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Mannarelli D, Pauletti C, Missori P, Trompetto C, Cotellessa F, Fattapposta F, Currà A. Cerebellum's Contribution to Attention, Executive Functions and Timing: Psychophysiological Evidence from Event-Related Potentials. Brain Sci 2023; 13:1683. [PMID: 38137131 PMCID: PMC10741792 DOI: 10.3390/brainsci13121683] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Since 1998, when Schmahmann first proposed the concept of the "cognitive affective syndrome" that linked cerebellar damage to cognitive and emotional impairments, a substantial body of literature has emerged. Anatomical, neurophysiological, and functional neuroimaging data suggest that the cerebellum contributes to cognitive functions through specific cerebral-cerebellar connections organized in a series of parallel loops. The aim of this paper is to review the current findings on the involvement of the cerebellum in selective cognitive functions, using a psychophysiological perspective with event-related potentials (ERPs), alone or in combination with non-invasive brain stimulation techniques. ERPs represent a very informative method of monitoring cognitive functioning online and have the potential to serve as valuable biomarkers of brain dysfunction that is undetected by other traditional clinical tools. This review will focus on the data on attention, executive functions, and time processing obtained in healthy subjects and patients with varying clinical conditions, thus confirming the role of ERPs in understanding the role of the cerebellum in cognition and exploring the potential diagnostic and therapeutic implications of ERP-based assessments in patients.
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Affiliation(s)
- Daniela Mannarelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (D.M.); (C.P.); (P.M.); (F.F.)
| | - Caterina Pauletti
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (D.M.); (C.P.); (P.M.); (F.F.)
| | - Paolo Missori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (D.M.); (C.P.); (P.M.); (F.F.)
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.T.); (F.C.)
- IRCCS Ospedale Policlinico San Martino, Division of Neurorehabilitation, Department of Neuroscience, 16132 Genoa, Italy
| | - Filippo Cotellessa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.T.); (F.C.)
| | - Francesco Fattapposta
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (D.M.); (C.P.); (P.M.); (F.F.)
| | - Antonio Currà
- Academic Neurology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04019 Terracina, Italy
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De Feo MS, Frantellizzi V, Locuratolo N, Di Rocco A, Farcomeni A, Pauletti C, Marongiu A, Lazri J, Nuvoli S, Fattapposta F, De Vincentis G, Spanu A. Role of Functional Neuroimaging with 123I-MIBG and 123I-FP-CIT in De Novo Parkinson's Disease: A Multicenter Study. Life (Basel) 2023; 13:1786. [PMID: 37629643 PMCID: PMC10455638 DOI: 10.3390/life13081786] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Parkinson's disease is a progressive neurodegenerative disorder, with incidence and prevalence rates of 8-18 per 100,000 people per year and 0.3-1%, respectively. As parkinsonian symptoms do not appear until approximately 50-60% of the nigral DA-releasing neurons have been lost, the impact of routine structural imaging findings is minimal at early stages, making Parkinson's disease an ideal condition for the application of functional imaging techniques. The aim of this multicenter study is to assess whether 123I-FP-CIT (DAT-SPECT), 123I-MIBG (mIBG-scintigraphy) or an association of both exams presents the highest diagnostic accuracy in de novo PD patients. METHODS 288 consecutive patients with suspected diagnoses of Parkinson's disease or non- Parkinson's disease syndromes were analyzed in the present Italian multicenter retrospective study. All subjects were de novo, drug-naive patients and met the inclusion criteria of having undergone both DAT-SPECT and mIBG-scintigraphy within one month of each other. RESULTS The univariate analysis including age and both mIBG-SPECT and DAT-SPECT parameters showed that the only significant values for predicting Parkinson's disease in our population were eH/M, lH/M, ESS and LSS obtained from mIBG-scintigraphy (p < 0.001). CONCLUSIONS mIBG-scintigraphy shows higher diagnostic accuracy in de novo Parkinson's disease patients than DAT-SPECT, so given the superiority of the MIBG study, the combined use of both exams does not appear to be mandatory in the early phase of Parkinson's disease.
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Affiliation(s)
- Maria Silvia De Feo
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy (J.L.)
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy (J.L.)
| | - Nicoletta Locuratolo
- Department of Human Neurosciences, Sapienza, University of Rome, 00161 Rome, Italy
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, 00161 Rome, Italy
| | - Arianna Di Rocco
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy (J.L.)
| | - Alessio Farcomeni
- Department of Economics & Finance, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Caterina Pauletti
- Department of Human Neurosciences, Sapienza, University of Rome, 00161 Rome, Italy
| | - Andrea Marongiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Julia Lazri
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy (J.L.)
| | - Susanna Nuvoli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | | | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy (J.L.)
