KETTE DUALIBI RAMOS VALENTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Complementary and alternative medicine in epilepsy: A global survey of physicians' opinions(2021) ASADI-POOYA, Ali A.; BRIGO, Francesco; LATTANZI, Simona; KARAKIS, Ioannis; ASADOLLAHI, Marjan; TRINKA, Eugen; GHONEIMY, Lobna Talaat El; PRETORIUS, Chrisma; CONTRERAS, Guilca; DAZA-RESTREPO, Anilu; VALENTE, Kette; D'ALESSIO, Luciana; TURUSPEKOVA, Saule T.; ALJANDEEL, Ghaieb; KHACHATRYAN, Samson; ASHKANANI, Abdulaziz; TOMSON, Torbjorn; KUTLUBAEV, Mansur; GUEKHT, Alla; ALSAADI, Taoufik; CALLE-LOPEZ, Yamile; MESRAOUA, Boulenouar; RIOS-POHL, Loreto; AL-ASMI, Abdullah; VILLANUEVA, Vicente; IGWE, Stanley C.; KISSANI, Najib; JUSUPOVA, AselPurpose: To investigate the opinions of physicians on the use of complementary and alternative medicine (CAM) in patients with epilepsy (PWE) worldwide. Methods: Online survey addressed to neurologists and psychiatrists from different countries. Results: Totally, 1112 physicians from 25 countries (different world region: Europe, North America, South America, Middle-East, Africa, Former Soviet Union Republics) participated; 804 (72.3%) believed that CAM might be helpful in PWE. The most commonly endorsed CAM included meditation (41%) and yoga (39%). Female sex, psychiatry specialization, and working in North and South America were associated with the belief that CAM is helpful in PWE. Two-hundred and forty five out of 1098 participants (22.3%) used/prescribed CAM to PWE; among them, 174 (71%) people perceived CAM to be less effective and 114 (46.5%) people found CAM to be safer than conventional antiseizure medications (ASMs). The most common reasons to prescribe CAM for PWE were: to satisfy the patient (49.9%), dissatisfaction with the efficacy (35.6%), and dissatisfaction with the adverse effects (31.2%) of conventional therapies. Conclusion: Although the evidence supporting the use of CAM for the treatment of epilepsy is extremely sparse, most physicians worldwide believe that it could be integrated with the use of conventional ASMs, at least in some patients. High-quality controlled trials are warranted to provide robust evidence on the usefulness of CAM options in PWE.
- Driving a motor vehicle and psychogenic nonepileptic seizures: ILAE Report by the Task Force on Psychogenic Nonepileptic Seizures(2020) ASADI-POOYA, Ali A.; NICHOLSON, Timothy R.; PICK, Susannah; BASLET, Gaston; BENBADIS, Selim R.; BEGHI, Massimiliano; BRIGO, Francesco; BUCHHALTER, Jeffrey; D'ALESSIO, Luciana; DWORETZKY, Barbara; GIGINEISHVILI, David; KANAAN, Richard A.; KOZLOWSKA, Kasia; LAFRANCE JR., W. Curt; LEHN, Alexander; PEREZ, David L.; POPKIROV, Stoyan; PRETORIUS, Chrisma; SZAFLARSKI, Jerzy P.; TOLCHIN, Benjamin; VALENTE, Kette; STONE, Jon; REUBER, MarkusObjectivesThis International League Against Epilepsy (ILAE) Report: (a) summarizes the literature about ""driving and psychogenic nonepileptic seizures (PNES)""; (b) presents the views of international experts; and (c) proposes an approach to assessing the ability of persons with PNES (PwPNES) to drive. MethodsPhase 1: Systematic literature review. Phase 2: Collection of international expert opinion using SurveyMonkey (R). Experts included the members of the ILAE PNES Task Force and individuals with relevant publications since 2000. Phase 3: Joint analysis of the findings and refinement of conclusions by all participants using email. As an ILAE Report, the resulting text was reviewed by the Psychiatry Commission, the ILAE Task Force on Driving Guidelines, and Executive Committee. ResultsEight studies identified by the systematic review process failed to provide a firm evidence base for PNES-related driving regulations, but suggest that most health professionals think restrictions are appropriate. Twenty-six experts responded to the survey. Most held the view that decisions about driving privileges should consider individual patient and PNES characteristics and take account of whether permits are sought for private or commercial driving. Most felt that those with active PNES should not be allowed to drive unless certain criteria were met and that PNES should be thought of as ""active"" if the last psychogenic seizure had occurred within 6 months. SignificanceRecommendations on whether PwPNES can drive should be made at the individual patient level. Until future research has determined the risk of accidents in PwPNES a proposed algorithm may guide decisions about driving advice.
