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Pizzanelli C, Pesaresi I, Milano C, Cecchi P, Fontanelli L, Giannoni S, Giorgi FS, Cosottini M, Bonanni E. Distinct limbic connectivity in left and right benign mesial temporal lobe epilepsy: Evidence from a resting state functional MRI study. Front Neurol 2022; 13:943660. [PMID: 36247782 PMCID: PMC9558280 DOI: 10.3389/fneur.2022.943660] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFunctional connectivity (FC) studies showed that pharmaco-resistant mesial temporal lobe epilepsy (MTLE) affects not only the limbic system, but also several extra-limbic regions, including areas belonging to resting state networks. Less is known about FC in subjects with benign MTLE (i.e., sensitive to antiseizure medication, bMTLE).Aim and methodsWe evaluated FC of hippocampus and amygdala in subjects with bMTLE, distinguished based on the epileptic focus lateralization. We enrolled 19 patients (10 with left and 9 with right bMTLE) and 10 age-matched healthy subjects. Connectivity was investigated at rest by using a seed-based regression analyses approach with four regions of interest (left and right hippocampus, left and right amygdala). Patients were also tested with a neuropsychological battery and their scores were correlated with fMRI data.Results and conclusionsOur study documented an asymmetrical disruption of FC in bMTLE, in relation to the side of the focus. Right subjects only exhibited limited altered connections, while left subjects—who performed worse in verbal memory tests—showed a wide bilateral hypoconnectivity of hippocampus and amygdala with areas belonging to language and memory network. The strength of FC between left limbic areas and language and memory network correlated with better performances in verbal memory tests. Moreover, we observed an increased FC with areas of default mode network, more pronounced in left subjects, a possible attempt to compensate cognitive deficit but without effectiveness.We believe that these findings could help to better characterize bMTLE, in which a dysfunction of limbic connectivity is detectable despite well-controlled epilepsy.
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Affiliation(s)
- Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
- *Correspondence: Chiara Pizzanelli
| | | | - Chiara Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Paolo Cecchi
- Department of Translational Research and New Technologies in Medicine and Surgery, Neuroradiology Unit, University of Pisa, Pisa, Italy
| | - Lorenzo Fontanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Sara Giannoni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, Human Anatomy, University of Pisa, Pisa, Italy
| | - Mirco Cosottini
- Neuroradiology Unit, Pisa University Hospital, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, Neuroradiology Unit, University of Pisa, Pisa, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
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2
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Belli E, Milano C, Pesaresi I, Trivelli I, Tavoni A, Ciancia E, Alì G, Zampa V, Pizzanelli C, Siciliano G, Ricci G. A case of intravascular large B cell lymphoma with brain involvement mimicking progressive multifocal leukoencephalopathy. Int J Neurosci 2021:1-5. [PMID: 34425062 DOI: 10.1080/00207454.2021.1972418] [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] [Indexed: 12/19/2022]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a very rare form of extranodal lymphoma, characterized by the proliferation of neoplastic B cells within the lumen of small vessels. Due to its high aggressivity, for years the prognosis had been really poor with only anectodical cases of remission after traditional chemotherapy. More recently, new therapeutic protocols allowed a significant increase in overall survival. It can virtually involve every organ, being skin and central nervous system the most affected. The clinical presentation is often unspecific and insidious; therefore, diagnosis can be challenging. Tissue biopsy, in particular random deep skin biopsy, is the gold standard for definitive diagnosis. We describe the case of a 58-year-old woman with a previous diagnosis of myelofibrosis, who presented with a rapidly progressive neurological deterioration and a brain MRI suggestive of Progressive Multifocal Leukoencephalopathy. Due to the absence of BK and JC viruses in cerebrospinal fluid and the presence of severe myalgias and subcutaneous nodules, a skin and muscle biopsy was performed, allowing diagnosis of IVLBCL. We describe the diagnostic pitfalls of this case, briefly reviewing existing literature about IVLBCL.
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Affiliation(s)
- Elisabetta Belli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Milano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ilaria Pesaresi
- Neuroradiology Unit, Department of Diagnostic and Interventional Radiology, AOUP, Pisa, Italy
| | - Ilaria Trivelli
- Neuroradiology Unit, Department of Diagnostic and Interventional Radiology, AOUP, Pisa, Italy
| | - Antonio Tavoni
- Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Greta Alì
- Second Division of Pathology, AOUP, Pisa, Italy
| | - Virna Zampa
- Radiology Unit, Department of Diagnostic and Interventional Radiology, AOUP, Pisa, Italy
| | - Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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3
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Latronico N, Piva S, Fagoni N, Pinelli L, Frigerio M, Tintori D, Berardino M, Bottazzi A, Carnevale L, Casalicchio T, Castioni CA, Cavallo S, Cerasti D, Citerio G, Fontanella M, Galiberti S, Girardini A, Gritti P, Manara O, Maremmani P, Mazzani R, Natalini G, Patassini M, Perna ME, Pesaresi I, Radolovich DK, Saini M, Stefini R, Minelli C, Gasparotti R, Rasulo FA. Impact of a posttraumatic cerebral infarction on outcome in patients with TBI: the Italian multicenter cohort INCEPT study. Crit Care 2020; 24:33. [PMID: 32014041 PMCID: PMC6998281 DOI: 10.1186/s13054-020-2746-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Post-traumatic cerebral infarction (PTCI) is common after traumatic brain injury (TBI). It is unclear what the occurrence of a PTCI is, how it impacts the long-term outcome, and whether it adds incremental prognostic value to established outcome predictors. METHODS This was a prospective multicenter cohort study of moderate and severe TBI patients. The primary objective was to evaluate if PTCI was an independent risk factor for the 6-month outcome assessed with the Glasgow Outcome Scale (GOS). We also assessed the PTCI occurrence and if it adds incremental value to the International Mission for Prognosis and Clinical Trial design in TBI (IMPACT) core and extended models. RESULTS We enrolled 143 patients, of whom 47 (32.9%) developed a PTCI. In the multiple ordered logistic regression, PTCI was retained in both the core and extended IMPACT models as an independent predictor of the GOS. The predictive performances increased significantly when PTCI was added to the IMPACT core model (AUC = 0.73, 95% C.I. 0.66-0.82; increased to AUC = 0.79, 95% CI 0.71-0.83, p = 0.0007) and extended model (AUC = 0.74, 95% C.I. 0.65-0.81 increased to AUC = 0.80, 95% C.I. 0.69-0.85; p = 0.00008). Patients with PTCI showed higher ICU mortality and 6-month mortality, whereas hospital mortality did not differ between the two groups. CONCLUSIONS PTCI is a common complication in patients suffering from a moderate or severe TBI and is an independent risk factor for long-term disability. The addition of PTCI to the IMPACT core and extended predictive models significantly increased their performance in predicting the GOS. TRIAL REGISTRATION The present study was registered in ClinicalTrial.gov with the ID number NCT02430324.
