Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-05-16T13:02:47Z No. of bitstreams: 1 luiziralbertodesouzalimajunior.pdf: 1017703 bytes, checksum: f428c0dd46d8e916774da450732d3c28 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-17T16:14:41Z (GMT) No. of bitstreams: 1 luiziralbertodesouzalimajunior.pdf: 1017703 bytes, checksum: f428c0dd46d8e916774da450732d3c28 (MD5) / Made available in DSpace on 2017-05-17T16:14:41Z (GMT). No. of bitstreams: 1 luiziralbertodesouzalimajunior.pdf: 1017703 bytes, checksum: f428c0dd46d8e916774da450732d3c28 (MD5) Previous issue date: 2012-03-27 / Durante o repouso, a atividade colinérgica predomina sobre o nódulo sinoatrial. Assim o mecanismo de controle da Frequência Cardíaca pela atividade vagal, juntamente com a diminuída demanda energética, irão determinar a frequência cardíaca de repouso (FCR) de um indivíduo fisiologicamente íntegro. A FCR possui importância reconhecida como indicador independente de saúde cardiovascular, relação com doenças não cardiovasculares, além da sua utilização em fórmulas, questionários e protocolos relacionados ao exercício físico. Apesar da reconhecida notoriedade da FCR na prática clínica e física, ainda não foi estabelecido um modo de medição com evidências científicas, que sustentam a existência de um padrão. Desta forma o presente estudo procurou investigar, através de dois artigos, de que forma a FCR vem sendo utilizada na prática profissional de profissionais de Educação Física, no que tange as formas de medição (tempo, posição), cuidados pré e durante (substâncias interferentes e condições ambientais) e objetivos da medição. Além disso, testar e propor aplicações práticas da FCR mediante tempo e postura corporal de medição. No primeiro estudo foram entrevistados profissionais de Educação Física, através de um questionário composto por oito questões sobre a forma de utilização da FCR, tais como, importância da variável, período de repouso antes e durante a mensuração, posição corporal, equipamento, e condições ambientais (temperatura, luminosidade, substâncias interferentes). De acordo com os resultados apresentados pelas respostas dos questionários, pôde-se concluir que o uso da FCR pelos profissionais de Educação Física, não possui uma padronização para sua medição, havendo divergências estatisticamente significativas nos critérios de utilização e avaliação. No segundo estudo foram avaliados 39 indivíduos jovens (21 homens e 18 mulheres), submetidos a avaliações em repouso em duas posições, supina e sentada, cada uma com a duração de 60 minutos. Os resultados mostraram que as medições realizadas em apenas cinco minutos não eram diferentes estatisticamente das medições realizadas nos 60 minutos. Além disso, na posição sentada a FCR é 12% maior que na posição supina, retratando diferença estatística. Estes resultados se repetiram entre gêneros e entre indivíduos mais e menos ativos. Portanto, de acordo com os resultados dos estudos, pôde- se verificar a inexistência de consensos para a medição da FCR entre os profissionais de educação física. Entretanto o presente estudo propõe a medição para homens e mulheres jovens mais e menos ativos, utilizando 5 minutos de repouso, registrandose a média deste período e observando a posição medida para as devidas correções. / During rest, cholinergic activity predominates over the sympathetic system. Thus the control mechanism of Heart Rate by vagal activity, together with the reduced energy requirements, will determine the frequency resting heart rate (RHR) of an individual physiologically intact. The RHR has recognized as important independent predictor of health cardiovascular disease compared with non-cardiovascular, beyond its use in formulas, questionnaires and protocols related to exercise physical. Despite the notoriety of the RHR recognized in clinical practice and physical not yet established a method of measuring with scientific evidence that support the existence of a pattern. Thus the present study sought investigate, by means of two articles, how the RHR has been used in professional practice of physical education professionals, regarding the forms of measurement (time, location), and during antenatal care (substances interference and environmental conditions) and objective measurement. Furthermore, test and propose practical applications of RHR through time and body posture measurement. In the first study were interviewed education professionals Physics, through a questionnaire consisting of eight questions on how to use of the RHR, such as importance of the variable, rest period before and during the measurement, body position, equipment, and conditions environmental (temperature, light, interfering substances). According with the results presented by the questionnaire responses, we conclude that the use of RHR by physical education professionals, has no a standard for its measurement, with differences statistically significant use and the criteria for evaluation. In the second study were studied 39 young subjects (21 men and 18 women) who underwent evaluations at rest in two positions, supine and sitting positions, each with for 60 minutes. The results show that measurements made on only five minutes were not statistically different measurements performed in 60 minutes. Furthermore, in the sitting position is 12% higher HRH that in the supine position, portraying statistical difference. These results repeated between genders and between more and less active individuals. Therefore the According to the results of the studies, it was possible to verify the absence of consensus for the measurement of HRH among physical education teachers. However the present study proposes to measure for young men and women more and less active, using 5-minute rest, recording the average this period and noting the position measured for the corrections.

