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Emoto N, Okazaki-Hada M, Yamaguchi Y, Okajima F, Goto R, Sugihara H. Risk Preferences, Rationality of Choices, and Willingness to Pay for Preventive Medicine in Patients with Graves' Thyrotoxicosis. Patient Prefer Adherence 2021; 15:1971-1979. [PMID: 34522090 PMCID: PMC8434921 DOI: 10.2147/ppa.s323472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Patients with thyrotoxicosis show neuropsychological changes, and these may damage the quality of informed consent in clinical practice. Therefore, we examined patients' real-life preferences to assess whether change in risk preferences was dependent on thyroid function state. PATIENTS AND METHODS The participants were 86 patients who were newly diagnosed with Graves' thyrotoxicosis between 1 January and 31 December 2018 (group A), and an additional 33 euthyroid patients diagnosed before 2018 (group B). In a survey conducted via a questionnaire based on the concept of behavioral economics, we sought to determine risk preferences, rationality of choices, and other relevant factors. An identical second survey was completed 6-12 months later by 36 patients in group A after their thyroid functions had been normalized by treatment, and by 11 euthyroid patients in group B. We performed paired analysis of the first and second surveys in 32 patients of group A and single regression analysis of a total of 140 surveys obtained from 119 patients by combining the first and second surveys of groups A and B with serum level of FT3 as an independent variable. RESULTS The paired analysis indicated that there was no significant difference in any survey item. The single regression analysis revealed that willingness-to-pay (WTP) for preventive medicine and monthly average out-of-pocket (OOP) expenditure on medical care were both significantly positively associated with serum level of FT3. Patients in the hyperthyroid state tend to have high WTP for preventive medicine, which may be accelerated by the anchoring effect of OOP expenditure. CONCLUSION Almost all risk preferences of patients with Graves' disease are constant, rational, and reproducible in the hyperthyroid and euthyroid states. However, medical professionals should be aware that the willingness of patients with thyrotoxicosis to pay for medical costs may change after the normalization of thyroid function.
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Affiliation(s)
- Naoya Emoto
- Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
- Department of Diabetes, Endocrinology and Metabolism, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
- Diabetes & Thyroid Clinic, Sakura Chuo Hospital, Chiba, Japan
- Correspondence: Naoya Emoto Diabetes & Thyroid Clinic, Sakura Chuo Hospital, 20-4, Sakaecho, Sakura City, Chiba, 285-0014, JapanTel +81-43-486-1311Fax +81-43-486-1314 Email
| | - Mikiko Okazaki-Hada
- Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuji Yamaguchi
- Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Fumitaka Okajima
- Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
- Department of Diabetes, Endocrinology and Metabolism, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Rei Goto
- Graduate School of Business Administration, Keio University, Tokyo, Japan
| | - Hitoshi Sugihara
- Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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Arora S, Lawrence MA, Klein RM. The Attention Network Test Database: ADHD and Cross-Cultural Applications. Front Psychol 2020; 11:388. [PMID: 32292363 PMCID: PMC7119191 DOI: 10.3389/fpsyg.2020.00388] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/19/2020] [Indexed: 12/24/2022] Open
Abstract
Attention is a central component of cognitive and behavioral processes and plays a key role in basic and higher-level functioning. Posner's model of attention describes three components or networks of attention: the alerting, which involves high intensity states of arousal; the orienting, which involves the selective direction of attention; and the executive control, which involves cognitive functions such as conflict resolution and working memory. The Attention Network Test (ANT) is a computerized testing measure that was developed to measure these three networks of attention. This project describes the ANT, its widely used variants, and the recently developed ANT Database, a repository of data extracted from all studies that have used the ANT as of 2019. To illustrate the potential uses of the database, two meta-analyses conducted using the ANT Database are described. One explores task performance in children with and without attention deficit/hyperactivity disorder (ADHD). The other one explores regional differences between studies conducted in China, Europe, and the United States. We are currently in the process of integrating the database into a publicly available web interface. When that work is complete, researchers, clinicians, and the general public will be able to use the database to explore topics of interest related to attention.
