ROSA MARIA FIGUEIREDO VALERIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
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- 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.
- 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.
- Left-sided epileptiform activity influences language lateralization in right mesial temporal sclerosis(2024) ALMEIDA, Juliana Passos de; CASTRO, Bettina Martins; PASSARELLI, Valmir; CHAIM, Khallil Taverna; CASTRO-LIMA, Humberto; LISTIK, Clarice; JORGE, Carmen Lisa; VALERIO, Rosa; ARANTES, Paula Ricci; JR, Edson Amaro; PIPEK, Leonardo Zumerkorn; CASTRO, Luiz H.Objective: To investigate the association between left epileptiform activity and language laterality indices (LI) in patients with right mesial temporal sclerosis (MTS).Methods: Twenty-two patients with right MTS and 22 healthy subjects underwent fMRI scanning while performing a language task. LI was calculated in multiple regions of interest (ROI). Data on the presence of left epileptiform abnormalities were obtained during prolonged video-EEG monitoring.Results: After correction for multiple comparisons, LI was reduced in the middle temporal gyrus in the left interictal epileptiform discharges (IED+) group, compared with the left IED- group (p < 0.05).Significance: Using a responsive reading naming fMRI paradigm, right MTS patients who presented left temporal interictal epileptiform abnormalities on video-EEG showed decreased LI in the middle temporal gyrus, indicating decreased left middle temporal gyrus activation, increased right middle temporal gyrus activation or a combination of both, demonstrative of language network reorganization, specially in the MTG, in this patient population.Plain Language Summary: This research studied 22 patients with right mesial temporal sclerosis (a specific type of epilepsy) comparing them to 22 healthy individuals. Participants were asked to perform a language task while undergoing a special brain imaging technique (fMRI). The findings showed that patients with epilepsy displayed a change in the area of the brain typically responsible for language processing. This suggests that their brains may have adapted due to their condition, altering the way language is processed.