BRENO JOSE ALENCAR PIRES BARBOSA
Projetos de Pesquisa
Unidades Organizacionais
LIM/15 - Laboratório de Investigação em Neurologia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
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Agora exibindo 1 - 10 de 12
- Intraoperative assistive technologies and insular gliomas surgery: Results from a volumetry-based retrospective cohort(2016) LEPSKI, Guilherme; BARBOSA, Breno Jose Alencar Pires; DIMOSTHENI, Artemisia; TEIXEIRA, Manoel Jacobsen; TATAGIBA, Marcos
- Adult Neurogenesis and Glial Oncogenesis: When the Process Fails(2014) BATISTA, Chary Marquez; MARIANO, Eric Domingos; BARBOSA, Breno Jose Alencar Pires; MORGALLA, Matthias; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; LEPSKI, GuilhermeMalignant brain tumors, including glioblastoma multiforme (GBM), are known for their high degree of invasiveness, aggressiveness, and lethality. These tumors are made up of heterogeneous cell populations and only a small part of these cells (known as cancer stem cells) is responsible for the initiation and recurrence of the tumor. The biology of cancer stem cells and their role in brain tumor growth and therapeutic resistance has been extensively investigated. Recent work suggests that glial tumors arise from neural stem cells that undergo a defective process of differentiation. The understanding of this process might permit the development of novel treatment strategies targeting cancer stem cells. In the present review, we address the mechanisms underlying glial tumor formation, paying special attention to cancer stem cells and the role of the microenvironment in preserving them and promoting tumor growth. Recent advancements in cancer stem cell biology, especially regarding tumor initiation and resistance to chemo-or radiotherapy, have led to the development of novel treatment strategies that focus on the niche of the stem cells that make up the tumor. Encouraging results from preclinical studies predict that these findings will be translated into the clinical field in the near future.
- Insular gliomas and the role of intraoperative assistive technologies: Results from a volumetry-based retrospective cohort(2016) BARBOSA, Breno Jose Alencar Pires; DIMOSTHENI, Artemisia; TEIXEIRA, Manoel Jacobsen; TATAGIBA, Marcos; LEPSKI, GuilhermeIntroduction: In the field of Glioma surgery, there has been an increasing interest in the use of assistive technologies to overcome the difficulty of preserving brain function while improving surgical radicality. In most reports, tumor localization has seldom been considered a variable and the role of intraoperative adjuncts is yet to be determined for gliomas of the insula. Objectives: To evaluate the efficacy of fluorescence-guided resection with 5-ALA, intraoperative neurophysiological monitoring (IOM), neuronavigation, and tractography in the Extent of Resection (EOR), functionality scores, overall survival (OS) and progression-free survival (PFS) in a retrospective cohort of insular gliomas. Methods: We reviewed all cases of insular tumors operated on at the Department of Neurosurgery, University Hospital of Tubingen Germany, between May 2008 and November 2013. EOR was determined by volumetric analysis. Mann Whitney, Chi-square and Kaplan Meier functions were used for assessment of each technology's effect on primary and secondary outcomes. Results: 28 cases (18 men (64%) and 10 women (36%); median age at diagnosis: 52.5 years, range 12 - 59) were considered eligible for analysis. High grade and low grade gliomas accounted for 20 (71%) and 8 (29%) cases, respectively. The most used technologies were IOM (64%) and Neuronavigation (68%). 5-ALA was the only technique associated with EOR >= 90% (p = 0.05). Tractography determined improvement in the Karnofsky Performance Scale (50% vs. 5% cases improved, p = 0.02). There was a positive association between the use of neuronavigation and overall survival (23 vs. 27.4 months, p = 0.03), but the use of 5-ALA was associated with shorter OS (34.8 vs. 21.1 months, p = 0.01) and PFS (24.4 vs. 11.8, p = 0.01). Conclusions: We demonstrate for the first time that for insular gliomas 5-ALA plays a role in achieving higher EOR, although this technology was associated with poor OS and PFS; also tractography and neuronavigation can be of great importance in the treatment of insular gliomas as they determined better functionality and OS in this study, respectively. Prospective studies with a more prominent sample and proper multivariate analysis will help determine the real benefit of these adjuncts in the setting of insular gliomas.