| | - Angela Spanu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
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3
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Mannarelli D, Pauletti C, Petritis A, Maffucci A, Currà A, Trompetto C, Marinelli L, Fattapposta F. The role of cerebellum in timing processing: a contingent negative variation study. Neurosci Lett 2023:137301. [PMID: 37244448 DOI: 10.1016/j.neulet.2023.137301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/08/2023] [Revised: 04/20/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
Time management is an important aspect of human behaviour and cognition. Several brain regions are thought to be involved in motor timing and time estimation tasks. However, subcortical regions such as the basal nuclei and cerebellum seem to play a role in timing control. The aim of this study was to investigate the role of the cerebellum in temporal processing. For this purpose, we transitorily inhibited cerebellar activity by means of cathodal transcranial direct current stimulation (tDCS) and studied the effects of this inhibition on contingent negative variation (CNV) parameters elicited during a S1-S2 motor task in healthy subjects. Sixteen healthy subjects underwent a S1-S2 motor task prior to and after cathodal and sham cerebellar tDCS in separate sessions. The CNV task consisted of a duration discrimination task in which subjects had to determine whether the duration of a probe interval trial was shorter (800 ms), longer (1600 ms), or equal to the target interval of 1200 ms. A reduction in total CNV amplitude emerged only after cathodal tDCS for short and target interval trials, while no differences were detected for the long interval trial. Errors were significantly higher after cathodal tDCS than at baseline evaluation of short and target intervals. No reaction time differences were found for any time interval after the cathodal and sham sessions. These results point to a role of the cerebellum in time perception. In particular, the cerebellum seems to regulate temporal interval discrimination for second and sub-second ranges.
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Affiliation(s)
- Daniela Mannarelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Caterina Pauletti
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Alessia Petritis
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Andrea Maffucci
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Terracina, LT, Sapienza University of Rome, Polo Pontino, Latina, Italy.
| | - Carlo Trompetto
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Department of Neurosciences, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Lucio Marinelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Department of Neurosciences, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Francesco Fattapposta
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
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Pauletti C, Locuratolo N, Mannarelli D, Maffucci A, Petritis A, Menini E, Fattapposta F. Fatigue in fluctuating Parkinson's disease patients: possible impact of safinamide. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02654-1. [PMID: 37210459 DOI: 10.1007/s00702-023-02654-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
Fatigue is a common non-motor symptom in Parkinson's disease (PD). Among other pathophysiological mechanisms, neuroinflammation, a pathological PD hallmark associated with changes in glutamatergic transmission in basal ganglia, has been proposed as a crucial factor closely related to fatigue. To test the hypothesis that safinamide could represent an effective treatment of fatigue in PD patients, given its dual mechanism of action (it selectively and reversibly inhibits MAOB and modulates glutamate release), we administered the validated versions of fatigue severity scale (FSS) and Parkinson fatigue scale-16 (PFS-16) to 39 fluctuating PD patients with fatigue before and after a 24-week treatment period with safinamide as add-on therapy. An assessment of secondary variables such as depression, quality of life (QoL), and motor and non-motor symptoms (NMS) was conducted. After 24 weeks of treatment with safinamide, both FSS (p < 0.001) and PF-S16 (p = 0.02) scores were significantly lower than at baseline. Moreover, 46.2% and 41% of patients scored below the cut-off for the presence of fatigue according to FSS and PFS-16, respectively (responders). At follow-up, a significant difference emerged between responders and non-responders in mood, QoL, and NMS. Fatigue improved in fluctuating PD, and more than 40% of patients were "fatigue-free" after a 6 month treatment with safinamide. Patients without fatigue at follow-up displayed significantly better scores in QoL domains, such as mobility or activities of daily living, although disease severity remained stable, supporting the hypothesis that fatigue could considerably affect QoL. Drugs that interact with multiple neurotransmission systems, such as safinamide, could be useful in reducing this symptom.
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Affiliation(s)
- Caterina Pauletti
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy.
| | - Nicoletta Locuratolo
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Daniela Mannarelli
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Andrea Maffucci
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Alessia Petritis
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Elisa Menini
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Fattapposta
- Department of Human Neurosciences, Universita degli Studi di Roma La Sapienza, Rome, Italy
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Mastropietro S, Favieri F, Forte G, Locuratolo N, Mannarelli D, Pauletti C, Fattapposta F, Casagrande M. Behavioral Addictions Questionnaire (BAQ): Validation of a New Tool for the Screening of Multiple Addictive Behaviors in the Italian Population. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00906-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
AbstractThis study deals with the uncertainty in defining behavioral addictions (BAs). BAs are characterized by specific compulsive behaviors, regardless of potential negative consequences. However, to differentiate a behavior from a leisure activity to an addictive one is still an object of debate in the literature. Accordingly, this study aimed to assess the psychometric properties of the Behavioral Addictions Questionnaire (BAQ) as a possible screening tool for multiple BAs (i.e., shopping, food addiction, gambling, sex, work, exercise, Internet, videogames, and smartphone). BAQ aims to give a dimensional and quantitative assessment of addictive behaviors in a continuum, including both the adaptive and maladaptive features of the behaviors. Five hundred and seventy-six healthy adults (age range: 18–88) participated in the study, completing a survey including the BAQ questionnaire. Considering both exploratory and confirmatory factor analyses, statistical examination suggested good psychometric properties, with adequate validity in all its subscales (i.e., the goodness of fit). Moreover, also higher reliability was confirmed for each dimension detected (i.e., all alpha over 0.65). The BAQ represents a comprehensive screening instrument that benefits from appropriate validity and reliability for assessing BAs. Therefore, it can be used in clinical fields and research. Moreover, the feature of BAs on a continuum, and the severity index adopted by the study, can help from a preventive perspective. However, further validation of the BAQ is needed in other countries and contexts.
