1
|
Cilione M, Martini M, Zampieri F, Riccardi N, Brigo F, Gazzaniga V. Aristotle - Ἀριστοτέλης (ARISTOTÉLĒS, 384/3- 322/1 BCE) The revelation of tuberculosis in his zoological works. Pathog Glob Health 2023; 117:605-610. [PMID: 36458497 PMCID: PMC10392237 DOI: 10.1080/20477724.2022.2143164] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
One of the most challenging issues with the sources of ancient medicine is to be able to identify the correspondence between the diseases we know today and those reported in ancient medical texts. Ancient diseases' definitions rarely help us, and the symptoms described often correspond to more than one disease. This is especially true about tuberculosis, a disease that historians of medicine habitually associates with the Greek words phthi(n)o (φθίνω), verb, phthisis/phthoe (φθίσις/φθόη), noun, phthinodes/phthisikos (φθινώδης/φθισικός), adjective, all etymologically linked to an Indo-European root that expresses the idea of consumption in a broad sense. This article aims to analyze a group of Greek words, branchos/branchia (βράγχος/βράγχια), krauros/kraurao (κραῦρος/κραυράω), and katarreo (καταρρέω), that appear in nosological contexts very close to the infectious disease that today we call tuberculosis. Moreover, the paper aims to focus on the transmission pathways of TB being via animal-human contact and some ancient strategies to cure it. The symptoms, transmission pathways and therapeutic approach of tuberculosis belong to a homogeneous pathological picture that emerges from a set of texts that date back to the period between the fifth century BC and the second century AD.
Collapse
Affiliation(s)
- M. Cilione
- Department of Biomedical, Metabolic and Neural Sciences - University of Modena and Reggio Emilia, Modena, Italy
| | - M. Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - F. Zampieri
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health - Unit of Medical Humanities, University of Padua, Padua, Italy
| | - N. Riccardi
- Infectious Diseases Clinic, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - F. Brigo
- Department of Neurology, Hospital of Merano (Sabes-Asdaa), Merano-Meran, Italy
| | - V. Gazzaniga
- Department of Medico-Surgical Science and Technology – Sapienza, University of Rome, Rome, Italy
| |
Collapse
|
2
|
Nucera B, Rinaldi F, Dono F, Lanzone J, Evangelista G, Consoli S, Tappatà M, Narducci F, Troisi S, Trinka E, Brigo F. Progesterone and its derivatives for the treatment of catamenial epilepsy: A systematic review. Seizure 2023; 109:52-59. [PMID: 37229848 DOI: 10.1016/j.seizure.2023.05.004] [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: 03/10/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Catamenial epilepsy (CE) is defined as an increase in seizure frequency during specific phases of the menstrual cycle in women with epilepsy. The treatment usually includes a combination of non-hormonal and hormonal therapies. This systematic review summarizes the available data on the efficacy of progesterone and its derivates to treat CE. METHODS We performed a systematic search of the literature to identify studies reporting data on the use of progesterone and its derivatives (any type and dose) for the treatment of CE. The main outcome included the efficacy of progesterone and its derivatives on seizure frequency. RESULTS Nineteen articles (457 patients) were included; four were randomized controlled trials (two comparing progesterone vs placebo and two comparing norethisterone vs placebo). Progesterone was generally administered during the luteal phase (from day 15 to 25) or during perimenstrual exacerbations (from day 23 to 25), with an average dose of 10-30 mg/day to a maximum of 300 mg/day. The therapy, usually well tolerated, was ineffective in the randomized controlled trials; conversely, it was associated with an overall reduction in seizure frequency in case reports and uncontrolled studies. CONCLUSIONS Although data from uncontrolled studies suggest that hormone therapy with progesterone may be useful in the treatment of CE, its efficacy has not been demonstrated in controlled trials. The possible antiseizure effect of progesterone could be mediated by its active metabolite allopregnanolone, making the plasmatic measurement of these hormones mandatory to evaluate efficacy. Further randomized controlled trials should investigate the efficacy of progesterone and its derivatives, addressing these pharmacological issues.
Collapse
Affiliation(s)
- B Nucera
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano, Italy; Paracelsus Medical University, A-5020 Salzburg, Austria.