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Affiliation(s)
- Nicola Latronico
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili University Hospital, Piazzale Ospedali Civili 1, 25121, Brescia, Italy
| | - Simone Piva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. .,Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili University Hospital, Piazzale Ospedali Civili 1, 25121, Brescia, Italy.
| | - Nazzareno Fagoni
- Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili University Hospital, Piazzale Ospedali Civili 1, 25121, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Lorenzo Pinelli
- Department of Radiology, Neuroradiology Unit, ASST Spedali Civili University Hospital, Brescia, Italy
| | - Michele Frigerio
- Department of Radiology, Neuroradiology Unit, ASST Spedali Civili University Hospital, Brescia, Italy
| | - Davide Tintori
- Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili University Hospital, Piazzale Ospedali Civili 1, 25121, Brescia, Italy
| | - Maurizio Berardino
- Anesthesia and Intensive Care Unit, AOU Città della Salute e della Scienza, Presidio CTO, Turin, Italy
| | - Andrea Bottazzi
- Department of Anesthesia and Critical Care Medicine, IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Livio Carnevale
- Department of Anesthesia and Critical Care Medicine, IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Tiziana Casalicchio
- Department of Anestesiology and Intensive Care Medicine, S. Giovanni Bosco Hospital, ASLTO2, Turin, Italy
| | - Carlo Alberto Castioni
- Department of Anestesiology and Intensive Care Medicine, S. Giovanni Bosco Hospital, ASLTO2, Turin, Italy
| | - Simona Cavallo
- Anesthesia and Intensive Care Unit, AOU Città della Salute e della Scienza, Presidio CTO, Turin, Italy
| | - Davide Cerasti
- Department of Neuroradiology, Ospedale Maggiore, University of Parma, Parma, Italy
| | - Giuseppe Citerio
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.,Department of Anesthesia and Critical Care Medicine, Unit of Neurointensive Care Medicine, ASST-Monza, Monza, Italy
| | - Marco Fontanella
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Serena Galiberti
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Alan Girardini
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy
| | - Paolo Gritti
- Department of Anesthesia and Critical Care Medicine, Papa Giovanni XXIII Hospital, ASST Bergamo, Bergamo, Italy
| | - Ornella Manara
- Department of Neuroradiology, Papa Giovanni XXIII Hospital, ASST Bergamo, Bergamo, Italy
| | - Paolo Maremmani
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Roberta Mazzani
- Department of Anesthesiology, Critical Care and Pain Medicine, Maggiore University Hospital, Parma, Italy
| | - Giuseppe Natalini
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy
| | - Mirko Patassini
- Department of Radiology, Section of Neuroradiology, ASST-Monza, Monza, Italy
| | - Maria Elena Perna
- Department of Radiology, S. Giovanni Bosco Hospital, ASLTO2, Turin, Italy
| | - Ilaria Pesaresi
- Department of Diagnosis and Imaging, Neuroradiology, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Danila Katia Radolovich
- Department of Anesthesia and Critical Care Medicine, IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Maurizio Saini
- Department of Anesthesia and Critical Care Medicine, Unit of Neurointensive Care Medicine, ASST-Monza, Monza, Italy
| | | | - Cosetta Minelli
- The National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Francesco A Rasulo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili University Hospital, Piazzale Ospedali Civili 1, 25121, Brescia, Italy
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Sartucci F, Ragazzoni A, Russo FD, Fabbri S, Pesaresi I, Rollo AD, Perri RL, Barloscio TD, Bocci T, Cosottini AM. O-03 Source modelling of endogenous potentials (ERPS), elicited by omitted targets, based on simultaneous EEG-FMRI recordings. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.319] [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]
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5
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Ragazzoni A, Di Russo F, Fabbri S, Pesaresi I, Di Rollo A, Perri RL, Barloscio D, Bocci T, Cosottini M, Sartucci F. "Hit the missing stimulus". A simultaneous EEG-fMRI study to localize the generators of endogenous ERPs in an omitted target paradigm. Sci Rep 2019; 9:3684. [PMID: 30842443 PMCID: PMC6403295 DOI: 10.1038/s41598-019-39812-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/11/2019] [Indexed: 11/09/2022] Open
Abstract
Event-Related Potentials (ERPs) occurring independently from any stimulus are purely endogenous (emitted potentials) and their neural generators can be unequivocally linked with cognitive processes. In the present study, the subjects performed two similar visual counting tasks: a standard two-stimulus oddball, and an omitted-target oddball task, characterized by the physical absence of the target stimulus. Our investigation aimed at localizing the neural sources of the scalp-recorded endogenous/emitted ERPs. To optimize the source localization, the high temporal resolution of electrophysiology was combined with the fine spatial information provided by the simultaneous recording of functional magnetic resonance (fMRI). Both tasks identified two endogenous ERP components in the 300 to 520 ms interval. An earlier component, pP2, showed a bilateral generator in the anterior Insula. A later P3 component (P3b) was generated bilaterally in the temporal-parietal junction, the premotor and motor area and the anterior intraparietal sulcus (this latter one only in the standard oddball). Anticipatory slow waves (beginning 900 to 500 ms pre-stimulus), also of endogenous nature, were produced by the inferior and middle frontal gyrus and the supplementary and cingulate motor areas. Our protocol disentangled pre- from post-stimulus fMRI activations and provided original clues to the psychophysiological interpretation of emitted/endogenous ERPs.
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Affiliation(s)
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
| | - Serena Fabbri
- Neuroradiology Unit, A.O.U.P., Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Andrea Di Rollo
- Department of Clinical and Experimental Medicine, Unit of Neurophysiopathology, Pisa University Medical School, Pisa, Italy
| | - Rinaldo Livio Perri
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Davide Barloscio
- Department of Clinical and Experimental Medicine, Unit of Neurophysiopathology, Pisa University Medical School, Pisa, Italy
| | - Tommaso Bocci
- Department of Clinical and Experimental Medicine, Unit of Neurophysiopathology, Pisa University Medical School, Pisa, Italy.,"Aldo Ravelli" Center for Neurotechnology and Experiental Brain Therapeutics, Department of Health Sciences, University of Milan & ASST Santi Paolo e Carlo, Milan, Italy
| | - Mirco Cosottini
- Neuroradiology Unit, A.O.U.P., Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Ferdinando Sartucci
- Department of Clinical and Experimental Medicine, Unit of Neurophysiopathology, Pisa University Medical School, Pisa, Italy.,CNR, Neuroscience Institute, Pisa, Italy
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6
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Chiti A, Cecchi P, Pesaresi I, Orlandi G, Giannini N, Gialdini G, Terni E, Tognoni G, Volpi L, Pagni C, Ghicopulos I, Siciliano G, Dotti MT, Federico A, Poggesi A, Salvadori E, Pantoni L, Inzitari D, Cosottini M, Bonuccelli U. Functional magnetic resonance imaging with encoding task in patients with mild cognitive impairment and different severity of leukoaraiosis. Psychiatry Res Neuroimaging 2018; 282:126-131. [PMID: 30539733 DOI: 10.1016/j.pscychresns.2018.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/15/2018] [Accepted: 06/28/2018] [Indexed: 11/20/2022]
Abstract
Leukoaraiosis is one of the main contributors to mild cognitive impairment due to vascular damage (vascular MCI, VMCI), whose pathophysiology has not been fully elucidated yet. We aimed to shed light on such issue using functional MRI (fMRI). Sixteen patients with VMCI were enrolled and compared with twenty-five patients with MCI but without significant vascular damage (non-vascular MCI, NVMCI) and with fifteen healthy controls (HC). They all underwent fMRI with incidental verbal learning paradigm, using a 3T scanner. Differently from cases with NVMCI (versus HC), VMCI patients presented a higher BOLD activation in the right parieto-occipital cortex and a lower activation in the left superior and middle frontal gyri, anterior cingulum and in left fronto-opercular area when compared to HC. Cortical activation evaluated by fMRI may reflect specific patterns of damage and attempt of compensation in patients with MCI and different severity of leukoaraiosis.
