ROSA MARIA FIGUEIREDO VALERIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
17 resultados
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- Contralateral ictal electrographic involvement is associated with decreased memory performance in unilateral mesial temporal sclerosis(2015) PASSARELLI, Valmir; CASTRO-LIMA FILHO, Humberto; ADDA, Carla C.; PRETURLON-SANTOS, Ana P.; VALERIO, Rosa M.; JORGE, Carmen L.; PUGLIA- JR., Paulo; LYRA, Katarina; OTADUY, Maria G.; WEN, Hung-Tzu; CASTRO, Luiz H.Purpose: To evaluate the effect of contralateral electrographic involvement on memory performance (measured by neuropsychological and Wada memory testing) in patients with epilepsy associated with unilateral mesial temporal sclerosis (MTS). Methods: We studied 51 patients with medically-refractory epilepsy associated with unilateral MTS (27 women, 30/51, left MTS) submitted to prolonged non-invasive video-EEG monitoring and bilateral Wada testing. According to ictal electrographic involvement, patients were classified as: Contralateral ictal involvement, when one or more seizures evolved with rhythmic activity in the temporal region contralateral to the MTS or exclusive ipsilateral ictal involvement if all seizures showed ictal EEG activity exclusively on the MTS side. Wada testing involved a twelve-item memory paradigm. Wada memory asymmetry score was calculated for each patient subtracting the number of recalled items after injection on the lesion side from the number of recalled items after contralateral injection. Expected asymmetry (EA) was considered if Wade memory asymmetry > 0, and Symmetrical or Reversed memory asymmetry (S-RA) when <= 0. Neuropsychological testing was applied in the 51 patients and in 40 healthy controls. Verbal Memory was evaluated with the Rey Auditory Verbal Learning Test (RAVLT), considering the number of recalled items on immediate recall after the initial five consecutive encoding trials (RAVLT 6), a post-interference delayed (30 min) recall (RAVLT 7), and recall after 7 days. Nonverbal memory was tested with Wechsler Memory Scale-III (WMS-III) Faces subtests 1 e 2. Results: Groups did not differ in demographic, clinical and video-EEG monitoring variables. S-RA was observed more frequently in the group with contralateral ictal involvement (57.2% vs. 27.0%; p: 0.03). Logistic regression analysis considering demographic, clinical, hippocampal volume and video-EEG monitoring variables showed contralateral ictal involvement as the only independent variable associated with S-RA (coefficient = 1.32, p = 0.029, odds ratio 3.77; 95% CI 1.1-12.47). Additionally, the patient group with contralateral ictal EEG involvement displayed worse verbal and nonverbal memory scores compared to healthy controls. Conclusion: In this cohort of unilateral MTS patients, contralateral ictal involvement was associated with decreased memory performance on Wada and on neuropsychological testing.
- Contralateral Interictal and Ictal EEG Epileptiform Activity Accentuate Memory Impairment in Unilateral Mesial Temporal Sclerosis Patients(2017) PINTO, Lecio F.; ADDA, Carla C.; SILVA, Liliane C. A.; BANASKIWITZ, Natalie H. C.; PASSARELLI, Valmir; JORGE, Carmen L.; VALERIO, Rosa M.; CASTRO, Luiz H.Objective: Memory impairment is a recognized complication of mesial temporal sclerosis (MTS). Epileptiform activity may negatively impact on cognition. We evaluated the impact of contralateral EEG involvement on memory in unilateral MTS (uMTS) patients. Method: Retrospective review of 121 right-handed uMTS patients (69 left) evaluated with prolonged video-EEG and verbal and nonverbal memory tests (Rey Auditory Verbal Learning Test and Rey-Osterrieth Complex figure), with additional very delayed trials. Patients were classified according to ictal/interictal EEG findings and MTS side as left or right concordant or discordant. Thirty-nine normal individuals who underwent the same neuropsychological battery served as controls. Results: Demographic, disease, and treatment features did not differ among groups. On the 7-day verbal memory free recall, left discordant performed significantly worse than controls and right concordant, recognized fewer words, and had more recognition errors than all other groups, including left concordant. For nonverbal memory, right discordant performed significantly worse than controls on delayed recall, and attained lower scores than other groups on immediate and 7-day recall, but this difference did not reach statistical significance. Left discordant had higher scores of memory complaints than controls and disclosed a trend toward accentuated memory impairment compared with the other groups over time. Conclusions: Our results suggest that contralateral electrographic involvement in uMTS was associated with more pronounced memory impairment for verbal material in left discordant patients, and to a lesser extent, for nonverbal material in right discordant patients. Left discordant group also had increased memory complaints.