- Pediatric-onset psychogenic nonepileptic seizures: A retrospective international multicenter study(2019) ASADI-POOYA, Ali A.; MYERS, Lorna; VALENTE, Kette; SAWCHUK, Tyson; RESTREPO, Anilu Daza; HOMAYOUN, Maryam; BUCHHALTER, Jeffrey; BAHRAMI, Zahra; TAHA, Firas; LAZAR, Lorraine M.; PAYTAN, Angelica Aroni; ALESSIO, Luciana D'; KOCHEN, Silvia; ALESSI, Ruda; PICK, Susannah; NICHOLSON, Timothy R.Purpose: We compared various clinical characteristics of pediatric-onset psychogenic nonepileptic seizures (PNES) between patients from five countries. The purpose of this study was to advance our understanding of pediatric-onset PNES cross-culturally. Methods: In this retrospective study, we compared consecutive patients with PNES with an age at onset of 16 years and younger from epilepsy monitoring units in Iran, Brazil, the USA, Canada, and Venezuela. Age, gender, age at seizure onset, seizure semiology, predisposing factors, and video-EEG recordings of all patients were extracted. Pearson Chi-Square, one-way ANOVA and Bonferroni correction tests were used for statistical analyses. Results: Two hundred twenty-nine patients were studied (83 from Iran, 50 from Brazil, 39 from Canada, 30 from the USA, and 27 from Venezuela). Mean age at the onset of seizures was 12.1 +/- 3.2 years (range: 4-16 years). The sex ratio of the patients was 1.83: 1 (148 females and 81 males). Clinical characteristics of pediatric-onset PNES showed some significant differences among the nations. However, factors associated with pediatric-onset PNES in these five nations were similar. Conclusion: This study underscores how international cross-cultural studies can make important contributions to our understanding of PNES. Patients with pediatric-onset PNES from different countries were similar on many risk factors associated with PNES. This suggests universality in many features of PNES. However, intriguing differences were also noted with regard to seizure semiology, which might be the result of cultural factors.
- Adult-onset psychogenic nonepileptic seizures: A multicenter international study(2019) ASADI-POOYA, Ali A.; VALENTE, Kette; RESTREPO, Anilu Daza; D'ALESSIO, Luciana; HOMAYOUN, Maryam; BAHRAMI, Zahra; ALESSI, Ruda; PAYTAN, Angelica Aroni; KOCHEN, Silvia; MYERS, Lorna; SAWCHUK, Tyson; BUCHHALTER, Jeffrey; TAHA, Firas; LAZAR, Lorraine M.; PICK, Susannah; NICHOLSON, TimothyPurpose: The aim of this multicenter international cross-cultural study was to compare clinical variables in a large sample of people with adult-onset psychogenic nonepileptic seizures (PNES). Methods: In this retrospective study, we evaluated persons with documented PNES, who were older than 16 years of age at the onset, from four countries (i.e., Iran, Brazil, Venezuela, and Argentina) regarding their age, gender, PNES semiology, and possible predisposing factors. Results: We included 389 patients (244 from Iran, 66 from Brazil. 51 from Venezuela. and 28 from Argentina). Age at diagnosis was 32 +/- 9 years (range: 17-64 years), and age at the onset of seizures was 27 +/- 8 years (range: 17-49 years). There was a female predominance in all countries. The demographic characteristics and factors associated with PNES were similar among the countries. However, there were significant semiological differences among the countries. Conclusion: This study corroborates the notion that PNES share more similarities than differences cross-culturally and across international borders. However, the background determined by cultural, ethnic, and religious differences may influence the semiology of PNES. Further cross-cultural studies involving more than two continents may advance our understanding of PNES.
