Prejuízo na velocidade de processamento em pacientes com polineuropatia inflamatória desmielinizante crônica: um estudo transversal

Senem, Iara; Spedo, Carina Telarolli; Conde, Rodrigo Melo; Reis, Geraldo Cassio dos; Santos, Antônio Carlos dos; Barreira, Amilton Antunes; Marques Jr., Wilson

Iara Senem

writing

research design

neuropsychological assessment

data collection

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0001-5331-946X

Carina Telarolli Spedo

research design

critical review

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

Universidade Federal de São Carlos, Departamento de Psicologia, São Carlos SP, Brazil.

http://orcid.org/0000-0001-6627-9698

Rodrigo Melo Conde

writing

critical review

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

Faculdade Anhanguera, Departamento de Fisioterapia, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0002-2025-3633

Geraldo Cassio dos Reis

statistical analysis

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0002-3183-7546

Antônio Carlos dos Santos

MRI data acquisition

MRI analysis

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0002-5502-4734

Amilton Antunes Barreira

in memoriam

research design

supervision

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0002-4791-223X

Wilson Marques Jr.Address for correspondence, Wilson Marques Júnior (e-mail: wmjunior@fmrp.usp.br).

exam analyses

critical

final reviews

extensively on the manuscript

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.

http://orcid.org/0000-0002-4589-2749

Address for correspondence, Wilson Marques Júnior (e-mail: wmjunior@fmrp.usp.br).

Conflict of interest:

The authors have no conflict of interests to declare.

	Total sample	CIDPnl	CIDPabnl	CG	Group differences	Dunn post hoc
N	38	5	9	24	−	−
Male gender: n (%)	22 (57.9%)	4 (80.0%)	6 (66.7%)	12 (50.0%)	χ²; p = 0.45	−
Age in years	41.66 (12.04) [24-59]	42.0 (13.95) [24-56]	46.22 (12.18) [24-58]	39.88 (11.67) [24-59]	χ² = 1.53;p = 0.46	−
Years of schooling	14.39 (4.42) [3-24]	11.0 (4.90) [3-15]	11.11 (4.04) [4-15]	16.33 (3.32) [11-24]	χ² = 11.36;p = 0.003^* * p < 0.05.	CG > CIDPabnl: 0.009^* * p < 0.05.
Disease duration (years)	−	9.20 (5.21) [2-16]	11.67 (10.61) [2-38]	−	χ² = 0.02;p = 0.89	−
HADS A	6.82 (3.41) [1-14]	7.0 (3.67) [4-11]	8.67 (3.61) [5-14]	6.08 (3.16) [1-14]	χ² = 3.51;p = 0.17	−
HADS D	4.92 (3.42) [0-13]	5.0 (3.46) [2-10]	5.11 (4.04) [0-12]	4.83 (3.33) [1-13]	χ² = 0.01;p = 0.99	−
R-ODS	47.74 (4.84) [29-50]	48.0 (2.55) [44-50]	42.0 (7.38) [29-50]	49.83 (0.38) [49-50]	χ² = 20.31;p < 0.001^* * p < 0.05.	CG > CIDPabnl < 0.001^* * p < 0.05. ; CG > CIDPnl 0.05^* * p < 0.05.

n = 5	Cranial nerves involved	Other conditions	Current treatment^* * The previous three months. Untreated patients had not been receiving medication in the past three months. These patients interrupted treatment on their own.
Patient 1	−	−	−
Patient 2	Trigeminal nerve thickening to right	−	−
Patient 3	−	−	−
Patient 4	−	Systemic arterial hypertension	−
Patient 5	−	Monoclonal gammopathy of undetermined significance	Intravenous immunoglobulin therapy

n = 9	MRI report/CNS involvement	Cranial nerves involved	Other conditions	Current treatment^* * The last three months; Only the principal treatment is described.
Patient 1	Cerebellar atrophy	−	Systemic arterial hypertension	Intravenous immunoglobulin
Patient 2	Mild cerebellar atrophy, reduction in corpus callosum thickness	−	−	Intravenous immunoglobulin
Patient 3	Cerebellar atrophy	Trigeminal nerve	Monoclonal gammopathy of undetermined significance	Methylprednisolone
Patient 4	periarteriolar demyelinatin features	−	−	Gabapentin
Patient 5	occipital demyelination	Trigeminal nerve	−	Methylprednisolone
Patient 6	Cerebellar atrophy, brain atrophy, microangiopathy	−	−	Intravenous immunoglobulin
Patient 7	Cerebellar atrophy	−	−	Carbamazepine
Patient 8	Cerebral parenchyma, microangiopathy	−	−	Intravenous immunoglobulin
Patient 9	Cerebellar atrophy	−	−	Intravenous immunoglobulin

