MARCELO CAMARGO BATISTUZZO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
39 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 39
- Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder(2021) SHEPHARD, Elizabeth; STERN, Emily R.; HEUVEL, Odile A. van den; COSTA, Daniel L. C.; BATISTUZZO, Marcelo C.; GODOY, Priscilla B. G.; LOPES, Antonio C.; BRUNONI, Andre R.; HOEXTER, Marcelo Q.; SHAVITT, Roseli G.; REDDY, Y. C. Janardhan; LOCHNER, Christine; STEIN, Dan J.; SIMPSON, H. Blair; MIGUEL, Euripedes C.An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
conferenceObject Associations Between Medial Prefrontal Cerebral Metabolic Features and Clinical Characteristics in Obsessive-compulsive Disorder(2016) BATISTUZZO, Marcelo C.; HOEXTER, Marcelo; COSTA, Fabiana; SHAVITT, Roseli; LOPES, Antonio C.; CAPPI, Carolina; VATTIMO, Edoardo; MATHIS, Alice de; DINIZ, Juliana B.; HENNING, Anke; PASTORELLO, Bruno; MIGUEL, Euripedes C.; OTADUY, Maria C.- Using supervised machine learning on neuropsychological data to distinguish OCD patients with and without sensory phenomena from healthy controls(2021) STAMATIS, Caitlin A.; BATISTUZZO, Marcelo C.; TANAMATIS, Tais; MIGUEL, Euripedes C.; HOEXTER, Marcelo Q.; TIMPANO, Kiara R.Objectives While theoretical models link obsessive-compulsive disorder (OCD) with executive function deficits, empirical findings from the neuropsychological literature remain mixed. These inconsistencies are likely exacerbated by the challenge of high-dimensional data (i.e., many variables per subject), which is common across neuropsychological paradigms and necessitates analytical advances. More unique to OCD is the heterogeneity of symptom presentations, each of which may relate to distinct neuropsychological features. While researchers have traditionally attempted to account for this heterogeneity using a symptom-based approach, an alternative involves focusing on underlying symptom motivations. Although the most studied symptom motivation involves fear of harmful events, 60-70% of patients also experience sensory phenomena, consisting of uncomfortable sensations or perceptions that drive compulsions. Sensory phenomena have received limited attention in the neuropsychological literature, despite evidence that symptoms motivated by these experiences may relate to distinct cognitive processes. Methods Here, we used a supervised machine learning approach to characterize neuropsychological processes in OCD, accounting for sensory phenomena. Results Compared to logistic regression and other algorithms, random forest best differentiated healthy controls (n = 59; balanced accuracy = .70), patients with sensory phenomena (n = 29; balanced accuracy = .59), and patients without sensory phenomena (n = 46; balanced accuracy = .62). Decision-making best distinguished between groups based on sensory phenomena, and among the patient subsample, those without sensory phenomena uniquely displayed greater risk sensitivity compared to healthy controls (d = .07, p = .008). Conclusions Results suggest that different cognitive profiles may characterize patients motivated by distinct drives. The superior performance and generalizability of the newer algorithms highlights the utility of considering multiple analytic approaches when faced with complex data. Practitioner points Practitioners should be aware that sensory phenomena are common experiences among patients with OCD. OCD patients with sensory phenomena may be distinguished from those without based on neuropsychological processes.
- Toward identifying reproducible brain signatures of obsessive-compulsive profiles: rationale and methods for a new global initiative(2020) SIMPSON, Helen Blair; HEUVEL, Odile A. van den; MIGUEL, Euripedes C.; REDDY, Y. C. Janardhan; STEIN, Dan J.; LEWIS-FERNANDEZ, Roberto; SHAVITT, Roseli Gedanke; LOCHNER, Christine; POUWELS, Petra J. W.; NARAYANAWAMY, Janardhanan C.; VENKATASUBRAMANIAN, Ganesan; HEZEL, Dianne M.; VRIEND, Chris; BATISTUZZO, Marcelo C.; HOEXTER, Marcelo Q.; JOODE, Niels T. de; COSTA, Daniel Lucas; MATHIS, Maria Alice de; SHESHACHALA, Karthik; NARAYAN, Madhuri; BALKOM, Anton J. L. M. van; BATELAAN, Neeltje M.; VENKATARAM, Shivakumar; CHERIAN, Anish; MARINCOWITZ, Clara; PANNEKOEK, Nienke; STOVEZKY, Yael R.; MARE, Karen; LIU, Feng; OTADUY, Maria Concepcion Garcia; PASTORELLO, Bruno; RAO, Rashmi; KATECHIS, Martha; METER, Page Van; WALL, MelanieBackground Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results. Methods We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations. Discussion Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.
- Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta-and Mega-Analysis (vol , pg , 2016)(2017) ABE, Yoshinari; ALONSO, Pino; AMEIS, Stephanie H.; ARNOLD, Paul D.; BARGALLO, Nuria; BATISTUZZO, Marcelo C.; BENEDETTI, Francesco; BEUCKE, Jan C.; BOEDHOE, Premika S. W.; BOLLETTINI, Irene; BOSE, Anushree; BREM, Silvia; BUSATTO, Geraldo F.; CALVO, Anna; CALVO, Rosa; CATH, Danielle C.; CHENG, Yuqi; CHO, Kang Ik K.; DALLASPEZIA, Sara; VRIES, Froukje E. de; WIT, Stella J. de; DENYS, Damiaan; FANG, Yu; FITZGERALD, Kate D.; FONTAINE, Martine; FOUCHE, Jean-Paul; GIMENEZ, Monica; GRUNER, Patricia; HANNA, Gregory L.; HIBAR, Derrek P.; HOEXTER, Marcelo Q.; HU, Hao; HUYSER, Chaim; IKARI, Keisuke; JAHANSHAD, Neda; KATHMANN, Norbert; KAUFMANN, Christian; KHADKA, Sabin; KOCH, Kathrin; KWON, Jun Soo; LAZARO, Luisa; LIU, Yanni; LOCHNER, Christine; MARSH, Rachel; MARTINEZ-ZALACAIN, Ignacio; MATAIX-COLS, David; MENCHON, Jose M.; MIGUEL, Euripedes C.; MINUZZI, Luciano; MORER, Astrid; NAKAMAE, Takashi; NAKAO, Tomohiro; NARAYANASWAMY, Janardhanan C.; PIRAS, Fabrizio; PIRAS, Federica; PITTENGER, Christopher; REDDY, Y. C. Janardhan; SATO, Joao R.; SIMPSON, H. Blair; SCHMAAL, Lianne; SORENI, Noam; SORIANO-MAS, Carles; SPALLETTA, Gianfranco; STEIN, Dan J.; STEVENS, Michael C.; SZESZKO, Philip R.; THOMPSON, Paul M.; TOLIN, David F.; VELTMAN, Dick J.; VENKATASUBRAMANIAN, Ganesan; HEUVEL, Odile A. van den; WERF, Ysbrand D. van der; WINGEN, Guido A. van; WALITZA, Susanne; WANG, Zhen; XU, Jian; XU, Xiufeng; YUN, Je-Yeon; ZHAO, Qing
- Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder(2013) HOEXTER, Marcelo Q.; DOUGHERTY, Darin D.; SHAVITT, Roseli G.; D'ALCANTE, Carina C.; DURAN, Fabio L. S.; LOPES, Antonio C.; DINIZ, Juliana B.; BATISTUZZO, Marcelo C.; EVANS, Karleyton C.; BRESSAN, Rodrigo A.; BUSATTO, Geraldo F.; MIGUEL, Euripedes C.Nearly one-third of patients with obsessive-compulsive disorder (OCD) fail to respond to adequate therapeutic approaches such as serotonin reuptake inhibitors and/or cognitive-behavioral therapy (CBT). This study investigated structural magnetic resonance imaging (MRI) correlates as potential pre-treatment brain markers to predict treatment response in treatment-naive OCD patients randomized between trials of fluoxetine or CBI Treatment-naive OCD patients underwent structural MRI scans before randomization to a 12-week clinical trial of either fluoxetine or group-based CBT. Voxel-based morphometry was used to identify correlations between pretreatment regional gray matter volume and changes in symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Brain regional correlations of treatment response differed between treatment groups. Notably, symptom improvement in the fluoxetine treatment group (n=14) was significantly correlated with smaller pretreatment gray matter volume within the right middle lateral orbitofrontal cortex (OFC), whereas symptom improvement in the CBT treatment group (n=15) was significantly correlated with larger pretreatment gray matter volume within the right medial prefrontal cortex (mPFC). No significant a priori regional correlations of treatment response were identified as common between the two treatment groups when considering the entire sample (n=29). These findings suggest that pretreatment gray matter volumes of distinct brain regions within the lateral OFC and mPFC were differentially correlated to treatment response to fluoxetine versus CBT in OCD patients. This study further implicates the mPFC in the fear/anxiety extinction process and stresses the importance of lateral portions of the OFC in mediating fluoxetine's effectiveness in OCD. Clinical registration information: http://clinicaltrials.gov-NCT00680602.
