Ricardo Augusto Leoni De Sousa

Ricardo Augusto Leoni De Sousa

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Previous Organizations / Institutes

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Ricardo Augusto Leoni De Sousa has a total of 138 co-authors. Here are the top co-authors by number of shared publications:


Latest Publications

  • Open Access

    Pooled prevalence of anxiety and depressive symptoms among adults with type 2 diabetes: a systematic review and meta-analysis

    by Rosiane R. Silva, Maurício S. da Costa, Luana A. L. Almeida, Poliany P. Cruz, Robervânia R. Silva, Alessandro C. Alves, Ricardo A. L. de Sousa, Ricardo C. Cassilhas

    Purpose: Anxiety and depressive symptoms are highly prevalent among individuals with type 2 diabetes mellitus (T2DM), yet they remain underdiagnosed despite their substantial impact on health outcomes. In addition to impairing treatment adherence, these conditions may contribute to the development of chronic complications, reduce quality of life, and, in severe cases, increase mortality. Therefore, this review aims to estimate the pooled prevalence of anxiety symptoms and depressive symptoms among adults with T2DM and to explore potential sources of between-study heterogeneity, including assessment instruments and cut-off points. Methods: PubMed, Embase, PsycINFO, Scopus, and Web of Science were searched from inception to July 6, 2026. After screening 6,948 records according to PRISMA 2020, 34 cross-sectional studies involving 21,024 participants were included. We considered observational studies involving adults with T2DM that reported the prevalence of anxiety symptoms or depressive symptoms assessed using validated screening instruments or diagnostic criteria. Two reviewers independently screened the records, extracted the data, and assessed the risk of bias. Separate random-effects meta-analyses were conducted for anxiety symptoms and depressive symptoms. Results: Thirty-four cross-sectional studies involving 21,024 participants were included. The pooled prevalence was 43.82% for anxiety symptoms (95% CI 36.86–50.90; $$\:{I}^{2}=99.06\%$$ ) and 41.83% for depressive symptoms (95% CI 33.83–50.06; $$\:{I}^{2}=99.31\%$$ ). Estimates varied substantially across assessment instruments and cut-off points. Several studies reported associations with sex, glycemic control, and social support; however, differences in the definitions, measurements, and analytical methods prevented quantitative pooling of these factors. Conclusion: Anxiety and depressive symptoms were frequently reported among adults with T2DM. However, the extreme between-study heterogeneity limits the interpretation of the pooled estimates, which should be understood as summary measures across diverse study populations rather than universal prevalence estimates. These findings should not be interpreted as estimates of clinically diagnosed anxiety or depressive disorders.

  • Molecular basis of insulin resistance and its impact on the brain: the role of physical exercise

    by Ricardo Augusto Leoni De Sousa

    Insulin resistance (IR) is a pathological condition in which peripheral tissues and the brain fail to respond effectively to circulating insulin, contributing to metabolic disorders and cognitive decline. Adipose distribution, and hormonal regulation modulate IR, resulting in distinct molecular and metabolic profiles between men and women. Physical exercise is a potent intervention for improving insulin sensitivity, impacting both peripheral and central mechanisms. At the molecular level, exercise enhances insulin signaling, glucose uptake, and mitochondrial function in skeletal muscle, liver, and adipose tissue. In the brain, exercise-induced factors such as PGC-1α and irisin mediate neuroplasticity, neuroprotection, and energy metabolism, contributing to improved cognitive function and reduced risk of neurodegenerative disease. Physical exercise modulates lipid intermediates, inflammatory markers, and transcriptional networks that contribute to IR, highlighting its systemic and tissue-specific effects. Understanding these mechanisms is essential for the development of precision exercise prescriptions tailored to individual metabolic and neurological profiles. This review synthesizes current evidence on the molecular mechanisms underlying peripheral and brain IR and examines how aerobic, resistance, and high-intensity interval training influence these pathways. By integrating molecular, physiological, and behavioral perspectives, this work underscores the critical role of physical exercise in mitigating IR and promoting metabolic and cognitive health.

  • Open Access

    Exercise Snacking in Alzheimer's Disease: A Mechanistic Rationale Based on Repeated Exerkine Signaling

    by Ricardo A. L. De Sousa, Joyce Mirlane Moreira Costa, Ramona Ramalho de Souza Pereira, Leiriel Cristina dos Reis Vieira, Caíque Olegário Diniz e Magalhães, Marco Fabrício Dias‐Peixoto

  • Open Access

    Association between lower limb strength, anxiety, and depression symptoms in older adults

    by Poliany Pereira Cruz, Ricardo Augusto Leoni De Sousa, Laís Francielle Francisca Felício, Renato Sobral Monteiro-Junior, Ricardo Cardoso Cassilhas

    SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between lower limb strength and symptoms of anxiety and depression in communitydwelling older adults. METHODS: This cross-sectional study included 99 community-dwelling older adults (69.5±6.6 years; 81.8% women) assessed between 2021 and 2023 in Minas Gerais, Brazil. Inclusion criteria were age ≥60 years, independent mobility, and medical clearance. Participants were excluded if they had uncontrolled chronic or cardiovascular diseases, a history of stroke, unmanaged neurodegenerative disorders, active psychiatric comorbidities that could interfere with psychological assessments, or musculoskeletal injuries preventing safe participation in testing. Anxiety and depressive symptoms were assessed using the Geriatric Anxiety Inventory and Geriatric Depression Scale. Lower limb strength was measured using the 30-Second Chair Stand test and classified according to age- and sex-specific normative values. RESULTS: Participants with below-average lower limb strength had higher odds of anxiety symptoms (OR 10.90; 95%CI 1.97–60.33; p=0.006). Lower limb strength was also associated with depressive symptoms, although with a smaller effect size (OR 3.96; 95%CI 1.06–14.74; p=0.040). Age was positively associated with anxiety (p=0.019), while no significant associations were observed for sex. CONCLUSION: The 30-Second Chair Stand test may have potential as a complementary screening indicator to identify older adults at elevated psychosocial risk.

  • Open Access

    Associations between muscle strength and mental health in older adults

    by Ricardo Augusto Leoni de Sousa, Poliany Pereira Cruz, Beatriz Gonçalves de Oliveira, Renato Sobral Monteiro-Júnior, Henrique Nunes Pereira Oliva, Ricardo Cardoso Cassilhas

  • Short-term swimming induces the enhancement of mitochondrial-, survival-, and proliferation-related proteins in the hippocampus of healthy aged mice without affecting behavior

    by Ricardo Augusto Leoni de Sousa, Caique Olegário Diniz-Magalhães, Poliany Pereira Cruz, Gustavo Henrique Bahia de Oliveira, Julia Tereza Aparecida Caldeira Prates, Crisley Mara de Azevedo Ferreira, Rosiane Rosa Silva, Ricardo Cardoso Cassilhas


  • Exercise-produced irisin effects on brain-related pathological conditions

    by Ricardo Augusto Leoni De Sousa

    Exercise increases peroxisome proliferator-activated receptor-gamma coactivator 1-alpha (PGC-1α) expression, which in turn causes the fibronectin type III domain containing 5 (FNDC5) protein to be produced. This protein is then cleaved, primarily in skeletal muscle fibers, to produce irisin. When the mature FNDC5 is cleaved by proteases, Irisin - which is the fibronectin III domain without the signal sequence - is released. Resistance, aerobic, and high-intensity interval training (HIIT) are recognized as forms of physical exercise that raise irisin levels, and insulin receptor phosphorylation in tyrosine residues, favoring an increase in the activity of the insulin-dependent pathway (PI3K pathway) and assisting in the fight against insulin resistance, inflammation, and cognitive decline. Irisin may represent a promising option for the therapeutic targeting in several brain-related pathological conditions, like Alzheimer’s disease (AD), Parkinson’s disease (PD), epilepsy, type 2 diabetes, and obesity. Exercise protocols are healthy and inexpensive interventions that can help find cellular and molecular changes in several brain-related pathological conditions. Here, it was reviewed what is known about exercise-produced irisin studies involving AD, PD, epilepsy, type 2 diabetes, and obesity.


  • Accumulated HIIT inhibits anxiety and depression, improves cognitive function, and memory-related proteins in the hippocampus of aged rats

    by Caíque Olegário Diniz e Magalhães, Ricardo Augusto Leoni De Sousa, Bruno Ferreira Mendes, Isabela Rocha Dias, Ramona Ramalho Souza Pereira, Gabriela Cruz Pereira, Kil Sun Lee, Marco Fabricio Dias Peixoto, Ricardo Cardoso Cassilhas

    This study aimed to compare the effects of High-Intensity Interval Training (HIIT) performed in a single session(1xHIIT) versus three daily sessions (3xHIIT) on fitness level and behavior of aged rats. Eighteen-month-old Wistar rats were assigned to Untrained (UN), 1xHIIT, or 3xHIIT (n = 12/group). Both groups, 1xHIIT and 3xHIIT, performed 15 min of a treadmill running HIIT protocol during 8 weeks. 1xHIIT protocol consisted of a single daily session of 15 min, while the 3xHIIT performed three daily sessions of 5 min with a 4 h interval between the sessions. Morris Water Maze (MWM) task was used to evaluate spatial learning and memory. Splash test, Forced Swim test, and Elevated Plus Maze task (EPM) were used to evaluate anhedonic, depressive-like, and anxious behaviors, respectively. Rats were euthanized, and the hippocampus was harvested for western blot analyses (CaMKII and BDNF). Both HIIT protocols improved VO2max and spatial memory. Notably, only the 3xHIIT protocol attenuated anxious and depressive-like behaviors. Western blot analyses of the hippocampus revealed that both HIIT protocols increased BDNF levels. BDNF levels were higher in the 3xHIIT when compared with 1xHIIT group, and we observed increasement of the CamKII levels just in the 3x HIIT group. Therefore, this study provides evidence indicating that accumulated HIIT sessions is more effective than traditional daily HIIT sessions in improving fitness level, cognitive function, memory, inhibiting the development of mood disorders, and enhancing BDNF and CaMKII levels in the hippocampus of aged rats.