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Di Lazzaro V, Bella R, Benussi A, Bologna M, Borroni B, Capone F, Chen KHS, Chen R, Chistyakov AV, Classen J, Kiernan MC, Koch G, Lanza G, Lefaucheur JP, Matsumoto H, Nguyen JP, Orth M, Pascual-Leone A, Rektorova I, Simko P, Taylor JP, Tremblay S, Ugawa Y, Dubbioso R, Ranieri F. Diagnostic contribution and therapeutic perspectives of transcranial magnetic stimulation in dementia. Clin Neurophysiol 2021; 132:2568-2607. [PMID: 34482205 DOI: 10.1016/j.clinph.2021.05.035] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/22/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023]
Abstract
Transcranial magnetic stimulation (TMS) is a powerful tool to probe in vivo brain circuits, as it allows to assess several cortical properties such asexcitability, plasticity and connectivity in humans. In the last 20 years, TMS has been applied to patients with dementia, enabling the identification of potential markers of thepathophysiology and predictors of cognitive decline; moreover, applied repetitively, TMS holds promise as a potential therapeutic intervention. The objective of this paper is to present a comprehensive review of studies that have employed TMS in dementia and to discuss potential clinical applications, from the diagnosis to the treatment. To provide a technical and theoretical framework, we first present an overview of the basic physiological mechanisms of the application of TMS to assess cortical excitability, excitation and inhibition balance, mechanisms of plasticity and cortico-cortical connectivity in the human brain. We then review the insights gained by TMS techniques into the pathophysiology and predictors of progression and response to treatment in dementias, including Alzheimer's disease (AD)-related dementias and secondary dementias. We show that while a single TMS measure offers low specificity, the use of a panel of measures and/or neurophysiological index can support the clinical diagnosis and predict progression. In the last part of the article, we discuss the therapeutic uses of TMS. So far, only repetitive TMS (rTMS) over the left dorsolateral prefrontal cortex and multisite rTMS associated with cognitive training have been shown to be, respectively, possibly (Level C of evidence) and probably (Level B of evidence) effective to improve cognition, apathy, memory, and language in AD patients, especially at a mild/early stage of the disease. The clinical use of this type of treatment warrants the combination of brain imaging techniques and/or electrophysiological tools to elucidate neurobiological effects of neurostimulation and to optimally tailor rTMS treatment protocols in individual patients or specific patient subgroups with dementia or mild cognitive impairment.
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Affiliation(s)
- Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Kai-Hsiang S Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada; Division of Brain, Imaging& Behaviour, Krembil Brain Institute, Toronto, Canada
| | | | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig University Medical Center, Germany
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy; Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy; Department of Neurology IC, Oasi Research Institute-IRCCS, Troina, Italy
| | - Jean-Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | | | - Jean-Paul Nguyen
- Pain Center, clinique Bretéché, groupe ELSAN, Multidisciplinary Pain, Palliative and Supportive care Center, UIC 22/CAT2 and Laboratoire de Thérapeutique (EA3826), University Hospital, Nantes, France
| | - Michael Orth
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Swiss Huntington's Disease Centre, Siloah, Bern, Switzerland
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Center for Memory Health, Hebrew SeniorLife, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Universitat Autonoma Barcelona, Spain
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic; Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Patrik Simko
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sara Tremblay
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, ON, Canada; Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Federico Ranieri
- Unit of Neurology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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"Parkinson's disease" on the way to progressive supranuclear palsy: a review on PSP-parkinsonism. Neurol Sci 2021; 42:4927-4936. [PMID: 34532773 DOI: 10.1007/s10072-021-05601-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022]
Abstract
Progressive supranuclear palsy (PSP) is a progressive atypical parkinsonian syndrome characterised by postural instability, supranuclear ophthalmoplegia, dysarthria, dysphagia, executive dysfunction and other features. This clinical presentation represents the classic PSP-Richardson syndrome (PSP-RS). However, several other clinical subtypes have been recognised, including PSP-parkinsonism (PSP-P), probably the second most common PSP variant. Unlike PSP-RS, PSP-P often presents with an asymmetric onset, tremor and a moderate initial response to levodopa, especially during the first years of the disease, thus resembling Parkinson's disease (PD). It runs a more favourable course, but over time, PSP-P may evolve clinically into PSP-RS. Therefore, it may seem that PSP-P stands clinically between PD and PSP. There are several peculiarities that can distinguish PSP-P from these entities. As there is lack of systematic reviews on PSP-P in the literature, we decided to summarise all the necessary data about the epidemiology, clinical picture, neuroimaging, genetics and other aspects of this PSP variant in order to provide complete information for the reader.
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Validation of the Parkinson's Disease Caregiver Burden Questionnaire in Progressive Supranuclear Palsy. PARKINSONS DISEASE 2021; 2021:9990679. [PMID: 34046156 PMCID: PMC8128535 DOI: 10.1155/2021/9990679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 01/10/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical Parkinson syndrome with axial akinetic-rigid symptoms, early postural instability, and ocular motor impairments. Patients experience a rapid loss of autonomy and care dependency; thus, caregivers must assist in the activities of daily living early in the course of the disease. Caregiver burden is an extremely important factor in disease management. However, there are no specific questionnaires for assessment of caregiver burden in PSP. This study aims to validate the Parkinson's disease caregiver burden questionnaire (PDCB) as a specific measure of caregiver burden in PSP. PSP patients were assessed by the PSP rating scale, PSP quality-of-life questionnaire (PSP-QoL), Montreal cognitive assessment test (MoCA), and geriatric depression scale (GDS-15). Caregivers filled out the short form 36-health survey, GDS-15, PDCB, and the caregiver burden inventory (CBI). 22 patient caregiver pairs completed the study. PDCB showed a highly significant correlation with the CBI (r 0.911; p < 0.001). Internal reliability of the PDCB measured by Cronbach's alpha was favourable at 0.803. These data support the specificity of the PDCB in PSP caregivers. Future studies with larger sample sizes of PSP patients and caregivers and a multicentric longitudinal design should be performed to gain further insight of caregiver burden in PSP.
