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Cannabis products: medical use
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Fernandes, César Eduardo

; Dolci, José Eduardo Lutaif

; Navarro, Leonardo Sobral

; Allevato, Marcelo

; Constantino, Clóvis Francisco

; Pereira, Rodrigo Pastor Alves

; Rieder, Carlos Roberto de Mello

; Torino, Flávia

; Bernardo, Wanderley Marques

Revista da Associação Médica Brasileira

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mar 2023, Volume 69 N. 3 Pages 358 - 364

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.2023d693

Evaluation of the complete Sniffin Sticks Test versus its subtests in differentiating Parkinson’s disease patients from healthy controls
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Trentin, Sheila

; Oliveira, Bruno Samuel Fraiman de

; Borges, Yuri Ferreira Felloni

; Rieder, Carlos Roberto de Mello

Arquivos de Neuro-Psiquiatria

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sep 2022, Volume 80 N. 9 Pages 908 - 913

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background Hyposmia is one of the most common, as well as the first nonmotor condition in Parkinson disease (PD). The sniffin sticks test (SST) evaluates three different aspects of olfactory function: threshold (T), discrimination (D), and identification (I). The sum of the scores of these three subtests produce a global score of olfaction, the Threshold-Discrimination-Identification (TDI) score. Objective The aim of this study was to investigate if the TDI score or one of its subtests is better to discriminate PD patients from controls. Methods We recruited 27 PD patients and 17 healthy age-matched controls (HC) who were evaluated through a clinical interview, the Montreal Cognitive Assessment and Movement Disorders Society – Unified Parkinson Disease Rating Scale. The olfaction was assessed using the complete SST. Results The performance of PD patients on the olfactory test was significantly worse when compared with the HC (T: 3.0 vs. 6.5, p < 0.001; D: 8.1 vs. 11.2, p <0.001; I: 7.3 vs. 11.7, p < 0.001; TDI: 18.8 vs. 29.9, p < 0.001). The prevalence of olfaction impairment in our study (PD: 100%, and HC: 56%) was greater than that found in the literature. Cognition influenced the performance on TDI. The olfactory subtests were impaired proportionally between patients and controls. Furthermore, D and I were correlated, but only in PD patients. The TDI showed a tendency to better discriminate PD patients from HC, when compared with its subtests. Conclusions Although the complete olfactory evaluation is time consuming, it seems to be a superior tool to identify olfaction impairment in PD patients, when compared with the isolated subtests.

Resumo Antecendentes Hiposmia é um dos sintomas mais comuns da doença de Parkinson (DP), além de ser um de seus primeiros sintomas não-motores. O Sniffin Sticks Test avalia três diferentes aspectos da função olfatória: limiar (L), discriminação (D) e identificação (I). A soma dos escores desses três subtestes produz um escore global do olfato, o Threshold-Discrimination-Identification (TDI). Objetivo O objetivo deste estudo foi investigar se oTDI ou um de seus subtestes seria melhor em discriminar pacientes com DP de controles saudáveis. Métodos Foram recrutados 27 pacientes com DP e 17 controles saudáveis de mesma faixa etária, que foram avaliados através de uma entrevista clínica, a Montreal Cognitive Assessment e Movement Disorders Society – Unified Parkinson Disease Rating Scale. O olfato foi examinado através da bateria completa do Sniffin Sticks Test (SST). Resultados Os pacientes com DP tiveram pior performance no teste olfatório quando comparados com os controles (L: 3,0 vs. 6,5; p < 0,001; D: 8,1 vs. 11,2; p <0,001; I: 7,3 vs. 11,7; p <0,001; TDI: 18,8 vs. 29,9; p < 0,001). A prevalência de comprometimento olfatório no nosso estudo (DP: 100%, e controles: 56%) foi maior do que a reportada na literatura. A cognição influenciou a performance no TDI. Os subtestes olfatórios foram afetados proporcionalmente entre pacientes e controles. Além disso, D e I se correlacionaram, mas apenas em pacientes de DP. O TDI mostrou uma tendência em melhor discriminar pacientes de DP dos controles, quando comparado com os seus subtestes. Conclusões Embora a avaliação olfatória completa consuma tempo, ela parece ser superior aos subtestes isolados para identificar comprometimento olfatório em pacientes com DP.

