Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/7170 |
Resumo: | Background: MS is a chronic neurological, inflammatory, autoimmune, demyelinating, degenerative disease. It affects the CNS, especially young adults and middle (15-40 years). Cognitive changes are more frequent than estimated. In addittion, psychiatric disorders in MS are common and they can emerge as inaugural symptoms even without physical symptoms. MS patients are more vulnerable to psychiatric disorders, which may affect two-thirds of them. However, the findings show that it is underdiagnosed and undertreated. According to the literature, within the psychiatric disorders in MS, depression is the most prevalent, followed by anxiety and bipolar disorder. Method: We radomly evaluated 109 patients from a specialized university service in MS (Centro de Referência, Investigação e Tratamento de Esclerose Múltipla - CRIEM), in Central Brazil. They were diagnosed by experienced neurologists, according to the criteria of McDonald- 2010 and reviewed by Polman et al. - 2011, seen at CRIEM. The final sample consisted of 84 patients with MS, which were divided into two groups (BD and no-BD). Neurocognitive assessment was made by widely used instruments and researched in order to assess cognition in MS (BRB-N). For psychiatric changes, it was used BDI, BAI and screening questionnaire for BD, which was evaluated by a psychiatrist. Results: The SDMT showed statistically significant correlations with all other subtests, being the strongest correlations with PASAT3 '' PASAT2 '' and WLG. More than 60% of the sample had losses in three or four cognitive domains. As for the age groups, there were no statistically significant differences between the performance in the tests. It was possible to infer that the longer the major disease , the bigger the losses in the tests: SRT-R SRT-S, SRT-D, 10/36, SDMT, PASAT3 "and WLG. There were statistically significant differences between the groups with four to six years of diagnosis and the seven to 10 years, and this group had higher losses. We found a non-expected data in our sample, which was the finding of 14 patients with dementia. Of these, nine had symptoms consistent with the phenotype of Frontotemporal Dementia. Conclusion: Neurocognitive changes in MS have high prevalence and major impact on quality of life of patients and their families, as well as high financial costs. There was no statistically significant difference between MS patients with BD and the MS no-BD group, suggesting that cognitive changes between MS / BD overlap. Beyond depression, few studies are available in the literature on psychiatric disorders arising in MS and rather intensify the suffering of the patient. We found a prevalence of 65.5% of BD in this population, higher than the literature findings, which can be justified by a thorough assessment. No statistically significant difference between age groups, but there were differences between disease duration. In this sample, the BD group had significantly higher anxiety than no-BD group. There was presence of 14 patients with dementia, and of these, nine had symptoms consistent with the phenotype of Frontotemporal Dementia |
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Caixeta, Leonardo Ferreirahttp://lattes.cnpq.br/9536747113677509Diniz, Denise Sisterollihttp://lattes.cnpq.br/5139602841690387Caixeta, Leonardo FerreiraDiniz, Denise SisterolliFerreira, Sandra de Fátima Barbozahttp://lattes.cnpq.br/9473701973876313Mendonça, Andreia Costa Rabelo2017-04-18T15:03:08Z2015-10-02MENDONÇA, A. C. R. Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar. 2015. 89 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2015.http://repositorio.bc.ufg.br/tede/handle/tede/7170Background: MS is a chronic neurological, inflammatory, autoimmune, demyelinating, degenerative disease. It affects the CNS, especially young adults and middle (15-40 years). Cognitive changes are more frequent than estimated. In addittion, psychiatric disorders in MS are common and they can emerge as inaugural symptoms even without physical symptoms. MS patients are more vulnerable to psychiatric disorders, which may affect two-thirds of them. However, the findings show that it is underdiagnosed and undertreated. According to the literature, within the psychiatric disorders in MS, depression is the most prevalent, followed by anxiety and bipolar disorder. Method: We radomly evaluated 109 patients from a specialized university service in MS (Centro de Referência, Investigação e Tratamento de Esclerose Múltipla - CRIEM), in Central Brazil. They were diagnosed by experienced neurologists, according to the criteria of McDonald- 2010 and reviewed by Polman et al. - 2011, seen at CRIEM. The final sample consisted of 84 patients with MS, which were divided into two groups (BD and no-BD). Neurocognitive assessment was made by widely used instruments and researched in order to assess cognition in MS (BRB-N). For psychiatric changes, it was used BDI, BAI and screening questionnaire for BD, which was evaluated by a psychiatrist. Results: The SDMT showed statistically significant correlations with all other subtests, being the strongest correlations with PASAT3 '' PASAT2 '' and WLG. More than 60% of the sample had losses in three or four cognitive domains. As for the age groups, there were no statistically significant differences between the performance in the tests. It was possible to infer that the longer the major disease , the bigger the losses in the tests: SRT-R SRT-S, SRT-D, 10/36, SDMT, PASAT3 "and WLG. There were statistically significant differences