L’imagerie par résonance magnétique fonctionnelle (IRMf) est un outil de choix pour cartographier d’une manière non invasive l’activité du cortex, donnant ainsi un accès à l’organisation fonctionnelle cérébrale. Cette organisation des aires cérébrales en réseaux complexes reste encore un vaste sujet d’étude, autant dans le domaine de la recherche fondamentale, pour mieux comprendre le développement et le fonctionnement du cerveau, que dans le domaine clinique, à des fins diagnostiques par exemple. Les réseaux cérébraux dits de repos, chez un sujet donné, peuvent être observés lors d’études IRMf lorsqu’aucune tâche motrice ou cognitive n’est imposée au sujet imagé. La première partie de cette thèse a permis le développement d’une méthode automatique d’identification de ces réseaux. Réalisée à l’échelle du sujet, cette méthode permet de sélectionner tous les réseaux spécifiques au sujet ce qui s’avère nécessaire dans un cadre diagnostique où l’individu prime. Au delà de la détection et de l’identification de ces réseaux, l’étude de leurs modes d’interaction dans l’espace et dans le temps et plus généralement l’analyse de la dynamique de la connectivité fonctionnelle (DCF) fait l’objet d’un intérêt grandissant. Cette analyse nécessite le développement de méthodes innovantes de traitement du signal et de l’image qui, pour l’heure, sont encore de nature exploratoire. La deuxième partie de cette thèse présente donc de nouvelles approches pour caractériser la DCF en utilisant le cadre probabiliste de modèles de Markov cachés multidimensionnels. Les mécanismes conversationnels entre réseaux cérébraux peuvent ainsi être identifiés et caractérisés à l’échelle de la seconde. Deux applications, au niveau du sujet puis du groupe, ont permis de mettre en avant les modifications des propriétés dynamiques des interactions entre réseaux sous certaines conditions ou pathologies. / The functional magnetic resonance imaging (fMRI) is a perfect tool for mapping in a non- invasive manner the activity of the cortex, giving access to the functional organization of the brain. This organization of brain areas into complex networks remains a large topic of study, both from a fundamental research perspective, to better understand the development and function of the brain, and from a clinical perspective, for diagnostic purposes for instance. The resting-state networks in a given subject can be observed in fMRI studies where no motor or cognitive tasks are imposed to the subject. The first part of this thesis focused on the development of an automatic identification method of these networks. Performed at the subject level, this method selects all the resting-state networks proper to the subject. Beyond the detection and identification of these networks, the study of interactions between these networks in space and time, and more generally the analysis of the dynamic functional connectivity (DFC), is the subject of growing interest. This analysis requires the development of innovative methods of signal or image processing that, for now, are still exploratory. The second part of this thesis thus presents new approaches to characterize the DFC using the probabilistic framework of multidimensional hidden Markov models. Conversational mechanisms between brain networks can be identified and characterized at the resolution of the second. Two applications, first on a single subject then on a group, helped to highlight the changes of dynamic properties of interaction between networks under certain conditions or diseases.