https://doi.org/10.1055/s-0042-1755268

Characterization of the nigroestriatal system in a sample of patients with amyotrophic lateral sclerosis
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Monsalve, Claudio Alejandro Jimenez

; Fornari, Luis Henrique Tieppo

; Silva Júnior, Neivo da

; Nakata, Douglas Tomio

; Carvalho Neto, Eurípedes Gomes de

; Rotta, Francisco Tellechea

; Rieder, Carlos Roberto de Mello

Arquivos de Neuro-Psiquiatria

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aug 2022, Volume 80 N. 8 Pages 806 - 811

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background The coexistence of amyotrophic lateral sclerosis (ALS) with clinical forms of Parkinson disease (PD), although uncommon, is found to a greater degree than one would expect by chance. The pathological mechanisms of ALS and PD are still not fully understood, and the coexistence of these two diseases suggests that they could share mechanisms in common. Objective Here we present a sample of patients with clinically definitive or probable ALS who were evaluated with single-photon emission computed tomography SPECT/TRODAT and compared with non-ALS controls. Methods Patients with clinically definite or probable ALS were assessed with the amyotrophic lateral sclerosis functional rating scale (ALSFRS) to define severity and had their demographic data collected. The TRODAT results of patients with ALS were compared with those of patients with a diagnosis of PD with less than 10 years of duration, and with patients with a diagnosis of others movement disorders not associated with neurodegenerative diseases. Results A total of 75% of patients with ALS had TRODAT results below the levels considered normal; that was also true for 25% of the patients in the control group without neurodegenerative disease, and for 100% of the patients in the PD group. A statistically significant difference was found between patients with ALS and the control group without neurodegenerative disease in the TRODAT values < 0.05. Conclusions Our study fits with the neuropathological and functional evidence that demonstrates the existence of nigrostriatal dysfunction in patients with ALS. Further research to better understand the role of these changes in the pathophysiological process of ALS needs to be performed.

Resumo Antecedentes A coexistência da esclerose lateral amiotrófica (ELA) com formas clínicas da doença de Parkinson (DP), embora incomum, é encontrada em um grau maior do que seria esperado ao acaso. Os mecanismos patológicos da ELA e da DP ainda não são totalmente compreendidos e a coexistência dessas duas doenças sugere que elas podem compartilhar mecanismos em comum. Objetivo Apresentamos uma amostra de pacientes com ELA clinicamente definida ou provável que foram avaliados com tomografia computadorizada por emissão de fóton único (SPECT)/TRODAT e comparados com controles sem ELA. Métodos Pacientes com ELA clinicamente definida ou provável foram avaliados com a escala funcional de esclerose lateral amiotrófica (ALSFRS) para definir a gravidade e foram coletados os seus dados demográficos. Os resultados do TRODAT de pacientes com ELA foram comparados com aqueles de pacientes com diagnóstico de DP com menos de 10 anos de duração e com pacientes com diagnóstico de outros distúrbios do movimento não associados a doenças neurodegenerativas. Resultados Um total de 75% dos pacientes com ELA apresentou resultados de TRODAT abaixo dos níveis considerados normais; 25% no grupo controle sem doença neurodegenerativa e 100% no grupo DP. Uma diferença estatisticamente significativa foi encontrada entre os pacientes com ELA e o grupo controle sem doença neurodegenerativa nos valores de TRODAT p< 0,05. Conclusões Nosso estudo está de acordo com as evidências neuropatológicas e funcionais que demonstram a existência de disfunção nigroestriatal em pacientes com ELA. Mais pesquisas para entender melhor o papel dessas mudanças no processo fisiopatológico da ELA precisam ser realizadas.

https://doi.org/10.1055/s-0042-1755282

Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms
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Saba, Roberta Arb

; Maia, Débora Palma

; Cardoso, Francisco Eduardo Costa

; Borges, Vanderci

; F. Andrade, Luiz Augusto

; Ferraz, Henrique Ballalai

; Barbosa, Egberto Reis

; Rieder, Carlos Roberto de Mello

; da Silva, Delson José

; Chien, Hsin Fen

; Capato, Tamine

; Rosso, Ana Lúcia

; Souza Lima, Carlos Frederico

; Bezerra, José Marcelo Ferreia

; Nicaretta, Denise

; Povoas Barsottini, Orlando Graziani

; Godeiro-Júnior, Clécio

; Broseghini Barcelos, Lorena

; Cury, Rubens Gisbert

; Spitz, Mariana

; Azevedo Silva, Sônia Maria César

; Della Colletta, Marcus Vinicius

Arquivos de Neuro-Psiquiatria

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mar 2022, Volume 80 N. 3 Pages 316 - 329

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT The treatment of Parkinson's disease (PD) is challenging, especially since it is considered highly individualized. The Brazilian Academy of Neurology has recognized the need to disseminate knowledge about the management of PD treatment, adapting the best evidence to the Brazilian reality. Thus, the main published treatment guidelines were reviewed based on the recommendations of group from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology.

