Fábio Porto neurologista

GNCC / CEREDIC HC/FMUSP

06/04/2016

Cognição e dor

Programa de Educação Continuada em Fisiopatologia e Terapêutica da Dor

2016Equipe de Controle de Dor da Divisão de Anestesia do Hospital das Clínicas da FMUSP

"Dor é uma experiência sensorial e

emocional desagradável associada

com danos reais ou potenciais em

tecidos, ou assim percepcionada como

dano.

Fenômeno subjetivo

International Association for

the Study of Pain

Avanços nas metodologias: neuroimagem e traçadores

•Fenomenologia clínica dos transtorno de humor implica em redes ligadas a regulação do humor, ansiedade, medo, processamento de recompensa, atenção, motivação, resposta ao estresse, interação social e funções neurovegetativas (sono, apetite, energia, peso, libido).•Normalmente congruente com o humor.

Processamento enviesado conguente

com o humor.

Methods:

•40 MCI (amnestic and non-amnestic) evaluated pre-

and pos-AT

•Subjects performed a twice-a-week, moderate

intensity, AT program for 24 weeks.

•Assessment with ADAS-cog, a neuropsychological

battery, and evaluation of rBGMwith positron emission

tomography with 18F-fluorodeoxyglucose (18FDG-PET)

•Aerobic capacity maximal oxygen consumption

VO2max (mL/Kg/min)

Methods:

Results

Results

P < 0.001 (uncorrected for multiple comparisons) minimum of 10 voxels within the

cluster ** ACC: familywise error method (FWE) (pFWE = 0.04).

correlation (ACC vs PCC) = −0.51, p < 0.01

Copy Rey Figure (rho =−0.38, p = 0.016)

Visual memory (r = 0.38, p = 0.01)

Results

In a post-hoc analysis, an additional comparison was

performed between participants (before and after the AT

program) and a CG of cognitively normal older adults

from our institution (Pre-AT versus CG and Post-AT

versus CG).

Pre-AT v.s Control group: Hypometabolism in PCC

and Precuneus p(FEW) < 0.05

A typical finding in early Alzheimer diseaseMinoshima , et al., Ann Neurol. 2007

Rogalski, et al., J Cogn Neurosci. 2013

Rogalski, et al., J Cogn Neurosci. 2013

Goodkind, et al., JAMA Psychiatry 2015

Seeley, et al., J Neurosci. 2007

It plays a role in the descending modulation of

pain and in defensive behaviour.

Substância cinzenta periaquedutal

Gate

control

theory of

pain

Muito obrigado

portofhg@gmail.com