Rodrigo Bazan
@fmb.unesp.br
Associate Professor
Unesp - Universidade Estadual Paulista
RESEARCH, TEACHING, or OTHER INTERESTS
Neurology (clinical), Neuroscience, Neurology, General Neuroscience
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Tiago Soares Bernardes, Kelly Cristina Sousa Santos, Monalisa Resende Nascimento, César Augusto Noronha e Sousa Filho, Rodrigo Bazan, Janser Moura Pereira, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
Elsevier BV
Gabrielly Fernanda Silva, Lorrane Freitas Campos, Jéssica Mariana de Aquino Miranda, Flávia Guirro Zuliani, Bruno Henrique de Souza Fonseca, Amaro Eduardo Tavares de Araújo, Priscilla Flávia de Melo, Luiz Gustavo Suzuki, Luiz Paulo Aniceto, Rodrigo Bazan,et al.
Informa UK Limited
BACKGROUND AND PURPOSE
Enhancing afferent information from the paretic limb can improve post-stroke motor recovery. However, uncertainties exist regarding varied sensory peripheral neuromodulation protocols and their specific impacts. This study outlines the use of repetitive peripheral sensory stimulation (RPSS) and repetitive magnetic stimulation (rPMS) in individuals with stroke.
METHODS
This scoping review was conducted according to the JBI Evidence Synthesis guidelines. We searched studies published until June 2023 on several databases using a three-step analysis and categorization of the studies: pre-analysis, exploration of the material, and data processing.
RESULTS
We identified 916 studies, 52 of which were included (N = 1,125 participants). Approximately 53.84% of the participants were in the chronic phase, displaying moderate-to-severe functional impairment. Thirty-two studies used RPSS often combining it with task-oriented training, while 20 used rPMS as a standalone intervention. The RPSS primarily targeted the median and ulnar nerves, stimulating for an average of 92.78 min at an intensity that induced paresthesia. RPMS targeted the upper and lower limb paretic muscles, employing a 20 Hz frequency in most studies. The mean stimulation time was 12.74 min, with an intensity of 70% of the maximal stimulator output. Among the 114 variables analyzed in the 52 studies, 88 (77.20%) were in the "s,b" domain, with 26 (22.8%) falling under the "d" domain of the ICF.
DISCUSSION AND CONCLUSION
Sensory peripheral neuromodulation protocols hold the potential for enhancing post-stroke motor recovery, yet optimal outcomes were obtained when integrated with intensive or task-oriented motor training.
Natalia Cristina Ferreira, Gustavo José Luvizutto, Silméia Garcia Zanati Bazan, Luana Aparecida Miranda Bonome, Fernanda Cristina Winckler, Daniel Fabiano Barbosa dos Santos, Cristiane Lara Mendes Chiloff, Gabriel Pinheiro Modolo, Carlos Clayton Macedo de Freitas, Pasqual Barretti,et al.
Frontiers Media SA
BackgroundSince the implementation of the stroke care line in Brazil, the relationship (adequacy) of costs spent during hospitalization with the Brazilian Ministry of Health indicators for a stroke unit have not yet been analyzed.AimsThis study aimed to assess the adequacy of a comprehensive stroke center for key performance indicators and analyze the costs involved in hospitalization. We verified the association between stroke severity at admission and care costs during hospitalization.MethodsA retrospective medical chart review of 451 patients was performed using semiautomatic electronic data from a single comprehensive stroke center in Brazil between July 2018 and January 2020. Clinical and resource utilization data were collected, and the mean acute treatment cost per person was calculated. The Kruskal–Wallis test with Dunn’s post-test was used to compare the total costs between stroke types and reperfusion therapies. A robust linear regression test was used to verify the association between stroke severity at hospital admission and the total hospitalization costs. Good adequacy rates were observed for several indicators.ResultsData from 451 patients were analyzed. The stroke unit had good adaptation to key performance indicators, but some critical points needed revision and improvement to adapt to the requirements of the Ministry of Health. The average total cost of the patient’s stay was the USD 2,637.3, with the daily hospitalization, procedure, operating room, and materials/medication costs equating to USD 2,011.1, USD 220.7, USD 234.1, and USD 98.8, respectively. There was a positive association between the total cost and length of hospital stay (p < 0.001).ConclusionThe stroke unit complied with most of the main performance indicators proposed by the Brazilian Ministry of Health. Underfunding of the costs involved in the hospitalization of patients was verified, and high costs were associated with the length of stay, stroke severity, and mechanical thrombectomy.
