GUARACI DE LIMA REQUENA
Projetos de Pesquisa
Unidades Organizacionais
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
16 resultados
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conferenceObject Attentional Bias to Symmetry and Cleaning Features in Obsessive-Compulsive Disorder: A Pilot Study(2015) MATHIS, Maria Alice De; SALUM, Giovanni; MORAES, Ivanil; BATISTUZZO, Marcelo; MARCO, Marina De; TOLEDO, Maria Cecilia; REQUENA, Guaraci; ABEND, Rany; BAR-HAIM, Yair; MIGUEL, Euripedes; SHAVITT, Roseli- Intelligence quotient (IQ) in pediatric patients with obsessive-compulsive disorder(2020) BATISTUZZO, Marcelo Camargo; SOUZA, Marina de Marco e; BERNARDES, Elisa Teixeira; REQUENA, Guaraci; MIGUEL, Euripedes Constantino; SHAVITT, Roseli GedankeObjective: The aim of the present study was to examine the intellectual quotient (IQ) in a large sample of youth with obsessive-compulsive disorder (OCD) and to compare them with typically developing individuals (TDI), adding to the scarce literature focusing on the intelligence evaluation of this population. Method: The IQ of 82 children and adolescents with OCD and 82 TDI, matched by age, sex, handedness and education, was assessed by the Wechsler Abbreviated Scale of Intelligence (WASI, Brazilian-version). Statistics were performed with independent t-test, correlations and ANCOVA (controlling for motor and processing speed and comorbidities), corrected using the Benjamini-Hochberg multiple comparisons correction. Results: No between-group differences were found on the full-scale IQ (FSIQ, p-value = 0.545) or verbal IQ (VIQ; p-value = 0.423). In contrast, a significant difference was found in the performance IQ (PIQ; p-value = 0.045, Cohen's d = 0.379) and IQ discrepancy, i.e. the difference between VIQ and PIQ (p-value = 0.012, Cohen's d = 0.494). Analyses of the PIQ subtest scores revealed impaired performance in the Block Design test among OCD patients (p-value = 0.012, Cohen's d = 0.273), that remained after correcting for motor and processing speed and comorbidity status. Conclusion: In our sample of pediatric patients with OCD, the FSIQ, VIQ and PIQ were within the average range (90-110), and we did not find between-group differences in the FSIQ or VIQ, indicating that youth with OCD do not present major deficits in intellectual efficiency. Nevertheless, replicating an extensive adult literature, we found lower PIQ scores in youth patients, that were not better explained by motor and processing speed or comorbidity status.
conferenceObject Treatment Response Prediction in Pediatric Patients With OCD Using Structural Neuroimaging Correlates: Simple Linear Regression Versus Support Vector Regression(2017) VATTIMO, Edoardo; BARROS, Vivian; BATISTUZZO, Marcelo; REQUENA, Guaraci; SATO, Joao; FATORI, Daniel; SHAVITT, Roseli; MIGUEL, Euripedes; HOEXTER, MarceloconferenceObject Early Life Adverse Experiences and Obsessive-Compulsive Disorder: A Study With Patients, Siblings and Controls(2018) COSTA, Fabiana; CAPPI, Carolina; BATISTUZZO, Marcelo; SHAVITT, Roseli; REQUENA, Guaraci; MIGUEL, Euripedes; HOEXTER, Marcelo- Epigenetic evidence for involvement of the oxytocin receptor gene in obsessive-compulsive disorder(2016) CAPPI, Carolina; DINIZ, Juliana Belo; REQUENA, Guaraci L.; LOURENCO, Tiaya; LISBOA, Bianca Cristina Garcia; BATISTUZZO, Marcelo Camargo; MARQUES, Andrea H.; HOEXTER, Marcelo Q.; PEREIRA, Carlos A.; MIGUEL, Euripedes Constantino; BRENTANI, HelenaBackground: Obsessive-compulsive disorder (OCD) is a chronic neurodevelopmental disorder that affects up to 3% of the general population. Although epigenetic mechanisms play a role in neurodevelopment disorders, epigenetic pathways associated with OCD have rarely been investigated. Oxytocin is a neuropeptide involved in neurobehavioral functions. Oxytocin has been shown to be associated with the regulation of complex socio-cognitive processes such as attachment, social exploration, and social recognition, as well as anxiety and other stress-related behaviors. Oxytocin has also been linked to the pathophysiology of OCD, albeit inconsistently. The aim of this study was to investigate methylation in two targets sequences located in the exon III of the oxytocin receptor gene (OXTR), in OCD patients and healthy controls. We used bisulfite sequencing to quantify DNA methylation in peripheral blood samples collected from 42 OCD patients and 31 healthy controls. Results: We found that the level of methylation of the cytosine-phosphate-guanine sites in two targets sequences analyzed was greater in the OCD patients than in the controls. The higher methylation in the OCD patients correlated with OCD severity. We measured DNA methylation in the peripheral blood, which prevented us from drawing any conclusions about processes in the central nervous system. Conclusion: To our knowledge, this is the first study investigating DNA methylation of the OXTR in OCD. Further studies are needed to evaluate the roles that DNA methylation and oxytocin play in OCD.