FDT tasks	CIDPnl (n = 5)	CIDPabnl (n = 9)	CG (n = 24)	Non-parametric test comparing groups^a a Kruskal-Wallis and Dunn post hoc tests.		Adjustment for schooling by the linear regression model^b b Only performed when there was a significant difference. The errors in reading, counting, and choosing were not presented. There were no statistically significant dofferences regarding errors in reading, counting and choosing.
FDT tasks	CIDPnl (n = 5)	CIDPabnl (n = 9)	CG (n = 24)	Group differences	Dunn post hoc		Beta	p
Processing speed – automatic process measures
Reading	31.8 (7.5) [22-39]	29.22 (6.06) [24-44]	22.08 (4.54) [13-28]	χ² = 13.21;p = 0.001^* * p < 0.05.	CIDPabnl > CG: 0.006^* * p < 0.05. ; CIDPnl > CG: 0.05	CIDPabnl	0.23	0.12
Reading	31.8 (7.5) [22-39]	29.22 (6.06) [24-44]	22.08 (4.54) [13-28]	χ² = 13.21;p = 0.001^* * p < 0.05.	CIDPabnl > CG: 0.006^* * p < 0.05. ; CIDPnl > CG: 0.05	CIDPnl	0.31	0.03 ^* * p < 0.05.
Counting	30.4 (2.97) [26-33]	33.89 (7.02) [27-46]	24.0 (3.88) [17-32]	χ² = 18.41;p < 0.001^* * p < 0.05.	CIDPabnl > CG: < 0.001^* * p < 0.05. ; CIDPnl > CG: 0.02^* * p < 0.05.	CIDPabnl	0.45	0.001 ^* * p < 0.05.
Counting	30.4 (2.97) [26-33]	33.89 (7.02) [27-46]	24.0 (3.88) [17-32]	χ² = 18.41;p < 0.001^* * p < 0.05.		CIDPnl	0.16	0.18
Executive functions – controlled process measures
Choosing	61.8 (28.92) [40-110]	49.67 (12.24) [32-69]	37.83 (7.73) [24-52]	χ² = 10.69;p = 0.005^* * p < 0.05.	CIDPabnl > CG: 0.03^* * p < 0.05. ; CIDPnl > CG: 0.05	CIDPabnl	0.02	0.91
Choosing	61.8 (28.92) [40-110]	49.67 (12.24) [32-69]	37.83 (7.73) [24-52]	χ² = 10.69;p = 0.005^* * p < 0.05.	CIDPabnl > CG: 0.03^* * p < 0.05. ; CIDPnl > CG: 0.05	CIDPnl	0.27	0.04 ^* * p < 0.05.
Shifting	76.4 (42.58) [45-148]	61.67 (17.76) [41-99]	49.75 (11.76) [29-77]	χ² = 6.21;p = 0.05	CIDPabnl > CG: 0.03^* * p < 0.05.	CIDPabnl	−0.53	0.73
Shifting	76.4 (42.58) [45-148]	61.67 (17.76) [41-99]	49.75 (11.76) [29-77]	χ² = 6.21;p = 0.05	CIDPabnl > CG: 0.03^* * p < 0.05.	CIDPnl	0.19	0.2
Inhibition	30 (23.91) [15-72]	20.44 (9.19) [8-38]	15.79 (7.18) [2-29]	χ² = 3.55;p = 0.16	−	−	−	−
Flexibility	44.6 (37.6) [19-110]	32.44 (15.52) [17-70]	27.67 (11.45) [14-52]	χ² = 1.81;p = 0.40	−	−	−	−
Shifting errors	2.2 (3.19) [0-7]	2.33 (2.64) [0-8]	0.37 (0.71) [0-2]	χ² = 6.7;p = 0.03^* * p < 0.05.	CIDPabnl > CG: 0.05	CIDPabnl	0.21	0.21
Shifting errors	2.2 (3.19) [0-7]	2.33 (2.64) [0-8]	0.37 (0.71) [0-2]	χ² = 6.7;p = 0.03^* * p < 0.05.	CIDPabnl > CG: 0.05	CIDPnl	0.14	0.37

n = 38	Schooling	R-ODS	HADS A	HADS D
FDT reading	r = −0,50; p = 0.001^* * Significant rank-order correlation atp < 0.05.	r = −0.47; p = 0.003^* * Significant rank-order correlation atp < 0.05.	r = 0.06; p = 0.72	r = −0.07; p = 0.69
FDT counting	r = −0.68; p < 0.001^* * Significant rank-order correlation atp < 0.05.	r = −0.53; p = 0.001^* * Significant rank-order correlation atp < 0.05.	r = 0.37; p = 0.02^* * Significant rank-order correlation atp < 0.05.	r = 0.16; p = 0.32
FDT choosing	r = −0.65; p < 0.001^* * Significant rank-order correlation atp < 0.05.	r = −0.41; p = 0.01^* * Significant rank-order correlation atp < 0.05.	r = 0.11; p = 0.51	r = −0.02; p = 0.89
FDT shifting	r = −0.60; p < 0.001^* * Significant rank-order correlation atp < 0.05.	r = −0.19; p = 0.26	r = 0.07; p = 0.69	r = 0.08; p = 0.62
FDT inhibition	r = −0.50; p = 0.002^* * Significant rank-order correlation atp < 0.05.	r = −0.15; p = 0.37	r = 0.10; p = 0.56	r = 0.02; p = 0.90
FDT flexibility	r = −0.38; p = 0.02^* * Significant rank-order correlation atp < 0.05.	r = 0.02^* * Significant rank-order correlation atp < 0.05. ; p = 0.89	r = 0.01^* * Significant rank-order correlation atp < 0.05. ; p = 0.93	r = 0.10; p = 0.57

[1] Address for correspondence, Wilson Marques Júnior (e-mail: wmjunior@fmrp.usp.br).

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Prejuízo na velocidade de processamento em pacientes com polineuropatia inflamatória desmielinizante crônica: um estudo transversal

Resumo

Antecedentes

Objetivo

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