PAULO ROSSI MENEZES

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Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder

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Autor e Coautores FMUSP-HC Normalizados: FABIO LUIS DE SOUZA DURAN ×

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  • article 11 Citação(ões) na Scopus
    Cardiovascular risk in cognitively preserved elderlies is associated with glucose hypometabolism in the posterior cingulate cortex and precuneus regardless of brain atrophy and apolipoprotein gene variations
    (2013) TAMASHIRO-DURAN, Jaqueline Hatsuko; SQUARZONI, Paula; DURAN, Fabio Luis de Souza; CURIATI, Pedro Kallas; VALLADA, Homero Pinto; BUCHPIGUEL, Carlos Alberto; LOTUFO, Paulo Andrade; WAJNGARTEN, Mauricio; MENEZES, Paulo Rossi; SCAZUFCA, Marcia; ALVES, Tania Correa de Toledo Ferraz; BUSATTO, Geraldo Filho
    Cardiovascular risk factors (CVRF) possibly contribute to the emergence of Alzheimer's disease (AD). Fluorodeoxyglucose-positron emission tomography (FDG-PET) has been widely used to demonstrate specific patterns of reduced cerebral metabolic rates of glucose (CMRgl) in subjects with AD and in non-demented carriers of the apolipoprotein epsilon 4 (APOE epsilon 4) allele, the major genetic risk factor for AD. However, functional neuroimaging studies investigating the impact of CVRF on cerebral metabolism have been scarce to date. The present FDG-PET study investigated 59 cognitively preserved elderlies divided into three groups according to their cardiovascular risk based on the Framingham 10-year risk Coronary Heart Disease Risk Profile (low-, medium-, and high-risk) to examine whether different levels of CVRF would be associated with reduced CMRgl, involving the same brain regions affected in early stages of AD. Functional imaging data were corrected for partial volume effects to avoid confounding effects due to regional brain atrophy, and all analyses included the presence of the APOE epsilon 4 allele as a confounding covariate. Significant cerebral metabolism reductions were detected in the high-risk group when compared to the low-risk group in the left precuneus and posterior cingulate gyrus. This suggests that findings of brain hypometabolism similar to those seen in subjects with AD can be detected in association with the severity of cardiovascular risk in cognitively preserved individuals. Thus, a greater knowledge about how such factors influence brain functioning in healthy subjects over time may provide important insigths for the future development of strategies aimed at delaying or preventing the vascular-related triggering of pathologic brain changes in the AD.
  • article 137 Citação(ões) na Scopus
    Age-related gray matter volume changes in the brain during non-elderly adulthood
    (2011) TERRIBILLI, Debora; SCHAUFELBERGER, Maristela S.; DURAN, Fabio L. S.; ZANETTI, Marcus V.; CURIATI, Pedro K.; MENEZES, Paulo R.; SCAZUFCA, Marcia; AMARO JR., Edson; LEITE, Claudia C.; BUSATTO, Geraldo F.
    Previous magnetic resonance imaging (MRI) studies described consistent age-related gray matter (GM) reductions in the fronto-parietal neocortex, insula and cerebellum in elderly subjects, but not as frequently in limbic/paralimbic structures. However, it is unclear whether such features are already present during earlier stages of adulthood, and if age-related GM changes may follow non-linear patterns at such age range. This voxel-based morphometry study investigated the relationship between GM volumes and age specifically during non-elderly life (18-50 years) in 89 healthy individuals (48 males and 41 females). Voxelwise analyses showed significant (p < 0.05, corrected) negative correlations in the right prefrontal cortex and left cerebellum, and positive correlations (indicating lack of GM loss) in the medial temporal region, cingulate gyrus, insula and temporal neocortex. Analyses using ROI masks showed that age-related dorsolateral prefrontal volume decrements followed non-linear patterns, and were less prominent in females compared to males at this age range. These findings further support for the notion of a heterogeneous and asynchronous pattern of age-related brain morphometric changes, with region-specific non-linear features.
  • article 15 Citação(ões) na Scopus
    Corpus callosum volumes in the 5 years following the first-episode of schizophrenia: Effects of antipsychotics, chronicity and maturation
    (2018) MOURA, Mariana T. M. de; ZANETTI, Marcus V.; DURAN, Fabio L. S.; SCHAUFELBERGER, Maristela S.; MENEZES, Paulo R.; SCAZUFCA, Marcia; BUSATTO, Geraldo F.; SERPA, Mauricio H.