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Affiliation(s)
- Alberto Chiti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy; Unit of Neurology, Ospedale Apuane, Via Mattei 21, Massa 54100, Italy.
| | - Paolo Cecchi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Ilaria Pesaresi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Giovanni Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy; Unit of Neurology, Ospedale Apuane, Via Mattei 21, Massa 54100, Italy
| | - Nicola Giannini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gino Gialdini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Eva Terni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Leda Volpi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristina Pagni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Irene Ghicopulos
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Maria Teresa Dotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, Siena 53100, Italy
| | - Antonio Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, Siena 53100, Italy
| | - Anna Poggesi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Emilia Salvadori
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Leonardo Pantoni
- "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via G.B Grassi, 74, Milan 20157, Italy
| | - Domenico Inzitari
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
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7
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Di Rollo A, Cosottini M, Pesaresi I, Fabbri S, Di Russo F, Perri R, Barloscio D, Bocci T, Ragazzoni A, Sartucci F. 29. ERP generators in an omitted-target oddball task: A simultaneous EEG-fMRI study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Baldanzi S, Cecchi P, Fabbri S, Pesaresi I, Simoncini C, Angelini C, Bonuccelli U, Cosottini M, Siciliano G. Relationship between neuropsychological impairment and grey and white matter changes in adult-onset myotonic dystrophy type 1. Neuroimage Clin 2016; 12:190-7. [PMID: 27437180 PMCID: PMC4939389 DOI: 10.1016/j.nicl.2016.06.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/01/2016] [Accepted: 06/13/2016] [Indexed: 01/18/2023]
Abstract
Myotonic dystrophy type 1 (DM1) has a wide phenotypic spectrum and potentially may affect central nervous system with mild to severe involvement. Our aim was to investigate grey matter (GM) and white matter (WM) structural alterations in a sample of adult-onset DM1 patients and to evaluate relationship with clinical and cognitive variables. Thirty DM1 patients underwent neuropsychological investigation and 3T-MRI protocol. GM and WM changes were evaluated calculating brain parenchymal fraction (BPF), voxel-based morphometry (VBM), white matter lesion load (LL% and Fazekas scale) and tract based spatial statistical (TBSS). Patients showed main impairment in tests exploring executive and mnesic domains with visuo-spatial involvement, significantly related to BPF. VBM revealed clusters of widespread GM reduction and TBSS revealed areas of decreased fractional anisotropy (FA) and increased radial diffusivity (RD), mean diffusivity (MD) and axial diffusivity (AD) in patients compared to a group of matched healthy controls. Multiple regression analyses showed areas of significant negative relationship between left temporal atrophy and verbal memory, between RD and mnesic and visuo-spatial cognitive domains, and between AD and verbal memory. TBSS results indicate that the involvement of normal appearance WM, beyond the signal changes detected with conventional MR imaging (Fazekas scale and LL%), was associated with neuropsychological deficit. These data suggest that disrupted complex neuronal networks can underlie cognitive-behavioural dysfunctions in DM1. We performed VBM and TBSS analyses in a sample of adult-onset DM1 patients. The relationship between neuroimaging variables and cognitive profile was studied. Global atrophy correlated with executive and visuo-spatial abilities. TBSS revealed associations between DTI indexes and cognitive performances. Disrupted complex neuronal networks can underlie cognitive dysfunction in DM1.
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Affiliation(s)
- Sigrid Baldanzi
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Paolo Cecchi
- Neuroradiology Unit, S.Chiara Hospital, via Roma 67, 56126 Pisa, Italy
| | - Serena Fabbri
- Neuroradiology Unit, S.Chiara Hospital, via Roma 67, 56126 Pisa, Italy
| | - Ilaria Pesaresi
- Neuroradiology Unit, S.Chiara Hospital, via Roma 67, 56126 Pisa, Italy
| | - Costanza Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Corrado Angelini
- Fondazione Ospedale S.Camillo, IRCCS, Via Alberoni 70, 30126 Lido Venice, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Mirco Cosottini
- Neuroradiology Unit, S.Chiara Hospital, via Roma 67, 56126 Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126 Pisa, Italy
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9
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Di Rollo A, Cosottini M, Pesaresi I, Fabbri S, Barloscio D, Ragazzoni A, Sartucci F. 21. Generators of oddball P300 to visual omitted stimuli: A simultaneous EEG-fMRI study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Cosottini M, Donatelli G, Costagli M, Caldarazzo Ienco E, Frosini D, Pesaresi I, Biagi L, Siciliano G, Tosetti M. High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis. AJNR Am J Neuroradiol 2016; 37:455-61. [PMID: 26680464 DOI: 10.3174/ajnr.a4562] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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: 06/26/2015] [Accepted: 08/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis is a progressive motor neuron disorder that involves degeneration of both upper and lower motor neurons. In patients with amyotrophic lateral sclerosis, pathologic studies and ex vivo high-resolution MR imaging at ultra-high field strength revealed the co-localization of iron and activated microglia distributed in the deep layers of the primary motor cortex. The aims of the study were to measure the cortical thickness and evaluate the distribution of iron-related signal changes in the primary motor cortex of patients with amyotrophic lateral sclerosis as possible in vivo biomarkers of upper motor neuron impairment. MATERIALS AND METHODS Twenty-two patients with definite amyotrophic lateral sclerosis and 14 healthy subjects underwent a high-resolution 2D multiecho gradient-recalled sequence targeted on the primary motor cortex by using a 7T scanner. Image analysis consisted of the visual evaluation and quantitative measurement of signal intensity and cortical thickness of the primary motor cortex in patients and controls. Qualitative and quantitative MR imaging parameters were correlated with electrophysiologic and laboratory data and with clinical scores. RESULTS Ultra-high field MR imaging revealed atrophy and signal hypointensity in the deep layers of the primary motor cortex of patients with amyotrophic lateral sclerosis with a diagnostic accuracy of 71%. Signal hypointensity of the deep layers of the primary motor cortex correlated with upper motor neuron impairment (r = -0.47; P < .001) and with disease progression rate (r = -0.60; P = .009). CONCLUSIONS The combined high spatial resolution and sensitivity to paramagnetic substances of 7T MR imaging demonstrate in vivo signal changes of the cerebral motor cortex that resemble the distribution of activated microglia within the cortex of patients with amyotrophic lateral sclerosis. Cortical thinning and signal hypointensity of the deep layers of the primary motor cortex could constitute a marker of upper motor neuron impairment in patients with amyotrophic lateral sclerosis.
