CONRADO REGIS BORGES
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LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- Are we ready to use anti-amyloid therapy in Alzheimer's disease?(2022) BRUCKI, Sonia Maria Dozzi; CESAR-FREITAS, Karolina Gouveia; SPERA, Raphael Ribeiro; BORGES, Conrado Regis; SMID, JerusaAlzheimer's disease (AD) is the most common neurodegenerative disease. Biomarkers have demonstrated that AD pathology exists over the disease continuum from a stage preceding symptoms over 15-25 years to the progressively more impaired symptomatic states, mild cognitive impairment (MCI), and dementia.Biomarkers include: amyloid (A beta),phosphorylated tau, and neurodegeneration.The plasma assays for A beta and tau show great promise for clinical and research use. This review has aimed not only to present the ATN diagnostic classification and the preclinical AD concepts in addressing some possibilities of cognitive assessment instruments, but also to briefly summarize the main anti-amyloid monoclonal antibodies studied in clinical trials. In addition, this paper presents a critical analysis by experts in cognitive neurology while addressing the question as to whether we are prepared for the anti-amyloid therapy era or not.
- Subjective sleep parameters in prodromal Alzheimer's disease: a case-control study(2021) BORGES, Conrado R.; PIOVEZAN, Ronaldo D.; POYARES, Dalva R.; FILHO, Geraldo Busatto; STUDART-NETO, Adalberto; COUTINHO, Artur M.; TUFIK, Sergio; NITRINI, Ricardo; BRUCKI, Sonia M.Objective: People with Alzheimer's disease (AD) dementia have impaired sleep. However, the characteristics of sleep in the early stages of AD are not well known, and studies with the aid of biomarkers are lacking. We assessed the subjective sleep characteristics of non-demented older adults and compared their amyloid profiles. Methods: We enrolled 30 participants aged >= 60 years, with no dementia or major clinical and psychiatric diseases. They underwent [C-11]PiB-PET-CT, neuropsychological evaluations, and completed two standardized sleep assessments (Pittsburgh Sleep Quality Inventory and Epworth Sleep Scale). Results: Comparative analysis of subjective sleep parameters across the two groups showed longer times in bed (p = 0.024) and reduced sleep efficiency (p = 0.05) in individuals with positive amyloid. No differences in other subjective sleep parameters were observed. We also found that people with multiple-domain mild cognitive impairment (MCI) had shorter self-reported total sleep times (p = 0.034) and worse overall sleep quality (p = 0.027) compared to those with single-domain MCI. Conclusions: Older adults testing positive for amyloid had a longer time in bed and lower sleep efficiency, regardless of cognitive status. In parallel, individuals with multiple-domain MCI reported shorter sleep duration and lower overall sleep quality.
- Oxford Cognitive Screen – Brazilian Portuguese version (OCS-Br) A pilot study(2018) RAMOS, Claudia Cristina Ferreira; AMADO, Daniel Krempel; BORGES, Conrado Regis; BERGAMASCHI, Eduardo; NITRINI, Ricardo; BRUCKI, Sonia Maria DozziABSTRACT Cognitive impairment is very common in stroke patients and underdiagnosed. Symptoms such as language, praxis, visuospatial, visuoconstructive and memory impairment are prominent. The screening cognitive tests available do not address some specific characteristics of stroke patients and have major limitations in relation to the most impaired cognitive domains. Objective: To test the applicability of a Brazilian version of the Oxford Cognitive Screen in a convenience sample of individuals with normal cognition. Methods: Thirty neurologically healthy participants underwent the OCS-Br in this pilot study. Results: The mean score on each task was: naming: 3.4 (SD=0.72) (maximum value of 4); semantics: 3 (SD=0) (maximum 3); orientation: 4 (SD=0) (maximum 4); visual field: 4 (SD=0) (maximum 4); sentence reading: 14.53 (SD: 1) (maximum 15); number writing: 2.86 (0.6) (maximum 3); calculation: 3.8 (SD=0.48) (maximum 4); and accuracy on the broken hearts test: 47.3 (3.3) (maximum 50). The scores obtained were similar to those of the English original sample. Conclusion: We observed similar values on each separate OCS task in comparison to the original test, confirming that the Brazilian Portuguese version is comparable to other studies.
- Alzheimer's disease and sleep disturbances: a review(2019) BORGES, Conrad Regis; POYARES, Dalva; PIOVEZAN, Ronald; NITRINI, Ricardo; BRUCKI, SoniaThe association between Alzheimer's disease (AD) and sleep disturbances has received increasing scientific attention in the last decades. However, little is known about the impact of sleep and its disturbances on the development of preclinical AD stages, such as mild cognitive impairment. This review describes the evolution of knowledge about the potential bidirectional relationships between AD and sleep disturbances exploring recent large prospective studies and meta-analyses and studies of the possible mechanisms through which sleep and the neurodegenerative process could be associated. The review also makes a comprehensive exploration of the sleep characteristics of older people, ranging from cognitively normal individuals, through patients with mild cognitive impairment, up to the those with dementia with AD.