290 resultados para Córtex


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Coding process is a fundamental aspect of cerebral functioning. The sensory stimuli transformation in neurophysiological responses has been a research theme in several areas of Neuroscience. One of the most used ways to measure a neural code e ciency is by the use of Information Theory measures, such as mutual information. Using these tools, recent studies show that in the auditory cortex both local eld potentials (LFPs) and action potential spiking times code information about sound stimuli. However, there are no studies applying Information Theory tools to investigate the e ciency of codes that use postsynaptics potentials (PSPs), alone and associated with LFP analysis. These signals are related in the sense that LFPs are partly created by joint action of several PSPs. The present dissertation reports information measures between PSP and LFP responses obtained in the primary auditory cortex of anaesthetized rats and auditory stimuli of distinct frequencies. Our results show that PSP responses hold information about sound stimuli in comparable levels and even greater than LFP responses. We have also found that PSPs and LFPs code sound information independently, since the joint analysis of these signals did neither show synergy nor redundancy.

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Parkinson disease (PD) is associated with motor symptoms and dopaminergic cell loss in the nigrostriatal pathway. Alpha-synuclein is the major component of the Lewy bodies, the biological hallmarks of disease, and has been associated with familial cases of PD. Recently, the spinal cord stimulation (SCS) showed to be effective to alleviate the Parkinson symptoms in animal models and human patients. In this project, we characterized the motor and electrophysiological effects of alpha-synuclein overexpression in the substantia nigra of rats. We further investigated the effects of spinal electrical stimulation, AMPT and L-dopa administration in this model. Method: Sprague-Dawley rats were injected with empty viral vector or the vector carrying the gene for alpha-synuclein in the substantia nigra, and were tested weekly for 10 weeks in the open field and cylinder tests. A separated group of animals implanted with bilateral electrode arrays in the motor cortex and the striatum were recorded in the open field, during the SCS sessions and the pharmacological experiments. Results: Alpha-synuclein expression resulted in motor asymmetry, observed as the reduction in use of contralateral forepaw in the cylinder test. Animals showed an increase of local field potential activity in beta band three and four weeks after the virus injection, that was not evident after the 5th week. AMPT resulted in a sever parkinsonian state, with reduction in the locomotor activity and significant peak of oscillatory activity in cortex and striatum. SCS was effective to alleviate the motor asymmetry at long term, but did not reduce the corticostriatal low frequency oscillations observed 24 hs after the AMPT administration. These oscillations were attenuated by L-dopa that, even as SCS, was not effective to restore the locomotor activity during the severe dopaminergic depletion period. Discussion: The alpha-synuclein model reproduces the motor impairment and the progressive neurodegenerative process of PD. We demonstrated, by the first time, that this model also presents the increase in low frequency oscillatory activity in the corticostriatal circuit, compatible with parkinsonian condition; and that SCS has a therapeutic effect on motor symptom of this model.

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The main inputs to the hippocampus arise from the entorhinal cortex (EC) and form a loop involving the dentate gyrus, CA3 and CA1 hippocampal subfields and then back to EC. Since the discovery that the hippocampus is involved in memory formation in the 50's, this region and its circuitry have been extensively studied. Beyond memory, the hippocampus has also been found to play an important role in spatial navigation. In rats and mice, place cells show a close relation between firing rate and the animal position in a restricted area of the environment, the so-called place field. The firing of place cells peaks at the center of the place field and decreases when the animal moves away from it, suggesting the existence of a rate code for space. Nevertheless, many have described the emergence of hippocampal network oscillations of multiple frequencies depending on behavioral state, which are believed to be important for temporal coding. In particular, theta oscillations (5-12 Hz) exhibit a spatio-temporal relation with place cells known as phase precession, in which place cells consistently change the theta phase of spiking as the animal traverses the place field. Moreover, current theories state that CA1, the main output stream of the hippocampus, would interplay inputs from EC and CA3 through network oscillations of different frequencies, namely high gamma (60-100 Hz; HG) and low gamma (30-50 Hz; LG), respectively, which tend to be nested in different phases of the theta cycle. In the present dissertation we use a freely available online dataset to make extensive computational analyses aimed at reproducing classical and recent results about the activity of place cells in the hippocampus of freely moving rats. In particular, we revisit the debate of whether phase precession is due to changes in firing frequency or space alone, and conclude that the phenomenon cannot be explained by either factor independently but by their joint influence. We also perform novel analyses investigating further characteristics of place cells in relation to network oscillations. We show that the strength of theta modulation of spikes only marginally affects the spatial information content of place cells, while the mean spiking theta phase has no influence on spatial information. Further analyses reveal that place cells are also modulated by theta when they fire outside the place field. Moreover, we find that the firing of place cells within the theta cycle is modulated by HG and LG amplitude in both CA1 and EC, matching cross-frequency coupling results found at the local field potential level. Additionally, the phase-amplitude coupling in CA1 associated with spikes inside the place field is characterized by amplitude modulation in the 40-80 Hz range. We conclude that place cell firing is embedded in large network states reflected in local field potential oscillations and suggest that their activity might be seen as a dynamic state rather than a fixed property of the cell.