| | - F Rinaldi
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano, Italy; Paracelsus Medical University, A-5020 Salzburg, Austria
| | - F Dono
- Department of Neuroscience, Imaging and Clinical Science, ''G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - J Lanzone
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Milan Institute, Italy
| | - G Evangelista
- Department of Neuroscience, Imaging and Clinical Science, ''G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - S Consoli
- Department of Neuroscience, Imaging and Clinical Science, ''G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - M Tappatà
- IRCCS Istituto delle Scienze Neurolgiche di Bologna, Ospedale Bellaria, Italy
| | - F Narducci
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Italy
| | - S Troisi
- Pediatric Neurology, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - E Trinka
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience, Member of the ERN EpiCARE, Salzburg, Austria
| | - F Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano, Italy
| |
Collapse
|
3
|
Brigo F, Lorusso L, Walusinski O, Drouin E. Voices from the past: The pioneering use of the phonograph in neurology. Rev Neurol (Paris) 2023; 179:137-140. [PMID: 36150939 DOI: 10.1016/j.neurol.2022.06.007] [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: 03/28/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 10/14/2022]
Abstract
Since its discovery by the American inventor and industrialist Thomas Alva Edison (1847-1931) in 1877, the phonograph attracted much interest in the field of medicine. This article describes the earliest pioneering examples of the use of the phonograph in neurology. In France, the use of the phonograph for obtaining audio recordings of delusions and speech or language disturbances was first proposed by Victor Maurice Dupont (1857-1910) in 1889 and in Italy by the physician Gaetano Rummo (1853-1917), who had studied at La Salpêtrière under Jean-Martin Charcot (1825-1893). The applicability of the phonograph to the record of speech disturbances was illustrated in England by John Hughlings Jackson (1835-1911) and William Halse Rivers (1864-1922), and by William Hale White (1857-1949) and Cuthbert Hilton Golding-Bird (1848-1939) in 1891. Since then, audio recordings have been used rarely in neurology, a branch of medicine where the visual aspects dominate, to the extent that inspection can be enough to reach a definite clinical diagnosis. In the mid-20th century, the advent of audio and video recordings supplanted audio recordings alone, relegating them to a very marginal role.
Collapse
Affiliation(s)
- F Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano, Italy.
| | - L Lorusso
- UOC Neurology and Stroke Unit, ASST Lecco, Merate, Italy
| | | | - E Drouin
- Service de neurologie, groupe hospitalier de l'institut catholique de Lille, GHICL, Lille, France
| | | |
Collapse
|
4
|
Abbadessa G, Brigo F, Clerico M, De Mercanti S, Trojsi F, Tedeschi G, Bonavita S, Lavorgna L. Digital therapeutics in neurology. J Neurol 2021; 269:1209-1224. [PMID: 34018047 PMCID: PMC8136262 DOI: 10.1007/s00415-021-10608-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 12/14/2022]
Abstract
Digital therapeutics (DTx) is a section of digital health defined by the DTx Alliance as “delivering evidence-based therapeutic interventions to patients that are driven by software to prevent, manage, or treat a medical disorder or disease. They are used independently or in concert with medications, devices, or other therapies to optimize patient care and health outcomes”. Chronic disabling diseases could greatly benefit from DTx. In this narrative review, we provide an overview of DTx in the care of patients with neurological dysfunctions.
Collapse
Affiliation(s)
- G Abbadessa
- Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), 39012, Naples, Italy
| | - M Clerico
- Clinical and Biological Sciences Department, University of Torino, 10124, Turin, Italy
| | - S De Mercanti
- Clinical and Biological Sciences Department, University of Torino, 10124, Turin, Italy
| | - F Trojsi
- Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Tedeschi
- Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - S Bonavita
- Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - L Lavorgna
- Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy.
| |
Collapse
|
5
|
Rohracher A, Kalss G, Kuchukhidze G, Neuray C, Leitinger M, Höfler J, Kreidenhuber R, Rossini F, Volna K, Mauritz M, Poppert N, Lattanzi S, Brigo F, Trinka E. New anti-seizure medication for elderly epilepsy patients - a critical narrative review. Expert Opin Pharmacother 2020; 22:621-634. [PMID: 33111598 DOI: 10.1080/14656566.2020.1843636] [Citation(s) in RCA: 13] [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] [Indexed: 10/23/2022]
Abstract
Introduction: The number of elderly patients with epilepsy is growing in resource rich countries due to demographic changes and increased longevity. Management in these patients is challenging as underlying etiology, co-morbidities, polypharmacy, age-related pharmacokinetic and pharmacodynamic changes need to be considered.Areas covered: Lacosamide, eslicarbazepine acetate, brivaracetam, and perampanel have been approved in the USA and Europe for monotherapy and/or adjunctive treatment of seizures in the last few years. The authors review the pharmacological properties and safety profile of these drugs and provide recommendations for their use in in the elderly.Expert opinion: There are only limited data available on more recent antiseizure medications (ASMs). Drugs with a low risk of interaction (lacosamide, brivaracetam) are preferred choices. Once daily formulations (perampanel and eslicarbazepine acetate) have the advantage of increased compliance. Intravenous formulations (brivaracetam and lacosamide) are useful in emergency situations and in patients who have difficulties to swallow. Dose adjustments are necessary for all ASMs used in the elderly with slow titration and lower target doses than in the regulatory trials. The adverse event profile does not significantly differ from that found in the general adult population.