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Pantelyat A, Higginbotham L, Rosenthal L, Lanham D, Nesspor V, AlSalihi M, Bang J, Wang J, Albert M. Association of Progressive Supranuclear Palsy Rating Scale with Progressive Supranuclear Palsy Quality of Life Scale. NEURODEGENER DIS 2021; 20:139-146. [PMID: 33789283 DOI: 10.1159/000514519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There is growing interest in using patient-reported outcomes as end points in clinical trials, such as the progressive supranuclear palsy quality of life (PSP-QoL) scale. However, this tool has not been widely validated and its correlation with validated motor scales has not been explored. To evaluate the potential utility of using PSP-QoL as an outcome, it is important to examine its relationship with a standard scale used to evaluate neurologic parameters, such as the PSP Rating Scale. METHODS PSP-QoL and PSP Rating Scale scores were gathered from 60 clinically diagnosed PSP patients, including patients with Richardson syndrome PSP (PSP-RS, n = 43) and those with non-RS PSP variants (n = 17). Linear regression analysis adjusted for age, sex, and disease duration was used to evaluate the cross-sectional relationship between the total and subscale scores of the 2 instruments. RESULTS Among 60 PSP patients, there was a significant correlation between total PSP-QoL and PSP Rating Scale scores. The physical and mentation subscales of each instrument also demonstrated significant correlations. Comparisons among PSP subtypes indicated that worsening PSP-QoL Total and Physical subscale scores correlated with worsening PSP Rating Scale gait subscale scores more strongly for the non-RS PSP variants than for PSP-RS. DISCUSSION There is a significant association between the total scores and many of the subscale scores of the PSP-QoL and the PSP Rating Scale. Additionally, the relationship between these measures may differ for PSP-RS and non-RS variants. These findings suggest that the PSP-QoL may be useful in clinical trials as a patient-reported outcome measure. Large prospective multicenter studies utilizing the PSP-QoL are necessary to examine its relationship to disease evolution and changes in the PSP Rating Scale.
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Affiliation(s)
- Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lenora Higginbotham
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Liana Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Diane Lanham
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanessa Nesspor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mina AlSalihi
- Kansas City University College of Osteopathic Medicine, Kansas City, Missouri, USA
| | - Jee Bang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Morgan JC, Ye X, Mellor JA, Golden KJ, Zamudio J, Chiodo LA, Bao Y, Xie T. Disease course and treatment patterns in progressive supranuclear palsy: A real-world study. J Neurol Sci 2020; 421:117293. [PMID: 33385754 DOI: 10.1016/j.jns.2020.117293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is a neurodegenerative disorder with symptoms including vertical gaze palsy, frequent falls, abnormal gait, and cognitive/language/behavioral changes, making diagnosis and treatment challenging. METHODS Descriptive analysis was undertaken of cross-sectional, real-world data for patients with PSP provided by neurologists in France, Germany, Italy, Spain, UK, and USA. RESULTS Data on 892 PSP patients were obtained from patient records. Common initial symptoms included difficulty walking/maintaining gait, confusion/disorientation, loss of balance/falling, and rigidity. These symptoms and vertical gaze palsy commonly aided diagnosis. At data collection, dysphagia and blepharospasm were also very common. Mean times from symptom-onset to consulting a healthcare professional and PSP diagnosis were 5.2 and 15.0 months, respectively. General practitioners or movement disorder specialists were most commonly consulted initially; 98% of patients were diagnosed with PSP by a movement disorder specialist or general neurologist. Alternative diagnoses, including Parkinson's disease (67%) and dementia (10%), were considered for 41% of patients prior to PSP diagnosis. Non-wheelchair walking aids and wheelchairs were used by 60% and 23% of patients, respectively, with mean times from symptom-onset to use being 20.8 and 39.5 months, respectively. Symptomatic medication, most often levodopa and antidepressants, was prescribed for 87% of patients. CONCLUSION This study provided information on disease course and treatment for a large number of PSP patients from various countries. PSP carries a considerable clinical burden. Diagnosis is often delayed. Consulting a movement disorder specialist might expediate diagnosis. Currently, only symptomatic treatments are available with a poor satisfaction, and there is an urgent need for disease-modifying agents.
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Affiliation(s)
- John C Morgan
- Movement & Memory Disorders Program, Parkinson Foundation Center of Excellence, Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | | | | | | | | | | | | | - Tao Xie
- Movement Disorder Program, Department of Neurology, University of Chicago Medicine, Chicago, IL, USA.
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Ohara M, Hattori T, Yokota T. Progressive supranuclear palsy often develops idiopathic normal pressure hydrocephalus‐like magnetic resonance imaging features. Eur J Neurol 2020; 27:1930-1936. [DOI: 10.1111/ene.14322] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 01/07/2023]
Affiliation(s)
- M. Ohara
- Department of Neurology and Neurological Science Graduate School of Medical and Dental Science Tokyo Medical and Dental University Tokyo Japan
| | - T. Hattori
- Department of Neurology and Neurological Science Graduate School of Medical and Dental Science Tokyo Medical and Dental University Tokyo Japan
| | - T. Yokota
- Department of Neurology and Neurological Science Graduate School of Medical and Dental Science Tokyo Medical and Dental University Tokyo Japan
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Chirra M, Marsili L, Gallerini S, Keeling EG, Marconi R, Colosimo C. Paraneoplastic movement disorders: phenomenology, diagnosis, and treatment. Eur J Intern Med 2019; 67:14-23. [PMID: 31200996 DOI: 10.1016/j.ejim.2019.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/18/2019] [Accepted: 05/29/2019] [Indexed: 01/21/2023]
Abstract
Paraneoplastic syndromes include, by definition, any symptomatic and non-metastatic condition associated with a neoplasm. Paraneoplastic movement disorders are a heterogeneous group of syndromes encompassing both hyperkinetic and hypokinetic conditions, characterized by acute/sub-acute onset, rapidly progressive evolution, and multifocal localizations with several overlapping features. These movement disorders are immune-mediated, as shown by the rapid onset and by the presence of antineuronal antibodies in biological samples of patients, fundamental for the diagnosis. Antineuronal antibodies could be targeted against intracellular or neuronal surface antigens. Paraneoplastic movement disorders associated with anti-neuronal surface antigens antibodies respond more frequently to immunotherapy. The underlying tumors may be different, according to the clinical presentation, age, and gender of patients. Our search considered articles involving human subjects indexed in PubMed. Abstracts were independently reviewed for eligibility criteria by one author and validated by at least one additional author. In this review, we sought to critically reappraise the clinical features and the pathophysiological mechanisms of paraneoplastic movement disorders, focusing on diagnostic and therapeutic strategies. Our main aim is to make clinicians aware of paraneoplastic movement disorders, and to provide assistance in the early diagnosis and management of these rare but life-threatening conditions.
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Affiliation(s)
- Martina Chirra
- Division of Hematology-Oncology, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Oncology, Medical Oncology Unit, University of Siena, Siena, Italy.
| | - Luca Marsili
- Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
| | | | - Elizabeth G Keeling
- Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
| | | | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy.
