ANDREA DE FATIMA HORVATH MARQUES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Association study between functional polymorphisms in the TNF-alpha gene and obsessive-compulsive disorder(2012) CAPPI, Carolina; MUNIZ, Renan Kawano; SAMPAIO, Aline Santos; CORDEIRO, Quirino; BRENTANI, Helena; PALACIOS, Selma A.; MARQUES, Andrea H.; VALLADA, Homero; MIGUEL, Euripedes Constantino; GUILHERME, Luiza; HOUNIE, Ana GabrielaObsessive-compulsive disorder (OCD) is a prevalent psychiatric disorder of unknown etiology. However, there is some evidence that the immune system may play an important role in its pathogenesis. In the present study, two polymorphisms (rs1800795 and rs361525) in the promoter region of the cytokine tumor necrosis factor-alpha (TNFA) gene were genotyped in 183 OCD patients and in 249 healthy controls. The statistical tests were performed using the PLINK (R) software. We found that the A allele of the TNFA rs361525 polymorphism was significantly associated with OCD subjects, according to the allelic x association test (p=0.007). The presence of genetic markers, such as inflammatory cytokines genes linked to OCD, may represent additional evidence supporting the rote of the immune system in its pathogenesis.
- Epigenetic evidence for involvement of the oxytocin receptor gene in obsessive-compulsive disorder(2016) CAPPI, Carolina; DINIZ, Juliana Belo; REQUENA, Guaraci L.; LOURENCO, Tiaya; LISBOA, Bianca Cristina Garcia; BATISTUZZO, Marcelo Camargo; MARQUES, Andrea H.; HOEXTER, Marcelo Q.; PEREIRA, Carlos A.; MIGUEL, Euripedes Constantino; BRENTANI, HelenaBackground: Obsessive-compulsive disorder (OCD) is a chronic neurodevelopmental disorder that affects up to 3% of the general population. Although epigenetic mechanisms play a role in neurodevelopment disorders, epigenetic pathways associated with OCD have rarely been investigated. Oxytocin is a neuropeptide involved in neurobehavioral functions. Oxytocin has been shown to be associated with the regulation of complex socio-cognitive processes such as attachment, social exploration, and social recognition, as well as anxiety and other stress-related behaviors. Oxytocin has also been linked to the pathophysiology of OCD, albeit inconsistently. The aim of this study was to investigate methylation in two targets sequences located in the exon III of the oxytocin receptor gene (OXTR), in OCD patients and healthy controls. We used bisulfite sequencing to quantify DNA methylation in peripheral blood samples collected from 42 OCD patients and 31 healthy controls. Results: We found that the level of methylation of the cytosine-phosphate-guanine sites in two targets sequences analyzed was greater in the OCD patients than in the controls. The higher methylation in the OCD patients correlated with OCD severity. We measured DNA methylation in the peripheral blood, which prevented us from drawing any conclusions about processes in the central nervous system. Conclusion: To our knowledge, this is the first study investigating DNA methylation of the OXTR in OCD. Further studies are needed to evaluate the roles that DNA methylation and oxytocin play in OCD.
- Telemental health in Brazil: past, present and integration into primary care(2015) DIAS, Rodrigo Da Silva; MARQUES, Andrea De Fatima Horvath; DINIZ, Paula Rejane Bezerra; SILVA, Tatiana Araújo Bertilino Da; COFIEL, Luciana; MARIANI, Mirella Martins De Castro; SALGADO, Christiana Leal; OLIVEIRA, Ana Emilia Figueiredo De; MIGUEL FILHO, Euripedes Constantino; WEN, Chao Lung; NOVAES, Magdala De Araújo; TAVARES, HermanoBackground Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords “telemedicine”, “primary health care” “mental health” and “telemental health”, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research.
- Innovative strategies for closing the mental health treatment gap globally(2014) REBELLO, Tahilia J.; MARQUES, Andrea; GUREJE, Oye; PIKE, Kathleen M.Purpose of review In the field of global mental health, an enormous gap between what we know and what we do exists in the delivery of clinical care. Creative and effective strategies that surmount the barriers to provision of mental healthcare are essential to improve the lives of millions affected by mental illness. This article provides a review of three classes of innovative strategies currently being developed and implemented to diminish the mental health treatment gap globally. Recent findings This review provides recent evidence related to the feasibility of implementation and efficacy for the following three classes of innovation that show promise for building clinical capacity and expanding mental health coverage: integration of mental health services into primary care; expansion of human capacity through task sharing and training of nonspecialists; and innovative use of technological platforms to enhance access, cut costs, and reduce stigma. Summary The strategies outlined in this review hold great potential for enhancing mental health treatment services, and address some of the major barriers globally to accessing mental healthcare, such as scarcity of resources (infrastructure, capacity, and funding) and stigma. Despite much evidence supporting the efficacy of these models, thorough studies that test their feasibility, acceptability, utility, and effectiveness in various contexts, including low-income and middle-income countries, are required. Moreover, these innovations require social support and political will in order to be successfully implemented and scaled-up such that they have a meaningful impact on the burden of disease associated with mental illness worldwide.
- Community-based global health program for maltreated children and adolescents in Brazil: the equilibrium program(2015) MARQUES, Andrea Horvath; OLIVEIRA, Paula Approbato; SCOMPARINI, Luciana Burim; SILVA, Uiara Maria Rego e; SILVA, Angelica Cristine; DORETTO, Victoria; MEDEIROS FILHO, Mauro Victor de; SCIVOLETTO, SandraThe maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries (""LMICs""). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (""TEP""), a community-based global health program implemented in Sao Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.