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Pauletti C, Mannarelli D, Locuratolo N, Maffucci A, Currà A, Marinelli L, Fattapposta F. Serotonergic central tone in Parkinson's disease with fatigue: Evidence from the loudness dependence of auditory evoked potentials (LDAEP). Neurosci Lett 2021; 764:136242. [PMID: 34509567 DOI: 10.1016/j.neulet.2021.136242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/02/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022]
Abstract
Central fatigue in Parkinson's disease (PD) is a common and disabling symptom that further worsens the patients' quality of life. A deficit in the serotonergic system may be implicated in the occurrence of fatigue in patients with PD as well as in those with other chronic conditions characterized by fatigue. The loudness dependence of auditory evoked potentials (LDAEP) is a neurophysiological tool that has proved to be effective in measuring the serotonergic central function in vivo. The aim of the present study was to assess central serotonergic activity in PD patients and to explore its possible association with the presence of fatigue. LDAEP was recorded in 38 PD patients (26 without fatigue - PDnF and 12 with fatigue - PDF) and 34 healthy controls. A significant difference between parkinsonian patients and controls emerged, with patients displaying stronger LDAEP values (which reflect a lower serotonergic central tone) than controls. By contrast, no differences in LDAEP emerged between PDF and PDnF. Our electrophysiological data confirmed the presence of a deficit in serotonergic central transmission in PD. An association between this deficit and fatigue was not demonstrated. It is likely that an altered dopamine/serotonin balance, rather than a serotonin deficit alone, is involved in the genesis of central fatigue. This complex and multifaceted symptom is related above all to a dysfunction in the striato-thalamo-cortical loop that connects the neostriatum to the frontal lobe and is strongly affected by motivation.
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Affiliation(s)
- Caterina Pauletti
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
| | - Daniela Mannarelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Nicoletta Locuratolo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Andrea Maffucci
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Terracina, LT, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Division of Clinical Neurophysiology, Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Fattapposta
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
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Maffucci A, Pauletti C, Mannarelli D, Petritis A, Minelli C, Fattapposta F. Mental flexibility in Parkinson's disease with central fatigue: Data from the frontal assessment battery. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Mannarelli D, Pauletti C, Petritis A, Delle Chiaie R, Currà A, Trompetto C, Fattapposta F. Effects of Cerebellar tDCS on Inhibitory Control: Evidence from a Go/NoGo Task. Cerebellum 2020; 19:788-798. [PMID: 32666284 PMCID: PMC7588382 DOI: 10.1007/s12311-020-01165-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Response inhibition as an executive function refers to the ability to suppress inappropriate but prepotent responses. Several brain regions have been implicated in the process underlying inhibitory control, including the cerebellum. The aim of the present study was to explore the role of the cerebellum in executive functioning, particularly in response inhibition. For this purpose, we transitorily inhibited cerebellar activity by means of cathodal tDCS and studied the effects of this inhibition on ERP components elicited during a Go/NoGo task in healthy subjects. Sixteen healthy subjects underwent a Go/NoGo task prior to and after cathodal and sham cerebellar tDCS in separate sessions. A reduction in N2-NoGo amplitude and a prolongation in N2-NoGo latency emerged after cathodal tDCS whereas no differences were detected after sham stimulation. Moreover, commission errors in NoGo trials were significantly higher after cathodal tDCS than at the basal evaluation. No differences emerged between performances in Go trials and those after sham stimulation. These data indicate that cerebellar inhibition following cathodal stimulation alters the ability to allocate attentional resources to stimuli containing conflict information and the inhibitory control. The cerebellum may regulate the attentional mechanisms of stimulus orientation and inhibitory control both directly, by making predictions of errors or behaviors related to errors, and indirectly, by controlling the functioning of the cerebral cortical areas involved in the perception of conflict signals and of the basal ganglia involved in the inhibitory control of movement.