Abstract The goal of this study was to explore preoperative evaluation of patients with intracranial tumours using magnetic resonance imaging (MRI) methods: oedema-attenuated inversion recovery (EDAIR) sequence in low-field MRI, and diffusion-weighted imaging (DWI) and resting-state functional MRI (fMRI) in high-field MRI. The aim was also to increase our knowledge about the effects of brain surgery on eloquent brain cortices using new MRI techniques. The total number of patients in these studies was 50 (24 women). Enhancement of the tumour in ten patients after intravenous administration of gadolinium-based contrast agent in low-field MRI was examined with a new sequence, EDAIR, and compared with more conventionally used partial saturation spin echo sequences. EDAIR may facilitate the perception of small enhancing lesions and is valuable in low-field imaging, where T1-based contrast is inferior to high-field imaging. DWI was performed on 25 patients in order to evaluate the potential of this imaging method to assist in differential diagnosis of intracranial tumours. It was shown that apparent diffusion coefficient values of the tumour and peritumoural oedema produced by DWI were different in benign and malignant tumours. Resting-state blood oxygen level-dependent (BOLD) fMRI was performed on eight patients and ten healthy volunteers to examine if functional sensorimotor areas in the brain could be determined without any task-related activations. It was shown that intracranial tumours do not appear to hamper visualization of the sensorimotor area in resting-state BOLD fMRI when independent component analysis is performed, and this method may be used in preoperative imaging when activation studies cannot be performed. Conventional BOLD fMRI with motor and auditory stimuli was used with seven patients as the effect of brain surgery was studied. The results suggest that resection of a tumour with preoperative oedema probably decreases pressure on the brain and makes the functional cortex transiently more easily detectable in BOLD fMRI. In conclusion, the MRI imaging methods used in this study can give valuable additional information about the tumour, specifically for preoperative imaging and planning for surgery.

Background: The aim of this thesis was to investigate the relationship of moral cognition and emotions to the pathophysiology of major depressive disorder (MDD). Patients with MDD may experience excessive guilt or self-blaming biases despite recovery from the depressed state. Since guilt is a moral emotion thought to motivate altruistic behaviours, it has been hypothesized that elevated self-blame in MDD may result in pathological increases to altruism in some patients. The relationship of self-blame to altruistic choices in individuals with remitted MDD (rMDD), however, has not been established. Guilt has been shown to activate the subgenual cingulate and adjacent septal region (SCSR) which is of known importance to the pathophysiology of MDD. Since MDD is thought to arise from network-level dysfunctions, and moral cognition and emotions are hypothesized to emerge from network-level binding, investigating resting-state SCSR functional connectivity in rMDD patients and healthy control (HC) participants could reveal networks of potential relevance both to MDD and to moral cognition and emotions. Chapter 2: We investigated whether melancholic rMDD patients could be distinguished from non-melancholic and HC groups on the basis of resting-state functional connectivity to an SCSR seed region. Lower SCSR-amygdala connectivity distinguished the melancholic rMDD group from non-melancholic and HC groups. Chapter 3: We investigated whether patients who remained resilient to recurring depressive episodes were distinguishable from recurring episode MDD and HC groups on the basis of resting-state connectivity to an SCSR seed region. Lower interhemispheric SCSR connectivity distinguished the resilient MDD patients from the recurring episode MDD and HC groups. Chapter 4: We measured explicit and implicit preferences for social options with and without altruistic motivations relative to selfish options in the rMDD and HC groups during emotion priming to modulate feelings of guilt. The rMDD patients explicitly preferred prosocial options (i.e., social options and altruism directed towards friends or colleagues) less than HC participants. Regardless of group, guilt priming increased explicit and implicit preferences for altruism towards strangers. Chapter 5: We investigated whether explicit and/or implicit preferences for prosocial options during guilt priming were correlated with resting-state connectivity to an SCSR seed region, and whether this relationship could distinguish the rMDD and HC groups. Across all participants, implicit prosocial choice preference negatively correlated with connectivity between the SCSR and right temporoparietal junction (TPJ). The relationship of SCSR-TPJ connectivity to implicit preferences for social options and for altruism towards friends and colleagues was weaker in the rMDD group compared to the HC group, particularly for implicit altruism. Conclusions: We identified resting-state SCSR networks associated with vulnerability to melancholia and with resilience to recurring depressive episodes. Patients with rMDD explicitly preferred options entailing social withdrawal, a symptom associated with MDD vulnerability. Irrespective of group, guilt motivated altruism towards strangers but not friends and colleagues. Implicit prosociality was negatively associated with connectivity in a social agency network, and the comparatively weak relationships between connectivity and implicit choice preferences in rMDD patients may reflect a vulnerability factor for MDD.

Energy intake (EI) and energy expenditure (EE) across the menstrual cycle (MC), while considering body adiposity, have not been previously evaluated in the same individuals. This study mainly examined the variations in energy balance (EB) across MC. Seventeen women (Body fat-DXA:28.5%) participated in three identical sessions during distinct phases of the MC: Early-follicular, Late-follicular/ovulation and Mid-luteal (confirmed by basal temperature and sex-steroid hormones). EI, resting metabolic rate (RMR), physical-activity EE (PAEE), severity of PMS, leptin and relative-reinforcing value (RRV) of preferred foods were measured during each phase. No differences in body fat, EI, RMR, PAEE, leptin and RRV of food were noted across MC. Trends were noted in preferred snack (p=0.06) and combined snack/fruit (p=0.06) intakes, while differences were noted in severity of PMS (p<0.05) across phases. Changes in EB across the MC were not noted. PMS was more severe, and preferred snack and combined snack/fruit intakes were slightly higher during mid-luteal phase.

