Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes
Ano de defesa: | 2017 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de São Paulo (UNIFESP)
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Programa de Pós-Graduação: |
Não Informado pela instituição
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Departamento: |
Não Informado pela instituição
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País: |
Não Informado pela instituição
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Palavras-chave em Português: | |
Link de acesso: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454064 http://repositorio.unifesp.br/handle/11600/49993 |
Resumo: | Objective: To describe the prevalence and characteristics of movement disorders in patients with MS (multiple sclerosis) and NMOSD (neuromyelitis optica spectrum disorder) followed at the Neuroimmunology clinic at Universidade Federal de São Paulo. In addition, to investigate the association between MS, NMOSD, disability, movement disorders and quality of life. Methods: A cross-sectional study of patients with demyelinating diseases was conducted from June 2015 to September 2016. Patients aged 18 years or older, without significant cognitive impairment and with diagnostic criteria for MS or NMOSD were eligible. We evaluated 268 patients, 15 were excluded. The main exclusion criteria was other possible cause related with the movement disorder. Patients were evaluated with interview and physical exam by a neurologist specialist in movement disorder. We used the following tools: the EDSS (Expanded Disability Status Scale), the Fahn Tolosa and Marín tremor rating scale, the modified Ashworth scale, for assessment of spasticity, and EuroQoL- 5 Dimensions questionnaire, for analysis of quality of life. Results: From 253 patients included, 26% presented with movement disorders. The majority of the patients was female (74.3%), with a mean age of 40.36 years (SD = 11.74). The median EDSS score of included patients was 2.5 with interquartile range of 1.0- 6.0. Paroxysmal dystonia (n=32) was the most common movement disorder, followed by tremor (n=27). The prevalence of tremor in MS was 12.5% and intention tremor was the most common (82%). Patients with MS and low EDSS score (<4,0), compared to NMOSD, have fewer movement disorders. Paroxysmal dystonia was strongly associated to NMOSD diagnosis (OR=22.07, 95%CI=2.56 - 189.78; p=0.005). The mean of utility scores of quality of life was 0.58 (SD=0.26), patients with MS have 0.15 points higher on average than patients with NMOSD, and patients with movement disorders have 0.083 points lower than those without them. Conclusion: The presence of movement disorders in patients with demyelinating diseases seems to be related with severity and progression of the disease. Paroxysmal dystonia is significantly more associated with NMOSD, and may be a clinical marker of this. Intention tremor was the most common movement disorder in MS. It has been demonstrated an impact on the quality of life of patients with demyelinating diseases and movement disorders. |
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Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantesAssessment of movement disorders in patients with demyelinating diseasesDemyelinating diseaseMovement disordersTremorDystoniaMultiple sclerosisOptical neuromyelitisDoença desmielinizanteTranstornos dos movimentosTremorDistoniaEsclerose múltiplaNeuromielite ópticaObjective: To describe the prevalence and characteristics of movement disorders in patients with MS (multiple sclerosis) and NMOSD (neuromyelitis optica spectrum disorder) followed at the Neuroimmunology clinic at Universidade Federal de São Paulo. In addition, to investigate the association between MS, NMOSD, disability, movement disorders and quality of life. Methods: A cross-sectional study of patients with demyelinating diseases was conducted from June 2015 to September 2016. Patients aged 18 years or older, without significant cognitive impairment and with diagnostic criteria for MS or NMOSD were eligible. We evaluated 268 patients, 15 were excluded. The main exclusion criteria was other possible cause related with the movement disorder. Patients were evaluated with interview and physical exam by a neurologist specialist in movement disorder. We used the following tools: the EDSS (Expanded Disability Status Scale), the Fahn Tolosa and Marín tremor rating scale, the modified Ashworth scale, for assessment of spasticity, and EuroQoL- 5 Dimensions questionnaire, for analysis of quality of life. Results: From 253 patients included, 26% presented with