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Affiliation(s)
- Daniela Mannarelli
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, Rome, Italy
| | - Caterina Pauletti
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, Rome, Italy
| | - Alessia Petritis
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, Rome, Italy
| | - Roberto Delle Chiaie
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, Rome, Italy
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Terracina, LT, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Fattapposta
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, Rome, Italy
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de Tommaso M, Betti V, Bocci T, Bolognini N, Di Russo F, Fattapposta F, Ferri R, Invitto S, Koch G, Miniussi C, Piccione F, Ragazzoni A, Sartucci F, Rossi S, Arcara G, Berchicci M, Bianco V, Delussi M, Gentile E, Giovannelli F, Mannarelli D, Marino M, Mussini E, Pauletti C, Pellicciari MC, Pisoni A, Raggi A, Valeriani M. Pearls and pitfalls in brain functional analysis by event-related potentials: a narrative review by the Italian Psychophysiology and Cognitive Neuroscience Society on methodological limits and clinical reliability-part I. Neurol Sci 2020; 41:2711-2735. [PMID: 32388645 DOI: 10.1007/s10072-020-04420-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 11/02/2019] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
Abstract
Event-related potentials (ERPs) are obtained from the electroencephalogram (EEG) or the magnetoencephalogram (MEG, event-related fields (ERF)), extracting the activity that is time-locked to an event. Despite the potential utility of ERP/ERF in cognitive domain, the clinical standardization of their use is presently undefined for most of procedures. The aim of the present review is to establish limits and reliability of ERP medical application, summarize main methodological issues, and present evidence of clinical application and future improvement. The present section of the review focuses on well-standardized ERP methods, including P300, Contingent Negative Variation (CNV), Mismatch Negativity (MMN), and N400, with a chapter dedicated to laser-evoked potentials (LEPs). One section is dedicated to proactive preparatory brain activity as the Bereitschaftspotential and the prefrontal negativity (BP and pN). The P300 and the MMN potentials have a limited but recognized role in the diagnosis of cognitive impairment and consciousness disorders. LEPs have a well-documented usefulness in the diagnosis of neuropathic pain, with low application in clinical assessment of psychophysiological basis of pain. The other ERP components mentioned here, though largely applied in normal and pathological cases and well standardized, are still confined to the research field. CNV, BP, and pN deserve to be largely tested in movement disorders, just to explain possible functional changes in motor preparation circuits subtending different clinical pictures and responses to treatments.
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Affiliation(s)
- Marina de Tommaso
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Viviana Betti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy
| | - Tommaso Bocci
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & NeuroMi, University of Milano Bicocca, Milan, Italy.,Laboratory of Neuropsychology, IRCCS Istituto Auxologico, Milan, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | | | | | - Sara Invitto
- INSPIRE - Laboratory of Cognitive and Psychophysiological Olfactory Processes, University of Salento, Lecce, Italy
| | - Giacomo Koch
- IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy.,Department of Neuroscience, Policlinico Tor Vergata, Rome, Italy
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy.,Cognitive Neuroscience Section, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Francesco Piccione
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Aldo Ragazzoni
- Unit of Neurology and Clinical Neurophysiology, Fondazione PAS, Scandicci, Florence, Italy
| | - Ferdinando Sartucci
- Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,CNR Institute of Neuroscience, Pisa, Italy
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience Siena Brain Investigation and Neuromodulation Lab (SI-BIN Lab), University of Siena, Siena, Italy
| | - Giorgio Arcara
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Marika Berchicci
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Valentina Bianco
- IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Marianna Delussi
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Eleonora Gentile
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Fabio Giovannelli
- Section of Psychology - Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | - Daniela Mannarelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Marco Marino
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Elena Mussini
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Caterina Pauletti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | - Alberto Pisoni
- Department of Psychology & NeuroMi, University of Milano Bicocca, Milan, Italy
| | - Alberto Raggi
- Unit of Neurology, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy
| | - Massimiliano Valeriani
- Neurology Ward Unit, Bambino Gesù Hospital, Rome, Italy. .,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
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Pauletti C, Mannarelli D, Locuratolo N, Currà A, Marinelli L, Fattapposta F. Central fatigue and attentional processing in Parkinson’s disease: An event-related potentials study. Clin Neurophysiol 2019; 130:692-700. [DOI: 10.1016/j.clinph.2019.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/11/2018] [Accepted: 01/17/2019] [Indexed: 12/23/2022]
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Mannarelli D, Pauletti C, Panzini C, Corrado A, Delle Chiaie R, Fattapposta F. Cerebellum and attention networks functioning: findings from a cerebellar transcranial Direct Current Stimulation and Attention Network Test study. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mannarelli D, Pauletti C, Accinni T, Carlone L, Frascarelli M, Lattanzi GM, Currà A, Fattapposta F. Attentional functioning in individuals with 22q11 deletion syndrome: insight from ERPs. J Neural Transm (Vienna) 2018. [PMID: 29520614 DOI: 10.1007/s00702-018-1873-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The 22q11 deletion syndrome (22q11DS), or DiGeorge syndrome (DG), is one of the most common genetic deletion syndromes. DG also carries a high risk for psychiatric disorders, with learning disabilities frequently being reported. Impairments in specific cognitive domains, such as executive functioning and attention, have also been described. The aim of this study was to investigate attentional functioning in a group of subjects with DG using ERPs, and in particular the P300 and CNV components. We studied ten patients with DG and ten healthy subjects that performed a P300 Novelty task and a CNV motor task. P3b amplitude was significantly lower in patients than in controls, while P3b latency was comparable in patients and controls. The P3a parameters were similar in both groups. All CNV amplitudes were significantly lower in DG patients than in controls. DG patients displayed slower reaction times in the CNV motor task than healthy subjects. These results point to a cognitive dysfunction related above all to executive attentional processing in DG patients. In particular, a specific difficulty emerged in selective attention and in the ability to orient and to sustain the anticipatory attention required for an executive motor response.