Collapse
Affiliation(s)
- A Rohracher
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - G Kalss
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - G Kuchukhidze
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - C Neuray
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - M Leitinger
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - J Höfler
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - R Kreidenhuber
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - F Rossini
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - K Volna
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - M Mauritz
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - N Poppert
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| | - S Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - F Brigo
- Department of Neurology, Franz Tappeiner Hospital, Meran, Italy
| | - E Trinka
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, affiliated partner of the ERN EpiCARE Center for Cognitive Neuroscience, Paracelsus Medical University Salzburg, and Christian Doppler Medical Centre, Salzburg, Austria
| |
Collapse
|
6
|
Brigo F, Lattanzi S, Giussani G, Tassi L, Pietrafusa N, Galimberti CA, Bragazzi NL, Mecarelli O. A cross-sectional survey among physicians on internet use for epilepsy-related information. Epilepsy Res 2020; 165:106393. [PMID: 32544785 DOI: 10.1016/j.eplepsyres.2020.106393] [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: 04/22/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to identify factors associated with the attitude of being influenced by information found on the Internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8 % of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9 %) or to confirm a diagnostic or therapeutic decision (37.3 %). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95 %CI: 1.28-6.76; p = 0.011), higher frequency of Internet use (OR: 3.66; 95 %CI: 1.56-9.21; p = 0.006) and higher confidence in reliability of online information (OR: 2.61; 95 %CI: 1.09-6.26; p = 0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSION Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.
Collapse
Affiliation(s)
- F Brigo
- Hospital Franz Tappeiner, Department of Neurology, Merano, Italy.
| | - S Lattanzi
- Marche Polytechnic University, Neurological Clinic, Department of Experimental and Clinical Medicine, Ancona, Italy
| | - G Giussani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Laboratory of Neurological Disorders, Department of Neuroscience, Milan, Italy
| | - L Tassi
- Niguarda Hospital, 'Claudio Munari' Epilepsy Surgery Centre, Milan, Italy
| | - N Pietrafusa
- Bambino Gesù Children's Hospital, IRCCS, Department of Neuroscience, Rome, Italy
| | - C A Galimberti
- IRCCS C. Mondino National Neurological Institute, Epilepsy Centre, Pavia, Italy
| | - N L Bragazzi
- School of Public Health, University of Genoa, Department of Health Sciences (DISSAL), Genoa, Italy
| | - O Mecarelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
7
|
Zelano J, Brigo F, Garcia‐Patek S. Increased risk of epilepsy in patients registered in the Swedish Dementia Registry. Eur J Neurol 2019; 27:129-135. [DOI: 10.1111/ene.14043] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/15/2019] [Indexed: 01/03/2023]
Affiliation(s)
- J. Zelano
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy Gothenburg University GothenburgSweden
- Department of Neurology Sahlgrenska University Hospital Gothenburg Sweden
| | - F. Brigo
- Department of Neuroscience, Biomedicine and Movement Science University of Verona VeronaItaly
- Division of Neurology ‘Franz Tappeiner’ Hospital Merano Italy
| | - S. Garcia‐Patek
- Department of Neurobiology, Care Sciences and Society Division of Clinical Geriatrics Karolinska Institutet StockholmSweden
- Internal Medicine Section for Neurology Södersjukhuset Stockholm Sweden
| |
Collapse
|
8
|
Lattanzi S, Trinka E, Russo E, Striano P, Citraro R, Silvestrini M, Brigo F. Cannabidiol as adjunctive treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome. Drugs Today (Barc) 2019; 55:177-196. [DOI: 10.1358/dot.2019.55.3.2909248] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
9
|
Brigo F, Lattanzi S. Consensus on diagnosis and management of psychogenic non-epileptic seizures: a wide view of a challenging condition. Eur J Neurol 2018; 26:203-204. [PMID: 30326171 DOI: 10.1111/ene.13842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F Brigo
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona.,Department of Neurology, Franz Tappeiner Hospital, Merano
| | - S Lattanzi
- Neurological Clinic, Marche Polytechnic University, Ancona, Italy
| |
Collapse
|
10
|
Brigo F, Lattanzi S, Zelano J, Bragazzi N, Belcastro V, Nardone R, Trinka E. Randomized controlled trials of antiepileptic drugs for the treatment of post-stroke seizures: A systematic review with network meta-analysis. Seizure 2018; 61:57-62. [DOI: 10.1016/j.seizure.2018.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/23/2018] [Accepted: 08/02/2018] [Indexed: 12/26/2022] Open
|
11
|
Brigo F, Trinka E. Lessons from the past: Hyperthermia in status epilepticus in the first descriptions by Désiré-Magloire Bourneville (1840-1909). Epilepsy Behav 2018; 85:248-249. [PMID: 29887402 DOI: 10.1016/j.yebeh.2018.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 05/19/2018] [Indexed: 11/18/2022]
Affiliation(s)
- F Brigo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Division of Neurology, "Franz Tappeiner" Hospital, Merano, Italy.