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Introduction: Slow abdominal breathing (SAB) stimulates baroreflex and generates respiratory sinus arrhythmia, changing cardiovascular, emotional and cerebral systems acute and chronically. However, although meditative practices have been receiving increasingly attention in the last years, there is no agreement on the neurophysiological changes underlying them, mainly because of the lack of topographical pieces of information. Purpose: We aimed to analyze the acute effect of SAB on brain activity, emotional and cardiovascular responses in untrained subjects in meditative techniques. Methods: Seventeen healthy adults’ men were assessed into two different sessions in a random and crossed order. Into experimental session, they breathed in 6 cycles/minute and in control session they kept breathing in normal rate, both for 20 minutes. xi Before, during, and after each session we assessed brain activity using electroencephalography (EEG), anxiety, mood, heart rate variability (HRV) and blood pressure. The sLORETA software was used to analyze EEG data for source localization of brain areas in which activity was changed. Results: The sLORETA showed that beta band frequency was reduced in frontal gyrus (P<0.01) and anterior cingulate cortex (P<0.05) both during and after SAB (P<0.05) compared to the moment before it. There was no change in brain activity in control session. Additionally, a two-way repeated measures ANOVA showed that there was no effect on anxiety (P>0.8) and mood (P>0.08). There were improvements in HRV (P<0.03), with increased RR interval and decreased HR after SAB, as well as increased SDNN, RMSSD, pNN50, low frequency, LF/HF ratio, and total power during it, with no changes in SBP and DBP. Conclusions: We conclude that SAB is able to change brain activity in areas responsible for emotional processing, even without behavioral changes. Furthermore, SAB improves HRV and does not change blood pressure in normotensive.

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Nos períodos críticos de plasticidade neural ocorre uma maior permissividade do sistema nervoso ao ambiente, por isto, a ação do estresse sobre o individuo e suas repercussões sobre áreas responsáveis pelo controle dos sistemas de resposta ao estresse e por funções cognitivas complexas vem recebendo bastante atenção. A utilização de modelos experimentais translacionais tem sido imprescindível na elucidação destes mecanismos e das patologias associadas. Diante disto, este trabalho investigou os efeitos do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e sobre a neurogênese no córtex pré-frontal (CPF) durante um período crítico de plasticidade cerebral, a fase juvenil, em machos de Callithrix jacchus. Durante cinco meses, 5 animais foram acompanhados em suas famílias (GF) e 5 animais foram isolados socialmente por 4 meses (GI), após um mês em observação em ambiente familiar (fase basal- FB). Ao final do 5º mês foram aplicados 2 testes de memória de trabalho (MT) nos animais GF e GI. Em seguida, 3 animais de cada grupo foram sacrificados para análise do fator de neurogênese BDNF ( Brain Derived Neurotrophic Factor) por imunofluorescência no CPF (sub-regiões orbitofrontal e lateral). Os animais do GF não variaram significativamente o cortisol ao longo do estudo, enquanto o GI elevou o cortisol e comportamentos indicadores de ansiedade (CA) na primeira semana do isolamento. Em seguida, o GI apresentou uma redução no cortisol, nos CA, no peso corporal e um aumento de comportamentos estereotipados e da anedonia, alterações tipicamente depressivas em primatas não-humanos. Ao final, o GI apresentaram níveis de cortisol menores que em FB. Ambos os grupos apresentaram dificuldades em realizar e aprender as tarefas cognitivas e a presença de BDNF no córtex pré-frontal foi independente do grupo (GF ou GI), porém correlacionou-se com os níveis de cortisol presentes na ultima semana do estudo, e os animais com presença de BDNF no CPF lateral e orbitofrontal apresentaram maiores níveis de cortisol. Estes resultados contribuem no processo de validação do sagui como um bom modelo psiquiátrico translacional e aponta para possibilidade de estudos sobre transtornos depressivos na juventude e suas repercussões posteriores. Além disto, os resultados observados para as tarefas cognitivas levou-nos a fazer uma releitura dos protocolos utilizados em estudos de memoria de trabalho com animais adultos desta espécie, com a finalidade de aprimora-los facilitando a aprendizagem em animais juvenis, naives e em situações de estresse. Ademais, evidenciou-se pela primeira vez a relação do estresse, cortisol e níveis de BDNF, em animais juvenis desta espécie, com a fim de contribuir com sua utilização como modelo animal neurocognitivo.

