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Riva N, Domi T, Pozzi L, Lunetta C, Schito P, Spinelli EG, Cabras S, Matteoni E, Consonni M, Bella ED, Agosta F, Filippi M, Calvo A, Quattrini A. Update on recent advances in amyotrophic lateral sclerosis. J Neurol 2024; 271:4693-4723. [PMID: 38802624 PMCID: PMC11233360 DOI: 10.1007/s00415-024-12435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
In the last few years, our understanding of disease molecular mechanisms underpinning ALS has advanced greatly, allowing the first steps in translating into clinical practice novel research findings, including gene therapy approaches. Similarly, the recent advent of assistive technologies has greatly improved the possibility of a more personalized approach to supportive and symptomatic care, in the context of an increasingly complex multidisciplinary line of actions, which remains the cornerstone of ALS management. Against this rapidly growing background, here we provide an comprehensive update on the most recent studies that have contributed towards our understanding of ALS pathogenesis, the latest results from clinical trials as well as the future directions for improving the clinical management of ALS patients.
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Affiliation(s)
- Nilo Riva
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy.
| | - Teuta Domi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Pozzi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Milan Institute, 20138, Milan, Italy
| | - Paride Schito
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edoardo Gioele Spinelli
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Cabras
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Matteoni
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Monica Consonni
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Eleonora Dalla Bella
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Federica Agosta
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Massimo Filippi
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Andrea Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Godoy-Corchuelo JM, Ali Z, Brito Armas JM, Martins-Bach AB, García-Toledo I, Fernández-Beltrán LC, López-Carbonero JI, Bascuñana P, Spring S, Jimenez-Coca I, Muñoz de Bustillo Alfaro RA, Sánchez-Barrena MJ, Nair RR, Nieman BJ, Lerch JP, Miller KL, Ozdinler HP, Fisher EMC, Cunningham TJ, Acevedo-Arozena A, Corrochano S. TDP-43-M323K causes abnormal brain development and progressive cognitive and motor deficits associated with mislocalised and increased levels of TDP-43. Neurobiol Dis 2024; 193:106437. [PMID: 38367882 PMCID: PMC10988218 DOI: 10.1016/j.nbd.2024.106437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/19/2024] Open
Abstract
TDP-43 pathology is found in several neurodegenerative disorders, collectively referred to as "TDP-43 proteinopathies". Aggregates of TDP-43 are present in the brains and spinal cords of >97% of amyotrophic lateral sclerosis (ALS), and in brains of ∼50% of frontotemporal dementia (FTD) patients. While mutations in the TDP-43 gene (TARDBP) are usually associated with ALS, many clinical reports have linked these mutations to cognitive impairments and/or FTD, but also to other neurodegenerative disorders including Parkinsonism (PD) or progressive supranuclear palsy (PSP). TDP-43 is a ubiquitously expressed, highly conserved RNA-binding protein that is involved in many cellular processes, mainly RNA metabolism. To investigate systemic pathological mechanisms in TDP-43 proteinopathies, aiming to capture the pleiotropic effects of TDP-43 mutations, we have further characterised a mouse model carrying a point mutation (M323K) within the endogenous Tardbp gene. Homozygous mutant mice developed cognitive and behavioural deficits as early as 3 months of age. This was coupled with significant brain structural abnormalities, mainly in the cortex, hippocampus, and white matter fibres, together with progressive cortical interneuron degeneration and neuroinflammation. At the motor level, progressive phenotypes appeared around 6 months of age. Thus, cognitive phenotypes appeared to be of a developmental origin with a mild associated progressive neurodegeneration, while the motor and neuromuscular phenotypes seemed neurodegenerative, underlined by a progressive loss of upper and lower motor neurons as well as distal denervation. This is accompanied by progressive elevated TDP-43 protein and mRNA levels in cortex and spinal cord of homozygous mutant mice from 3 months of age, together with increased cytoplasmic TDP-43 mislocalisation in cortex, hippocampus, hypothalamus, and spinal cord at 12 months of age. In conclusion, we find that Tardbp M323K homozygous mutant mice model many aspects of human TDP-43 proteinopathies, evidencing a dual role for TDP-43 in brain morphogenesis as well as in the maintenance of the motor system, making them an ideal in vivo model system to study the complex biology of TDP-43.
