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-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- Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia(2017) CURY, Rubens Gisbert; FRAIX, Valerie; CASTRIOTO, Anna; FERNANDEZ, Maricely Ambar Perez; KRACK, Paul; CHABARDES, Stephan; SEIGNEURET, Eric; ALHO, Eduardo Joaquim Lopes; BENABID, Alim-Louis; MORO, ElenaObjective: To report on the long-term outcomes of deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM) in Parkinson disease (PD), essential tremor (ET), and dystonic tremor. Methods: One hundred fifty-nine patients with PD, ET, and dystonia underwent VIM DBS due to refractory tremor at the Grenoble University Hospital. The primary outcome was a change in the tremor scores at 1 year after surgery and at the latest follow-up (21 years). Secondary outcomes included the relationship between tremor score reduction over time and the active contact position. Tremor scores (Unified Parkinson's Disease Rating Scale-III, items 20 and 21; Fahn, Tolosa, Marin Tremor Rating Scale) and the coordinates of the active contacts were recorded. Results: Ninety-eight patients were included. Patients with PD and ET had sustained improvement in tremor with VIM stimulation (mean improvement, 70% and 66% at 1 year; 63% and 48% beyond 10 years, respectively; p< 0.05). There was no significant loss of stimulation benefit over time (p> 0.05). Patients with dystonia exhibited a moderate response at 1-year follow-up (41% tremor improvement, p = 0.027), which was not sustained after 5 years (30% improvement, p = 0.109). The more dorsal active contacts' coordinates in the right lead were related to a better outcome 1 year after surgery (p = 0.029). During the whole follow-up, forty-eight patients (49%) experienced minor side effects, whereas 2 (2.0%) had serious events (brain hemorrhage and infection). Conclusions: VIM DBS is an effective long-term (beyond 10 years) treatment for tremor in PD and ET. Effects on dystonic tremor were modest and transient.
- 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.
- Dramatic improvement of tardive dyskinesia movements by inline skating(2017) CASAGRANDE, Sara Carvalho Barbosa; CURY, Rubens Gisbert; LIMA-PARDINI, Andrea Cristina de; COELHO, Daniel Boari; SOUZA, Carolina de Oliveira; GHILARDI, Maria Gabriela dos Santos; SILVEIRA-MORIYAMA, Laura; TEIXEIRA, Luis Augusto; BARBOSA, Egberto Reis; FONOFF, Erich Talamoni
- Teaching Video NeuroImage: Peculiar Hobby Horse Gait in Huntington Disease-like 2(2022) GUIMARAES, Thiago G.; PARMERA, Jacy Bezerra; BARBOSA, Egberto Reis; HADDAD, Monica S.; CURY, Rubens Gisbert
article 105 Citação(ões) na Scopus Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease(2014) CURY, Rubens G.; GALHARDONI, Ricardo; FONOFF, Erich T.; GHILARDI, Maria G. dos Santos; FONOFF, Fernanda; ARNAUT, Debora; MYCZKOWSKI, Martin L.; MARCOLIN, Marco A.; BOR-SENG-SHU, Edson; BARBOSA, Egberto R.; TEIXEIRA, Manoel J.; ANDRADE, Daniel Ciampi deObjective: To prospectively evaluate the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on the different characteristics of pain and other nonmotor symptoms (NMS) in patients with Parkinson disease (PD). Methods: Forty-four patients with PD and refractory motor symptoms were screened for STN-DBS. Patients were evaluated before and 1 year after surgery. The primary outcome was change in pain prevalence after surgery. Secondary outcome measures were changes in motor function (Unified Parkinson's Disease Rating Scale), characteristics of pain and other NMS using specific scales and questionnaires, and quality of life. Results: Forty-one patients completed the study. The prevalence of pain changed from 70% to 21% after surgery (p < 0.001). There were also significant improvements in pain intensity, NMS, and quality of life after STN-DBS (p < 0.05). Dystonic and musculoskeletal pain responded well to DBS, while central pain and neuropathic pain were not influenced by surgery. There was a strong correlation between the change in pain intensity and the improvement in quality of life (r = 0.708, p < 0.005). No correlation was found between pain improvement and preoperative response to levodopa or motor improvement during stimulation (r = 0.247, p = 0.197 and r = 0.249, p = 0.193, respectively) or with changes in other NMS. Conclusions: STN-DBS decreased pain after surgery, but had different effects in different types of PD-related pain. Motor and nonmotor symptom improvements after STN-DBS did not correlate with pain relief. Classification of evidence: This study provides Class IV evidence that in patients with idiopathic PD with refractory motor fluctuations, STN-DBS decreases the prevalence of pain and improves quality of life.article 47 Citação(ões) na Scopus DEEP BRAIN STIMULATION OF THE DENTATE NUCLEUS IMPROVES CEREBELLAR ATAXIA AFTER CEREBELLAR STROKE(2015) TEIXEIRA, Manoel J.; CURY, Rubens Gisbert; GALHARDONI, Ricardo; BARBOZA, Victor Rossetto; BRUNONI, Andre R.; ALHO, Eduardo; LEPSKI, Guilherme; ANDRADE, Daniel Ciampi de