Elevadas concentrações de tirglicerídeos (TAG) no período pós-prandial são associados com o desenvolvimento de doenças cardiovasculares (DCV), bem como são responsáveis por mais de 23% da mortalidade em mulheres na menopausa. O treinamento de força (TF) é uma intervenção não farmacológica impregada na prevenção e redução dos múltiplos fatores de risco para o desenvolvimento de DCV. O exercício de força realizado em alto volume vem sendo apresentado como estratégia efetiva na redução da lipemia pós-prandial (LPP) em jovens. No entanto, a comparação entre alto e baixo volume do TF não havia sido investigado. Por esse motivo, o objetivo deste estudo foi comparar a resposta aguda e de 11 semanas de TF realizado em baixo e alto volume na força dinâmica máxima, espessura muscular, gasto energético e perfil lipidico de mulheres pós-menopáusicas. Trinta e nove mulheres pós-menopausicas saudáveis e destreinadas (59,5±4,8 anos de idade, massa corporal 69,6±9,1 kg, estatura 157,9±7,2 cm; IMC 27,6±4,1 kg•m2; circunferência da cintura 76,1±9,7 cm; VO2pico 18,7±1,4 mL•kg•min) foram aleatóriamente distribuídas em três grupos que realizaram a sessão de exercícios de força em: baixo volume (uma série) (BVEF, n=12), alto volume (AVEF, n=14) e um grupo controle (GC, n = 13) que permaneceu em repouso. Os grupos experimentais (BVEF e AVEF) foram submetidos a uma sessão de exercícios de força (SEF), envolvendo oito exercícios. O grupo BVEF realizou uma série de 15 repetições máximas (RM), e o grupo AVEF realizou três séries de 15RM. Na SEF foram avaliados o gasto energético da sessão e o EPOC (excess post-exercise oxygen consumption). No teste de tolerancia oral a gordura (TTOG), ~16 horas após a SEF, todos os grupos receberam um refeição hiperlipidica a base de leite seguido por uma avaliação do perfil lipídico (colesterol total (CT), glicose (GLU), HDL, LDL e TAG) nos períodos basal, 1, 2, 3, 4 e 5 horas após o TTOG. Resultados: Não houve diferença significativa entre os grupos no perfil lipidico em nenhum dos períodos avaliados. O gasto energético total (SEF+EPOC) foi significativamente maior para AVEF em comparação ao BVEF (6,0±0,12 MJ e 3,1±1,1 MJ, respectivamente, p<0,001). No estudo com treinamento, foram avaliadas trinta e seis mulheres pós-menopáusicas com uma perda amostral de três mulheres, sendo estas submetidas a 11 semanas de TF. Os grupos AVEF e BVTF foram divididos em alto volume de treinamento de força (AVTF=13) e baixo volume de treinamento de força (BVTF=12), o GC (n=11) foi preservado. Neste estudo, todas as variáveis foram avaliadas pré e pós treinamento. Como resultados; nenhuma diferença significativa foi observada entre os grupos na LPP (mmol/L/5hs) para GLU, HDL, LDL e CT. Além disso, o AVTF vs BVTF foi significativamente maior após 11 semanas de TF nas variáveis taxa de oxidação de gordura (5,52±1,69 g/h vs 4,11±1,12 g/h), espessura muscular (VM, 21,4 ± 1,8 mm vs 18,4±1,2 mm e VL (22,3±1,2 mm vs 20,8±1,3 mm). Os pontos 0, 1, 2, 4 e 5 horas após TTOG para TAG e AUC de TAG (5,79±0,42 mmol/L/5hs vs 7,78±0,68 mmol/L/5hs), respectivamente, foram significativamente menores no grupo AVTF (p<0,05). Em conclusão, diferentes volumes de uma única sessão de exercícios de força não são capazes de reduzir a lipemia pós-prandial de mulheres pósmenopáusicas após teste de tolerância a gordura. Entretanto, os