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Stamelou M, Giagkou N, Höglinger GU. One decade ago, one decade ahead in progressive supranuclear palsy. Mov Disord 2019; 34:1284-1293. [DOI: 10.1002/mds.27788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/23/2022] Open
Affiliation(s)
- Maria Stamelou
- Parkinson's disease and Movement Disorders DepartmentHYGEIA Hospital Athens Greece
- Neurology ClinicPhilipps University Marburg Germany
- First Department of Neurology, Aiginiteion HospitalUniversity of Athens Athens Greece
| | - Nikolaos Giagkou
- Parkinson's disease and Movement Disorders DepartmentHYGEIA Hospital Athens Greece
| | - Günter U Höglinger
- Department of NeurologyTechnische Universität München Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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Berardelli I, Belvisi D, Pasquini M, Fabbrini A, Petrini F, Fabbrini G. Treatment of psychiatric disturbances in hypokinetic movement disorders. Expert Rev Neurother 2019; 19:965-981. [PMID: 31241368 DOI: 10.1080/14737175.2019.1636648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: We reviewed studies that assessed the treatment of psychiatric disturbances in Parkinson's disease and atypical parkinsonisms. Neuropsychiatric disturbances in these conditions are frequent and have a profound impact on quality of life of patients and of their caregivers. It is therefore important to be familiar with the appropriate pharmacological and non-pharmacological interventions for treating these disorders. Areas covered: The authors searched for papers in English in Pubmed using the following keywords: Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, Lewy body dementia, depression, apathy, anxiety, fatigue, sleep disorders, obsessive compulsive disorders, psychosis, hallucinations, delusions, impulse control disorders. Expert opinion: In Parkinson's disease, depression may benefit from the optimization of dopaminergic therapy, from the use of antidepressants acting on both the serotoninergic and noradrenergic pathways and from cognitive behavioral therapy. Psychosis in Parkinson's disease may improve with the use of clozapine; the serotonin inverse agonist pimavanserin has been shown to be effective. Treatment of impulse control disorders is primarily based on the removal of dopamine agonists. No controlled studies have investigated the treatment of neuropsychiatric disorders in multiple system atrophy, progressive supranuclear palsy or corticobasal degeneration. Acethylcholinesterase inhibitors may be used to treat hallucinations in Lewy body dementia.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Federica Petrini
- Department of Neurosciences and Mental Health, Azienda Universitaria Policlinico Umberto I° , Rome , Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed , Pozzilli , Italy.,Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
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Panza F, Imbimbo BP, Lozupone M, Greco A, Seripa D, Logroscino G, Daniele A, Colosimo C. Disease-modifying therapies for tauopathies: agents in the pipeline. Expert Rev Neurother 2019; 19:397-408. [PMID: 30973276 DOI: 10.1080/14737175.2019.1606715] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Tauopathies are heterogeneous clinicopathological entities characterized by abnormal neuronal and/or glial inclusions of the microtubule-binding protein tau. Primary tauopathies considered to be diseases correspond to a major class of frontotemporal lobar degeneration (FTLD) neuropathology (FTLD-Tau), including several forms of frontotemporal dementia (FTD) clinical syndromes. Little progress has been made in the past 20 years in developing effective disease-modifying drugs for primary tauopathies and available symptomatic treatments have limited efficacy. Areas covered: Potential disease-modifying drugs in clinical development to slow neuropathological progression of primary tauopathies. Expert opinion: Since the underlying pathology of primary tauopathies consists of abnormal tau protein aggregates, treatments are being developed to interfere with the aggregation process or to promote the clearance of this protein. Unfortunately, disease-modifying treatments remain years away as demonstrated by the recent negative Phase III findings of a tau aggregation inhibitor (LMTM) for treating the behavioral variant of FTD. Further evidence will come from ongoing Phase I/II trials on novel drugs and immunotherapeutics with various targets - prevention of deposition or removal of tau aggregates, inhibition of tau phosphorylation/acetylation, modulation of O-GlcNAcylation, activation of autophagy or ubiquitin-proteasome system pathways, and rescue of selected tau loss of function or suppression of tau gene expression.
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Affiliation(s)
- Francesco Panza
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy.,c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Bruno P Imbimbo
- d Department of Research and Development , Chiesi Farmaceutici , Parma , Italy
| | - Madia Lozupone
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy
| | - Antonio Greco
- c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Davide Seripa
- c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Giancarlo Logroscino
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy
| | - Antonio Daniele
- e Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy.,f Institute of Neurology , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Carlo Colosimo
- g Department of Neurological Sciences , Santa Maria University Hospital , Terni , Italy
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Fabbrini G, Fabbrini A, Suppa A. Progressive supranuclear palsy, multiple system atrophy and corticobasal degeneration. ACTA ACUST UNITED AC 2019; 165:155-177. [DOI: 10.1016/b978-0-444-64012-3.00009-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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De Icaza Valenzuela MM, Bak TH, Pal S, Abrahams S. The Edinburgh Cognitive and Behavioral ALS screen: relationship to age, education, IQ and the Addenbrooke’s Cognitive Examination-III. Amyotroph Lateral Scler Frontotemporal Degener 2018; 19:585-590. [DOI: 10.1080/21678421.2018.1491601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Mónica M. De Icaza Valenzuela
- Human Cognitive Neuroscience – Department of Psychology, The University of Edinburgh, Edinburgh, UK,
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), The University of Edinburgh, Edinburgh, UK,
- Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, Edinburgh, UK,
| | - Thomas H. Bak
- Human Cognitive Neuroscience – Department of Psychology, The University of Edinburgh, Edinburgh, UK,
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), The University of Edinburgh, Edinburgh, UK,
- Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, Edinburgh, UK,
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, UK, and
| | - Suvankar Pal
- Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, Edinburgh, UK,
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, UK, and
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Sharon Abrahams
- Human Cognitive Neuroscience – Department of Psychology, The University of Edinburgh, Edinburgh, UK,
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), The University of Edinburgh, Edinburgh, UK,
- Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, Edinburgh, UK,
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, UK, and
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Pell Fonts E. Parálisis supranuclear progresiva: estudio longitudinal a partir del análisis acústico del habla. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2018. [DOI: 10.5209/rlog.59611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El objetivo de este estudio es medir de forma objetiva y cuantitativa los distintos parámetros del habla en un caso de Parálisis Supranuclear Progresiva durante un periodo de cuatro años. Se realizó un análisis acústico de la vocal sostenida /a/, del automatismo “1,2,3,4” y de la repetición rápida de las sílabas /pa/, /ta/, /ka/ y /pataka/. Se consideraron diversos parámetros: la frecuencia fundamental (F0), el tiempo máximo fonatorio (TMF), la intensidad, los formantes, el shimmer, el jitter, el ruido en relación con los armónicos (NHR), la duración y el número de sílabas, el “Voice Onset Time” (VOT), la tasa de habla, la tasa de silencios y los aspectos prosódicos del habla. Las alteraciones en la voz y en el habla evolucionan hacia la imprecisión articulatoria, una pobre calidad vocal, reducido TMF, reducida tasa del habla, disminución de la variabilidad de la entonación y pausas prolongadas en las diadococinesias. El análisis reveló la coincidencia en el tiempo entre el deterioro progresivo del habla en general y el elevado porcentaje de cierres incompletos en el VOT, con la disfagia
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14
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Calogero AM, Viganò M, Budelli S, Galimberti D, Fenoglio C, Cartelli D, Lazzari L, Lehenkari P, Canesi M, Giordano R, Cappelletti G, Pezzoli G. Microtubule defects in mesenchymal stromal cells distinguish patients with Progressive Supranuclear Palsy. J Cell Mol Med 2018; 22:2670-2679. [PMID: 29502334 PMCID: PMC5908108 DOI: 10.1111/jcmm.13545] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/11/2017] [Indexed: 01/01/2023] Open
Abstract
Progressive Supranuclear Palsy (PSP) is a rare neurodegenerative disease whose etiopathogenesis remains elusive. The intraneuronal accumulation of hyperphosphorylated Tau, a pivotal protein in regulating microtubules (MT), leads to include PSP into tauopathies. Pathological hallmarks are well known in neural cells but no word yet if PSP‐linked dysfunctions occur also in other cell types. We focused on bone marrow mesenchymal stromal cells (MSCs) that have recently gained attention for therapeutic interventions due to their anti‐inflammatory, antiapoptotic and trophic properties. Here, we aimed to investigate MSCs biology and to disclose if any disease‐linked defect occurs in this non‐neuronal compartment. First, we found that cells obtained from patients showed altered morphology and growth. Next, Western blotting analysis unravelled the imbalance in α‐tubulin post‐translational modifications and in MT stability. Interestingly, MT mass is significantly decreased in patient cells at baseline and differently changes overtime compared to controls, suggesting their inability to efficiently remodel MT cytoskeleton during ageing in culture. Thus, our results provide the first evidence that defects in MT regulation and stability occur and are detectable in a non‐neuronal compartment in patients with PSP. We suggest that MSCs could be a novel model system for unravelling cellular processes implicated in this neurodegenerative disorder.
