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Camarda C, Torelli P, Pipia C, Battaglini I, Sottile G, Cilluffo G, Camarda R. Activation-Induced Rigidity in Neurologically and Cognitively Healthy Individuals Aged 18-90 Years: A Cross-Sectional Study. J Parkinsons Dis 2021; 11:847-856. [PMID: 33612497 DOI: 10.3233/jpd-202488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Rigidity is a key clinical feature of Parkinson's disease (PD), but in a very early phase of the disease it may be absent and can be enhanced through active movements of the arm contralateral to the one being tested. OBJECTIVE To evaluate in a large cohort of neurologically and cognitively healthy (NCH) subjects aged 18-90 years if activation-induced rigidity (AR) is present in all age classes, and if there are biological differences between subjects showing AR (AR+) and not showing AR (AR-). METHODS 2,228 NCH subjects categorized as young adult (18-44 years), adult (45-64 years), elderly (65-74 years), and old/oldest-old (75-90 years) were included in the analysis, and underwent brain MRI. White matter hyperintensities were assessed through two visual rating scales. Lacunes were also rated. Atrophy of the caudate nuclei and ventricular enlargement were assessed through the bicaudate ratio and the lateral ventricles to brain ratio. To elicit AR, the Froment's maneuver (FM) and the instructions of the UPDRS-ME were used. RESULTS Among the sample, 1,689 (75.81%) subjects showed AR, of which 1,270 (57.00%) subjects showed AR by using FM, and 419 (18.81%) showed AR by using UPDRS-ME instructions. The latter subjects also showed AR by using FM. The number of AR+ subjects significantly increased with increasing age, regardless of the activation maneuver used. In each age class, the number of AR+ subjects was significantly higher by using the FM than the UPDRS-ME instructions. CONCLUSION Our findings suggest that AR is likely to be one of the signs of the prodromal phase of PD.
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Affiliation(s)
- Cecilia Camarda
- Department of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Paola Torelli
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Iacopo Battaglini
- Ospedale Santa Croce, U.O. di Neurologia, A.S.L. Torino 5, Torino, Italy
| | - Gianluca Sottile
- Department of Economics, Business, and Statistics, University of Palermo, Palermo, Italy.,Institute for Biomedical Research and Innovation (IRIB), National Research Council, Palermo, Italy
| | - Giovanna Cilluffo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Camarda C, Torelli P, Pipia C, Sottile G, Cilluffo G, Camarda R. APOE Genotypes and Brain Imaging Classes in Normal Cognition, Mild Cognitive Impairment, and Alzheimer's Disease: A Longitudinal Study. Curr Alzheimer Res 2020; 17:766-780. [PMID: 33167837 DOI: 10.2174/1567205017666201109093314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/20/2020] [Accepted: 10/10/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate in 419 stroke-free cognitively normal subjects (CN) aged 45-82 years covering during a long prospective study (11.54 ± 1.47 years) the preclinical to dementia spectrum: 1) the distribution of small vessel disease (V) and brain atrophy (A) aggregated as following: V-/A-, V-/A+, V+/A-, V+/A+; 2) the relationship of these imaging classes with individual apolipoprotein E (APOE) genotypes; 3) the risk of progression to Alzheimer Disease (AD) of the individual APOE genotypes. METHODS Participants underwent one baseline (t0), and 4 clinical and neuropsychological assessments (t1,t2,t3, and t4). Brain MRI was performed in all subjects at t0, t2, t3 and t4.. White matter hyperintensities were assessed through two visual rating scales. Lacunes were also rated. Subcortical and global brain atrophy were determined through the bicaudate ratio and the lateral ventricle to brain ratio, respectively. APOE genotypes were determined at t0 in all subjects. Cox proportional hazard model was used to evaluate the risk of progression to AD. RESULTS The imaging class of mixed type was very common in AD, and in non amnestic mild cognitive impaired APOE ε4 non carriers. In these subjects, frontal and parieto-occipital regions were most affected by small vessel disease. CONCLUSION Our findings suggest that the APOE ε3 allele is probably linked to the brain vascular pathology.
