RUBENS GISBERT CURY
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Non-motor symptoms in PD candidates for DBS treatment(2016) GHILARDI, M. G. dos Santos; MARTINEZ, R. C. R.; CURY, R. G.; ARANHA, J. R.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.conferenceObject Subthalamic deep brain stimulation modulates small fiber-dependent sensory threshold in Parkinson's disease(2015) CURY, R. G.; GALHARDONI, R.; FONOFF, E. T.; GHILARDI, M. G. dos Santos; MYCZKOWSKI, M.; MARCOLIN, M. A.; BARBOSA, E. R.; TEIXEIRA, M. J.; ANDRADE, D. Ciampi de- Non-motor effects of deep brain stimulation in Parkinson?s disease motor subtypes(2023) JOST, Stefanie T.; KONITSIOTI, Agni; LOEHRER, Philipp A.; ASHKAN, Keyoumars; RIZOS, Alexandra; SAUERBIER, Anna; GHILARDI, Maria Gabriela dos Santos; ROSENKRANZ, Franz; STROBEL, Lena; GRONOSTAY, Alexandra; BARBE, Michael T.; EVANS, Julian; VISSER-VANDEWALLE, Veerle; NIMSKY, Christopher; FINK, Gereon R.; SILVERDALE, Monty; CURY, Rubens G.; FONOFF, Erich T.; ANTONINI, Angelo; CHAUDHURI, K. Ray; TIMMERMANN, Lars; MARTINEZ-MARTIN, Pablo; DAFSARI, Haidar S.Introduction: Deep brain stimulation (DBS) is a well-established treatment for patients with Parkinson's disease (PD) improving quality of life, motor, and non-motor symptoms. However, non-motor effects in PD subtypes are understudied. We hypothesized that patients with 'postural instability and gait difficulty' (PIGD) experience more beneficial non-motor effects than 'tremor-dominant' patients undergoing DBS for PD.Methods: In this prospective, observational, international multicentre study with a 6-month follow-up, we assessed the Non-Motor Symptom Scale (NMSS) as primary and the following secondary outcomes: Unified PD Rating Scale-motor examination (UPDRS-III), Scales for Outcomes in PD (SCOPA)-activities of daily living (ADL) and-motor complications, PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose (LEDD). We analysed within-group longitudinal changes with Wilcoxon signed-rank test and Benjamini-Hochberg correction for multiple comparisons. Additionally, we explored outcome between-group differences of motor subtypes with Mann-Whitney U-tests.Results: In 82 PIGD and 33 tremor-dominant patients included in this study, baseline NMSS total scores were worse in PIGD patients, both groups experienced postoperative improvements of the NMSS sleep/fatigue domain, and between-group differences in postoperative outcomes were favourable in the PIGD group for the NMSS total and miscellaneous domain scores.Conclusions: This study provides evidence of a favourable outcome of total non-motor burden in PIGD compared to tremor-dominant patients undergoing DBS for PD. These differences of clinical efficacy on non-motor aspects should be considered when advising and monitoring patients with PD undergoing DBS.
