1
|
Ghezzi A, Mutta E, Bianchi F, Bonavita S, Buttari F, Caramma A, Cavarretta R, Centonze D, Coghe GC, Coniglio G, Del Carro U, Ferrò MT, Marrosu MG, Patti F, Rovaris M, Sparaco M, Simone I, Tortorella C, Bergamaschi R. Diagnostic tools for assessment of urinary dysfunction in MS patients without urinary disturbances. Neurol Sci 2016; 37:437-42. [PMID: 26613723 DOI: 10.1007/s10072-015-2415-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Received: 05/12/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
Many guidelines are available for the management of lower urinary tract symptoms (LUTSs) in multiple sclerosis (MS) patients, but no agreement exists on the best approach for subjects without LUTSs. The objective of this study was to evaluate whether LUTSs can be detected in MS patients asymptomatic for urinary dysfunction, comparing three different tools [measure of post-void residual volume (PRV), bladder diary (BD), a focused questionnaire (IPSS)], and whether disability, disease duration and signs of pyramidal involvement are linked to their subclinical presence. 178 MS patients (118 women) have been included (mean age 41.2 years, mean disease duration 11.3 years, mean EDSS 2.2), and tested with the above-mentioned tools. PRV was abnormal in 14 subjects (7.8%), associated to abnormal findings at IPSS in 3 cases, at BD in 2 cases, at both in 1. BD was abnormal in 37 subjects (20.8%), with concomitant abnormal PRV in 2, abnormal IPSS in 10 cases, abnormal IPSS and BD in 1. IPSS was ≥ 9 in 43 subjects (24.1%). At least one test was abnormal in 76 patients (42.7%): 1 in 57 patients (32.0%), 2 in 17 (9.5%), and 3 tests in 2 (1.1%). Patients with at least one abnormal urinary variable, compared to patients without urinary abnormalities, had a more frequent pyramidal involvement (69.5 vs. 16.8%, χ(2) = 48.6, p < 0.00001), a more frequent occurrence of EDSS ≥2 (83.1 vs. 23.5%, χ(2) = 56.9, p < 0.00001), and a longer disease duration (15.7 ± 7.3 vs. 9.1 ± 7.1, t = 5.7, p < 0.00001). Asymptomatic LUTS were frequent but none of the tests used permitted to better identify asymptomatic patients.
Collapse
Affiliation(s)
- A Ghezzi
- Neurologia 2-Centro Studi Sclerosi Multipla, Ospedale di Gallarate, Via Pastori 4, 21013, Gallarate, Italy.
| | - E Mutta
- Neurologia 2-Centro Studi Sclerosi Multipla, Ospedale di Gallarate, Via Pastori 4, 21013, Gallarate, Italy
| | - F Bianchi
- Divisione di Neurologia, Ospedale S. Raffaele Milano, Milan, Italy
| | - S Bonavita
- Clinica Neurologica, Università Federico II Napoli, Naples, Italy
| | - F Buttari
- Clinica Neurologica, Università Tor Vergata, Rome, Italy
| | - A Caramma
- Clinica Neurologica, Università di Catania, Catania, Italy
| | - R Cavarretta
- Centro Sclerosi Multipla, IRCCS Don Gnocchi, Milan, Italy
| | - D Centonze
- Clinica Neurologica, Università Tor Vergata, Rome, Italy
| | - G C Coghe
- Centro Sclerosi Multipla, Ospedale Binaghi, Cagliari, Italy
| | - G Coniglio
- Divisione di Neurologia, Ospedale S. Carlo, Matera, Italy
| | - U Del Carro
- Divisione di Neurologia, Ospedale S. Raffaele Milano, Milan, Italy
| | - M T Ferrò
- Divisione di Neurologia, Ospedale di Cremona, Cremona, Italy
| | - M G Marrosu
- Centro Sclerosi Multipla, Ospedale Binaghi, Cagliari, Italy
| | - F Patti
- Clinica Neurologica, Università di Catania, Catania, Italy
| | - M Rovaris
- Centro Sclerosi Multipla, IRCCS Don Gnocchi, Milan, Italy
| | - M Sparaco
- Clinica Neurologica, Università Federico II Napoli, Naples, Italy
| | - I Simone
- Clinica Neurologica, Università di Bari, Bari, Italy
| | - C Tortorella
- Clinica Neurologica, Università di Bari, Bari, Italy
| | | |
Collapse
|
2
|
Chiò A, Battistini S, Calvo A, Caponnetto C, Conforti FL, Corbo M, Giannini F, Mandrioli J, Mora G, Sabatelli M, Ajmone C, Mastro E, Pain D, Mandich P, Penco S, Restagno G, Zollino M, Surbone A, Lunetta C, Pintor GL, Salvi F, Bartolomei I, Quattrone A, Gambardella A, Logroscino G, Simone I, Pisano F, Spataro R, La Bella V, Colletti T, Mancardi G, Origone P, Sola P, Borghero G, Marrosu F, Marrosu MG, Murru MR, Floris G, Cannas A, Piras V, Costantino E, Pani C, Sotgiu MA, Pugliatti M, Parish LD, Cossu P, Ticca A, Rodolico C, Portaro S, Ricci C, Moglia C, Ossola I, Brunetti M, Barberis M, Canosa A, Cammarosano S, Bertuzzo D, Fuda G, Ilardi A, Manera U, Pastore I, Sproviero W, Logullo F, Tanel R, Ajmone C, Mastro E, Pain D, Mandich P, Penco S, Restagno G, Zollino M, Surbone A. Genetic counselling in ALS: facts, uncertainties and clinical suggestions. J Neurol Neurosurg Psychiatry 2014; 85:478-85. [PMID: 23833266 DOI: 10.1136/jnnp-2013-305546] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [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] [Indexed: 11/04/2022]