conferenceObject Intracarotid Ethomidate - WADA Test: A 75 Patient Series(2013) BASTOS, Carla; HOBI, Camila; LIMA FILHO, Humberto; PASSARELLI, Valmir; PINTO, Lecio; JORGE, Carmen; VALERIO, Rosa; CASTRO, Luiz- Metabolic differences in the contralateral hippocampus of concordant and discordant mesial temporal sclerosis (MTS) patients: evaluation with proton magnetic resonance spectroscopy (1H-MRS)(2012) NASCIMENTO, SC; PARK, EJ; LYRA, KP; VALÉRIO, RM; JORGE, CL; PASSARELLI, V; CASTRO-LIMA, H; LEITE, CC; CASTRO, LHM; OTADUY, MCGPURPOSE: Patients with mesial temporal sclerosis (MTS) are clinically classified as concordant or discordant according to the extent of epileptogenic activity. The aim of this study is to determine whether the metabolic changes in the hippocampus are different in the two groups. MATERIALS AND METHODS: 33 patients diagnosed with MTS, 23 concordant (33±9 years old) and 10 discordant (33±10 years old) and 28 controls (33±10 years old) were evaluated. We obtained magnetic resonance spectroscopy of both hippocampi (ipsilateral and contralateral) on a 3T scanner with single voxel PRESS sequence with TE/TR=135/1500ms. The main metabolites were quantified with LC Model. For comparison between groups statistical tests were performed with a significance level of 0.05. RESULTS: In all patients a reduction of NAAipsi and Cr ipsi was observed, when compared to the contralateral side, but this difference was only significant for the group of concordant patients. In comparison with controls a significant reduction of Cr ipsi and NAAipsi was observed for both groups and for Naa/Cr ipsi in the group of concordant patients while NAA/Cr contra was reduced only in the group of discordant patients. CONCLUSION: Our findings suggest a stronger decline of NAA/Cr ipsi in the group of concordant patients and of NAA/Cr contra in discordant patients, suggesting a slightly different metabolic pattern for both groups. However, we need to increase the sample size to confirm these findings.
- Extratemporal abnormalities in phosphorus magnetic resonance spectroscopy of patients with mesial temporal sclerosis(2016) PARK, Eun Joo; OTADUY, Maria Concepcion Garcia; LYRA, Katarina Paz de; ANDRADE, Celi Santos; CASTRO, Luiz Henrique Martins; PASSARELLI, Valmir; VALERIO, Rosa Maria Figueiredo; JORGE, Carmen Lisa; TSUNEMI, Miriam Harumi; LEITE, Claudia da CostaObjective: We evaluated extratemporal metabolic changes with phosphorus magnetic resonance spectroscopy (P-31-MRS) in patients with unilateral mesial temporal sclerosis (MTS). Method: P-31-MRS of 33 patients with unilateral MTS was compared with 31 controls. The voxels were selected in the anterior, posterior insula-basal ganglia (AIBG, PIBG) and frontal lobes (FL). Relative values of phosphodiesters-PDE, phosphomonoesters-PME, inorganic phosphate - Pi, phosphocreatine-PCr, total adenosine triphosphate [ATP(t=) gamma- + a- + b-ATP] and the ratios PCr/ATP(t), PCr/gamma-ATP, PCr/Pi and PME/PDE were obtained. Results: We found energetic abnormalities in the MTS patients compared to the controls with Pi reduction bilaterally in the AIBG and ipsilaterally in the PIBG and the contralateral FL; there was also decreased PCr/gamma-ATP in the ipsilateral AIBG and PIBG. Increased ATP(T) in the contralateral AIBG and increased gamma-ATP in the ipsilateral PIBG were detected. Conclusion: Widespread energy dysfunction was detected in patients with unilateral MTS.
