ANA SOLEDADE GRAEFF MARTINS
Índice h a partir de 2011
9
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
bookPart Instrumentos de avaliação de uso na infância e adolescência(2016) GRAEFF-MARTINS, Ana Soledade; FLEITLICH-BILYK, Bacy- An integrative approach to investigate the respective roles of single-nucleotide variants and copy-number variants in Attention-Deficit/Hyperactivity Disorder(2016) LIMA, Leandro de Araujo; FEIO-DOS-SANTOS, Ana Cecilia; BELANGERO, Sintia Iole; GADELHA, Ary; BRESSAN, Rodrigo Affonseca; SALUM, Giovanni Abrahao; PAN, Pedro Mario; MORIYAMA, Tais Silveira; GRAEFF-MARTINS, Ana Soledade; TAMANAHA, Ana Carina; ALVARENGA, Pedro; KRIEGER, Fernanda Valle; FLEITLICH-BILYK, Bacy; JACKOWSKI, Andrea Parolin; BRIETZKE, Elisa; SATO, Joao Ricardo; POLANCZYK, Guilherme Vanoni; MARI, Jair de Jesus; MANFRO, Gisele Gus; ROSARIO, Maria Conceicao do; MIGUEL, Euripedes Constantino; PUGA, Renato David; TAHIRA, Ana Carolina; SOUZA, Viviane Neri; CHILE, Thais; GOUVEIA, Gisele Rodrigues; SIMOES, Sergio Nery; CHANG, Xiao; PELLEGRINO, Renata; TIAN, Lifeng; GLESSNER, Joseph T.; HASHIMOTO, Ronaldo Fumio; ROHDE, Luis Augusto; SLEIMAN, Patrick M. A.; HAKONARSON, Hakon; BRENTANI, HelenaMany studies have attempted to investigate the genetic susceptibility of Attention-Deficit/Hyperactivity Disorder (ADHD), but without much success. The present study aimed to analyze both single-nucleotide and copy-number variants contributing to the genetic architecture of ADHD. We generated exome data from 30 Brazilian trios with sporadic ADHD. We also analyzed a Brazilian sample of 503 children/adolescent controls from a High Risk Cohort Study for the Development of Childhood Psychiatric Disorders, and also previously published results of five CNV studies and one GWAS meta-analysis of ADHD involving children/adolescents. The results from the Brazilian trios showed that cases with de novo SNVs tend not to have de novo CNVs and vice-versa. Although the sample size is small, we could also see that various comorbidities are more frequent in cases with only inherited variants. Moreover, using only genes expressed in brain, we constructed two ""in silico"" protein-protein interaction networks, one with genes from any analysis, and other with genes with hits in two analyses. Topological and functional analyses of genes in this network uncovered genes related to synapse, cell adhesion, glutamatergic and serotoninergic pathways, both confirming findings of previous studies and capturing new genes and genetic variants in these pathways.
- Mental health economics: Insights from Brazil(2013) CRUZ, Luciane; LIMA, Ana Flavia Da Silva; GRAEFF-MARTINS, Ana; MAIA, Carlos Renato Moreira; ZIEGELMANN, Patricia; MIGUEL, Sandoro; FLECK, Marcelo; POLANCZYK, CarisiBackground: As the responsibility and demand on health care grows and resources do not increase at the same pace, the healthcare system has been forced to reconsider the benefits and costs of their actions, to ensure a rational and effective decision-making process regarding the adoption of interventions and allocation of resources. Cost-effectiveness (CE) studies represent one of the basic tools to achieve this goal. Aims: To present the current state of Health Technology Assessment (HTA) and health economics in mental health in Brazil and its importance to the decision-making process. Methodology: Descriptive paper on HTA and health economics in Brazil. Databases from government and universities as well as some scientific databases to assess the information are presented. Results and Conclusion: Economic analysis to evaluate interventions in mental health care is a relatively recent addition to the field of health economics; in Brazil, it is also considered a topic within Epidemiology research area. There have been an increased number of studies developed in high-income countries. However, there are fewer CE studies in low-and middle-income ones. Psychiatric disorders represent a significant burden in developing countries, where resources devoted to health care are even scarcer.