- Current clinical and research practices on frontotemporal dementia in Brazil: a national survey(2023) SOUZA, Leonardo Cruz de; BRUCKI, Sonia Maria Dozzi; SCHILLING, Lucas Porcello; SILVA, Leticia Costa da; TAKADA, Leonel Tadao; BAHIA, Valeria Santoro; BARBOSA, Breno Jose Alencar Pires; BALTHAZAR, Marcio Luiz Figueredo; FROTA, Norberto Anizio Ferreira; NITRINI, Ricardo; CARAMELLI, Paulo; SMID, JerusaBackground Frontotemporal dementia (FTD) is a frequent cause of young-onset dementia and represents a major challenge for the diagnosis and clinical management. It is essential to evaluate the difficulties faced by physicians on the diagnostic workup and on patient care.Objective The aim of this study was to investigate the current practices and the local limits on the diagnosis and management of FTD in Brazil.Methods We elaborated an online survey, composed of 29 questions and divided in four parts, comprising questions about existing health facilities, clinical practices related to FTD, and suggestions to increment the national research on FTD. The invitation to participate was sent by email to all neurologists affiliated to the Brazilian Academy of Neurology ( n = 3658), and to all physicians who attended the XII Meeting of Researchers on Alzheimer's disease, in 2019 ( n = 187). The invitation was also diffused through social media.Results 256 Brazilian physicians answered the questionnaire. The three most relevant disorders for the differential diagnosis of FTD were Alzheimer's disease (AD) ( n = 211), bipolar disorder ( n = 117) and dementia with Lewy bodies ( n = 92). Most respondents (125/256) reported the difficulty in performing genetic testing as the main limit in the diagnostic of FTD. 93% and 63% of participants considered that the assessment of social cognition and AD CSF biomarkers are useful for the diagnosis of FTD, respectively.Conclusions The present study may provide valuable insights for the medical education and clinical training of physicians, and to foster future research on FTD in Brazil.
- Current perspectives in stem cell therapy for spinal cord repair in humans: a review of work from the past 10 years(2014) MARIANO, Eric Domingos; BATISTA, Chary Marquez; BARBOSA, Breno Jose Alencar Pires; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; MORGALLA, Matthias; TATAGIBA, Marcos; LI, Jun; LEPSKI, GuilhermeSpinal cord injury (SCI) and amyotrophic laterals sclerosis (ALS) are devastating neurological conditions that affect individuals worldwide, significantly reducing quality of life, both for patients and their relatives. Objective: The present review aims to summarize the multiple restorative approaches being developed for spinal cord repair, the use of different stem cell types and the current knowledge regarding stem cell therapy. Method: Review of the literature from the past 10 years of human studies using stem cell transplantation as the main therapy, with or without adjuvant therapies. Conclusion: The current review offers an overview of the state of the art regarding spinal cord restoration, and serves as a starting point for future studies.
conferenceObject Successful Bilateral Subthalamic Nucleus Stimulation in Refractory Status Dystonicus(2018) CURY, Rubens; BARBOSA, Breno Jose Alencar Pires; CARRA, Rafael Bernhardt; DUARTE, Kleber Paiva; GODINHO, Fabio; CIAMPI, Daniel; TEIXEIRA, Manoel Jacobsen; BARBOSA, Egberto Reis- Intraoperative assistive technologies and extent of resection in glioma surgery: a systematic review of prospective controlled studies(2015) BARBOSA, Breno Jose Alencar Pires; MARIANO, Eric Domingos; BATISTA, Chary Marquez; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; PEREIRA, Carlos Umberto; TATAGIBA, Marcos Soares; LEPSKI, Guilherme AlvesSeveral studies published to date about glioma surgery have addressed the validity of using novel technologies for intraoperative guidance and potentially improved outcomes. However, most of these reports are limited by questionable methods and/or by their retrospective nature. In this work, we performed a systematic review of the literature to address the impact of intraoperative assistive technologies on the extent of resection (EOR) in glioma surgery, compared to conventional unaided surgery. We were also interested in two secondary outcome variables: functional status and progression-free survival. We primarily used PubMed to search for relevant articles. Studies were deemed eligible for our analysis if they (1) were prospective controlled studies; (2) used EOR as their primary target outcome, assessed by MRI volumetric analysis; and (3) had a homogeneous study population with clear inclusion criteria. Out of 493 publications identified in our initial search, only six matched all selection criteria for qualitative synthesis. Currently, the evidence points to 5-ALA, DTI functional neuronavigation, neurophysiological monitoring, and intraoperative MRI as the best tools for improving EOR in glioma surgery. Our sample and conclusions were limited by the fact that studies varied in terms of population characteristics and in their use of different volumetric analyses. We were also limited by the low number of prospective controlled trials available in the literature. Additional evidence-based high-quality studies assessing cost-effectiveness should be conducted to better determine the benefits of intraoperative assistive technologies in glioma surgery.
