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Previous issue date: 2012-03-19 / Introduction: Aging is a life cycle stage that may be associated with higher or lower limits imposed by the years. Among these limitations we find the presence of different degrees of cognitive impairment, particularly memory, affecting the daily activities and may interfere with the functioning of the individual. Despite the knowledge that the aging indicate a positive association between serum levels of brain-derived neurotrophic factor (BDNF), hippocampal volume and cognitive functions, very few studies explore these aspects together. However the association between these three aspects and their relationship to changes in activities of daily living was not found in the literature reviewed. Objectives: To investigate the relationship between serum levels of BDNF, hippocampal volumes, memory performance and functionality in a sample of elderly. Subjects and Methods: Forty-nine subjects of both sexes, right handed, aged from 60 years were selected from examinations of hippocampal volumetry (Magnetom Vision Plus 1.5 T) requested by the neurologist from complaints of forgetfulness. To the exclusion criteria was applied a short scale in Portuguese-validated Structured Clinical Interview, SCID-IV-TR (Structured Clinial Interview For DSM-IV-TR) that allows the diagnosis of major mental disorders (mood episodes, psychosis, abuse substances, anxiety and somatoform disorders). It was also an exclusion criterion: deafness, blindness and mental retardation. To assess cognitive deficits was administered the mini mental state examination (MMSE). In the evaluation of verbal memory (logical memory) and visual (visual reproduction), early and late was applied to the Wechsler Memory Scale (WMS-R), and the Verbal Learning Test of Rey assessing learning immediate recall and recognition later. For the functional assessment of activities of daily living scales were applied functional Katz and Lawton. After application of these tests were submitted to the elderly collection, fasting, 5 ml of blood by venipuncture and forwarded it to the laboratory of immunology at the industry-HSL PUCRS to be subsequently carried out the analysis of BDNF serum using sandwich Kit - ELISA. Thus, this study examined the relationship between the levels of BDNF with the results of hippocampal volumetry and memory performance and functionality that this sample of elderly. Results: Considering the comparison between BDNF and volume of the hippocampus was detected statistically significant positive correlation, indicating that the lower serum levels of BDNF was related with shrinkage of the hippocampus, both on the right (r = 0.407, p <0.001) and the left (r = 0.593, p <0.001). When BDNF was compared to MMEE, there was also a significant correlation (r = 0.493, p <0.001). In the analysis between BDNF and tests related to memory, all associations were significant and positive, indicating that poor performance on memory tests Rey Verbal, and WMS-R (ML) I was significantly correlated to lower values of serum levels of BDNF, respectively, (r=0,555; p<0,001) and (r=0,589; p<0,001). A similar correlation was observed comparisons between BDNF and Lawton (r = 0.511, p <0.001). Considering the comparison between volumetry of the hippocampus and tests related to memory, there was a significant positive association in virtually all tests assessed, namely, REY Verbal (r = 0.555, p <0.001) REY VERBAL R (r = 0.531, p <0.001), functional scale (r = 0.374, p 0, 008) and MMEE (r = 0.358, p 0.012). A volumetric reduction of the hippocampus was associated with decrease of memory. Conclusion: Our findings suggest a possible association between reductions in BDNF serum levels, shrinkage of the hippocampus, episodic memory deficits, and dysfunction in activities of daily living. It should be noted, therefore, the potential diagnostic power of BDNF, when associated with hippocampal volumetric MRI, memory test and evaluation functional. They will become reliable biomarkers of neurodegenerative diseases associated with aging, especially in its early stages, as a rule, there are only changes in memory. / Introdu??o: O envelhecimento ? uma fase do ciclo vital que pode cursar com maior ou menor limita??o imposta pelo decorrer dos anos. Dentre estas limita??es podemos encontrar a presen?a de diferentes graus de decl?nio