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Browsing by Author "Paes, Flávia"

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  • Activity-dependent neurorehabilitation beyond physical trainings: "mental exercise" through mirror neuron activation
    Publication . Yuan, Ti-Fei; Chen, Wei; Shan, Chunlei; Rocha, Nuno; Arias-Carrión, Oscar; Paes, Flávia; de Sa, Alberto Souza; Machado, Sergio
    The activity dependent brain repair mechanism has been widely adopted in many types of neurorehabilitation. The activity leads to target specific and non-specific beneficial effects in different brain regions, such as the releasing of neurotrophic factors, modulation of the cytokines and generation of new neurons in adult hood. However physical exercise program clinically are limited to some of the patients with preserved motor functions; while many patients suffered from paralysis cannot make such efforts. Here the authors proposed the employment of mirror neurons system in promoting brain rehabilitation by "observation based stimulation". Mirror neuron system has been considered as an important basis for action understanding and learning by mimicking others. During the action observation, mirror neuron system mediated the direct activation of the same group of motor neurons that are responsible for the observed action. The effect is clear, direct, specific and evolutionarily conserved. Moreover, recent evidences hinted for the beneficial effects on stroke patients after mirror neuron system activation therapy. Finally some music-relevant therapies were proposed to be related with mirror neuron system.
    2015Journal article Open access Show more
  • Aerobic Exercise Does Not Predict Brain Derived Neurotrophic Factor And Cortisol Alterations in Depressed Patients
    Publication . Lamego, Murilo Khede; Souza Moura, Antonio Marcos de; Paes, Flávia; Rocha, Nuno; de Sá Filho, Alberto Souza; Lattari, Eduardo; Rimes, Ridson; Manochio, João; Budde, Henning; Wegner, Mirko; Mura, Gioia; Arias-Carrión, Oscar; Yuan, Ti-Fei; Nardi, Antonio Egidio; Machado, Sergio
    The pathophysiology of depression is related to neurobiological changes that occur in the monoamine system, hypothalamic-pituitary-adrenal axis, neurogenesis system and the neuroimmune system. In recent years, there has been a growing interest in the research of the effects of exercise on brain function, with a special focus on its effects on brainderived neurotrophic factor (BDNF), cortisol and other biomarkers. Thus, the aim of this study is to present a review investigating the acute and chronic effects of aerobic exercise on BDNF and cortisol levels in individuals with depression. It was not possible to establish an interaction between aerobic exercise and concentration of BDNF and cortisol, which may actually be the result of the divergence of methods, such as type of exercises, duration of the sessions, and prescribed intensity and frequency of sessions.
    2015Journal article Open access Show more
  • Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorder
    Publication . Lamego, Murilo Khede; Lattari, Eduardo; Sá Filho, Alberto Souza de; Paes, Flávia; Mascarenhas Jr., Jarbas; Maranhão Neto, Geraldo; Oliveira, Aldair José de; Campos, Carlos; Rocha, Nuno; Nardi, Antonio E.; Machado, Sergio
    To investigate the effects of a regularly repeated aerobic exercise series on anxiety and maximum oxygen consumption (VO2max) in Panic Disorder patients. METHODS: Ten previously sedentary female subjects diagnosed with Panic Disorder performed 36 sessions of aerobic exercise (at 70 to 75% of VO2max), 3 times per week during 12 weeks. A cardiopulmonary evaluation (ergospirometry test) was used to set the intensity of training as well as to establish baseline and post-training VO2max parameters. The assessment of anxiety symptoms was performed at baseline, at the end of the 6th and 12th weeks, using the Trait Anxiety Inventory (STAI-T) and State Anxiety Inventory (STAI-S), and the Subjective Units of Distress Scale (SUDS) questionnaires. One-way ANOVA for repeated measurements (at 3 moments: Baseline, 6th week (mid-training) and 12th week (post-training) was used to compare the evolution of the questionnaires; the Bonferroni post hoc test was applied to identify differences between moments. A dependent t-test was performed for measures of VO2max. RESULTS: Compared to baseline, (a) STAI-T showed significant anxiety reductions at mid- and post-training moments; (b) STAI-S and SUDS recorded anxiety reductions only at Post-training; (c) VO2max showed a significant improvement at Post-training. CONCLUSION: This protocol promoted beneficial effects on cardiorespiratory fitness and anxiety levels of Panic Disorder patients.
