CRISTIANA BORGES PEREIRA

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 5 Citação(ões) na Scopus
    Assessment of gait deviation on the Babinski-Weill test in healthy Brazilians
    (2013) MIRANDA, Camila Souza; STEFANI, Camila Piccirilli; MORIMOTO, Marcia Midori; PIEMONTE, Maria Elisa Pimentel; PEREIRA, Cristiana Borges
    Objective: The aim of this study was to validate a simple and reproducible method for assessing gait deviation on the Babinski-Weill test in a representative sample of healthy Brazilians. Methods: Gait deviations were measured in 75 individuals (median=30 years, 41 women) for forward, backwards, and Babinski-Weill steps. The test entailed blindfolded individuals walking 10 paces at a frequency of 1 Hz with deviations subsequently measured by a protractor. Results: Mean gait deviation forward was 0.53 degrees with standard deviation (SD)=4.22 and backwards was 2.14 degrees with SD=4.29. No significant difference in deviation was detected between genders (t test p=0.40 forward and p=0.77 backwards) or for age (ANOVA, p=0.33 forward and p=0.63 backwards). On the Babinski-Weill test, mean gait deviation was 5.26 degrees;SD=16.32 in women and -3.11 degrees; SD=12.41 in men, with no significant difference between genders (t test, p=0.056). Discussion: Defining normative gait patterns helps distinguish pathological states.
  • article 20 Citação(ões) na Scopus
    Correlation of impaired subjective visual vertical and postural instability in Parkinson's disease
    (2014) PEREIRA, Cristiana Borges; KANASHIRO, Aline Kozoroski; MAIA, Fernanda Martins; BARBOSA, Egberto Reis
    Perception of verticality is essential for postural control. On the other hand, postural instability is one of the cardinal features in Parkinson's disease (PD). Thus, the objective of this study was to evaluate the vertical perception using the subjective visual vertical test in PD patients with different degrees of postural instability and in different stages of disease. Forty five idiopathic PD patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS), the Hoehn and Yahr Scale, the clinical test for postural instability, and the subjective visual vertical test. Forty-five healthy individuals were evaluated in the control group. PD patients had a compromised perception of verticality and a disturbed processing of graviceptive pathways. Good correlation was also found between subjective visual vertical and postural instability. Patients with the worst postural instability had greater deviations of subjective visual vertical. There was also a positive correlation between subjective visual vertical and scores on the UPDRS and Hoehn and Yahr Scale, with good and reasonable degree of intensity, respectively. These findings suggest that the perception of verticality is affected in PD patients and this abnormal vertical perception and disturbed processing of graviceptive pathways are associated with postural instability and to a lesser degree with disease severity.
  • article 7 Citação(ões) na Scopus
    A disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in patients with multiple sclerosis
    (2016) FONSECA, Bruna Antinori Vignola da; PEREIRA, Cristiana Borges; JORGE, Frederico; SIMM, Renata; APOSTOLOS-PEREIRA, Samira; CALLEGARO, Dagoberto
    The purpose of this study was to determine the relationship between perception of verticality and balance disorders in multiple sclerosis patients. We evaluated patients and healthy controls. Patients were divided into two groups according to their risk of fall, with or without risk of fall, measured by a Dynamic Gait Index scale. Graviceptive perception was assessed using the subjective visual vertical test. Patients with risk of fall showed worse perception than those without risk of fall, p < 0.001. Misperception of verticality was correlated with the dynamic gait index scores (p < 0.001), suggesting that the larger the error for verticality judgment, the greater risk for falling. Considering that the perception of verticality is essential for postural control, our results suggested that the disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in these patients.