- Dimensions of Oppositionalay in a Brazilian Communiiy Sample: Testing the DSM-5 Proposal and Etiological Links(2013) KRIEGER, Fernanda Valle; POLANCZYK, Guilherme Vanoni; GOODMAN, Robert; ROHDE, Luis Augusto; GRAEFF-MARTINS, Ana Soledade; SALUM, Giovanni; GADELHA, Ary; PAN, Pedro; STAHL, Daniel; STRINGARIS, ArgyrisObjective: Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the DSM-5-proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not previously been tested in samples outside Europe or the United States. In this study, we used a large Brazilian community sample to compare the fit of different models for dimensions of oppositional symptoms; to examine the association of psychiatric diagnoses and symptoms with dimensions of oppositionality; and to examine the associations between dimensions of oppositionality and parental history of mental disorders. Method: A Brazilian community sample of 2,512 children 6 through 12 years old were investigated in this study. Confirmatory factorial analyses were performed to compare the fit of alternative models, followed by linear and logistic regression analyses of associations with psychiatric diagnosis and parental history of psychopathology. Results: A three-factor model with irritable, headstrong, and hurtful dimensions fitted best. The irritable dimension showed a strong association with emotional disorders in the child (p < .001) and history of depression (p < .01) and suicidality (p < .05) in the mother. The headstrong dimension was uniquely associated with attention-deficit/hyperactivity disorder (ADHD) in the child (p < .001) and with maternal history of ADHD symptoms (p < .05). The hurtful dimension was specifically associated with conduct disorder (p < .05). Conclusions: Our findings from a large community sample of Brazilian children support a distinction between dimensions of oppositionality consistent with current DSM-5 recommendations and provide further evidence for etiological distinctions between these dimensions. J. Am. Acad. Child Adolesc. Psychiatry; 201352(4):389-400.
- Mechanisms underpinning inattention and hyperactivity: neurocognitive support for ADHD dimensionality(2014) SALUM, G. A.; SONUGA-BARKE, E.; SERGEANT, J.; VANDEKERCKHOVE, J.; GADELHA, A.; MORIYAMA, T. S.; GRAEFF-MARTINS, A. S.; MANFRO, G. G.; POLANCZYK, G.; ROHDE, L. A. P.Background. Taxometric and behavioral genetic studies suggest that attention deficit hyperactivity disorder (ADHD) is best modeled as a dimension rather than a category. We extended these analyses by testing for the existence of putative ADHD-related deficits in basic information processing (BIP) and inhibitory-based executive function (IB-EF) in individuals in the subclinical and full clinical ranges. Consistent with the dimensional model, we predicted that ADHD-related deficits would be expressed across the full spectrum, with the degree of deficit linearly related to the severity of the clinical presentation. Method. A total of 1547 children (aged 6-12 years) participated in the study. The Development and Well-Being Assessment (DAWBA) was used to classify children into groups according to levels of inattention and hyperactivity independently: (1) asymptomatic, (2) subthreshold minimal, (3) subthreshold moderate and (4) clinical ADHD. Neurocognitive performance was evaluated using a two-choice reaction time task (2C-RT) and a conflict control task (CCT). BIP and IB-EF measures were derived using a diffusion model (DM) for decomposition of reaction time (RT) and error data. Results. Deficient BIP was found in subjects with minimal, moderate and full ADHD defined in terms of inattention (in both tasks) and hyperactivity/impulsivity dimensions (in the 2C-RT). The size of the deficit increased in a linear manner across increasingly severe presentations of ADHD. IB-EF was unrelated to ADHD. Conclusions. Deficits in BIP operate at subclinical and clinical levels of ADHD. The linear nature of this relationship provides support for a dimensional model of ADHD in which diagnostic thresholds are defined in terms of clinical and societal burden rather than representing discrete pathophysiological states.
bookPart Development and well-being assessment (DAWBA)(2016) GRAEFF-MARTINS, Ana Soledade; FLEITLICH-BILYK, Bacy- High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results(2015) SALUM, Giovanni Abrahao; GADELHA, Ary; PAN, Pedro Mario; MORIYAMA, Tais Silveira; GRAEFF-MARTINS, Ana Soledade; TAMANAHA, Ana Carina; ALVARENGA, Pedro; KRIEGER, Fernanda Valle; FLEITLICH-BILYK, Bacy; JACKOWSKI, Andrea; SATO, Joao Ricardo; BRIETZKE, Elisa; POLANCZYK, Guilherme Vanoni; BRENTANI, Helena; MARI, Jair de Jesus; ROSARIO, Maria Conceicao Do; MANFRO, Gisele Gus; BRESSAN, Rodrigo Affonseca; MERCADANTE, Marcos Tomanik; MIGUEL, Euripedes Constantino; ROHDE, Luis AugustoThe objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random =958; high risk =1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with high risk for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information.