resultados desta investigação sugerem que a prescrição do alto volume de treinamento de força reduz a lipemia pós-prandial em mulheres pós-menopáusicas. / Elevated concentrations of triglycerides (TAG) in the postprandial period are associated with the development of cardiovascular disease (CVD) and are responsible for over 23 % mortality in postmenopausal women. Resistance training (RT) is a non-pharmacological strategy to reduce multiple risk factors for developing CVD. The RT performed at high volume has been shown to be effective for the reduction of postprandial lipemia (PPL) in young people. However, the RT regular and systematic comparing high and low volume training had not been investigated. Therefore, the aim of this study was to compare the response subacute and 11 weeks of RT in low volume and high in strength, muscle thickness, energy expenditure and lipid profile of postmenopausal women. In article acute, thirty-nine postmenopausal women and healthy untrained (59.5±4.8 years, body mass 69.6±9.1 kg, height 157.9±7.2 cm, BMI 27,6±4.1 kg•m-2, waist circumference 76.1±9.7 cm; VO2peak 18.7±1.4 mL•kg-1•min-1) were randomly divided into three groups: group that conducted the exercise session strength at low volume (one set) ( LVSE, n=12), high volume (HVSE, n=14) and a control group (CG, n=13) who did not perform any exercise session. The experimental groups (LVSE and HVSE) held a session of strength exercises (SSE), involving eight exercises. In LVSE held a series of 15 repetitions maximum (RM), and the HVSE group performed three sets of 15RM, SSE were evaluated in the energy expenditure of the session and the EPOC (excess post -exercise oxygen consumption). In the test of oral fat tolerance (OGTT), ~16 hours of the SSE, all groups were given a high-fat meal and the milk, were evaluate; lipid profile (total cholesterol (TC), glucose (GLU), HDL, LDL and TAG) in times baseline, 1, 2, 3, 4 and 5 hours after an OGTT. Results: No significant difference between groups in lipid profile in any of the periods. Total energy expenditure (SSE+EPOC) was significantly higher compared to HVSE vs LVSE (6.0±0.12 MJ and 3.1±1.1 MJ, respectively, p<0.001). In the third study was evaluated thirty-six postmenopausal women, with a sample loss of three women who underwent 11 weeks of ST, and HVSE and LVSE groups were divided into high-volume strength training (HVST=13) and low volume strength training (LVST=12), GC (n=11) was preserved. In this study, all variables were assessed before and after 11 weeks os ST. Results: no significant difference was observed among groups in LPP (mmol/L/5 hours) to GLU, HDL, LDL and TC, also the HVSE versus LVSE was significantly greater after 11 weeks of ST for variables; rate fat oxidation, 5.52±1.69 g/h vs. 4.11±1.12g/h), muscle thickness (VM 21.4±1.2 mm versus 18.4±1.8 mm and VL, 22.3±1.2 mm versus 20.8±1.3 mm). In points 0, 1, 2, 4 and 5 hours after OGTT for TAG and TAG AUC (5.79±0.42 versus 7.78±0.68), respectively, were significantly lower in group AVTF (p<0.05). In conclusion, different volumes of a session of strength exercises do not reduce the subacutely postprandial lipemia in postmenopausal women after oral fat tolerance test. The results of this investigation suggest that the prescription of high volume strength training reduces postprandial lipemia in postmenopausal women.

