ANA SOFIA CUEVA MOSCOSO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
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- Methadone in post-herpetic neuralgia: A pilot proof-of-concept study(2013) TEIXEIRA, Manoel J.; OKADA, Massako; MOSCOSO, Ana Sofia Cueva; PUERTA, Mariana Yumi Takahashi; YENG, Lin T.; GALHARDONI, Ricardo; TENGAN, Sergio; ANDRADE, Daniel Ciampi deOBJECTIVE: This research was designed as a pilot proof-of-concept study to evaluate the use of low-dose methadone in post-herpetic neuralgia patients who remained refractory after first and second line post-herpetic neuralgia treatments and had indications for adding an opioid agent to their current drug regimens. METHODS: This cross-over study was double blind and placebo controlled. Ten opioid naive post-herpetic neuralgia patients received either methadone (5 mg bid) or placebo for three weeks, followed by a 15-day washout period and a second three-week treatment with either methadone or placebo, accordingly. Clinical evaluations were performed four times (before and after each three-week treatment period). The evaluations included the visual analogue scale, verbal category scale, daily activities scale, McGill pain questionnaire, adverse events profile, and evoked pain assessment. All patients provided written informed consent before being included in the study. ClinicalTrials.gov: NCT01752699 RESULTS: Methadone, when compared to placebo, did not significantly affect the intensity of spontaneous pain, as measured by the visual analogue scale. The intensity of spontaneous pain was significantly decreased after the methadone treatment compared to placebo on the category verbal scale (50% improved after the methadone treatment, none after the placebo, p = 0.031). Evoked pain was reduced under methadone compared to placebo (50% improved after the methadone treatment, none after the placebo, p = 0.031). Allodynia reduction correlated with sleep improvement (r = 0.67, p = 0.030) during the methadone treatment. The side effects profile was similar between both treatments. CONCLUSIONS: Methadone seems to be safe and larger prospective studies.
- Epigenetics insights into chronic pain: DNA hypomethylation in fibromyalgia-a controlled pilot-study(2017) ANDRADE, Daniel Ciampi de; MASCHIETTO, Mariana; GALHARDONI, Ricardo; GOUVEIA, Gisele; CHILE, Thais; KREPISCHI, Ana C. Victorino; DALE, Camila S.; BRUNONI, Andre R.; PARRAVANO, Daniella C.; MOSCOSO, Ana S. Cueva; RAICHER, Irina; KAZIYAMA, Helena H. S.; TEIXEIRA, Manoel J.; BRENTANI, Helena P.To evaluate changes in DNA methylation profiles in patients with fibromyalgia (FM) compared to matched healthy controls (HCs). All individuals underwent full clinical and neurophysiological assessment by cortical excitability (CE) parameters measured by transcranial magnetic stimulation. DNA from the peripheral blood of patients with FM (n = 24) and HC (n = 24) were assessed using the IlluminaHumanMethylation450 BeadChips. We identified 1610 differentially methylated positions (DMPs) in patients with FM displaying a nonrandom distribution in regions of the genome. Sixty-nine percent of DMP in FM were hypomethylated compared to HC. Differentially methylated positions were enriched in 5 genomic regions (1p34; 6p21; 10q26; 17q25; 19q13). The functional characterization of 960 genes related to DMPs revealed an enrichment for MAPK signaling pathway (n 5 18 genes), regulation of actin cytoskeleton (n = 15 genes), and focal adhesion (n = 13 genes). A gene-gene interaction network enrichment analysis revealed the participation of DNA repair pathways, mitochondria-related processes, and synaptic signaling. Even though DNA was extracted from peripheral blood, this set of geneswas enriched for disorders such as schizophrenia, mood disorders, bulimia, hyperphagia, and obesity. Remarkably, the hierarchical clusterization based on the methylation levels of the 1610 DMPs showed an association with neurophysiological measurements of CE in FM and HC. Fibromyalgia has a hypomethylation DNA pattern, which is enriched in genes implicated in stress response and DNA repair/free radical clearance. These changes occurred parallel to changes in CE parameters. New epigenetic insights into the pathophysiology of FM may provide the basis for the development of biomarkers of this disorder.
- Normative data of cortical excitability measurements obtained by transcranial magnetic stimulation in healthy subjects(2016) CUEVA, Ana Sofia; GALHARDONI, Ricardo; CURY, Rubens Gisbert; PARRAVANO, Daniella Cardoso; CORREA, Guilherme; ARAUJO, Haniel; CECILIO, Sofia Barros; RAICHER, Irina; TOLEDO, Diego; SILVA, Valquiria; MARCOLIN, Marco Antonio; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deObjectives. - To obtain normative data for CE measurements by transcranial magnetic stimulation, to assess inter- /intra-investigator variability and the influence of sex, age and oral contraception use. Methods. - A sample of 216 healthy volunteers matched according to age and gender was evaluated. Bilateral rest motor thresholds, motor evoked potentials (MEP), intracortical inhibition and facilitation were measured in the first dorsal interosseous muscle area representation of the primary motor cortex with a circular transcranial magnetic stimulation coil delivering biphasic pulses. Normative data were obtained for 200 participants (in a 1:1 male:female ratio) in a balanced proportion between five age groups (18-30; 31-40; 41-50; 51-60; > 60 years). Inter/intra-investigator variability was assessed in 20 healthy volunteers in two sessions performed within a 30-minute interval. Measurements were also performed in a subgroup of 16 healthy female volunteers, using oral contraception and during the menstrual phase. Results. - Age had a dichotomous effect on CE measurements, providing significantly different normative data for subjects < 50 and > 50 years old, with smaller MEP's and intracortical inhibition in older individuals. There were no differences between genders or between left and right hemispheres. Also, CE parameters did not significantly differ with use of contraceptive treatment compared to the menstrual phase of the cycle. The inter-/intra-investigator reliability assessment showed some variability that may not be clinically significant. Conclusions. - Age had a non-linear effect on CE. There were non-significant differences between genders, hemispheres or with use of oral contraceptives. There was good inter- /intra-investigator correlation for rest motor thresholds and motor evoked potentials while intracortical inhibition and facilitation had low correlations but acceptable reliability. 2016 Elsevier Masson SAS. All rights reserved.