MARCIO GERHARDT SOEIRO DE SOUZA
Projetos de Pesquisa
Unidades Organizacionais
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
7 resultados
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- Lithium efficacy in bipolar depression with flexible dosing: A six-week, open-label, proof-of-concept study(2014) MACHADO-VIEIRA, Rodrigo; ZANETTI, Marcus V.; SOUSA, Rafael T. De; SOEIRO-DE-SOUZA, Marcio G.; MORENO, Ricardo A.; BUSATTO, Geraldo F.; GATTAZ, Wagner F.Lithium has a narrow therapeutic index with a subtle balance between effectiveness and adverse effects. Current guidelines recommend the use of lithium as a treatment for acute bipolar depression; however, the therapeutic range for the treatment has not been fully defined. Recently, the adjunctive lower lithium dose in bipolar depression has revealed potential efficacy; however, no study has investigated it predominantly in monotherapy. In this open-label, proof-of-concept study, 31 individuals with bipolar disorder during a depressive episode were randomized and 29 were followed up for six weeks with flexible lithium dosing. All subjects had a 21-item Hamilton Rating Scale for Depression (HAM-D) score of >= 18 at baseline. Subjects were divided into two groups, with higher (Li >= 0.5 mEq/l) or lower (Li <0.5 mEq/l) blood lithium levels. Response and remission rates were evaluated using the HAM-D scores. Following 6 weeks of lithium treatment, the remission rate for all patients was 62.0%. The plasma lithium levels did not impact the clinical response. However, subjects with higher blood lithium levels had an increased prevalence of nausea, restlessness, headaches and cognitive complaints. The results indicate that the lithium dose for the treatment of bipolar depression in an individual should be based on the clinical efficacy and side-effects. In the context of personalized psychiatric treatments, it is necessary to evaluate the therapeutic action of lithium with individual regimens in order to develop more tolerable and effective treatment approaches.
conferenceObject LICAVAL - results of a long term treatment study(2013) MISSIO, G.; CAMPOS, R. N.; SOEIRO-DE-SOUZA, M. G.; MORENO, D.; MORENO, R. A.- Physical activity as an adjuvant therapy for depression and influence on peripheral inflammatory markers: A randomized clinical trial(2022) FERNANDES, Beatriz Monteiro; SIQUEIRA, Cristiana Carvalho; VIEIRA, Rodrigo Machado; MORENO, Ricardo Alberto; SOEIRO-DE-SOUZA, Marcio GerhardtIntroduction: Regular exercise is recommended for people with major depressive disorder (MDD) by major treatment guidelines (e.g. the NICE guideline, 2009). In addition, an effect of antidepressant (AD) treatment on pro-inflammatory markers has been reported. However, it remains unclear whether physical activity as an adjuvant to AD treatment increases clinical response rates and is associated with levels of inflammatory markers. Methods: A four-week single-blind clinical trial involving forty people with major MDD, divided into an AD group (sertraline) and AD + exercise (40 min/day, four times weekly for four weeks) group was conducted. Peripheral inflammatory markers (IL-12, IL-10, IL-8, IL-6, IL-1 beta, TNF-alpha) and cortisol were collected at baseline and at endpoint. Results: We observed a significant decrease in cortisol levels over time, but this change did not differ between the AD and AD + exercise groups. None of the other inflammatory markers showed a significant change in level during the trial. Also, most of the individuals who achieved remission were from the AD + exercise group. Conclusion: Although our study failed to find that the association of physical activity as an adjunct to antide-pressants promotes a change in cortisol or interleukins in people with MDD, we found that cortisol seems to be the most sensitive biomarker to antidepressant treatment. Further studies involving larger samples of, longer duration and with other classes of antidepressants and types of exercise should be conducted to better elucidate the link between inflammatory markers and depression.
- Role of quetiapine beyond its clinical efficacy in bipolar disorder: From neuroprotection to the treatment of psychiatric disorders (Review)(2015) SOEIRO-DE-SOUZA, Marcio G.; DIAS, Vasco Videira; MISSIO, Giovanni; BALANZA-MARTINEZ, Vicent; VALIENGO, Leandro; CARVALHO, Andre F.; MORENO, Ricardo AlbertoThe aim of the present review was to discuss the following aspects of treatment with quetiapine in psychiatric disorders: i) Neurocognition and functional recovery in bipolar disorder (BD); ii) neuroprotective profile in different models; and iii) potential off-label indications. A PubMed search was conducted of articles published in English between 2000 and 2012 on quetiapine, cross-referenced with the terms 'anxiety', 'attention deficit disorder', 'borderline personality disorder', 'dementia', 'insomnia', 'major depressive disorder' (MDD), 'obsessive-compulsive disorder', 'post-traumatic stress disorder', 'remission', 'cognition', 'neurobiology', 'neuroprotection', 'efficacy' and 'effectiveness'. Articles were selected from meta-analyses, randomized clinical trials and open trials, and the results were summarized. Quetiapine, when studied in off-label conditions, has shown efficacy as a monotherapy in MDD and general anxiety disorder. Quetiapine also appears to exhibit a small beneficial effect in dementia. The review of other conditions was affected by methodological limitations that precluded any definitive conclusions on the efficacy or safety of quetiapine. Overall, the present review shows evidence supporting a potential role for quetiapine in improving cognition, functional recovery and negative symptoms in a cost-effective manner in BD. These benefits of quetiapine are potentially associated with its well-described neuroprotective effects; however, further studies are clearly warranted.