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In the primary visual cortex, neurons with similar physiological features are clustered together in columns extending through all six cortical layers. These columns form modular orientation preference maps. Long-range lateral fibers are associated to the structure of orientation maps since they do not connect columns randomly; they rather cluster in regular intervals and interconnect predominantly columns of neurons responding to similar stimulus features. Single orientation preference maps – the joint activation of domains preferring the same orientation - were observed to emerge spontaneously and it was speculated whether this structured ongoing activation could be caused by the underlying patchy lateral connectivity. Since long-range lateral connections share many features, i.e. clustering, orientation selectivity, with visual inter-hemispheric connections (VIC) through the corpus callosum we used the latter as a model for long-range lateral connectivity. In order to address the question of how the lateral connectivity contributes to spontaneously generated maps of one hemisphere we investigated how these maps react to the deactivation of VICs originating from the contralateral hemisphere. To this end, we performed experiments in eight adult cats. We recorded voltage-sensitive dye (VSD) imaging and electrophysiological spiking activity in one brain hemisphere while reversible deactivating the other hemisphere with a cooling technique. In order to compare ongoing activity with evoked activity patterns we first presented oriented gratings as visual stimuli. Gratings had 8 different orientations distributed equally between 0º and 180º. VSD imaged frames obtained during ongoing activity conditions were then compared to the averaged evoked single orientation maps in three different states: baseline, cooling and recovery. Kohonen self-organizing maps were also used as a means of analysis without prior assumption (like the averaged single condition maps) on ongoing activity. We also evaluated if cooling had a differential effect on evoked and ongoing spiking activity of single units. We found that deactivating VICs caused no spatial disruption on the structure of either evoked or ongoing activity maps. The frequency with which a cardinally preferring (0º or 90º) map would emerge, however, decreased significantly for ongoing but not for evoked activity. The same result was found by training self-organizing maps with recorded data as input. Spiking activity of cardinally preferring units also decreased significantly for ongoing when compared to evoked activity. Based on our results we came to the following conclusions: 1) VICs are not a determinant factor of ongoing map structure. Maps continued to be spontaneously generated with the same quality, probably by a combination of ongoing activity from local recurrent connections, thalamocortical loop and feedback connections. 2) VICs account for a cardinal bias in the temporal sequence of ongoing activity patterns, i.e. deactivating VIC decreases the probability of cardinal maps to emerge spontaneously. 3) Inter- and intrahemispheric long-range connections might serve as a grid preparing primary visual cortex for likely junctions in a larger visual environment encompassing the two hemifields.