Orientador: Sarah Monte Alegre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T08:26:23Z (GMT). No. of bitstreams: 1 Batista_GiseleAlmeida_M.pdf: 1859346 bytes, checksum: 3cb1bc28cbd20d9ddb7e8e3a58874a1e (MD5) Previous issue date: 2014 / Resumo: Introdução: O acetato de medroxiprogesterona de depósito (AMPD, Depoprovera®) é um método contraceptivo de alta eficácia e segurança; seu uso tem se difundido amplamente e vem sendo utilizado por milhões de mulheres. Existem poucos estudos na literatura sobre o gasto energético em repouso nas usuárias de Depoprovera®, e é possível que existam variações especialmente naquelas que ganham peso em uso do método. Objetivo: Avaliar as alterações no peso, composição corporal e gasto energético em repouso de mulheres em uso de acetato de medroxiprogesterona de depósito e DIU TCu 380 no período de 12 meses. Métodos: Estudo prospectivo com 20 usuárias de Depoprovera® e 17 usuárias de DIU TCu380, como controle, no período de um ano. Mulheres atendidas no ambulatório de Planejamento Familiar do CAISM/UNICAMP em idade fértil, que optaram como método contraceptivo o injetável Depoprovera®, sem uso prévio deste método, e que apresentavam Índice de Massa Corporal (IMC) < 30 kg/m², além de mulheres que utilizavam o método contraceptivo não hormonal DIU TCu 380A foram convidadas a participar do estudo. Resultados: Os grupos foram pareados no período basal, tornando-se um grupo homogêneo em relação a peso, idade e IMC. Após 12 meses de avaliação, pode-se observar aumento de peso, IMC e superfície corporal de forma significativa no grupo Depo. Em relação ao gasto energético em repouso e quociente respiratório, houve aumento significativo da taxa metabólica basal nos dois grupos. O quociente respiratório reduziu de forma significante nos dois grupos. Quando o grupo Depo foi subdividido por ganho de peso, o subgrupo que ganhou < 3 kg após 12 meses teve aumento significativo de peso, IMC, superfície corporal e quociente respiratório, já o subgrupo que ganhou > 3 kg aumentou significativamente peso, IMC, superfície corporal, peso de massa magra, peso de massa gorda, taxa metabólica basal, Leptina, HOMA-IR e circunferência da cintura e reduziu quociente respiratório após os 12 meses de acompanhamento. Conclusão: Nosso estudo encontrou alterações relevantes no peso, composição corporal e perfil metabólico da população estudada nos primeiros 12 meses de uso do contraceptivo. Essas alterações principalmente o aumento de peso corporal, aumento dos níveis de leptina e HOMA-IR, podem contribuir para o desenvolvimento de algumas complicações crônicas, entre elas a obesidade, resistência à insulina e diabetes mellitus / Abstract: Introduction: Depot Medroxyprogesterone Acetate (DMPA, Depoprovera®) is an high contraceptive efficacy and safety; its use has spread broadly and has been used by millions of women. There are few studies on the resting energy expenditure in Depoprovera® users, and it is possible that there are variations especially those who gain weight using the method. Objective: To evaluate the changes in weight, body composition and resting energy expenditure in women using depot medroxyprogesterone acetate and IUD TCu 380 in 12 months. Methods: This was a prospective study with 20 Depoprovera® users and 17 IUD users TCu380 as a control within one year. Women attending the outpatient clinic of CAISM / UNICAMP of childbearing age who chose the injectable contraceptive Depoprovera ® without previous use of this method, Body Mass Index (BMI) < 30kg / m², and women using non-hormonal contraception IUD TCu 380, were invited to participate in the study. Results: The groups were paired at baseline, becoming a homogeneous group in relation to age (± 1 year), and BMI (+1 kg/m²). After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight, BMI and body surface. Relative to resting energy expenditure and respiratory quotient, there was an increase of baseline metabolic rate in both groups after one year. The respiratory quotient was significantly reduced after 12 months in groups DMPA and IUD. The sub-group DMPA that gained < 3kg had increased significant weight, BMI and body surface with respiratory quotient reduction, while the sub-group that gained > 3kg had a significant increase in weight, BMI, body surface, free fat mass, fat mass, baseline metabolic rate, Leptin, HOMA-IR and waist circumference, with respiratory quotient significantly reduced. Conclusion: Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus / Mestrado / Clinica Medica / Mestra em Clínica Médica

Esta dissertação desenvolve e aplica métodos para caracterizar regiões cerebrais durante o estado de repouso. Utilizam-se grafos para representar a inter-dependência temporal de sinais de ressonância magnética funcional provenientes de regiões cerebrais distintas. Vértices representam regiões cerebrais e arestas representam a conectividade funcional. Buscando superar os problemas de visualização e interpretação desta forma de representação, elaboram-se métodos quantitativos para caracterizar padrões de conectividade entre regiões cerebrais. Para cada sujeito analisado: 1) Faz-se a redução da dimensionalidade espacial das imagens de ressonância magnética funcional respeitando os limites anatômicos das regiões cerebrais. 2) Estima-se a rede de conectividade funcional pela coerência direcionada entre pares de regiões distintas. 3) Constrói-se um grafo direcionado e pesado pela medida de conectividade. 