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Affiliation(s)
- Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Tommaso Accinni
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Luca Carlone
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Marianna Frascarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Guido Maria Lattanzi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Terracina, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
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Bersani FS, Minichino A, Bernabei L, Spagnoli F, Corrado A, Vergnani L, Mannarelli D, Pauletti C, Fattapposta F, Biondi M, Delle Chiaie R. Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation. J Affect Disord 2017; 209:262-269. [PMID: 27951511 DOI: 10.1016/j.jad.2016.11.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 11/07/2016] [Accepted: 11/25/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The present double blind placebo-controlled study aimed at investigating the efficacy of 3-weeks prefronto-cerebellar transcranial direct current stimulation (tDCS) on neurocognitive functioning in euthymic BD patients. METHODS Forty-two outpatients with BD were randomly assigned to receive either active (n=21) or sham (n=21) prefronto-cerebellar tDCS for 3 consecutive weeks. Neurocognitive abilities were assessed with both neuropsychological testing and psychophysiological evaluation with a P300 novelty task. RESULTS Our results showed that (i) Trail Making Test-B, a measure of executive functioning, decreased significantly in the active but not in the sham group, (ii) Rey Complex Figure Test Delay Recall, a measure of visuospatial memory, increased significantly in both groups with a greater increase in the active compared to the sham group, and (iii) P3b latency, a measure of brain information processing stream, decreased significantly in the active but not in the sham group. No significant changes were observed in the other explored neuropsychological and psychophysiological measures. CONCLUSIONS The study suggests that concomitant prefrontal-excitatory and cerebellar-inhibitory tDCS in euthymic BD patients may lead to better neurocognitive performance, quantified through neuropsychological and psychophysiological measures.
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Affiliation(s)
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
| | - Laura Bernabei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Francesco Spagnoli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Alessandra Corrado
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Lucilla Vergnani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | | | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
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Mannarelli D, Pauletti C, Mancini P, Fioretti A, Greco A, De Vincentiis M, Fattapposta F. Selective attentional impairment in chronic tinnitus: Evidence from an event-related potentials study. Clin Neurophysiol 2017; 128:411-417. [PMID: 28160746 DOI: 10.1016/j.clinph.2016.12.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/25/2016] [Revised: 12/10/2016] [Accepted: 12/23/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Tinnitus is an auditory phantom sensation experienced in the absence of a sound source. Cognitive dysfunctions, especially in working memory and attention, are frequently reported to be associated with tinnitus. The aim of this study was to investigate attentional functioning in a group of subjects with chronic tinnitus using ERPs, and in particular the P300 components. METHODS We studied 20 patients with chronic tinnitus and 20 healthy subjects that performed a P300 Novelty task. RESULTS P3a amplitude was significantly lower in tinnitus subjects than in controls. P3a latency was comparable in patients and controls. The P3b parameters were similar in the two groups. N1 latency for all the stimuli was significantly longer in tinnitus subjects than in controls. CONCLUSION These results point to a general slowing in early stimulus perception in tinnitus subjects. Moreover, a specific difficulty emerged in attentional switching to unexpected events during an orienting response, probably owing to a dysfunction in the ventral attention network. SIGNIFICANCE Psychophysiological approach reveals selective attentional impairment and could provide useful data for rehabilitative strategies in chronic tinnitus.
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Affiliation(s)
- Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome, Italy.
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome, Italy.
| | - Marco De Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome, Italy.
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
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Mannarelli D, Pauletti C, Leuzzi V, D’Agnano D, Rinalduzzi S, Currà A, Locuratolo N, Fattapposta F. 25. Attentional dysfunctions in Ataxia-teleangectasia: A psychophysiological study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pauletti C, Mannarelli D, Locuratolo N, Pollini L, Currà A, Marinelli L, Rinalduzzi S, Fattapposta F. Attention in Parkinson's disease with fatigue: evidence from the attention network test. J Neural Transm (Vienna) 2016; 124:335-345. [PMID: 27783210 DOI: 10.1007/s00702-016-1637-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 08/21/2016] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
Fatigue is a non-specific symptom that is common in chronic diseases and represents one of the most disabling symptoms in Parkinson's disease. PD patients often experience cognitive deficits related above all to executive functions. The relationship between cognitive changes and fatigue in PD patients has not been explored in depth. The Attention Network Test (ANT) is a rapid, widely used test to measure the efficiency of three attentional networks, i.e., alerting, orienting, and executive, by evaluating reaction times (RTs) in response to visual stimuli. To assess the association between fatigue and the efficiency of the attentional networks, according to the Posnerian view, ANT was administered to 15 parkinsonian patients with fatigue (PFS-16 > 2.95), 17 parkinsonian patients without fatigue, and 37 age- and sex-matched healthy controls. Anxiety, depression, quality of sleep, and quality of life were also assessed. Parkinsonian patients displayed significantly longer RTs and lower executive network efficiency than controls. Patients with fatigue displayed significantly lower executive network efficiency than patients without fatigue. Moreover, patients with fatigue exhibited a lower accuracy than either patients without fatigue or controls. Finally, patients without fatigue displayed a more efficient alerting network than either patients with fatigue or controls. Although the pathogenesis of fatigue is multifactorial, our results indicate that fatigue may be closely related to an alteration of the striato-thalamo-cortical loop connecting the neostriatum to the prefrontal cortex, which is also responsible for the executive dysfunction that is typical of Parkinson's disease.
