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
14 resultados
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- 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.
- 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.
bookPart Transtornos obsessivo-compulsivo na infância e adolescência(2021) FATORI, Daniel; BATISTUZZO, Marcelo Camargo; MORIKAWA, Márcia; SAWADA, Julio Renó; ASBAHR, Fernando RamosconferenceObject Different Brain Activation in Patients With OCD Compared to Healthy Participants During Conditioning: An fMRI Fear Extinction Paradigm(2021) DINIZ, Juliana; BAZAN, Paulo; PEREIRA, Carlos Alberto; SARAIVA, Erlandson; RAMOS, Paula; OLIVEIRA, Amanda; REIMER, Adriano; BRANDAO, Marcus; HOEXTER, Marcelo; SHAVITT, Roseli; MIGUEL, Euripedes; BATISTUZZO, Marcelo- 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.
bookPart Métodos de investigação em neuroimagem(2021) BATISTUZZO, Marcelo Camargo; OTADUY, Maria Concepción García; HOEXTER, Marcelo Queiroz; SATO, João Ricardo- Association between tDCS computational modeling and clinical outcomes in depression: data from the ELECT-TDCS trial(2021) SUEN, Paulo J. C.; DOLL, Sarah; BATISTUZZO, Marcelo C.; BUSATTO, Geraldo; RAZZA, Lais B.; PADBERG, Frank; MEZGER, Eva; BULUBAS, Lucia; KEESER, Daniel; DENG, Zhi-De; BRUNONI, Andre R.Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation intervention investigated for the treatment of depression. Clinical results have been heterogeneous, partly due to the variability of electric field (EF) strength in the brain owing to interindividual differences in head anatomy. Therefore, we investigated whether EF strength was correlated with behavioral changes in 16 depressed patients using simulated electric fields in real patient data from a controlled clinical trial. We hypothesized that EF strength in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), brain regions implicated in depression pathophysiology, would be associated with changes in depression, mood and anxiety scores. SimNIBS were used to simulate individual electric fields based on the MRI structural T1-weighted brain scans of depressed subjects. Linear regression models showed, at the end of the acute treatment phase, that simulated EF strength was inversely associated with negative affect in the bilateral ACC (left: beta = - 160.463, CI [- 291.541, - 29.385], p = 0.021; right: beta = - 189.194, CI [- 289.479, - 88.910], p = 0.001) and DLPFC (left: beta = - 93.210, CI [- 154.960, - 31.461], p = 0.006; right: beta = - 82.564, CI [- 142.867, - 22.262], p = 0.011) and with depression scores in the left ACC (beta = - 156.91, CI [- 298.51, - 15.30], p = 0.033). No association between positive affect or anxiety scores, and simulated EF strength in the investigated brain regions was found. To conclude, our findings show preliminary evidence that EF strength simulations might be associated with further behavioral changes in depressed patients, unveiling a potential mechanism of action for tDCS. Further studies should investigate whether individualization of EF strength in key brain regions impact clinical response.