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In the primary visual cortex, neurons with similar physiological features are clustered together in columns extending through all six cortical layers. These columns form modular orientation preference maps. Long-range lateral fibers are associated to the structure of orientation maps since they do not connect columns randomly; they rather cluster in regular intervals and interconnect predominantly columns of neurons responding to similar stimulus features. Single orientation preference maps – the joint activation of domains preferring the same orientation - were observed to emerge spontaneously and it was speculated whether this structured ongoing activation could be caused by the underlying patchy lateral connectivity. Since long-range lateral connections share many features, i.e. clustering, orientation selectivity, with visual inter-hemispheric connections (VIC) through the corpus callosum we used the latter as a model for long-range lateral connectivity. In order to address the question of how the lateral connectivity contributes to spontaneously generated maps of one hemisphere we investigated how these maps react to the deactivation of VICs originating from the contralateral hemisphere. To this end, we performed experiments in eight adult cats. We recorded voltage-sensitive dye (VSD) imaging and electrophysiological spiking activity in one brain hemisphere while reversible deactivating the other hemisphere with a cooling technique. In order to compare ongoing activity with evoked activity patterns we first presented oriented gratings as visual stimuli. Gratings had 8 different orientations distributed equally between 0º and 180º. VSD imaged frames obtained during ongoing activity conditions were then compared to the averaged evoked single orientation maps in three different states: baseline, cooling and recovery. Kohonen self-organizing maps were also used as a means of analysis without prior assumption (like the averaged single condition maps) on ongoing activity. We also evaluated if cooling had a differential effect on evoked and ongoing spiking activity of single units. We found that deactivating VICs caused no spatial disruption on the structure of either evoked or ongoing activity maps. The frequency with which a cardinally preferring (0º or 90º) map would emerge, however, decreased significantly for ongoing but not for evoked activity. The same result was found by training self-organizing maps with recorded data as input. Spiking activity of cardinally preferring units also decreased significantly for ongoing when compared to evoked activity. Based on our results we came to the following conclusions: 1) VICs are not a determinant factor of ongoing map structure. Maps continued to be spontaneously generated with the same quality, probably by a combination of ongoing activity from local recurrent connections, thalamocortical loop and feedback connections. 2) VICs account for a cardinal bias in the temporal sequence of ongoing activity patterns, i.e. deactivating VIC decreases the probability of cardinal maps to emerge spontaneously. 3) Inter- and intrahemispheric long-range connections might serve as a grid preparing primary visual cortex for likely junctions in a larger visual environment encompassing the two hemifields.

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The primary somatosensory cortex (S1) receives inputs from peripheral tactile receptors and plays a crucial role on many important behaviors. However, the plastic potential of this region is greatly reduced during adulthood, limiting functional recovery after injuries. This fact is due to the presence, in the brain parenchima, of structures and substances that have an inhibitory effect on plasticity, such as chondroitin sulfate proteoglicans (CSP) present in the perineuronal.nets (PNNs) surrounding a subset of neurons. Maturation of PNNs coincide with the closure of critical periods of plasticity in cortical areas, since CSP act to stabilize synaptic contacts. Removal of CSP is proven to be an effective therapeutic approach to restore plasticity and increase the odds of functional recovery after cortical lesion. In the present work, we removed CSP from the sensorimotor cortex of rats to restore plasticity and promote the compensatory morphofunctional regeneration of cortical circuits modified by removal of mystacial vibrissae during the critical period. Treatment with the CSP-digesting enzyme chondroitinase ABC proved efficient to restore plasticity in S1 circuits, as evidenced by morphological rearrangements and functional recovery.

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The primary somatosensory cortex (S1) receives inputs from peripheral tactile receptors and plays a crucial role on many important behaviors. However, the plastic potential of this region is greatly reduced during adulthood, limiting functional recovery after injuries. This fact is due to the presence, in the brain parenchima, of structures and substances that have an inhibitory effect on plasticity, such as chondroitin sulfate proteoglicans (CSP) present in the perineuronal.nets (PNNs) surrounding a subset of neurons. Maturation of PNNs coincide with the closure of critical periods of plasticity in cortical areas, since CSP act to stabilize synaptic contacts. Removal of CSP is proven to be an effective therapeutic approach to restore plasticity and increase the odds of functional recovery after cortical lesion. In the present work, we removed CSP from the sensorimotor cortex of rats to restore plasticity and promote the compensatory morphofunctional regeneration of cortical circuits modified by removal of mystacial vibrissae during the critical period. Treatment with the CSP-digesting enzyme chondroitinase ABC proved efficient to restore plasticity in S1 circuits, as evidenced by morphological rearrangements and functional recovery.

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Se denomina visión ciega (Blindsight) al fenómeno tradicionalmente estudiado en pacientes con lesiones en su córtex visual primario (V1), quienes logran discriminar estímulos visuales pese a no tener consciencia de haberlos percibido. A partir de una revisión de literatura del área se exponen hitos del desarrollo del estudio de Blindsight como paradigma de investigación en neurociencias, sus aportes fundamentales, y controversias conceptuales y metodológicas. Se exponen además datos surgidos de la investigación reciente en el área, la cual plantea un énfasis en explicar el fenómeno asociado a sus correlatos neuroanatómicos, existiendo hallazgos recurrentes respecto a un rol central del colículo superior. Se concluye que el estudio del blindsight como paradigma de investigación se encuentra actualmente en un proceso de replanteamiento tanto de carácter metodológico como conceptual.