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Affiliation(s)
| | - Mariele Viganò
- Department of Services and Preventive Medicine, Laboratory of Regenerative Medicine - Cell Factory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Budelli
- Department of Services and Preventive Medicine, Laboratory of Regenerative Medicine - Cell Factory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy
| | - Daniela Galimberti
- Department of Physiopathology and Transplantation, Dino Ferrari Center, Neurodegenerative Disease Unit, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, University of Milan, Milan, Italy
| | - Chiara Fenoglio
- Department of Physiopathology and Transplantation, Dino Ferrari Center, Neurodegenerative Disease Unit, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, University of Milan, Milan, Italy
| | - Daniele Cartelli
- Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Lorenza Lazzari
- Department of Services and Preventive Medicine, Laboratory of Regenerative Medicine - Cell Factory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Petri Lehenkari
- Department of Surgery and Anatomy, Medical Research Center, University of Oulu and University of Oulu Hospital, Oulu, Finland
| | | | - Rosaria Giordano
- Department of Services and Preventive Medicine, Laboratory of Regenerative Medicine - Cell Factory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Graziella Cappelletti
- Department of Biosciences, Università degli Studi di Milano, Milan, Italy.,Center of Excellence on Neurodegenerative Diseases, Università degli Studi di Milano, Milan, Italy
| | - Gianni Pezzoli
- Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy
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15
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Galimberti D, Bertram K, Formica A, Fenoglio C, Cioffi SMG, Arighi A, Scarpini E, Colosimo C. Plasma Screening for Progranulin Mutations in Patients with Progressive Supranuclear Palsy and Corticobasal Syndromes. J Alzheimers Dis 2018; 53:445-9. [PMID: 27163816 DOI: 10.3233/jad-160073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Progranulin gene (GRN) mutations are characterized by heterogeneous presentations. Corticobasal syndrome (CBS) is often associated with GRN mutations, whereas association with progressive supranuclear palsy syndrome (PSPS) is rare. Plasma progranulin levels were evaluated in 34 patients, including 19 with PSPS, 12 with CBS, and 3 with mixed signs, with the purpose to screen for the presence of causal mutations, associated with low levels. We found undetectable levels in a patient with CBS. Sequencing confirmed the presence of the Thr272fs deletion. Progranulin mutation screening is suggested in cases of CBS, even in the absence of positive family history for dementia and/or movement disorders.
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Affiliation(s)
- Daniela Galimberti
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Kelly Bertram
- Department of Neurosciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Alessandra Formica
- Dipartimento di Neurologia e Psichiatria, Sapienza Università di Roma, Italy
| | - Chiara Fenoglio
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Sara M G Cioffi
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Andrea Arighi
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Elio Scarpini
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Carlo Colosimo
- Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria Santa Maria, Terni, Italy
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16
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Belvisi D, Berardelli I, Suppa A, Fabbrini A, Pasquini M, Pompili M, Fabbrini G. Neuropsychiatric disturbances in atypical parkinsonian disorders. Neuropsychiatr Dis Treat 2018; 14:2643-2656. [PMID: 30349262 PMCID: PMC6186304 DOI: 10.2147/ndt.s178263] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonisms. These disorders are characterized by varying combinations of autonomic, cerebellar and pyramidal system, and cognitive dysfunctions. In this paper, we reviewed the evidence available on the presence and type of neuropsychiatric disturbances in MSA, PSP, and CBD. A MedLine, Excerpta Medica, PsycLit, PsycInfo, and Index Medicus search was performed to identify all articles published on this topic between 1965 and 2018. Neuropsychiatric disturbances including depression, anxiety, agitation, and behavioral abnormalities have been frequently described in these disorders, with depression as the most frequent disturbance. MSA patients show a higher frequency of depressive disorders when compared to healthy controls. An increased frequency of anxiety disorders has also been reported in some patients, and no studies have investigated apathy. PSP patients may have depression, apathy, disinhibition, and to a lesser extent, anxiety and agitation. In CBD, neuropsychiatric disorders are similar to those present in PSP. Hallucinations and delusions are rarely reported in these disorders. Neuropsychiatric symptoms in MSA, PSP, and CBD do not appear to be related to the severity of motor dysfunction and are one of the main factors that determine a low quality of life. The results suggest that neuropsychiatric disturbances should always be assessed in patients with atypical parkinsonisms.