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Affiliation(s)
- M Cosottini
- From the Department of Translational Research and New Technologies in Medicine and Surgery (M.Cosottini) and Neurology Unit
| | - G Donatelli
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Costagli
- IMAGO7 Foundation (M.Costagli), Pisa, Italy
| | - E Caldarazzo Ienco
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - D Frosini
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - I Pesaresi
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - L Biagi
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - M Tosetti
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
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Delishaj D, Ursino S, Pasqualetti F, Pesaresi I, Desideri I, Cosottini M, Laliscia C, Paiar F, Fabrini MG. The Effectiveness of Bevacizumab in Radionecrosis After Radiosurgery of a Single Brain Metastasis. Rare Tumors 2015; 7:6018. [PMID: 26788278 PMCID: PMC4703924 DOI: 10.4081/rt.2015.6018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 07/26/2015] [Accepted: 07/29/2015] [Indexed: 11/22/2022] Open
Abstract
Radionecrosis (RN) of brain tissue is a serious late complication of brain irradiation and historically has been treated with corticos-teroid therapy and alternatively surgical decompression. Recently, bevacizumab has been suggested for treatment of cerebral radiation necrosis. We present a case of a 73-years-old women affected by a primary non-small cell lung cancer with a single brain metastasis treated with radiosurgery. Two years after radiosurgery the patient referred neurological symptoms and a brain magnetic resonance confirmed the presence of RN. The patient refused surgical decompression so underwent at the treatment with bevacizumab 7.5 mg/kg/2 weeks for a total of 4 cycles. After two months of treatment the patient reported strumental and clinical improvement. Ten months after bevacizumab discontinuation the patient experienced a recurrence of RN with evident clinical manifestation and confirmed by radiological imaging. A new treatment with bevacizumab was not performed due to the systemic progression disease and the worsening of clinical status. Despite limited to only one clinical case, our study suggests the efficacy of bevacizumab to treat RN. Future studies are needed to confirm its mechanism and to properly define the optimal scheduling, dosage and duration of therapy.
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Affiliation(s)
- Durim Delishaj
- Department of Radiotherapy, University Hospital of Pisa , Italy
| | - Stefano Ursino
- Department of Radiotherapy, University Hospital of Pisa , Italy
| | | | | | | | | | | | - Fabiola Paiar
- Department of Radiotherapy, University Hospital of Pisa , Italy
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12
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Pesaresi I, Sabato M, Doria R, Desideri I, Guida M, Giorgi FS, Cosottini M. Susceptibility-weighted imaging in parenchymal neurosyphilis: identification of a new MRI finding. Sex Transm Infect 2015; 91:489-92. [PMID: 25834123 DOI: 10.1136/sextrans-2014-051961] [Citation(s) in RCA: 8] [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] [Received: 12/02/2014] [Accepted: 03/09/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND General paresis (GP) is a late form of parenchymal neurosyphilis causing dementia and neuropsychiatric disorders. The diagnosis is often difficult since the clinical signs are protean. So far, neuroimaging has played a minor role as radiological findings are not specific. METHODS We studied three immunocompetent patients, admitted to hospital for cognitive impairment. The diagnosis of neurosyphilis was formulated on the basis of serological texts and cerebrospinal fluid analysis. The patients underwent a 3 T MR examination including susceptibility-weighted imaging (SWI) sequence before and after the initiation of penicillin therapy. RESULTS In all patients, SWI revealed cortical hypointensity, mostly distributed in frontal and temporal lobes. In drug-naive patients, the hypointensity extended over the whole cortical thickness, from the cortical/subcortical junction to the pial surface. After starting the penicillin therapy, the cortical hypointensity partially reversed, involving only the deep cortical layers. CONCLUSIONS The MRI pattern at SWI observed in patients with GP was not reported in other infectious or inflammatory disease of the central nervous system, thus we suggest it could be a peculiar radiological finding of the disease. On the basis of previous pathological data, we hypothesise that cortical SWI hypointensity could be expression of iron deposits within activated microglia.
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Affiliation(s)
- Ilaria Pesaresi
- Unit of Neuroradiology, AOUP, Santa Chiara Hospital, Pisa, Italy
| | - Mario Sabato
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Roberta Doria
- Unit of Infectious Diseases, AOUP, Santa Chiara Hospital, Pisa, Italy
| | - Ilaria Desideri
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Melania Guida
- Unit of Neurology, AOUP, Santa Chiara Hospital, Pisa, Italy
| | | | - Mirco Cosottini
- Unit of Neuroradiology, AOUP, Santa Chiara Hospital, Pisa, Italy Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Lucchesi C, Schirinzi E, Pesaresi I, Stefanini A, Siciliano G. Chronic inflammatory demyelinating polyradiculoneuropathy with cranial nerves hypertrophy, thyroid-related orbitopathy and IgG monoclonal gammopathy: a case report. Neurol Sci 2015; 36:1027-9. [PMID: 25647292 DOI: 10.1007/s10072-015-2090-8] [Citation(s) in RCA: 2] [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] [Received: 07/15/2014] [Accepted: 08/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Cinzia Lucchesi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
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14
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Cosottini M, Frosini D, Pesaresi I, Donatelli G, Cecchi P, Costagli M, Biagi L, Ceravolo R, Bonuccelli U, Tosetti M. Comparison of 3T and 7T susceptibility-weighted angiography of the substantia nigra in diagnosing Parkinson disease. AJNR Am J Neuroradiol 2014; 36:461-6. [PMID: 25376811 DOI: 10.3174/ajnr.a4158] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [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 Standard neuroimaging fails in defining the anatomy of the substantia nigra and has a marginal role in the diagnosis of Parkinson disease. Recently 7T MR target imaging of the substantia nigra has been useful in diagnosing Parkinson disease. We performed a comparative study to evaluate whether susceptibility-weighted angiography can diagnose Parkinson disease with a 3T scanner. MATERIALS AND METHODS Fourteen patients with Parkinson disease and 13 healthy subjects underwent MR imaging examination at 3T and 7T by using susceptibility-weighted angiography. Two expert blinded observers and 1 neuroradiology fellow evaluated the 3T and 7T images of the sample to identify substantia nigra abnormalities indicative of Parkinson disease. Diagnostic accuracy and intra- and interobserver agreement were calculated separately for 3T and 7T acquisitions. RESULTS Susceptibility-weighted angiography 7T MR imaging can diagnose Parkinson disease with a mean sensitivity of 93%, specificity of 100%, and diagnostic accuracy of 96%. 3T MR imaging diagnosed Parkinson disease with a mean sensitivity of 79%, specificity of 94%, and diagnostic accuracy of 86%. Intraobserver and interobserver agreement was excellent at 7T. At 3T, intraobserver agreement was excellent for experts, and interobserver agreement ranged between good and excellent. The less expert reader obtained a diagnostic accuracy of 89% at 3T. CONCLUSIONS Susceptibility-weighted angiography images obtained at 3T and 7T differentiate controls from patients with Parkinson disease with a higher diagnostic accuracy at 7T. The capability of 3T in diagnosing Parkinson disease might encourage its use in clinical practice. The use of the more accurate 7T should be supported by a dedicated cost-effectiveness study.
