DANIEL FUENTES MOREIRA
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- Memory in children with temporal lobe epilepsy is at least partially explained by executive dysfunction(2012) RZEZAK, Patricia; GUIMARAES, Catarina A.; FUENTES, Daniel; GUERREIRO, Marilisa M.; VALENTE, Kette D.An association between memory and executive dysfunction (ED) has been demonstrated in patients with mixed neurological disorders. We aimed to investigate the impact of ED in memory tasks of children with temporal lobe epilepsy (TLE). We evaluated 36 children with TLE and 28 controls with tests for memory, learning, attention, mental flexibility, and mental tracking. Data analysis was composed of comparison between patients and controls in memory and executive function; correlation between memory and executive function tests; and comparison between patients with mild and severe ED in memory tests. Children with TLE had worse performance in focused attention, immediate and delayed recall, phonological memory, mental tracking, planning, and abstraction. Planning, abstraction, and mental tracking were correlated with visual and verbal memory. Children with severe ED had worse performance in verbal and visual memory and learning tests. This study showed that ED was related to memory performance in children with TLE.
- Changes in Neuropsychological Tests and Brain Metabolism After Bariatric Surgery(2014) MARQUES, Emerson Leonildo; HALPERN, Alfredo; MANCINI, Marcio Correa; MELO, Maria Edna de; HORIE, Ndia Celeste; BUCHPIGUEL, Carlos Alberto; COUTINHO, Artur Martins Novaes; ONO, Carla Rachel; PRANDO, Silvana; SANTO, Marco Aurelio; CUNHA-NETO, Edecio; FUENTES, Daniel; CERCATO, CintiaContext: The mechanisms by which obesity alters the cerebral function and the effect of weight loss on the brain have not been completely clarified. Objective: The objective of the study was to assess the effect of bariatric surgery on the cognitive function and cerebral metabolism. Design: Seventeen obese women were studied prior to and 24 weeks after bariatric surgery using neuropsychological tests and positron emission tomography. Setting: The study was conducted in a reference center for the treatment of obesity of a Brazilian public university. Participants: Thirty-three women paired by age and level of education made up two groups: 17 severely obese patients and 16 lean patients. They did not have diabetes mellitus or a family history of dementia. Main Outcome Measures: Comparison of performance in neuropsychological tests and cerebral metabolism of the obese women before and after bariatric surgery was measured. The results found at the two moments were compared with those of the women of normal weight. Results: Women with a mean age of 40.5 years and mean body mass index of 50.1 kg/m(2) when compared with women with mean body mass index of 22.3 kg/m(2) showed increased cerebral metabolism, especially in the posterior cingulate gyrus (P <.004). No difference was found between the groups for the neuropsychological tests. After 24 weeks the cerebral metabolism of the obese women was lower, similar to the lean women, and there was an improvement of executive function, accompanying changes of metabolic and inflammatory parameters. Conclusions: Obese women may have increased cerebral metabolism when compared with women of normal weight, and this appears to reverse after weight loss induced by bariatric surgery, accompanied by improved executive function.
- Episodic and semantic memory in children with mesial temporal sclerosis(2011) RZEZAK, Patricia; GUIMARAES, Catarina; FUENTES, Daniel; GUERREIRO, Marilisa M.; VALENTE, Kette Dualibi RamosThe aim of this study was to analyze semantic and episodic memory deficits in children with mesial temporal sclerosis (MTS) and their correlation with clinical epilepsy variables. For this purpose, 19 consecutive children and adolescents with MTS (8 to 16 years old) were evaluated and their performance on five episodic memory tests (short- and long-term memory and learning) and four semantic memory tests was compared with that of 28 healthy volunteers. Patients performed worse on tests of immediate and delayed verbal episodic memory, visual episodic memory, verbal and visual learning, mental scanning for semantic clues, object naming, word definition, and repetition of sentences. Clinical variables such as early age at seizure onset, severity of epilepsy, and polytherapy impaired distinct types of memory. These data confirm that children with MTS have episodic memory deficits and add new information on semantic memory. The data also demonstrate that clinical variables contribute differently to episodic and semantic memory performance.
- Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure(2011) GOIS, J.; VALENTE, K.; VICENTIIS, S.; MOSCHETTA, S.; KUCZYNSKI, E.; FIORE, L.; FUENTES, D.Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.
- Correlation between insight dimensions and cognitive functions in patients with deficit and nondeficit schizophrenia(2013) PEGORARO, Luiz F. L.; DANTAS, Clarissa R.; BANZATO, Claudio E. M.; FUENTES, DanielPrevious studies have shown correlations between poor insight and neurocognitive impairment in schizophrenia. Deficit schizophrenia has been associated with worse cognitive functioning and poorer insight. This study aimed at investigating the relationship between insight dimensions (measured by Schedule for the Assessment of Insight-Expanded Version and its factors) and specific neurocognitive functions (assessed through a battery of neuropsychological tests) considering separately patients with deficit (n = 29) and nondeficit schizophrenia (n = 44), categorized according to the Schedule for the Deficit Syndrome. We found that working memory correlated positively and significantly with awareness of mental illness in both groups. In nondeficit group, awareness of mental illness correlated additionally with verbal fluency and attention. If confirmed by further studies, these results may have important consequences, such as the need of tailoring differently cognitive rehabilitation for each group.
- Memory in children with symptomatic temporal lobe epilepsy(2014) GUIMARAES, Catarina A.; RZEZAK, Patricia; FUENTES, Daniel; FRANZON, Renata C.; MONTENEGRO, Maria Augusta; CENDES, Fernando; VALENTE, Kette D.; GUERREIRO, Marilisa M.In children with temporal lobe epilepsy (TLE), memory deficit is not so well understood as it is in adults. The aim of this study was to identify and describe memory deficits in children with symptomatic TLE, and to verify the influence of epilepsy variables on memory. We evaluated 25 children with TLE diagnosed on clinical, EEG and MRI findings. Twenty-five normal children were compared with the patients. All children underwent a neuropsychological assessment to estimate intellectual level, attention, visual perception, handedness, and memory processes (verbal and visual: short-term memory, learning, and delayed recall). The results allowed us to conclude: besides memory deficits, other neuropsychological disturbances may be found in children with TLE such as attention, even in the absence of overall cognitive deficit; the earlier onset of epilepsy, the worse verbal stimuli storage; mesial lesions correlate with impairment in memory storage stage while neocortical temporal lesions correlate with retrieval deficits.
- Decision-making in Cognitively Unimpaired Illiterate and Low-educated Older Women: Results on the Iowa Gambling Task(2017) CASSIMIRO, Luciana; FUENTES, Daniel; NITRINI, Ricardo; YASSUDA, Monica SanchesObjective: This study investigated the pattern of decision-making (DM) on the Iowa Gambling Task (IGT) in a sample of Portuguese speaking healthy older women in Brazil with limited education: illiterate, 1-2 years, and 3-4 years of schooling. Methods: Around 164 non-demented community-dwelling women participated in the study. Among them 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini-Mental State Examination, Verbal Fluency Test (animal category), Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven's Coloured Progressive Matrices, Wisconsin Card Sorting Test, and IGT. Results: The three education groups were equivalent as to age, number of diseases, medications taken daily, depression, and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate and IGT performance improved linearly with higher levels of education. IGT performance correlated significantly with all cognitive test scores with the exception of the memorization of the pictures on the BCSB. Conclusion: The results suggested that education influences IGT performance, with worse scores among the illiterate. Results may be used by clinicians to interpret IGT performance among seniors with low literacy levels.