Resumo O tratamento da doença de Parkinson (DP) constitui um desafio, especialmente por ser considerado muito individualizado. A Academia Brasileira de Neurologia (ABN) identificou a necessidade de disseminar o conhecimento sobre o manejo do tratamento da DP, adaptando as melhores evidências à realidade brasileira. Assim, foi realizada uma revisão sobre as principais orientações de tratamento publicadas, baseada nas recomendações elaboradas por um grupo de especialistas em transtornos do movimento do departamento científico da ABN.

https://doi.org/10.1590/0004-282x-anp-2021-0219

Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms
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Saba, Roberta Arb

; Maia, Débora Palma

; Cardoso, Francisco Eduardo Costa

; Borges, Vanderci

; F. Andrade, Luiz Augusto

; Ferraz, Henrique Ballalai

; Barbosa, Egberto Reis

; Rieder, Carlos Roberto de Mello

; da Silva, Delson José

; Chien, Hsin Fen

; Capato, Tamine

; Rosso, Ana Lúcia

; Souza Lima, Carlos Frederico

; Bezerra, José Marcelo Ferreia

; Nicaretta, Denise

; Povoas Barsottini, Orlando Graziani

; Godeiro-Júnior, Clécio

; Broseghini Barcelos, Lorena

; Gisbert Cury, Rubens

; Spitz, Mariana

; Azevedo Silva, Sônia Maria César

; Della Colletta, Marcus Vinicius

Arquivos de Neuro-Psiquiatria

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2022, N. ahead

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/0004-282x-anp-2021-0219

Deglutition Impairment during Dual Task in Parkinson Disease Is Associated with Cognitive Status
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Ardenghi, Luciana Grolli

; Signorini, Alana Verza

; Maahs, Gerson Schulz

; Selaimen, Fabio

; Deutsch, Konrado Massing

; Dornelles, Silvia

; Rieder, Carlos Roberto de Mello

International Archives of Otorhinolaryngology

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jan 2021, Volume 25 N. 1 Pages 41 - 47

Abstract: En | Text: En | PDF: En

Abstract Introduction Dysphagia is a relevant symptom in Parkinson disease (PD), and its pathophysiology is poorly understood. To date, researchers have not investigated the effects of combined motor tasks on swallowing. Such an assessment is of particular interest in PD, in which patients have specific difficulties while performing two movements simultaneously. Objective The present study tested the hypothesis that performing concurrent tasks could decrease the safety of swallowing in PD patients as visualized using fiberoptic endoscopic evaluation of swallowing (FEES). Methods A total of 19 patients and 19 controls matched by age, gender, and level of schooling were compared by FEES under two conditions: isolated swallowing and dual task (swallowing during non-sequential opposition of the thumb against the other fingers). The two tasks involved volumes of food of 3 mL and 5 mL. The PD subjects were classified according to the Hoehn & Yahr (H&Y) Scale, the Mini Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). The FEES assessment was performed according to the Boston Residue and Clearance Scale (BRACS). Results The data showed a significant worsening of swallowing in the dual task assessment for both volumes (3 mL: p ≤ 0.001; 5 mL: p ≤ 0.001) in the PD group. A correlation between the MoCA and dual-task swallowing of 3 mL was also found. Conclusion These findings suggest that additional tasks involving manual motor movements result in swallowing impairment in patients with PD. Moreover, these data highlight the need to further evaluate such conditions during treatment and assessment of PD patients.

https://doi.org/10.1055/s-0039-3402440

Acoustic Voice Modifications in Individuals with Parkinson Disease Submitted to Deep Brain Stimulation
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Romann, Aline Juliane

