PAULA VILLELA NUNES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- A review on shared clinical and molecular mechanisms between bipolar disorder and frontotemporal dementia(2019) NASCIMENTO, Camila; NUNES, Paula Villela; RODRIGUEZ, Roberta Diehl; TAKADA, Leonel; SUEMOTO, Claudia Kimie; GRINBERG, Lea Tenenholz; NITRINI, Ricardo; LAFER, BenyMental disorders are highly prevalent and important causes of medical burden worldwide. Co-occurrence of neurological and psychiatric symptoms are observed among mental disorders, representing a challenge for their differential diagnosis. Psychiatrists and neurologists have faced challenges in diagnosing old adults presenting behavioral changes. This is the case for early frontotemporal dementia (FTD) and bipolar disorder. In its initial stages, FTD is characterized by behavioral or language disturbances in the absence of cognitive symptoms. Consequently, patients with the behavioral subtype of FTD (bv-FTD) can be initially misdiagnosed as having a psychiatric disorder, typically major depression disorder (MDD) or bipolar disorder (BD). Bipolar disorder is associated with a higher risk of dementia in older adults and with cognitive impairment, with a subset of patients presents a neuroprogressive pattern during the disease course. No mendelian mutations were identified in BD, whereas three major genetic causes of FTD have been identified. Clinical similarities between BD and bv-FTD raise the question whether common molecular pathways might explain shared clinical symptoms. Here, we reviewed existing data on clinical and molecular similarities between BD and FTD to propose biological pathways that can be further investigated as common or specific markers of BD and FTD.
- Cognitive impairment and dementia in late-life bipolar disorder(2013) APRAHAMIAN, Ivan; NUNES, Paula V.; FORLENZA, Orestes V.Purpose of review This work aims to review the most recent publications on cognitive impairment and dementia associated with bipolar disorder (BPD), especially in the elderly. Recent findings In the last years, a growing number of studies aiming at better understanding of cognitive impairment in BPD were found. Impairments found in BPD were compared with other psychiatric disorders and primary cognitive diseases. The impact of cognitive impairment on functionality was also recently highlighted. With respect to neurobiology, studies that explored inflammatory, neurotrophic and pathological cascades possibly associated with BPD and cognition were published. Finally, the first study covering treatment of cognitive impairment was carried out with pramipexole, and it raised important methodological issues for future research in BPD. Summary Cognitive impairment and dementia in BPD should be better explored with cognitive and functionality protocols along with biological and neuroimaging markers.
- Functioning in older adults with bipolar disorder: A report on recommendations by the International Society of bipolar disorder (ISBD) older adults with bipolar disorder (OABD) task force(2023) MONTEJO, Laura; ORHAN, Melis; CHEN, Peijun; EYLER, Lisa T.; GILDENGERS, Ariel; MARTINEZ-ARAN, Anabel; NUNES, Paula Villela; OLAGUNJU, Andrew T.; PATRICK, Regan; VIETA, Eduard; DOLS, Annemiek; JIMENEZ, EstherObjectivesDespite the importance of psychosocial functioning impairment in Bipolar Disorder (BD), its role among Older Adults with BD (OABD) is not well known. The development of guidelines for the assessment of psychosocial functioning helps to facilitate a better understanding of OABD and can lead to better tailored interventions to improve the clinical outcomes of this population. MethodsThrough a series of virtual meetings, experts from eight countries in the International Society of Bipolar Disorder (ISBD) on OABD task force developed recommendations for the assessment of psychosocial functioning. ResultsWe present (1) a conceptualization of functioning in OABD and differences compared with younger patients; (2) factors related to functioning in OABD; (3) current measures of functioning in OABD and their strengths and limitations; and, (4) other potential sources of information to assess functioning. ConclusionsThe task force created recommendations for assessing functioning in OABD. Current instruments are limited, so measures specifically designed for OABD, such as the validated FAST-O scale, should be more widely adopted. Following the proposed recommendations for assessment can improve research and clinical care in OABD and potentially lead to better treatment outcomes.
- Problematic Social Media Use and Its Relationship with Depression or Anxiety: A Systematic Review(2022) LOPES, Lucas Silva; VALENTINI, Joao Pedro; MONTEIRO, Thomas Hagemann; COSTACURTA, Marcelo Cunha de Freitas; SOARES, Luiza Oliveira Nicastro; TELFAR-BARNARD, Lucy; NUNES, Paula VillelaThere has been a notable increase in social media and Internet use over recent decades, not only for social interaction or entertainment, but also for working and meeting tools, as seen during the COVID-19 pandemic. A relationship between this usage and the development of mental illness is frequently hypothesized, but a few studies have empirical findings. This study is a systematic review of the relationship between social media use and depression or anxiety. Our Medline search yielded 1,747 papers. Our study found a strong and often bidirectional relationship between social media use and depression or anxiety. This relationship was frequently related to problematic social media use. No definite linear relationship was found between time spent using social media and depressive or anxious symptoms, but usually, the longer the time spent in that activity, the worse the outcomes. Factors related to problematic social media use were often different for men and women. Other variables may also play a role, such as nighttime-specific use, emotional involvement, and whether the individual behaves as an active or passive user. Evidence from this review provides a solid base for recommending cautious use of social media. Intense use and unhealthy habits, evidenced by addiction symptoms, may be problematic in less resilient individuals.
- Neuropathological relationship between major depression and dementia: A hypothetical model and review(2016) KIM, Helena Kyunghee; NUNES, Paula Villela; OLIVEIRA, Katia C.; YOUNG, L. Trevor; LAFER, BenyMajor depression (MDD) is a chronic psychiatric condition in which patients often show increasing cognitive impairment with recurring episodes. Neurodegeneration may play an important component in the pathogenesis of MDD associated with cognitive complaints. In agreement with this, patients with MDD show decreased brain volumes in areas implicated in emotional regulation and cognition, neuronal and glial cell death as well as activation of various pathways that can contribute to cell death. Therefore, the aim of this review is to provide an integrative overview of potential contributing factors to neurodegeneration in MDD. Studies have reported increased neuronal and glial cell death in the frontal cortex, amygdala, and hippocampus of patients with MDD. This may be due to decreased neurogenesis from lower levels of brain-derived neurotrophic factor (BDNF), excitotoxicity from increased glutamate signaling, and lower levels of gamma-aminobutyric acid (GABA) signaling. In addition, mitochondrial dysfunction and oxidative stress are found in similar brain areas where evidence of excitotoxicity has been reported. Also, levels of antioxidant enzymes were reported to be increased in patients with MDD. Inflammation may also be a contributing factor, as levels of inflammatory cytokines were reported to be increased in the prefrontal cortex of patients with MDD. While preliminary, studies have also reported neuropathological alterations in patients with MDD. Together, these studies suggest that lower BDNF levels, mitochondrial dysfunction, oxidative stress, inflammation and excitotoxicity may be contributing to neuronal and glial cell death in MDD, leading to decreased brain volume and cognitive dysfunction with multiple recurrent episodes. This highlights the need to identify specific pathways involved in neurodegeneration in MDD, which may elucidate targets that can be treated to ameliorate the effects of disease progression in this disorder.