- Transcranial Direct Current Stimulation Combined with Aerobic Exercise to Optimize Analgesic Responses in Fibromyalgia: A Randomized Placebo-Controlled Clinical Trial(2016) MENDONCA, Mariana E.; SIMIS, Marcel; GRECCO, Luanda C.; BATTISTELLA, Linamara R.; BAPTISTA, Abrahao F.; FREGNI, FelipeFibromyalgia is a chronic pain syndrome that is associated with maladaptive plasticity in neural central circuits. One of the neural circuits that are involved in pain in fibromyalgia is the primary motor cortex. We tested a combination intervention that aimed to modulate the motor system: transcranial direct current stimulation (tDCS) of the primary motor cortex (M1) and aerobic exercise (AE). In this phase II, sham-controlled randomized clinical trial, 45 subjects were assigned to 1 of 3 groups: tDCS + AE, AE only, and tDCS only. The following outcomes were assessed: intensity of pain, level of anxiety, quality of life, mood, pressure pain threshold, and cortical plasticity, as indexed by transcranial magnetic stimulation. There was a significant effect for the group-time interaction for intensity of pain, demonstrating that tDCS/AE was superior to AE [F-(13,F- 364) = 2.25, p = 0.007] and tDCS [F-(13,F- 364) = 2.33, p = 0.0056] alone. Post-hoc adjusted analysis showed a difference between tDCS/AE and tDCS group after the first week of stimulation and after 1 month intervention period (p = 0.02 and p = 0.03, respectively). Further, after treatment there was a significant difference between groups in anxiety and mood levels. The combination treatment effected the greatest response. The three groups had no differences regarding responses in motor cortex plasticity, as assessed by TMS. The combination of tDCS with aerobic exercise is superior compared with each individual intervention (cohen's d effect sizes > 0.55). The combination intervention had a significant effect on pain, anxiety and mood. Based on the similar effects on cortical plasticity outcomes, the combination intervention might have affected other neural circuits, such as those that control the affective-emotional aspects of pain.
conferenceObject Dimensional approach to bipolar symptoms in childhood and early adolescence(2012) PAN, Pedro Mario; GADELHA, Ary; MORIYAMA, Tais; COGO-MOREIRA, Hugo; SALUM, Giovanni Abrahao; GRAEFF-MARTINS, Ana Soledade; ALVARENGA, Pedro; BRIETZKE, Elisa; BERNARDES, Thomas; ROHDE, Luis Augusto; MIGUEL, Euripedes Constantino; BRESSAN, Rodrigo A.- An integrative approach to investigate the respective roles of single-nucleotide variants and copy-number variants in Attention-Deficit/Hyperactivity Disorder (vol 6, 22851, 2016)(2016) LIMA, Leandro de Araujo; FEIO-DOS-SANTOS, Ana Cecilia; BELANGERO, Sintia Iole; GADELHA, Ary; BRESSAN, Rodrigo Affonseca; SALUM, Giovanni Abrahao; PAN, Pedro Mario; MORIYAMA, Tais Silveira; GRAEFF-MARTINS, Ana Soledade; TAMANAHA, Ana Carina; ALVARENGA, Pedro; KRIEGER, Fernanda Valle; FLEITLICH-BILYK, Bacy; JACKOWSKI, Andrea Parolin; BRIETZKE, Elisa; SATO, Joao Ricardo; POLANCZYK, Guilherme Vanoni; MARI, Jair de Jesus; MANFRO, Gisele Gus; ROSARIO, Maria Conceiao do; MIGUEL, Euripedes Constantino; PUGA, Renato David; TAHIRA, Ana Carolina; SOUZA, Viviane Neri; CHILE, Thais; GOUVEIA, Gisele Rodrigues; SIMOES, Sergio Nery; CHANG, Xiao; PELLEGRINO, Renata; TIAN, Lifeng; GLESSNER, Joseph T.; HASHIMOTO, Ronaldo Fumio; ROHDE, Luis Augusto; SLEIMAN, Patrick M. A.; HAKONARSON, Hakon; BRENTANI, Helena