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Affiliation(s)
- Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. .,Vaclav Vojta Rehabilitation Center, Via Pincherle 186, 00146, Rome, Italy.
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Nicoletta Locuratolo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Luca Pollini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Antonio Currà
- Academic Neurologic Unit, A. Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Lucio Marinelli
- Department of Neurosciences Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), Institute of Neurology, University of Genova, Largo Daneo 3, 16132, Genova, Italy
| | - Steno Rinalduzzi
- Neurology and Neurophysiopathology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
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Mannarelli D, Pauletti C, De Lucia MC, Delle Chiaie R, Bersani FS, Spagnoli F, Minichino A, Currà A, Trompetto C, Fattapposta F. Effects of cerebellar transcranial direct current stimulation on attentional processing of the stimulus: Evidence from an event-related potentials study. Neuropsychologia 2016; 84:127-35. [DOI: 10.1016/j.neuropsychologia.2016.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 01/08/2023]
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Pauletti C, Mannarelli D, De Lucia MC, Locuratolo N, Currà A, Missori P, Marinelli L, Fattapposta F. Selective attentional deficit in essential tremor: Evidence from the attention network test. Parkinsonism Relat Disord 2015; 21:1306-11. [PMID: 26365776 DOI: 10.1016/j.parkreldis.2015.08.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/08/2015] [Accepted: 08/30/2015] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The traditional view of essential tremor (ET) as a monosymptomatic and benign disorder has been reconsidered after patients with ET have been shown to experience cognitive deficits that are also related to attention. The Attention Network Test (ANT) is a rapid, widely used test to measure the efficiency of three attentional networks, i.e. alerting, orienting and executive, by evaluating reaction times (RTs) in response to visual stimuli. The aim of this study was to investigate attentional functioning in ET patients by means of the ANT. METHODS 21 non-demented patients with ET and 21 age- and sex-matched healthy controls performed the ANT. RESULTS RT was significantly longer in ET patients than in controls (p < 0.001). Moreover, a significant difference in alerting and executive efficiency (p = 0.003 and p = 0.01 respectively) was found between groups, while the difference in the orienting efficiency only bordered on significance. CONCLUSION Our results point to a difficulty in the alerting and executive domains of attention in ET patients, probably owing to a dysfunction in the cerebello-thalamo-cortical loop. These selective attentional deficits are not related to clinical motor symptoms, contributing to shed further light on the clinical picture of ET.
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Affiliation(s)
- Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Maria Caterina De Lucia
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Nicoletta Locuratolo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Sapienza University of Rome, Polo Pontino, Via Firenze, 04019, Terracina, LT, Italy.
| | - Paolo Missori
- Department of Neurology and Psychiatry, Neurosurgery, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
| | - Lucio Marinelli
- Institute of Neurology, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), Largo Daneo 3, University of Genova, 16132, Genova, Italy.
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
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Bersani FS, Minichino A, Fattapposta F, Bernabei L, Spagnoli F, Mannarelli D, Francesconi M, Pauletti C, Corrado A, Vergnani L, Taddei I, Biondi M, Delle Chiaie R. Prefrontocerebellar transcranial direct current stimulation increases amplitude and decreases latency of P3b component in patients with euthymic bipolar disorder. Neuropsychiatr Dis Treat 2015; 11:2913-7. [PMID: 26640377 PMCID: PMC4657792 DOI: 10.2147/ndt.s91625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Neurocognitive impairments have been observed in patients with bipolar disorder (BD) even during the euthymic phase of the disease, potentially representing trait-associated rather than state-associated characteristics of the disorder. In the present study, we used transcranial direct current stimulation (tDCS) applied to cerebellar and prefrontal cortices to improve the neurophysiological performances of patients with euthymic BD. METHODS Twenty-five outpatients with BD underwent open-label prefrontocerebellar tDCS for 3 consecutive weeks. Neurophysiological performances were assessed through the examination of the P3b and P3a subcomponents of P300 event-related potential at baseline and after stimulation. RESULTS Compared to baseline, P3b component after tDCS showed significantly higher amplitude and shorter latency (latency: Fz P=0.02, Cz P=0.03, and Pz P=0.04; amplitude: Fz P=0.24, Cz P=0.02, and Pz P=0.35). CONCLUSION In our sample of patients with euthymic BD, concomitant prefrontoexcitatory and cerebellar-inhibitory modulations led to improved brain information processing stream. This improvement may at least partially result from neuroplastic modulation of prefrontocerebellar circuitry activity.
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Affiliation(s)
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Laura Bernabei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Francesco Spagnoli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Alessandra Corrado
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Lucilla Vergnani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Ines Taddei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Roberto Delle Chiaie
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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Abstract
The role of the cerebellum in cognitive performance and attentional processes is a focus of research in recent years. We investigated the P300 component in a patient with a left posterior cerebellar ischemic stroke during both the acute phase and over 4 weeks of follow-up. After stroke, auditory event-related potentials showed a reduction in P3 amplitude, which appears to improve instead after 4 weeks of follow-up. These event-related potential findings could suggest a specific neural pattern of disruption in selective attention during the discrimination processes of the stimulus following a posterior cerebellar lesion. A recovery is observed in the long term.
