Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea

Detalhes bibliográficos
Ano de defesa: 2012
Autor(a) principal: Costa, Danielle Irigoyen da lattes
Orientador(a): Portuguez, Mirna Wetters lattes
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Pontif?cia Universidade Cat?lica do Rio Grande do Sul
Programa de Pós-Graduação: Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
Departamento: Faculdade de Medicina
País: BR
Palavras-chave em Português:
Área do conhecimento CNPq:
Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/1701
Resumo: Introduction: As a chronic disease which is highly prevalent, epilepsy has an important impact on the affected person's psychic/cognitive functioning and their family and social relationships. Among refractory epilepsies, epilepsy of the temporal lobe (ETL) is the most frequent in adults. Studies about lesions on the hippocampus and their effects found that patients with ETL presented verbal and visual memory deficits, depending on the affected hemisphere. Refractoriness to clinical treatment leads to the recommendation of surgery when it is seen that up to that point there have not been any other therapeutic alternatives available. In this context, there is a glimpse of a new treatment possibility for refractory epilepsies, using stem cells. These present a large capacity for proliferation and auto-renovation and the capacity to respond to external stimuli and give rise to different, more specialized cell lines. Objectives: To evaluate the effect of autologous stem cell transplants of bone marrow on the memory functions of patients with refractory epilepsy of the mesial temporal lobe. Patients and Methods: The selection of patients was done at the Outpatient Center for Clinical Epilepsy Research at PUCRS S?o Lucas Hospital [Ambulat?rio de Pesquisa Cl?nica em Epilepsia do Hospital S?o Lucas da PUCRS]. The 13 patients submitted themselves to therapy, and they were evaluated before and after the stem cell treatment (3 and 6 months after). The tests utilized for neuropsychological evaluation (pre and post-therapy) include the Wechsler Memory Scale revised (WMS-R), the Rey Auditory Verbal Learning Test (RAVLT) and the Taylor Complex Figure. Results and Conclusions: The results indicate a significant increase in the neuropsychological scores over time. In six out of seven utilized tests, the increase of average score obtained was significant. In only one test (visual reproduction I WMS R), the increase showed limitrofe statistical significance (between 5% and 10%). Given the favorable evolution of those patients analyzed, the stem cell transplant showed itself to be feasible, safe and with important perspectives for rehabilitation as well as psychosocial and professional reinsertion.
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spelling Portuguez, Mirna WettersCPF:38932946000http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4765068Y6CPF:94041253004http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4735242T2Costa, Danielle Irigoyen da2015-04-14T13:35:34Z2012-08-232012-03-26COSTA, Danielle Irigoyen da. Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea. 2012. 104 f. Tese (Doutorado em Medicina e Ci?ncias da Sa?de) - Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2012.http://tede2.pucrs.br/tede2/handle/tede/1701Introduction: As a chronic disease which is highly prevalent, epilepsy has an important impact on the affected person's psychic/cognitive functioning and their family and social relationships. Among refractory epilepsies, epilepsy of the temporal lobe (ETL) is the most frequent in adults. Studies about lesions on the hippocampus and their effects found that patients with ETL presented verbal and visual memory deficits, depending on the affected hemisphere. Refractoriness to clinical treatment leads to the recommendation of surgery when it is seen that up to that point there have not been any other therapeutic alternatives available. In this context, there is a glimpse of a new treatment possibility for refractory epilepsies, using stem cells. These present a large capacity for proliferation and auto-renovation and the capacity to respond to external stimuli and give rise to different, more specialized cell lines. Objectives: To evaluate the effect of autologous stem cell transplants of bone marrow on the memory functions of patients with refractory epilepsy of the mesial temporal lobe. Patients and Methods: The selection of patients was done at the Outpatient Center for Clinical Epilepsy Research at PUCRS S?o Lucas Hospital [Ambulat?rio de Pesquisa Cl?nica em Epilepsia do Hospital S?o Lucas da PUCRS]. The 13 patients submitted themselves to therapy, and they were evaluated before and after the stem cell treatment (3 and 6 months after). The tests utilized for neuropsychological evaluation (pre and post-therapy) include the Wechsler Memory Scale revised (WMS-R), the Rey Auditory Verbal Learning Test (RAVLT) and the Taylor Complex Figure. Results and Conclusions: The results indicate a significant increase in the neuropsychological scores over time. In six out of seven utilized tests, the increase of average score obtained was significant. In only one test (visual reproduction I WMS R), the increase showed limitrofe statistical significance (between 5% and 10%). Given the favorable evolution of those patients analyzed, the stem cell transplant showed itself to be feasible, safe and with important perspectives for rehabilitation as well as psychosocial and professional reinsertion.Introdu??o: A epilepsia, enquanto condi??o cr?nica de alta preval?ncia tem impacto importante no funcionamento ps?quico/cognitivo e nas rela??es familiares e sociais da pessoa acometida. Entre as epilepsias refrat?rias, a epilepsia do lobo temporal (ELT) ? a mais freq?ente em adultos. Estudos sobre les?es no hipocampo e seus efeitos, constataram que pacientes com ELT apresentam d?ficits de mem?ria verbal e visual, dependendo do hemisf?rio