Luana Aparecida Miranda, Gustavo José Luvizutto, Pedro Augusto Cândido Bessornia, Natalia Eduarda Furlan, Fernanda Cristina Winckler, Natalia Cristina Ferreira, Pedro Tadao Hamamoto Filho, Juli Thomaz de Souza, Luis Cuadrado Martin, Silméia Garcia Zanati Bazan,et al.
Frontiers Media SA
ObjectiveWe evaluated the extent to which frailty mediated the association between age, poor functional outcomes, and mortality after acute ischemic stroke when patients were treated with brain reperfusion (thrombolytic therapy and/or thrombectomy).Materials and methodsThis retrospective cohort study included patients diagnosed with ischemic stroke who had undergone intravenous cerebral reperfusion therapy and/or mechanical thrombectomy. We created a mediation model by analyzing the direct natural effect of an mRS score > 2 and death on age-mediated frailty according to the Frailty Index.ResultsWe enrolled 292 patients with acute ischemic stroke who underwent brain reperfusion. Their mean age was 67.7 ± 13.1 years. Ninety days after the stroke ictus, 54 (18.5%) participants died, and 83 (28.4%) lived with moderate to severe disability (2 < mRS < 6). In the mediation analysis of the composite outcome of disability (mRS score > 2) or death, frailty accounted for 28% of the total effect of age. The models used to test for the interaction between age and frailty did not show statistically significant interactions for either outcome, and the addition of the interaction did not significantly change the direct or indirect effects, nor did it improve model fit.ConclusionFrailty mediated almost one-third of the effect of age on the composite outcome of disability or death after acute ischemic stroke.
Juli Thomaz de Souza, Marcos F. Minicucci, Natália C. Ferreira, Bertha F. Polegato, Marina Politi Okoshi, Gabriel P. Modolo, Bethan E. Phillips, Philip J. Atherton, Kenneth Smith, Daniel Wilkinson,et al.
Springer Science and Business Media LLC
Abstract Background Stroke is a leading cause of mortality and disability, and its sequelae are associated with inadequate food intake which can lead to sarcopenia. The aim of this study is to verify the effectiveness of creatine supplementation on functional capacity, strength, and changes in muscle mass during hospitalization for stroke compared to usual care. An exploratory subanalysis will be performed to assess the inflammatory profiles of all participants, in addition to a follow-up 90 days after stroke, to verify functional capacity, muscle strength, mortality, and quality of life. Methods Randomized, double-blind, unicenter, parallel-group trial including individuals with ischemic stroke in the acute phase. The duration of the trial for the individual subject will be approximately 90 days, and each subject will attend a maximum of three visits. Clinical, biochemical, anthropometric, body composition, muscle strength, functional capacity, degree of dependence, and quality of life assessments will be performed. Thirty participants will be divided into two groups: intervention (patients will intake one sachet containing 10g of creatine twice a day) and control (patients will intake one sachet containing 10g of placebo [maltodextrin] twice a day). Both groups will receive supplementation with powdered milk protein serum isolate to achieve the goal of 1.5g of protein/kg of body weight/day and daily physiotherapy according to the current rehabilitation guidelines for patients with stroke. Supplementation will be offered during the 7-day hospitalization. The primary outcomes will be functional capacity, strength, and changes in muscle mass after the intervention as assessed by the Modified Rankin Scale, Timed Up and Go test, handgrip strength, 30-s chair stand test, muscle ultrasonography, electrical bioimpedance, and identification of muscle degradation markers by D3-methylhistidine. Follow-up will be performed 90 days after stroke to verify functional capacity, muscle strength, mortality, and quality of life. Discussion The older population has specific nutrient needs, especially for muscle mass and function maintenance. Considering that stroke is a potentially disabling event that can lead the affected individual to present with numerous sequelae, it is crucial to study the mechanisms of muscle mass loss and understand how adequate supplementation can help these patients to better recover. Trial registration The Brazilian Clinical Trials Registry (ReBEC) RBR-9q7gg4. Registered on 21 January 2019.