  • article 9 Citação(ões) na Scopus
    Multidisciplinary Assessment of Patients with Musical Hallucinations, Tinnitus and Hearing Loss
    (2015) ROCHA, Savya Cybelle Milhomem; KII, Marcia Akemi; PEREIRA, Cristiana Borges; BORELLI, Danilo Totarelli; FORLENZA, Orestes; SANCHEZ, Tanit Ganz
    Background: Although auditory hallucinations are considered a psychopathological phenomenon, musical hallucinations have been reported in individuals without psychosis but with auditory symptoms (tinnitus and/or hearing loss). Thus, a possible different cognitive functioning may be involved in musical hallucinations. The aim of the study was to characterize patients with tinnitus and musical hallucinations through a multidisciplinary assessment, allowing a better understanding of these concomitant phenomena. Sampling and Methods: As this sample is rare to find, all consecutive patients with tinnitus, hearing loss and musical hallucinations were included over a 3-year period, excluding those unable to respond. All subjects underwent the following assessments: (1) otolaryngological and audiological assessment (physical examination and audiometry), (2) neurological assessment (cognition, electroencephalogram and imaging examination) and (3) psychiatric assessment (structured interview). Results: A total of 16 patients were included (87.5% women; mean age 61.43 +/- 15.99 years). The otolaryngological examination was normal in all cases, but audiometry revealed that the degree of hearing loss was severe to profound in 68.75% of participants. Neurological assessment showed electroencephalogram changes in only 17.6% of cases, while 25% presented with mild attention deficit and 43.75% had small foci of gliosis or ischemia on the imaging examination. Psychiatric assessment showed that 68.75% of cases had depression, 6.25% had anxiety disorder and 25% had no psychiatric conditions. Conclusions: Musical hallucinations were strongly associated with female elderly adults and with mood disorders. Thus, in contrast to common auditory hallucinations, patients with musical hallucinations associated with tinnitus and hearing loss should be offered a more multidisciplinary assessment. (C) 2015 S. Karger AG, Basel
  • article 4 Citação(ões) na Scopus
    Vestibular Migraine: Vestibular Symptom May Identify Different Subgroups
    (2016) PEREIRA, Cristiana B.; NADER, Saulo N.; KANASHIRO, Aline K.; CARVALHO, William L. de
    Objective:The objective of this study was to evaluate patients with vestibular migraine and analyze whether different vestibular symptoms were able to discriminate different subgroups.Patients:Eighty-three patients (73 women, mean age 42 yr) who fulfilled the criteria for vestibular migraine were selected.Intervention: Participants were divided into two groups according to their vestibular symptoms: spontaneous vertigo (SV) or triggered vertigo (TV). In each group, migraine subtype (migraine with aura and migraine without aura) was further analyzed.Results:The SV group comprised 40 patients (35 women, mean age 42.6 yr) of which 26 had migraine with aura. The TV group comprised 43 patients (38 women, mean age 41.3 yr) of which 34 had migraine without aura. A significant difference in the presence of spontaneous vertigo was noted, proving more frequent in the migraine with aura group, whereas TV was more frequent in the migraine without aura group ((2) test, p<0.0001).Conclusion:Spontaneous rotatory vertigo was more frequent in migraine with aura, whereas triggered nonrotatory vertigo was more frequent in migraine without aura. This finding suggests a broad spectrum of clinical symptomatology in vestibular migraine patients. All of these patients are classified as vestibular migraine but they may represent two extremes of a disease spectrum.
  • article 0 Citação(ões) na Scopus
    Risk of fall in the elderly: how to evaluate
    (2013) PEREIRA, Cristiana Borges
  • article 24 Citação(ões) na Scopus
    Musical hallucination associated with hearing loss
    (2011) SANCHEZ, Tanit Ganz; ROCHA, Savya Cybelle Milhomem; KNOBEL, Keila Alessandra Baraldi; KII, Marcia Akemi; SANTOS, Rosa Maria Rodrigues dos; PEREIRA, Cristiana Borges
    In spite of the fact that musical hallucination have a significant impact on patients' lives, they have received very little attention of experts. Some researchers agree on a combination of peripheral and central dysfunctions as the mechanism that causes hallucination. The most accepted physiopathology of musical hallucination associated to hearing loss (caused by cochlear lesion, cochlear nerve lesion or by interruption of mesencephalon or pontine auditory information) is the disinhibition of auditory memory circuits due to sensory deprivation. Concerning the cortical area involved in musical hallucination, there is evidence that the excitatory mechanism of the superior temporal gyrus, as in epilepsies, is responsible for musical hallucination. In musical release hallucination there is also activation of the auditory association cortex. Finally, considering the laterality, functional studies with musical perception and imagery in normal individuals showed that songs with words cause bilateral temporal activation and melodies activate only the right lobe. The effect of hearing aids on the improvement of musical hallucination as a result of the hearing loss improvement is well documented. It happens because auditory hallucination may be influenced by the external acoustical environment. Neuroleptics, antidepressants and anticonvulsants have been used in the treatment of musical hallucination. Cases of improvement with the administration of carbamazepine, meclobemide and donepezil were reported, but the results obtained were not consistent.