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Affiliation(s)
- Cecilia Camarda
- Department of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Paola Torelli
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Gianluca Sottile
- Department of Economics, Business, and Statistics, University of Palermo, Palermo, Italy,Institute for Research and Biomedical Innovation (IRIB), National Research Council, Palermo, Italy
| | - Giovanna Cilluffo
- Institute for Research and Biomedical Innovation (IRIB), National Research Council, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Camarda C, Torelli P, Pipia C, Battaglini I, Azzarello D, Rosano R, Ventimiglia CC, Sottile G, Cilluffo G, Camarda R. Mild Parkinsonian Signs in a Hospital-based Cohort of Mild Cognitive Impairment Types: A Cross-sectional Study. Curr Alzheimer Res 2019; 16:633-649. [DOI: 10.2174/1567205016666190726100744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/24/2019] [Accepted: 06/17/2019] [Indexed: 12/27/2022]
Abstract
Background:Mild Parkinsonian Signs (MPS) have been associated with Mild Cognitive Impairment (MCI) types with conflicting results.Objective:To investigate the association of individual MPS with different MCI types using logistic ridge regression analysis, and to evaluate for each MCI type, the association of MPS with caudate atrophy, global cerebral atrophy, and the topographical location of White Matter Hyperintensities (WMH), and lacunes.Methods:A cross-sectional study was performed among 1,168 subjects with different types of MCI aged 45-97 (70,52 ± 9,41) years, who underwent brain MRI. WMH were assessed through two visual rating scales. The number and location of lacunes were also rated. Atrophy of the caudate nuclei and global cerebral atrophy were assessed through the bicaudate ratio, and the lateral ventricles to brain ratio, respectively. Apolipoprotein E (APOE) genotypes were also assessed. Using the items of the motor section of the Unified Parkinson’s Disease Rating Scale, tremor, rigidity, bradykinesia, and gait/balance/axial dysfunction were evaluated.Results:Bradykinesia, and gait/balance/axial dysfunction were the MPS more frequently encountered followed by rigidity, and tremor. MPS were present in both amnestic and non-amnestic MCI types, and were associated with WMH, lacunes, bicaudate ratio, and lateral ventricles to brain ratio.Conclusion:MPS are present in both amnestic and non-amnestic MCI types, particularly in those multiple domain, and carrying the APOE ε4 allele. Cortical and subcortical vascular and atrophic processes contribute to MPS. Long prospective studies are needed to disentangle the contribution of MPS to the conversion from MCI to dementia.
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Affiliation(s)
- Cecilia Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Paola Torelli
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Iacopo Battaglini
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Delia Azzarello
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Rosamaria Rosano
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | | | - Gianluca Sottile
- Department of Economics, Business, and Statistics Sciences, University of Palermo, Palermo, Italy
| | - Giovanna Cilluffo
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Camarda C, Pipia C, Azzarello D, Battaglini I, Romeo G, Chiodi M, Camarda R. Vascular Risk Factors, Vascular Diseases, and Imaging Findings in a Hospital-based Cohort of Mild Cognitive Impairment Types. Curr Alzheimer Res 2019; 15:679-690. [PMID: 29357798 DOI: 10.2174/1567205015666180119110712] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/13/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mild Cognitive Impairment (MCI) is a transitional state between normal cognition and dementia. OBJECTIVE The aim of this study is to investigate the role of vascular risk factors, vascular diseases, cerebrovascular disease and brain atrophy in a large hospital-based cohort of MCI types including 471 amnestic MCI (a-MCI), 693 amnestic MCI multiple domain (a-MCImd), 322 single non-memory MCI (snm-MCI), and 202 non amnestic MCI multiple domain (na-MCImd). For comparison, 1,005 neurologically and cognitively healthy subjects were also evaluated. METHOD Several vascular risk factors and vascular diseases were assessed. All participants underwent neurological, neuropsychological and behavioural assessments as well as carotid ultrasonography and standard brain MRI. Multinomial logistic regression models on the MCI cohort with the NCH group and a-MCI type as reference categories were used to assess the effects of the variables evaluated on the estimated probability of one of the four MCI types. RESULTS This study demonstrates that cerebrovascular disease contributes substantially to the risk of non-memory MCI types and a-MCImd type, and that brain atrophy is present in all MCI types and is greater in multiple domain types particularly in the na-MCI type. CONCLUSION Improving detection and control of cerebrovascular disease in aging individuals should be mandatory. Since the incidence of MCI and dementia will be expected to rise because of the progressive life expectancy, a better management of cerebrovascular disease could indeed prevent or delay the onset of MCI, or could delay progression of MCI to dementia.