| | - E Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Center for Cognitive Neuroscience, Salzburg, Austria; Public Health, Health Services Research and HTA, University for Health Sciences, Medical Informatics and Technology, Hall i.T, Austria
| |
Collapse
|
12
|
Nardone R, Brigo F, Höller Y, Sebastianelli L, Versace V, Saltuari L, Lochner P, Trinka E. Transcranial magnetic stimulation studies in complex regional pain syndrome type I: A review. Acta Neurol Scand 2018; 137:158-164. [PMID: 28971481 DOI: 10.1111/ane.12852] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 01/23/2023]
Abstract
The sensory and motor cortical representation corresponding to the affected limb is altered in patients with complex regional pain syndrome (CRPS). Transcranial magnetic stimulation (TMS) represents a useful non-invasive approach for studying cortical physiology. If delivered repetitively, TMS can also modulate cortical excitability and induce long-lasting neuroplastic changes. In this review, we performed a systematic search of all studies using TMS to explore cortical excitability/plasticity and repetitive TMS (rTMS) for the treatment of CRPS. Literature searches were conducted using PubMed and EMBASE. We identified 8 articles matching the inclusion criteria. One hundred fourteen patients (76 females and 38 males) were included in these studies. Most of them have applied TMS in order to physiologically characterize CRPS type I. Changes in motor cortex excitability and brain mapping have been reported in CRPS-I patients. Sensory and motor hyperexcitability are in the most studies bilateral and likely involve corresponding regions within the central nervous system rather than the entire hemisphere. Conversely, sensorimotor integration and plasticity were found to be normal in CRPS-I. TMS examinations also revealed that the nature of motor dysfunction in CRPS-I patients differs from that observed in patients with functional movement disorders, limb immobilization, or idiopathic dystonia. TMS studies may thus lead to the implementation of correct rehabilitation strategies in CRPS-I patients. Two studies have begun to therapeutically use rTMS. This non-invasive brain stimulation technique could have therapeutic utility in CRPS, but further well-designed studies are needed to corroborate initial findings.
Collapse
Affiliation(s)
- R. Nardone
- Department of Neurology Franz Tappeiner Hospital Merano Italy
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg Austria
| | - F. Brigo
- Department of Neurology Franz Tappeiner Hospital Merano Italy
- Department of Neuroscience, Biomedicine and Movement Science University of Verona Verona Italy
| | - Y. Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
| | - L. Sebastianelli
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
| | - V. Versace
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
| | - L. Saltuari
- Department of Neurorehabilitation Hospital of Vipiteno, and Research Department for Neurorehabilitation South Tyrol Bolzano Italy
- Department of Neurology Hochzirl Hospital Zirl Austria
| | - P. Lochner
- Department of Neurology Saarland University Medical Center Homburg Germany
| | - E. Trinka
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience Paracelsus Medical University Salzburg Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg Austria
- University for Medical Informatics and Health Technology, UMIT Hall in Tirol Austria
| |
Collapse
|
13
|
Brigo F, Bragazzi NL, Lattanzi S, Nardone R, Trinka E. A critical appraisal of randomized controlled trials on intravenous phenytoin in convulsive status epilepticus. Eur J Neurol 2018; 25:451-463. [PMID: 29288520 DOI: 10.1111/ene.13560] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 10/27/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022]
Abstract
Since the 1970s, intravenous (IV) phenytoin (PHT) has traditionally been used as second-stage treatment for convulsive status epilepticus (SE) after failure of benzodiazepines. The aim of this review was to critically assess the evidence supporting the use of IV PHT as treatment of convulsive SE in patients of any age. In particular, we critically appraised the results of randomized controlled trials (RCTs) evaluating IV PHT as treatment of convulsive SE. A systematic search of the literature was carried out to identify RCTs evaluating IV PHT as treatment of convulsive SE in patients of any age. Eight RCTs (544 patients allocated to IV PHT) were included. The included studies differed in almost every single characteristic considered. Six RCTs (472 patients) used IV PHT without demonstrating refractoriness of SE to benzodiazepines. Only two RCTs (72 patients) used IV PHT as second-line treatment for benzodiazepine-resistant convulsive SE. Overall, most evidence from RCTs supports the use of IV PHT immediately after IV diazepam, even if seizures have not recurred. The recommendation derived from RCTs supporting the use of IV PHT as second-line treatment in benzodiazepine-resistant convulsive SE is weak. This is emblematic of the lack of robust evidence from large RCTs to inform clinical practice on how to treat SE after failure of first-line drugs. IV PHT given immediately after first-line benzodiazepines could prolong their short antiepileptic effect and prevent seizure recurrence.