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Affiliation(s)
- Daniela Mannarelli
- a Department of Neurology and Psychiatry , Sapienza University of Rome , Rome , Italy
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Pauletti C, Mannarelli D, Grippo A, Currà A, Locuratolo N, De Lucia MC, Fattapposta F. Phasic alertness in a cued double-choice reaction time task: A Contingent Negative Variation (CNV) study. Neurosci Lett 2014; 581:7-13. [DOI: 10.1016/j.neulet.2014.07.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/19/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
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Leuzzi V, Mannarelli D, Manti F, Pauletti C, Locuratolo N, Carducci C, Carducci C, Vanacore N, Fattapposta F. Age-related psychophysiological vulnerability to phenylalanine in phenylketonuria. Front Pediatr 2014; 2:57. [PMID: 25003100 PMCID: PMC4066367 DOI: 10.3389/fped.2014.00057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/23/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Phenylketonuria (PKU) is caused by the inherited defect of the phenylalanine hydroxylase enzyme, which converts phenylalanine (Phe) into tyrosine (Tyr). Neonatal screening programs and early treatment have radically changed the natural history of PKU. Nevertheless, an increased risk of neurocognitive and psychiatric problems in adulthood remains a challenging aspect of the disease. In order to assess the vulnerability of complex skills to Phe, we explored: (a) the effect of a rapid increase in blood Phe levels on event-related potentials (ERP) in PKU subjects during their second decade of life; (b) the association (if existing) between psychophysiological and neurocognitive features. METHODS Seventeen early-treated PKU subjects, aged 10-20, underwent ERP [mismatch negativity, auditory P300, contingent negative variation (CNV), and Intensity Dependence of Auditory Evoked Potentials] recording before and 2 h after an oral loading of Phe. Neurocognitive functioning, historical and concurrent biochemical values of blood Phe, Tyr, and Phe/Tyr ratio, were all included in the statistical analysis. RESULTS Event-related potential components were normally detected in all the subjects. In subjects younger than 13 CNV amplitude, W2-CNV area, P3b latency, and reaction times in motor responses were negatively influenced by Phe-loading. Independently from the psychophysiological vulnerability, some neurocognitive skills were more impaired in younger patients. No correlation was found between biochemical alterations and neurocognitive and psychophysiological findings. CONCLUSION The vulnerability of the emerging neurocognitive functions to Phe suggests a strict metabolic control in adolescents affected by PKU and a neurodevelopmental approach in the study of neurocognitive outcome in PKU.
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Affiliation(s)
- Vincenzo Leuzzi
- Department of Paediatrics, Child Neurology and Psychiatry, Sapienza Università di Roma , Rome , Italy
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza Università di Roma , Rome , Italy
| | - Filippo Manti
- Department of Paediatrics, Child Neurology and Psychiatry, Sapienza Università di Roma , Rome , Italy
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza Università di Roma , Rome , Italy
| | - Nicoletta Locuratolo
- Department of Neurology and Psychiatry, Sapienza Università di Roma , Rome , Italy
| | - Carla Carducci
- Department of Experimental Medicine, Sapienza Università di Roma , Rome , Italy
| | - Claudia Carducci
- Department of Molecular Medicine, Sapienza Università di Roma , Rome , Italy
| | - Nicola Vanacore
- Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità , Rome , Italy
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Mannarelli D, Pauletti C, Locuratolo N, Vanacore N, Frasca V, Trebbastoni A, Inghilleri M, Fattapposta F. Attentional processing in bulbar- and spinal-onset amyotrophic lateral sclerosis: Insights from event-related potentials. Amyotroph Lateral Scler Frontotemporal Degener 2013; 15:30-8. [DOI: 10.3109/21678421.2013.787628] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Mannarelli D, Pauletti C, Locuratolo N, De Lucia M, Vanacore N, Fattapposta F. Involuntary attention in essential tremor: A MMN study. Int J Psychophysiol 2012. [DOI: 10.1016/j.ijpsycho.2012.07.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Locuratolo N, Mannarelli D, Colonnese C, Pauletti C, Antonaci L, Ferretti G, Fattapposta F. Unusual posterior reversible encephalopathy syndrome in a case of influenza A/H1N1 infection. J Neurol Sci 2012; 321:114-6. [PMID: 22910147 DOI: 10.1016/j.jns.2012.07.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 12/09/2022]
Abstract
Central nervous system involvement is an uncommon though potentially a severe complication during influenza infection; the pathogenic mechanisms of the neurological syndromes described in humans are largely unknown. We describe a case of a 51-year-old man who presented with fever and behavioral changes but no focal neurological deficits. The next day, the condition rapidly evolved into a severe neurological syndrome with recurrent focal motor seizures with secondary generalization. At the brain MRI, FLAIR disclosed a slight area of increased signal in the left mesial frontal cortex extending to the frontopolar area and insula. At DWI, a mild hyperintensity was evident in the mesial-frontopolar cortex, with normal ADC values. MR perfusion was indicative of severe hypoperfusion. Fungal, bacterial and viral cultures in CSF, blood and urine were negative. The nasopharyngeal swab PCR was positive for the H1N1-influenza A virus. The patient was thus treated and by day five the neurological examination results had returned to normal. A follow-up MRI, performed two weeks later, only revealed a residual slight hyperintensity in the left medial frontal cortex. The onset of a rapidly evolving encephalopathy syndrome, its close association with a MRI brain pattern of acute vasogenic edema and favorable outcome support a diagnosis of PRES during influenza A infection. However, the topographic characteristics of the cerebral lesion seem to define a PRES with an atypical pattern.
