Does TRODAT-1 SPECT Uptake Correlate with Cerebrospinal Fluid α-Synuclein Levels in Mid-Stage Parkinson's Disease?

BACKGROUND: Parkinson's disease (PD) is characterized by a progressive loss of nigrostriatal dopaminergic neurons with impaired motor and non-motor symptoms. It has been suggested that motor asymmetry could be caused due to an imbalance in dopamine levels, as visualized by dopamine transporter single emission computed tomography test (DAT-SPECT), which might be related to indirect measures of neurodegeneration, evaluated by the Montreal Cognitive Assessment (MOCA) and α-synuclein levels in the cerebrospinal fluid (CSF). Therefore, this study aimed to understand the correlation between disease laterality, DAT-SPECT, cognition, and α-synuclein levels in PD. METHODS: A total of 28 patients in the moderate-advanced stage of PD were subjected to neurological evaluation, TRODAT-1-SPECT/CT imaging, MOCA, and quantification of the levels of α-synuclein. RESULTS: We found that α-synuclein in the CSF was correlated with global cognition (positive correlation, r2 = 0.3, p = 0.05) and DAT-SPECT concentration in the putamen (positive correlation, r2 = 0.4, p = 0.005), and striatum (positive correlation, r2 = 0.2, p = 0.03), thus working as a neurodegenerative biomarker. No other correlations were found between DAT-SPECT, CSF α-synuclein, and cognition, thus suggesting that they may be lost with disease progression. CONCLUSIONS: Our data highlight the importance of understanding the dysfunction of the dopaminergic system in the basal ganglia and its complex interactions in modulating cognition.

Martim: pescador de palavras: a trama da linguagem em Clarice Lispector / Martim: kingfisher of the words: the language plot in Clarice Lispector

A trama da linguagem no tocante à concepção e ao enredo da obra A maçã no escuro (1961), de Clarice Lispector, é nosso fio condutor. A linguagem de Martim, entrelaçada à sua aventura interior - seu percurso pela e para linguagem, a fim de alcançar sua individuação, através do retorno simbólico à gênese do mundo, à gênese do homem e à gênese da criação literária -, é o que nos propomos a acompanhar de perto nesta análise. Para tanto, realizar-se-á o estudo do percurso de Martim, que se caracteriza, sobretudo, pelos movimentos narrativos de recuos assim como de avanços, ao qual denominaremos de movimento helicoidal. A fortuna crítica da autora, especialmente da crítica literária deste romance, unidas à teoria psicanalítica assim como à teoria literária, servirão como subsídios desta empreitada.

The language plot related to the conception and the story of A maçã no escuro - The apple in the dark -, Clarice Lispector (1961) is our guiding thread. Martim's language entangled to his interior adventure - his way through and to the language, in order to reach his individuality over the figurative return to the genesis of words, genesis of the human beings and genesis of literary creation - is what we propose to come close to in this analysis. This is a study of Martim's journey marked by the narrative movement around the axis of time, which in turn is named a helicoidal movement. The critical fortune of the writer, specially to this romance, united to psychoanalytic and literary theory will serve as subsides to this course.

Correlation between impulsivity and executive function in patients with Parkinson disease experiencing depression and anxiety symptoms.

BACKGROUND: Depression and anxiety are comorbidities often associated with Parkinson disease (PD). Recent studies debate on how affective disorders can influence the cognition of patients with PD. This study sought to investigate how depression and anxiety affect specific executive functions and impulsivity traits in these patients. METHODS: Twenty-eight patients with advanced PD and 28 closely matched healthy volunteers (HV) were assessed for depressive and anxiety symptoms, impulsivity, executive function and control attention and behavioral response. RESULTS: Compared to the HV group, the PD group showed significantly higher perseverative responses and slowness to adapt to changes in environmental stimuli and longer reaction time for inter-stimulus interval change. Depression symptoms were significantly correlated to motor impulsivity score and total Barratt Impulsiveness Scale (BIS -11) score. Moreover, there was also significant correlation between anxiety symptoms and attentional impulsivity score and total BIS-11 score. Correlation analysis between impulsivity and control attention indicated a positive correlation in commission and a negative correlation in reaction time and detectability in the PD group. CONCLUSIONS: The present results suggest that depression and anxiety were highly correlated to impulsivity but not to executive functions changes in these PD patients.

Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease.

OBJECTIVE: To prospectively evaluate the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on the different characteristics of pain and other nonmotor symptoms (NMS) in patients with Parkinson disease (PD). METHODS: Forty-four patients with PD and refractory motor symptoms were screened for STN-DBS. Patients were evaluated before and 1 year after surgery. The primary outcome was change in pain prevalence after surgery. Secondary outcome measures were changes in motor function (Unified Parkinson's Disease Rating Scale), characteristics of pain and other NMS using specific scales and questionnaires, and quality of life. RESULTS: Forty-one patients completed the study. The prevalence of pain changed from 70% to 21% after surgery (p < 0.001). There were also significant improvements in pain intensity, NMS, and quality of life after STN-DBS (p < 0.05). Dystonic and musculoskeletal pain responded well to DBS, while central pain and neuropathic pain were not influenced by surgery. There was a strong correlation between the change in pain intensity and the improvement in quality of life (r = 0.708, p < 0.005). No correlation was found between pain improvement and preoperative response to levodopa or motor improvement during stimulation (r = 0.247, p = 0.197 and r = 0.249, p = 0.193, respectively) or with changes in other NMS. CONCLUSIONS: STN-DBS decreased pain after surgery, but had different effects in different types of PD-related pain. Motor and nonmotor symptom improvements after STN-DBS did not correlate with pain relief. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that in patients with idiopathic PD with refractory motor fluctuations, STN-DBS decreases the prevalence of pain and improves quality of life.

os heróis, as princesas e o imaginário infantil / Heroes, princess and children’s imaginary

As autoras propõem-se a explorar as vicissitudes do complexo edípico nos meninos e nas meninas, a partir da análise das diferenças estruturais nas estórias infantis. Baseando-se na percepção de que as princesas, nos contos de fada, são órfãs de mãe e que os super-heróis são órfãos do casal parental, este texto examina como a presença dos mitos compartilhados ajuda a formar os mitos pessoais de cada criança dentro do universo das relações objetais pré-genitais e objetais genitais e conflitos edípicos. Feita sob quatro enfoques – Édipo-herói; Super-heróis; Princesas; e uma estória atual diferenciada, que apresenta a trama edípica sendo vivida por toda uma família –, a análise é concluída com o desenvolvimento de considerações teóricas. (AU)

The authors propose an exploration of the vicissitudes of Oedipus complex in boys and girls through the analysis of the structural differences in children’s stories. From the perceptions of princesses that in fairy tales are motherless and of superheroes that are bereaved of both parents, this paper aims to explore how the presence of the shared myths contributes for the development of personal myths of each child inside of the universe of the pregenital object relations, genital object relations and Oedipus conflicts. Thus, this study will be divided in 4 parts: the first will be of Oedipus-hero; the second, of the superheroes; the third, of the princesses; and the forth will analyze a current story that is different because it presents an Oedipus plot that is lived by all family. Finally, the authors conclude with the development of the theoretical considerations. (AU)

Entre a fuga do social e a busca do individual: parcerias na leitura d’A maçã no escuro, de Clarice Lispector / The fuge from social and the search of individual: partnerships on the study of A maçã no escuro of Clarice Lispector

A análise literária dos trechos inicial e final do romance A maçã no escuro, de Clarice Lispector, é o ponto de partida deste trabalho. Após ter cometido um crime, o personagem Martim inicia uma travessia inédita, que se caracteriza pela aparente rejeição da linguagem convencionada socialmente e pela busca de uma linguagem própria. A partir dessa leitura propomos a investigação de temas como individuação, formação de sujeito e a importância da função paterna para a introjeção das leis sociais (AU)

Entre a fuga do social e a busca do individual: parcerias na leitura d’A maçã no escuro, de Clarice Lispector / The fuge from social and the search of individual: partnerships on the study of A maçã no escuro of Clarice Lispector

A análise literária dos trechos inicial e final do romance A maçã no escuro, de Clarice Lispector, é o ponto de partida deste trabalho. Após ter cometido um crime, o personagem Martim inicia uma travessia inédita, que se caracteriza pela aparente rejeição da linguagem convencionada socialmente e pela busca de uma linguagem própria. A partir dessa leitura propomos a investigação de temas como individuação, formação de sujeito e a importância da função paterna para a introjeção das leis sociais.