acometido. A refratariedade ao tratamento cl?nico, leva ? indica??o cir?rgica, visto que at? o momento, n?o est?o dispon?veis outras alternativas terap?uticas. Neste contexto, se vislumbra uma nova possibilidade de tratamento para as epilepsias refrat?rias, utilizando-se c?lulas-tronco (CT). Estas apresentam grande capacidade de prolifera??o e auto-renova??o e capacidade de responder a est?mulos externos dando origem a diferentes linhagens celulares mais especializadas. Objetivos: Avaliar o efeito do transplante aut?logo de c?lulas-tronco da medula ?ssea (CTMO) nas fun??es de mem?ria de pacientes com epilepsia refrat?ria do lobo temporal mesial. Pacientes e M?todos: A sele??o dos pacientes foi realizada no Ambulat?rio de Pesquisa Cl?nica em Epilepsia do Hospital S?o Lucas da PUCRS. Os 13 pacientes que se submeteram ? terapia, foram avaliados antes e ap?s o tratamento com c?lulas-tronco (3 meses e 6 meses depois). Os testes utilizados para avalia??o neuropsicol?gica: Escala de Mem?ria Wechsler-revisada (WMS-R), Teste de Aprendizado de Mem?ria Verbal de Rey (RAVLT) e Figura Complexa de Taylor. Resultados e Conclus?es: Os resultados indicam um aumento significativo nos escores neuropsicol?gicos ao longo do tempo. Em seis dos sete testes utilizados, o acr?scimo no escore m?dio obtido foi significativo e, em apenas um teste (WMS R visual imediato), o acr?scimo apresentou signific?ncia estat?stica lim?trofe (entre 5% e 10%). Dada a evolu??o favor?vel dos pacientes analisados, o transplante de CTMO mostrou-se fact?vel, seguro e com perspectivas importantes para a reabilita??o e reinser??o psicossocial e profissional.Made available in DSpace on 2015-04-14T13:35:34Z (GMT). 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dc.title.por.fl_str_mv Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
title Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
spellingShingle Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
Costa, Danielle Irigoyen da
MEDICINA
NEUROCI?NCIA
EPILEPSIA
C?LULAS-TRONCO
MEM?RIA
CNPQ::CIENCIAS DA SAUDE::MEDICINA
title_short Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
title_full Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
title_fullStr Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
title_full_unstemmed Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
title_sort Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea
author Costa, Danielle Irigoyen da
author_facet Costa, Danielle Irigoyen da
author_role author
dc.contributor.advisor1.fl_str_mv Portuguez, Mirna Wetters
dc.contributor.advisor1ID.fl_str_mv CPF:38932946000
dc.contributor.advisor1Lattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4765068Y6
dc.contributor.authorID.fl_str_mv CPF:94041253004
dc.contributor.authorLattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4735242T2
dc.contributor.author.fl_str_mv Costa, Danielle Irigoyen da
contributor_str_mv Portuguez, Mirna Wetters
dc.subject.por.fl_str_mv MEDICINA
NEUROCI?NCIA
EPILEPSIA
C?LULAS-TRONCO
MEM?RIA
topic MEDICINA
NEUROCI?NCIA
EPILEPSIA
C?LULAS-TRONCO
MEM?RIA
CNPQ::CIENCIAS DA SAUDE::MEDICINA
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::MEDICINA
description Introduction: As a chronic disease which is highly prevalent, epilepsy has an important impact on the affected person's psychic/cognitive functioning and their family and social relationships. Among refractory epilepsies, epilepsy of the temporal lobe (ETL) is the most frequent in adults. Studies about lesions on the hippocampus and their effects found that patients with ETL presented verbal and visual memory deficits, depending on the affected hemisphere. Refractoriness to clinical treatment leads to the recommendation of surgery when it is seen that up to that point there have not been any other therapeutic alternatives available. In this context, there is a glimpse of a new treatment possibility for refractory epilepsies, using stem cells. These present a large capacity for proliferation and auto-renovation and the capacity to respond to external stimuli and give rise to different, more specialized cell lines. Objectives: To evaluate the effect of autologous stem cell transplants of bone marrow on the memory functions of patients with refractory epilepsy of the mesial temporal lobe. Patients and Methods: The selection of patients was done at the Outpatient Center for Clinical Epilepsy Research at PUCRS S?o Lucas Hospital [Ambulat?rio de Pesquisa Cl?nica em Epilepsia do Hospital S?o Lucas da PUCRS]. The 13 patients submitted themselves to therapy, and they were evaluated before and after the stem cell treatment (3 and 6 months after). The tests utilized for neuropsychological evaluation (pre and post-therapy) include the Wechsler Memory Scale revised (WMS-R), the Rey Auditory Verbal Learning Test (RAVLT) and the Taylor Complex Figure. Results and Conclusions: The results indicate a significant increase in the neuropsychological scores over time. In six out of seven utilized tests, the increase of average score obtained was significant. In only one test (visual reproduction I WMS R), the increase showed limitrofe statistical significance (between 5% and 10%). Given the favorable evolution of those patients analyzed, the stem cell transplant showed itself to be feasible, safe and with important perspectives for rehabilitation as well as psychosocial and professional reinsertion.
publishDate 2012
dc.date.available.fl_str_mv 2012-08-23
dc.date.issued.fl_str_mv 2012-03-26
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dc.identifier.uri.fl_str_mv http://tede2.pucrs.br/tede2/handle/tede/1701
identifier_str_mv COSTA, Danielle Irigoyen da. Fun??es de mem?ria em pacientes com epilepsia refrat?ria do lobo temporal antes e ap?s transplante aut?logo de c?lulas-tronco da medula ?ssea. 2012. 104 f. Tese (Doutorado em Medicina e Ci?ncias da Sa?de) - Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2012.
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