Abstract
The clinical approach to patients with amyotrophic lateral sclerosis (ALS) has been largely modified by the identification of novel genes, the detection of gene mutations in apparently sporadic patients, and the discovery of the strict genetic and clinical relation between ALS and frontotemporal dementia (FTD). As a consequence, clinicians are increasingly facing the dilemma on how to handle genetic counselling and testing both for ALS patients and their relatives. On the basis of existing literature on genetics of ALS and of other late-onset life-threatening disorders, we propose clinical suggestions to enable neurologists to provide optimal clinical and genetic counselling to patients and families. Genetic testing should be offered to ALS patients who have a first-degree or second-degree relative with ALS, FTD or both, and should be discussed with, but not offered to, all other ALS patients, with special emphasis on its major uncertainties. Presently, genetic testing should not be proposed to asymptomatic at-risk subjects, unless they request it or are enrolled in research programmes. Genetic counselling in ALS should take into account the uncertainties about the pathogenicity and penetrance of some genetic mutations; the possible presence of mutations of different genes in the same individual; the poor genotypic/phenotypic correlation in most ALS genes; and the phenotypic pleiotropy of some genes. Though psychological, social and ethical implications of genetic testing are still relatively unexplored in ALS, we recommend multidisciplinary counselling that addresses all relevant issues, including disclosure of tests results to family members and the risk for genetic discrimination.
Collapse
Affiliation(s)
- Adriano Chiò
- Department of Neuroscience, ALS Center, 'Rita Levi Montalcini', University of Torino, Torino, and Azienda Ospedaliera Città della Salute e della Scienza, , Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Zoccolella S, Artuso L, Capozzo R, Amati A, Guerra F, Simone I, Logroscino G, Petruzzella V. Mitochondrial genome large rearrangements in the skeletal muscle of a patient with PMA. Eur J Neurol 2012; 19:e63-4. [DOI: 10.1111/j.1468-1331.2012.03720.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Zoccolella
- Department of Neurosciences and Organs of Sense; University of Bari; Bari; Italy
| | - L. Artuso
- Department of Basic Medical Sciences; University of Bari; Bari; Italy
| | - R. Capozzo
- Department of Neurosciences and Organs of Sense; University of Bari; Bari; Italy
| | - A. Amati
- Department of Neurosciences and Organs of Sense; University of Bari; Bari; Italy
| | - F. Guerra
- Department of Gynecological Sciences, Obstetrics and Pediatrics; O.U. Medical Genetics; University of Bologna; Bologna; Italy
| | - I. Simone
- Department of Neurosciences and Organs of Sense; University of Bari; Bari; Italy
| | - G. Logroscino
- Department of Neurosciences and Organs of Sense; University of Bari; Bari; Italy
| | - V. Petruzzella
- Department of Basic Medical Sciences; University of Bari; Bari; Italy
| |
Collapse
|
4
|
Simone I, Mezzapesa D, D'Errico E, Dicuonzo F, Zoccolella S, Tortelli R, Cortese R, Federico F, Logroscino G, Livrea P. Cortical Thinning in Frontal Lobes Is Relate with Faster Progression of Amyotrophic Lateral Sclerosis (P03.161). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.161] [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] Open
|
5
|
Barulli MR, Tursi M, Tortelli R, Capozzo R, Cortese R, D'Errico E, Leo A, Simone I, Logroscino G. Verbal Learning Abilities in ALS Patients (P01.109). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.109] [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] Open
|
6
|