- Mapping brain volumetric abnormalities in never-treated pathological gamblers(2015) FUENTES, Daniel; RZEZAK, Patricia; PEREIRA, Fabricio R.; MALLOY-DINIZ, Leandro F.; SANTOS, Luciana C.; DURAN, Fabio L. S.; BARREIROS, Maria A.; CASTRO, Claudio C.; BUSATTO, Geraldo F.; TAVARES, Hermano; GORENSTEIN, ClariceSeveral magnetic resonance imaging (MRI) studies to date have investigated brain abnormalities in association with the diagnosis of pathological gambling (PG), but very few of these have specifically searched for brain volume differences between PG patients and healthy volunteers (HV). To investigate brain volume differences between PG patients and HV, 30 male never treated PG patients (DSM-IV-TR criteria) and 30 closely matched HV without history of psychiatric disorders in the past 2 years underwent structural magnetic resonance imaging with a 1.5-T instrument. Using Freesurfer software, we performed an exploratory whole brain voxelwise volume comparison between the PG group and the HV group, with false discovery rate correction for multiple comparisons (p <0.05), Using a more flexible statistical threshold (p < 0.01, uncorrected for multiple comparisons), we also measured absolute and regional volumes of several brain structures separately. The voxelwise analysis showed no clusters of significant regional differences between the PG and HV groups. The additional analyses of absolute and regional brain volumes showed increased absolute global gray matter volumes in PG patients relative to the HV group, as well as relatively decreased volumes specifically in the left putamen, right thalamus and right hippocampus (corrected for total gray matter). Our findings indicate that structural brain abnormalities may contribute to the functional changes associated with the symptoms of PG, and they highlight the relevance of the brain reward system to the pathophysiology of this disorder.
- Personality traits in patients with juvenile myoclonic epilepsy(2011) MOSCHETTA, Sylvie; FIORE, Lia A.; FUENTES, Daniel; GOIS, Juliana; VALENTE, Kette D.There is evidence of personality disorders in patients with juvenile myoclonic epilepsy (JME). To date, there have been no published quantitative studies on personality traits in JME. The aim of the work described here was to study a group of patients with JME and quantitatively measure personality traits. We evaluated 42 patients (mean age: 26.57 years, SD: 8.38) and 42 controls (mean age: 26.96, SD: 8.48) using a validated personality inventory, the Temperament and Character Inventory (TCI). We applied two scores, one for the Beck Depression Inventory and one for the State-Trait-Anxiety Inventory, as depression and anxiety may impact the performance of these patients on the TCI. We compared both groups on TCI scales using analysis of covariance with Beck Depression Inventory and State-Trait-Anxiety Inventory scores as covariates. Patients with JME obtained significantly higher scores on Novelty Seeking (P=0.001) and Harm Avoidance (P=0.002) and significantly lower scores on Self-Directedness (P=0.001). Patients with JME have a higher expression of impulsive personality traits that demand early recognition to avoid further consequences and facilitate social insertion, consequently avoiding future stigma.
- Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video(2017) MESSINA, Bruna; FUENTES, Daniel; TAVARES, Hermano; ABDO, Carmita H. N.; SCANAVINO, Marco de T.Introduction: Despite the serious behavioral consequences faced by individuals with sexual compulsivity, related neuropsychological studies are sparse. Aim: To compare decision making and cognitive flexibility at baseline and after exposure to an erotic video in sexually compulsive participants and non-sexually compulsive controls. Methods: The sample consisted of 30 sexually compulsive men and 30 controls. Cognitive flexibility was investigated through the Wisconsin Card Sorting Test and decision making was examined through the Iowa Gambling Task. Main Outcome Measures: Wisconsin Card Sorting Test categories, correct responses, and perseverative errors and Iowa Gambling Task general trends and blocks. Results: Sexually compulsive subjects and controls performed similarly at baseline. After watching an erotic video, controls performed better in block 1 of the Iowa Gambling Task (P = .01) and had more correct responses on the Wisconsin Card Sorting Test (P = .01). Conclusions: The controls presented fewer impulsive initial choices and better cognitive flexibility after exposure to erotic stimuli.