conferenceObject Nonmotor effects of subthalamic stimulation in Parkinson's disease motor subtypes(2021) JOST, S.; KONITSIOTI, A.; LOEHRER, P.; ASHKAN, K.; RIZOS, A.; SAUERBIER, A.; GHILARDI, M.; ROSENKRANZ, F.; STROBEL, L.; GRONOSTAY, A.; BARBE, M.; EVANS, J.; SILVERDALE, M.; CURY, R.; FONOFF, E.; FINK, G.; ANTONINI, A.; NIMSKY, C.; CHAUDHURI, K. Ray; TIMMERMANN, L.; VISSER-VANDEWALLE, V.; MARTINEZ-MARTIN, P.; DAFSARI, H.conferenceObject Effects of Deep Brain Stimulation on olfactory function in Parkinson's disease(2017) CURY, R.; CARVALHO, M.; GHILARDI, M. G. Santos; ESTEVO, A.; PAIVA, A. de; LOPEZ, F.; COUTINHO, A.; TEIXEIRA, M.; BARBOSA, E.; FONOFF, E.- Effect of Levodopa plus Carbidopa on the Laryngeal Electromyographic Pattern in Parkinson Disease(2017) NOFFS, Gustavo; DUPRAT, Andre de Campos; ZARZUR, Ana Paula; CURY, Rubens Gisbert; CATALDO, Berenice Oliveira; FONOFF, ErichBackground. Vocal impairment is one of the main debilitating symptoms of Parkinson disease (PD). The effect of levodopa on vocal function remains unclear. Objective. This study aimed to determine the effect of levodopa on electromyographic patterns of the laryngeal muscle in patients with PD. Study design. This is a prospective interventional trial. Methods. Nineteen patients with PD-diagnosed by laryngeal electromyography-were enrolled. Cricothyroid and thyroarytenoid (TA) muscle activities were measured at rest and during muscle contraction (phonation), when participants were on and off medication (12 hours after the last levodopa dose). Results. Prevalence of resting hypertonia in the cricothyroid muscle was similar in the off and on states (7 of 19, P = 1.00). Eight patients off medication and four patients on medication had hypertonic TA muscle at rest (P = 0.289). No electromyographic alterations were observed during phonation for either medication states. Conclusion. Despite a tendency for increased rest tracings in the TA muscle when participants were on medication, no association was found between laryngeal electromyography findings and levodopa + carbidopa administration.
conferenceObject Pallidal versus subthalamic stimulation for PD: Beyond the motor effects(2016) GHILARDI, M. G. dos Santos; CURY, R. G.; MARTINEZ, R. C. R.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.conferenceObject Effects of STN versus GPi deep brain stimulation on impulse control disorders(2015) GHILARDI, M. G. dos Santos; COUTINHO, A. M. N.; CURY, R. G.; BARBOSA, E. R.; TEIXEIRA, M. J.; ETCHEBEHERE, E.; FONOFF, E. T.conferenceObject Correlation between pain, other non-motor symptoms, quality of life and motor improvement in patients with Parkinson's disease after deep brain stimulation(2014) CURY, R. G.; GHILARDI, M. G.; GALHARDONI, R.; SOUZA, C.; FONOFF, F.; MARCOLIN, M. A.; MYCZKOWSKI, M. L.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.; ANDRADE, D. Ciampi de- Deep brain stimulation in Tourette's syndrome: evidence to date(2019) CASAGRANDE, Sara C. B.; CURY, Rubens G.; ALHO, Eduardo J. L.; FONOFF, Erich TalamoniTourette's syndrome (TS) is a neurodevelopmental disorder that comprises vocal and motor tics associated with a high frequency of psychiatric comorbidities, which has an important impact on quality of life. The onset is mainly in childhood and the symptoms can either fade away or require pharmacological therapies associated with cognitive-behavior therapies. In rare cases, patients experience severe and disabling symptoms refractory to conventional treatments. In these cases, deep brain stimulation (DBS) can be considered as an interesting and effective option for symptomatic control. DBS has been studied in numerous trials as a therapy for movement disorders, and currently positive data supports that DBS is partially effective in reducing the motor and non-motor symptoms of TS. The average response, mostly from case series and prospective cohorts and only a few controlled studies, is around 40% improvement on tic severity scales. The ventromedial thalamus has been the preferred target, but more recently the globus pallidus internus has also gained some notoriety. The mechanism by which DBS is effective on tics and other symptoms in TS is not yet understood. As refractory TS is not common, even reference centers have difficulties in performing large controlled trials. However, studies that reproduce the current results in larger and multicenter randomized controlled trials to improve our knowledge so as to support the best target and stimulation settings are still lacking. This article will discuss the selection of the candidates, DBS targets and mechanisms on TS, and clinical evidence to date reviewing current literature about the use of DBS in the treatment of TS.