    2016Journal article Restricted access Show more
  • Association between depression severity and executive functioning in late-life depression: a systematic review
    Publication . Monteiro, Suzana; Monteiro, Bárbara; Candida, Maristela; Adler, Nathalia; Campos, Carlos; Rocha, Nuno; Paes, Flávia; Nardi, Antônio Egidio; Machado, Sérgio
    OBJECTIVE: Late-life depression is an under-diagnosed and under-treated disease that reduces the well-being of older adults. Executive dysfunction is another critical impairment in elderly depressed individuals which further disrupts their everyday functioning. This systematic review aims to analyze the association between executive function and depression severity in elderly individuals diagnosed with major depressive disorder. METHOD: The studies were retrieved from MEDLINE/PubMed, ISI Web of Knowledge and PsychInfo, after a search strategy combining the terms "depression", "executive function", "neuropsychological assessment", "elderly" and "late life". Study selection, data collection and quality ratings was performed by two independent raters. RESULTS: A total of 1,130 articles were found but only 8 studies met the defined eligibility criteria and evaluated the association between depression severity and executive functioning. Six out of 8 studies found an association between depression severity and executive function, with correlations ranging from small to large (r= -0.15 to -0.53). The included reports had several methodological limitations such as selective data reporting, non-comprehensive executive function assessment and not controlling potential biases. CONCLUSION: Depression severity may be more strongly correlated with a specific set of executive abilities although it also seems to be a broad-based association with executive functioning as a whole. Future high-quality prospective studies are recommended in order to understand the causal relationship between depression severity and executive functioning taking into account possible mediators such as age-related or neurodegenerative cognitive impairment, educational level and other clinic characteristics (e.g. age of onset, medication).
    2016Journal article Restricted access Show more
  • Bilateral DMPFC-rTMS Leads to Sustained Remission in Geriatric Treatment-Resistant Depression: A Case Report
    Publication . Sender, David; Nazar, Bruno Palazzo; Baczynski, Tathiana; Paes, Flávia; Fettes, Peter; Downar, Jonathan; Campos, Carlos; Nardi, Antonio Egidio; Machado, Sergio
    Major Depressive Disorder (MDD) is a highly prevalent condition that has been labeled the current leading cause of disability adjusted life years (Ferrari et al. 2013). Approximately 30% of MDD patients are treatment resistant, not achieving remission after two or more antidepressant trials (Baldessarini et al. 2015). In the geriatric population, MDD is associated with both lower rates of remission and increased levels of recurrence (Kiosses & Alexopoulos 2013). Geriatric MDD not only shows an impoverished response to pharmacological approaches, but also presents new treatment challenges associated with clinical limitations such as frequent metabolic issues, comorbidity and poly-medication. Hence, additional therapeutic alternatives such as repetitive transcranial magnetic stimulation (rTMS) might be beneficial in these resistant cases (Downar & Daskalakis 2013).