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Affiliation(s)
- Swasti Arora
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | | | - Raymond M. Klein
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
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Yuan L, Zhang Y, Luan D, Xu X, Yang Q, Zhao S, Zhou Z. Reversible Affective Symptoms and Attention Executive Control Network Impairment Following Thyroid Function Normalization in Hyperthyroidism. Neuropsychiatr Dis Treat 2019; 15:3305-3312. [PMID: 32063707 PMCID: PMC6884974 DOI: 10.2147/ndt.s227386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/11/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Affective symptoms and attention impairments are found in patients with hyperthyroidism. Our previous data have revealed that the patients with hyperthyroidism experience impairments of the attention networks, but it remains unclear whether these disorders persist after the treatment of hyperthyroidism. METHODS Twenty healthy controls and 25 hyperthyroid patients were recruited and performed the attention network test (ANT) which can simultaneously examine the alertness, orientation and execution control components of the participants. The effect of treatment on affective symptom and attention networks impairments were examined in the patient group after 1-year anti-thyroid medication and reaching euthyroidism for at least 3 months. RESULTS Anxiety and depression scores of patients with hyperthyroidism were significantly higher than those of the healthy control group. The patients with hyperthyroidism had impairments of the alerting and executive control networks. Meanwhile, the score of HAMA correlated significantly with thyroid hormone and TSH levels, and there was a negative significant correlation between the score of HAMD and TSH level in all subjects. There was a positive correlation between the value of the executive control network and thyroid hormones' levels in all subjects and in the hyperthyroidism group. Anxiety and depression symptoms were improved with methimazole treatment after euthyroidism was reached. The value of the executive control network no longer differed from that of healthy controls, but deficits in the alerting network of hyperthyroidism still persisted after treatment. CONCLUSION The patients with hyperthyroidism existed affective symptoms and attention networks impairments. Affective symptoms and attention executive control network impairment were improved following thyroid function normalization in hyperthyroidism.
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Affiliation(s)
- Lili Yuan
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Yuanxiang Zhang
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Di Luan
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Xiangjun Xu
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Qian Yang
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Shoucai Zhao
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Zhiming Zhou
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
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Cognitive Deficit-Related Interhemispheric Asynchrony within the Medial Hub of the Default Mode Network Aids in Classifying the Hyperthyroid Patients. Neural Plast 2018; 2018:9023604. [PMID: 30532774 PMCID: PMC6250039 DOI: 10.1155/2018/9023604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/30/2018] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose Recent studies suggest that abnormal structure and function in the brain network were related to cognitive and emotional impairment in hyperthyroid patients (HPs). The association between altered voxel-mirrored homotopic connectivity (VMHC) and neuropsychological impairment in HPs remains unclear. This study is aimed at investigating the association between the disrupted functional coordination and psychological dysfunction in hyperthyroidism. Method Thirty-three hyperthyroid patients and thirty-three matched healthy controls (HCs) were recruited, and they received resting-state functional magnetic resonance imaging (fMRI) scans and neuropsychological evaluation. The VMHC value was computed to reveal the functional coordination between homotopic regions in both groups. The neurobehavioral relevancy method was employed to explore the relationship between the altered VMHC and emotional, cognition measures. Further receiver operating characteristic (ROC) curve analysis was adopted to examine the power of changed regional VMHC in classifying the patients with hyperthyroidism. Results Compared with the HCs, the HPs exhibited significantly declined VMHC values in the bilateral medial frontal gyrus (MeFG). The interhemispheric asynchrony in the MeFG was positively correlated with Z scores of episodic memory. The ROC analysis further determined that abnormal VMHC in the MeFG could efficiently distinguish the HPs from the HCs (area under the curve (AUC) = 0.808, P < 0.001). Conclusion The altered interhemispheric coordination in the hub of the default mode network may implicated in the modulation of episodic memory in HPs patients and the distinct feature of the interhemispheric asynchrony may be treated as a potential target for the early recognition and intervention for the HPs with cognitive impairments. Clinical Trial Registration This is a study of the neurological basis for dysfunction of mood and cognition in hyperthyroid patients: a resting-state fMRI study (registration number: ChiCTR-OOC-16008607).
