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
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
- Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: proof of concept and histological correlation(2017) ALHO, A. T. D. L.; HAMANI, C.; ALHO, E. J. L.; SILVA, R. E. da; SANTOS, G. A. B.; NEVES, R. C.; CARREIRA, L. L.; ARAUJO, C. M. M.; MAGALHAES, G.; COELHO, D. B.; ALEGRO, M. C.; MARTIN, M. G. M.; GRINBERG, L. T.; PASQUALUCCI, C. A.; HEINSEN, H.; FONOFF, E. T.; AMARO JR., E.The pedunculopontine nucleus (PPN) has been proposed as target for deep brain stimulation (DBS) in patients with postural instability and gait disorders due to its involvement in muscle tonus adjustments and control of locomotion. However, it is a deep-seated brainstem nucleus without clear imaging or electrophysiological markers. Some studies suggested that diffusion tensor imaging (DTI) may help guiding electrode placement in the PPN by showing the surrounding fiber bundles, but none have provided a direct histological correlation. We investigated DTI fractional anisotropy (FA) maps from in vivo and in situ postmortem magnetic resonance images (MRI) compared to histological evaluations for improving PPN targeting in humans. A post-mortem brain was scanned in a clinical 3T MR system in situ. Thereafter, the brain was processed with a special method ideally suited for cytoarchitectonic analyses. Also, nine volunteers had in vivo brain scanning using the same MRI protocol. Images from volunteers were compared to those obtained in the post-mortem study. FA values of the volunteers were obtained from PPN, inferior colliculus, cerebellar crossing fibers and medial lemniscus using histological data and atlas information. FA values in the PPN were significantly lower than in the surrounding white matter region and higher than in areas with predominantly gray matter. In Nissl-stained histologic sections, the PPN extended for more than 10 mm in the rostro-caudal axis being closely attached to the lateral parabrachial nucleus. Our DTI analyses and the spatial correlation with histological findings proposed a location for PPN that matched the position assigned to this nucleus in the literature. Coregistration of neuroimaging and cytoarchitectonic features can add value to help establishing functional architectonics of the PPN and facilitate neurosurgical targeting of this extended nucleus.
- Lateral hypothalamic activity indicates hunger and satiety states in humans(2017) TALAKOUB, Omid; PAIVA, Raquel R.; MILOSEVIC, Matija; HOEXTER, Marcelo Q.; FRANCO, Ruth; ALHO, Eduardo; NAVARRO, Jessie; PEREIRA JR., Jose F.; POPOVIC, Milos R.; SAVAGE, Cary; LOPES, Antonio C.; ALVARENGA, Pedro; DAMIANI, Durval; TEIXEIRA, Manoel J.; MIGUEL, Euripides C.; FONOFF, Erich T.; BATISTUZZO, Marcelo C.; HAMANI, ClementLateral hypothalamic area (LHA) local field potentials (LFPs) were recorded in a Prader-Willi patient undergoing deep brain stimulation (DBS) for obesity. During hunger, exposure to food-related cues induced an increase in beta/low-gamma activity. In contrast, recordings during satiety were marked by prominent alpha rhythms. Based on these findings, we have delivered alpha-frequency DBS prior to and during food intake. Despite reporting an early sensation of fullness, the patient continued to crave food. This suggests that the pattern of activity in LHA may indicate hunger/satiety states in humans but attest to the complexity of conducting neuromodulation studies in obesity.
conferenceObject Riding the puzzle: deep brain stimulation and the non-motor symptoms in Parkinson's disease(2017) CAMPOS, A. C.; FONOFF, E. Talamoni; HAMANI, C.; PAGANO, R. Lima- Ablative surgery for Parkinson's disease: Is there still a role for pallidotomy in the deep brain stimulation era?(2017) SPINDOLA, Bruno; LEITE, Marco Antonio; ORSINI, Marco; FONOFF, Erich; LANDEIRO, Jose Alberto; PESSOA, Bruno LimaPosteroventral pallidotomy has already been considered the surgical procedure of choice for Parkinson's disease patients with motor complications. Recently, however, several factors led to its replacement by deep brain stimulation. Nevertheless, pallidotomy has a well-documented efficacy and safety evidence regarding the reduction of parkinsonian motor symptoms. Yet, there may be manysituations where it may be considered as a better option than neuromodulation. Herein we review those possible conditions, giving emphasis to the costs, which we found to be the most limiting factor. Importantly, a cost comparison between deep brain stimulation and pallidotomy was also provided.