; Beber, Bárbara Costa

; Cielo, Carla Aparecida

; Rieder, Carlos Roberto de Mello

International Archives of Otorhinolaryngology

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jun 2019, Volume 23 N. 2 Pages 203 - 208

Abstract: En | Text: En | PDF: En

Abstract Introduction Subthalamic nucleus deep brain stimulation (STN-DBS) improvesmotor function in individuals with Parkinson disease (PD). The evidence about the effects of STN-DBS on the voice is still inconclusive. Objective To verify the effect of STN-DBS on the voice of Brazilian individuals with PD. Methods Sixteen participants were evaluated on the Unified Parkinson Disease Rating Scale-Part III, and by the measurement of the acoustic modifications in on and off conditions of stimulation. Results The motor symptoms showed significant improvement with STN-DBS on. Regarding the acoustic measures of the voice, only the maximum fundamental frequency (fhi) showed a statistical difference between on- and off-conditions, with reduction in off-condition. Conclusion Changes in computerized acoustic measures are more valuable when interpreted in conjunction with changes in other measures. The single finding in fhi suggests that DBS-STN increases vocal instability. The interpretation of this result should be done carefully, since it may not be of great value if other measures that also indicate instability are not significantly different.

https://doi.org/10.1055/s-0038-1675392

Validação de conteúdo e confiabilidade do Protocolo de Avaliação dos Distúrbios Adquiridos de Fala em Indivíduos com Doença de Parkinson (PADAF)
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Presotto, Monia

; Rieder, Carlos Roberto de Mello

; Olchik, Maira Rozenfeld

CoDAS

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2019, Volume 31 N. 5 elocation e20180230

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose To develop a protocol for the evaluation of acquired speech disorders in individuals with Parkinson's disease (PADAF) and to validate its content and determine its inter-judge reliability. Methods The study was carried out in three stages: in the first one, the protocol was prepared and its content validated through the analysis of seven specialists; in the second, the instrument was applied to 25 individuals with idiopathic Parkinson's disease (PD); in the third and last stage, the inter-judge reliability was determined. Results The final version of PADAF consisted of 32 items that evaluated breathing, phonation, resonance, articulation, and prosody. It was shown to be valid, with a content validity index (CVI) much higher than that established in the literature, and with perfect agreement in the determination of inter-judge reliability. Conclusion PADAF for PD individuals was developed and its content was validated, showing perfect instrument reliability.

RESUMO Objetivo Elaborar e realizar a validação de conteúdo, assim como verificar a confiabilidade entre examinador do Protocolo de Avaliação dos Distúrbios Adquiridos de Fala em Indivíduos com Doença de Parkinson (PADAF). Método O estudo foi realizado em três etapas. Na primeira, foi elaborado o protocolo e validado seu conteúdo mediante análise de sete especialistas. Na segunda, aplicou-se o instrumento em 25 indivíduos com doença de Parkinson (DP) idiopática. Na terceira e última etapa, verificou-se a confiabilidade entre-examinador. Resultados A versão final do PADAF foi composta de 32 itens que avaliam a respiração, a fonação, a ressonância, a articulação e a prosódia. Mostrou-se válido, com índice de validade de conteúdo (IVC) bem acima daquele estabelecido na literatura e com perfeita concordância na verificação da confiabilidade entre examinador. Conclusão O PADAF para indivíduos com DP foi desenvolvido e teve seu conteúdo validado com perfeita confiabilidade do instrumento.

https://doi.org/10.1590/2317-1782/20192018230

The Impact of Deep Brain Stimulation on the Quality of Life and Swallowing in Individuals with Parkinson’s Disease
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Olchik, Maira Rozenfel

; Ghisi, Marciéle

; Ayres, Annelise

; Schuh, Arthur Francisco Shumacher

; Oppitz, Paulo Petry

; Rieder, Carlos Roberto de Mello

International Archives of Otorhinolaryngology

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jun 2018, Volume 22 N. 2 Pages 125 - 129

