehension in Mild Cognitive Impairment: The Influence of Semantic Processing and Verbal Episodic Memory(2021) MAZIERO, Maria Paula; BELAN, Ariella Fornachari Ribeiro; CAMARGO, Marina von Zuben de Arruda; SILAGI, Marcela Lima; FORLENZA, Orestes Vicente; RADANOVIC, MarciaLanguage complaints, especially in complex tasks, may occur in mild cognitive impairment (MCI). Various language measures have been studied as cognitive predictors of MCI conversion to Alzheimer's type dementia. Understanding textual inferences is considered a high-demanding task that recruits multiple cognitive functions and, therefore, could be sensitive to detect decline in the early stages of MCI. Thus, we aimed to compare the performance of subjects with MCI to healthy elderly in a textual inference comprehension task and to determine the best predictors of performance in this ability considering one verbal episodic memory and two semantic tasks. We studied 99 individuals divided into three groups: (1) 23 individuals with amnestic mild cognitive impairment (aMCI), (2) 42 individuals with non-amnestic mild cognitive impairment (naMCI), (3), and (4) 34 cognitively healthy individuals for the control group (CG). A reduced version of The Implicit Management Test was used to assess different types of inferential reasoning in text reading. MCI patients performed poorer than healthy elderly, and there were no differences between MCI subgroups (amnestic and non-amnestic). The best predictors for inference-making were verbal memory in the aMCI and semantic tasks in the naMCI group. The results confirmed that the failure to understand textual inferences can be present in MCI and showed that different cognitive skills like semantic knowledge and verbal episodic memory are necessary for inference-making.
conferenceObject AVALIANDO A CARGA DE CUIDADORES E FAMILIARES DE ADULTOS E IDOSOS COM SINDROME DE DOWN: DADOS DA ESCALA DE ZARIT(2019) CARVALHO, C. L.; ARAUJO, M. C. C.; FERRO, K. N.; SENA, R. C.; KATSUKI, A. M. I.; NOGUEIRA, C.; BRAM, J.; SANTANA, L.; BELAN, A.; GONCALVES, A.; RADANOVIC, M.; FORLENZA, O.; DIAS, R.