    Background: White matter (WM) structural changes, particularly affecting the corpus callosum (CC), seem to be critically implicated in psychosis. Whether such abnormalities are progressive or static is still a matter of debate in schizophrenia research. Aberrant maturation processes might also influence the longitudinal trajectory of age-related CC changes in schizophrenia patients. We investigated whether patients with first-episode schizophreniarelated psychoses (FESZ) would present longitudinal CC and whole WM volume changes over the 5 years after disease onset. Method: Thirty-two FESZ patients and 34 controls recruited using a population-based design completed a 5-year assessment protocol, including structural MRI scanning at baseline and follow-up. The linear effects of disease duration, clinical outcome and antipsychotic (AP) use over time on WM and CC volumes were studied using both voxelwise and volume-based morphometry analyses. We also examined maturation/aging abnormalities through cross-sectional analyses of age-related trajectories of total WM and CC volume changes. Results: No interaction between diagnosis and time was observed, and clinical outcome did not influence CC volumes in patients. On the other hand, FESZ patients continuously exposed to AP medication showed volume increase over time in posterior CC. Curve-estimation analyses revealed a different aging pattern in FESZ patients versus controls: while patients displayed a linear decline of total WM and anterior CC volumes with age, a non-linear trajectory of total WM and relative preservation of CC volumes were observed in controls. Conclusions: Continuous AP exposure can influence CC morphology during the first years after schizophrenia onset. Schizophrenia is associated with an abnormal pattern of total WM and anterior CC aging during nonelderly adulthood, and this adds complexity to the discussion on the static or progressive nature of structural abnormalities in psychosis.
  • conferenceObject
    Brain Structure and the Prediction of Outcome in First-Episode Schizophrenia-Spectrum Disorders and Affective Psychosis: A Population-Based Study
    (2012) ROSA, Pedro G.; SCHALFELBERGER, Maristela S.; DURAN, Fabio L. S.; SANTOS, Luciana C.; MENEZES, Paulo R.; SCAZUFCA, Marcia; MURRAY, Robin M.; BUSATTO, Geraldo F.
    Background: MRI studies of the prediction of outcome among subjects with first-episode psychosis (FEP) have brought misleading evidence to discussion. Cognitive impairment in subjects with psychosis is receiving particular attention, and may be the symptom dimension most associated with outcome in those patients. Methods: Structural MRI on a FEP (N=96) sample with subjects with schizophrenia-spectrum disorders (N=55) and affective psychoses (N=41). Outcome evaluation after a median period of one year consisted on PANSS, cognitive measures (verbal fluency and digit spans) and disability evaluation (WHO-DAS). Lateral ventricles, studied using a region of interest approach, and regional GM, analyzed using VBM with SPM, at the baseline entered statistics as predictive of outcome at the follow-up. Results: Frontal and temporal cortices GM volume were associated with outcome measures, in particular with the performance o cognitive tasks, in the overall FEP Group and in the subgroups (schizophrenia and affective psychoses). Particularly, the affective psychosis subgroup showed more robust associations of GM volumes with outcome measures than the schizophrenia-spectrum subgroup. Furthermore, temporal horns measures were negatively correlated with digit spans’ performances in the FEP group and in the subgroups. None of these findings could be attributed to confounding factors, such as outcome measures at baseline and antipsychotic intake. Conclusions: Brain structure at the moment of the first-episode of psychosis of patients with schizophrenia and subjects with affective psychoses was associated with outcome, particularly cognitive measures. The predominance of findings on frontal-temporal regions is compatible with the presence of a fronto-temporal disconnectivity underlying psychoses. Keyword(s): Schizophrenia, Bipolar Disorder, Neuroimaging, Outcome, Cognition
  • article 53 Citação(ões) na Scopus
    Lack of progression of brain abnormalities in first-episode psychosis: a longitudinal magnetic resonance imaging study
    (2011) SCHAUFELBERGER, M. S.; LAPPIN, J. M.; DURAN, F. L. S.; ROSA, P. G. P.; UCHIDA, R. R.; SANTOS, L. C.; MURRAY, R. M.; MCGUIRE, P. K.; SCAZUFCA, M.; MENEZES, P. R.; BUSATTO, G. F.
