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Piscopo P, Crestini A, Carbone E, Rivabene R, Ancidoni A, Lo Giudice M, Corbo M, Vanacore N, Lacorte E. A systematic review on drugs for synaptic plasticity in the treatment of dementia. Ageing Res Rev 2022; 81:101726. [PMID: 36031056 DOI: 10.1016/j.arr.2022.101726] [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: 05/03/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
The aim of the present systematic review (SR) was to provide an overview of all published and unpublished clinical trials investigating the safety and efficacy of disease-modifying drugs targeting synaptic plasticity in dementia. Searches on CT.gov and EuCT identified 27 trials (4 phase-1, 1 phase-1/2, 18 phase-2, 1 phase-2/3, 1 phase-3, 1 phase-4, and 1 not reported). Twenty of them completed, and seven are currently active or enrolling. The structured bibliographic searches yielded 3585 records. A total of 12 studies were selected on Levetiracetam, Masitinib, Saracatinib, BI 40930, Bryostatin 1, PF-04447943 and Edonerpic drugs. We used RoB tool for quality analysis of randomized studies. Efficacy was assessed as a primary outcome in all studies except one and the main scale used was ADAS-Cog (7 studies), MMSE and CDR (4 studies). Safety and tolerability were reported in eleven studies. The incidence of SAEs was similar between treatment and placebo. At the moment, only one molecule reached phase-3. This could suggest that research on these drugs is still preliminary. Of all, three studies reported promising results on Levetiracetam, Bryostatin 1 and Masitinib.
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Affiliation(s)
- P Piscopo
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy.
| | - A Crestini
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - E Carbone
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - R Rivabene
- Department of Neuroscience, Italian National Institute of Health, Rome, Italy
| | - A Ancidoni
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
| | - M Lo Giudice
- Need Institute, Foundation for Cure and Rehabilitation of Neurological Diseases, Milan, Italy
| | - M Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy.
| | - N Vanacore
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
| | - E Lacorte
- National Center for Disease Prevention ad Heath Promotion, Italian National Institute of Health, Rome, Italy
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Bellomo G, Piscopo P, Corbo M, Pupillo E, Stipa G, Beghi E, Vanacore N, Lacorte E. A systematic review on the risk of neurodegenerative diseases and neurocognitive disorders in professional and varsity athletes. Neurol Sci 2022; 43:6667-6691. [PMID: 35976476 PMCID: PMC9663371 DOI: 10.1007/s10072-022-06319-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/06/2022] [Accepted: 08/01/2022] [Indexed: 01/01/2023]
Abstract
Abstract
Objective
The aim of this systematic review (SR) was to gather all available epidemiological evidence on former participation in any type of sport, at a professional and varsity level, as a potential risk factor for neurodegenerative diseases (NDs) and neurocognitive disorders (NCDs).
Design
Systematic searches were performed on PubMed, the Cochrane databases, and the ISI Web of Knowledge databases. Included studies were assessed using the NOS checklist.
Eligibility criteria for selecting studies
All epidemiological studies reporting data on the possible association between a clinical diagnosis of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND), dementia or mild cognitive impairment (MCI), Parkinson’s disease (PD), chronic traumatic encephalopathy (CTE) at any stage and with any clinical pattern and the former participation in any types of sport at a varsity and professional level were included.
Results
Data from the 17 included studies showed a higher frequency of NDs and NCDs in former soccer and American football players. Updating the previous SR confirmed a higher frequency of ALS/MND in former soccer players. Data reported a significantly higher risk of dementia/AD in former soccer players, and of MCI in former American football players. Results also showed a significantly higher risk of PD in former soccer and American football players, and a significantly higher risk of CTE in former boxers and American football players.
Summary/conclusions
This SR confirmed a higher risk of NDs and NCDs in former professional/varsity athletes. However, the pathological mechanisms underlying this association remain unclear, and further high-quality studies should be performed to clarify whether the association could be sport specific.
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Affiliation(s)
- G Bellomo
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.
| | - P Piscopo
- Department of Neurosciences, Italian National Institute of Health, Rome, Italy
| | - M Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - E Pupillo
- Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - G Stipa
- Clinical Neurophysiology Division, Neuroscience Department, S. Maria University Hospital, Terni, Italy
| | - E Beghi
- Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - N Vanacore
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - E Lacorte
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
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Canevelli M, Lacorte E, Cova I, Cascini S, Bargagli AM, Giusti A, Pomati S, Pantoni L, Vanacore N. The emerging issue of cognitive disorders and dementia among migrants. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Due to population aging, people with a migration background are (and will be) increasingly exposed to the burden of chronic, age-related diseases. Specifically, the occurrence of dementia and cognitive disorders in this population of individuals can assume special clinical and public health relevance. The ImmiDem project (GR-2016-02364975) is aimed at characterizing the emerging phenomenon of cognitive disorders in migrants in Italy.