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Affiliation(s)
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, Italy, .,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy, .,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy,
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17
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Neurophysiological studies on atypical parkinsonian syndromes. Parkinsonism Relat Disord 2017; 42:12-21. [DOI: 10.1016/j.parkreldis.2017.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/14/2017] [Accepted: 06/24/2017] [Indexed: 01/31/2023]
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18
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Reversal of long term potentiation-like plasticity in primary motor cortex in patients with progressive supranuclear palsy. Clin Neurophysiol 2017; 128:1547-1552. [DOI: 10.1016/j.clinph.2017.06.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 06/06/2017] [Accepted: 06/09/2017] [Indexed: 11/20/2022]
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19
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Incipient progressive supranuclear palsy is more common than expected and may comprise clinicopathological subtypes: a forensic autopsy series. Acta Neuropathol 2017; 133:809-823. [PMID: 28064358 DOI: 10.1007/s00401-016-1665-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/30/2016] [Accepted: 12/30/2016] [Indexed: 12/14/2022]
Abstract
We investigated 998 serial Japanese forensic autopsy cases (0-101 years old, mean age 61.7 ± 21.9), with no case selection, using immunohistochemistry to detect cases with progressive supranuclear palsy (PSP). Twenty-nine cases (mean age 82.3 ± 7.2 years, 11 males, 18 females) fulfilled the National Institute of Neuronal Disorders and Stroke (NINDS)-PSP pathological criteria (2.9% of all cases, 4.6% of cases over 60). All had neuronal and glial inclusions in the basal ganglia and brainstem. However, 13 cases had low tau pathology and were categorized as atypical PSP. In addition to PSP pathology, multiple types of astrocytic inclusions and comorbid proteinopathies, particularly a high prevalence of argyrophilic grain disease, were found. All cases had not been diagnosed with PSP and had preserved daily functioning prior to death. However, 14 (48.3%), 11 (37.9%), and 16 (55.2%) cases showed signs of dementia, depressive state, and gait disturbance, respectively. Sixteen accidental death cases (55.2%), including from falls and getting lost, and 11 suicide cases (37.9%) appear to have a relationship with incipient PSP pathology. Cluster analysis using the distribution and amount of 4-repeat-tau pathology classified the cases into three subgroups: Group 1 (10 cases) had typical PSP pathology and seven cases (70.0%) had dementia as the most frequent symptom; Group 2 (7 cases) had significantly higher frequency of gait disorder (6 cases, 85.7%), and less neocortical tau pathology than Group 1; Group 3 (12 cases) had relatively mild PSP pathology and high argyrophilic grain burdens. Granular-shaped astrocytes were the dominant astrocytic inclusion in all cases. We conclude that in forensic cases incipient PSP occurs with a higher prevalence than expected. If these findings can be extrapolated to other population-based cohorts, PSP may be more common than previously thought.
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20
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Upadhyay N, Suppa A, Piattella MC, Giannì C, Bologna M, Di Stasio F, Petsas N, Tona F, Fabbrini G, Berardelli A, Pantano P. Functional disconnection of thalamic and cerebellar dentate nucleus networks in progressive supranuclear palsy and corticobasal syndrome. Parkinsonism Relat Disord 2017; 39:52-57. [PMID: 28318985 DOI: 10.1016/j.parkreldis.2017.03.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 02/10/2017] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
Abstract
AIM To assess functional rearrangement following neurodegeneration in the thalamus and dentate nucleus in patients with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). METHODS We recruited 19 patients with PSP, 11 with CBS and 14 healthy subjects. All the subjects underwent resting-state (rs) fMRI using a 3T system. Whole brain functional connectivity of the thalamus and dentate nucleus were calculated by means of a seed-based approach with FEAT script in FSL toolbox. Thalamic volume was calculated by means of FIRST, and the dentate area by means of Jim software. RESULTS Both thalamic volume and dentate area were significantly smaller in PSP and CBS patients than in healthy subjects. No significant difference emerged in thalamic volume between PSP and CBS patients, whereas dentate area was significantly smaller in PSP than in CBS. Thalamic functional connectivity was significantly reduced in both patient groups in various cortical, subcortical and cerebellar areas. By contrast, changes in dentate nucleus functional connectivity differed in PSP and CBS: it decreased in subcortical and prefrontal cortical areas in PSP, but increased asymmetrically in the frontal cortex in CBS. CONCLUSIONS Evaluating the dentate nucleus size and its functional connectivity may help to differentiate patients with PSP from those with CBS.
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Affiliation(s)
- Neeraj Upadhyay
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy
| | - Antonio Suppa
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | | | - Costanza Giannì
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy
| | - Matteo Bologna
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | | | - Nikolaos Petsas
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy
| | - Francesca Tona
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | - Patrizia Pantano
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy.
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21
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van Meerkerk-Aanen PJ, de Vroege L, Khasho D, Foruz A, van Asseldonk JT, van der Feltz-Cornelis CM. La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder. Neuropsychiatr Dis Treat 2017; 13:2057-2067. [PMID: 28814874 PMCID: PMC5546807 DOI: 10.2147/ndt.s130475] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD). However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson's syndrome (PSPS) misdiagnosed as a case of CD. CASE A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient's physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS. CONCLUSION La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological reexamination and reinterpretation of la belle indifférence should be considered.
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Affiliation(s)
| | - Lars de Vroege
- Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg.,Department Tranzo, Tilburg School of Behavioral and Social Sciences, Tilburg University
| | - David Khasho
- Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg
| | - Aziza Foruz
- Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg
| | | | - Christina M van der Feltz-Cornelis
- Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg.,Department Tranzo, Tilburg School of Behavioral and Social Sciences, Tilburg University
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22
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Quattrone A, Morelli M, Williams DR, Vescio B, Arabia G, Nigro S, Nicoletti G, Salsone M, Novellino F, Nisticò R, Pucci F, Chiriaco C, Pugliese P, Bosco D, Caracciolo M. MR parkinsonism index predicts vertical supranuclear gaze palsy in patients with PSP-parkinsonism. Neurology 2016; 87:1266-73. [PMID: 27558375 PMCID: PMC5035983 DOI: 10.1212/wnl.0000000000003125] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/07/2016] [Indexed: 11/15/2022] Open
Abstract
Objective: To identify a biomarker for predicting the appearance of vertical supranuclear gaze palsy (VSGP) in patients affected by progressive supranuclear palsy–parkinsonism (PSP-P). Methods: Twenty-four patients with PSP-P were enrolled in the current study. Patients were clinically followed up every 6 months until the appearance of VSGP or the end of the follow-up (4 years). Participants underwent MRI at baseline and at the end of follow-up. Magnetic resonance parkinsonism index (MRPI), an imaging measure useful for diagnosing PSP, was calculated. Results: Twenty-one patients with PSP-P completed follow-up, and 3 patients dropped out. Eleven of 21 patients with PSP-P developed VSGP after a mean follow-up period of 28.5 months (range 6–48 months), while the remaining 10 patients with PSP-P did not develop VSGP during the 4-year follow-up period. At baseline, patients with PSP-P who later developed VSGP had MRPI values significantly higher than those of patients not developing VSGP without overlapping values between the 2 groups. MRPI showed a higher accuracy (100%) in predicting VSGP than vertical ocular slowness (accuracy 33.3%) or postural instability with or without vertical ocular slowness (accuracy 71.4% and 42.9%, respectively). Conclusions: Our study demonstrates that MRPI accurately predicted, on an individual basis, the appearance of VSGP in patients with PSP-P, thus confirming clinical diagnosis in vivo.
