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 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 Non-rapid-eye movement and rapid-eye-movement parasomnia with sleep breathing disorder, chorea and dementia associated with antibodies to IgLON5: Case Report(2016) SIMABUKURO, Mateus; ADONI, Tarso; CURY, Rubens Gisbert; HADDAD, Monica; GRAUS, Francesc- 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.
bookPart Neurocirurgia funcional para o Clínico: Estimulação Cerebral Profunda em Doença de Parkinson, Distonia e Outros Distúrbios do movimento(2016) FONOFF, Erich Talamoni; GHILARDI, Maria Gabriela dos Santos; CURY, Rubens Gisbert- Subthalamic deep brain stimulation modulates conscious perception of sensory function in Parkinson's disease(2016) CURY, Rubens G.; GALHARDONI, Ricardo; TEIXEIRA, Manoel J.; GHILARDI, Maria G. dos Santos; SILVA, Valquiria; MYCZKOWSKI, Martin L.; MARCOLIN, Marco A.; BARBOSA, Egberto R.; FONOFF, Erich T.; ANDRADE, Daniel Ciampi deSubthalamic deep brain stimulation (STN-DBS) is used to treat refractory motor complications in Parkinson disease (PD), but its effects on nonmotor symptoms remain uncertain. Up to 80% of patients with PD may have pain relief after STN-DBS, but it is unknown whether its analgesic properties are related to potential effects on sensory thresholds or secondary to motor improvement. We have previously reported significant and long-lasting pain relief after DBS, which did not correlate with motor symptomatic control. Here we present secondary data exploring the effects of DBS on sensory thresholds in a controlled way and have explored the relationship between these changes and clinical pain and motor improvement after surgery. Thirty-seven patients were prospectively evaluated before STN-DBS and 12 months after the procedure compared with healthy controls. Compared with baseline, patients with PD showed lower thermal and mechanical detection and higher cold pain thresholds after surgery. There were no changes in heat and mechanical pain thresholds. Compared with baseline values in healthy controls, patients with PD had higher thermal and mechanical detection thresholds, which decreased after surgery toward normalization. These sensory changes had no correlation with motor or clinical pain improvement after surgery. These data confirm the existence of sensory abnormalities in PD and suggest that STN-DBS mainly influenced the detection thresholds rather than painful sensations. However, these changes may depend on the specific effects of DBS on somatosensory loops with no correlation to motor or clinical pain improvement.
conferenceObject Anti-GAD antibody cerebellar ataxia mimicking multiple system atrophy(2016) PARMERA, J. B.; SCHNEIDER, L. S. V.; CURY, R. G.; SIMABUKURO, M. M.; CASTRO, L. H. M.; BARBOSA, E. R.conferenceObject Speech and voice range profile in patients with Parkinson's disease with deep brain stimulation: Preliminary data(2016) DIAFERIA, G. L. A.; DIAS, A. E.; CARVALHO, M. J.; CURY, R.; BARBOSA, E. R.; FONOFF, E. T.- Long-Term Outcome of Dentatotomy in a Dystonic Patient(2016) TEIXEIRA, Manoel Jacobsen; FRANCA, Carina C.; ANDRADE, Daniel Ciampi de; ROGANO, Luis Augusto Carvalho; LEPSKI, Guilherme; FONOFF, Erich Talamoni; CURY, Rubens GisbertDystonia is characterized by sustained or intermittent muscle contractions leading to abnormal movements and impairment in daily activities. Stereotactic dentatotomy has been a treatment option in cases of spasticity or dystonia, especially in patients with cerebral palsy, but the long-term effect of dentatotomy in dystonia is still unknown. Here we describe a dystonic patient who underwent dentatotomy for symptomatic treatment of refractory dystonia and whose 20-year follow-up showed improvement in symptoms.
conferenceObject Functional motor outcomes after globus pallidus internus deep brain stimulation in Huntington's disease - A case report(2016) CAPATO, T. T. C.; CURY, R. G.; GIMAAES, R.; FONOFF, E. T.; HADDAD, M. S.