Collapse
Affiliation(s)
- F Brigo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona.,Department of Neurology, Franz Tappeiner Hospital, Merano
| | - N L Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa
| | - S Lattanzi
- Neurological Clinic, Marche Polytechnic University, Ancona, Italy
| | - R Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano.,Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg
| | - E Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg.,Center for Cognitive Neuroscience, Salzburg.,Public Health, Health Services Research and HTA, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| |
Collapse
|
14
|
Sebastianelli L, Versace V, Martignago S, Brigo F, Trinka E, Saltuari L, Nardone R. Low-frequency rTMS of the unaffected hemisphere in stroke patients: A systematic review. Acta Neurol Scand 2017; 136:585-605. [PMID: 28464421 DOI: 10.1111/ane.12773] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2017] [Indexed: 01/02/2023]
Abstract
The aim of this review was to summarize the evidence for the effectiveness of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the unaffected hemisphere in promoting functional recovery after stroke. We performed a systematic search of the studies using LF-rTMS over the contralesional hemisphere in stroke patients and reviewed the 67 identified articles. The studies have been gathered together according to the time interval that had elapsed between the stroke onset and the beginning of the rTMS treatment. Inhibitory rTMS of the contralesional hemisphere can induce beneficial effects on stroke patients with motor impairment, spasticity, aphasia, hemispatial neglect and dysphagia, but the therapeutic clinical significance is unclear. We observed considerable heterogeneity across studies in the stimulation protocols. The use of different patient populations, regardless of lesion site and stroke aetiology, different stimulation parameters and outcome measures means that the studies are not readily comparable, and estimating real effectiveness or reproducibility is very difficult. It seems that careful experimental design is needed and it should consider patient selection aspects, rTMS parameters and clinical assessment tools. Consecutive sessions of rTMS, as well as the combination with conventional rehabilitation therapy, may increase the magnitude and duration of the beneficial effects. In an increasing number of studies, the patients have been enrolled early after stroke. The prolonged follow-up in these patients suggests that the effects of contralesional LF-rTMS can be long-lasting. However, physiological evidence indicating increased synaptic plasticity, and thus, a more favourable outcome, in the early enrolled patients, is still lacking. Carefully designed clinical trials designed are required to address this question. LF rTMS over unaffected hemisphere may have therapeutic utility, but the evidence is still preliminary and the findings need to be confirmed in further randomized controlled trials.
Collapse
Affiliation(s)
- L. Sebastianelli
- Department of Neurorehabilitation; Hospital of Vipiteno; Vipiteno Italy
- Research Unit for Neurorehabilitation of South Tyrol; Bolzano Italy
| | - V. Versace
- Department of Neurorehabilitation; Hospital of Vipiteno; Vipiteno Italy
- Research Unit for Neurorehabilitation of South Tyrol; Bolzano Italy
| | - S. Martignago
- Department of Neurorehabilitation; Hospital of Vipiteno; Vipiteno Italy
- Research Unit for Neurorehabilitation of South Tyrol; Bolzano Italy
| | - F. Brigo
- Department of Neurology; Franz Tappeiner Hospital; Merano Italy
- Department of Neurosciences, Biomedicine and Movement Sciences; University of Verona; Verona Italy
| | - E. Trinka
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
| | - L. Saltuari
- Research Unit for Neurorehabilitation of South Tyrol; Bolzano Italy
- Department of Neurology; Hochzirl Hospital; Zirl Austria
| | - R. Nardone
- Department of Neurology; Franz Tappeiner Hospital; Merano Italy
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
| |
Collapse
|
15
|
Nardone R, Höller Y, Langthaler PB, Lochner P, Golaszewski S, Schwenker K, Brigo F, Trinka E. rTMS of the prefrontal cortex has analgesic effects on neuropathic pain in subjects with spinal cord injury. Spinal Cord 2016; 55:20-25. [DOI: 10.1038/sc.2016.87] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/26/2015] [Accepted: 11/30/2015] [Indexed: 01/24/2023]
|
16
|
Bongiovanni L, Barbieri F, Rossini F, Brigo F, Paluani F, Fondrieschi L, Marchi SD, Monaco S. 49. Disrupted autonomic control in spinal cord injury. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.057] [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: 11/15/2022]
|
17
|
Nardone R, Höller Y, Thomschewski A, Bathke AC, Ellis AR, Golaszewski SM, Brigo F, Trinka E. Assessment of corticospinal excitability after traumatic spinal cord injury using MEP recruitment curves: a preliminary TMS study. Spinal Cord 2015; 53:534-8. [PMID: 25665538 DOI: 10.1038/sc.2015.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 12/30/2014] [Accepted: 01/08/2015] [Indexed: 12/20/2022]
Abstract
STUDY DESIGN Transcranial magnetic stimulation study. OBJECTIVES To further investigate the corticospinal excitability changes after spinal cord injury (SCI), as assessed by means of transcranial magnetic stimulation (TMS). SETTING Merano (Italy) and Salzburg (Austria). METHODS We studied resting motor threshold (RMT), motor evoked potential (MEP) amplitude and recruitment curve in five subjects with good recovery after traumatic incomplete cervical SCI. RESULTS RMT did not differ significantly between patients and controls, whereas the slope of MEP recruitment curve was significantly increased in the patients. CONCLUSION This abnormal finding may represent an adaptive response after SCI. The impaired ability of the motor cortex to generate proper voluntary movement may be compensated by increasing spinal excitability. The easily performed measurement of MEP recruitment curve may provide a useful additional tool to improve the assessment and monitoring of motor cortical function in subjects with SCI. Increasing our knowledge of the corticospinal excitability changes in the functional recovery after SCI may also support the development of effective therapeutic strategies.