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Affiliation(s)
- M Cosottini
- From the IMAGO7 Foundation (M. Cosottini, M. Costagli), Pisa, Italy Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini, G.D.)
| | - D Frosini
- Neurology Unit (D.F., R.C., U.B.), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Pesaresi
- Neuroradiology Unit (I.P., P.C.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - G Donatelli
- Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini, G.D.)
| | - P Cecchi
- Neuroradiology Unit (I.P., P.C.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - M Costagli
- From the IMAGO7 Foundation (M. Cosottini, M. Costagli), Pisa, Italy
| | - L Biagi
- Stella Maris Scientific Institute (L.B., M.T.), Pisa, Italy
| | - R Ceravolo
- Neurology Unit (D.F., R.C., U.B.), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - U Bonuccelli
- Neurology Unit (D.F., R.C., U.B.), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Tosetti
- Stella Maris Scientific Institute (L.B., M.T.), Pisa, Italy
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15
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Cosottini M, Frosini D, Pesaresi I, Ceravolo R, Tosetti M. Response. Radiology 2014; 273:628-629. [PMID: 25513662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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16
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Desideri I, Canovetti S, Pesaresi I, Caniglia M, Ciancia E, Bartolozzi C, Puglioli M, Cosottini M. Cerebellar mass as a location of acute lymphoblastic leukaemia. Neuroradiol J 2014; 27:439-43. [PMID: 25196617 DOI: 10.15274/nrj-2014-10069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/11/2014] [Accepted: 06/29/2014] [Indexed: 11/12/2022] Open
Abstract
A 22-year-old man with acute lymphoblastic leukaemia was referred to our observation for headache, cervical pain and sopor. A computed tomography study revealed triventricular obstructive hydrocephalus due to a left cerebellar hyperdense mass impinging on the fourth ventricle. A magnetic resonance study demonstrated an area of hyperintensity on T2-weighted images, hypointensity on T1, restricted diffusivity and contrast enhancement involving the left hemispherical cerebellar cortex and the vermis and causing cerebellar herniation. After surgical excision of the lesion, histological examination revealed an infiltrate of lymphoblastic leukaemia with B cells. Leukaemic intracranial masses are rare. Our report describes a case presenting a cerebellar mass of leukaemic tissue characterized by high cellularity and low apparent diffusion coefficient value comparable to acute ischaemia. Therefore leukaemic intracranial mass has to be considered in the differential diagnosis of cerebellar masses.
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Affiliation(s)
- Ilaria Desideri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy -
| | - Silvia Canovetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy
| | | | - Michele Caniglia
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy
| | - Eugenio Ciancia
- Department of Pathology, Pisa University Hospital; Pisa, Italy
| | - Carlo Bartolozzi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy
| | | | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy - Neuroradiology Unit, Pisa University Hospital; Pisa, Italy
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Bartolini E, Pesaresi I, Fabbri S, Cecchi P, Giorgi FS, Sartucci F, Bonuccelli U, Cosottini M. Abnormal response to photic stimulation in Juvenile Myoclonic Epilepsy: An EEG-fMRI study. Epilepsia 2014; 55:1038-47. [DOI: 10.1111/epi.12634] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Emanuele Bartolini
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | | | - Serena Fabbri
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | - Paolo Cecchi
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | | | | | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine; University of Pisa; Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery; University of Pisa; Pisa Italy
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Catarsi E, Pelliccia V, Pizzanelli C, Pesaresi I, Cosottini M, Migliorini P, Tavoni A. Cyclophosphamide and methotrexate in Susac’s Syndrome: a successful sequential therapy in a case with involvement of the cerebellum. Clin Rheumatol 2014; 34:1149-52. [DOI: 10.1007/s10067-014-2638-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/28/2022]
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19
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Pizzanelli C, Tavoni A, Pelliccia V, Catarsi E, Pesaresi I, Caltran E, Cosottini M, Bianchi MC, Migliorini P. Multiple life-threatening relapses in a woman with primary angiitis of the central nervous system mimicking brain tumour: a case report. Clin Exp Rheumatol 2014; 32:S143-S144. [PMID: 24854383] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 03/20/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Chiara Pizzanelli
- Department of Neuroscience, Section of Neurology, University of Pisa, Italy.
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20
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Cosottini M, Frosini D, Pesaresi I, Costagli M, Biagi L, Ceravolo R, Bonuccelli U, Tosetti M. MR imaging of the substantia nigra at 7 T enables diagnosis of Parkinson disease. Radiology 2014; 271:831-8. [PMID: 24601752 DOI: 10.1148/radiol.14131448] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the anatomy of the substantia nigra (SN) in healthy subjects by performing 7-T magnetic resonance (MR) imaging of the SN, and to prospectively define the accuracy of 7-T MR imaging in distinguishing Parkinson disease (PD) patients from healthy subjects on an individual basis. MATERIALS AND METHODS The 7-T MR imaging protocol was approved by the Italian Ministry of Health and by the local competent ethics committee. SN anatomy was described ex vivo on a gross brain specimen by using highly resolved proton-density (spin-echo proton density) and gradient-recalled-echo (GRE) images, and in vivo in eight healthy subjects (mean age, 40.1 years) by using GRE three-dimensional multiecho susceptibility-weighted images. After training on appearance of SN in eight healthy subjects, the SN anatomy was evaluated twice by two blinded observers in 13 healthy subjects (mean age, 54.7 years) and in 17 PD patients (mean age, 56.9 years). Deviations from normal SN appearance were described and indicated as abnormal, and both diagnostic accuracy and intra- and interobserver agreement for diagnosis of PD with 7-T MR imaging were calculated. RESULTS Three-dimensional multiecho susceptibility-weighted 7-T MR imaging reveals a three-layered organization of the SN allowing readers to distinguish pars compacta ventralis and dorsalis from pars reticulata. The abnormal architecture of the SN allowed a discrimination between PD patients and healthy subjects with sensitivity and specificity of 100% and 96.2% (range, 92.3%-100%), respectively. Intraobserver agreement (κ = 1) and interobserver agreement (κ = 0.932) were excellent. CONCLUSION MR imaging at 7-T allows a precise characterization of the SN and visualization of its inner organization. Three-dimensional multiecho susceptibility-weighted images can be used to accurately differentiate healthy subjects from PD patients, which provides a novel diagnostic opportunity.
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Affiliation(s)
- Mirco Cosottini
- From the IMAGO7 Foundation, Pisa, Italy (M. Cosottini, M. Costagli); Department of Translational Research and New Surgical and Medical Technologies (M. Cosottini) and Neurology Unit, Department of Clinical and Experimental Medicine (D.F., R.C., U.B.), University of Pisa, Pisa, Italy; Neuroradiology Unit, Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy (I.P.); and Stella Maris Scientific Institute, Pisa, Italy (L.B., M.T.)