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Affiliation(s)
- Cecilia Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | | | - Delia Azzarello
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Iacopo Battaglini
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Giovanni Romeo
- Oslo Centre for Biostatistics and Epidemiology (OCBE), University of Olso, Olso, Norway
| | - Marcello Chiodi
- Department of Economics, Business, and Statistics, University of Palermo, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Camarda C, Torelli P, Pipia C, Battaglini I, Azzarello D, Rosano R, Ventimiglia GD, Sottile G, Cilluffo G, Camarda R. Association Between Atrophy of the Caudate Nuclei, Global Brain Atrophy, Cerebral Small Vessel Disease and Mild Parkinsonian Signs in Neurologically and Cognitively Healthy Subjects Aged 45-84 Years: A Crosssectional Study. Curr Alzheimer Res 2018; 15:1013-1026. [DOI: 10.2174/1567205015666180702111110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/17/2018] [Accepted: 06/25/2018] [Indexed: 11/22/2022]
Abstract
Background:
Mild Parkinsonian signs (MPS) are commonly seen in aging, and have been
related to cerebral Small Vessel Diseases (SVD) with no univocal results.
Objective:
The aim of this study was to investigate the cross-sectional relation between MPS and White
Matter Hyperintensities (WMH), lacunes, caudate atrophy, and global cerebral atrophy in a large cohort
of Neurologically and Cognitively Healthy (NCH) aging individuals.
Method:
1,219 NCH individuals were included in the analysis, and underwent standard brain MRI. The
items of the motor section of the Unified Parkinson’s Disease Rating Scale were used to evaluate
tremor, rigidity, bradykinesia, and gait/balance/axial dysfunction. Caudate atrophy and global cerebral
atrophy were assessed through the bicaudate ratio and the lateral ventricles to brain ratio, respectively.
WMH were assessed through two visual rating scales. Lacunes were also rated. Associations of MPS
with vascular risk factors/diseases and imaging findings were determined through the logistic regression
analysis.
Results:
Frontal and basal ganglia lacunes, frontal WMH, caudate atrophy, and global cerebral atrophy
were associated with bradykinesia. Basal ganglia lacunes, caudate atrophy, and global cerebral atrophy
were associated with gait/balance/axial dysfunction. Rigidity was associated with frontal WMH, and
tremor with caudate atrophy and global cerebral atrophy. NCH subjects with MPS, performed less than
subjects without MPS in tests evaluating global cognition and language.
Conclusion:
This study demonstrates that in NCH aging individuals, MPS are associated with cortical
and subcortical vascular and atrophic changes, and are probably, a warning sign of incipient cognitive
decline. Subjects with MPS should manage rigorously cerebral SVD to prevent future physical and cognitive
disabilities.
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Affiliation(s)
- Cecilia Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Paola Torelli
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Iacopo Battaglini
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Delia Azzarello
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Rosamaria Rosano
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Giusi Daniela Ventimiglia
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
| | - Gianluca Sottile
- Department of Economics, Business, and Statistics Sciences, University of Palermo, Palermo, Italy
| | - Giovanna Cilluffo
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Camarda C, Monastero R, Pipia C, Recca D, Camarda R. Interictal Executive Dysfunction in Migraineurs Without Aura: Relationship With Duration and Intensity of Attacks. Cephalalgia 2016; 27:1094-100. [PMID: 17711495 DOI: 10.1111/j.1468-2982.2007.01394.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Subjects with migraine are at increased risk of subcortical white matter lesions (WML). Reports of cognitive testing in adults with migraine have yielded inconsistent results. We performed a cross-sectional study to assess whether migraine without aura (MwA) is associated with impairment in executive functioning, a typical cognitive correlate of subcortical WML. Forty-five subjects with MwA and 90 controls, matched for age and education, underwent a cognitive battery of tests evaluating executive functions. The following migraine characteristics were collected: age at onset and length of migraine history, and frequency, duration and intensity of attacks. Subjects with MwA performed significantly lower than controls in tests evaluating complex, multifactorial executive functions. After multiple adjustments, the duration and intensity of migraine attacks significantly predicted cognitive disturbances. In the interictal phase of MwA there is evidence of mild executive dysfunction. The cumulative effects of repeated migraine attacks on prefronto-cerebellar loop probably account for our results.