Abstract: En | Text: En | PDF: En

Abstract Introduction Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD). However, there is little evidence regarding the effect of DBS on dysphagia. Objective To assess the swallowing and quality of life of individuals with PD before and after DBS surgery. Methods Our sample consisted of people who had undergone DBS surgery in a referral hospital in the state of Rio Grande do Sul, Brazil. The inclusion criteria were a diagnosis of PD and having undergone DBS surgery. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Evaluations of each patient’s swallowing were performed before and after surgery. The assessment consisted of anamnesis, clinical assessment, the Functional Oral Intake Scale, clinical evaluation of swallowing, and the Hoehn and Yahr scale. Results The sample included 10 individuals, all male, with a mean age of 57.3 years (±4.7), a mean disease duration of 13.0 years (±2.4), and mean level education of 8.1 years (±4.0). In the clinical evaluation of the swallowing, a significant improvement after DBS was not observed. However, little changes in the signs and symptoms of dysphagia that had a positive impact on the quality of life were observed. Furthermore, there was no relation between the patients’ motor subtype and swallowing pre- and post-DBS. Conclusion There was an improvement in the quality of life of the patients after DBS. However, the improvement in the clinical signs and symptoms of dysphagia did not cause an overall improvement in the swallowing function.

https://doi.org/10.1055/s-0037-1603466

10.

Brazilian Academy of Neurology (2006 – 2016)
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Coelho, Fernando Morgadinho

; Castro, Luiz Henrique de

; Fukujima, Marcia Maiumi

; Adoni, Tarso

; Rieder, Carlos Roberto de Mello

; Bichuetti, Denis Bernardi

; Prado, Gilmar Fernandes do

; Gagliardi, Rubens Jose

Arquivos de Neuro-Psiquiatria

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sep 2017, Volume 75 N. 9 Pages 635 - 638

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Brazil is a heterogeneous country with continental dimensions. The different characteristics of cultural, socioeconomic, and demographic status of the population drive different strategies for neurological care. This knowledge helps the understanding of the current scenario with the consequent possibility of preparing for future challenges. We used data from annual internal forms of the Brazilian Academy of Neurology (BAN) since 2006 and the survey for all BAN members (3,240) in 2016. The geographic distribution of BAN members in Brazil follows the demographic concentration of the population. Participation of members from big cities was the most prevalent, 18.7% of participants were young neurologists, and 36.7% of neurologists had more than of 20 years of neurological practice. The improvement of knowledge of neurological practice in Brazil will be useful for BAN leadership in planning future actions. The BAN must make an effort to aggregate a greater number of neurologists, offering updating support contributing to health policies to disseminate neurological care in Brazil.

RESUMO O Brasil é um país heterogêneo com dimensões continentais. As diferentes características culturais, do padrão socioeconômico e demográfico da população direcionam diferentes estratégias de atenção neurológica. Este conhecimento ajuda a entender o cenário atual para consequente preparação para os desafios futuros. Utilizamos informações dos relatórios anuais de Academia Brasileira de Neurologia (ABN) desde 2006, além de dados de uma pesquisa para os membros da ABNr ealizada em 2016. A distribuição geográfica dos membros da ABN no Brasil segue a concentração demográfica da população. A participação na pesquisa dos membros das grandes cidades foi a mais prevalente. 18,7% eram neurologistas jovens e 36,7% tinham mais de 20 anos de prática neurológica. O aperfeiçoamento do conhecimento da prática neurológica no Brasil será útil para a liderança da ABN planejar ações futuras. A ABN deve se esforçar para agregar um maior número de neurologistas, oferecendo constante atualização e apoio profissional contribuindo para políticas de saúde para disseminar o conceito de doenças neurológicas no Brasil.

https://doi.org/10.1590/0004-282x20170095

11.

Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire – Current Short (QUIP-CS) – Translation and validation of content of Portuguese Version
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Krieger, Débora Mascella

; Cardoso, Sabrina Vilanova

; Caumo, Wolnei

; Valença, Guilherme

; Weintraub, Daniel

; Rieder, Carlos Roberto de Mello

Jornal Brasileiro de Psiquiatria

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jun 2017, Volume 66 N. 2 Pages 111 - 115

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective Parkinson’s disease (PD) management is usually successfully reached with proper pharmacological treatment. However, PD patients can manifest neuropsychiatric symptoms secondary to medical therapy, including impulse control disorders (ICD), presenting as pathological gambling, hypersexuality, compulsive buying, drinking or eating disorders. We translated and validated the Portuguese version of the gold-standard questionnaire Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire, or (QUIP) for identifying ICDs in PD patients. Methods Translation, back translation and submission to instrument developer was performed, that approved its new version comparing it to his original, validated version, with no loss of it’s original properties. Then, the Portuguese version was administered to 30 PD patients. They also were asked to rate from 1 to 5 the level of comprehensibility of the questions. Results The average level of comprehension was 4.06 ± 0.69 DP, considering 3 or more as acceptable. No patient has answered 1 or 2. Conclusion Our results on Portuguese version of QUIP-CS show that QUIP-CS translated and corrected version was easily understood and easily self-applied.