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Zhi M, Hou Z, We Q, Zhang Y, Li L, Yuan Y. Abnormal spontaneous brain activity is associated with impaired emotion and cognition in hyperthyroidism: A rs-fMRI study. Behav Brain Res 2018; 351:188-194. [DOI: 10.1016/j.bbr.2018.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/02/2018] [Accepted: 05/22/2018] [Indexed: 12/13/2022]
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Li L, Zhi M, Hou Z, Zhang Y, Yue Y, Yuan Y. Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional MRI study. Oncotarget 2018; 8:6283-6294. [PMID: 28009983 PMCID: PMC5351631 DOI: 10.18632/oncotarget.14060] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/13/2016] [Indexed: 12/18/2022] Open
Abstract
Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor memory, depression, anxiety, nervousness, and irritability, suggesting brain dysfunction. However, the underlying process of these symptoms remains unclear. Using resting-state functional magnetic resonance imaging (rs-fMRI), we depicted the altered graph theoretical metric degree centrality (DC) and seed-based resting-state functional connectivity (FC) in 33 hyperthyroid patients relative to 33 healthy controls. The peak points of significantly altered DC between the two groups were defined as the seed regions to calculate FC to the whole brain. Then, partial correlation analyses were performed between abnormal DC, FC and neuropsychological performances, as well as some clinical indexes. The decreased intrinsic functional connectivity in the posterior lobe of cerebellum (PLC) and medial frontal gyrus (MeFG), as well as the abnormal seed-based FC anchored in default mode network (DMN), attention network, visual network and cognitive network in this study, possibly constitutes the latent mechanism for emotional and cognitive changes in hyperthyroidism, including anxiety and impaired processing speed.
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Affiliation(s)
- Ling Li
- Department of Endocrinology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Mengmeng Zhi
- Department of Endocrinology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yuqun Zhang
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, 210009, China
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Li X, Hou Y, Ren Y, Tian X, Song Y. Alterations of theta oscillation in executive control in temporal lobe epilepsy patients. Epilepsy Res 2018; 140:148-154. [DOI: 10.1016/j.eplepsyres.2017.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 12/06/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
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Dai F, Yuan L, Fang J, Zhang Q, Wang K. Impaired decision making under risky conditions in the acute phase of Graves' thyroitoxicosis. Neurosci Lett 2017; 661:1-4. [PMID: 28859864 DOI: 10.1016/j.neulet.2017.08.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/27/2017] [Accepted: 08/26/2017] [Indexed: 11/29/2022]
Abstract
The patients with Graves' thyroitoxicosis often complain that they have neuropsychiatric symptoms and impaired cognitive function. Decision making is important and complex process involving the interaction and integration of a series of cognitive components. In the 31 newly diagnosed patients with Graves' thyroitoxicosis and 30 healthy controls, we used the Hamilton Anxiety Rating Scale (HAMD), Hamilton Depression Rating Scale (HAMD) and The Game of Dice Task (GDT) to assess the emotion and decision making under risky conditions. The patients with Graves' disease had higher score on HAMA and HAMD, and had poorer performance in GDT than healthy controls. A negative correlation was found between utilization of negative feedback and score of HAMA in the patients with Graves' disease. Our findings in Graves' disease might be association with the extensive brain disorders including prefrontal cortex and the limbic system, and dopamine dysfunction.