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Microglial cells are the resident immune cells of central nervous system (CNS) and the major players in neuroinflammation. These cells are also responsible for surveilling the neuronal microenvironment, and upon injury to the CNS they change their morphology and molecular profile and become activated. Activated status is associated with microglia proliferation, migration to injury foci, increased phagocytic capacity, production and release of reactive oxygen species (ROS), cytokines (pro- or anti-inflammatory) and reactive nitrogen species. Microglia activation is crucial for tissue repair in the healthy brain. However, their chronic activation or deregulation might contribute for the pathophysiology of neurodegenerative diseases. A better understanding of the mechanisms underlying microglial cell activation is important for defining targets and develop appropriate therapeutic strategies to control the chronic activation of microglia. It has been observed an increase in profilin (Pfn) mRNA in microglial cells in the rat hippocampus after unilateral ablation of its major extrinsic input, the entorhinal cortex. This observation suggested that Pfn might be involved in microglia activation. Pfn1 is an actin binding protein that controls assembly and disassembly of actin filaments and is important for several cellular processes, including, motility, cell proliferation and survival. Here, we studied the role of Pfn1 in microglial cell function. For that, we used primary cortical microglial cell cultures and microglial cell lines in which we knocked down Pfn1 expression and assessed the activation status of microglia, based on classical activation markers, such as: phagocytosis, glutamate release, reactive oxygen species (ROS), pro- and anti-inflammatory cytokines. We demonstrated that Pfn1 (i) is more active in hypoxia-challenged microglia, (ii) modulates microglia pro- and anti-inflammatory signatures and (iii) plays a critical role in ROS generation in microglia. Altogether, we conclude that Pfn1 is a key protein for microglia homeostasis, playing an essential role in their activation, regardless the polarization into a pro or anti-inflammatory signature.

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The present study was undertaken to identify proteins interacting with PrPC that could provide new insights into its physiological functions and pathological role. We performed a target search for lysosomal network protein, Rab7a and Rab9, in frontal cortex and cerebellum of human brain from patients with sCJD-MM1 and sCJD-VV2. The intracellular level of Rab7a was increased significantly, when compared with healthy age-matched control. Interactions of PrPC and Rab7a/Rab9 were further investigated by using confocal laser scanning microscopy. Immunofluorescence results suggested potential interactions of Rab7a and PrPC. siRNA against the Rab7a gene was used to knockdown the expression of Rab7a protein in primary cell culture of cortical neurons from wild type mice. This depleted Rab7a resulted an impairment of PrPC trafficking leading to an accumulation of PrPC in the endocytosis pathway. Furthermore, interactions of Tau and Rab7a were investigated by using western blot analysis and confocal laser scanning microscopy. Cell cultures of cortex of wildtype mice were treated with siRNA-Tau, siRNA-Rab7 and control siRNA followed by immunofluorescence. The results of immunofluorescence suggested potential interaction of Tau and Rab7a. Cells lines treated with siRNA-Tau, the intracellular levels of Rab7a and Rab9 significantly increases and their localization is also modified. When we transfected this cells lines with siRNA-rab7a the accumulation of Tau decreases in cytosolic region and their localization was also modified when compared with control cells. In conclusion, this study may help to understand and characterize the subtype specific disease progression in CJD cases. Furthermore, it could be a step ahead to development of new treatment strategies for diseases subtype specific manner.

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No período extra-uterino o sistema visual já se encontra totalmente constituído. Desenvolve-se desde o nascimento até à primeira infância. A primeira evidência clínica da visão binocular é demonstrada aos 6 meses de idade – visão estereoscópica. A visão binocular não é inata. O sistema visual decompõe todas as estimulações visuais que se apresentam à retina, em imagens com contraste variável. O cérebro, ao nível do córtex occipital, analisa-as e reconstitui a imagem inicial, com os dados de base, fruto da aprendizagem do indivíduo. É um processo cerebral correspondente à percepção dos objectos no espaço que é realizado em simultâneo para que as imagens obtidas por cada olho se formem sobre as respectivas fóveas. Pode ser definida como a visão conseguida através da coordenação dos dois olhos, de modo que as imagens de cada olho separadamente possam ser apreciadas como uma impressão mental única na parte visual do córtex cerebral.

