ANDRE RUSSOWSKY BRUNONI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
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article 46 Citação(ões) na Scopus Manic Psychosis After Sertraline and Transcranial Direct-Current Stimulation(2011) BRUNONI, Andre Russowsky; VALIENGO, Leandro; ZANAO, Tamires; OLIVEIRA, Janaina Farias de; BENSENOR, Isabela Martins; FREGNI, Felipe- Changes in motor cortical excitability in schizophrenia following transcranial direct current stimulation(2019) GORDON, Pedro Caldana; VALIENGO, Leandro da Costa Lane; PAULA, Vanessa Jesus Rodrigues de; GALHARDONI, Ricardo; ZIEMANN, Ulf; ANDRADE, Daniel Ciampi de; BRUNONI, Andre RussowskySchizophrenia is a disorder associated with cortical inhibition deficits. Transcranial direct current stimulation (tDCS) induces changes in cortical excitability in healthy subjects and individuals with neuropsychiatric disorders depending on the stimulation parameters. Our aim was to investigate whether a previously published tDCS protocol associated with symptomatic improvement in schizophrenia would induce changes in motor cortical excitability, assessed by transcranial magnetic stimulation paradigms, i.e., short-interval intracortical inhibition (SICI) and intra-cortical facilitation (ICF). We assessed cortical excitability measurements in 48 subjects with schizophrenia before and after a single session of active tDCS (20 min, 2 mA, anode over left dorsolateral prefrontal cortex, cathode over left temporoparietal cortex) or sham. Those who received active tDCS had a significant increase of SICI in the left motor cortex compared to those who received sham stimulation (Cohen's d = 0.54, p = .019). No changes were observed for ICF. In addition, lower SICI was associated with higher age (beta = -0.448, p < .01). Increase in intracortical inhibition may indicate a mechanism of action of tDCS in this population. Future studies should investigate whether this finding is a biomarker of treatment response for schizophrenia.
- Reference values for short-term resting-state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult HealthELSA-Brasil study(2018) DANTAS, Eduardo Miranda; KEMP, Andrew Haddon; ANDREAO, Rodrigo Varejao; SILVA, Valdo Jose Dias da; BRUNONI, Andre Russowsky; HOSHI, Rosangela Akemi; BENSENOR, Isabela Martins; LOTUFO, Paulo Andrade; RIBEIRO, Antonio Luiz Pinho; MILL, Jose GeraldoHeart rate variability (HRV) is a psychophysiological phenomenon with broad implications, providing an accessible index of vagal function, underpinning psychological constructs, including the capacity for social engagement and emotion regulation, and may predict future morbidity and mortality. However, the lack of reference values for short-term HRV indices for participants of both sexes across the age spectrum is a limiting factor. This was the objective of the present study. Resting electrocardiographic records were obtained from 13,214 participants (both sexes, 35-74 years), and HRV indices in time and frequency domains (mean +/- SD) were determined from 5-min records. Results were based on a subsample of 2,874 nonmedicated, healthy participants stratified by sex across 10-year age groupings. Men showed lower heart rate (HR, 64 +/- 8 bpm vs. 68 +/- 8 bpm, p<.05) and normalized high frequency (HF; 39.4 +/- 18.0 normalized units [n.u.] vs. 50.4 +/- 18.5 n.u., p<.05) than women, and higher N-N variance (2,214 +/- 1,890 ms(2) vs. 1,883 +/- 1,635 ms(2), p<.05), standard deviation of all N-N intervals (SDNN; 43.7 +/- 17.3 ms vs. 40.3 +/- 15.8 ms, p<.05) and LF/HF (2.30 +/- 2.68 vs. 1.33 +/- 1.82, p<.05). HR and HF (n.u.) were also higher in younger than older women. LF/HF was lower in women than men. Percentile curves showed almost all HRV indices decreasing with aging. The availability of short-term, resting-state HRV reference values in a large sample of healthy and nonmedicated participants from 35-74 years will provide a valuable tool for researchers, clinicians, and those in the quantified-self community.
