DANIEL CIAMPI ARAUJO DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
16 resultados
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- Electrical stimulation of the posterior insular cortex induces opioid and cannabinoid-dependent antinociception and regulates glial cells in the spinal cord(2022) GONÇALVES, Elizamara Santos; MATIELO, Heloísa Alonso; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de; HAMANI, Clement; DALE, Camila SquarzoniABSTRACT BACKGROUND AND OBJECTIVES: Half of neuropathic pain patients still end up failing clinical treatments. Electrical stimulation of the posterior insular cortex (ESI) modulates sensory and nociceptive circuits. This study evaluated the effects of a range of frequencies of ESI proposed to improve neuropathic pain. METHODS: Male Sprague Dawley rats, 280-340 g, submitted to the chronic constriction of the right sciatic nerve were tested for mechanical sensitivity using the paw pressure and von Frey flaments tests, and for thermal sensitivity using the hot plate test. The rats were submitted to ESI 10, 60 or 100 Hz (one, five or seven ESI, 15 min, 210 µs, 1V), applied to the posterior insular cortex, and were evaluated in the tests before and after ESI, or in follow-up of 48, 72 and 168h. The open field evaluated general activity after ESI 5. The involvment of opioid and cannabinoid testes were evaluated through treatment with naloxone and SR1416A - antagonist and inverse agonist/antagonist of the receptors, respectively, after ESI 5, while activation of astrocytes, marked by glial fibrillary acid protein (GFAP), and of microglia, marked by IBA-1 (glial marker), in the spinal cord evaluated by immunohistochemistry. RESULTS: Data demonstrate that 10, 60, and 100 Hz ESIs modulate mechanical and thermal sensitivity. ESI 5 increased immunoreactivity of GFAP in the spinal cord, without altering IBA-1 (glial marker). Naloxone and SR141716A reversed the antinociception of 60 Hz ESI 5. 60 Hz ESI 7 induced antinociception up to 72h. CONCLUSION: 60 Hz ESI induces opioid and cannabinoid-dependent antinociception and regulates glia. HIGHLIGHTS 60 Hz-delivered ESI was the best analgesic protocol for the insular stimulation. Data showed a prolonged analgesic effect up to 72h after repetitive ESI. ESI regulates glia activation in pain modulatory system.
- Non-invasive insular stimulation for peripheral neuropathic pain: Influence of target or symptom?(2022) CUNHA, Pedro Henrique Martins da; Liu Dongyang; FERNANDES, Ana Mercia; THIBES, Raissa Benocci; SATO, Joao; TANAKA, Harki; DALE, Camila; LAPA, Jorge Dornellys da Silva; MORAIS, Adriano Donizeth Silva de; SOARES, Felipe Henriques Carvalho; SILVA, Valquiria Aparecida da; GRAVEN-NIELSEN, Thomas; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deObjectives: The posterior-superior insula (PSI) has been shown to be a safe and potentially effective target for neuromodulation in peripheral neuropathic pain (PNP) in humans and animal models. However, it remains unknown whether there is a measurable responder profile to PSI stimulation. Two factors were hypothesized to influence the response of repetitive transcranial magnetic stimulation (rTMS) of the PSI: differences in rTMS target (discrete subregions of the PSI) or PNP phenotype. Methods: This is a secondary analysis from a randomized, double-blind, sham-controlled, crossover trial assessing PSI-rTMS in PNP (N = 31, 5 days rTMS) (10.1016/j.neucli.2021.06.003). Active PSI-rTMS true responders (>50% pain reduction from baseline after active but not after sham series of treatment) were compared with not true responders, to determine whether they differed with respect to 1) rTMS neuro-navigational target coordinates, and/or 2) specific neuropathic pain symptom inventory (NPSI) clusters (pinpointed pain, evoked pain, and deep pain) at baseline. Results: Mean rTMS target coordinates did not differ between true (n = 45.1%) and not true responders (p = 0.436 for X, p = 0.120 for Y, and p = 0.116 for Z). The Euclidian distance between true and not true responders was 4.04 mm. When comparing differences in responders between NPSI clusters, no participant within the evoked pain cluster was a true responder (p = 0.024). Conclusion: Response to PSI-rTMS may depend on pain cluster subtype rather than on differences in targeting within the PSI.