movement disorders. The majority of the patients was female (74.3%), with a mean age of 40.36 years (SD = 11.74). The median EDSS score of included patients was 2.5 with interquartile range of 1.0- 6.0. Paroxysmal dystonia (n=32) was the most common movement disorder, followed by tremor (n=27). The prevalence of tremor in MS was 12.5% and intention tremor was the most common (82%). Patients with MS and low EDSS score (<4,0), compared to NMOSD, have fewer movement disorders. Paroxysmal dystonia was strongly associated to NMOSD diagnosis (OR=22.07, 95%CI=2.56 - 189.78; p=0.005). The mean of utility scores of quality of life was 0.58 (SD=0.26), patients with MS have 0.15 points higher on average than patients with NMOSD, and patients with movement disorders have 0.083 points lower than those without them. Conclusion: The presence of movement disorders in patients with demyelinating diseases seems to be related with severity and progression of the disease. Paroxysmal dystonia is significantly more associated with NMOSD, and may be a clinical marker of this. Intention tremor was the most common movement disorder in MS. It has been demonstrated an impact on the quality of life of patients with demyelinating diseases and movement disorders.Objetivo: Descrever a prevalência e as características dos transtornos do movimento em pacientes com EM (esclerose múltipla) e NMOSD (doença do espectro da neuromielite óptica) em seguimento no ambulatório de Neuroimunologia da Universidade Federal de São Paulo. Além disto, investigar a associação entre EM, NMOSD, incapacidade, transtornos do movimento e qualidade de vida. Métodos: Foi realizado um estudo de corte transversal com pacientes com doenças desmielinizantes de junho de 2015 a Setembro de 2016. Foram elegíveis pacientes com idade acima de 18 anos e sem comprometimento cognitivo significativo com diagnóstico de EM e NMOSD. Foram avaliados 268 pacientes, 15 foram excluídos. O principal critério de exclusão foi outra possível causa relacionada ao distúrbio do movimento. Os pacientes foram avaliados através de entrevista e exame físico por um neurologista, especialista em transtornos do movimento. Os instrumentos utilizados foram: a EDSS (Expanded Disability Status Scale), a escala de tremor de Fahn Tolosa e Marín, a escala de Ashworth modificada, para avaliação da espasticidade, e o questionário EuroQoL-5 Dimensions, para análise da qualidade de vida. Resultados: Dos 253 pacientes incluídos, 26% apresentaram transtornos do movimento. A maioria dos pacientes era do sexo feminino (74,3%), com média de idade de 40,36 anos (DP=11,74). A mediana do escore de EDSS dos pacientes incluídos foi de 2,5 com intervalo interquartil de 1,0-6,0. A distonia paroxística foi o transtorno do movimento mais comum (n=32), seguido pelo tremor (n=27). A prevalência do tremor na EM foi de 12,5% e o tremor de intenção foi o mais comum (82%). Pacientes com EM e escore de EDSS baixo (<4,0), comparados a NMOSD, tiveram menos transtornos do movimento. A distonia paroxística foi fortemente associada ao diagnóstico de NMOSD (OR=22.07, 95%CI=2.56 - 189.78; p=0.005). A média dos valores de utilidade de qualidade de vida foi 0,58 (DP=0,26). Os pacientes com EM tiveram 0,15 pontos acima em média que os pacientes com NMOSD e os pacientes com distúrbios do movimento tiveram 0,083 pontos abaixo que os pacientes sem estes. Conclusão: A presença dos transtornos do movimento nos pacientes com doenças desmielinizantes parece estar associada à gravidade e progressão da doença. A distonia paroxística é significativamente mais associada com a NMOSD, e pode ser um marcador clínico desta. O tremor de intenção foi o transtorno do movimento mais comum na EM. Foi demonstrado um impacto na qualidade de vida dos pacientes com doenças desmielinizantes e transtornos do movimento.Dados abertos - Sucupira - Teses e dissertações (2017)Universidade Federal de São Paulo (UNIFESP)Borges, Vanderci [UNIFESP]Oliveira, Enedina Maria Lobato de [UNIFESP]http://lattes.cnpq.br/9619603975043505http://lattes.cnpq.br/2742450111759824http://lattes.cnpq.br/8841277346692168Universidade Federal de São Paulo (UNIFESP)Silva, Carolina Candeias da [UNIFESP]2019-06-19T14:57:15Z2019-06-19T14:57:15Z2017-11-30info:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/publishedVersion98 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454064http://repositorio.unifesp.br/handle/11600/49993porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-02T15:10:24Zoai:repositorio.unifesp.br/:11600/49993Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-02T15:10:24Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes Assessment of movement disorders in patients with demyelinating diseases |