- Verbal-memory impairment is associated with widespread white-matter tract involvement in patients with temporal lobe epilepsy and hippocampal sclerosis(2023) OLIVEIRA, Joao Vitor Mahler Ferreira; SOLTI, Marina; ADDA, Carla; JORGE, Carmen; VALERIO, Rosa Maria; LYRA, Katarina; PASTORELLO, Bruno; LEITE, Claudia; OTADUY, Maria; CASTRO, Luiz Henrique Martins
- Serial and prolonged EEG monitoring in anti-N-Methyl-D-Aspartate receptor encephalitis(2014) SILVA-JUNIOR, Francisco Pereira da; CASTRO, Luiz Henrique Martins; ANDRADE, Joaquina Queiroz; BASTOS, Carla Guimaraes; MOREIRA, Camila Hobi; VALERIO, Rosa Maria Figueiredo; JORGE, Carmen Lisa; MARCHIORI, Paulo Euripedes; NITRINI, Ricardo; GARZON, ElianaObjective: To describe serial electroencephalographic (EEG) findings of three patients with anti-NMDAR encephalitis. Methods: Three women (age 15-34 years) with confirmed anti-NMDAR encephalitis underwent serial EEG recordings. Continuous EEG for 72 h was performed in one case and 3-day video-EEG monitoring was obtained in two cases. Results: Generalized rhythmic delta activity (GRDA) was found in all patients. GRDA persisted for hours, but was not continuous on a 24-h EEG recording, disclosed no frequency, voltage or field evolution, and was not seen on the first EEG of two patients. Extreme delta brush was noted in two patients who presented more severe disease. One patient presented seizures, which were electrographically and clinically different from the GRDA pattern and from dyskinetic movements. Conclusions: Serial or continuous EEG may be necessary to detect GRDA in anti-NMDAR patients. To avoid unnecessary treatment, this pattern should not be interpreted as indicative of ictal activity, unless there is evidence of its ictal nature. Significance: Our findings may contribute to the diagnosis of anti-NMDAR encephalitis in cases with characteristic clinical picture.
- Bilateral ictal EEG is associated with better memory outcome after hippocampal sclerosis surgery(2023) CASTRO-LIMA, Humberto; PASSARELLI, Valmir; RIBEIRO, Elyse S.; ADDA, Carla C.; PRETURLON-SANTOS, Ana Paula P.; JORGE, Carmen L.; VALERIO, Rosa; TZU, Wen Hung; BOA-SORTE, Ney; PIPEK, Leonardo Zumerkorn; CASTRO, Luiz Henrique M.ObjectiveTo compare memory outcomes after surgery for unilateral hippocampal sclerosis (HS)-associated epilepsy in patients with unilateral and bilateral ictal electrographic involvement.MethodsWe prospectively evaluated HS patients, aged 18-55 years and IQ >= 70. Left (L) and right (R) surgical groups underwent noninvasive video-EEG monitoring and Wada test. We classified patients as Ipsilateral if ictal EEG was restricted to the HS side, or Bilateral, if at least one seizure onset occurred contralaterally to the HS, or if ictal discharge evolved to the opposite temporal region. Patients who declined surgery served as controls. Memory was evaluated on two occasions with Rey Auditory-Verbal Learning Test and Rey Visual-Design Learning Test. Baseline neuropsychological test scores were compared between groups. Pre- and postoperative scores were compared within each group. Reliable change index Z-scores (RCI) were obtained using controls as references, and compared between surgical groups.ResultsWe evaluated 64 patients. Patients were classified as: L-Ipsilateral (9), L-Bilateral (15), L-Control (9), R-Ipsilateral (10), R-Bilateral (9), and R-Control (12). On preoperative evaluation, memory performance did not differ among surgical groups. Right HS patients did not present postoperative memory decline. L-Ipsilateral group presented postoperative decline on immediate (P = 0.036) and delayed verbal recall (P = 0.011), while L-Bilateral did not decline. L-Ipsilateral had lower RCI Z-scores, indicating delayed verbal memory decline compared to L-Bilateral (P = 0.012).SignificanceDominant HS patients with bilateral ictal involvement presented less pronounced postoperative verbal memory decline compared to patients with exclusive ipsilateral ictal activity. Surgery was indicated in these patients regardless of memory impairment on neuropsychological testing, since resection of the left sclerotic hippocampus could result in cessation of contralateral epileptiform activity, and, therefore, improved memory function.
- White matter tract abnormalities are associated with executive dysfunction in temporal lobe epilepsy and hippocampal sclerosis(2023) SOLTI, Marina; OLIVEIRA, Joao Vitor Mahler Ferreira; ADDA, Carla; VALERIO, Rosa; JORGE, Carmen; LYRA, Katarina; PASTORELLO, Bruno; LEITE, Claudia; OTADUY, Maria; CASTRO, Luiz Henrique Martins
conferenceObject Semantic fluency impairment in unilateral mesial temporal sclerosis related epilepsy is associated with extensive white matter involvement: a diffusion tensor imaging study(2017) PERES, Matheus; CASTRO, Bettina; MESSAS, Cristiane; MARTUCCI, Caio; CHAIM, Khalil; PASTORELLO, Bruno; VALERIO, Rosa; JORGE, Carmen; LYRA, Katarina; OTADUY, Maria; LEITE, Claudia; CASTRO, Luiz