between the groups with four to six years of diagnosis and the seven to 10 years, and this group had higher losses. We found a non-expected data in our sample, which was the finding of 14 patients with dementia. Of these, nine had symptoms consistent with the phenotype of Frontotemporal Dementia. Conclusion: Neurocognitive changes in MS have high prevalence and major impact on quality of life of patients and their families, as well as high financial costs. There was no statistically significant difference between MS patients with BD and the MS no-BD group, suggesting that cognitive changes between MS / BD overlap. Beyond depression, few studies are available in the literature on psychiatric disorders arising in MS and rather intensify the suffering of the patient. We found a prevalence of 65.5% of BD in this population, higher than the literature findings, which can be justified by a thorough assessment. No statistically significant difference between age groups, but there were differences between disease duration. In this sample, the BD group had significantly higher anxiety than no-BD group. There was presence of 14 patients with dementia, and of these, nine had symptoms consistent with the phenotype of Frontotemporal DementiaIntrodução: Esclerose Múltipla (EM) é uma doença neurológica crônica, inflamatória, autoimune, desmielinizante, degenerativa que acomete o sistema nervoso central (SNC), principalmente de adultos jovens e médios (15 a 40 anos). Além de alterações cognitivas serem mais frequente que o estimado, alterações psiquiátricas, na EM, são comuns e elas podem surgir como sintomas inaugurais mesmo sem sintomas físicos. Os pacientes de EM são mais vulneráveis a transtornos psiquiátricos, podendo dois terços deles serem acometidos, porém, os achados mostram que ela é subdiagnosticada e subtratada. De acordo com a literatura, dos transtornos psiquiátricos na EM, a depressão é a mais prevalente, seguida pela ansiedade e Transtorno Afetivo Bipolar (TAB). Método: Foram avaliados de forma aleatória, 109 pacientes provenientes de um serviço universitário especializado em EM (Centro de Referência, Investigação e Tratamento em Esclerose Múltipla - CRIEM), no Brasil Central, diagnosticada por neurologistas experientes, de acordo com os critérios de McDonald-2010, revisados por Polman et al.- 2011, atendidos no CRIEM. A amostra final contou com 84 pacientes com EM, que foram divididos em dois grupos (TAB e ñ-TAB). A avaliação neurocognitiva foi feita utilizando instrumentos vastamente usados e pesquisados para avaliar cognição na EM (BRB-N). Para alterações psiquiátricas, foram utilizados BDI, BAI e questionário de screening para TAB e avaliados por psiquiatra. Resultados: O SDMT apresentou correlações estatisticamente significativas com todos os demais subtestes, sendo as correlações mais fortes com o PASAT3’’, PASAT2’’ e WLG. Mais de 60% da amostra apresentou prejuízos em três ou quatro domínios cognitivos. Quanto às faixas etárias não houveram diferenças estatisticamente significativas entre o desempenho nos testes. Foi possível inferir que quanto maior o tempo de doença maiores os prejuízos nos testes: SRT-R, SRT-S, SRT-D, 10/36, SDMT, PASAT3” e WLG. Houveram diferenças estatisticamente significativas entre os grupos com quatro a seis anos de diagnóstico e o de sete a 10 anos, sendo que este grupo apresentou maiores prejuízos. Não houve diferença estatisticamente significativa entre alterações cognitivas dos gupos TAB e ñ-TAB, porém o grupo TAB apresenta ansiedade significativamente maior que o grupo ñ-TAB. Encontramos um dado não esperado em nossa amostra que foi o achado de 14 pacientes com síndrome demencial. Destes, nove apresentaram sintomatologia compatível com o fenótipo de Demência Frontotemporal. Conclusão: Alterações neurocognitivas na EM apresentam alta prevalência e grande impacto na qualidade de vida do paciente e familiares, bem como altos custos financeiros. Não houve diferença estatisticamente significativa entre os portadores de EM com TAB e o grupo EM ñ-TAB, sugerindo que as alterações cognitivas entre essas comorbidade, EM/TAB, se sobrepõem. Além da depressão, poucos estudos estão disponíveis na literatura sobre as alterações psiquiátricas que surgem na EM e intensificam bastante o sofrimento do paciente. Encontrou-se uma prevalência TAB nesta população superior aos achados da literatura, o que pode ser justificado por uma avaliação minuciosa. Não apresentou diferença estatisticamente significativa entre grupos etários, mas houve diferença entre tempo de doença. Nesta amostra, o grupo TAB apresentou ansiedade significativamente mais elevada que o grupo ñ-TAB. Houve presença de pacientes com síndrome demêncial, sendo que sua maioria, apresentaram sintomatologia compatível com o fenótipo de Demência Frontotemporal.Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-18T15:02:37Z No. of bitstreams: 2 Dissertação - Andreia Costa Rabelo Mendonça - 2015.pdf: 2352078 bytes, checksum: 52168659370d5ee5fd9ef15d5a1e7f8a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-18T15:03:08Z (GMT) No. of bitstreams: 2 Dissertação - Andreia Costa Rabelo Mendonça - 2015.pdf: 2352078 bytes, checksum: 52168659370d5ee5fd9ef15d5a1e7f8a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2017-04-18T15:03:08Z (GMT). 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dc.title.por.fl_str_mv |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
dc.title.alternative.eng.fl_str_mv |
Comparative neurocognitive assessment in Multiple Sclerosis associated or not to Bipolar disease |
title |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