- The fast-posterior superior insula (Fast-PSI): A neuronavigation-free targeting method for non-invasive neuromodulation(2022) CUNHA, Pedro Henrique Martins da; TANAKA, Harki; LAPA, Jorge Dornellys da Silva; Liu Dongyang; SORTE JUNIOR, Anselmo Alves Boa; PEREIRA, Tamara Maria Ribeiro; SOARES, Felipe Henriques Carvalho; FERNANDES, Ana Mercia; SILVA, Valquiria Aparecida da; GRAVEN-NIELSEN, Thomas; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de
- Assessing the burden of osteoarthritis in Latin America: a rapid evidence assessment(2022) ANDRADE, Daniel Ciampi de; SAAIBI, Diego; SARRIA, Nicolas; VAINSTEIN, Nora; RUIZ, Leslie Cano; ESPINOSA, RolandoThis rapid evidence assessment (REA) was conducted to explore the burden of weight-bearing joint osteoarthritis in the developing countries of Latin America. REA methodology used a standardized search strategy to identify observational studies published from 2010 to 23 April 2020 that reported outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from each included study were used to populate bespoke data extraction tables and qualitatively analyzed. Thirteen publications were identified that reported on knee and hip osteoarthritis in the Latin American region. Overall prevalence of physician-diagnosed symptomatic knee osteoarthritis in adults ranged from 1.55% in Peru to 7.4% in Ecuador. Total prevalence of grade >= 2 radiographic knee osteoarthritis was 22% among those >= 39 years of age in Brazil and 25.5% among those >= 40 years of age in Mexico. The prevalence of symptomatic/ radiographic knee osteoarthritis was 7.1% in people >= 18 years of age in Mexico and 17.6% among those >= 40 years of age. Prevalence of hip osteoarthritis was similar to or slightly lower than knee osteoarthritis. The limited data available indicates weight-bearing osteoarthritis negatively affects quality of life and that the economic burden may vary between countries with different healthcare systems. The limited evidence found in the published literature suggests the burden of osteoarthritis in Latin America is substantial. Our analysis identified several evidence gaps, particularly for health-related quality of life and socioeconomic outcomes. Further research is of particular importance in areas where government-subsidized healthcare and resources are scarce.
- CoaguChek (R) XS versus standard laboratory prothrombin time for anticoagulant monitoring in patients with antiphospholipid syndrome(2022) FONSECA, Maria Ester S.; BALBI, Gustavo G. M.; SIGNORELLI, Flavio; GOUVEA, Christiane P.; ANDRADE, Danieli C. O. deIntroduction: The standard of care for thrombotic antiphospholipid syndrome (APS) is anticoagulation with vitamin K antagonists (VKAs). Prothrombin time, and its corresponding international normalized ratio (INR), is the laboratory test routinely performed to assess anticoagulation. Self-management of VKA therapy using point-of-care (POC) devices seems to be an attractive option. Purpose/objective: To evaluate the accuracy of a POC device (CoaguChek XS) in APS patients by comparing it with venous laboratory INR. Furthermore, we analyzed whether other clinical and laboratory features could interfere with the CoaguChek XS results. Patients and methods: This is a single-center cross-sectional study with 94 APS patients from a tertiary rheumatology clinic performed from August 2014 to March 2015. The comparison between CoaguChek XS and venous laboratory INR results was evaluated using the coefficient of determination (r) followed by the Bland-Altman test. A paired t-test was also applied. A difference of up to +/- 0.5 INR unit between the two systems was considered clinically acceptable. Results: The mean CoaguChek-INR was 2.94 +/- 1.41 and venous laboratory INR was 2.43 +/- 0.86, with a correlation coefficient (r) of 0.95. Categorizing I NR values in ranges (INR <2, INR 2-3, I NR 3-4, and I NR >4), we found that the INR >4 group presented a lower correlation (r = 0.64) compared to the other ranges (p < 0.05). Although both methods were highly correlated, CoaguChek XS showed higher values than the venous laboratory INR, with an increased average of 0.42 +/- 0.54. Therefore, we proposed a simple linear regression model to predict the venous laboratory INR values, using results obtained from CoaguChek XS. A difference <= 0.5 INR unit between the two systems was observed in 57.4% of patients, and the aPL profile did not influence the results. Conclusion: Although CoaguChek XS and venous laboratory INR demonstrated a good linear correlation in the group of INR <= 4, extra caution should be taken in APS patients, since a reasonable proportion of patients can present differences in INR results that are not acceptable. We do not recommend routine POC in APS patients.