Tedeschi G, Dinacci D, Comerci M, Lavorgna L, Savettieri G, Quattrone A, Livrea P, Patti F, Brescia Morra V, Servillo G, Orefice G, Paciello M, Prinster A, Coniglio G, Bonavita S, Di Costanzo A, Bellacosa A, Valentino P, Quarantelli M, Brunetti A, Salemi G, D’Amelio M, Simone I, Salvatore M, Bonavita V, Alfano B. Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study. Mult Scler 2008; 15:204-11. [DOI: 10.1177/1352458508098270] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression. Methods Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points. Results The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression. Conclusions In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.
Collapse
Affiliation(s)
- G Tedeschi
- Department of Neurological Sciences, Second University of Naples, Naples, Italy; Institute Hermitage Capodimonte, Naples, Italy
| | - D Dinacci
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - M Comerci
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - L Lavorgna
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - G Savettieri
- Department of Neurology, University of Palermo, Palermo, Italy
| | - A Quattrone
- Department of Neurology, University of Catanzaro, Catanzaro, Italy
| | - P Livrea
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - F Patti
- Department of Neurology, University of Catania, Catania, Italy
| | - V Brescia Morra
- Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - G Servillo
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - G Orefice
- Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - M Paciello
- Department of Neurology, San Carlo Hospital, Potenza, Italy
| | - A Prinster
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - G Coniglio
- Department of Neurology, San Carlo Hospital, Potenza, Italy
| | - S Bonavita
- Department of Neurological Sciences, Second University of Naples, Naples, Italy; Institute Hermitage Capodimonte, Naples, Italy
| | - A Di Costanzo
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - A Bellacosa
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - P Valentino
- Department of Neurology, University of Catanzaro, Catanzaro, Italy
| | - M Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - A Brunetti
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy; Department of Diagnostic Imaging, University of Naples “Federico II,” Naples, Italy
| | - G Salemi
- Department of Neurology, University of Palermo, Palermo, Italy
| | - M D’Amelio
- Department of Neurology, University of Palermo, Palermo, Italy
| | - I Simone
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - M Salvatore
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy; Department of Diagnostic Imaging, University of Naples “Federico II,” Naples, Italy
| | - V Bonavita
- Institute Hermitage Capodimonte, Naples, Italy; Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - B Alfano
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| |
Collapse
|
7
|
Bonavita S, Dinacci D, Lavorgna L, Savettieri G, Quattrone A, Livrea P, Bresciamorra V, Orefice G, Paciello M, Coniglio G, Di Costanzo A, Valentino P, Patti F, Salemi G, Simone I, Tedeschi G. Treatment of multiple sclerosis with interferon beta in clinical practice: 2-year follow-up data from the South Italy Mobile MRI Project. Neurol Sci 2006; 27 Suppl 5:S365-8. [PMID: 16998722 DOI: 10.1007/s10072-006-0696-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This follow-up study assessed the 2-year clinical and magnetic resonance imaging (MRI) outcomes of patients with multiple sclerosis (MS) originally enrolled in an MRI study conducted at eight centres in south Italy (the South Italy Mobile MRI Project). Of the 597 MS patients recruited at baseline, 391 returned for the follow-up study. Of these, 363 provided 2-year clinical and MRI follow-up data, and 215 were still undergoing treatment with one of four interferon beta regimens: Avonex, 30 mcg intramuscularly once weekly; Betaferon, 250 mcg subcutaneously (sc) every other day; Rebif 22 mcg sc three times weekly (tiw; Rebif 22); or Rebif 44 mcg sc tiw (Rebif 44). Over the 2-year follow-up period, patients receiving the higher dose of Rebif were more likely to remain free from relapses [odds ratio (OR) = 2.23] and from developing both new T2 (OR = 0.15) and new T1 black hole lesions (OR = 0.22), when compared with patients in the Avonex group. Despite some limitations in the trial design, the results from this follow-up study provide helpful clinical and MRI data on the efficacy of interferon beta regimens in MS patients treated in the clinical setting.