Carlos Alexandre Aguiar Moreira, Luis Henrique Vallesquino Murayama, Tatiane de Camargo Martins, Vinicius Tadeu Oliveira, Diego Generoso, Vania Maria de Vasconcelos Machado, Sabrina Setembre Batah, Alexandre Todorovic Fabro, Rodrigo Bazan, Marco Antônio Zanini,et al.
Springer Science and Business Media LLC
Milena Miranda Vasconcelos, Camilla Sousa Ganan, Caroline Ferreira da Silva Mazeto Pupo da Silveira, Karina Nogueira Dias Secco Malagutte, Juliane Rosa Poiati, Hélio Rubens de Carvalho Nunes, Luis Cuadrado Martin, Rodrigo Bazan, Vera Therezinha Medeiros Borges, and Silméia Garcia Zanati Bazan
Elsevier BV
Lu Ma, Xin Hu, Lili Song, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Alejandra Malavera, Xi Li, Paula Muñoz-Venturelli,et al.
Elsevier BV
Daniele Andreza Antonelli Rossi, Jonas Alves De Araujo Junior, Gustavo José Luvizutto, Rodrigo Bazan, Péricles Sidnei Salmazo, Gabriel Pinheiro Modolo, João Carlos Hueb, Hélio Rubens de Carvalho Nunes, Newton Key Hokama, Marcos Ferreira Minicucci,et al.
MDPI AG
Introduction: The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. Methods: A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1—Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2—Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. Statistical analysis: Comparisons between groups were made using Student’s t-test, Mann–Whitney test, chi-square test, or Fisher’s exact test. Spearman’s correlation coefficient was calculated. The significance level was set at p < 0.05. Results: There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient −0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient −0.480; p = 0.013) in SCD patients in both groups. Conclusions: The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.
Isabella Polo Monteiro, Pablo Andrei Appelt, Angélica Taciana Sisconetto, Kelly Savana Minaré Baldo Sucupira, Rodrigo Bazan, Gustavo José Luvizutto, and Luciane Aparecida Pascucci Sande de Souza
SAGE Publications
Background Current knowledge regarding coronavirus disease 2019 (COVID-19) is constantly evolving, and the long-term functional impairments, limitations, and restrictions have not yet been well established. Objective to evaluate the impact of post-COVID condition on the human functioning through the International Classification of Functioning, Disability and Health (ICF) classification. Methods This is a prospective cohort study with 53 individuals with post-COVID condition at 3 time points: 0 to 3 (baseline), 3 to 6, and 6-12 months (follow-up). Outcomes were organized in dichotomous variable: No impairment (0); presence of impairment (≥1) in body function, structure, activities, and participation domains according to the ICF checklist. Chi-square test was used to determine the differences of 3 time points, and association with persistent symptoms. Results A statistically significant difference was observed between the periods, with greater disabilities at 6-12 than at 0-3 months in mental, sensory, pain, and movement-related functions; cardiovascular, immunological, and respiratory systems. In terms of activity and participation, a greater limitation at 6-12 months was observed than at 0-3 months in learning and applying knowledge, general tasks, and mobility. In the domain of interpersonal interactions and relationships, there was a statistically significant difference between the 6-12 and 3-6 months groups. Associations between COVID-19 symptoms and ICF components at the first follow-up were: anosmia and dysgeusia with weight maintenance, fatigue and irritability with pain, brain fog with watching and listening, walking difficulty with pain, and headache with pain, watching, and listening. At the second follow-up were: anosmia and dysgeusia with energy and drive functions, attention, memory, and emotional functions; dizziness with watching and listening; fatigue with emotional function, pain, undertaking multiple tasks, lifting and carrying objects, and driving; irritability with energy and drive, emotional function, undertaking multiple tasks, lifting and carrying objects, and walking; walking difficulty with energy and driving, emotional function, respiration, muscle power, cardiovascular system, undertaking multiple tasks, lifting and carrying objects, and walking; and headache with emotional function, watching, and listening. Conclusions Individuals with COVID-19 persistent symptoms showed impairments in structure and function, activity limitations, and participation restrictions during the 1-year follow-up period.