title |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
spellingShingle |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes Silva, Carolina Candeias da [UNIFESP] Demyelinating disease Movement disorders Tremor Dystonia Multiple sclerosis Optical neuromyelitis Doença desmielinizante Transtornos dos movimentos Tremor Distonia Esclerose múltipla Neuromielite óptica |
title_short |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
title_full |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
title_fullStr |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
title_full_unstemmed |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
title_sort |
Avaliação dos distúrbios do movimento em pacientes com doenças desmielinizantes |
author |
Silva, Carolina Candeias da [UNIFESP] |
author_facet |
Silva, Carolina Candeias da [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Borges, Vanderci [UNIFESP] Oliveira, Enedina Maria Lobato de [UNIFESP] http://lattes.cnpq.br/9619603975043505 http://lattes.cnpq.br/2742450111759824 http://lattes.cnpq.br/8841277346692168 Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Silva, Carolina Candeias da [UNIFESP] |
dc.subject.por.fl_str_mv |
Demyelinating disease Movement disorders Tremor Dystonia Multiple sclerosis Optical neuromyelitis Doença desmielinizante Transtornos dos movimentos Tremor Distonia Esclerose múltipla Neuromielite óptica |
topic |
Demyelinating disease Movement disorders Tremor Dystonia Multiple sclerosis Optical neuromyelitis Doença desmielinizante Transtornos dos movimentos Tremor Distonia Esclerose múltipla Neuromielite óptica |
description |
Objective: To describe the prevalence and characteristics of movement disorders in patients with MS (multiple sclerosis) and NMOSD (neuromyelitis optica spectrum disorder) followed at the Neuroimmunology clinic at Universidade Federal de São Paulo. In addition, to investigate the association between MS, NMOSD, disability, movement disorders and quality of life. Methods: A cross-sectional study of patients with demyelinating diseases was conducted from June 2015 to September 2016. Patients aged 18 years or older, without significant cognitive impairment and with diagnostic criteria for MS or NMOSD were eligible. We evaluated 268 patients, 15 were excluded. The main exclusion criteria was other possible cause related with the movement disorder. Patients were evaluated with interview and physical exam by a neurologist specialist in movement disorder. We used the following tools: the EDSS (Expanded Disability Status Scale), the Fahn Tolosa and Marín tremor rating scale, the modified Ashworth scale, for assessment of spasticity, and EuroQoL- 5 Dimensions questionnaire, for analysis of quality of life. Results: From 253 patients included, 26% presented with movement disorders. The majority of the patients was female (74.3%), with a mean age of 40.36 years (SD = 11.74). The median EDSS score of included patients was 2.5 with interquartile range of 1.0- 6.0. Paroxysmal dystonia (n=32) was the most common movement disorder, followed by tremor (n=27). The prevalence of tremor in MS was 12.5% and intention tremor was the most common (82%). Patients with MS and low EDSS score (<4,0), compared to NMOSD, have fewer movement disorders. Paroxysmal dystonia was strongly associated to NMOSD diagnosis (OR=22.07, 95%CI=2.56 - 189.78; p=0.005). The mean of utility scores of quality of life was 0.58 (SD=0.26), patients with MS have 0.15 points higher on average than patients with NMOSD, and patients with movement disorders have 0.083 points lower than those without them. Conclusion: The presence of movement disorders in patients with demyelinating diseases seems to be related with severity and progression of the disease. Paroxysmal dystonia is significantly more associated with NMOSD, and may be a clinical marker of this. Intention tremor was the most common movement disorder in MS. It has been demonstrated an impact on the quality of life of patients with demyelinating diseases and movement disorders. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-11-30 2019-06-19T14:57:15Z 2019-06-19T14:57:15Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454064 http://repositorio.unifesp.br/handle/11600/49993 |
url |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454064 http://repositorio.unifesp.br/handle/11600/49993 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
98 f. application/pdf |
dc.coverage.none.fl_str_mv |
São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268857776340992 |