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Affiliation(s)
- C Camarda
- Adult Headache Centre-Section of Neurology and Psychiatry, Department of Clinical Neuroscience, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
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Camarda C, Pipia C, Taglialavori A, Di Fiore P, Camarda R, Monastero R. Comorbidity between depressive symptoms and migraine: preliminary data from the Zabút Aging Project. Neurol Sci 2008; 29 Suppl 1:S149-51. [PMID: 18545919 DOI: 10.1007/s10072-008-0909-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We evaluated the association between depressive symptoms and migraine using cross-sectional data from the Zabút Aging Project, a population-based study including subjects aged > or =50 years. A total of 1285 nonmigraineurs and 151 migraineurs were included. Diagnosis of migraine was carried out using the criteria of the International Headache Society. The Center for Epidemiologic Studies Depression scale (CES-D) was used to score depressive symptoms. Depressive symptoms were clustered in four groups: depressed and positive affects, somatic activity and intrapersonal feelings. Migraineurs showed higher total and specific depressive symptoms than controls (p from 0.005 to <0.0001). Mild-to-moderate depressive symptoms (CES-D score of > or =16) were present in 47.2% of migraineurs compared to 15.8% of controls (p<0.0001). After adjustment for demographics, mild-to-moderate depressive symptoms were strongly associated with migraine (OR [95% CI]=4.7 [3.1-7.0]). This association significantly increased in males (OR [95% CI]=6.2 [2.8-14.6]). Depressive features represent highly frequent comorbid symptoms of adult-to-elderly migraineurs.
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Affiliation(s)
- Cecilia Camarda
- Adult Headache Centre Department of Clinical Neuroscience, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy.
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Monastero R, Pipia C, Cefalù AB, Liveri ET, Rosano R, Camarda R, Camarda C. Association between plasma lipid levels and migraine in subjects aged ≥50 years: preliminary data from the Zabùt Aging Project. Neurol Sci 2008; 29 Suppl 1:S179-81. [DOI: 10.1007/s10072-008-0919-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Camarda R, Camarda C, Monastero R, Grimaldi S, Camarda LKC, Pipia C, Caltagirone C, Gangitano M. Movements execution in amnestic mild cognitive impairment and Alzheimer's disease. Behav Neurol 2007; 18:135-42. [PMID: 17726241 PMCID: PMC5469954 DOI: 10.1155/2007/845914] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI) and early Alzheimer’s Disease (AD). Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD.
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Affiliation(s)
- Rosolino Camarda
- Laboratory of Epidemiology and Psychology of Aging and Dementia, Section of Neurology, Department of Clinical Neuroscience, University of Palermo, Palermo, Italy.
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Monastero R, Camarda C, Pipia C, Camarda R. Visual hallucinations and agitation in Alzheimer's disease due to memantine: report of three cases. J Neurol Neurosurg Psychiatry 2007; 78:546. [PMID: 17030587 PMCID: PMC2117848 DOI: 10.1136/jnnp.2006.096420] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
OBJECTIVE To determine the long-term outcome of migraine headaches in adolescents and to identify possible predictors of prognosis. METHODS Fifty-five of 80 subjects with migraine headaches (ages 11 to 14 years), who attended the baseline examination of a population-based study conducted in southern Italy in 1989, were eligible for follow-up in 1999. All interviews and examinations were conducted by neurologists, and migraine diagnoses were based on the International Headache Society (IHS) criteria. The association between possible prognostic factors and the long-term persistence of migraine headaches was explored using logistic regression analysis. RESULTS Of 55 subjects with migraine headaches at baseline, 41.8% had persistent migraine, 38.2% had experienced remission, and 20.0% transformed to tension-type headache. Only migraine without aura persisted in the same IHS code after 10 years, whereas migrainous disorder and nonclassifiable headache did not. The family history of migraine significantly predicted the 10-year persistence of migraine headaches (odds ratio [OR] = 7.0; 95% CI: 1.7 to 26.8). The risk persisted when only subjects with migraine with or without aura were evaluated (OR = 5.0; 95% CI: 1.2 to 20.9). CONCLUSIONS Migraine headaches in adolescents have a favorable long-term prognosis. Familial disposition for migraine predicted a poorer outcome, especially in subjects with migraine without aura.