RESUMO Objetivo O manejo da doença de Parkinson (DP) é usualmente alcançado com sucesso com o tratamento farmacológico apropriado. Entretanto, os pacientes com DP podem manifestar sintomas neuropsiquiátricos secundários à terapêutica, como a síndrome de descontrole dos impulsos (SDI), que se apresenta como o jogar patológico, a hipersexualidade, o comprar, beber ou comer compulsivos. Traduzimos e validamos a versão em português do questionário padrão-ouro para identificação de transtornos impulsivo-compulsivos na DP (QUIP-CS) para identificar nesses pacientes a presença de SDI. Métodos Foram realizadas a tradução, a retrotradução e a submissão do instrumento ao desenvolvedor deste, que aprovou a nova versão comparando esta à sua, que já está validada, sem a perda das suas propriedades originais. Após, a versão em português foi administrada a 30 pacientes com o diagnóstico de DP. Eles também foram solicitados a classificar o nível de compreensibilidade das questões, graduando-as de 1 a 5. Resultados O nível médio de compreensão foi 4,06 ± 0,69 DP, considerando-se 3 ou mais como aceitável. Nenhum paciente respondeu 1 ou 2. Conclusão Os nossos resultados para a versão em português da QUIP-CS mostraram que essa versão, traduzida e corrigida, foi facilmente compreendida e aplicada pelos próprios pacientes.

https://doi.org/10.1590/0047-2085000000158

12.

The Impact of Dysphagia Therapy on Quality of Life in Patients with Parkinson's Disease as Measured by the Swallowing Quality of Life Questionnaire (SWALQOL)
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Ayres, Annelise

; Jotz, Geraldo Pereira

; Rieder, Carlos Roberto de Mello

; Schuh, Artur Francisco Schumacher

; Olchik, Maira Rozenfeld

International Archives of Otorhinolaryngology

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sep 2016, Volume 20 N. 3 Pages 202 - 206

Abstract: En | Text: En | PDF: En

Abstract Introduction Dysphagia is a common symptom in Parkinson's disease (PD) and it has been associated with poor quality of life (QoL), anxiety, depression. Objective The aim of this study was to evaluate the quality of life in individuals with PD before and after SLP therapy. Methods The program consisted of four individual therapy sessions. Each session comprised guidelines regarding food and postural maneuvers (chin down). The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was applied before and after therapy. Results The sample comprised of 10 individuals (8men), with amean (SD) age of 62.2 (11.3) years, mean educational attainment of 7.5 (4.3) years, andmean disease duration of 10.7 (4.7) years. Thirty percent of patients were Hoehn and Yahr (H&Y) stage 2, 50% were H&Y stage 3, and 20% were H&Y stage 4. Mean scores for all SWAL-QOL domains increased after the intervention period, with significant pre- to post-therapy differences in total score (p = 0.033) and domain 4 (symptom frequency) (p = 0.025). There was also a bias significance for domain 5 (food selection) (p = 0.095). Conclusion Patients exhibited improvement in swallowing-related quality of life after a SLP therapy program. The earlier in the course of PD, greater the improvement observed after therapy.

https://doi.org/10.1055/s-0036-1582450

13.

Aspectos de comunicação oral em pacientes com doença de Parkinson submetidos à Estimulação Cerebral Profunda
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Cruz, Aline Nunes da

; Beber, Bárbara Costa

; Olchik, Maira Rozenfeld

; Chaves, Márcia Lorena Fagundes

; Rieder, Carlos Roberto de Mello

; Dornelles, Sílvia

CoDAS

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aug 2016, Volume 28 N. 4 Pages 480 - 485