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21
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Marini A, Carulli G, Lari T, Buda G, Lambelet P, Ciancia EM, Benedetti E, Caracciolo F, Ferreri MI, Pesaresi I, Rousseau M, Ottaviano V, Azzar^|^agrave; A, Petrini M. Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature. J Clin Exp Hematop 2014; 54:129-36. [DOI: 10.3960/jslrt.54.129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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22
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Guida M, Pesaresi I, Fabbri S, Sartucci F, Cosottini M, Giorgi FS. Epilepsy and phenylketonuria: a case description and EEG-fMRI findings. Funct Neurol 2014; 29:75-79. [PMID: 25014052 PMCID: PMC4172251] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Phenylketonuria (PKU) is characterized by phenylalanine accumulation due to phenylalanine hydroxylase deficiency. Up to 50% of PKU patients experience seizures. We evaluated an adult PKU patient who suffered from absences and primarily generalized tonicclonic seizures, associated with generalized spikeand-wave discharges (GSWs) on EEG. An analysis of blood oxygenation level-dependent (BOLD) signal changes during interictal epileptiform discharges showed early activation of the left perirolandic cortex followed by a BOLD signal decrease within cortical regions belonging to the default mode network and left frontoparietal cortex. Moreover, deactivation of the head of the right caudate nucleus and the left thalamus was observed. The fMRI pattern observed in our patient during GSWs is similar but not identical to that observed in idiopathic generalized epilepsy, suggesting different neurophysiological mechanisms. This is the first description of BOLD-fMRI patterns in a PKU patient with epilepsy. Similar studies in more patients might help to uncover the pathophysiology of seizures in this disease.
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Affiliation(s)
- Melania Guida
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa and Neurology Unit, Department of Neuroscience, A.O.U.P., Pisa, Italy
| | | | - Serena Fabbri
- Neuroradiology Unit, A.O.U.P., Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Ferdinando Sartucci
- Department of Clinical and Experimental Medicine, University of Pisa and Neurology Section of Cisanello H., Department of Neuroscience, A.O.U.P., Pisa, Italy
| | - Mirco Cosottini
- Neuroradiology Unit, A.O.U.P., Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Filippo Sean Giorgi
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa and Neurology Unit, Department of Neuroscience, A.O.U.P., Pisa, Italy
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Pesaresi I, Sabato M, Desideri I, Puglioli M, Moretti P, Cosottini M. 3.0T MR investigation of CLIPPERS: Role of susceptibility weighted and perfusion weighted imaging. Magn Reson Imaging 2013; 31:1640-2. [DOI: 10.1016/j.mri.2013.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/25/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022]
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Pizzanelli C, Caciagli L, Bartolami V, Giorgi FS, Pesaresi I, Guida M, Bonuccelli U. Reversible MRI abnormalities in mesial temporal lobe epilepsy: a case report. CMI 2013. [DOI: 10.7175/cmi.v7i3.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The question regarding the existence of abnormalities in the neuroimaging exams immediately after status epilecticus or epileptic seizures, but showing complete reversibility after a proper antiepileptic therapy, has long been debated. The first reports attempting to demonstrate their existence date back to the 1980s, and relied upon computed tomography as the imaging method of choice. After the introduction of MRI, a more appropriate characterization of these abnormalities was obtained along with the description of their most frequent features: (a) T2 signal hyperintensity in the white matter and, occasionally, (b) reduced apparent diffusion coefficient (ADC) and increased signal in DWI sequences.The MRI abnormalities induced by epileptic activity pose a broad differential diagnosis including infections, inflammatory autoimmune encephalopathies, neoplasms. It remains a diagnosis of exclusion and requires proper diagnostic iter in order to reduce the risk of misdiagnosis and unnecessary intervention.In this case report, a thorough presentation will be outlined about MRI alterations in the left mesial temporal lobe, which resulted completely reversible after a proper antiepileptic therapy.
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Kiferle L, Mazzucchi S, Unti E, Pesaresi I, Fabbri S, Nicoletti V, Volterrani D, Cosottini M, Bonuccelli U, Ceravolo R. Nigral involvement and nigrostriatal dysfunction in Huntington's disease: Evidences from an MRI and SPECT study. Parkinsonism Relat Disord 2013; 19:800-5. [DOI: 10.1016/j.parkreldis.2013.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 04/15/2013] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
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Cosottini M, Cecchi P, Piazza S, Pesaresi I, Fabbri S, Diciotti S, Mascalchi M, Siciliano G, Bonuccelli U. Mapping cortical degeneration in ALS with magnetization transfer ratio and voxel-based morphometry. PLoS One 2013; 8:e68279. [PMID: 23874570 PMCID: PMC3706610 DOI: 10.1371/journal.pone.0068279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 05/27/2013] [Indexed: 12/02/2022] Open
Abstract
Pathological and imaging data indicate that amyotrophic lateral sclerosis (ALS) is a multisystem disease involving several cerebral cortical areas. Advanced quantitative magnetic resonance imaging (MRI) techniques enable to explore in vivo the volume and microstructure of the cerebral cortex in ALS. We studied with a combined voxel-based morphometry (VBM) and magnetization transfer (MT) imaging approach the capability of MRI to identify the cortical areas affected by neurodegeneration in ALS patients. Eighteen ALS patients and 18 age-matched healthy controls were examined on a 1.5T scanner using a high-resolution 3D T1 weighted spoiled gradient recalled sequence with and without MT saturation pulse. A voxel-based analysis (VBA) was adopted in order to automatically compute the regional atrophy and MT ratio (MTr) changes of the entire cerebral cortex. By using a multimodal image analysis MTr was adjusted for local gray matter (GM) atrophy to investigate if MTr changes can be independent of atrophy of the cerebral cortex. VBA revealed several clusters of combined GM atrophy and MTr decrease in motor-related areas and extra-motor frontotemporal cortex. The multimodal image analysis identified areas of isolated MTr decrease in premotor and extra-motor frontotemporal areas. VBM and MTr are capable to detect the distribution of neurodegenerative alterations in the cortical GM of ALS patients, supporting the hypothesis of a multi-systemic involvement in ALS. MT imaging changes exist beyond volume loss in frontotemporal cortices.
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Affiliation(s)
- Mirco Cosottini
- Department of Neuroscience, University of Pisa, Pisa, Italy.
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Cosottini M, Pesaresi I, Piazza S, Diciotti S, Cecchi P, Fabbri S, Carlesi C, Mascalchi M, Siciliano G. Structural and functional evaluation of cortical motor areas in Amyotrophic Lateral Sclerosis. Exp Neurol 2011; 234:169-80. [PMID: 22226599 DOI: 10.1016/j.expneurol.2011.12.024] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 12/15/2011] [Accepted: 12/16/2011] [Indexed: 11/30/2022]
Abstract
The structural and functional data gathered with Magnetic Resonance Imaging (MRI) techniques about the brain cortical motor damage in Amyotrophic Lateral Sclerosis (ALS) are controversial. In fact some structural MRI studies showed foci of gray matter (GM) atrophy in the precentral gyrus, even in the early stage, while others did not. Most functional MRI (fMRI) studies in ALS reported hyperactivation of extra-primary motor cortices, while contradictory results were obtained on the activation of the primary motor cortex. We aimed to investigate the cortical motor circuitries in ALS patients by a combined structural and functional approach. Twenty patients with definite ALS and 16 healthy subjects underwent a structural examination with acquisition of a 3D T1-weighted sequence and fMRI examination during a maximal force handgrip task executed with the right-hand, the left-hand and with both hands simultaneously. The T1-weighted images were analyzed with Voxel-Based Morphometry (VBM) that showed several clusters of reduced cortical GM in ALS patients compared to controls including the pre and postcentral gyri, the superior, middle and inferior frontal gyri, the supplementary motor area, the superior and inferior parietal cortices and the temporal lobe, bilaterally but more extensive on the right side. In ALS patients a significant hypoactivation of the primary sensory motor cortex and frontal dorsal premotor areas as compared to controls was observed. The hypoactivated areas matched with foci of cortical atrophy demonstrated by VBM. The fMRI analysis also showed an enhanced activation in the ventral premotor frontal areas and in the parietal cortex pertaining to the fronto-parietal motor circuit which paralleled with disease progression rate and matched with cortical regions of atrophy. The hyperactivation of the fronto-parietal circuit was asymmetric and prevalent in the left hemisphere. VBM and fMRI identified structural and functional markers of an extended cortical damage within the motor circuit of ALS patients. The functional changes in non-primary motor cortices pertaining to fronto-parietal circuit suggest an over-recruitment of a pre-existing physiological sensory-motor network. However, the concomitant fronto-parietal cortical atrophy arises the possibility that such a hyper-activation reflects cortical hyper-excitability due to loss of inhibitory inter-neurons.