Collapse
Affiliation(s)
- R Nardone
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [3] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - Y Höller
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - A Thomschewski
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - A C Bathke
- 1] Department of Mathematics, Paris Lodron University, Salzburg, Austria [2] Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - A R Ellis
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - S M Golaszewski
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria
| | - F Brigo
- 1] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [2] Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - E Trinka
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
18
|
Nardone R, Höller Y, Thomschewski A, Brigo F, Orioli A, Höller P, Golaszewski S, Trinka E. rTMS modulates reciprocal inhibition in patients with traumatic spinal cord injury. Spinal Cord 2014; 52:831-5. [PMID: 25112970 DOI: 10.1038/sc.2014.136] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/20/2014] [Accepted: 07/13/2014] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Randomized, double-blind, crossover, sham-controlled trial. OBJECTIVES Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) leads to a significant reduction of spasticity in subjects with spinal cord injury (SCI), but the physiological basis of this effect is still not well understood. The purpose of this study was to evaluate the disynaptic reciprocal Ia inhibition of soleus motoneurons in SCI patients. SETTING Department of Neurology, Merano, Italy and TMS Laboratory, Paracelsus Medical University, Salzburg, Austria. METHODS Nine subjects with incomplete cervical or thoracic SCI received 5 days of daily sessions of real or sham rTMS applied over the contralateral M1. We compared the reciprocal inhibition, the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool for Spasticity at baseline, after the last session and 1 week later in the real rTMS and sham stimulation groups. RESULTS We found that real rTMS significantly reduced lower limb spasticity and restored the impaired excitability in the disynaptic reciprocal inhibitory pathway. CONCLUSIONS In a small proof-of-concept study, rTMS strengthened descending projections between the motor cortex and inhibitory spinal interneuronal circuits. This reversed a defect in reciprocal inhibition after SCI, and reduced leg spasticity.
Collapse
Affiliation(s)
- R Nardone
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [3] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - Y Höller
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - A Thomschewski
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - F Brigo
- 1] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [2] Department of Neurological, Neuropsychological, Morphological and Movement Sciences. Section of Clinical Neurology, University of Verona, Verona, Italy
| | - A Orioli
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
| | - P Höller
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - S Golaszewski
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - E Trinka
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
19
|
Lochner P, Cantello R, Brigo F, Coppo L, Nardone R, Tezzon F, Raymkulova O, Strigaro G, Comi C, Leone MA. Transorbital sonography in acute optic neuritis: a case-control study. AJNR Am J Neuroradiol 2014; 35:2371-5. [PMID: 25034772 DOI: 10.3174/ajnr.a4051] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Acute unilateral optic neuritis is associated with a thickening of the retrobulbar portion of the optic nerve as revealed by transorbital sonography, but no comparison has been made between nerve sheath diameter and optic nerve diameter in patients with acute optic neuritis versus healthy controls. We evaluated optic nerve sheath diameter and optic nerve diameter in patients with acute optic neuritis and healthy controls and compared optic nerve sheath diameter and optic nerve diameter with visual-evoked potentials in patients. MATERIALS AND METHODS A case-control study was performed in 2 centers. Twenty-one consecutive patients with onset of visual loss during the prior 10 days and established acute noncompressive unilateral optic neuritis were compared with 21 healthy controls, matched for sex and age (±5 years). Two experienced vascular sonographers performed the study by using B-mode transorbital sonography. Visual-evoked potentials were performed on the same day as the transorbital sonography and were evaluated by an expert neurophysiologist. Sonographers and the neurophysiologist were blinded to the status of the patient or control and to clinical information, including the side of the affected eye. RESULTS The median optic nerve sheath diameter was thicker on the affected side (6.3 mm; interquartile range, 5.9-7.2 mm) compared with the nonaffected side (5.5 mm; interquartile range, 5.1-6.2 mm; P < .0001) and controls (5.2 mm; interquartile range, 4.8-5.5 mm; P < .0001). The median optic nerve diameter was 3.0 mm (range, 2.8-3.1 mm) on the affected side and 2.9 mm (range, 2.8-3.1 mm) on the nonaffected side (P = not significant.). Both sides were thicker than those in controls (2.7 mm; interquartile range, 2.5-2.8 mm; P = .001 and .009). No correlation was found between optic nerve sheath diameter and optic nerve diameter and amplitude and latency of visual-evoked potentials in patients with optic neuritis. CONCLUSIONS Transorbital sonography is a promising tool to support the clinical diagnosis of acute optic neuritis. Further studies are needed to define its specific role in the diagnosis and follow-up of optic neuritis.