- Searching for the Immune Basis of Obsessive-Compulsive Disorder(2014) TEIXEIRA, Antonio Lucio; RODRIGUES, David Henrique; MARQUES, Andrea Hovarth; MIGUEL, Euripedes C.; FONTENELLE, Leonardo F.The etiopathogenesis of obsessive-compulsive disorder (OCD) remains elusive. Clinical observation of the elevated frequency of obsessive-compulsive symptoms in patients with rheumatic fever, a post-streptococcal autoimmune disease, prompted the study of immune parameters in OCD. Anti-basal ganglia antibodies have been described in a subset of OCD patients. The assessment of circulating cytokines and immune cells confirmed unequivocal changes in at least some patients, although it is difficult to establish a particular immune profile in OCD. Several factors, including the use of psychotropic drugs and the presence of comorbid conditions, seem to influence these immune parameters. (C) 2014 S. Karger AG, Basel
- Gender differences in the impact of daily sadness on 24-h heart rate variability(2015) VERKUIL, Bart; BROSSCHOT, Jos F.; MARQUES, Andrea H.; KAMPSCHROER, Kevin; STERNBERG, Esther M.; THAYER, Julian F.Reduced heart rate variability (HRV) is proposed to mediate the relation between depressive symptoms and cardiovascular health problems. Yet, several studies have found that in women depression is associated with higher HRV levels, whereas in men depression is associated with lower HRV levels. So far, these studies have only examined gender differences in HRV levels using a single assessment. This study aimed to test the interactive effects of gender and sadness on ambulatory-assessed HRV levels. A sample of 60 (41 women) employees participated in an ambulatory study. HRV levels (mean of successive differences; MSD) were continuously measured for 24 h. During the daytime, hourly assessments of sadness and other mood states were taken, while depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale (CES-D). Gender differences were observed when examining the impact of average daily sadness on MSD. In women, but not in men, the total amount of sadness experienced during the day was associated with higher circadian MSD levels. These findings suggest that researchers need to take gender differences into account when examining the relation between sadness, HRV, and cardiovascular problems.
conferenceObject Does inflammation play a role in Obsessive Compulsive Disorder?(2013) SILVERMAN, M.; CASSAB, R.; MUNIZ, R.; SHAVITT, R. G.; TOLEDO, M. C.; CAPPI, C.; THAYER, J.; MATHIS, A. de; DINIZ, J.; HOEXTER, M.; ALCANTE, C. D.; BORCATO, S.; HOUNIE, A. G.; WHITFIELD, J.; BELYAVSKAYA, E.; STERNBERG, E.; MIGUEL, E.; MARQUES, A.- Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines(2016) SOLIS, Ana Cristina de Oliveira; MARQUES, Andrea Horvath; DOMINGUEZ, Wagner Vasques; PRADO, Euthymia Brandao de Almeida; PANNUTI, Claudio Mendes; LOTUFO, Roberto Fraga Moreira; LOTUFO-NETO, FranciscoAn imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (+/- 3 years) with a healthy control (n = 36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1 beta (IL-1 beta), and interferon-gamma (INF-gamma) production in whole blood culture (WBC) and IL-6 and IL-1 beta levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1 beta (unstimulated) as well as GCF IL-1 beta were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann-Whitney, p = 0.002, 0.0075, ANCOVA, p = 0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r = 0.07, p = 0.67), and between the levels of circulating IL-1 beta and the IL-1 beta level in the CGF (r = -0.08, p = 0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r = 0.02, p= 0.91) or between the circulating IL-1 beta and GCF IL-1 beta (r = 0.13, p= 0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.
- Maternal stress, nutrition and physical activity: Impact on immune function, CNS development and psychopathology(2015) MARQUES, Andrea Horvath; BJORKE-MONSEN, Anne-Lise; TEIXEIRA, Antonio L.; SILVERMAN, Marni N.Evidence suggests that maternal and fetal immune dysfunction may impact fetal brain development and could play a role in neurodevelopmental disorders, although the definitive pathophysiological mechanisms are still not completely understood. Stress, malnutrition and physical inactivity are three maternal behavioral lifestyle factors that can influence immune and central nervous system (CNS) functions in both the mother and fetus, and may therefore, increase risk for neurodevelopmental/psychiatric disorders. First, we will briefly review some aspects of maternal-fetal immune system interactions and development of immune tolerance. Second, we will discuss the bidirectional communication between the immune system and CNS and the pathways by which immune dysfunction could contribute to neurodevelopmental disorders. Third, we will discuss the effects of prenatal stress and malnutrition (over and undernutrition) on perinatal programming of the CNS and immune system, and how this might influence neurodevelopment. Finally, we will discuss the beneficial impact of physical fitness during pregnancy on the maternal-fetal unit and infant and how regular physical activity and exercise can be an effective buffer against stress- and inflammatory-related disorders. Although regular physical activity has been shown to promote neuroplasticity and an anti-inflammatory state in the adult, there is a paucity of studies evaluating its impact on CNS and immune function during pregnancy. Implementing stress reduction, proper nutrition and ample physical activity during pregnancy and the childbearing period may be an efficient strategy to counteract the impact of maternal stress and malnutrition/obesity on the developing fetus. Such behavioral interventions could have an impact on early development of the CNS and immune system and contribute to the prevention of neurodevelopmental and psychiatric disorders. Further research is needed to elucidate this relationship and the underlying mechanisms of protection. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.