Bruno Henrique de Souza Fonseca, Pedro Henrique Sousa de Andrade, Maria Eduarda Salum Aveiro Henrique, Jussara Almeida de Oliveira Baggio, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
SAGE Publications
Background SARS-CoV-2 infection affects multiple systems, including musculoskeletal, neurological, and respiratory systems. Changes associated with physical inactivity due to prolonged hospitalization can affect the functional capacity of individuals with long coronavirus disease 2019 (COVID-19) or post-COVID-19 condition and may cause changes in some postural control functions, such as verticality. Objectives This study aimed to evaluate the perception of verticality in individuals with long COVID. Design Cross-sectional study Methods This study included 60 participants with post-COVID-19 condition divided into 2 groups: hospitalized group (n = 24), those hospitalized owing to SARS-CoV-2 infection; and non-hospitalized group (n = 36), those infected with SARS-CoV-2 but not hospitalized. All participants were examined using a post-COVID-19 functional status (PCFS) , sit-to-stand test, grip strength assessment, painful and tactile sensory assessments, visual acuity assessment, and vestibular assessment. Verticality perception was evaluated using the subjective visual vertical (SVV) and subjective haptic vertical (SHV) tests. In both tests, the absolute values (positive values only) and true values (positive and negative values) were considered. To verify potential confounders that could influence the verticality of the results, logistic regression models were used for categorical variables and multiple linear regressions were used for continuous variables. For analysis between groups, the independent samples test (Mann–Whitney U test) was used. Results There were no confounders between clinical variables and verticality in either group. There was a significant increase in absolute SVV (mean deviation [MD]: 2.83; P < .0001) and true SVV (MD: −4.18; P = .005) in the hospitalized group compared to the non-hospitalized group. Furthermore, there was a significant increase in the true SHV (MD: −3.6; P = .026) in the hospitalized group compared to that in the non-hospitalized group. Conclusion Less accurate visual and haptic verticality perception task performance was observed in hospitalized patients with post-COVID-19 condition.
Roberta de Oliveira Cacho, Carla Heloisa Cabral Moro, Rodrigo Bazan, Suzete Nascimento Farias da Guarda, Elen Beatriz Pinto, Suellen Mary Marinho dos Santos Andrade, Lenise Valler, Kelson James Almeida, Tatiana Souza Ribeiro, Renata Viana Brígido de Moura Jucá,et al.
Georg Thieme Verlag KG
Resposta à carta referente ao artigo intitulado: “Acesso à reabilitação após o AVC no Brasil (estudo AReA): protocolo de estudo multicêntrico” Roberta de Oliveira Cacho1 Carla Heloisa Cabral Moro2 Rodrigo Bazan3 Suzete Nascimento Farias da Guarda4 Elen Beatriz Pinto5 Suellen Mary Marinho dos Santos Andrade6 Lenise Valler7 Kelson James Almeida8 Tatiana Souza Ribeiro9 Renata Viana Brígido de Moura Jucá10 Cesar Minelli11,12 Maria Elisa Pimentel Piemonte13 Eric Homero Albuquerque Paschoal14 Marco Túlio Araújo Pedatella15 Octávio Marques Pontes-Neto16 Ana Paula Fontana17 Aline de Souza Pagnussat18 Adriana Bastos Conforto19,20 and AReA Study Group
Igor Oliveira da Fonseca, Gustavo José Luvizutto, Isaac Pantaleão Souza, André Petean Trindade, Carlos Clayton Macedo de Freitas, Rodrigo Bazan, and Gabriel Pinheiro Modolo
FapUNIFESP (SciELO)
Abstract Neurofibromatosis Type 1 (NF1) is a rare cause of ischemic stroke (IS) in the general population. We report a case of a young patient with NF1 in whom IS was caused by fibromuscular dysplasia. An angiographic study demonstrated occlusion in the right internal carotid artery (ICA), just after its origin, and the left ICA, just before the intracranial portion, and brain magnetic resonance imaging showed the limits of an area of brain infarction in the right frontoparietal region. Despite these concomitant neuroimaging findings, this association is rare, and it is difficult to establish the contribution to the outcome made by each of these diseases, which treatment is the best to implement, or what prognosis is.
Gustavo José Luvizutto and Rodrigo Bazan
VM Media SP. zo.o VM Group SK
T.R. da Silva, G.J. Luvizutto, L.G. Martins, R.D.M. da Costa, J.T. de Souza, F.C. Winckler, L.C.A. Sartor, G.P. Modolo, N.C. Ferreira, J.C.S. Rodrigues,et al.