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Introduction Deep Brain Stimulation (DBS) has been satisfactorily used to control the cardinal motor symptoms of Parkinson’s disease (PD), but little is known about its impact on communication. Purpose This study aimed to characterize the aspects of cognition, language, speech, voice, and self-perception in two patients with PD, pre- and post- DBS implant surgery. Methods The patients were assessed using a cognitive screening test, a brief language evaluation, a self-declared protocol, and an analysis of the aspects of voice and speech, which was conducted by a specialized Speech-language Therapist who was blinded for the study. Results At the pre-surgery assessment, Case I showed impairment regarding the aspects of cognition, language and voice, whereas Case II showed impairment only with respect to the voice aspect. The post-surgery evaluation of the cases showed an opposite pattern of the effect of DBS after analysis of the communication data: Case I, who presented greater impairment before the surgery, showed improvement in some aspects; Case II, who presented lower communicative impairment before the surgery, showed worsening in other aspects. Conclusion This study shows that DBS may influence different communication aspects both positively and negatively. Factors associated with the different effects caused by DBS on the communication of patients with PD need to be further investigated.

RESUMO Introdução A Estimulação Cerebral Profunda tem sido considerada uma intervenção satisfatória para os sintomas motores cardinais da doença de Parkinson, porém ainda há poucas evidências sobre seu impacto na comunicação. Objetivo Esse trabalho teve como objetivo caracterizar os seguintes aspectos da comunicação: cognição, linguagem, fala, voz, e autopercepção de dois pacientes com doença de Parkinson em situação pré e pós a cirurgia de implantação da Estimulação Cerebral Profunda. Método Os pacientes foram avaliados através de: um teste de rastreio cognitivo; uma avaliação breve da linguagem; um protocolo autodeclarado e aspectos da voz e da fala, que foram avaliados por um fonoaudiólogoexpertna área e cegado para o estudo. Resultado Observou-se no momento pré-cirurgia que o Caso I apresentava comprometimento nos aspectos cognitivo, da linguagem e voz, enquanto que o Caso II apresentava alteração apenas na voz. A avaliação pós-cirúrgica dos casos mostrou um padrão oposto de efeito da Estimulação Cerebral Profunda, quando analisados os dados pós-cirúrgicos, referente à comunicação. O Caso I, que era considerado com o maior prejuízo no período anterior à cirurgia, apresentou melhora em alguns aspectos, enquanto o Caso II, que era observado com menos prejuízo comunicativo previamente à cirurgia, apresentou piora em outros aspectos. Conclusão Este estudo demonstrou que a Estimulação Cerebral Profunda pode influenciar diferentes aspectos da comunicação, tanto de modo positivo quanto negativo, e que é necessário investigar fatores associados aos diferentes efeitos causados pela Estimulação Cerebral Profunda sobre a comunicação dos pacientes com doença de Parkinson.

https://doi.org/10.1590/2317-1782/20162015169

14.

Evaluation of quality of life and psychological aspects of Parkinson's disease patients who participate in a support group
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Artigas, Nathalie Ribeiro

; Striebel, Vera Lúcia Widniczck

; Hilbig, Arlete

; Rieder, Carlos Roberto de Mello

Dementia & Neuropsychologia

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sep 2015, Volume 9 N. 3 Pages 295 - 300

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Parkinson's disease (PD) is a neurodegenerative disorder that can dramatically impair patient quality of life (QoL). Objective: To analyze the QoL, motor capacity, depression, anxiety and social phobia of individuals who attended a patient support group (PSG) compared to non-participants. Methods: A cross-sectional study was performed. The sample consisted of 20 individuals with PD who attended a PSG and another 20 PD patients who did not attend a support group for PD patients, serving as the control group (nPSG). All patients answered questionnaires on motor capacity (UPDRS), QoL (Parkinson's Disease Questionnaire- PDQ-39), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory) and social phobia (Liebowitz Social Anxiety Scale). To determine data distribution, the Shapiro-Wilk test was performed. For comparison of means, Student's t-test was applied. In cases of asymmetry, the Mann-Whitney test was employed. To assess the association between the scales, Pearson's correlation coefficient (symmetric distribution) and Spearman's coefficient (asymmetric distribution) were applied. For the association between qualitative variables, Pearson's Chi-squared test was performed. A significance level of 5% (p≤0.05) was adopted. Results: Individuals in the PSG had a significantly better QoL (p=0.002), and lower depression (p=0.026), anxiety (p<0.001) and social phobia (p=0.01) scores compared to the nPSG. Conclusion: The participation of PD patients in social activities such as support groups is associated with better QoL and fewer symptoms of depression, anxiety and social phobia.