- The new Parkinson's disease pain classification system (PD-PCS)(2022) MYLIUS, V; LLORET, S. Perez; BROOK, C. S.; KRUEGER, M. T.; HAEGELE-LINK, S.; GONZENBACH, R.; KASSUBEK, J.; BOHLHALTER, S.; LEFAUCHEUR, J. P.; TIMMERMANN, L.; KAEGI, G.; BRUGGER, F.; ANDRADE, D. Ciampi de; MOELLER, J. C.Background Chronic pain is a common non-motor symptom in patients with Parkinson's disease (PD). Aim To facilitate the diagnosis of pain in PD, we developed a new classification system the Parkinson's disease pain classification system (PD-PCS) and translated the corresponding validated questionnaire into German. Methods A causal relationship of the respective pain syndrome with PD can be determined by four questions before assigning it hierarchically into one of three pain categories (neuropathic, nociceptive and nociplastic). Results In the initial validation study 77% of the patients (122/159) had PD-associated pain comprising 87 (55%) with nociceptive, 36 (22%) with nociplastic and 24 (16%) with neuropathic pain. The study revealed a high validity of the questionnaire and a moderate intrarater and interrater reliability. The questionnaire has been adapted into German and employed in 30 patients. Discussion The PD-PCS questionnaire is a valid and reliable tool to determine the relationship of a pain syndrome with PD before classifying it according to the underlying category, facilitating further diagnostics and treatment.
- Facial expressions of acute pain in 23-week fetus(2022) BERNARDES, L. S.; ROSA, A. S.; CARVALHO, M. A.; OTTOLIA, J.; RUBLOSKI, J. M.; CASTRO, D.; VELLOSO, A.; SILVA, V. A. da; ANDRADE, D. C. de
- Cognitive decline over time in patients with chronic pain and headache: how can different outcomes be explained? Reply(2022) ANDRADE, Daniel Ciampi de; SARAIVA, Marcos Daniel Cabral
- On the diagnosis of pain in Parkinson disease: a mechanism-based approach(2022) MYLIUS, Veit; LLORET, Santiago Perez; ANDRADE, Daniel Ciampi de
- Dissecting neuropathic from poststroke pain: the white matter within(2022) LEMOS, Marcelo Delboni; FAILLENOT, Isabelle; LUCATO, Leandro Tavares; TEIXEIRA, Manoel Jacobsen; BARBOSA, Luciana Mendonca; ALHO, Eduardo Joaquim Lopes; CONFORTO, Adriana Bastos; RODRIGUES, Antonia Lilian de Lima; GALHARDONI, Ricardo; SILVA, Valquiria Aparecida da; LISTIK, Clarice; ROSI, Jefferson; PEYRON, Roland; GARCIA-LARREA, Luis; ANDRADE, Daniel Ciampi dePoststroke pain (PSP) is a heterogeneous term encompassing both central neuropathic (ie, central poststroke pain [CPSP]) and nonneuropathic poststroke pain (CNNP) syndromes. Central poststroke pain is classically related to damage in the lateral brainstem, posterior thalamus, and parietoinsular areas, whereas the role of white matter connecting these structures is frequently ignored. In addition, the relationship between stroke topography and CNNP is not completely understood. In this study, we address these issues comparing stroke location in a CPSP group of 35 patients with 2 control groups: 27 patients with CNNP and 27 patients with stroke without pain. Brain MRI images were analyzed by 2 complementary approaches: an exploratory analysis using voxel-wise lesion symptom mapping, to detect significant voxels damaged in CPSP across the whole brain, and a hypothesis-driven, region of interest-based analysis, to replicate previously reported sites involved in CPSP. Odds ratio maps were also calculated to demonstrate the risk for CPSP in each damaged voxel. Our exploratory analysis showed that, besides known thalamic and parietoinsular areas, significant voxels carrying a high risk for CPSP were located in the white matter encompassing thalamoinsular connections (one-tailed threshold Z > 3.96, corrected P value <0.05, odds ratio = 39.7). These results show that the interruption of thalamocortical white matter connections is an important component of CPSP, which is in contrast with findings from nonneuropathic PSP and from strokes without pain. These data can aid in the selection of patients at risk to develop CPSP who could be candidates to pre-emptive or therapeutic interventions.