RAQUEL CHACON RUIZ MARTINEZ
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
Resultados de Busca
Agora exibindo 1 - 10 de 14
- Long-Term Follow-Up on Bilateral Posterior Hypothalamic Deep Brain Stimulation for Treating Refractory Aggressive Behavior in a Patient with Cri du Chat Syndrome: Analysis of Clinical Data, Intraoperative Microdialysis, and Imaging Connectomics(2023) RIOS, Adriana Lucia Lopez; GERMANN, Jurgen; HUTCHISON, William D.; POSADA, Luis Fernando Botero; VELASQUEZ, Luisa Fernanda Ahunca; JIMENEZ, Francisco Aureliano Garcia; ESCOBAR, Jose Miguel Gloria; MARTINEZ, Raquel Chacon Ruiz; HAMANI, Clement; LEBRUN, Ivo; AUADA, Aline V. V.; BRAVO, Carlos Anibal Restrepo; GOUVEIA, Flavia VenetucciPosterior hypothalamic-deep brain stimulation (pHyp-DBS) has been reported as a successful treatment for reducing refractory aggressive behaviors in patients with distinct primary diagnoses. Here, we report on a patient with cri du chat syndrome presenting severe self-injury and aggressive behaviors toward others, who was treated with pHyp-DBS. Positive results were observed at long-term follow-up in aggressive behavior and quality of life. Intraoperative microdialysis and imaging connectomics analysis were performed to investigate possible mechanisms of action. Our results suggest the involvement of limbic and motor areas and alterations in main neurotransmitter levels in the targeted area that are associated with positive results following treatment.
- Active vs. reactive threat responding is associated with differential c-Fos expression in specific regions of amygdala and prefrontal cortex(2013) MARTINEZ, Raquel C. R.; GUPTA, Nikita; LAZARO-MUNOZ, Gabriel; SEARS, Robert M.; KIM, Soojeong; MOSCARELLO, Justin M.; LEDOUX, Joseph E.; CAIN, Christopher K.Active avoidance (AA) is an important paradigm for studying mechanisms of aversive instrumental learning, pathological anxiety, and active coping. Unfortunately, AA neurocircuits are poorly understood, partly because behavior is highly variable and reflects a competition between Pavlovian reactions and instrumental actions. Here we exploited the behavioral differences between good and poor avoiders to elucidate the AA neurocircuit. Rats received Sidman AA training and expression of the activity-dependent immediate-early gene c-fos was measured after a shock-free AA test. Six brain regions with known or putative roles in AA were evaluated: amygdala, periaqueductal gray, nucleus accumbens, dorsal striatum, prefrontal cortex (PFC), and hippocampus. Good avoiders showed little Pavlovian freezing and high AA rates at test, the opposite of poor avoiders. Although c-Fos activation was observed throughout the brain, differential activation was found only in subregions of amygdala and PFC. Interestingly, c-Fos correlated with avoidance and freezing in only five of 20 distinct areas evaluated: lateral amygdala, central amygdala, medial amygdala, basal amygdala, and infralimbic PFC. Thus, activity in specific amygdala-PFC circuits likely mediates the competition between instrumental actions and Pavlovian reactions after AA training. Individual differences in AA behavior, long considered a nuisance by researchers, may be the key to elucidating the AA neurocircuit and understanding pathological response profiles.
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 Rat brain basal ganglia imaged with optical coherence tomography: Feasibility and future perspectives(2015) ANGELOS, J. S. dos; LOPEZ, W. O. C.; MARTINEZ, R. C. R.; REIS, P. R.; TAKIMURA, C. K.; TEIXEIRA, M. J.; LEMOS NETO, P. A.; FONOFF, E. T.- Directional Deep Brain Stimulation of the Posteromedial Hypothalamus for Refractory Intermittent Explosive Disorder: A Case Series Using a Novel Neurostimulation Device and Intraoperative Microdialysis(2021) LOPEZ, William Omar Contreras; NAVARRO, Paula Alejandra; GOUVEIA, Flavia Venetucci; FONOFF, Erich Talamoni; LEBRUN, Ivo; AUADA, Aline V. V.; ALHO, Eduardo Joaquim Lopes; MARTINEZ, Raquel C. R.BACKGROUND: Intermittent explosive disorder (IED) is a psychiatric disorder characterized by recurrent outbursts of aggressive behavior. Deep brain stimulation (DBS) in the posteromedial nucleus of the hypothalamus (pHyp) is an alternative therapy for extreme cases and shows promising results. Intraoperative microdialysis can help elucidate the neurobiological mechanism of pHyp-DBS. We sought to evaluate efficacy and safety of pHyp-DBS using 8-contact directional leads in patients with refractory IED (rIED) and the accompanying changes in neurotransmitters. METHODS: This was a prospective study in which patients with a diagnosis of rIED were treated with pHyp-DBS for symptom alleviation. Bilateral pHyp-DBS was performed with 8-contact directional electrodes. Follow-up was performed at 3, 6, and 12 months after surgery. RESULTS: Four patients (3 men, mean age 27 +/- 2.8 years) were included. All patients were diagnosed with rIED and severe intellectual disability. Two patients had congenital rubella, one had a co-diagnosis of infantile autism, and the fourth presented with drug-resistant epilepsy. There was a marked increase in the levels of gamma-aminobutyric acid and glycine during intraoperative stimulation. The average improvement in aggressive behavior in the last follow-up was 6 points (D: 50%, P [ 0.003) while also documenting an important improvement of the Short Form Health Survey in all domains except bodily pain. No adverse events associated with pHyp-DBS were observed. CONCLUSIONS: This is the first study to show the safety and beneficial effect of directional lead pHyp-DBS in patients with rIED and to demonstrate the corresponding mechanism of action through increases in gamma-aminobutyric acid and glycine concentration in the pHyp.