conferenceObject Serotonin reuptake inhibitor augmentation with n-acetylcysteine in treatment resistant ocd: a double-blind randomized controlled trial(2015) COSTA, D. L. C.; DINIZ, J. B.; JOAQUIM, M.; ACCIARITO, A. C.; RODRIGUES, B.; ODA, E.; REQUENA, G.; MIGUEL, E. C.; SHAVITT, R. Gedanke- Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder(2017) COSTA, Daniel L. da Conceicao; BARBOSA, Veronica S.; REQUENA, Guaraci; SHAVITT, Roseli G.; PEREIRA, Carlos A. de Braganca; DINIZ, Juliana B.We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (<= 80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient. >= 0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.
- Whole-exome sequencing in obsessive-compulsive disorder identifies rare mutations in immunological and neurodevelopmental pathways(2016) CAPPI, C.; BRENTANI, H.; LIMA, L.; SANDERS, S. J.; ZAI, G.; DINIZ, B. J.; REIS, V. N. S.; HOUNIE, A. G.; ROSARIO, M. Conceicao do; MARIANI, D.; REQUENA, G. L.; PUGA, R.; SOUZA-DURAN, F. L.; SHAVITT, R. G.; PAULS, D. L.; MIGUEL, E. C.; FERNANDEZ, T. V.Studies of rare genetic variation have identified molecular pathways conferring risk for developmental neuropsychiatric disorders. To date, no published whole-exome sequencing studies have been reported in obsessive-compulsive disorder (OCD). We sequenced all the genome coding regions in 20 sporadic OCD cases and their unaffected parents to identify rare de novo (DN) single-nucleotide variants (SNVs). The primary aim of this pilot study was to determine whether DN variation contributes to OCD risk. To this aim, we evaluated whether there is an elevated rate of DN mutations in OCD, which would justify this approach toward gene discovery in larger studies of the disorder. Furthermore, to explore functional molecular correlations among genes with nonsynonymous DN SNVs in OCD probands, a protein-protein interaction (PPI) network was generated based on databases of direct molecular interactions. We applied Degree-Aware Disease Gene Prioritization (DADA) to rank the PPI network genes based on their relatedness to a set of OCD candidate genes from two OCD genome-wide association studies (Stewart et al., 2013; Mattheisen et al., 2014). In addition, we performed a pathway analysis with genes from the PPI network. The rate of DN SNVs in OCD was 2.51 x 10(-8) per base per generation, significantly higher than a previous estimated rate in unaffected subjects using the same sequencing platform and analytic pipeline. Several genes harboring DN SNVs in OCD were highly interconnected in the PPI network and ranked high in the DADA analysis. Nearly all the DN SNVs in this study are in genes expressed in the human brain, and a pathway analysis revealed enrichment in immunological and central nervous system functioning and development. The results of this pilot study indicate that further investigation of DN variation in larger OCD cohorts is warranted to identify specific risk genes and to confirm our preliminary finding with regard to PPI network enrichment for particular biological pathways and functions.
- Obsessive-Compulsive Personality Symptoms Predict Poorer Response to Gamma Ventral Capsulotomy for Intractable OCD(2020) COPETTI, Maria Eugenia; LOPES, Antonio C.; REQUENA, Guaraci; JOHNSON, Isaac N. S.; GREENBERG, Benjamin D.; NOREN, Georg; MCLAUGHLIN, Nicole C. R.; SHAVITT, Roseli G.; MIGUEL, Euripedes C.; BATISTUZZO, Marcelo C.; HOEXTER, Marcelo Q.Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive-compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (beta = -0.085, t-value = -2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive-compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.
- Personality measures after gamma ventral capsulotomy in intractable OCD(2018) PAIVA, Raquel R.; BATISTUZZO, Marcelo C.; MCLAUGHLIN, Nicole C.; CANTERAS, Miguel M.; MATHIS, Maria E. de; REQUENA, Guaraci; SHAVITT, Roseli G.; GREENBERG, Benjamin D.; NOREN, Georg; RASMUSSEN, Steven A.; TAVARES, Hermano; MIGUEL, Euripedes C.; LOPES, Antonio C.; HOEXTER, Marcelo Q.Background: Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients. Methods: The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n = 5) and non-responders (n = 9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables. Results: Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p = 0.043) and an increase in extraversion (p = 0.043). No significant changes were observed in nonresponders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery. Conclusions: The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.