Methods
The number of dementia and mild cognitive impairment (MCI) cases among migrants living in the extended European Union was calculated by applying the age- and gender-specific prevalence rates of these conditions to the population data of international migrants provided by Eurostat. A pilot survey was addressed to a representative sample of Italian centers for cognitive disorders and dementia (CCDDs) with the aim of collecting information on the number of migrants attending these services, the adopted diagnostic, and the possible barriers and resources in the provision of care.
Results
Nearly 700,000 cases of dementia and 680,000 cases of MCI can be estimated in the migrant population living in Europe in 2018. Nevertheless, the number of migrants referred to the surveyed CCDDs was very low and was considered as stable over the last 5 years. Most of CCDDs reported the possibility of contacting cultural mediators and/or interpreters, while only a few reported the availability and regular use of translated and/or cross-cultural cognitive assessment tools.
Conclusions
The data produced by the ImmiDem project allow a preliminary characterization of the emerging phenomenon of cognitive disturbances in the migrant population. The survey will be extended to all Italian dementia services (CDCD, day centers, residential structures). Activities aimed at identifying and promoting dedicated care pathways or good practices will also be conducted.
Key messages
The clinical and epidemiological characterization of cognitive disorders occurring in migrants represent an emerging public health matter for Western countries. The onset of dementia in migrants can result in important clinical-diagnostic and healthcare complexities.
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Affiliation(s)
- M Canevelli
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - E Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - I Cova
- Center for Research and Treatment on Cognitive Dysfunctions, Luigi Sacco University Hospital, Milan, Italy
| | - S Cascini
- Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy
| | - A M Bargagli
- Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy
| | - A Giusti
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - S Pomati
- Center for Research and Treatment on Cognitive Dysfunctions, Luigi Sacco University Hospital, Milan, Italy
| | - L Pantoni
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - N Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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Canevelli M, Lacorte E, Cova I, Zaccaria V, Valletta M, Raganato R, Bruno G, Bargagli AM, Pomati S, Pantoni L, Vanacore N. Estimating dementia cases amongst migrants living in Europe. Eur J Neurol 2019; 26:1191-1199. [PMID: 30968532 DOI: 10.1111/ene.13964] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 11/12/2018] [Accepted: 04/04/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE The phenomenon of dementia amongst migrants and ethnic minorities represents an emerging concern for European healthcare systems, posing additional challenges in terms of clinical approach, access to care and resource utilization. The aim of the present study was to estimate the cases of dementia amongst immigrant older subjects living in Europe and in each European country. METHODS The estimated cases of dementia amongst older (i.e. 65+) migrants living in the European Union (EU-28) and European Free Trade Association member states were calculated by multiplying the number of migrants (obtained through the data provided by Eurostat) with the age- and sex-specific prevalence rates (derived by a recent meta-analysis). RESULTS Overall, 6 507 360 older migrants lived in Europe in 2017. In addition, 1 204 671 migrants were registered in Germany in 2010. Nearly 475 000 dementia cases (329 028 women, 147 410 men) were estimated in this population by applying age- and sex-specific prevalence rates. When considering each European country, the number of estimated cases ranged from 108 (Iceland) to 119 161 (France). In parallel, the proportion of dementia cases occurring in migrants ranged from 0.9% (Czech Republic) to 51.2% (Liechtenstein). CONCLUSIONS The issue of dementia in migrants and ethnic minorities is emerging but already relevant for European healthcare systems. The magnitude of this phenomenon and its complexities reinforce the need for coordinated initiatives both at a national and continental level. These epidemiological data should ideally be integrated with those coming from 'real world' services in order to better calibrate these actions.