Collapse
Affiliation(s)
- P Lochner
- From the Department of Neurology (P.L., F.B., F.T.), General Hospital, Merano, Italy Section of Neurology (P.L., R.C., L.C., G.S., C.C.), Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro," Novara, Italy
| | - R Cantello
- Section of Neurology (P.L., R.C., L.C., G.S., C.C.), Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro," Novara, Italy
| | - F Brigo
- From the Department of Neurology (P.L., F.B., F.T.), General Hospital, Merano, Italy Department of Neurological and Movement Sciences (F.B.), Section of Clinical Neurology, University of Verona, Verona, Italy
| | - L Coppo
- Section of Neurology (P.L., R.C., L.C., G.S., C.C.), Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro," Novara, Italy
| | - R Nardone
- Department of Neurology (R.N.), Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
| | - F Tezzon
- From the Department of Neurology (P.L., F.B., F.T.), General Hospital, Merano, Italy
| | - O Raymkulova
- Head and Neck Department (O.R.), SCDU Neurology, MS Centre, AOU "Maggiore della Carità," Novara, Italy
| | - G Strigaro
- Section of Neurology (P.L., R.C., L.C., G.S., C.C.), Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro," Novara, Italy
| | - C Comi
- Section of Neurology (P.L., R.C., L.C., G.S., C.C.), Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro," Novara, Italy Interdisciplinary Research Center of Autoimmune Diseases (C.C., M.A.L.), Novara, Italy
| | - M A Leone
- Interdisciplinary Research Center of Autoimmune Diseases (C.C., M.A.L.), Novara, Italy
| |
Collapse
|
20
|
Nardone R, Tezzon F, Höller Y, Golaszewski S, Trinka E, Brigo F. Transcranial magnetic stimulation (TMS)/repetitive TMS in mild cognitive impairment and Alzheimer's disease. Acta Neurol Scand 2014; 129:351-66. [PMID: 24506061 DOI: 10.1111/ane.12223] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2014] [Indexed: 12/20/2022]
Abstract
Several Transcranial Magnetic Stimulation (TMS) techniques can be applied to noninvasively measure cortical excitability and brain plasticity in humans. TMS has been used to assess neuroplastic changes in Alzheimer's disease (AD), corroborating findings that cortical physiology is altered in AD due to the underlying neurodegenerative process. In fact, many TMS studies have provided physiological evidence of abnormalities in cortical excitability, connectivity, and plasticity in patients with AD. Moreover, the combination of TMS with other neurophysiological techniques, such as high-density electroencephalography (EEG), makes it possible to study local and network cortical plasticity directly. Interestingly, several TMS studies revealed abnormalities in patients with early AD and even with mild cognitive impairment (MCI), thus enabling early identification of subjects in whom the cholinergic degeneration has occurred. Furthermore, TMS can influence brain function if delivered repetitively; repetitive TMS (rTMS) is capable of modulating cortical excitability and inducing long-lasting neuroplastic changes. Preliminary findings have suggested that rTMS can enhance performances on several cognitive functions impaired in AD and MCI. However, further well-controlled studies with appropriate methodology in larger patient cohorts are needed to replicate and extend the initial findings. The purpose of this paper was to provide an updated and comprehensive systematic review of the studies that have employed TMS/rTMS in patients with MCI and AD.
Collapse
Affiliation(s)
- R. Nardone
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
- Department of Neurology; Franz Tappeiner Hospital; Merano Italy
| | - F. Tezzon
- Department of Neurology; Franz Tappeiner Hospital; Merano Italy
| | - Y. Höller
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
| | - S. Golaszewski
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
| | - E. Trinka
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
| | - F. Brigo
- Department of Neurology; Franz Tappeiner Hospital; Merano Italy
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences; Section of Clinical Neurology; University of Verona; Verona Italy
| |
Collapse
|
21
|
Brigo F, Matinella A, Erro R, Tinazzi M. [¹²³I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis. Eur J Neurol 2014; 21:1369-e90. [PMID: 24779862 DOI: 10.1111/ene.12444] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [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: 11/19/2013] [Accepted: 03/03/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating idiopathic Parkinson's disease from secondary parkinsonian syndromes is crucial since their management and prognosis differ considerably. Functional imaging of the dopaminergic pathway by means of [¹²³I]FP-CIT SPECT (DaTSCAN) might be useful in this regard, but its role is still controversial. The accuracy of DaTSCAN in the differential diagnosis between Parkinson's disease and vascular or drug-induced parkinsonism was therefore systematically reviewed. METHODS MEDLINE and CENTRAL were searched for studies aiming to determine accuracy measures (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism. RESULTS Five studies were included. Pooled accuracy measures in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism were relatively high, with sensitivity and specificity values above 85% and 80%, respectively. CONCLUSIONS DaTSCAN might accurately differentiate between early Parkinson's disease and secondary parkinsonian conditions, namely vascular or drug-induced, in patients with clinically unclear parkinsonism. However, all the studies reviewed here show several methodological limits, which prevent definitive conclusions on the role of DaTSCAN being drawn in this context. Further studies are needed to confirm our results and definitely evaluate the utility of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism.
