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
13 resultados
Resultados de Busca
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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.- Case report: 5 Years follow-up on posterior hypothalamus deep brain stimulation for intractable aggressive behaviour associated with drug-resistant epilepsy(2021) GOUVEIA, Flavia Venetucci; GERMANN, Jurgen; ELIAS, Gavin JB.; HAMANI, Clement; FONOFF, Erich Talamoni; MARTINEZ, Raquel Chacon Ruiz
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.- Increased Anxiety-Like Behavior in the Acute Phase of a Preclinical Model of Periodontal Disease(2020) VAROTTO, Bruna Luiza Roim; MARTINEZ, Raquel Chacon Ruiz; GOUVEIA, Flavia Venetucci; ANTUNES, Geiza Fernanda; FABRI, Gisele Maria de Campos; BALLESTER, Gerson; ANTEQUERA, Reynaldo; SIQUEIRA, Silvia Regina Dowgan Tesseroli de; FONOFF, Erich Talamoni; TEIXEIRA, Manoel Jacobsen; SIQUEIRA, Jose Tadeu Tesseroli dePeriodontal disease (PD) is an infectious-inflammatory oral disease that is highly prevalent among adolescence and adulthood and can lead to chronic orofacial pain and be associated with anxiety, stress and depression. This study aimed to identify anxiety-like behaviors in the ligature-induced murine preclinical model of PD in different phases of the disease (i.e., acute vs. chronic). Also, we investigated orofacial mechanical allodynia thresholds and superficial cortical plasticity along the orofacial motor cortex in both disease phases. To this aim, 25 male Wistar rats were randomly allocated in acute (14 days) or chronic (28 days) ligature-induced-PD groups and further divided into active-PD or sham-PD. Anxiety-like behavior was evaluated using the elevated plus maze, mechanical allodynia assessed using the von Frey filaments test and superficial motor cortex mapping was performed with electrical transdural stimulation. We observed increased anxiety-like behavior in active-PD animals in the acute phase, characterized by decreased number of entries into the open arm extremities [t((1,7)) = 2.42, p = 0.04], and reduced time spent in the open arms [t((1,7)) = 3.56, p = 0.01] and in the open arm extremities [t((1,7)) = 2.75, p = 0.03]. There was also a reduction in the mechanical allodynia threshold in all active-PD animals [Acute: t((1,7)) = 8.81, p < 0.001; Chronic: t((1,6)) = 60.0, p < 0.001], that was positively correlated with anxiety-like behaviors in the acute group. No differences were observed in motor cortex mapping. Thus, our findings show the presence of anxiety-like behaviors in the acute phase of PD making this a suitable model to study the impact of anxiety in treatment response and treatment efficacy.
- 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
- Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease(2020) DAFSARI, Haidar S.; GHILARDI, Maria Gabriela dos Santos; VISSER-VANDEWALLE, Veerle; RIZOS, Alexandra; ASHKAN, Keyoumars; SILVERDALE, Monty; EVANS, Julian; MARTINEZ, Raquel C. R.; CURY, Rubens G.; JOST, Stefanie T.; BARBE, Michael T.; FINK, Gereon R.; ANTONINI, Angelo; RAY-CHAUDHURI, K.; MARTINEZ-MARTIN, Pablo; FONOFF, Erich Talamoni; TIMMERMANN, LarsBackground: Subthalamic (STN) and pallidal (GPi) deep brain stimulation (DBS) improve quality of life, motor, and nonmotor symptoms (NMS) in advanced Parkinson's disease (PD). However, few studies have compared their nonmotor effects. Objective: To compare nonmotor effects of STN-DBS and GPi-DBS. Methods: In this prospective, observational, multicenter study including 60 PD patients undergoing bilateral STN-DBS (n = 40) or GPi-DBS (n = 20), we examined PDQuestionnaire (PDQ), NMSScale (NMSS), Unified PD Rating Scale-activities of daily living, -motor impairment, -complications (UPDRS-II, -III, -IV), Hoehn&Yahr, Schwab&England Scale, and levodopa-equivalent daily dose (LEDD) preoperatively and at 6-month follow-up. Intra-group changes at follow-up were analyzed with Wilcoxon signed-rank or paired t-test, if parametric tests were applicable, and corrected for multiple comparisons. Inter-group differences were explored with Mann-Whitney-U/unpaired t-tests. Analyses were performed before and after propensity score matching which balanced out demographic and preoperative clinical characteristics. Strength of clinical changes was assessed with effect size. Results: In both groups, PDQ UPDRS-II, -IV, Schwab&England Scale, and NMSS improved significantly at follow-up. STN-DBS was significantly better for LEDD reduction, GPi-DBS for UPDRS-IV. While NMSS total score outcomes were similar, explorative NMSS domain analyses revealed distinct profiles: Both targets improved sleep/fatigue and mood/cognition, but only STN-DBS the miscellaneous (pain/olfaction) and attention/memory and only GPi-DBS cardiovascular and sexual function domains. Conclusions: To our knowledge, this is the first study to report distinct patterns of beneficial nonmotor effects of STN-DBS and GPi-DBS in PD. This study highlights the importance of NMS assessments to tailor DBS target choices to patients' individual motor and nonmotor profiles. (C) 2020 The Author(s).
- 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.