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Affiliation(s)
- Fang Dai
- Department of Endocrinology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Lili Yuan
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, PR China
| | - Juan Fang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Qiu Zhang
- Department of Endocrinology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, PR China.
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, PR China.
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Wang YQ, Pan Y, Zhu S, Wang YG, Shen ZH, Wang K. Selective impairments of alerting and executive control in HIV-infected patients: evidence from attention network test. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2017; 13:11. [PMID: 28651626 PMCID: PMC5485500 DOI: 10.1186/s12993-017-0129-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/30/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Attention ability can be subdivided into three functionally independent networks, i.e., alerting network, orienting network, and executive network. Previous literature has documented that deficits in attention are a common consequence of HIV infection. However, the precise nature of deficits of attention in HIV-infected patients is poorly understood. Accordingly, the aim of the study was to identify whether the HIV-infected patients showed a specific attention network deficit or a general attentional impairment. METHODS We investigated 27 HIV-infected patients and 31 normal controls with the Attention Network Test (ANT). RESULTS The patients exhibited less efficient alerting network and executive network than controls. No significant difference was found in orienting network effect between groups. Our results also indicate a tendency for poorer efficiency on alerting attention and executive attention in patients with CD4 ≤ 200. CONCLUSIONS Our findings suggest that HIV-infected patients exhibited selective impairments of attention network of alerting and executive control. The link between lower CD4 T cell count and poorer attention network function imply the importance of starting antiretroviral therapy earlier to avoid irreversible neurocognitive impairment.
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Affiliation(s)
- Yi-Quan Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang, China
- Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang, China
| | - Yang Pan
- School of Media and Design, Hangzhou Dianzi University, Hangzhou, Zhejiang, China
| | - Sheng Zhu
- The Fifth Hospital of Ruian, Ruian, Zhejiang, China
| | - Yong-Guang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang, China.
- Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang, China.
- Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, Anhui, China.
| | - Zhi-Hua Shen
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang, China
- Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang, China
| | - Kai Wang
- Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, Anhui, China
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Pauletti C, Mannarelli D, De Lucia MC, Locuratolo N, Currà A, Missori P, Marinelli L, Fattapposta F. Selective attentional deficit in essential tremor: Evidence from the attention network test. Parkinsonism Relat Disord 2015; 21:1306-11. [PMID: 26365776 DOI: 10.1016/j.parkreldis.2015.08.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/08/2015] [Accepted: 08/30/2015] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The traditional view of essential tremor (ET) as a monosymptomatic and benign disorder has been reconsidered after patients with ET have been shown to experience cognitive deficits that are also related to attention. The Attention Network Test (ANT) is a rapid, widely used test to measure the efficiency of three attentional networks, i.e. alerting, orienting and executive, by evaluating reaction times (RTs) in response to visual stimuli. The aim of this study was to investigate attentional functioning in ET patients by means of the ANT. METHODS 21 non-demented patients with ET and 21 age- and sex-matched healthy controls performed the ANT. RESULTS RT was significantly longer in ET patients than in controls (p < 0.001). Moreover, a significant difference in alerting and executive efficiency (p = 0.003 and p = 0.01 respectively) was found between groups, while the difference in the orienting efficiency only bordered on significance. CONCLUSION Our results point to a difficulty in the alerting and executive domains of attention in ET patients, probably owing to a dysfunction in the cerebello-thalamo-cortical loop. These selective attentional deficits are not related to clinical motor symptoms, contributing to shed further light on the clinical picture of ET.
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Affiliation(s)
- Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Maria Caterina De Lucia
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Nicoletta Locuratolo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Sapienza University of Rome, Polo Pontino, Via Firenze, 04019, Terracina, LT, Italy.
| | - Paolo Missori
- Department of Neurology and Psychiatry, Neurosurgery, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Lucio Marinelli
- Institute of Neurology, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), Largo Daneo 3, University of Genova, 16132, Genova, Italy.
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
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