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Introdução: A catarata em idade pediátrica constitui um desafio cirúrgico. Este desafio assume maior dimensão quando a catarata pediátrica é secundária ao tratamento com radioterapia por tumor ocular. A complexidade da técnica, a maior fragilidade ou fibrose de estruturas oculares e o maior risco de complicações intra e pós operatórias são obstáculos que o cirurgião deve equacionar. Os autores apresentam um caso clinico de uma cirurgia de catarata unilateral, secundária a radiação por feixe de protões externo para tratamento de melanoma da íris, em criança com 11 anos de idade. Métodos: Criança de 8 anos, com lesão pigmentada infero-temporal no olho esquerdo. Estabeleceu-se o diagnóstico de melanoma da íris, tendo realizado radioterapia com feixe acelerado de protões com excisão e recolocação de células limbares. Após 18 meses de radioterapia, constatou-se desenvolvimento de catarata subcapsular posterior com evolução para catarata branca. Aos 11 anos, foi submetida, sob anestesia geral, a facoemulsificação microincisional. Realizaram-se 2 paracenteses de 1 mm e, através destas, efectuou-se a capsulorexis anterior, após coloração com azul tripano. Procedeu-se à realização da incisão principal (2,2mm), à faco-aspiração do cristalino opacificado e à irrigação/aspiração bimanual do córtex. Implantou-se a lente intra-ocular monobloco monofocal (SN 60WF) no saco capsular e efectuou-se capsulorexis posterior primária. Com o objectivo de excluir a presença de vítreo na câmara anterior e simultaneamente obter um efeito anti-inflamatório, injectou-se intra-camerularmente triamcinolona sem conservantes. Resultados: Não se observaram complicações intra ou pós-operatórias, imediatas ou tardias, de relevo. Com 1 ano de evolução, a acuidade visual do olho esquerdo é de 10/10. Após 4 anos de radioterapia não se observa recorrência do tumor, doença metastática nem complicações da radioterapia. Conclusões: A micro-incisão, a capsulorexis posterior primária e a aplicação de triamcinolona intracamerular asseguram maior segurança no procedimento, mais rápida recuperação visual com transparência duradoura do eixo visual e menor inflamação no pós-operatório.

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Introdução: A musicoembriologia engloba a audição de música durante a gravidez, com o objetivo de melhorar a relação materno-fetal e o neurodesenvolvimento infantil. Contudo, a relação entre estes ainda não está bem estabelecida, pelo que permanece um tema controverso. Objetivo: Rever a evidência disponível sobre o impacto da audição de música durante a gravidez no neurodesenvolvimento infantil. Material e Métodos: Pesquisa de meta-análises (MA), revisões sistemáticas (RS), ensaios clínicos aleatorizados e contro- lados (ECAC), e normas de orientação clinica (NOC), em inglês e português, publicados entre 01/2004 e 04/2014, nas bases de dados Pubmed/Medline, sítios de medicina baseada na evidência e Índex de Revistas Médicas Portuguesas, utilizando os termos MeSH: music; pregnancy; child; neurodevelopment. Para a avaliação dos níveis de evidência (NE) e atribuição de forças de recomendação (FR) foi utilizada a escala SORT (Strength of Recommendation Taxonomy) da American Family Phisician. Resultados: Foram encontrados onze artigos, dos quais quatro foram selecionados: três ECAC e uma RS. Um ECAC (NE 1) mostrou melhoria significativa do comportamento neonatal nas crianças cujas mães ouviram música durante a gravidez. Outro ECAC (NE 2) demonstrou uma melhoria da relação ma- terno-fetal com a musicoembriologia. Outro ECAC (NE3) e a RS (FR B) demonstraram que o ambiente intrauterino é importante no neurodesenvolvimento neonatal, sobretudo no desenvolvi- mento do córtex cerebral motor e neurosensorial. Conclusões: A evidência disponível demonstrou que a au- dição de música durante o período embrionário apresenta benefício no neurodesenvolvimento infantil. (FR B) No entanto os estudos obtidos são em número reduzido e apresentam grande heterogeneidade em termos metodológicos. São necessários mais estudos, com populações controladas e metodologia semelhantes, para a recomendação global desta medida.