- Bilateral subthalamic nucleus stimulation in refractory status dystonicus(2018) BARBOSA, Breno Jose Alencar Pires; CARRA, Rafael Bernhardt; DUARTE, Kleber Paiva; GODINHO, Fabio; ANDRADE, Daniel Ciampi de; TEIXEIRA, Manoel Jacobsen; BARBOSA, Egberto Reis; CURY, Rubens Gisbert
- Second-Generation RT-QuIC Assay for the Diagnosis of Creutzfeldt-Jakob Disease Patients in Brazil(2020) BARBOSA, Breno Jose Alencar Pires; CASTRILLO, Bruno Batitucci; ALVIM, Ricardo Pires; BRITO, Marcelo Houat de; GOMES, Helio R.; BRUCKI, Sonia M. D.; SMID, Jerusa; NITRINI, Ricardo; LANDEMBERGER, Michele C.; MARTINS, Vilma R.; SILVA, Jerson L.; VIEIRA, Tuane C. R. G.The recent development of IQ-CSF, the second generation of real-time quaking-induced conversion (RT-QuIC) using cerebrospinal fluid (CSF), for the diagnosis of Creutzfeldt-Jakob Disease (CJD) represents a major diagnostic advance in the field. Highly accurate results have been reported with encouraging reproducibility among different centers. However, availability is still insufficient, and only a few research centers have access to the method in developing countries. In Brazil, we have had 603 suspected cases of CJD since 2005, when surveillance started. Of these, 404 were undiagnosed. This lack of diagnosis is due, among other factors, to the lack of a reference center for the diagnosis of these diseases in Brazil, resulting in some of these samples being sent abroad for analysis. The aim of this research study is to report the pilot use of IQ-CSF in a small cohort of Brazilian patients with possible or probable CJD, implementing a reference center in the country. We stored CSF samples from patients with possible, probable or genetic CJD (one case) during the time frame of December 2016 through June 2018. All CSF samples were processed according to standardized protocols without access to the clinical data. Eight patients presented to our team with rapidly progressive dementia and typical neurological signs of CJD. We used CSF samples from seven patients with other neurological conditions as negative controls. Five out of seven suspected cases had positive tests; two cases showed inconclusive results. Among controls, there was one false-positive (a CSF sample from a 5-year-old child with leukemia under treatment). The occurrence of a false positive in one of the negative control samples raises the possibility of the presence of interfering components in the CSF sample from patients with non-neurodegenerative pathologies. Our pilot results illustrate the feasibility of having CJD CSF samples tested in Brazilian centers and highlight the importance of interinstitutional collaboration to pursue a higher diagnostic accuracy in CJD in Brazil and Latin America.
- Physical exercise as a non-pharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials(2021) RODRIGUES, Susana Ligia da Silva; SILVA, Jamily Matias da; OLIVEIRA, Maria Clara Cordeiro de; SANTANA, Charleny Mary Ferreira de; CARVALHO, Kaliandra Meneses; BARBOSA, Breno Jose Alencar PiresBackground: Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Nonpharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. Objective: The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. Methods: A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. Results: Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. Conclusions: Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.