FapUNIFESP (SciELO)
There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.
Bruno Henrique de Souza Fonseca, Pedro Henrique Sousa de Andrade, Otávio Borges, Jessica Mariana de Aquino Miranda, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
Informa UK Limited
Abstract Objectives New types of treatments have emerged, such as non-invasive brain stimulation (NIBS), to treat chronic vestibular dysfunction (VD). Considering that NIBS is a promising approach to reduce VD symptoms, this review was aimed to analyze the effects of NIBS in patients with VD. Methods We adhered to the methods described in the Cochrane Handbook for Intervention Reviews. The eligibility criteria were as follows: (a) individuals with vestibulopathy having clinical and neuroimaging; (b) Interventions: non-invasive brain stimulation, this intervention comprised transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS); (c) Control: any comparison or sham; and (d) Outcomes: dizziness and balance. We included randomized controlled trials and non-randomized studies from July 2004 to February 2020. We searched the PubMed, CINAHL, Web of Science, Scopus, Cochrane, and Ovid databases. Two pairs of reviewers independently screened all titles and abstracts. Two authors assessed the risk of bias for each study using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the certainty of the evidence for each outcome. Results We identified 136 studies, and included two studies. Both studies used tDCS application. One study used anodal cerebellar tDCS or sham at 2 mA for 25 min associated with vestibular rehabilitation therapy (VRT), and the other study used anodal tDCS over the left dorsolateral prefrontal cortex (F3) for 25–30 min associated with VRT at home. Both studies showed clinical improvement in the Dizziness Handicap Inventory (DHI), State-Trait Anxiety Inventory (STAI), Activities-Specific Balance Confidence (ABC), and Self-Rating Depression Scale (SDS) scores. Both studies presented higher-quality evidence on the GRADE scale and a low risk of bias. Conclusions Based on two studies, anodal tDCS over F3 or the cerebellum associated with VRT improved chronic vestibular symptoms.
Jéssica Mariana de Aquino Miranda, Viviany Mendes Borges, Rodrigo Bazan, Gustavo José Luvizutto, and Jullyanna Sabrysna Morais Shinosaki
Informa UK Limited
ABSTRACT Background Early mobilization is defined as out-of-bed activities in acute stroke phase, and has led to improvements in functional capacity and reduction of complications after stroke. Objective This study aimed to investigate the effectiveness and safety of early mobilization in the acute stroke phase. Methods This was a systematic review. We searched for studies with the keywords: “Stroke,” “Early mobilization” and “Functional outcomes.” Data source: NLM, LILACS, MEDLINE, PEDro, and Science Direct. Studies published up to June 2020 were included; (b) study eligibility criteria: clinical trials; (c) participants: stroke patients in the acute phase; (d) interventions: early mobilization; (e) study appraisal: two authors independently assessed the risk of bias, Grading of Recommendations Assessment, Development and Evaluation, and the Oxford Center for Evidence-Based Medicine Levels of Evidence. The safety was evaluated based on related and non-related adverse effects. Results Altogether, 476 studies were retrieved. After exclusion, seven studies involving 8663 patients were included in the qualitative synthesis. The main activities were elevation of the headboard, sitting, standing, and walking. The most important outcome assessed was the modified Rankin scale score (disability) after 3 months of stroke, and two studies showed that early mobilization improves functional capacity after stroke. Conclusion the optimal time to start early mobilization is > 24 h of stroke according to hemodynamic stability and safety criteria. The duration of mobilization is recommended between 15 and 45 minutes, divided into one, two, or three times a day. The focus of early mobilization should be on sitting, standing, and walking activity.
Luana Aparecida Miranda, Gustavo José Luvizutto, Blossom Christa Maree Stephan, Juli Thomaz de Souza, Taís Regina da Silva, Fernanda Cristina Winckler, Natalia Cristina Ferreira, Leticia Claudia de Oliveira Antunes, Pedro Augusto Cândido Bessornia, Silméia Garcia Zanati Bazan,et al.
