ERICH TALAMONI FONOFF
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Neurologia, Faculdade de Medicina - Docente
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
26 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 26
conferenceObject Subthalamic deep brain stimulation modulates small fiber-dependent sensory threshold in Parkinson's disease(2015) CURY, R. G.; GALHARDONI, R.; FONOFF, E. T.; GHILARDI, M. G. dos Santos; MYCZKOWSKI, M.; MARCOLIN, M. A.; BARBOSA, E. R.; TEIXEIRA, M. J.; ANDRADE, D. Ciampi debookPart Manejo da Dor no Paciente Oncológico(2014) TEIXEIRA, Manoel Jacobsen; VALVERDE FILHO, João; FONOFF, Erich Talamoni; ROSA, Christiane Pellegrino; ANDRADE, Daniel Ciampi de- Restless legs syndrome in Wilson's disease: frequency, characteristics, and mimics(2017) TRINDADE, M. C.; BITTENCOURT, T.; LORENZI-FILHO, G.; ALVES, R. C.; ANDRADE, D. C. de; FONOFF, E. T.; BOR-SENG-SHU, E.; MACHADO, A. A.; TEIXEIRA, M. J.; BARBOSA, E. R.; TRIBL, G. G.ObjectiveTo determine characteristics, clinical significance, frequency, and mimics of restless legs syndrome (RLS) in a cohort of Wilson's disease (WD, n = 42/f = 18), compared to healthy, matched controls. Materials and methodsStructured clinical interviews (patients and caregiving family members), repeated neurological examinations (afternoon and presleep), comprehensive laboratory tests, WD-, RLS-, and sleep-specific rating scales, and video-polysomnography. ResultsThirteen patients with WD (13/42 = 31.0%) clearly fulfilled the five diagnostic criteria of RLS; in eight patients (19.1%), the burden of RLS was clinically significant. The RLS was of moderate severity, equally distributed among sexes, manifested mainly in the evening and before falling asleep, and had developed mostly after clinical manifestation of WD (time elapsed 10.2 14.5 years), still at a young mean age (27.5 +/- 11.5 years). The known RLS-associated features were absent (normal iron and kidney parameters) or rare (positive family history, polyneuropathy). Compared to WD patients without RLS, patients with RLS were significantly elder and had suffered longer from WD. WD-specific RLS mimics as well as RLS confounding motor comorbidities (dystonia, tremor, chorea) were frequent and a diagnostic challenge; in difficult cases, the differentiation was reached by clinical observation of the motor behavior in the evening or at nighttime. ConclusionRLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and video-polysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.
conferenceObject Subthalamic Deep Brain Stimulation Modulates Small-Fiber Dependent Sensory Thresholds in Parkinson's Disease(2012) ANDRADE, Daniel Ciampi De; LEFAUCHEUR, Jean-Pascal; GALHARDONI, Ricardo; FERREIRA, Karine; PAIVA, Anderson de; BOHR-SENG-SHU, Edson; ALVARENGA, Luciana; MYCZKOWSKI, Martin; MARCOLIN, Marco; SIQUEIRA, Silvia de; FONOFF, Erich; BARBOSA, Egberto; TEIXEIRA, Manoel- Echogenicity of the substantia nigra region in Parkinson's disease(2012) BAR-SENG-SHU, Edson; ALMEIDA, Kelson James; ANDRADE, Daniel Ciampi de; FONOFF, Erich Talamoni; TEIXEIRA, Manoel Jacobsen; BARBOSA, Egberto Reis
conferenceObject Correlation between pain, other non-motor symptoms, quality of life and motor improvement in patients with Parkinson's disease after deep brain stimulation(2014) CURY, R. G.; GHILARDI, M. G.; GALHARDONI, R.; SOUZA, C.; FONOFF, F.; MARCOLIN, M. A.; MYCZKOWSKI, M. L.; TEIXEIRA, M. J.; BARBOSA, E. R.; FONOFF, E. T.; ANDRADE, D. Ciampi de- Quality of Life After Motor Cortex Stimulation: Clinical Results and Systematic Review of the Literature(2019) PARRAVANO, Daniella C.; CIAMPI, Daniel A.; FONOFF, Erich T.; MONACO, Bernardo; NAVARRO, Jessie; YENG, Lin T.; TEIXEIRA, Manoel J.; HAMANI, ClementBACKGROUND: Motor cortex stimulation (MCS) is routinely used for the treatment of chronic neuropathic pain but its effect on quality of life remains uncertain. OBEJCTIVE: To systematically review the published literature on MCS and quality of life and report the effects of this therapy in a series of patients prospectively followed in our center. METHODS: The systematic literature review was conducted using the search words ""motor cortex stimulation and pain and neurosurgery"" and ""motor cortex stimulation and pain and quality of life."" Quality of life in our clinical trial was investigated in a series of 10 patients with chronic neuropathic pain prospectively followed for 12 mo after MCS. RESULTS: Two hundred eighteen nonreplicated articles were pooled for analysis. Of these, 6 described measures of quality of life in the pre- and postoperative period. In these studies, 64 patients with different clinical conditions associated with neuropathic pain were followed for 6 to 84 mo after MCS surgery. Improvement in quality of life ranged from 35% to 85%. In our clinical series, visual analog scale (VAS), SF-12 physical (PhysCS), and mental scores (MenCS) recorded 12 mo after MCS were improved by 60 +/- 10% (P = .002), 50 +/- 13% (P = .002), and 22 +/- 6% (P = .01), respectively. No significant correlation was found between postoperative improvement in pain and either PhysCS (r = 0.18; P = .6) or MenCS (r = -0.24; P = .5). CONCLUSION: MCS improves quality of life in patients with chronic refractory neuropathic pain. Additional factors other than a simple analgesic effect may contribute to these results.
- Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation(2011) FONOFF, Erich Talamoni; HAMANI, Clement; ANDRADE, Daniel Ciampi de; YENG, Lin Tchia; MARCOLIN, Marco Antonio; TEIXEIRA, Manoel JacobsenIn addition to pain and neurovegetative symptoms, patients with severe forms of complex regional pain syndrome (CRPS) develop a broad range of symptoms, including sensory disturbances, motor impairment and dystonic posturing. While most patients respond to medical therapy, some are considered refractory and become surgical candidates. To date, the most commonly used surgical procedure for CRPS has been spinal cord stimulation. This therapy often leads to important analgesic effects, but no sensory or motor improvements. We report on 2 patients with pain related to CRPS and severe functional deficits treated with motor cortex stimulation (MCS) who not only had significant analgesic effects, but also improvements in sensory and motor symptoms. In the long term (27 and 36 months after surgery), visual analog scale pain scores were improved by 60-70% as compared to baseline. There was also a significant increase in the range of motion in the joints of the affected limbs and an improvement in allodynia, hyperpathia and hypoesthesia. Positron emission tomography scan in both subjects revealed that MCS influenced regions involved in the circuitry of pain.
- Substantia nigra hyperechogenicity and Parkinson's disease surgery(2014) BOR-SENG-SHU, Edson; ANDRADE, Daniel Ciampi de; OLIVEIRA, Marcelo de Lima; FONOFF, Erich Talamoni; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen
- Subthalamic deep brain stimulation modulates conscious perception of sensory function in Parkinson's disease(2016) CURY, Rubens G.; GALHARDONI, Ricardo; TEIXEIRA, Manoel J.; GHILARDI, Maria G. dos Santos; SILVA, Valquiria; MYCZKOWSKI, Martin L.; MARCOLIN, Marco A.; BARBOSA, Egberto R.; FONOFF, Erich T.; ANDRADE, Daniel Ciampi deSubthalamic deep brain stimulation (STN-DBS) is used to treat refractory motor complications in Parkinson disease (PD), but its effects on nonmotor symptoms remain uncertain. Up to 80% of patients with PD may have pain relief after STN-DBS, but it is unknown whether its analgesic properties are related to potential effects on sensory thresholds or secondary to motor improvement. We have previously reported significant and long-lasting pain relief after DBS, which did not correlate with motor symptomatic control. Here we present secondary data exploring the effects of DBS on sensory thresholds in a controlled way and have explored the relationship between these changes and clinical pain and motor improvement after surgery. Thirty-seven patients were prospectively evaluated before STN-DBS and 12 months after the procedure compared with healthy controls. Compared with baseline, patients with PD showed lower thermal and mechanical detection and higher cold pain thresholds after surgery. There were no changes in heat and mechanical pain thresholds. Compared with baseline values in healthy controls, patients with PD had higher thermal and mechanical detection thresholds, which decreased after surgery toward normalization. These sensory changes had no correlation with motor or clinical pain improvement after surgery. These data confirm the existence of sensory abnormalities in PD and suggest that STN-DBS mainly influenced the detection thresholds rather than painful sensations. However, these changes may depend on the specific effects of DBS on somatosensory loops with no correlation to motor or clinical pain improvement.
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