Collapse
Affiliation(s)
- S Bonavita
- Department of Neurological Sciences, Second University of Naples, Piazza Miraglia 2, I-80138 Naples, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
Fifty-four subjects (36 females and 18 males) affected by clinically definite multiple sclerosis (MS) and with onset of the disease at 15 years of age or before were prospectively studied in five Italian MS centres. Female/male ratio was 4.7 in subjects with age > or = 12 years, suggesting a role of hormonal changes in triggering MS onset The mean follow-up duration was 10.9+/-5.6 years. The functional systems more frequently involved at onset were the pyramidal and brainstem (both in 28% of cases). The onset was monosymptomatic in 31 subjects (57%). The course was relapsing-remitting in 39 subjects (72%) and relapsing-progressive in 15 (28%). Disability was assessed by the Expanded Disability Status Scale (EDSS): the mean score after 8 years of follow up was 3.5 (+/-2.5). The score was <4 in 68% of cases, between 4 and 6 in 8% of cases, >6 in 24% of cases. Disability after 8 years was highly predicted by disability in the first year (p=0.008). There was a tendency to a worse prognosis in relation to the number of relapses in the first 2 years (p=0.08). The outcome was not influenced by the characteristics of symptoms at onset age and gender.
Collapse
Affiliation(s)
- A Ghezzi
- Centro Studi Sclerosi Multipla, Ospedale di Gallarate, Universìta di Milano, Milan, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Crucitti A, Cecchi E, Gensini GF, Simone I, Conti A, Gialloni S, Pedone C, Pahor M, Mugelli A. Use of antihypertensive drugs in the Italian hospitals. GIFA group. Gruppo Italiano di Farmacoepidemiologia nell'Anziano. Pharmacol Res 2000; 41:249-53. [PMID: 10623493 DOI: 10.1006/phrs.1999.0582] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Calcium channel blockers and ACE-inhibitors are among the most common drugs prescribed for the initial treatment of hypertension. While their ability to control surrogate outcomes, such as blood pressure and left ventricular hypertrophy, is proven, there is limited evidence of their prevention of major cardiovascular events, including mortality. The aim of our work was to assess the use of these drugs in Italy in comparison with beta-blockers and diuretics. We examined the consumption of the four main antihypertensive classes of drugs (beta-blockers, diuretics, calcium channel blockers and ACE- inhibitors). In-hospitalization data from the GIFA (Gruppo Italiano di Farmacoepidemiologia nell'Anziano) database were used. During the period from 1988 to 1995, the most frequently prescribed antihypertensive drugs were calcium channel blockers (47%) followed by diuretics (37%), ACE-inhibitors (33%) and beta-blockers (5.5%). Changes over time in the use of these drugs were analysed: ACE-inhibitors had the greatest increase in use over time. Calcium channel blockers, ACE-inhibitors and beta-blockers were usually prescribed to the youngest patients (aged <65 years), while diuretics to the oldest. Calcium channel blockers were prescribed to 60% of patients with myocardial infarction and to 55% of those with congestive heart failure. In conclusion, our study demonstrates that the Italian physicians very often prescribe drugs like calcium channel blockers and ACE-inhibitors. Among these pharmacological agents, enalapril (twice per day) and slow release calcium channel blockers are the most frequently prescribed drugs.