    2017-06Journal article Restricted access Show more
  • Chronic effects of aerobic exercise on panic disorder: a systematic review of randomized and non-randomized trials
    Publication . Lattari, Eduardo; Paes, Flávia; Machado, Ana; Rocha, Nuno Barbosa Ferreira; Nardi, Antônio Egidio; Machado, Sérgio
    In general, most studies have supported an association between the acute effects of exercise and a reduced state anxiety, but failed to completely explain the relationship between the chronic effect of exercise and anxiety traits. The aim of this study was to systematically review the literature regarding the chronic effect of exercise on symptoms associated with panic disorder. The studies were retrieved from a MEDLINE/PubMed, ISI Web of Knowledge and SciELO. We adopted PICOS’s strategy recommended to determine the eligibility criteria. The survey was conducted using an advanced search in the ISI Web of Science and MEDLINE / PubMed with MeSH terms and Entry Terms for the keywords “Panic Disorder” basis and “Exercise”. Boolean operators “AND” and “OR” were used separately or in combination. Two independent researchers performed the selection of studies; in case of disagreement they sought a consensus on the selection. A total of 265 articles were identified: 199 articles from PubMed/Medline, 63 articles from ISI Web of Science and 3 articles by manual searches. Thus, 31 articles were analyzed by the eligibility criteria and the exclusion criteria, a total of five studies included in the systematic review. The regular practice of aerobic exercise seems to be an appropriate intervention to promote improvements in the severity of anxiety symptoms in PD patients.
    2015-12Journal article Open access Show more
  • Cognitive-behavioral therapy for schizophrenia: an overview on efficacy, recent trends and neurobiological findings
    Publication . Candida, Maristela; Campos, Carlos; Monteiro, Bárbara; Rocha, Nuno; Paes, Flávia; Nardi, António Egídio; Machado, Sérgio
    Cognitive Behavioral Therapy (CBT) has been recommended by several international guidelines as the gold-standard treatment to address the needs of patients with schizophrenia. This review provides an overview on recent advances regarding CBT for schizophrenia. An electronic search was performed on PubMed/MEDLINE, Web of Science and Cochrane Database, using the key-words: "schizophrenia"; "psychosis"; "cognitive-behavioral therapy", "CBT"and "psychotherapy". Numerous systematic reviews support the immediate and long-term efficacy of Cognitive Behavioral Therapy to reduce positive and negative symptoms in patients with schizophrenia. In the last decade, CBT for schizophrenia has been applied to clinical high-risk subjects and delivered using innovative approaches (low intensity, web-based and self-guided). Brain regions and networks which support high-level cognitive functions have been associated with CBT responsiveness. There is preliminary evidence indicating that CBT induces a prefrontal dependent increase in the top-down modulation of social threat activation. In the last decade, CBT for schizophrenia has explored new treatment outcomes, targeted acute and pre-clinical populations and provided alternative methods to reach more patients and reduce intervention costs. The patients' neurocognitive profile seems to play a critical role in treatment response and combining CBT with cognitive remediation may allow to enhance therapeutic effects. Although CBT for schizophrenia is widely established as a gold-standard practice, future studies using innovative CBT protocols, exploring brain-related predictors and treatment outcomes may allow this intervention to be more effective, personalized and to reach a wider number of patients.
    2016Journal article Open access Show more
  • Comparative Study of Subcortical Atrophy in Patients with Frontotemporal Dementia and Dementia with Extrapyramidal Signs
    Publication . Caixeta, Leonardo; Vieira, Renata Teles; Paes, Flávia; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Arias-Carrión, Oscar; Rocha, Nuno; Budde, Henning; Machado, Sergio
    To investigate the severity of subcortical atrophy in frontotemporal dementia (FTD) without extrapyramidal symptoms (EPS) and dementia with EPS. In addition, we aim to verify if there is correlation between demographic and clinical characteristics and subcortical atrophy in the groups. Methodology : The sample was composed of 21 patients with dementia and EPS as well as 19 patients with FTD without EPS. A linear assessment was conducted in order to identify the degree of subcortical atrophy (i.e., bifrontal index - BFI) using MRI. Moreover, the Mini-Mental State Examination (MMSE), Pfeffer Functional Activities Questionnaire (FAQ) and the Clinical Dementia Rating (CDR) were used to investigate clinical aspects. Results : It was verified that patients with dementia and EPS was older than the patients with FTD (p=0.01). The severity of cognitive deficits was associated with BFI, as well as the dementia severity in the EPS group. Conclusion : FTD group presented mean BFI scores above the cutoff for normal elderly population, indicating the presence of subcortical atrophy in this group. Mean BFI was higher (although not statistically significant) in FTD group than in dementia with EPS, which can suggest at least that subcortical pathology in FTD may be as important as in the dementia with EPS group. Subcortical atrophy is a good biological marker for cognitive deterioration in FTD and in dementia with EPS.