A doença de Parkinson (DP) é uma doença neurodegenerativa que pode prejudicar a qualidade de vida (QV) do paciente. Objetivo: Analisar a qualidade de vida, capacidade motora, depressão, ansiedade e fobia social dos indivíduos que frequentavam um grupo de apoio a pacientes (PSG) em comparação com aqueles que não frequentavam. Métodos: Tratase de um estudo transversal. Amostra composta por 20 indivíduos com Parkinson que participavam de uma PSG e outros 20 pacientes com DP que não participavam de qualquer grupo de apoio para pacientes com DP, denominado de grupo de controle (nPSG). Os participantes responderam questionários sobre capacidade motora (UPDRS), QV (PDQ-39), depressão (Inventário de depressão de Beck), ansiedade (Inventário de ansiedade de Beck) e fobia social (Escala de Ansiedade Social de Liebowitz). Determinando a distribuição dos dados, foi realizado o teste de Shapiro-Wilk. Comparando médias, teste t de Student foi aplicado. Em assimetria, foi realizado o teste de Mann-Whitney. Avaliando a associação entre as escalas, o coeficiente de correlação de Pearson (distribuição simétrica) e o coeficiente de Spearman (distribuição assimétrica) foram aplicados. Para a associação entre as variáveis qualitativas, foi realizado o teste qui-quadrado de Pearson. Adotado o nível de significância de 5% (p≤0,05). Resultados: Os indivíduos do PSG apresentaram uma qualidade de vida significativamente melhor (p=0,002), menos depressão (p=0,026), ansiedade (p<0,001) e fobia social (p=0,01) quando comparado com o nPSG. Conclusão: A participação de pacientes com DP em atividades sociais como os grupos de apoio está associado a melhor qualidade de vida e menor presença de sintomas de depressão, ansiedade e fobia social.

https://doi.org/10.1590/1980-57642015dn93000013

15.

Ressonância magnética funcional e deglutição: revisão sistemática
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Ardenghi, Luciana Grolli

; Signorini, Alana Verza

; Battezini, Ana Carolina

; Dornelles, Silvia

; Rieder, Carlos Roberto de Mello

Audiology - Communication Research

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jun 2015, Volume 20 N. 2 Pages 167 - 174

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Purpose Evaluate the feasibility and safety of functional magnetic resonance imaging (fMRI) for the evaluation of cortical areas involved in swallowing. Research strategy The search was conducted from April 2003 to April 2013, using the keywords “functional magnetic resonance imaging” or“fMRI” and “dysphagia” and“functional magnetic resonance imaging” or“fMRI” and “swallowing” in “PubMed” database. Selection criteria Studies were reviewed by analyzing their titles and abstracts with the following inclusion criteria: research involving human subjects, use of neurofunctional tests, reference to swallowing function, adult and/or elderly population analysis and association with neurological disorders. Results the search strategy resulted in 1167 citations, from which only 35 met the eligibility criteria. Conclusion the functional magnetic resonance imaging was considered safe and feasible for evaluating cortical areas involved in swallowing. However, the reports of functional magnetic resonance usage differed between the reviewed studies and the variability in the methodology used, made meaningful comparisons difficult.

Objetivo Avaliar a viabilidade e segurança da ressonância magnética funcional para a avaliação de áreas corticais envolvidas na deglutição. Estratégia de pesquisa Conduziu-se uma busca entre abril de 2003 e abril de 2013, usando as palavras chave “functional magnetic resonance imaging” or“fMRI” and “dysphagia” e“functional magnetic resonance imaging” or“fMRI” and “swallowing” na base de dados PubMed. Critérios de seleção Os estudos foram revisados por análise de seus títulos eabstracts e os critérios de inclusão utilizados foram: pesquisas envolvendo seres humanos, utilização de exames neurofuncionais, referência à função de deglutição, análise de população adulta e/ou idosa, relação com patologias neurológicas. Resultados A estratégia de busca resultou em 1167 citações, das quais apenas 35 preencheram os critérios de elegibilidade. Conclusão A ressonância magnética funcional foi considerada segura e viável para a avaliação de áreas corticais envolvidas na deglutição. Entretanto, os relatos de utilização de ressonâcia magnética funcional diferiram entre os estudos revisados e houve variabilidade na metodologia utilizada, dificultando as comparações.

https://doi.org/10.1590/S2317-64312015000200001471

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