- The impact of limbic system morphology on facial emotion recognition in bipolar I disorder and healthy controls(2013) BIO, Danielle Soares; SOEIRO-DE-SOUZA, Marcio Gerhardt; OTADUY, Maria Concepcion Garcia; MACHADO-VIEIRA, Rodrigo; MORENO, Ricardo AlbertoIntroduction: Impairments in facial emotion recognition (FER) have been reported in bipolar disorder (BD) subjects during all mood states. This study aims to investigate the impact of limbic system morphology on FER scores in BD subjects and healthy controls. Material and methods: Thirty-nine euthymic BD I (type I) subjects and 40 healthy controls were subjected to a battery of FER tests and examined with 3D structural imaging of the amygdala and hippocampus. Results: The volume of these structures demonstrated a differential pattern of influence on FER scores in BD subjects and controls. In our control sample, larger left and right amygdala demonstrated to be associated to less recognition of sadness faces. In BD group, there was no impact of amygdala volume on FER but we observed a negative impact of the left hippocampus volume in the recognition of happiness while the right hippocampus volume positively impacted on the scores of happiness. Conclusion: Our results indicate that amygdala and hippocampus volumes have distinct effects on FER in BD subjects compared to controls. Knowledge of the neurobiological basis of the illness may help to provide further insights on the role of treatments and psychosocial interventions for BD. Further studies should explore how these effects of amygdala and hippocampus volumes on FER are associated with social networks and social network functioning.
conferenceObject ACC neuro-metabolic changes from bipolar depression to euthymia: Repeated 1H-MRS measurement as a function of mood state and lithium efficacy(2020) SOEIRO-DE-SOUZA, M.; SCOTTI-MUZZI, E.; FERNANDES, F.; ZANETTI, M. V.; DESOUZA, R.; LEITE, C.; OTADUY, M. C.; MACHADO-VIEIRA, R.- BDNF rs6265 differentially influences neurometabolites in the anterior cingulate of healthy and bipolar disorder subjects(2023) SCOTTI-MUZZI, Estevao; CHILE, Thais; VALLADA, Homero; OTADUY, Maria Concepcion Garcia; SOEIRO-DE-SOUZA, Marcio GerhardtBrain-derived neurotrophic factor (BDNF) is the most abundant brain neurotrophin and plays a critical role in neuronal growth, survival and plasticity, implicated in the pathophysiology of Bipolar Disorders (BD). The single-nucleotide polymorphism in the BDNF gene (BDNF rs6265) has been associated with decreased hippocampal BDNF secretion and volume in met carriers in different populations, although the val allele has been reported to be more frequent in BD patients. The anterior cingulate cortex (ACC) is a key center integrating cognitive and affective neuronal connections, where consistent alterations in brain metabolites such as Glx (Glutamate + Glutamine) and N-acetylaspartate (NAA) have been consistently reported in BD. However, little is known about the influence of BDNF rs6265 on neurochemical profile in the ACC of Healthy Controls (HC) and BD subjects. The aim of this study was to assess the influence of BDNF rs6265 on ACC neurometabolites (Glx, NAA and total creatine- Cr) in 124 euthymic BD type I patients and 76 HC, who were genotyped for BDNF rs6265 and underwent a 3-Tesla proton magnetic resonance imaging and spectroscopy scan ((1) H-MRS) using a PRESS ACC single-voxel (8cm(3)) sequence. BDNF rs6265 polymorphism showed a significant two-way interaction (diagnosis x genotype) in relation to NAA/Cr and total Cr. While met carriers presented increased NAA/Cr in HC, BD-I subjects with the val allele revealed higher total Cr, denoting an enhanced ACC metabolism likely associated with increased glutamatergic metabolites observed in BD-I val carriers. However, these results were replicated only in men. Therefore, our results support evidences that the BDNF rs6265 polymorphism exerts a complex pleiotropic effect on ACC metabolites influenced by the diagnosis and sex.