    2015Journal article Restricted access Show more
  • Comparison Among Aerobic Exercise and Other Types of Interventions to Treat Depression: A Systematic Review
    Publication . de Souza Moura, Antonio Marcos; Lamego, Murilo Khede; Paes, Flávia; Rocha, Nuno; Simoes-Silva, Vitor; Rocha, Susana; de Sá Filho, Alberto Souza; Rimes, Ridson; Manochio, João; Budde, Henning; Wegner, Mirko; Mura, Gioia; Arias-Carrión, Oscar; Yuan, Ti-Fei; Nardi, Antonio Egidio; Machado, Sergio
    Depression is a common and disabling disease that affects over 100 million people worldwide and can have a significant impact on physical and mental health, reducing their quality of life. Thus, the aim of this article was to provide information on research results and key chains related to the therapeutic effects of chronic aerobic exercise compared with other types of interventions to treat depression, which may become a useful clinical application in a near future. Researches have shown the effectiveness of alternative treatments, such as physical exercise, minimizing high financial costs and minimizing side effects. In this review, the data analyzed allows us to claim that alternative therapies, such as exercise, are effective on controlling and reducing symptoms. 69.3% of the studies that investigated the antidepressant effects of exercise on depressive were significant, and the other 30.7% of the studies improved only in general physiological aspects, such as increased oxygen uptake, increased use of blood glucose and decreased body fat percentage, with no improvement on symptoms of depression. From the sample analyzed, 71.4% was composed of women, and regarding the severity of symptoms, 85% had mild to moderate depression and only 15% had moderate to severe depression. However, there is still disagreement regarding the effect of exercise compared to the use of antidepressants in symptomatology and cognitive function in depression, this suggests that there is no consensus on the correct intensity of aerobic exercise as to achieve the best dose-response, with intensities high to moderate or moderate to mild.
    2015Journal article Open access Show more
  • Effects of Aerobic Exercise on Anxiety Disorders: A Systematic Review
    Publication . de Souza Moura, Antonio Marcos; Lamego, Murilo Khede; Paes, Flávia; Rocha, Nuno; Simoes-Silva, Vitor; Rocha, Susana; de Sá Filho, Alberto Souza; Rimes, Ridson; Manochio, João; Budde, Henning; Wegner, Mirko; Mura, Gioia; Arias-Carrión, Oscar; Yuan, Ti-Fei; Nardi, Antonio Egidio; Machado, Sergio
    Anxiety disorders are the most common psychiatric disorders observed currently. It is a normal adaptive response to stress that allows coping with adverse situations. Nevertheless, when anxiety becomes excessive or disproportional in relation to the situation that evokes it or when there is not any special object directed at it, such as an irrational dread of routine stimuli, it becomes a disabling disorder and is considered to be pathological. The traditional treatment used is medication and cognitive behavioral psychotherapy, however, last years the practice of physical exercise, specifically aerobic exercise, has been investigated as a new non-pharmacological therapy for anxiety disorders. Thus, the aim of this article was to provide information on research results and key chains related to the therapeutic effects of aerobic exercise compared with other types of interventions to treat anxiety, which may become a useful clinical application in a near future. Researches have shown the effectiveness of alternative treatments, such as physical exercise, minimizing high financial costs and minimizing side effects. The sample analyzed, 66.8% was composed of women and 80% with severity of symptoms anxiety as moderate to severe. The data analyzed in this review allows us to claim that alternative therapies like exercise are effective in controlling and reducing symptoms, as 91% of anxiety disorders surveys have shown effective results in treating. However, there is still disagreement regarding the effect of exercise compared to the use of antidepressant symptoms and cognitive function in anxiety, this suggests that there is no consensus on the correct intensity of aerobic exercise as to achieve the best dose-response, with intensities high to moderate or moderate to mild.
    2015Journal article Open access Show more