- Counseling about sudden unexpected death in epilepsy (SUDEP): A global survey of neurologists' opinions(2022) ASADI-POOYA, Ali A.; TRINKA, Eugen; BRIGO, Francesco; HINGRAY, Coraline; KARAKIS, Ioannis; LATTANZI, Simona; VALENTE, Kette D.; CONTRERAS, Guilca; TURUSPEKOVA, Saule T.; KISHK, Nirmeen Adel; ALJANDEEL, Ghaieb; FARAZDAGHI, Mohsen; LOPEZ, Yamile Calle; KISSANI, Najib; TRIKI, Chahnez; KRAEMER, Gunter; SURGES, Rainer; MESRAOUA, Boulenouar; YU, Hsiang-Yu; DAZA-RESTREPO, Anilu; ALSAADI, Taoufik; AL-ASMI, Abdullah; KUTLUBAEV, Mansur A.; PRETORIUS, Chrisma; JUSUPOVA, Asel; KHACHATRYAN, Samson G.; RANGANATHAN, Lakshmi Narasimhan; ASHKANANI, Abdulaziz; TOMSON, Torbjorn; GIGINEISHVILI, DavidObjective: To investigate the opinions and attitudes of neurologists on the counseling about sudden unex-pected death in epilepsy (SUDEP) worldwide. Methods: Practicing neurologists from around the world were invited to participate in an online survey. On February 18th, 2021, we emailed an invitation including a questionnaire (using Google-forms) to the lead neurologists from 50 countries. The survey anonymously collected the demographic data of the par-ticipants and answers to the questions about their opinions and attitudes toward counseling about SUDEP. Results: In total, 1123 neurologists from 27 countries participated; 41.5% of the respondents reported they discuss the risk of SUDEP with patients and their care-givers only rarely. Specific subgroups of patients who should especially be told about this condition were considered to be those with poor anti-seizure medication (ASM) adherence, frequent tonic-clonic seizures, or with drug-resistant epilepsy. The propensity to tell all patients with epilepsy (PWE) about SUDEP was higher among those with epilepsy fellowship. Having an epilepsy fellowship and working in an academic setting were factors associated with a comfortable discussion about SUDEP. There were significant differences between the world regions. Conclusion: Neurologists often do not discuss SUDEP with patients and their care-givers. While the results of this study may not be representative of practitioners in each country, it seems that there is a severe dissociation between the clinical significance of SUDEP and the amount of attention that is devoted to this matter in daily practice by many neurologists around the world.
- Sex differences in demographic and clinical characteristics of psychogenic nonepileptic seizures: A retrospective multicenter international study(2019) ASADI-POOYA, A.; MYERS, L.; VALENTE, K.; RESTREPO, A. Daza; ALESSIO, L. D'.; SAWCHUK, T.; HOMAYOUN, M.; BAHRAMI, Z.; ALESSI, R.; PAYTAN, A. Aroni; KOCHEN, S.; BUCHHALTER, J.; TAHA, F.; LAZAR, L. M.; PICK, S.; NICHOLSON, T.
- Sex differences in demographic and clinical characteristics of psychogenic nonepileptic seizures: A retrospective multicenter international study(2019) ASADI-POOYA, Ali A.; MYERS, Lorna; VALENTE, Kette; RESTREPO, Anilu Daza; D'ALESSIO, Luciana; SAWCHUK, Tyson; HOMAYOUN, Maryam; BAHRAMI, Zahra; ALESSI, Ruda; PAYTAN, Angelica Aroni; KOCHEN, Silvia; BUCHHALTER, Jeffrey; TAHA, Firas; LAZAR, Lorraine M.; PICK, Susannah; NICHOLSON, ImothyPurpose: Sex-related differences have been reported in patients with neurological and psychiatric disorders. It is also plausible to assume that there might be differences between females and males with psychogenic nonepileptic seizures (PNES). Methods: In this retrospective study, we investigated patients with PNES, who were admitted to the epilepsy monitoring units at centers in Iran, the USA, Canada, Brazil, Argentina, and Venezuela. Age, sex, age at seizure onset, seizure semiology, factors potentially predisposing to PNES, and video-electroencephalography recording of all patients were registered routinely. Results: Four hundred and fifty-one patients had PNES-only and were eligible for inclusion; 305 patients (67.6%) were females. We executed a logistic regression analysis, evaluating significant variables in univariate analyses (i.e., age, age at onset, aura, presence of historical sexual or physical abuse, and family dysfunction). The only variables retaining significance were historical sexual abuse (p = 0.005) and presence of aura (p = 0.01); physical abuse was borderline significant (p = 0.05) (all three were more prevalent among females). Conclusion: Similarities between females and males outweigh the differences with regard to the demographic and clinical characteristics of PNES. However, notable differences are that females more often report lifetime adverse experiences (sexual and probably physical abuse) and auras. While social, psychological, and genetic factors may interact with lifetime adverse experiences in the inception of PNES, the link is not yet clear. This is an interesting avenue for future studies.
- Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey(2022) ASADI-POOYA, Ali A.; BRIGO, Francesco; TRINKA, Eugen; LATTANZI, Simona; KARAKIS, Ioannis; KISHK, Nirmeen Adel; VALENTE, Kette D.; JUSUPOVA, Asel; TURUSPEKOVA, Saule T.; DAZA-RESTREPO, Anilu; CONTRERAS, Guilca; KUTLUBAEV, Mansur A.; GUEKHT, Alla; RAHIMI-JABERI, Abbas; ALJANDEEL, Ghaieb; CALLE-LOPEZ, Yamile; ALSAADI, Taoufik; ASHKANANI, Abdulaziz; RANGANATHAN, Lakshmi Narasimhan; AL-ASMI, Abdullah; KHACHATRYAN, Samson G.; GIGINEISHVILI, David; MESRAOUA, Boulenouar; MWENDAWELI, NalucaPurpose: To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide.Methods: Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy.Results: In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p < 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients.Conclusion: This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug -resistant seizures worldwide.