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
22 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 22
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 deconferenceObject 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.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.- Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time(2016) FONOFF, Erich Talamoni; AZEVEDO, Angelo; ANGELOS, Jairo Silva dos; MARTINEZ, Raquel Chacon Ruiz; NAVARRO, Jessie; REIS, Paul Rodrigo; SEPULVEDA, Miguel Ernesto San Martin; CURY, Rubens Gisbert; GHILARDI, Maria Gabriela dos Santos; TEIXEIRA, Manoel Jacobsen; LOPEZ, William Omar ContrerasOBJECTIVE Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. METHODS Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. RESULTS Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 +/- 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 +/- 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% +/- 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% +/- 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. CONCLUSIONS A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional stereotactic procedures.
- Does TRODAT-1 SPECT Uptake Correlate with Cerebrospinal Fluid alpha-Synuclein Levels in Mid-Stage Parkinson's Disease?(2023) COUTINHO, Artur M.; GHILARDI, Maria Gabriela; CAMPOS, Ana Carolina P.; ETCHEBEHERE, Elba; FONOFF, Fernanda C.; CURY, Rubens G.; PAGANO, Rosana L.; MARTINEZ, Raquel C. R.; FONOFF, Erich T.Background: Parkinson's disease (PD) is characterized by a progressive loss of nigrostriatal dopaminergic neurons with impaired motor and non-motor symptoms. It has been suggested that motor asymmetry could be caused due to an imbalance in dopamine levels, as visualized by dopamine transporter single emission computed tomography test (DAT-SPECT), which might be related to indirect measures of neurodegeneration, evaluated by the Montreal Cognitive Assessment (MOCA) and alpha-synuclein levels in the cerebrospinal fluid (CSF). Therefore, this study aimed to understand the correlation between disease laterality, DAT-SPECT, cognition, and alpha-synuclein levels in PD. Methods: A total of 28 patients in the moderate-advanced stage of PD were subjected to neurological evaluation, TRODAT-1-SPECT/CT imaging, MOCA, and quantification of the levels of alpha-synuclein. Results: We found that alpha-synuclein in the CSF was correlated with global cognition (positive correlation, r(2) = 0.3, p = 0.05) and DAT-SPECT concentration in the putamen (positive correlation, r(2) = 0.4, p = 0.005), and striatum (positive correlation, r(2) = 0.2, p = 0.03), thus working as a neurodegenerative biomarker. No other correlations were found between DAT-SPECT, CSF alpha-synuclein, and cognition, thus suggesting that they may be lost with disease progression. Conclusions: Our data highlight the importance of understanding the dysfunction of the dopaminergic system in the basal ganglia and its complex interactions in modulating cognition.
- Effects of Subthalamic Stimulation on Olfactory Function in Parkinson Disease(2018) CURY, Rubens Gisbert; CARVALHO, Margarete de Jesus; LASTEROS, Fernando Jeyson Lopez; DIAS, Alice Estevo; GHILARDI, Maria Gabriela dos Santos; PAIVA, Anderson Rodrigues Brandao; COUTINHO, Artur Martins; BUCHPIGUEL, Carlos Alberto; TEIXEIRA, Manoel J.; BARBOSA, Egberto Reis; FONOFF, Erich TalamoniBACKGROUND: Olfactory dysfunction is a nonmotor symptom of Parkinson disease (PD) associated with reduction in quality of life. There is no evidence on whether improvements in olfaction after subthalamic deep brain stimulation (STN-DBS) may be directly attributable to motor improvement or whether this reflects a direct effect of DBS on olfactory brain areas. The aim of the present study was to evaluate the effect of DBS on olfactory function in PD, as well as to explore the correlation between these changes and changes in motor symptoms and brain metabolism. METHODS: Thirty-two patients with PD were screened for STN-DBS. Patients were evaluated before and 1 year after surgery. Primary outcome was the change in olfactory function (Sniffin' Sticks odor-identification test [SST]) after surgery among the patients with hyposmia at baseline. Secondary outcomes included the relationship between motor outcomes and olfactory changes and [F-18] fluo-rodeoxyglucose-positron emission tomography analysis between subgroups with improvement versus no improvement of smell. RESULTS: STN-DBS improved SST after surgery (preoperative SST, median 7.3 +/- 2.4 vs. postoperative SST, median 8.2 +/- 2.1; P = 0.045) in a subset of patients among 29 of 32 patients who presented with hyposmia at baseline. The improvement in SST was correlated with DBS response (r = 0.424; P = 0.035). There was also an increase in glucose metabolism in the midbrain, cerebellum, and right frontal lobe in patients with SST improvement (P < 0.001). CONCLUSIONS: STN-DBS improves odor identification in a subset of patients with PD. Motor improvement together with changes in the brain metabolism may be linked to this improvement.
- LONG-TERM IMPROVEMENT OF TREMOR AND ATAXIA AFTER BILATERAL DBS OF VOP/ZONA INCERTA IN FXTAS(2015) GHILARDI, Maria Gabriela dos Santos; CURY, Rubens Gisbert; ANGELOS, Jairo Silva dos; BARBOSA, Danilo Costa; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; FONOFF, Erich TalamoniFragile X-associated tremor/ataxia syndrome (FXTAS) is an X-linked adult-onset neurodegenerative disorder that affects carriers of the fragile X mental retardation 1 (FMR1) gene premutation, which is a 55-200 CGG repeat expansion in the 5' untranslated region of the gene.(1) The core symptoms of FXTAS are progressive intention tremor and cerebellar ataxia. These symptoms can be disabling and, when combined, severely reduce the patient's quality of life. Symptomatic control with medication has limited effects.(1) Very few cases have been treated with deep brain stimulation (DBS), mostly in the ventrointermediate thalamic (VIM) nucleus. This treatment results in tremor improvement with either no benefit or worsening of the ataxia and balance.(2-4) We present a patient who experienced long-term tremor control and ataxia improvement after chronic bilateral stimulation of the ventro-oralis posterior thalamic nucleus and zona incerta (VoP/ZI), which resulted in significant improvement in daily life activities.
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