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Affiliation(s)
- Aldo Quattrone
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
| | - Maurizio Morelli
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - David R Williams
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Basilio Vescio
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Gennarina Arabia
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Salvatore Nigro
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Giuseppe Nicoletti
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Maria Salsone
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Fabiana Novellino
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Rita Nisticò
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Franco Pucci
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Carmelina Chiriaco
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Pierfrancesco Pugliese
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Domenico Bosco
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
| | - Manuela Caracciolo
- From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy
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Robertson EE, Hall DA, McAsey AR, O'Keefe JA. Fragile X-associated tremor/ataxia syndrome: phenotypic comparisons with other movement disorders. Clin Neuropsychol 2016; 30:849-900. [PMID: 27414076 PMCID: PMC7336900 DOI: 10.1080/13854046.2016.1202239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this paper is to review the typical cognitive and motor impairments seen in fragile X-associated tremor/ataxia syndrome (FXTAS), essential tremor (ET), Parkinson disease (PD), spinocerebellar ataxias (SCAs), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) in order to enhance diagnosis of FXTAS patients. METHODS We compared the cognitive and motor phenotypes of FXTAS with each of these other movement disorders. Relevant neuropathological and neuroimaging findings are also reviewed. Finally, we describe the differences in age of onset, disease severity, progression rates, and average lifespan in FXTAS compared to ET, PD, SCAs, MSA, and PSP. We conclude with a flow chart algorithm to guide the clinician in the differential diagnosis of FXTAS. RESULTS By comparing the cognitive and motor phenotypes of FXTAS with the phenotypes of ET, PD, SCAs, MSA, and PSP we have clarified potential symptom overlap while elucidating factors that make these disorders unique from one another. In summary, the clinician should consider a FXTAS diagnosis and testing for the Fragile X mental retardation 1 (FMR1) gene premutation if a patient over the age of 50 (1) presents with cerebellar ataxia and/or intention tremor with mild parkinsonism, (2) has the middle cerebellar peduncle (MCP) sign, global cerebellar and cerebral atrophy, and/or subcortical white matter lesions on MRI, or (3) has a family history of fragile X related disorders, intellectual disability, autism, premature ovarian failure and has neurological signs consistent with FXTAS. Peripheral neuropathy, executive function deficits, anxiety, or depression are supportive of the diagnosis. CONCLUSIONS Distinct profiles in the cognitive and motor domains between these movement disorders may guide practitioners in the differential diagnosis process and ultimately lead to better medical management of FXTAS patients.
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Affiliation(s)
- Erin E Robertson
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Deborah A Hall
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
| | - Andrew R McAsey
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Joan A O'Keefe
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
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24
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Upadhyay N, Suppa A, Piattella MC, Bologna M, Di Stasio F, Formica A, Tona F, Colosimo C, Berardelli A, Pantano P. MRI gray and white matter measures in progressive supranuclear palsy and corticobasal syndrome. J Neurol 2016; 263:2022-31. [PMID: 27411806 DOI: 10.1007/s00415-016-8224-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/28/2016] [Accepted: 06/29/2016] [Indexed: 02/02/2023]
Abstract
We evaluated MRI measures of gray and white matter damages in 19 patients with progressive supranuclear palsy (PSP), 11 with corticobasal syndrome (CBS), and 14 healthy subjects (HS) to differentiate patients with PSP from those with CBS. We calculated surface-based maps of the cortical volume, cortical thickness, surface area, and voxel level maps of sub-cortical volume, and diffusion tensor imaging parameters using automated scripts implemented in FreeSurfer and FSL toolboxes. No significant differences in cortical volume loss were observed between PSP and CBS. When cortical volume was divided into cortical thickness and surface area, cortical thickness in peri-rolandic brain regions was significantly smaller in CBS than in PSP patients, whereas surface area was significantly smaller in PSP than HS. We also found widespread volume loss in sub-cortical structures in patients with PSP and CBS in comparison to HS. Both patient groups displayed diffusion tensor imaging abnormalities: compared to HS, widespread fractional anisotropy and radial diffusivity changes were observed in PSP, whereas axial and radial diffusivity changes were prominent in CBS. Mini-mental state examination positively correlated with diffusion changes in patients with PSP. In conclusion, cortical thickness, surface area, and diffusion tensor imaging parameters may be sensitive enough to help differentiate patients with PSP from those with CBS.
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Affiliation(s)
- Neeraj Upadhyay
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Antonio Suppa
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
- IRCCS INM Neuromed, Pozzilli, IS, Italy
| | - Maria Cristina Piattella
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Matteo Bologna
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
- IRCCS INM Neuromed, Pozzilli, IS, Italy
| | | | - Alessandra Formica
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Francesca Tona
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
- IRCCS INM Neuromed, Pozzilli, IS, Italy
| | - Patrizia Pantano
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
- IRCCS INM Neuromed, Pozzilli, IS, Italy.
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25
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Bologna M, Piattella MC, Upadhyay N, Formica A, Conte A, Colosimo C, Pantano P, Berardelli A. Neuroimaging correlates of blinking abnormalities in patients with progressive supranuclear palsy. Mov Disord 2015; 31:138-43. [PMID: 26636556 DOI: 10.1002/mds.26470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/15/2015] [Accepted: 10/05/2015] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We aimed to identify the possible relationship between blinking abnormalities and neuroimaging changes in patients with progressive supranuclear palsy. METHODS We studied 18 patients with progressive supranuclear palsy and 13 healthy subjects. Voluntary and spontaneous blinking were recorded using kinematic techniques. Changes in brain structures were detected by T1-weighted magnetic resonance imaging and voxel-based morphometry. We then sought possible correlations between blinking and neuroimaging abnormalities in patients. RESULTS Kinematic analysis indicated several abnormalities during voluntary blinking and a markedly reduced spontaneous blink rate in patients compared with healthy subjects. Neuroimaging showed gray matter loss in cortical and subcortical structures and lower white matter volume in the brainstem. Gray matter loss in subcortical structures correlated with the prolonged pause duration between the closing and opening phases, during voluntary blinking. CONCLUSIONS This study provides a more specific insight into the pathophysiological mechanisms underlying blinking abnormalities in progressive supranuclear palsy.