cognitivo, particularmente da mem?ria, comprometendo as atividades de vida di?ria e interferindo na funcionalidade do indiv?duo. Estudos do envelhecimento indicam uma associa??o entre os n?veis s?ricos do fator neurotr?fico derivado do c?rebro (BDNF), volume hipocampal e fun??es cognitivas. No entanto a associa??o entre esses tr?s aspectos e suas correspond?ncias nas modifica??es das atividades de vida di?ria, n?o foi encontrada na literatura revisada. No entanto a associa??o entre esses tr?s aspectos e suas correspond?ncias nas modifica??es das atividades de vida di?ria, n?o foi encontrada na literatura revisada. Objetivos: Verificar a rela??o entre os n?veis s?ricos do BDNF e os volumes hipocampais, o desempenho de mem?ria e a funcionalidade em uma amostra de idosos. Sujeitos e M?todos: Quarenta e nove sujeitos de ambos os sexos, destros, com idade a partir de 60 anos foram selecionados a partir dos exames de volumetria hipocampal (Magnetom Vision Plus de 1,5 T) solicitados pelo neurologista a partir de queixas de esquecimentos. Para os crit?rios de exclus?o foi aplicada uma escala breve validada em portugu?s Entrevista Cl?nica Estruturada, SCID- IV-TR (Structured Clinial Interview For DSM-IV-TR) que permite o diagn?stico dos principais transtornos mentais (epis?dios de humor, psicose, abuso de subst?ncias, transtorno de ansiedade e somatoformes). Tamb?m foi crit?rio de exclus?o: surdez, cegueira e retardo mental. Para avaliar os d?ficits cognitivos foi aplicado o mini exame do estado mental (MMEE). Na avalia??o da mem?ria verbal (mem?ria l?gica) e visual (reprodu??o visual), imediata e tardia foi aplicada a Escala de Mem?ria de Wechsler (WMS-R), al?m do teste do Aprendizado Verbal de Rey que avalia aprendizado de mem?ria imediata e de reconhecimento tardio. Para a avalia??o funcional das atividades da vida di?ria foram aplicadas as escalas funcionais de Katz e de Lawton. Ap?s a aplica??o destes testes os idosos foram submetidos ? coleta, em jejum, de 5 ml de sangue por venopun??o e este encaminhado ao laborat?rio do setor de imunologia do HSL-PUCRS para, posteriormente, ser realizada a an?lise do BNDF s?rico utilizando o Kit sandwich ELISA. Desta maneira, este estudo analisou a rela??o dos n?veis de BDNF com os resultados da volumetria hipocampal e o desempenho da mem?ria e da funcionalidade nesta referida amostra de idosos. Resultados: Considerando a compara??o entre BDNF e volumetria do hipocampo, foi detectada correla??o estat?stica significativa e positiva (p<0,001), indicando que, quanto menor os n?veis s?ricos do BDNF menor o volume do hipocampo, tanto o direito (r=0,407; p<0,001) quanto o esquerdo (r=0,593; p<0,001). Quando o BDNF foi comparado ao MMEE, a correla??o positiva e significativa tamb?m ocorreu (r=0,493; p<0,001). Nas an?lises das associa??es entre o BDNF e os testes referentes ? mem?ria, todas estas se mostraram significativas e positivas, indicando que um pior desempenho nos testes de mem?ria do REY Verbal R (evoca??o tardia) e na mem?ria verbal (evoca??o imediata), se correlacionaram a valores menores dos n?veis s?ricos do BDNF, respectivamente (r=0,555; p<0,001) e (r=0,589; p<0,001). Correla??o semelhante foi evidenciada nas compara??es entre BDNF e Lawton (r=0,511; p<0,001). Considerando a compara??o entre volumetria do hipocampo e os testes referentes ? mem?ria, houve associa??o positiva significativa em praticamente todas as rela??es avaliadas, REY VERBAL (r=0,555; p<0,001), e REY VERBAL R (r=0,531; p<0,001), na escala funcional (r=0,374; p=0,008) e MMEE (r=0,358; p=0,012) menor a volumetria do hipocampo. Conclus?o: Nossos resultados mostram que as redu??es observadas nos n?veis de BDNF s?ricos se associam com a diminui??o do volume do hipocampo, com d?ficits da mem?ria epis?dica e disfun??es nas atividades da vida di?ria. Destaca-se, portanto, o potencial do BDNF, quando associado ? volumetria hipocampal por RM, e aos testes de mem?ria e de avalia??o funcional, como marcadores importantes na identifica??o precoce de d?ficits cognitivos-funcionais, frequentemente presentes nas doen?as neurodegenerativas relacionadas ao processo de envelhecimento.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1680 |
| Date | 19 March 2012 |
| Creators | Ferreira, Eloisa Elena Silveira |
| Contributors | Portuguez, Mirna Wetters |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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