- The effectiveness of aspirin for migraine prophylaxis: a systematic review(2017) BAENA, Cristina Pellegrino; D'AMICO, Raissa Campos; SLONGO, Helena; BRUNONI, Andre Russowsky; GOULART, Alessandra Carvalho; BENSENOR, IsabelaCONTEXT AND OBJECTIVE: Many researchers have suggested that aspirin prevents migraines. However, the evidence is unclear. The aim of this study was to analyze the available evidence on the effect of aspirin as a migraine prophylactic. DESIGN AND SETTING: Systematic review, conducted at the Pontificia Universidade Catalica do Parana, Brazil, and at the University of Sao Paulo, Brazil. METHODS: We performed electronic searches in the databases of MEDLINE/PubMed, Embase, WEB OF SCIENCE, the World Health Organization, CENTRAL and OpenGrey, and we also searched manually for interventional studies published before April 2016 that compared the effects of aspirin with a control, in adults. Two authors independently extracted data on the publication, population recruited, intervention (aspirin dosage, follow-up and combined treatment) and main outcomes (frequency, severity and duration of migraine). We evaluated the quality of the studies using the Cochrane risk-of-bias tool. RESULTS: Our search retrieved 1,098 references, of which 8 met the selection criteria for this systematic review. The total population was 28,326 participants (18-64 years old); most (96%) were men. The dosage varied from 50 to 650 mg/day across the studies. The risk of bias was generally low or unclear. The only outcome for which most of the studies included (6/8) reported a significant reduction was frequency of migraine, which was reduced at an aspirin dosage of at least 325 mg/day. CONCLUSION: Aspirin can reduce the frequency of migraines. However, the optimal dosage is unclear.
- Repetitive TMS does not improve cognition in patients with TBI(2019) NEVILLE, Iuri Santana; ZANINOTTO, Ana Luiza; HAYASHI, Cintya Yukie; RODRIGUES, Priscila Aparecida; GALHARDONI, Ricardo; ANDRADE, Daniel Ciampi de; BRUNONI, Andre Russowsky; AMORIM, Robson L. Oliveira; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaObjective To determine whether high-frequency repetitive transcranial magnetic stimulation (rTMS) improves cognition in patients with severe traumatic brain injury. Methods A single-center, randomized, double-blind, placebo-controlled study of rTMS was conducted in patients aged 18-60 years with chronic (> 12 months postinjury) diffuse axonal injury (DAI). Patients were randomized to either a sham or real group in a 1:1 ratio. A 10-session rTMS protocol was used with 10-Hz stimulation over the left dorsolateral prefrontal cortex (DLPFC). Neuropsychological assessments were performed at 3 time points: at baseline, after the 10th rTMS session, and 90 days after intervention. The primary outcome was change in executive function evaluated using the Trail Making Test Part B. Results Thirty patients with chronic DAI met the study criteria. Between-group comparisons of performance on TMT Part B at baseline and after the 10th rTMS session did not differ between groups (p = 0.680 and p = 0.341, respectively). No significant differences were observed on other neuropsychological tests. No differences in adverse events between treatment groups were observed. Conclusions Cognitive function in individuals with chronic DAI is not improved by high-frequency rTMS over the left DLPFC, though it appears safe and well-tolerated in this population.
- Transcranial Direct Current Stimulation for Generalized Anxiety Disorder: A Case Study(2014) SHIOZAWA, Pedro; LEIVA, Andre Pereira G.; CASTRO, Claudia Dornfeld C.; SILVA, Mailu Enokibara da; CORDEIRO, Quirino; FREGNI, Felipe; BRUNONI, Andre Russowsky
- A century of research on neuromodulation interventions: A scientometric analysis of trends and knowledge maps(2023) SABE, Michel; SULSTAROVA, Adi; CHEN, Chaomei; HYDE, Joshua; POULET, Emmanuel; ALEMAN, Andre; DOWNAR, Jonathan; BRANDT, Valerie; MALLET, Luc; SENTISSI, Othman; NITSCHE, Michael A.; BIKSON, Marom; BRUNONI, Andre Russowsky; CORTESE, Samuele; SOLMI, MarcoInterest in neurostimulation interventions has significantly grown in recent decades, yet a scientometric analysis objectively mapping scientific knowledge and recent trends remains unpublished. Using relevant keywords, we conducted a search in the Web of Science Core Collection on September 23, 2022, retrieving a total of 47,681 documents with 987,979 references. We identified two prominent research trends: 'noninvasive brain stimulation' and 'invasive brain stimulation.' These methods have interconnected over time, forming a cluster focused on evidence synthesis. Noteworthy emerging research trends encompassed 'transcutaneous auricular vagus nerve stimulation,' 'DBS/epilepsy in the pediatric population,' 'spinal cord stimulation,' and 'brain-machine interface.' While progress has been made for various neurostimulation interventions, their approval as adjuvant treatments remains limited, and optimal stimulation parameters lack consensus. Enhancing communication between experts of both neurostimulation types and encouraging novel translational research could foster further development. These findings offer valuable insights for funding agencies and research groups, guiding future directions in the field.
- Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor(2021) NEVILLE, Iuri Santana; SANTOS, Alexandra Gomes dos; ALMEIDA, Cesar Cimonari; HAYASHI, Cintya Yukie; SOLLA, Davi Jorge Fontoura; GALHARDONI, Ricardo; ANDRADE, Daniel Ciampi de; BRUNONI, Andre Russowsky; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaBackground: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS). Methods: We recruited 40 patients with a single brain tumor surrounding or directly involving the CST as well as 82 age- and sex-matched healthy controls. The patients underwent standard nTMS and CE evaluations. Single and paired pulses were applied to the primary motor area (M1) of both affected and unaffected cerebral hemispheres 1 week before surgery. The CE parameters included resting motor threshold (RMT), motor evoked potential (MEP) ratio for 140 and 120% stimulus (MEP 140/120 ratio), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Motor outcome was evaluated on hospital discharge and on 30-day and 90-day postoperative follow-up. Results: In the affected hemispheres of patients, SICI and ICF were significantly higher than in the unaffected hemispheres (p=0.002 and p=0.009, respectively). The 140/120 MEP ratio of patients' unaffected hemispheres was lower than that in controls (p=0.001). Patients with glioblastomas (GBM) had a higher interhemispheric RMT ratio than patients with grade II and III gliomas (p = 0.018). A weak correlation was observed among the RMT ratio and the preoperative motor score (R-2 = 0.118, p = 0.017) and the 90-day follow-up (R-2 = 0.227, p = 0.016). Conclusion: Using preoperative nTMS, we found that brain hemispheres affected by tumors had abnormal CE and that patients with GBM had a distinct pattern of CE. These findings suggest that tumor biological behavior might play a role in CE changes.
- Clinical predictors of acute response to transcranial direct current stimulation (tDCS) in major depression(2017) D'URSO, Giordano; DELL'OSSO, Bernardo; ROSSI, Rodolfo; BRUNONI, Andre Russowsky; BORTOLOMASI, Marco; FERRUCCI, Roberta; PRIORI, Alberto; BARTOLOMEIS, Andrea de; ALTAMURA, Alfredo CarloBackground: Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. Methods: Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. Results: Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of ""Cognitive Disturbances"" and ""Retardation"" factors, whilst the ""Anxiety/Somatization"" factor showed a mild association with the response. Limitations: Open-label design, the lack of control group, and minor differences in stimulation protocols. Conclusions: No differences in response to tDCS were found between unipolar and bipolar patients, suggesting that tDCS is effective for both conditions. ""Cognitive disturbance"", ""Retardation"", and ""Anxiety/Somatization"", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressed patients.
- Cognitive effects of transcranial direct current stimulation in depression: Results from the SELECT-TDCS trial and insights for further clinical trials(2016) BRUNONI, Andre Russowsky; TORTELLA, Gabriel; BENSENOR, Isabela Martins; LOTUFO, Paulo Andrade; CARVALHO, Andre Ferrer; FREGNI, FelipeBackground: Cognitive dysfunction treatment remains an unmet clinical need in major depressive disorder (MDD). Transcranial direct current stimulation (tDCS) may improve cognitive symptoms in MDD. Our aim was to investigate the cognitive effects of tDCS in the Sertraline vs. Electric Current Therapy for Treating Depression Clinical Study (SELECT-TDCS). We also explored whether tDCS could have mood independent cognitive effects. Methods: One hundred twenty MDD patients aged from 18 to 65 years received 12 sessions of active/sham tDCS (2 mA for 30 min) and real/placebo 50 mg/d sertraline over 6 weeks in a factorial trial. We analyzed whether changes in performance of neuropsychological tests (Trail Making, Digit Span, Stroop Task, Mini-Mental Status Exam and Montreal Cognitive Assessment) occurred over time, according to treatment group and depression improvement. Exploratory analyses were carried out to verify the influence of clinical and demographic variables on the outcomes. Results: Cognitive improvement was showed in most tests used, although they occurred regardless of intervention type and depression improvement. Further exploratory analyses revealed that clinical response and education level could have mediated pro-cognitive tDCS effects on some of the tests used. Limitations: The neuropsychological battery used might not have been sensitive to detect tDCS-induced effects on cognition. Lack of simultaneous cognitive training during application may have also limited its cognitive effects. Conclusions: We found no evidence of beneficial or deleterious cognitive effects of tDCS as a treatment for depression. We discussed clinical trial design considerations for further tDCS studies assessing cognitive effects, including sample and outcomes considerations.