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Pauletti C, Pujia F, Accorinti M, Pauri F, Tinelli E, Bianco F, Morocutti C, Fattapposta F. An atypical case of neuro-Whipple: Clinical presentation, magnetic resonance spectroscopy and follow-up. J Neurol Sci 2010; 297:97-100. [DOI: 10.1016/j.jns.2010.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Revised: 06/29/2010] [Accepted: 07/08/2010] [Indexed: 01/12/2023]
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Affiliation(s)
- P Barbanti
- Department of Neurosciences, University La Sapienza, Rome, Italy.
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Fabbrini G, Barbanti P, Aurilia C, Pauletti C, Vanacore N, Meco G. Excessive daytime somnolence in Parkinson?s disease. Follow-up after 1 year of treatment. Neurol Sci 2003; 24:178-9. [PMID: 14598075 DOI: 10.1007/s10072-003-0118-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [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: 11/29/2022]
Abstract
Excessive daytime somnolence (EDS) and quality of sleep were studied in 25 parkinsonian patients at baseline, when they had not yet received any antiparkinsonian medication, and after 1 year of treatment with dopaminergic drugs. EDS was measured by the Epworth Sleepiness Scale (ESS) and sleep quality by the Pittsburgh Sleep Quality Index (PSQI). At baseline, the ESS score was not different from that of age-matched healthy controls. The mean ESS score increased significantly after 1 year of follow-up, being more than 10 in 12 patients. The mean PSQI also increased significantly after 1 year of treatment, but there were no differences in the number of "bad sleepers" at baseline and at follow-up. In conclusion, EDS seems to emerge during the course of the illness, at least in a proportion of PD patients, and could represent another clinical correlate of the interaction between the ongoing neurodegenerative process and the side effects of drugs.
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Affiliation(s)
- G Fabbrini
- Department of Neurological Sciences, University La Sapienza, Viale dell'Università 30, Rome, Italy
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Fabbrini G, Barbanti P, Aurilia C, Pauletti C, Meco G. Pramipexole in Parkinson's disease. A short-term study using the combined levodopa-dopamine agonist test. Funct Neurol 2002; 17:199-201. [PMID: 12675263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The aim of our study was to investigate the efficacy of pramipexole in advanced parkinsonian patients by means of an acute stimulation test. We studied the motor effects of pramipexole in fluctuating parkinsonian patients by comparing the response to acute levodopa with the response to levodopa + pramipexole. The adjunct of pramipexole to levodopa increased the time spent on from 136 +/- 22.3 to 186 +/- 20.6 minutes (p<0.01), while it did not change the latency to on, the magnitude of the motor improvement, or the duration and severity of dyskinesias. The main effect of pramipexole in fluctuating parkinsonian patients is an increased duration of the on phase.
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Fabbrini G, Barbanti P, Aurilia C, Vanacore N, Pauletti C, Meco G. Excessive daytime sleepiness in de novo and treated Parkinson's disease. Mov Disord 2002; 17:1026-30. [PMID: 12360553 DOI: 10.1002/mds.10193] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [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: 11/06/2022] Open
Abstract
Excessive daytime sleepiness (EDS) in Parkinson's disease (PD) is due to either treatment-related factors or the disease itself. The study of this disturbing phenomenon in de novo parkinsonian patients may contribute to a better understanding of its pathophysiology. We conducted a case control study in which we compared 25 PD patients who had never been treated before with dopaminergic drugs (de novo PD), 50 PD patients being treated with dopaminergic drugs (treated PD), and 25 healthy control subjects, all of whom were matched for age and gender. EDS was measured by means of the Epworth Sleepiness Scale (ESS) and quality of sleep by means of the Pittsburgh Sleep Quality Index (PSQI). ESS and PSQI scores were not statistically different between de novo PD patients and controls, whereas they were significantly higher in treated PD. Differences in ESS score variability were best explained by the treatment effect, whereas there was no clear correlation between PSQI and any of the clinical variables considered.
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Affiliation(s)
- Giovanni Fabbrini
- Department of Neurological Sciences, University La Sapienza, Rome, Italy.
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Abstract
As cholinergic mechanisms may be at least partially responsible for hallucinations and delusions in Parkinson's disease (PD), we conducted an open study in 8 PD patients to assess the efficacy and tolerability of the cholinesterase inhibitor donepezil, 5 mg at bedtime for two months, in the treatment of these complications. Hallucinations and delusions improved significantly in all patients. Donezepil was overall well tolerated, but a deterioration in motor disability was noted in 2 out of 8 patients.
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Affiliation(s)
- G Fabbrini
- Department of Neurological Sciences, La Sapienza University, Viale del'Università 30, I-00185 Rome, Italy
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