Elsevier BV
Gabriel Pinheiro Modolo, Gustavo José Luvizutto, Pedro Tadao Hamamoto Filho, Gabriel Pereira Braga, Silmeia Garcia Zanati Bazan, Natalia Cristina Ferreira, Juli Thomaz de Souza, Fernanda Cristina Winckler, Carlos Clayton Macedo de Freitas, Newton Key Hokama,et al.
Springer Science and Business Media LLC
Abstract Background Sickle cell anemia (SCA) is the leading cause of childhood stroke. We aimed to evaluate whether altered cerebral flow velocities, as measured by transcranial Doppler (TCD), are associated with vaso-occlusive complications in addition to stroke in pediatric SCA patients. Methods We evaluated 37 children aged between 2 and 16 years with SCA who underwent screening for TCD between January 2012 and October 2018. Genotypic profiles and demographic data were collected, TCD examinations were performed during follow-up, and the presence of sickling crises was compared. Survival analyses were performed using simple frailty models, in which each predictor variable was analyzed separately in relation to the occurrence of a sickling crisis. Results The variables related to sickle cell crises in the univariate analysis were peak systolic velocity (PSV) in the middle cerebral artery (MCA), hazard ratio (HR) 1.01 (1.00—1.02) p = 0.04; end-diastolic velocity (EDV) in the MCA, HR 1.02 (1.01—1.04) p = 0.01; time average mean maximum velocity (TAMMV) in the basilar artery (BA), HR 1.02 (1.00—1.04) p = 0.04; hemoglobin, HR 0.49 (0.38—0.65) p < 0.001; hematocrit, HR 0.78 (0.71—0.85) p < 0.001; leukocyte counts, HR 1.1 (1.05—1.15) p < 0.001; platelets counts, HR 0.997 (0.994—0.999) p = 0.02; and reticulocyte numbers, HR 1.14 (1.06—1.23) p < 0.001. Conclusions Our results indicate PSV and EDV in the MCA and TAMMV in the BA as markers of risk for the occurrence of sickling crises in SCA.
Pablo Andrei Appelt, Angélica Taciana Sisconetto, Kelly Savana Minaré Baldo Sucupira, Eduardo de Moura Neto, Tatiane de Jesus Chagas, Rodrigo Bazan, Ariana Moura Cabral, Adriano de Oliveira Andrade, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
SAGE Publications
The coronavirus disease 2019 (COVID-19) can disrupt various brain functions. Over a one-year period, we aimed to assess brain activity and cognitive function in 53 COVID-19 patients and 30 individuals without COVID-19 (or asymptomatic). The Montreal Cognitive Assessment, Trail Making Test Parts A and B (TMT-A and B), and Digit Span Test were used to assess cognitive function. Cognitive variables and electroencephalography (EEG) data (activity, mobility, and complexity) were compared between the groups at rest and during cognitive demand (F3-F7, Fz-F3, Fz-F4, and F4-F8). There was a reduction in F3-F7 activity during the TMT-B in the COVID-19 group at 6-12 months compared to the controls (p = 0.01) at baseline (p = 0.03), a reduction in signal complexity at F3-F7 at rest in the COVID-19 group at baseline and 6-12 months compared to the controls (p < 0.001), and a reduction in Fz-F4 activity at rest from 6-12 months in the post-COVID group compared to baseline (p = 0.02) and 3-6 months (p = 0.04). At 6-12 months, there was a time increase in TMT-A in the COVID-19 group compared to that in the controls (p = 0.04). Some correlations were found between EEG data and cognitive test in both groups. In conclusion, there was a reduction in brain activity at rest in the Fz-F4 areas and during high cognitive demands in the F3-F7 areas. A reduction in signal complexity in F3-F7 at rest was found in the COVID-19 group at 6-12 months after acute infection. Furthermore, individuals with COVID-19 experience long-term changes in cognitive function.
Roberta de Oliveira Cacho, Carla Heloisa Cabral Moro, Rodrigo Bazan, Suzete Nascimento Farias da Guarda, Elen Beatriz Pinto, Suellen Mary Marinho dos Santos Andrade, Lenise Valler, Kelson James Almeida, Tatiana Souza Ribeiro, Renata Viana Brígido de Moura Jucá,et al.