    Background. Some neuroimaging studies have supported the hypothesis of progressive brain changes after a first episode of psychosis. We aimed to determine whether (i) first-episode psychosis patients would exhibit more pronounced brain volumetric changes than controls over time and (ii) illness course/treatment would relate to those changes. Method. Longitudinal regional grey matter volume and ventricle : brain ratio differences between 39 patients with first-episode psychosis (including schizophrenia and schizophreniform disorder) and 52 non-psychotic controls enrolled in a population-based case-control study. Results. While there was no longitudinal difference in ventricle : brain ratios between first-episode psychosis subjects and controls, patients exhibited grey matter volume changes, indicating a reversible course in the superior temporal cortex and hippocampus compared with controls. A remitting course was related to reversal of baseline temporal grey matter deficits. Conclusions. Our findings do not support the hypothesis of brain changes indicating a progressive course in the initial phase of psychosis. Rather, some brain volume abnormalities may be reversible, possibly associated with a better illness course.
  • conferenceObject
    Voxel-based morphometric imaging in first-episode psychosis: interrogating the role of familial liability
    (2023) CORSI-ZUELLI, F. C.; DURAN, F. L. Souza; LOUREIRO, C. M.; SANTOS, A. C. dos; BUSATTO, G.; MENEZES, P. R.; DEL-BEN, C. M.
  • article 3 Citação(ões) na Scopus
    Prefrontal-Parietal White Matter Volumes in Healthy Elderlies Are Decreased in Proportion to the Degree of Cardiovascular Risk and Related to Inhibitory Control Deficits
    (2017) SANTOS, Pedro P.; SILVEIRA, Paula S. Da; SOUZA-DURAN, Fabio L.; TAMASHIRO-DURAN, Jaqueline H.; SCAZUFCA, Marcia; MENEZES, Paulo R.; LEITE, Claudia Da Costa; LOTUFO, Paulo A.; VALLADA, Homero; WAJNGARTEN, Mauricio; ALVES, Tania C. De Toledo Ferraz; RZEZAK, Patricia; BUSATTO, Geraldo F.
    Cardiovascular risk (CVR) factors may be associated with poor cognitive functioning in elderlies and impairments in brain structure. Using MRI and voxel-based morphometry (VBM), we assessed regional white matter (WM) volumes in a population-based sample of individuals aged 65-75 years (n = 156), subdivided in three CVR subgroups using the Framingham Risk Score. Cognition was assessed using the Short Cognitive Performance Test. In high-risk subjects, we detected significantly reduced WM volume in the right juxtacortical dorsolateral prefrontal region compared to both low and intermediate CVR subgroups. Findings remained significant after accounting for the presence of the APOE epsilon 4 allele. Inhibitory control performance was negatively related to right prefrontal WM volume, proportionally to the degree of CVR. Significantly reduced deep parietal WM was also detected bilaterally in the high CVR subgroup. This is the first large study documenting the topography of CVR-related WM brain volume deficits. The significant association regarding poor response inhibition indicates that prefrontal WM deficits related to CVR are clinically meaningful, since inhibitory control is known to rely on prefrontal integrity.
  • article 17 Citação(ões) na Scopus
    Voxelwise evaluation of white matter volumes in first-episode psychosis
    (2012) COLOMBO, Renata Rodrigues da Cunha; SCHAUFELBERGER, Maristela Spanghero; SANTOS, Luciana Cristina; DURAN, Fabio Luis de Souza; MENEZES, Paulo Rossi; SCAZUFCA, Marcia; BUSATTO, Geraldo Filho; ZANETTI, Marcus Vinicius
    The occurrence of white matter (WM) abnormalities in psychotic disorders has been suggested by several studies investigating brain pathology and diffusion tensor measures, but evidence assessing regional WM morphometry is still scarce and conflicting. In the present study, 122 individuals with first-episode psychosis (FEP) (62 fulfilling criteria for schizophrenia/schizophreniform disorder, 26 psychotic bipolar I disorder, and 20 psychotic major depressive disorder) underwent magnetic resonance imaging, as well as 94 epidemiologically recruited controls. Images were processed with the Statistical Parametric Mapping (SPM2) package, and voxel-based morphometry was used to compare groups (t-test) and subgroups (ANOVA). Initially, no regional WM abnormalities were observed when both groups (overall FEP group versus controls) and subgroups (i.e., schizophrenia/schizophreniform, psychotic bipolar I disorder, psychotic depression, and controls) were compared. However, when the voxelwise analyses were repeated excluding subjects with comorbid substance abuse or dependence, the resulting statistical maps revealed a focal volumetric reduction in right frontal WM, corresponding to the right middle frontal gyral WM/third subcomponent of the superior longitudinal fasciculus, in subjects with schizophrenia/schizophreniform disorder (n = 40) relative to controls (n = 89). Our results suggest that schizophrenia/schizophreniform disorder is associated with right frontal WM volume decrease at an early course of the illness.