conferenceObject Cortico-Basal Ganglia-Thalamo-Cortical Circuitry Structural Correlates of Treatment Response in Children with Obsessive-Compulsive Disorder(2016) VATTIMO, Edoardo F. Q.; BATISTUZZO, Marcelo C.; SATO, Joao R.; SA, Daniel G. F. de; SHAVITT, Roseli G.; MIGUEL, Euripedes C.; HOEXTER, Marcelo Q.- The Child Behavior Checklist-Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children(2017) SAAD, Laura O.; ROSARIO, Maria C. do; CESAR, Raony C.; BATISTUZZO, Marcelo C.; HOEXTER, Marcelo Q.; MANFRO, Gisele G.; SHAVITT, Roseli G.; LECKMAN, James F.; MIGUEL, Euripedes C.; ALVARENGA, Pedro G.Objective: The aims of this study were (1) to assess obsessive-compulsive symptoms (OCS) dimensionally in a school-aged community sample and to correlate them with clinical and demographical variables; (2) to determine a subgroup with significant OCS ""at-risk for OCD'') using the Child Behavior Checklist (CBCL-OCS) and (3) to compare it with the rest of the sample; (4) To review the CBCL-OCS subscale properties as a screening tool for pediatric OCD. Methods: Data from the Brazilian High Risk Cohort were analyzed. The presence and severity of OCS were assessed through the CBCL-OCS subscale. DSM-IV psychiatric diagnoses were obtained by the Developmental and Well-Being Assessment. Behavioral problems were assessed using the Strengths and Difficulties Questionnaire, the Youth Strengths Inventory, and the CBCL internalizing and externalizing behavior subscales. Results: A total of 2512 (mean age: 8.86 +/- 1.84 years; 55.0% male) children were included. Moderate correlations were found between OCS severity and functional impairment (r = 0.36, p < 0.001). Children with higher levels of OCS had higher rates of psychiatric comorbidity and behavioral problems (p < 0.001). A score of 5 or higher in the CBCL-OCS scale determined an ""at-risk for OCD'' subgroup, comprising 9.7% of the sample (n = 244), with behavioral patterns and psychiatric comorbidities (e.g., tics [odds ratios, OR = 6.41, p < 0.001]), anxiety disorders grouped [OR = 3.68, p < 0.001] and depressive disorders [OR = 3.0, p < 0.001] very similar to those described in OCD. Sensitivity, specificity, positive predictive value, and negative predictive value of the CBCL-OCS for OCD diagnosis were, respectively, 48%, 91.5%; 15.1%, and 98.2%. Conclusions: The dimensional approach suggests that the presence of OCS in children is associated with higher rates of comorbidity, behavioral problems, and impairment. The ""at-risk for OCD'' group defined by the CBCL revealed a group of patients phenotypically similar to full blown OCD.
- White matter microstructure and its relation to clinical features of obsessive-compulsive disorder: findings from the ENIGMA OCD Working Group(2021) PIRAS, Fabrizio; PIRAS, Federica; ABE, Yoshinari; AGARWAL, Sri Mahavir; ANTICEVIC, Alan; AMEIS, Stephanie; ARNOLD, Paul; BANAJ, Nerisa; BARGALLO, Nuria; BATISTUZZO, Marcelo C.; BENEDETTI, Francesco; BEUCKE, Jan-Carl; BOEDHOE, Premika S. W.; BOLLETTINI, Irene; BREM, Silvia; CALVO, Anna; CHO, Kang Ik Kevin; CIULLO, Valentina; DALLASPEZIA, Sara; DICKIE, Erin; ELY, Benjamin Adam; FAN, Siyan; FOUCHE, Jean-Paul; GRUNER, Patricia; GUERSEL, Deniz A.; HAUSER, Tobias; HIRANO, Yoshiyuki; HOEXTER, Marcelo Q.; IORIO, Mariangela; JAMES, Anthony; REDDY, Y. C. Janardhan; KAUFMANN, Christian; KOCH, Kathrin; KOCHUNOV, Peter; KWON, Jun Soo; LAZARO, Luisa; LOCHNER, Christine; MARSH, Rachel; NAKAGAWA, Akiko; NAKAMAE, Takashi; NARAYANASWAMY, Janardhanan C.; SAKAI, Yuki; SHIMIZU, Eiji; SIMON, Daniela; SIMPSON, Helen Blair; SORENI, Noam; STAEMPFLI, Philipp; STERN, Emily R.; SZESZKO, Philip; TAKAHASHI, Jumpei; VENKATASUBRAMANIAN, Ganesan; WANG, Zhen; YUN, Je-Yeon; STEIN, Dan J.; JAHANSHAD, Neda; THOMPSON, Paul M.; HEUVEL, Odile A. van den; SPALLETTA, Gianfranco; ASSOGNA, Francesca; CALVO, Rosa; WIT, Stella J. de; HOUGH, Morgan; KUNO, Masaru; MIGUEL, Euripedes C.; MORER, Astrid; PITTENGER, Christopher; POLETTI, Sara; SMERALDI, Enrico; SATO, Joao