4) Quantificam-se os vértices por índices e faz-se o registro destes valores no espaço comum MNI. 5) Avalia-se a consistência de cada índice pelo teste não paramétrico de Friedman seguido de análises de múltiplas comparações. A análise de 198 imagens de sujeitos sadios produziu resultados consistentes e biologicamente plausíveis. Em sua maioria, revelou regiões associadas a conceitos anatômicos de conectividade e integração cerebral. Embora de implementação simples, o método proporciona informações de natureza dinâmica sobre as relações entre diferentes regiões cerebrais e pode ser utilizado futuramente para estudar e entender desordens psiquiátricas/neurológicas. / This dissertation develops and applies methods to characterize brain regions during resting state. Graphs are used to represent functional MRI connectivity from different brain regions. Vertices represent brain regions and edges represent connectivity. To overcome the visualization and interpretation problems of this form of representation, we developed quantitative methods to characterize its patterns. Methods: For each subject: 1) The reduction of spatial dimensionality of functional magnetic resonance imaging is carried out taking into account the anatomic limits of the brain regions. 2) The network is estimated by directed coherence between pairs of separate regions. 3) A directed graph with weights on its edges is constructed using the later connectivity measure. 4) The vertices are quantified by indexes that are registered in the MNI common space. 5) The consistency of each index is evaluated by the nonparametric Friedman followed by Post-Hoc analysis. Results: The analysis of 198 images of healthy subjects produced consistent and biologically plausible results. They revealed anatomical regions involved in brain integration. Conclusion: The method provides information about the dynamic nature of the relationships between different brain regions and can be used in future clinical studies to understand psychiatric and neurological disorders.

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The sensorimotor cortex is a brain region comprising the primary motor cortex (MI) and the primary somatosensory (SI) cortex. In humans, investigation into these regions suggests that MI and SI are involved in the modulation and control of motor and somatosensory processing, and are somatotopically organized according to a body plan (Penfield & Boldrey, 1937). Additional investigations into somatotopic mapping in relation to the limbs in the peripheral nervous system and SI in central nervous system have further born out the importance of this body-based organization (Wall & Dubner, 1972). Understanding the nature of the sensorimotor cortex‟s structure and function has broad implications not only for human development, but also motor learning (Taubert et al., 2011) and clinical applications in structural plasticity in Parkinson‟s disease (Sehm et al., 2014), among others. The aim of the present thesis is to identify functionally meaningful subregions within the sensorimotor cortex via parcellation analysis. Previously, cerebral subregions were identified in postmortem brains by invasive procedures based on histological features (Brodmann, 1909; Vogt. & Vogt., 1919; Economo, 1926; Sanides, 1970). One widely used atlas is based on Brodmann areas (BA). Brodmann divided human brains into several areas based on the visually inspected cytoarchitecture of the cortex as seen under a microscope (Brodmann, 1909). In this atlas, BA 4, BA 3, BA 1 and BA 2 together constitute the sensorimotor cortex (Vogt. & Vogt., 1919; Geyer et al., 1999; Geyer et al., 2000). However, BAs are incapable of delineating the somatotopic detail reflected in other research (Blankenburg et al., 2003). And, although invasive approaches have proven reliable in the discovery of functional parcellation in the past, such approaches are marked by their irreversibility which, according to ethical standards, makes them unsuitable for scientific inquiry. Therefore, it is necessary to develop non-invasive approaches to parcellate functional brain regions. In the present study, a non-invasive and task-free approach to parcellate the sensorimotor cortex with resting-state fMRI was developed. This approach used functional connectivity patterns of brain areas in order to delineate functional subregions as connectivity-based parcellations (Wig et al., 2014). We selected two adjacent BAs (BA 3 and BA 4) from a standard template to cover the area along the central sulcus (Eickhoff et al., 2005). Then subregions within this area were generated using resting-state fMRI data. These subregions were organized somatotopically from medial-dorsal to ventral-lateral (corresponding roughly to the face, hand and foot regions, respectively) by comparing them with the activity maps obtained by using independent motor tasks. Interestingly, resting-state parcellation map demonstrated higher correspondence to the task-based divisions after individuals had performed motor tasks. We also observed higher functional correlations between the hand area and the foot and tongue area, respectively, than between the foot and tongue regions. The functional relevance of those subregions indicates the feasibility of a wide range of potential applications to brain mapping (Nebel et al., 2014). In sum, the present thesis provides an investigation of functional network, functional structure, and properties of the sensorimotor cortex by state-of-art neuroimaging technology. The methodology and the results of the thesis hope to carry on the future research of the sensorimotor system.