  • article 3 Citação(ões) na Scopus
    Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology
    (2021) BRUCKI, Sonia Maria Dozzi; ADONI, Tarso; ALMEIDA, Carlos Mauricio Oliveira; ANDRADE, Daniel Ciampi de; ANGHINAH, Renato; BARBOSA, Luciana Mendonca; BAZAN, Rodrigo; CARVALHO, Alzira Alves de Siqueira; CARVALHO, William; CHRISTO, Paulo Pereira; COLETTA, Marcus Della; CONFORTO, Adriana Bastos; CORREA-NETO, Ylmar; ENGELHARDT, Eliasz; FRANCA JUNIOR, Marcondes Cavalcante; FRANCO, Clelia; GLEHN, Felipe Von; GOMES, Helio Rodrigues; HOULY, Caroline Gomes de Barros; KAUP, Alexandre Ottoni; KOWACS, Fernando; KANASHIRO, Aline; LOPES, Victor Goncalves; MAIA, Debora; MANREZA, Maria; MARTINEZ, Alberto Rolim Muro; MARTINEZ, Sandra Cristina Goncalves; NADER, Saulo Nardy; NEVES, Luciana de Oliveira; OKAMOTO, Ivan Hideyo; OLIVEIRA, Rogerio Adas Ayres de; PEIXOTO, Fabiano de Melo; PEREIRA, Cristiana Borges; SABA, Roberta Arb; SAMPAIO, Leticia Pereira de Brito; SCHILLING, Lucas Porcello; SILVA, Marcus Tulius Teixeira; SILVA, Emanuelle Roberta; SMID, Jerusa; SOARES, Cristiane Nascimento; SOBREIRA-NETO, Manoel; SOUSA, Nise Alessandra de Carvalho; SOUZA, Leonardo Cruz de; TEIVE, Helio Afonso Ghizoni; TERRA, Vera Cristina; VALE, Matheus; VIEIRA, Vitor Mendes Grise; ZANOTELI, Edmar; PRADO, Gilmar
    Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.
  • article 4 Citação(ões) na Scopus
    Falls in older adults: a practical approach
    (2022) PEREIRA, Cristiana Borges; KANASHIRO, Aline Mizuta Kozoroski
    Background: Falls are a major problem in public health since they are an important cause of morbidity and mortality. To evaluate the risk of fall and prescribe preventive interventions may be a challenging task. Objectives: The objectives of this study are to summarize the most relevant information on the topic ""falls in the elderly"" and to give a critical view and practical clinical approach on this topic. Methods: In March 2022, a search of Pubmed database was performed, using the terms ""fall elderly"", fall prevention"", ""fall risk"", with the following parameters: five years, review, systematic review, meta-analysis, practice guidelines. Results: There are several risk factors for falls that can be grouped in different areas (psychosocial, demographic, medical,medication, behavioral, environmental).The clinical evaluation of an older adult prone to falls must include identification of risk factors through history and examination and identification of risk of falls through an assessment tool such as gait velocity, functional reach test, timed up and go, Berg balance test, and miniBEST test. Fall prevention strategies can be single or multiple, and physical activity is the most cited. Technology can be used to detect and prevent falls. Conclusion: A systematic approach to the older patient in risk of falls is feasible and may impact fall prevention.