  • conferenceObject
    Structural Brain Changes in First-Episode Schizophrenia: A 4-5 Year Follow-Up Study Using MRI
    (2012) SCHALFELBERGER, Maristela S.; ROSA, Pedro G. P.; DURAN, Fabio L. S.; MENEZES, Paulo R.; SCAZUFCA, Marcia; MURRAY, Robin M.; BUSATTO, Geraldo F.
    Background: The presence of progressive structural brain changes over the first years of disease in first-episode schizophrenia (FES) patients is still controversial. The supposed progression of brain abnormalities in these patients may be associated with outcome and with antipsychotic exposure. Methods: Longitudinal population-based study performed in São Paulo - Brazil. Longitudinal analysis of GM matter volume using SPM was performed in 32 FES and 34 controls 4-5 years after baseline. Outcome measures were assessed by clinical course of symptoms (DSM-IV) and by global functioning (GAF scores). Results: FES did not differ from controls regarding GM changes over time, but those that remained psychotic and had lower global functioning over the follow-up period had GM concentration reduction in the left insula and in the left superior temporal gyrus in comparison to controls. Medication status had no effect on GM volumetric changes. Conclusions: Our findings suggest that a poor outcome, with chronic symptoms and a poor global functioning over 4-5 years after the first episode of psychosis is associated with brain abnormalities progression in brain regions which showed GM reduction at baseline (Schaufelberger et al, 2007). These results suggest that the progressive hypothesis in schizophrenia is probably not valid to all subjects that suffer from this illness.
  • article 32 Citação(ões) na Scopus
    Longitudinal follow-up of cavum septum pellucidum and adhesio interthalamica alterations in first-episode psychosis: a population-based MRI study
    (2012) TRZESNIAK, C.; SCHAUFELBERGER, M. S.; DURAN, F. L. S.; SANTOS, L. C.; ROSA, P. G. P.; MCGUIRE, P. K.; MURRAY, R. M.; SCAZUFCA, M.; MENEZES, P. R.; HALLAK, J. E. C.; CRIPPA, J. A. S.; BUSATTO, G. F.
    Background. Neurodevelopmental alterations have been described inconsistently in psychosis probably because of lack of standardization among studies. The aim of this study was to conduct the first longitudinal and population-based magnetic resonance imaging (MRI) evaluation of the presence and size of the cavum septum pellucidum (CSP) and adhesio interthalamica (AI) in a large sample of patients with first-episode psychosis (FEP). Method. FEP patients (n=122) were subdivided into schizophrenia (n=62), mood disorders (n=46) and other psychosis (n=14) groups and compared to 94 healthy next-door neighbour controls. After 13 months, 80 FEP patients and 52 controls underwent a second MRI examination. Results. We found significant reductions in the AI length in schizophrenia FEP in comparison with the mood disorders and control subgroups (longer length) at the baseline assessment, and no differences in any measure of the CSP. By contrast, there was a diagnosis x time interaction for the CSP length, with a more prominent increase for this measure in the psychosis group. There was an involution of the AI length over time for all groups but no diagnosis x time interaction. Conclusions. Our findings suggest that the CSP per se may not be linked to the neurobiology of emerging psychotic disorders, although it might be related to the progression of the disease. However, the fact that the AI length was shown to be shorter at the onset of the disorder supports the neurodevelopmental model of schizophrenia and indicates that an alteration in this grey matter junction may be a risk factor for developing psychosis.