spellingShingle |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar Mendonça, Andreia Costa Rabelo Neuropsicologia Cognição Esclerose Múltipla Doença bipolar Neuropsychology Cognition Multiple Sclerosis Bipolar disorder CIENCIAS DA SAUDE::MEDICINA |
title_short |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
title_full |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
title_fullStr |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
title_full_unstemmed |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
title_sort |
Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar |
author |
Mendonça, Andreia Costa Rabelo |
author_facet |
Mendonça, Andreia Costa Rabelo |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Caixeta, Leonardo Ferreira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9536747113677509 |
dc.contributor.advisor-co1.fl_str_mv |
Diniz, Denise Sisterolli |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/5139602841690387 |
dc.contributor.referee1.fl_str_mv |
Caixeta, Leonardo Ferreira |
dc.contributor.referee2.fl_str_mv |
Diniz, Denise Sisterolli |
dc.contributor.referee3.fl_str_mv |
Ferreira, Sandra de Fátima Barboza |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9473701973876313 |
dc.contributor.author.fl_str_mv |
Mendonça, Andreia Costa Rabelo |
contributor_str_mv |
Caixeta, Leonardo Ferreira Diniz, Denise Sisterolli Caixeta, Leonardo Ferreira Diniz, Denise Sisterolli Ferreira, Sandra de Fátima Barboza |
dc.subject.por.fl_str_mv |
Neuropsicologia Cognição Esclerose Múltipla Doença bipolar |
topic |
Neuropsicologia Cognição Esclerose Múltipla Doença bipolar Neuropsychology Cognition Multiple Sclerosis Bipolar disorder CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Neuropsychology Cognition Multiple Sclerosis Bipolar disorder |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Background: MS is a chronic neurological, inflammatory, autoimmune, demyelinating, degenerative disease. It affects the CNS, especially young adults and middle (15-40 years). Cognitive changes are more frequent than estimated. In addittion, psychiatric disorders in MS are common and they can emerge as inaugural symptoms even without physical symptoms. MS patients are more vulnerable to psychiatric disorders, which may affect two-thirds of them. However, the findings show that it is underdiagnosed and undertreated. According to the literature, within the psychiatric disorders in MS, depression is the most prevalent, followed by anxiety and bipolar disorder. Method: We radomly evaluated 109 patients from a specialized university service in MS (Centro de Referência, Investigação e Tratamento de Esclerose Múltipla - CRIEM), in Central Brazil. They were diagnosed by experienced neurologists, according to the criteria of McDonald- 2010 and reviewed by Polman et al. - 2011, seen at CRIEM. The final sample consisted of 84 patients with MS, which were divided into two groups (BD and no-BD). Neurocognitive assessment was made by widely used instruments and researched in order to assess cognition in MS (BRB-N). For psychiatric changes, it was used BDI, BAI and screening questionnaire for BD, which was evaluated by a psychiatrist. Results: The SDMT showed statistically significant correlations with all other subtests, being the strongest correlations with PASAT3 '' PASAT2 '' and WLG. More than 60% of the sample had losses in three or four cognitive domains. As for the age groups, there were no statistically significant differences between the performance in the tests. It was possible to infer that the longer the major disease , the bigger the losses in the tests: SRT-R SRT-S, SRT-D, 10/36, SDMT, PASAT3 "and WLG. There were statistically significant differences between the groups with four to six years of diagnosis and the seven to 10 years, and this group had higher losses. We found a non-expected data in our sample, which was the finding of 14 patients with dementia. Of these, nine had symptoms consistent with the phenotype of Frontotemporal Dementia. Conclusion: Neurocognitive changes in MS have high prevalence and major impact on quality of life of patients and their families, as well as high financial costs. There was no statistically significant difference between MS patients with BD and the MS no-BD group, suggesting that cognitive changes between MS / BD overlap. Beyond depression, few studies are available in the literature on psychiatric disorders arising in MS and rather intensify the suffering of the patient. We found a prevalence of 65.5% of BD in this population, higher than the literature findings, which can be justified by a thorough assessment. No statistically significant difference between age groups, but there were differences between disease duration. In this sample, the BD group had significantly higher anxiety than no-BD group. There was presence of 14 patients with dementia, and of these, nine had symptoms consistent with the phenotype of Frontotemporal Dementia |
publishDate |
2015 |
dc.date.issued.fl_str_mv |
2015-10-02 |
dc.date.accessioned.fl_str_mv |
2017-04-18T15:03:08Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
MENDONÇA, A. C. R. Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar. 2015. 89 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2015. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/7170 |
identifier_str_mv |
MENDONÇA, A. C. R. Avaliação neurocognitiva comparativa na Esclerose Múltipla associada ou não à doença Bipolar. 2015. 89 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2015. |
url |
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