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Affiliation(s)
- M Canevelli
- Department of Human Neuroscience, 'Sapienza' University, Rome, Italy.,National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - E Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - I Cova
- Center for Research and Treatment on Cognitive Dysfunctions, 'Luigi Sacco' University Hospital, Milan, Italy
| | - V Zaccaria
- Department of Human Neuroscience, 'Sapienza' University, Rome, Italy
| | - M Valletta
- Department of Human Neuroscience, 'Sapienza' University, Rome, Italy
| | - R Raganato
- Department of Human Neuroscience, 'Sapienza' University, Rome, Italy
| | - G Bruno
- Department of Human Neuroscience, 'Sapienza' University, Rome, Italy
| | - A M Bargagli
- Department of Epidemiology, Regional Health Service, Rome, Italy
| | - S Pomati
- Center for Research and Treatment on Cognitive Dysfunctions, 'Luigi Sacco' University Hospital, Milan, Italy
| | - L Pantoni
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - N Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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Canevelli M, Bruno G, Vico C, Zaccaria V, Lacorte E, Iavicoli I, Vanacore N, Cesari M. Socioeconomic disparities in clinical trials on Alzheimer's disease: a systematic review. Eur J Neurol 2018; 25:626-e43. [PMID: 29383812 DOI: 10.1111/ene.13587] [Citation(s) in RCA: 2] [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: 10/19/2017] [Accepted: 01/19/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE There is now a wide consensus at recognizing social and economic circumstances as main determinants of an individual's health status. Nevertheless, characteristics relating to socioeconomic status (SES) are poorly described in research reports. The aim of the present review was to verify whether the SES of participants is adequately reported in interventional studies targeting Alzheimer's disease (AD), and to explore the impact of SES proxy measures on the efficacy of the considered medications. METHODS A systematic review of available randomized controlled trials (RCTs) on the currently marketed drugs for AD (i.e. cholinesterase inhibitors and memantine) was conducted by performing a structured search on PubMed and the Cochrane databases. The following indicators of SES were considered in the retained studies: (i) educational level, (ii) lifetime job category, (iii) income and (iv) wealth. The study quality was assessed using the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RESULTS A total of 48 articles were finally selected. Overall, only eight RCTs reported data concerning the four considered SES indicators. Indeed, only information pertaining to the educational level of participants was provided. Only one RCT (n = 60) performed ad hoc, secondary analyses accounting for the SES of participating subjects. CONCLUSIONS The research and clinical relevance of SES has mistakenly been overlooked by the vast majority of RCTs on AD. A greater effort should be made to collect and report data on those SES indicators that may significantly affect the clinical manifestations and trajectories of patients with cognitive disturbances.
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Affiliation(s)
- M Canevelli
- Department of Human Neuroscience, Sapienza University, Rome
| | - G Bruno
- Department of Human Neuroscience, Sapienza University, Rome
| | - C Vico
- Department of Human Neuroscience, Sapienza University, Rome
| | - V Zaccaria
- Department of Human Neuroscience, Sapienza University, Rome
| | - E Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome
| | - I Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - N Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome
| | - M Cesari
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan.,Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Cova I, Di Battista ME, Vanacore N, Papi CP, Alampi G, Rubino A, Valente M, Meco G, Contri P, Di Pucchio A, Lacorte E, Priori A, Mariani C, Pomati S. Adaptation and psychometric properties of the Italian version of the Non-Motor Symptoms Questionnaire for Parkinson's disease. Neurol Sci 2017; 38:673-678. [PMID: 28150102 DOI: 10.1007/s10072-017-2830-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/15/2016] [Accepted: 01/24/2017] [Indexed: 11/30/2022]
Abstract
Although non-motor symptoms (NMS) of Parkinson's disease (PD) are very common also in early stages of the disease, they are still under-recognized. Screening tools for non-motor symptoms, such as non-motor symptoms questionnaire (NMSQuest), help clinicians to recognize NMS and to evaluate if patients could require further assessment or specific treatments. To validate an adapted Italian version of NMSQuest and study its psychometric properties, Italian PD patients self-completed Italian NMSQuest, and then underwent a standard clinical evaluation including motor assessment (by Hoehn and Yahr staging, unified Parkinson's disease rating scale part III) and non-motor assessment (by Montreal cognitive assessment, Beck depression inventory, neuropsychiatric inventory, Epworth sleepiness scale, scale for outcomes in Parkinson's disease-Autonomic and movement disorder society-sponsored revision of the unified Parkinson's disease rating scale part I). Somatic comorbidities were quantified using the modified cumulative illness rating scale (CIRS). Seventy-one subjects were assessed (mean age years 69.8 ± 9.6 SD; 31% women; mean duration of disease 6.3 ± 4.6 years; H&Y median 2). Italian NMSQuest showed adequate satisfactory clinimetrics in terms of data quality, precision, acceptability, internal consistency and reliability. A significant correlation was found between NMSQuest and most of non-motor assessment scales, while no significant correlation appeared with motor severity as well as with age of patients, disease duration, levodopa equivalent daily dose, L-DOPA/dopamine agonists assumption and CIRS total score. The Italian version of the NMSQuest resulted as a reliable instrument for screening NMS in Italian PD patients.