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Affiliation(s)
| | | | - Neeraj Upadhyay
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Alessandra Formica
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Antonella Conte
- Neuromed Institute IRCCS, Pozzilli (IS), Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Carlo Colosimo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Patrizia Pantano
- Neuromed Institute IRCCS, Pozzilli (IS), Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Alfredo Berardelli
- Neuromed Institute IRCCS, Pozzilli (IS), Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
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26
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Wang G, Wang J, Zhan J, Nie B, Li P, Fan L, Zhu H, Feng T, Shan B. Quantitative assessment of cerebral gray matter density change in progressive supranuclear palsy using voxel based morphometry analysis and cerebral MR T1-weighted FLAIR imaging. J Neurol Sci 2015; 359:367-72. [PMID: 26671144 DOI: 10.1016/j.jns.2015.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/21/2015] [Accepted: 11/04/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the gray matter (GM) atrophy in Progressive supranuclear palsy (PSP) using T1-weighted Fluid-Attenuated Inversion Recovery (FLAIR) images based on voxel based morphometry (VBM) method. MATERIALS AND METHODS In this study, we firstly modified the conventional VBM method to make it can process the T1-weighted FLAIR brain images. Then, we used this method on the 24 PSP patients and 23 healthy age- and sex-matched control subjects to find the local gray matter density changes of PSP patients. RESULTS Compared with healthy controls, GM reductions of PSP patients mainly located in the thalamus, basal ganglia, pons, midbrain, insular cortex, frontal cortex, temporal lobe, cerebellum, cingulate cortex and hippocampus. CONCLUSION We used the modified VBM technique into T1 FLAIR data to study the brain gray matter atrophy in PSP, and found some new atrophy areas, including pallidum, middle and posterior cingulum, lingual, fusiform gyrus and the post part of inferior temporal gyrus. These areas have not been described in the former VBM studies, but they revealed abnormity in the pathologic and other studies on PSP. Our results might be expected to provide significant underlining neurology information and diagnostic value for PSP.
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Affiliation(s)
- Guihong Wang
- Center for Neurodegenerative Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Jingjuan Wang
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China
| | - Jiong Zhan
- Neuroscience Imaging Center, Beijing Tiantan Hospital, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Binbin Nie
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China
| | - Panlong Li
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China; Physical Science and Technology College, Zhengzhou University, Zhengzhou 450052, China
| | - Lidan Fan
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China; Physical Science and Technology College, Zhengzhou University, Zhengzhou 450052, China
| | - Haitao Zhu
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China
| | - Tao Feng
- Center for Neurodegenerative Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
| | - Baoci Shan
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China; Beijing Engineering Research Center of Radiographic Techniques and Equipment, Beijing 100049, China.
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27
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Cordato NJ, Halliday GM. The differentiation of progressive supranuclear palsy. Neurodegener Dis Manag 2015; 5:385-8. [PMID: 26510162 DOI: 10.2217/nmt.15.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nicholas J Cordato
- St George & Calvary Hospitals, 3 Chapel Street, Kogarah NSW 2217, Sydney, Australia.,Neuroscience Research Australia & University of New South Wales, Sydney, Australia
| | - Glenda M Halliday
- Neuroscience Research Australia & University of New South Wales, Sydney, Australia
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28
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Repetitive transcranial magnetic stimulation can alleviate treatment-resistant depression in patients with progressive supranuclear palsy. Parkinsonism Relat Disord 2015; 21:1113-4. [PMID: 26182830 DOI: 10.1016/j.parkreldis.2015.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 06/27/2015] [Accepted: 07/07/2015] [Indexed: 11/23/2022]
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29
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Levin J, Bak TH, Rominger A, Mille E, Arzberger T, Giese A, Ackl N, Lorenzl S, Bader B, Patzig M, Bötzel K, Danek A. The association of aphasia and right-sided motor impairment in corticobasal syndrome. J Neurol 2015; 262:2241-6. [PMID: 26143172 DOI: 10.1007/s00415-015-7833-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 06/21/2015] [Accepted: 06/22/2015] [Indexed: 12/18/2022]
Abstract
Corticobasal syndrome is defined clinically on the basis of symptoms and findings related to dysfunction of the cerebral cortex and the basal ganglia. Usually, marked asymmetry of motor findings is observed. Although aphasia has now been recognized as a frequent feature of corticobasal syndrome, it remains unclear whether it is usually associated with right-sided motor symptoms, pointing to the involvement of the left hemisphere. Hence, we set out to examine the relationship between the presence of language symptoms and the side affected by extrapyramidal symptoms. We analyzed the electronic care records of patients seen in the years 2003-2013 in the Neurology Department of the University Hospital of Munich. The diagnosis of corticobasal syndrome was discussed in ninety-two individuals. Of those, 38 cases fulfilled diagnostic criteria for corticobasal syndrome. Aphasia correlated highly with a predominant right-sided movement disorder (p = 0.002). In contrast, it was less common in patients with left-sided motor presentation. Dysarthria did not show a preferential correlation (p = 0.25). Our analysis suggests a characteristic presentation of corticobasal syndrome in which motor dysfunction of the right side of the body is associated with aphasia.
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Affiliation(s)
- Johannes Levin
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
| | - Thomas H Bak
- Department of Psychology and Centre for Clinical Brain Sciences, Edinburgh University, Edinburgh, UK
| | - Axel Rominger
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Erik Mille
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Thomas Arzberger
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Armin Giese
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Nibal Ackl
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Stefan Lorenzl
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Benedikt Bader
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Maximilian Patzig
- Department of Neuroradiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kai Bötzel
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Adrian Danek
- Neurology Department, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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30
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Nishida N, Hata Y, Yoshida K, Kinoshita K. Neuropathologic features of suicide victims who presented with acute poststroke depression: significance of association with neurodegenerative disorders. J Neuropathol Exp Neurol 2015; 74:401-10. [PMID: 25853693 DOI: 10.1097/nen.0000000000000184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To investigate the neuropathologic characteristics of poststroke depression (PSD) leading to suicide, we retrospectively selected deceased subjects who had been diagnosed as having early PSD. Cases were divided into subjects who had committed suicide and those who had not. Neuropathologic examinations, including immunohistochemistry, were conducted. Twenty-four subjects fulfilled criteria for early PSD; 11 of these had committed suicide, and the other 13 had not. Lesion type, size of stroke, and location of stroke were variable but did not differ significantly between the groups. Alzheimer disease-related pathology stages also did not differ between the groups. Argyrophilic grain disease was found in both the suicide group (6 of 11) and the nonsuicide group (2 of 13); there were 2 highly possible cases of early progressive supranuclear palsy in the suicide group. Together, argyrophilic grain disease and progressive supranuclear palsy were found significantly more frequently in suicide cases than in nonsuicide cases (p = 0.01). These data suggest that overlapping 4-repeat tauopathies, which include argyrophilic grain disease and progressive supranuclear palsy, might be an important aggravating factor of PSD that could lead to suicide. The presence of other neurodegenerative diseases does not preclude PSD because the prevalence of these diseases in older persons suggests that they might often occur concomitantly.