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Affiliation(s)
- Roberto Monastero
- Adult Headache Centre, Section of Neurology and Psychiatry, DiNOP, University of Palermo, Italy
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Monastero R, Camarda C, Pipia C, Lopez G, Camarda LKC, Baiamonte V, Ferrante A, Triolo G, Camarda R. Cognitive impairment in Behçet's disease patients without overt neurological involvement. J Neurol Sci 2004; 220:99-104. [PMID: 15140614 DOI: 10.1016/j.jns.2004.02.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Revised: 02/20/2004] [Accepted: 02/23/2004] [Indexed: 11/29/2022]
Abstract
We investigated the prevalence of cognitive impairment in patients with Behçet's disease (BD) without overt neurological involvement. The influence of disease duration, disease activity, prednisone dosage, and anxiety and depression levels was evaluated. Twenty-six consecutive BD outpatients and 26 healthy controls matched for age, education and sex completed a comprehensive neuropsychological battery including tests of memory, visuospatial and constructional abilities, language, attention and psychomotor speed, non-verbal reasoning and executive functioning. The Hamilton scales for anxiety and depression were administered. Disease activity was assessed using the Behçet's Disease Current Activity Form (BDCAF). Compared to controls, BD patients were significantly impaired on tasks evaluating long-term verbal and non-verbal memory, and visuospatial skills. In addition, BD patients were significantly more anxious and depressed than controls. Cognitive impairment was evident in 46.1% of BD patients compared with none of control subjects (p<0.0001), with memory representing the cognitive domain most affected. Both high disease activity (OR 1.3, 95% CI 1.0-1.5, p<0.04) and high prednisone dosage (OR 1.3, 95% CI 1.0-1.7, p<0.03) were independently associated with cognitive impairment in BD after adjustment for demographic variables. Cognitive impairment, involving mainly memory functions, occurs frequently in BD patients. It may occur independently of clinically overt neurological involvement, and is more common in patients with an active disease and in those receiving prednisone.
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Affiliation(s)
- Roberto Monastero
- Department of Neurology and Rehabilitation, Institute of Neuropsychiatry, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
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Camarda R, Monastero R, Santangelo G, Raimondo D, Puma D, Pipia C, Camarda LKC, Camarda C, Raieli V. Migraine headaches in adolescents: a five-year follow-up study. Headache 2002; 42:1000-5. [PMID: 12453031 DOI: 10.1046/j.1526-4610.2002.02229.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Longitudinal studies of juvenile migraine are very few. We investigated the prevalence and evolution over 5 years of migraine without aura (MWOA) and migraineous disorder (MD) in an adolescent population. METHODS Sixty-four subjects (34 girls and 30 boys, mean age 17.3+/-1.1 years) out of 80 selected in our 1989 epidemiological survey were included in the study. The diagnostic criteria of the International Headache Society were used in both studies. RESULTS Thirty-two of 64 subjects (50%) had MWAO, 18 (28.1%) had MD, and 14 (21.9%) had headache not classifiable (HnC). Our results show that MWOA persisted in 56.2%, converted to MD or HnC in 9.4% and 3.1% of cases, respectively, changed to episodic tension-type headache (ETTH) in 12.5%, and remitted in 18.8%. MD persisted in 11.1%, converted to MWOA or HnC in 27.8% and 5.5% of cases, respectively, changed to ETTH in 11.1%, and remitted in 44.5%. HnC persisted in 14.3%, converted to MD or MWOA in 21.4% and 14.3% of cases, respectively, changed to ETTH in 14.3%, and remitted in 35.7%. CONCLUSIONS Our data indicate that juvenile-onset MWOA and MD may change in character over time, generally with a favorable prognosis.
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Affiliation(s)
- Rosolino Camarda
- Department of Neurology and Rehabilitation, Institute of Neuropsychiatry, University of Palermo, Italy.
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Marasini B, Pipia C, DeValle G, Crosignani A, Petroni L, Cugno M, Zeni S, Bruno S, Bassani C. Vascular impairment in patients with primary biliary cirrhosis. Int J Microcirc Clin Exp 1995; 15:75-9. [PMID: 8655255 DOI: 10.1159/000178953] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Experimental and clinical observation suggest that patients with primary biliary cirrhosis (PBC) have endothelial dysfunction. Postischemic digital blood flow, nailfold capillaroscopy, von Willebrand factor (vWf) and tissue-type plasminogen activator (t-PA) plasma levels were examined in 59 PBC patients. Forty-six subjects (15 with liver diseases other than PBC, 11 hypercholesterolemics, 20 healthy subjects) served as controls. PBC versus healthy controls (209.8 +/- 1.4% and 16.54 +/- 1.44 ng/ml vs. 120.2 +/- 1.4% and 9.91 +/- 1.49 ng/ml; p<0.001) and related to bilirubin (r = 0.38, p<0.02; r = 0.47, p<0.0005, respectively). vWf was also increased in other liver diseases (249.9 +/- 1.7%; p<0.001) and related to bilirubin (r = 0.59, p<0.05). Postischemic finger blood flow negatively correlated with vWf(p<0.05 or less). Our data indicate that PBC patients have microvascular disease. Whether vessels other than those of the fingers were involved remained unclear. vWf and t-PA might reflect a dysfunction of teh hepatic vascular endothelium.
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Affiliation(s)
- B Marasini
- Department of Rheumatology, University of Milan, Italy
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