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Affiliation(s)
- Mirco Cosottini
- Department of Neuroscience, University of Pisa, Pisa, Italy.
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Giannelli M, Belmonte G, Toschi N, Pesaresi I, Ghedin P, Traino AC, Bartolozzi C, Cosottini M. Technical note: DTI measurements of fractional anisotropy and mean diffusivity at 1.5 T: comparison of two radiofrequency head coils with different functional designs and sensitivities. Med Phys 2011; 38:3205-11. [PMID: 21815395 DOI: 10.1118/1.3592013] [Citation(s) in RCA: 25] [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] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Diffusion tensor imaging (DTI) is highly sensitive to noise and improvement of radiofrequency coil technology represents a straightforward way for augmenting signal-to-noise ratio (SNR) performance in magnetic resonance imaging (MRI) scanners. The aim of this study was to characterize the dependence of DTI measurements of fractional anisotropy (FA) and mean diffusivity (MD) on the choice of head coil, comparing two head coils with different functional designs and sensitivities. METHODS Fourteen healthy subjects underwent DTI acquisitions at 1.5 T. Every subject was scanned twice, using a standard quadrature birdcage head coil (coil-A) and an eight-channel array head coil (coil-B). FA and MD maps, estimated using both the linear least squares (LLS) and nonlinear least squares (NLLS) methods, were nonlinearly normalized into a standard space. Then, volumetric regions of interest encompassing typical white and gray matter structures [splenium of the corpus callosum (SCC), internal capsule (IC), cerebral peduncles (CP), middle cerebellar peduncles (MCP), globus pallidus (GP), thalamus (TH), caudate (CA), and putamen (PU)] were analyzed. Significant differences and trends of variation in DTI measurements were assessed by the Wilcoxon test for paired samples with and without Bonferroni correction for multiple comparisons, respectively. RESULTS The overall SNR of coil-B was 30% higher than that of coil-A. When comparing DTI measurements (coil-B versus coil-A), mean FA values (SCC, IC, and TH), mean MD values (IC, CP, GP, and TH), FA standard deviation (CP, MCP, GP, and CA), and MD standard deviation (IC, CP, TH, and PU) resulted decreased (significant difference, p(cor) < 0.05, or trend of variation, P(uncor) < 0.05) in several gray and white matter regions of the human brain. With the exception of CP, the results in terms of revealed significant difference or trend of variation were independent of the method (LLS and NLLS) used for estimating the diffusion tensor. CONCLUSIONS In various gray and white matter structures, the eight-channel array head coil yielded more precise and accurate measurements of DTI derived indices compared to the standard quadrature birdcage head coil.
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Affiliation(s)
- Marco Giannelli
- Unit of Medical Physics, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy.
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Pesaresi I, Cosottini M, Belmonte G, Maritato P, Mascalchi M, Puglioli M, Sartucci F, Bartolozzi C, Murri L. Reproducibility of BOLD localization of interictal activity in patients with focal epilepsy: intrasession and intersession comparisons. Magn Reson Mater Phy 2011; 24:285-96. [DOI: 10.1007/s10334-011-0263-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 05/31/2011] [Accepted: 05/31/2011] [Indexed: 12/01/2022]
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Ginestroni A, Diciotti S, Cecchi P, Pesaresi I, Tessa C, Giannelli M, Della Nave R, Salvatore E, Salvi F, Dotti MT, Piacentini S, Soricelli A, Cosottini M, De Stefano N, Mascalchi M. Neurodegeneration in friedreich's ataxia is associated with a mixed activation pattern of the brain. A fMRI study. Hum Brain Mapp 2011; 33:1780-91. [PMID: 21674694 DOI: 10.1002/hbm.21319] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 11/23/2010] [Accepted: 03/10/2011] [Indexed: 12/11/2022] Open
Abstract
Friedreich's ataxia (FRDA) is associated with a distributed pattern of neurodegeneration in the spinal cord and the brain secondary to selective neuronal loss. We used functional MR Imaging (fMRI) to explore brain activation in FRDA patients during two motor-sensory tasks of different complexity, i.e. continuous hand tapping and writing of "8" figure, with the right dominant hand and without visual feedback. Seventeen FRDA patients and two groups of age-matched healthy controls were recruited. Task execution was monitored and recorded using MR-compatible devices. Hand tapping was correctly performed by 11 (65%) patients and writing of the "8" by 7 (41%) patients. After correction for behavioral variables, FRDA patients showed in both tasks areas of significantly lower activation in the left primary sensory-motor cortex and right cerebellum. Also left thalamus and right dorsolateral prefrontal cortex showed hypo-activation during hand tapping. During writing of the "8" task FRDA patients showed areas of higher activation in the right parietal and precentral cortex, globus pallidus, and putamen. Activation of right parietal cortex, anterior cingulum, globus pallidus, and putamen during writing of the "8" increased with severity of the neurological deficit. In conclusion fMRI demonstrates in FRDA a mixed pattern constituted by areas of decreased activation and areas of increased activation. The decreased activation in the primary motor cortex and cerebellum presumably reflects a regional neuronal damage, the decreased activation of the left thalamus and primary sensory cortex could be secondary to deafferentation phenomena, and the increased activation of right parietal cortex and striatum might have a possible compensatory significance.
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Affiliation(s)
- Andrea Ginestroni
- Department of Clinical Physiopathology, Radiodiagnostic Section, University of Florence, Florence, Italy
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Pizzanelli C, Catarsi E, Pelliccia V, Cosottini M, Pesaresi I, Puglioli M, Moretti P, Tavoni A. Primary angiitis of the central nervous system: report of eight cases from a single Italian center. J Neurol Sci 2011; 307:69-73. [PMID: 21636100 DOI: 10.1016/j.jns.2011.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 05/10/2011] [Accepted: 05/11/2011] [Indexed: 11/30/2022]
Abstract
The primary angiitis of the central nervous system (PACNS) is a rare and potentially fatal form of vasculitis with unknown etiology. Headache and encephalopathy are the most frequent symptoms. Neuroimaging plays an important role in the diagnosis, but the pattern of abnormal findings is not specific. In some cases brain biopsy is mandatory. PACNS is often described as a diagnostic and therapeutic challenge for clinicians considering the lack of univocal diagnostic criteria and paucity of studies evaluating the long-term outcome. This brief work reports how we managed eight patients with PACNS from diagnosis to long-term follow up treatment. Headache and focal acute neurological deficits were the most common symptoms. Magnetic resonance imaging (MRI) was abnormal in all patients with different patterns of infarctions or intraparenchymal/subarachnoid hemorrhages or their combination. Cerebral angiography demonstrated pathological findings compatible with vasculitis in all cases. Other causes of encephalopathy were ruled out. Patients with severe clinical and neuroradiological findings were treated with steroids and immunosuppressive therapy using cyclophosphamide/methotrexate. Patients with less aggressive PACNS, were treated with steroids only. In one case with multiple relapses infliximab was used after first-line immunosuppressive therapy failure. PACNS suspicion is based on the combination of demographic/clinical and MRI findings and the exclusion of other causes of multifocal encephalopathy. A positive angiography has a diagnostic value in an adequate clinical field. A strict collaboration of neurologists, neuroradiologists, and immunoreumatologists is essential in the management of PACNS both in the diagnostic and therapeutic phases.