- Longitudinal Changes After Amygdala Surgery for Intractable Aggressive Behavior: Clinical, Imaging Genetics, and Deformation-Based Morphometry Study-A Case Series(2021) GOUVEIA, Flavia Venetucci; GERMANN, Jurgen; MORAIS, Rosa de; FONOFF, Erich Talamoni; HAMANI, Clement; ALHO, Eduardo Joaquim; BRENTANI, Helena; MARTINS, Ana Paula; DEVENYI, Gabriel; PATEL, Raihaan; STEELE, Christopher; GRAMER, Robert; CHAKRAVARTY, Mallar; MARTINEZ, Raquel Chacon Ruiz
- Intraoperative Dopamine Release During Globus Pallidus Internus Stimulation in Parkinson's Disease(2013) MARTINEZ, Raquel C. R.; HAMANI, Clement; CARVALHO, Milene Cristina de; OLIVEIRA, Amanda Ribeiro de; ALHO, Eduardo; NAVARRO, Jessie; GHILARDI, Maria Gabriela dos Santos; BOR-SENG-SHU, Edson; HEINSEN, Helmut; OTOCH, Jose Pinhata; BRANDAO, Marcus Lira; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; FONOFF, Erich TalamoniBackgroundIt is still unclear whether dopamine (DA) levels correlate with Parkinson's disease (PD) severity or play a role in the mechanisms of high-frequency stimulation (HFS). MethodsWe have used microdialysis to record pallidal DA in 5 patients with PD undergoing microelectrode-guided pallidotomy. ResultsWe found that patients with more severe disease and, consequently, lower pallidal DA did poorly after pallidal lesions. In the operating room, 4 of 5 patients had a significant increase in DA levels during HFS (600%, on average). To test the hypothesis that DA was important for the effects of stimulation, we correlated the amelioration in rigidity observed in the operating room with pallidal DA release. Though rigidity was 56% better during stimulation, no correlation was found between such an improvement and DA release. ConclusionsThese findings suggest that additional mechanisms not directly dependent on pallidal DA release may be involved in the clinical effects of HFS of the globus pallidus internus. (c) 2013 International Parkinson and Movement Disorder Society
- Cerebral Microdialysis in Traumatic Brain Injury and Subarachnoid Hemorrhage: State of the Art(2014) OLIVEIRA, Marcelo de Lima; KAIRALLA, Ana Carolina; FONOFF, Erich Talamoni; MARTINEZ, Raquel Chacon Ruiz; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, EdsonCerebral microdialysis (CMD) is a laboratory tool that provides on-line analysis of brain biochemistry via a thin, fenestrated, double-lumen dialysis catheter that is inserted into the interstitium of the brain. A solute is slowly infused into the catheter at a constant velocity. The fenestrated membranes at the tip of the catheter permit free diffusion of molecules between the brain interstitium and the perfusate, which is subsequently collected for laboratory analysis. The major molecules studied using this method are glucose, lactate, pyruvate, glutamate, and glycerol. The collected substances provide insight into the neurochemical features of secondary injury following traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and valuable information about changes in brain metabolism within a short time frame. In this review, the authors detail the CMD technique and its associated markers and then describe pertinent findings from the literature about the clinical application of CMD in TBI and SAH.
conferenceObject Simultaneous bilateral MER-guided stereotactic implantation of deep brain stimulation electrodes(2014) FONOFF, E. T.; CONTRERAS, W. O.; GHILARDI, Lopez M.; CURY, R. G.; MARTINEZ, R. C. R.; AZEVEDO, A.; BARBOSA, E. R.; NAVARRO, J.; TEIXEIRA, M. J.