Collapse
Affiliation(s)
- A Crucitti
- Dipartimento di Farmacologia Preclinica e Clinica, Universita degli Studi di Firenze, V.le Pieraccini no. 6, Firenze, 50139, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Prisco D, Paniccia R, Bandinelli B, Giusti B, Colella A, Comeglio M, Abbate R, Simone I, Gensini G, Neri Serneri G. Short-term ACE inhibition may influence exercise-induced changes in haemostasis in healthy subjects. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0268-9499(97)80049-5] [Citation(s) in RCA: 3] [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: 10/25/2022]
|
11
|
Gensini GF, Simone I, Pantoni L, Inzitari D. [Large trials in the secondary prevention of stroke]. Ann Ital Med Int 1996; 11 Suppl 2:102S-109S. [PMID: 9004808] [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: 02/03/2023]
Abstract
To date, no drug has been demonstrated as efficacious in the treatment of acute ischemic stroke. Therefore, primary and secondary prevention play a fundamental role. Besides adequate control of risk factors, trials and meta-analyses have demonstrated that both medical and surgical therapy are effective in secondary prevention of stroke. In patients with atherothrombotic transient ischemic attack (TIA) or minor stroke and carotid stenosis > 70%, surgical therapy (endarterectomy) is the treatment of choice, while antiplatelet drugs are the elective treatment in the case of stenosis < 70%. Acetylsalicylic acid is the first choice medical treatment, but the optimal dosage is still a matter of debate. Ticlopidine has an efficacy similar to that of aspirin, but shows a certain number of side effects; recently a European study has shown the efficacy of dipyridamole, and the superiority of the combination dipyridamole-aspirin vs low-dose aspirin. In the secondary prevention of cardioembolic stroke, oral anticoagulants have higher efficacy than antiplatelet drugs, at least in selected groups of patients.
Collapse
Affiliation(s)
- G F Gensini
- Istituto di Clinica Medica Generale e Cardiologia, Università degli Studi di Firenze
| | | | | | | |
Collapse
|
12
|
Lauriero F, Federico F, Rubini G, Conte C, Simone I, Inchingolo V, d'Addabbo A. 99Tcm-HMPAO SPET and 1H-MRS (proton magnetic resonance spectroscopy) in patients with ischaemic cerebral infarction. Nucl Med Commun 1996; 17:140-6. [PMID: 8778638 DOI: 10.1097/00006231-199602000-00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 02/02/2023]
Abstract
Brain 99Tcm-HMPAO single photon emission tomography (SPET) and 1H-MRS (proton magnetic resonance spectroscopy) were used to determine correlations between alterations in regional cerebral blood flow (rCBF) and changes in neuronal metabolites in 21 patients (28 examinations) with ischaemic cerebral infarction examined in different phases. rCBF was determined semi-quantitatively using Lassen's linearization algorithm. SPET provided evidence of the hypoperfused site of necrosis within a few hours after the acute event and alterations in rCBF were detected in both the infarcted and diaschistic areas at all stages. 1H-MRS was used to monitor the concentration of the following metabolites: N-acetyl-aspartate (NAA), creatine and phosphocreatine (CR + PCr), compounds containing choline (Cho) and lactate (Lac). A significant correlation was found between reduction in rCBF and a fall in NAA and Cr + PCr in both the acute and chronic phases, but not during "luxury perfusion' in the subacute phase. The presence of LAC in the infarcted area up to 9 months post-ictus was totally unexpected. Simultaneous SPET and 1H-MRS thus provides additional information regarding the physiopathogenesis of cerebral ictus by clarifying the relation between alterations in rCBF and biochemical neuronal changes. We believe that NAA and Cr + PCr concentrations are the best expression of agreement between flow and metabolism in infarcted areas, particularly with regard to hypoperfused areas not clearly detectable by magnetic resonance imaging in the early post-ictus stage.
Collapse
Affiliation(s)
- F Lauriero
- Department of Nuclear Medicine, University of Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
13
|
Livrea P, Federico F, Simone I, Zimatore G, Turso L, Negro C. Isoelectric focusing (IF) of cerebrospinal fluid (CSF) proteins: II) preliminary results in brain atrophies of various etiologies. Boll Soc Ital Biol Sper 1977; 53:511-7. [PMID: 911508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
14
|
Livrea P, Simone I, Zimatore G, Negro C, Graziano A, Chindemi A. Isoelectric focusing (IF) of cerebrospinal fluid (CSF) proteins: I) Preliminary results in multiple sclerosis (MS). Boll Soc Ital Biol Sper 1977; 53:504-10. [PMID: 71910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|