PAULA VILLELA NUNES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
3 resultados
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- Low brain-derived neurotrophic factor levels in post-mortem brains of older adults with depression and dementia in a large clinicopathological sample(2018) NUNES, Paula Villela; NASCIMENTO, Camila Fernandes; KIM, Helena Kyunghee; ANDREAZZA, Ana Cristina; BRENTANI, Helena Paula; SUEMOTO, Claudia Kimie; LEITE, Renata Elaine Paraizo; FERRETTI-REBUSTINI, Renata Eloah de Lucena; PASQUALUCCI, Carlos Augusto; NITRINI, Ricardo; GRINBERG, Lea Tenenholz; YONG, Lionel Trevor; JACOB-FILHO, Wilson; LAFER, BenyBackground: Disturbances in peripheral brain-derived neurotrophic factor (BDNF) have been reported in major depressive disorder (MDD). However, there are no studies measuring BDNF levels directly in post-mortem brains of older subjects with MDD and dementia. We aimed to verify if brain BDNF levels were lower in older adults with lifetime history of MDD with and without dementia. Methods: BDNF levels of post-mortem brains from 80 community-dwelling older individuals with lifetime MDD with and without dementia were compared with levels from 80 controls without lifetime MDD. Participants with no reliable close informant, or with prolonged agonal state were excluded. Lifetime MDD was defined as at least one previous episode according to the Structured Clinical Interview for DSM (SCID). Results: BDNF levels were lower in the MDD group with dementia than in participants with dementia and without MDD as confirmed by multivariate analysis adjusted for clinical and cardiovascular risk factors (beta = - 0.106, 95%CI = - 0.204; - 0.009, p = 0.034). No difference was found in the group with MDD without dementia compared with their controls. Limitations: The retrospective assessment of a lifetime history of depression may be subject to information bias and this study only establishes a cross-sectional association between lifetime history of MDD and lower levels of BDNF in patients with dementia. Conclusions: In this community sample of older individuals, lower brain BDNF levels were found in cases with both lifetime MDD and dementia. Low BDNF levels could be a moderator to accelerated brain aging observed in MDD with dementia.
- beta-amyloid pathology is not associated with depression in a large community sample autopsy study(2021) SALDANHA, Nanci Moreira; SUEMOTO, Claudia Kimie; RODRIGUEZ, Roberta Diehl; LEITE, Renata Elaine Paraizo; NASCIMENTO, Camila; FERRETI-REBUSTINI, Renata; SILVA, Magnolia Moreira da; PASQUALUCCI, Carlos Augusto; NITRINI, Ricardo; JACOB-FILHO, Wilson; LAFER, Beny; GRINBERG, Lea T.; NUNES, Paula VillelaBackground: : Depression has been associated with dementia. This study aimed to verify if 13-amyloid Alzheimer's disease-type burden was associated with lifetime major depressive disorder (MDD) and with current depressive symptoms in a large population-based autopsy study. Methods: : We included 1013 deceased subjects submitted to autopsy (mean age=74.3 +/- 11.6 years, 49% men) in a community sample. 13-amyloid burden was measured in all cases based on the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) criteria for presence and density of neuritic plaques. Lifetime MDD was defined when at least one previous episode according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - DSM (SCID). Depressive symptoms and cognitive impairment were determined using the depression item of the Neuropsychiatric Inventory (D-NPI>0) and the Clinical Dementia Rating scale (CDR>0.5) respectively. Results: : Lifetime MDD, late life depression (LLD) and current depressive symptoms were associated with cognitive impairment (p<0.001). Additionally, neuritic plaques were associated with cognitive impairment (p<0.001). Moderate or frequent neurite plaque density was not associated with MDD, LLD or current depressive symptoms in multiple logistic models adjusted for age, gender, and cognitive impairment. Limitations:: In this cross-sectional study, all neuropsychiatric and cognitive assessment were based on informant-report of deceased participants. Conclusions: : Different clinical depictions of depression were associated with dementia in this large community sample of elderly individuals with multiethnic backgrounds. Notwithstanding, they were unrelated to 13-amyloid pathology in the brain areas studied. The link between depression and dementia might be complex and determined by multiple factors.
- Cognitive-linguistic deficits in euthymic elderly patients with bipolar disorder(2013) RADANOVIC, Marcia; NUNES, Paula Villela; FORLENZA, Orestes Vicente; LADEIRA, Rodolfo Braga; GATTAZ, Wagner FaridBackground: There is increasing evidence that bipolar disorder is also associated with neuropsychological impairments persisting during euthymia, thus representing a trait-like feature of the disease. Language and speech abnormalities are also present in bipolar disorder, especially in verbal fluency and verbal memory. However, there is a lack of studies in the literature investigating different levels of linguistic processing (phonological, syntactical, and semantic) in a single cohort of euthymic bipolar patients. Based on previous Findings of pervasive language impairment in euthymic elderly bipolar patients, the aim of this study was to comprise a more thorough investigation on the subject. Methods: We studied 19 euthymic bipolar patients aged 60 and above, and 20 cognitively healthy subjects using the Arizona Battery for Communication Disorders of Dementia (ABCD) and the Test for Reception of Grammar Version 2 (TROG-2) in order to assess the phonological, syntactic, and semantic domains of language. Results: Bipolar patients performed poorer than controls in Linguistic Expression (p=0.011), in Linguistic Comprehension (Following Commands; p=0.025 and Reading Comprehension of Sentences; p=0.007), and in the TROG-2 (p=0.006). Limitations: The small sample comprising only elderly patients; the lack of statistical power to analyze the potential effect of individual medications on the cognitive performance. Conclusions: Our data demonstrate that linguistic impairment is present in euthymic bipolar patients, affecting mostly syntactic and lexical semantic abilities, both in comprehension and production of language. These deficits are interrelated with other cognitive skills also known to be affected in bipolar disorder, such as executive functions and episodic memory.