- 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 Effects of Deep Brain Stimulation on olfactory function in Parkinson's disease(2017) CURY, R.; CARVALHO, M.; GHILARDI, M. G. Santos; ESTEVO, A.; PAIVA, A. de; LOPEZ, F.; COUTINHO, A.; TEIXEIRA, M.; BARBOSA, E.; FONOFF, E.- Effect of Levodopa plus Carbidopa on the Laryngeal Electromyographic Pattern in Parkinson Disease(2017) NOFFS, Gustavo; DUPRAT, Andre de Campos; ZARZUR, Ana Paula; CURY, Rubens Gisbert; CATALDO, Berenice Oliveira; FONOFF, ErichBackground. Vocal impairment is one of the main debilitating symptoms of Parkinson disease (PD). The effect of levodopa on vocal function remains unclear. Objective. This study aimed to determine the effect of levodopa on electromyographic patterns of the laryngeal muscle in patients with PD. Study design. This is a prospective interventional trial. Methods. Nineteen patients with PD-diagnosed by laryngeal electromyography-were enrolled. Cricothyroid and thyroarytenoid (TA) muscle activities were measured at rest and during muscle contraction (phonation), when participants were on and off medication (12 hours after the last levodopa dose). Results. Prevalence of resting hypertonia in the cricothyroid muscle was similar in the off and on states (7 of 19, P = 1.00). Eight patients off medication and four patients on medication had hypertonic TA muscle at rest (P = 0.289). No electromyographic alterations were observed during phonation for either medication states. Conclusion. Despite a tendency for increased rest tracings in the TA muscle when participants were on medication, no association was found between laryngeal electromyography findings and levodopa + carbidopa administration.
conferenceObject Posterior Hypothalamic Stimulation in Chronic Cluster Headache(2017) MENDES NETO, Nilson Nogueira; MAIA, Jessika Thais da Silva; ROLIM, Daniel Duarte; ZACARKIM, Marcelo Rodrigues; SILVA, Juliano Jose da; JALES JUNIOR, Levi Higino; SOUZA, Servulo Marciano Pinheiro de; VIDAL, Sebastiana Jayne Alves; MENDES, Tatyana Vidal; DANTAS, Sergio Adrian Fernandes; FONOFF, Erich Talamoni- Dramatic improvement of tardive dyskinesia movements by inline skating(2017) CASAGRANDE, Sara Carvalho Barbosa; CURY, Rubens Gisbert; LIMA-PARDINI, Andrea Cristina de; COELHO, Daniel Boari; SOUZA, Carolina de Oliveira; GHILARDI, Maria Gabriela dos Santos; SILVEIRA-MORIYAMA, Laura; TEIXEIRA, Luis Augusto; BARBOSA, Egberto Reis; FONOFF, Erich Talamoni
- Subthalamic nucleus deep brain stimulation: Basic concepts and novel perspectives(2017) HAMANI, C.; FLORENCE, G.; HEINSEN, H.; PLANTINGA, B. R.; TEMEL, Y.; ULUDAG, K.; ALHO, E.; TEIXEIRA, M. J.; AMARO, E.; FONOFF, E. T.Over the last decades, extensive basic and clinical knowledge has been acquired on the use of subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson’s disease (PD). It is now clear that mechanisms involved in the effects of this therapy are far more complex than previously anticipated. At frequencies commonly used in clinical practice, neural elements may be excited or inhibited and novel dynamic states of equilibrium are reached. Electrode contacts used for chronic DBS in PD are placed near the dorsal border of the nucleus, a highly cellular region. DBS may thus exert its effects by modulating these cells, hyperdirect projections from motor cortical areas, afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques may allow us to identify these structures optimizing surgical targeting. In this review, we provide an update on mechanisms and the neural elements modulated by STN DBS. © 2017 Hamani et al.