Collapse
Affiliation(s)
- F Brigo
- Divisione di Neurologia, Ospedale 'Franz Tappeiner', Merano, Italy; Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy
| | | | | | | |
Collapse
|
22
|
Brigo F, Storti M, Lochner P, Tezzon F, Nardone R. Selenium supplementation for primary prevention of cardiovascular disease: proof of no effectiveness. Nutr Metab Cardiovasc Dis 2014; 24:e2-e3. [PMID: 24418382 DOI: 10.1016/j.numecd.2013.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 08/20/2013] [Indexed: 11/23/2022]
Affiliation(s)
- F Brigo
- Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy; Division of Neurology, Franz Tappeiner Hospital, Merano, Italy.
| | - M Storti
- Division of Internal Medicine, Franz Tappeiner Hospital, Merano, Italy
| | - P Lochner
- Division of Neurology, Franz Tappeiner Hospital, Merano, Italy
| | - F Tezzon
- Division of Neurology, Franz Tappeiner Hospital, Merano, Italy
| | - R Nardone
- Division of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
23
|
Nardone R, Zuccoli G, Brigo F, Trinka E, Golaszewski S. Cerebral toxoplasmosis following adalimumab treatment in rheumatoid arthritis. Rheumatology (Oxford) 2013; 53:284. [DOI: 10.1093/rheumatology/ket364] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
24
|
Bongiovanni L, Rossini F, Barbieri F, Riva SD, Paluani F, Fondreschi L, Brigo F, Marchi ED, Monaco S. 129. Heart rate variability in patients with spinal cord injuries. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.156] [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: 11/29/2022]
|
25
|
Brigo F, Tezzon F, Bongiovanni L, Nardone R. Common reference-based indirect comparison meta-analysis of intravenous valproate versus intravenous phenobarbitone in generalized convulsive status epilepticus. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.064] [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: 11/26/2022]
|
26
|
Lochner P, Cantello R, Coppo L, Nardone R, Tezzon F, Raymkulova O, Leone M, Brigo F. Transorbital sonography in the hyperacute stage of optic neuritis: A bicentric case–/INS;control longitudinal, blind study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1373] [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: 10/26/2022]
|
27
|
Brigo F, Rossini F, Stefani A, Nardone R, Tezzon F, Fiaschi A, Manganotti P, Bongiovanni L. Fixation-off sensitivity. Clin Neurophysiol 2013; 124:221-7. [DOI: 10.1016/j.clinph.2012.07.017] [Citation(s) in RCA: 14] [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] [Received: 06/20/2012] [Revised: 07/19/2012] [Accepted: 07/30/2012] [Indexed: 11/24/2022]
|
28
|
Brigo F. Das Auge des Minnesängers. Klin Monbl Augenheilkd 2012; 229:650. [DOI: 10.1055/s-0032-1312780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F. Brigo
- Klinik für Neurologie, Universität Verona, Italien
| |
Collapse
|
29
|
Abstract
Aim of this review was to evaluate efficacy and safety of intravenous valproate (IV VPA) in the treatment of generalized convulsive status epilepticus (GCSE) in patients of any age, synthesizing available evidences from randomized controlled trials (RCTs). RCTs on IV VPA administered in patients (no age restriction) for GCSE at any stage were searched in MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials. Studies were selected and data independently extracted. Following outcomes were considered: clinical seizure cessation after drug administration, seizure freedom at 24 h, and adverse effects. Outcomes were assessed using standard methods to calculate risk ratio (RR) with 95% confidence intervals. Five trials met inclusion criteria. Two different comparisons were available (IV VPA versus phenytoin (PHT), IV VPA versus IV Diazepam), but only the former included more than one study with enough information to permit a meta-analysis. Compared with PHT, VPA had statistically lower risk of adverse effects (RR 0.31, 95% CI 0.12-0.85), with no differences in GCSE cessation after drug administration (RR 1.31, 95% CI 0.93-1.84) and in seizure freedom at 24 h (RR 0.96, 95% CI 0.88-1.06). This review suggests that IV VPA has a better tolerability than PHT in treatment of GCSE, without any statistically significant differences in terms of efficacy. More rigorous RCTs of VPA versus an appropriate comparator, in a well-defined population with a systematic definition of SE, are however required to conclude about efficacy and tolerability of VPA in clinical practice.
Collapse
Affiliation(s)
- F Brigo
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy.
| | | | | | | | | |
Collapse
|