R.; TSUCHIYAGAITO, Aki; WALITZA, Susanne; WERF, Ysbrand D. van der; VECCHIO, Daniela; ZAREI, MojtabaMicrostructural alterations in cortico-subcortical connections are thought to be present in obsessive-compulsive disorder (OCD). However, prior studies have yielded inconsistent findings, perhaps because small sample sizes provided insufficient power to detect subtle abnormalities. Here we investigated microstructural white matter alterations and their relation to clinical features in the largest dataset of adult and pediatric OCD to date. We analyzed diffusion tensor imaging metrics from 700 adult patients and 645 adult controls, as well as 174 pediatric patients and 144 pediatric controls across 19 sites participating in the ENIGMA OCD Working Group, in a cross-sectional case-control magnetic resonance study. We extracted measures of fractional anisotropy (FA) as main outcome, and mean diffusivity, radial diffusivity, and axial diffusivity as secondary outcomes for 25 white matter regions. We meta-analyzed patient-control group differences (Cohen's d) across sites, after adjusting for age and sex, and investigated associations with clinical characteristics. Adult OCD patients showed significant FA reduction in the sagittal stratum (d=-0.21, z=-3.21, p=0.001) and posterior thalamic radiation (d=-0.26, z=-4.57, p<0.0001). In the sagittal stratum, lower FA was associated with a younger age of onset (z=2.71, p=0.006), longer duration of illness (z=-2.086, p=0.036), and a higher percentage of medicated patients in the cohorts studied (z=-1.98, p=0.047). No significant association with symptom severity was found. Pediatric OCD patients did not show any detectable microstructural abnormalities compared to controls. Our findings of microstructural alterations in projection and association fibers to posterior brain regions in OCD are consistent with models emphasizing deficits in connectivity as an important feature of this disorder.
- Is it time to change the gold standard of obsessive-compulsive disorder severity assessment? Factor structure of the Yale-Brown Obsessive-Compulsive Scale(2020) FATORI, Daniel; COSTA, Daniel L. C.; ASBAHR, Fernando R.; FERRAO, Ygor A.; ROSARIO, Maria Conceicao; MIGUEL, Euripedes C.; SHAVITT, Roseli G.; BATISTUZZO, Marcelo C.Objectives: The Yale-Brown Obsessive-Compulsive Scale has been considered the gold standard scale to assess obsessive-compulsive disorder severity. Previous studies using exploratory factor analysis and confirmatory factor analysis with this scale showed mixed findings in terms of factor structure and fit of models. Therefore, we used confirmatory factor analysis to compare different Yale-Brown Obsessive-Compulsive Scale models in a large sample aiming to identify the best model fit. Methods: We assessed adult obsessive-compulsive disorder patients (n = 955) using three measures: Yale-Brown Obsessive-Compulsive Scale severity ratings, the Dimensional Yale-Brown Obsessive-Compulsive Scale and the clinical global impression scale. We tested all factor structures reported by previous studies to investigate which model best fitted the data: one-factor, two-factor, three-factor and their equivalent high-order solutions. We also investigated Yale-Brown Obsessive-Compulsive Scale items correlations with scores from the other measures of obsessive-compulsive disorder severity. Results: Confirmatory factor analysis models presented mediocre to fair goodness-of-fit indexes. Severity items related to resistance to obsessions and compulsions presented low factor loadings. The model with the best fit indexes was a high-order model without obsessive-compulsive disorder resistance items. These items also presented small correlations with other obsessive-compulsive disorder severity measures. Conclusion: The obsessive-compulsive disorder field needs to discuss further improvements in the Yale-Brown Obsessive-Compulsive Scale and/or continue to search for better measures of obsessive-compulsive disorder severity.