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Affiliation(s)
- I Cova
- Department of Clinical Sciences, Institute of Clinical Neurology, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy. .,Neurology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, "San Paolo" University Hospital, Milan, Italy.
| | - M E Di Battista
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy.,Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy
| | - N Vanacore
- National Centre of Epidemiology, National Institute of Health, Rome, Italy
| | - C P Papi
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy
| | - G Alampi
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy
| | - A Rubino
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy
| | - M Valente
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy.,Parkinson's Clinical Trials Centre, Neurological Centre of Latium (NCL), Rome, Italy
| | - G Meco
- Department of Neurology and Psychiatry (Parkinson's Centre) and Research Centre of Social Diseases (CIMS), "Sapienza" University, Rome, Italy.,Parkinson's Clinical Trials Centre, Neurological Centre of Latium (NCL), Rome, Italy
| | - P Contri
- Department of Clinical Sciences, Institute of Clinical Neurology, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy
| | - A Di Pucchio
- National Centre of Epidemiology, National Institute of Health, Rome, Italy
| | - E Lacorte
- National Centre of Epidemiology, National Institute of Health, Rome, Italy
| | - A Priori
- Neurology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, "San Paolo" University Hospital, Milan, Italy
| | - C Mariani
- Department of Clinical Sciences, Institute of Clinical Neurology, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy
| | - S Pomati
- Department of Clinical Sciences, Institute of Clinical Neurology, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy
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Cova I, Di Battista M, Vanacore N, Papi C, Alampi G, Rubino A, Valente M, Meco G, Contri P, Di Pucchio A, Lacorte E, Priori A, Mariani C, Pomati S. Validation of the Italian version of the Non Motor Symptoms Scale for Parkinson's disease. Parkinsonism Relat Disord 2017; 34:38-42. [DOI: 10.1016/j.parkreldis.2016.10.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/05/2016] [Accepted: 10/24/2016] [Indexed: 12/01/2022]
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Ginex V, Vanacore N, Lacorte E, Sozzi M, Pisani L, Corbo M, Clerici F. General cognition predicts post-stroke recovery defined through minimal clinically important difference (MCID): a cohort study in an Italian rehabilitation clinic. Eur J Phys Rehabil Med 2015; 51:597-606. [PMID: 25375185] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In the field of rehabilitation it is crucial to define if changes in functional scores correspond to relevant clinical improvements. AIM To assess whether cognition affects motor recovery in post-stroke patients using a clinical meaningful criterion: the minimal clinically important difference (MCID). DESIGN Retrospective cohort study. SETTING Inpatient rehabilitation clinic POPULATION Two hundred nine first-ever stroke patients undergoing a post-acute inpatient rehabilitation. METHODS Cognitive status was assessed with the cognitive FIM and the Mini-Mental State Examination (MMSE). The response to the rehabilitation was defined as the achievement of the MCID between admission and discharge in the motor FIM (responder) and both in the motor and in the cognitive FIM (best-responder). RESULTS Subjects with a baseline higher MMSE>24.9 had a near four-fold higher probability of being responder (OR 3.91; 95% CI 1.72-8.89) and a two-fold higher probability of being best-responder (OR 2.69; 95% CI 1.24-5.84) on motor FIM as compared to those with a MMSE≤24.9. A duration of the rehabilitation of 55-61 days implies a three-fold higher probability (OR 3.17; 95% CI 1.15-8.72) to be responder as compared to shorter period of treatment; a treatment >61 days does not involve a greater probability of response. CONCLUSIONS This is the first study that examined post-stroke motor recovery mainly in terms of clinical relevance (MCID). Subjects with a higher cognitive level are more likely to achieve a clinically meaningful recovery. CLINICAL REHABILITATION IMPACT MCID can be applied extensively to post-stroke patients undergoing to an inpatient rehabilitation in order to have a clinically useful instrument that assess the recovery.
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Affiliation(s)
- V Ginex
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy -
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