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Affiliation(s)
- Juan M Godoy-Corchuelo
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Zeinab Ali
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain; MRC Harwell Institute, Oxfordshire, UK
| | - Jose M Brito Armas
- Unidad de Investigación, Hospital Universitario de Canarias, ITB-ULL and CIBERNED, La Laguna, Spain
| | | | - Irene García-Toledo
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Luis C Fernández-Beltrán
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain; Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan I López-Carbonero
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Pablo Bascuñana
- Brain Mapping Group, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Shoshana Spring
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Irene Jimenez-Coca
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | | | - Maria J Sánchez-Barrena
- Department of Crystallography and Structural Biology, Institute of Physical Chemistry "Blas Cabrera", CSIC, Madrid, Spain
| | - Remya R Nair
- MRC Harwell Institute, Oxfordshire, UK; Nucleic Acid Therapy Accelerator (NATA), Harwell Campus, Oxfordshire, UK
| | - Brian J Nieman
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jason P Lerch
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Karla L Miller
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Hande P Ozdinler
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth M C Fisher
- Department of Neuromuscular Diseases, and UCL Queen Square Motor Neuron Disease Centre, UCL, Institute of Neurology, London, UK
| | - Thomas J Cunningham
- MRC Harwell Institute, Oxfordshire, UK; MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, UK
| | - Abraham Acevedo-Arozena
- Unidad de Investigación, Hospital Universitario de Canarias, ITB-ULL and CIBERNED, La Laguna, Spain.
| | - Silvia Corrochano
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain; MRC Harwell Institute, Oxfordshire, UK.
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6
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Moglia C, Calvo A, Canosa A, Manera U, Vasta R, Di Pede F, Daviddi M, Matteoni E, Brunetti M, Sbaiz L, Cabras S, Gallone S, Grassano M, Peotta L, Palumbo F, Mora G, Iazzolino B, Chio A. Cognitive and Behavioral Features of Patients With Amyotrophic Lateral Sclerosis Who Are Carriers of the TARDBP Pathogenic Variant. Neurology 2024; 102:e208082. [PMID: 38261982 PMCID: PMC10962913 DOI: 10.1212/wnl.0000000000208082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/26/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES TARDBP patients are considered particularly prone to cognitive involvement, but no systematic studies of cognitive impairment in TARDBP patients are available. The aim of this article was to depict in depth the cognitive-behavioral characteristics of a cohort of patients with amyotrophic lateral sclerosis (ALS) carrying TARDBP pathogenetic variants followed by an ALS referral center. METHODS We enrolled all patients with ALS seen at the Turin ALS expert center in the 2009-2021 period who underwent extensive genetic testing and a neuropsychological battery encompassing executive function, verbal memory, language, visual memory, visuoconstructive abilities, attention/working memory, psychomotor speed, nonverbal intelligence, cognitive flexibility, social cognition, and behavior. Tests were compared with the Mann-Whitney U test on age-corrected, sex-corrected, and education-corrected scores. Cognition was classified as normal (ALS-CN); isolated cognitive impairment (ALSci), that is, evidence of executive and/or language dysfunction; isolated behavioral impairment (ALSbi), that is, identification of apathy; cognitive and behavioral impairment (ALScbi), that is, evidence meeting the criteria for both ALSci and ALSbi; and frontotemporal dementia (ALS-FTD). RESULTS This study includes 33 patients with TARDBP pathogenetic variants (TARDBP-ALS) (median age 61 years [interquartile range (IQR) 53-67], 8 female [24.2%]) and 928 patients with ALS not carrying the pathogenic variant (WT-ALS) (median age 67 years [IQR 59-74], 386 female [41.6%]). TARDBP-ALS cases were also compared with 129 matched controls (median age 66 years [IQR 57.5-71.5], 55 female [42.6%]). TARDBP-ALS and WT-ALS patients were cognitively classified as ALS-CN (54% vs 58.8%, respectively), ALSci (21.2% vs 18.3%), ALSci (9.1% vs 9.5%), ALScbi (6.1% vs 6.0%), and ALS-FTD (9.1 vs 6.7%), with no significant difference (p = 0.623). Compared with controls, TARDBP-ALS had a worse performance in executive functions, visual memory, visuoconstructive abilities, verbal fluency, and the apathy behavioral component of FrSBe. The scores of performed tests, including all Edinburgh Cognitive and Behavioral ALS Screen subdomains, were similar in TARDBP-ALS and WT-ALS. DISCUSSION TARDBP-ALS patients were significantly more impaired than controls in most examined domains but do not show any specific pattern of cognitive impairment compared with WT-ALS. Our findings are relevant both clinically, considering the effect of cognitive impairment on patients' decision-making and caregivers' burden, and in designing clinical trials for the treatment of patients carrying TARDBP pathogenetic variants.
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Affiliation(s)
- Cristina Moglia
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Andrea Calvo
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Antonio Canosa
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Umberto Manera
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Rosario Vasta
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Francesca Di Pede
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Margherita Daviddi
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Enrico Matteoni
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Maura Brunetti
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Luca Sbaiz
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Sara Cabras
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Salvatore Gallone
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Maurizio Grassano
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Laura Peotta
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Francesca Palumbo
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Gabriele Mora
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Barbara Iazzolino
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Adriano Chio
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
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