- Lower Ventromedial Prefrontal Cortex Glutamate Levels in Patients With Obsessive-Compulsive Disorder(2021) BATISTUZZO, Marcelo C.; SOTTILI, Bruna A.; SHAVITT, Roseli G.; LOPES, Antonio C.; CAPPI, Carolina; MATHIS, Maria Alice de; PASTORELLO, Bruno; DINIZ, Juliana B.; SILVA, Renata M. F.; MIGUEL, Euripedes C.; HOEXTER, Marcelo Q.; OTADUY, Maria C.Background: Recent studies using magnetic resonance spectroscopy (H-1-MRS) indicate that patients with obsessive-compulsive disorder (OCD) present abnormal levels of glutamate (Glu) and gamma aminobutyric acid (GABA) in the frontal and striatal regions of the brain. These abnormalities could be related to the hyperactivation observed in cortico-striatal circuits of patients with OCD. However, most of the previous H-1-MRS studies were not capable of differentiating the signal from metabolites that overlap in the spectrum, such as Glu and glutamine (Gln), and referred to the detected signal as the composite measure-Glx (sum of Glu and Gln). In this study, we used a two-dimensional JPRESS H-1-MRS sequence that allows the discrimination of overlapping metabolites by observing the differences in J-coupling, leading to higher accuracy in the quantification of all metabolites. Our objective was to identify possible alterations in the neurometabolism of OCD, focusing on Glu and GABA, which are key neurotransmitters in the brain that could provide insights into the underlying neurochemistry of a putative excitatory/inhibitory imbalance. Secondary analysis was performed including metabolites such as Gln, creatine (Cr), N-acetylaspartate, glutathione, choline, lactate, and myo-inositol. Methods: Fifty-nine patients with OCD and 42 healthy controls (HCs) underwent 3T H-1-MRS in the ventromedial prefrontal cortex (vmPFC, 30 x 25 x 25 mm(3)). Metabolites were quantified using ProFit (version 2.0) and Cr as a reference. Furthermore, Glu/GABA and Glu/Gln ratios were calculated. Generalized linear models (GLMs) were conducted using each metabolite as a dependent variable and age, sex, and gray matter fraction (fGM) as confounding factors. GLM analysis was also used to test for associations between clinical symptoms and neurometabolites. Results: The GLM analysis indicated lower levels of Glu/Cr in patients with OCD (z = 2.540; p = 0.011). No other comparisons reached significant differences between groups for all the metabolites studied. No associations between metabolites and clinical symptoms were detected. Conclusions: The decreased Glu/Cr concentrations in the vmPFC of patients with OCD indicate a neurochemical imbalance in the excitatory neurotransmission that could be associated with the neurobiology of the disease and may be relevant for the pathophysiology of OCD.
- Higher volumes of hippocampal subfields in pediatric obsessive-compulsive disorder(2021) VATTIMO, Edoardo F. Q.; SANTOS, Allan Christiano dos; HOEXTER, Marcelo Q.; FRUDIT, Paula; MIGUEL, Euripedes C.; SHAVITT, Roseli G.; BATISTUZZO, Marcelo C.Differences in hippocampus volume have been identified in adult patients with obsessive-compulsive disorder (OCD). However, the role of this limbic structure in pediatric patients is unclear. This study aimed to investigate the hippocampus and its subregions in a sample of 29 children and adolescents with OCD compared to 28 healthy controls, matched for age, sex, education, and IQ. Volumetric segmentation was performed using the Freesurfer software to calculate the volumes of the subregions that reflect the hippocampal cytoarchitecture. The volumes of three anatomic subregions (tail, body, and head) were also calculated. ANCOVA was performed to investigate differences of these volumes between patients and controls, controlling for total gray matter volume. After Bonferroni correction for multiple comparisons (p-value < 0.00556 for the body and < 0.00625 for the head structures), patients presented statistically significant larger volumes of the following structures: left subiculum body; left CA4 body; left GC-DG body; left molecular layer body; right parasubiculum; left CA4 head; left molecular layer head; right subiculum head and right molecular layer head. These enlarged volumes resulted in larger left and right whole hippocampi in patients, as well as bilateral hippocampal heads and left hippocampal body (all p-values < 0.00625). There were no associations between OCD severity and hippocampal volumes. These findings diverge from previous reports on adults and may indicate that larger hippocampal volumes could reflect an early marker of OCD, not present in adults.
- Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children(2021) BLANCO-VIEIRA, Thiago; HOEXTER, Marcelo Queiroz; BATISTUZZO, Marcelo C.; ALVARENGA, Pedro; SZEJKO, Natalia; FUMO, Afonso Mazine Tiago; MIGUEL, Euripedes C.; ROSARIO, Maria Conceicao doBackground: The non-clinical presentation of obsessive-compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children. Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL). Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). ""Aggression/violence"" was the most frequent symptom dimension (32.2%), followed by the ""symmetry/ordering"" (16.4%) and the ""sexual/religious"" dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p < 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p < 0.001), internalizing (p < 0.001), externalizing (p < 0.001), and OCS subscale scores (p < 0.001) on the CBCL. Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.