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Affiliation(s)
- Naoki Nishida
- From the Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama (NN, YH, KK); and Department of Neurology, Toyama University Hospital (KY), Toyama, Japan
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31
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Sitek EJ, Barczak A, Kluj-Kozłowska K, Kozłowski M, Narożańska E, Konkel A, Dąbrowska M, Barcikowska M, Sławek J. Writing in Richardson variant of progressive supranuclear palsy in comparison to progressive non-fluent aphasia. Neurol Neurochir Pol 2015; 49:217-22. [PMID: 26188937 DOI: 10.1016/j.pjnns.2015.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/24/2015] [Accepted: 05/27/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The overlap between progressive supranuclear palsy (PSP) and progressive non-fluent aphasia (PNFA) is being increasingly recognized. In this paper descriptive writing in patients with Richardson syndrome of progressive supranuclear palsy (PSP-RS) is compared to writing samples from patients with PNFA. METHODS Twenty-seven patients participated in the study: 17 with the clinical diagnosis of PSP-RS and 10 with PNFA. Untimed written picture description was administered during neuropsychological assessment and subsequently scored by two raters blinded to the clinical diagnosis. Lexical and syntactic content, as well as writing errors (e.g. omission and perseverative errors) were analyzed. RESULTS In patients with PSP-RS both letter and diacritic mark omission errors were very frequent. Micrographia was present in 8 cases (47%) in PSP-RS group and in one case (10%) with PNFA. Perseverative errors did not differentiate between the groups. CONCLUSIONS As omission errors predominate in writing of patients with PSP-RS, writing seems to be compromised mainly because of oculomotor deficits, that may alter visual feedback while writing.
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Affiliation(s)
- Emilia J Sitek
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland; Department of Neurological and Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland.
| | - Anna Barczak
- Neurology Department, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.
| | - Klaudia Kluj-Kozłowska
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland; Speech Therapy Chair, Faculty of Languages, University of Gdansk, Gdansk, Poland.
| | - Marcin Kozłowski
- Speech Therapy Chair, Faculty of Languages, University of Gdansk, Gdansk, Poland; Neurological Rehabilitation Department, Specialist Hospital in Koscierzyna, Dzierzazno, Poland.
| | - Ewa Narożańska
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland.
| | - Agnieszka Konkel
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland; Department of Neurological and Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland.
| | - Magda Dąbrowska
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland.
| | - Maria Barcikowska
- Neurodegenerative Disorders Department, Mossakowski Medical Research Center, Polish Academy of Sciences, Warsaw, Poland.
| | - Jarosław Sławek
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland; Department of Neurological and Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland.
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32
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Neuroimaging evidence of gray and white matter damage and clinical correlates in progressive supranuclear palsy. J Neurol 2015; 262:1850-8. [PMID: 25980906 DOI: 10.1007/s00415-015-7779-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 12/31/2022]
Abstract
To evaluate gray matter (GM) and white matter (WM) abnormalities and their clinical correlates in patients with progressive supranuclear palsy (PSP). Sixteen PSP patients and sixteen age-matched healthy subjects underwent a clinical evaluation and multimodal magnetic resonance imaging, including three-dimensional T1-weighted imaging and diffusion tensor imaging (DTI). Volumetric and DTI analyses were computed using SPM and FSL tools. PSP patients showed GM volume decrease, involving the frontal cortex, putamen, pallidum, thalamus and accumbens nucleus, cerebellum, and brainstem. Additionally, they had widespread changes in WM bundles, mainly affecting cerebellar peduncles, thalamic radiations, corticospinal tracts, corpus callosum, and longitudinal fasciculi. GM volumes did not correlate with WM abnormalities. DTI indices of WM damage, but not GM volumes, correlated with clinical scores of disease severity and cognitive impairment. The neurodegenerative changes that occur in PSP involve both GM and WM structures and develop concurrently though independently. WM damage in PSP correlates with clinical scores of disease severity and cognitive impairment, thus providing further insight into the pathophysiology of the disease.
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Ahmad Nabil M, Rosdinom R, Norlinah M, Sahathevan R. Clinical overlap between progressive supranuclear palsy (PSP) and frontotemporal dementia (FTD) in an elderly patient with earlier depression and psychosis. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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34
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Piattella MC, Tona F, Bologna M, Sbardella E, Formica A, Petsas N, Filippini N, Berardelli A, Pantano P. Disrupted resting-state functional connectivity in progressive supranuclear palsy. AJNR Am J Neuroradiol 2015; 36:915-21. [PMID: 25655870 DOI: 10.3174/ajnr.a4229] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/11/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Studies on functional connectivity in progressive supranuclear palsy have been restricted to the thalamus and midbrain tegmentum. The present study aims to evaluate functional connectivity abnormalities of the subcortical structures in these patients. Functional connectivity will be correlated with motor and nonmotor symptoms of the disease. MATERIALS AND METHODS Nineteen patients with progressive supranuclear palsy (mean age, 70.93 ± 5.19 years) and 12 age-matched healthy subjects (mean age, 69.17 ± 5.20 years) underwent multimodal MR imaging, including fMRI at rest, 3D T1-weighted imaging, and DTI. fMRI data were processed with fMRI of the Brain Software Library tools by using the dorsal midbrain tegmentum, thalamus, caudate nucleus, putamen, and pallidum as seed regions. RESULTS Patients had lower functional connectivity than healthy subjects in all 5 resting-state networks, mainly involving the basal ganglia, thalamus, anterior cingulate, dorsolateral prefrontal and temporo-occipital cortices, supramarginal gyrus, supplementary motor area, and cerebellum. Compared with healthy subjects, patients also displayed subcortical atrophy and DTI abnormalities. Decreased thalamic functional connectivity correlated with clinical scores, as assessed by the Hoehn and Yahr Scale and by the bulbar and mentation subitems of the Progressive Supranuclear Palsy Rating Scale. Decreased pallidum functional connectivity correlated with lower Mini-Mental State Examination scores; decreased functional connectivity in the dorsal midbrain tegmentum network correlated with lower scores in the Frontal Assessment Battery. CONCLUSIONS The present study demonstrates a widespread disruption of cortical-subcortical connectivity in progressive supranuclear palsy and provides further insight into the pathophysiologic mechanisms of motor and cognitive impairment in this condition.
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Affiliation(s)
- M C Piattella
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - F Tona
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - M Bologna
- Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
| | - E Sbardella
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - A Formica
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - N Petsas
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - N Filippini
- Department of Psychiatry and FMRIB Centre (N.F.), University of Oxford, United Kingdom
| | - A Berardelli
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
| | - P Pantano
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
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