Georg Thieme Verlag KG
Abstract Background Most of the Brazilian population relies on public healthcare and stroke is a major cause of disability in this country of continental dimensions. There is limited information about access to rehabilitation after stroke in Brazil. Objective To provide comprehensive information about Access to Rehabilitation After discharge from public hospitals in Brazil (AReA study), up to 6 months after stroke. Methods The present study intends to collect information from 17 public health centers in 16 Brazilian cities in the 5 macroregions of the country. Each center will include 36 participants (n = 612). The inclusion criteria are: age ≥ 18 years old; ischemic or hemorrhagic stroke, from 6 months to 1 year prior to the interview; admission to a public hospital in the acute phase after stroke; any neurological impairment poststroke; patient or caregiver able to provide informed consent and answer the survey. Patients can only be recruited in public neurology or internal medicine outpatient clinics. Outcomes will be assessed by a standard questionnaire about rehabilitation referrals, the rehabilitation program (current status, duration in months, number of sessions per week) and instructions received. In addition, patients will be asked about preferences for locations of rehabilitation (hospitals, clinics, or at home). Trial Status The study is ongoing. Recruitment started on January 31st, 2020 and is planned to continue until June 2022. Conclusion The AReA study will fill a gap in knowledge about access to stroke rehabilitation in the public health system in different Brazilian regions.
Gustavo José Luvizutto, Gabriel Pereira Braga, Luiz Eduardo Gomes Garcia Betting, and Rodrigo Bazan
Georg Thieme Verlag KG
A 53-year-old right-handed man developed left hemiparesis (of grade 2 in the Medical Research Council Scale) and right headdeviationduetoischemicstroke.Wheninstructedtoclap his hands, he brought his right hand to the midline and searched for the other hand ( ► Video 1 ). Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) scans, the unilateral spatial neglect (USN) test
Taís Regina da Silva, Hélio Rubens de Carvalho Nunes, Laís Geronutti Martins, Rafael Dalle Molle da Costa, Juli Thomaz de Souza, Fernanda Cristina Winckler, Lorena Cristina Alvarez Sartor, Gabriel Pinheiro Modolo, Natalia Cristina Ferreira, Josiela Cristina da Silva Rodrigues,et al.
Annals of Neurology Wiley
Rehabilitation top‐down techniques based on brain stimulation present variable outcomes in unilateral spatial neglect (USN) after stroke. This study aimed to examine the effects of physical therapy after anodal and cathodal transcranial direct current stimulation (A‐tDCS and C‐tDCS, respectively) to improve visuospatial and functional impairments in individuals with USN after stroke.
Rodrigo Bazan, Bruno Henrique de Souza Fonseca, Jessica Mariana de Aquino Miranda, Hélio Rubens de Carvalho Nunes, Silméia Garcia Zanati Bazan, and Gustavo José Luvizutto
SAGE Publications
BackgroundSeveral studies have shown that robotic devices can effectively improve motor function in stroke patients through limb activation. However, the effects of robot-assisted therapy on perceptual deficits after stroke is unclear.ObjectiveThis review aimed to evaluate the effectiveness of robotic limb activation in patients with unilateral spatial neglect (USN) after stroke.MethodsIn this systematic review, a literature search was performed using MEDLINE, EMBASE, CENTRAL, CINAHL, and LILACS databases without language restrictions. Randomized controlled trials (RCTs) and quasi-RCTs of robot-assisted therapy for USN after stroke were selected. Two reviewers independently assessed the risk of bias and certainty of the evidence of the included studies.ResultsA total of 630 studies were identified, including five studies for qualitative synthesis and four meta-analyses. The results of RCTs comparing robotic limb activation with a control group suggested an improvement in the degree of USN measured by the line bisection test (standardized mean difference [SMD], −0.64; 95% confidence interval [CI], −1.13 to −0.15; P = .01). There were no differences between the groups in the motor-free visual perception test 3rd edition (SMD, 0.27; 95% CI, −0.25–0.79; P = .31), star cancellation test (SMD, 0.26; 95% CI, −0.42−0.94; P = .54), Albert’s test (SMD, −0.67; 95% CI, −2.01−0.66; P = .32), and Catherine Bergego Scale (SMD, −0.81; 95% CI, −2.07−0.45; P = .21).ConclusionThe study demonstrated that limb activation through robotic therapy can improve midline perception. However, there was no impact on tasks assessing visual scanning, functionality, or activities of daily living.