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Affiliation(s)
- Chiara Pizzanelli
- Department of Neuroscience, Section of Neurology, University of Pisa, Italy.
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Cosottini M, Pesaresi I, Piazza S, Diciotti S, Belmonte G, Battaglini M, Ginestroni A, Siciliano G, De Stefano N, Mascalchi M. Magnetization transfer imaging demonstrates a distributed pattern of microstructural changes of the cerebral cortex in amyotrophic lateral sclerosis. AJNR Am J Neuroradiol 2011; 32:704-8. [PMID: 21436337 PMCID: PMC7965898 DOI: 10.3174/ajnr.a2356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 08/24/2010] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE To date, damage of the cerebral cortex neurons in ALS was investigated by using conventional MR imaging and proton MR spectroscopy. We explored the capability of MTI to map the microstructural changes in cerebral motor and extramotor cortices of patients with ALS. MATERIALS AND METHODS Twenty patients with ALS and 17 age-matched healthy controls were enrolled. A high-resolution 3D SPGR sequence with and without MT saturation pulses was obtained on a 1.5T scanner to compute MTR values. Using the FMRIB Software Library tools, we automatically computed the MTR of the cerebral cortex GM in 48 regions of the entire cerebral cortex derived from the standard Harvard-Oxford cortical atlas. RESULTS The MTR values were significantly lower in patients with ALS than in healthy controls in the primary motor cortex (precentral gyrus), nonprimary motor areas (superior and middle frontal gyri and superior parietal lobe), and some extramotor areas (frontal pole, planum temporale, and planum polare). No correlation was found between regional MTR values and the severity of clinical deficits or disease duration. CONCLUSIONS MTI analysis can detect the distributed pattern of microstructural changes of the GM in the cerebral cortex of patients with ALS with involvement of both the motor and extramotor areas.
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Affiliation(s)
- M Cosottini
- Department of Neuroscience, University of Pisa, Pisa, Italy.
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Frosini D, Pesaresi I, Cosottini M, Belmonte G, Rossi C, Dell'Osso L, Murri L, Bonuccelli U, Ceravolo R. Parkinson's Disease and pathological gambling: Results from a functional MRI study. Mov Disord 2010; 25:2449-53. [DOI: 10.1002/mds.23369] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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De Cori S, Biancofiore G, Bindi L, Cosottini M, Pesaresi I, Murri L, Mascalchi M. Clinical Recovery despite Cortical Cerebral and Cerebellar Damage in Heat Stroke. Neuroradiol J 2010; 23:35-7. [PMID: 24148330 DOI: 10.1177/197140091002300105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 12/22/2009] [Indexed: 11/16/2022] Open
Abstract
The prognosis of heat stroke has considerably improved with a mortality rate drop to 10% when therapeutic measurements including external cooling and aggressive rehydration are adopted. The role of imaging in predicting prognosis is uncertain. Some noted that development of cortical cerebellar atrophy is associated with development of a pancerebellar syndrome, while others suggested that evidence of cerebral cortical damage due to hypoxic-ischemic injury implies a poor prognosis. We observed a 17-year-old female who presented with lost of consciousness and seizure while jogging on a hot summer day followed by multi-organ failure. Brain MRI revealed a symmetric area of T2 hyperintensity and decreased diffusion in the cortical gyri of the frontal lobes. The patient made a complete recovery. MRI two years later showed disappearance of signal changes in the frontal cortex, but progressive atrophy of the cerebellum which was clinically silent. Our observation challenges the view of a close correlation between the imaging findings and prognosis in heat stroke.
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Affiliation(s)
- S. De Cori
- Department of Radiology, University of Pisa; Pisa, Italy
| | - G. Biancofiore
- Intensive Care Unit, Pisa University Hospital; Pisa, Italy
| | - L. Bindi
- Intensive Care Unit, Pisa University Hospital; Pisa, Italy
| | | | - I. Pesaresi
- Department of Radiology, University of Pisa; Pisa, Italy
| | | | - M. Mascalchi
- Department of Clinical Physiopathology, University of Florence; Florence, Italy
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Cosottini M, Pesaresi I, Maritato P, Belmonte G, Taddei A, Sartucci F, Mascalchi M, Murri L. EEG topography-specific BOLD changes: a continuous EEG-fMRI study in a patient with focal epilepsy. Magn Reson Imaging 2010; 28:388-93. [PMID: 20071117 DOI: 10.1016/j.mri.2009.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 08/11/2009] [Accepted: 11/27/2009] [Indexed: 11/28/2022]
Abstract
Blood oxygenation level dependent (BOLD) response related to interictal activity was evaluated in a patient with post-traumatic focal epilepsy at repeated continuous electroencephalogram (EEG)-functional magnetic resonance imaging examinations. Lateralized interictal EEG activity induced a main cluster of activation co-localized with the anatomical lesion. Spreading of EEG interictal activity to both frontal lobes evoked bilateral clusters of activation indicating that topography of BOLD response might depend on the spatial distribution of epileptiform activity.
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Affiliation(s)
- Mirco Cosottini
- Department of Neuroscience University of Pisa, 56100 Pisa, Italy.
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Frosini D, Ceravolo R, Rossi C, Pesaresi I, Cosottini M, Bonuccelli U. Bilateral thalamic glioma presenting with parkinsonism. Mov Disord 2010; 24:2168-9. [PMID: 19735095 DOI: 10.1002/mds.22761] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Frosini D, Pesaresi I, Rossi C, De Feo P, Cosottini M, Bonuccelli U, Ceravolo R. P1.091 Parkinson's disease and pathological gambling: results from a fMRI study investigating cue induced brain activity. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70213-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Morelli N, Pesaresi I, Cafforio G, Maluccio MR, Gori S, Di Salle F, Murri L. Functional magnetic resonance imaging in episodic cluster headache. J Headache Pain 2009; 10:11-4. [PMID: 19083151 PMCID: PMC3451754 DOI: 10.1007/s10194-008-0085-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Accepted: 11/26/2008] [Indexed: 12/20/2022] Open
Abstract
We have investigated the cerebral activation centre in four patients with episodic cluster headache (CH) with functional magnetic resonance imaging (f-MRI). The patients underwent MRI scans for anatomical and functional data acquisition in the asymptomatic state, during a headache attack and after subcutaneous administration of sumatriptan. Anatomical images were acquired by means of 3D-MPRAGE sequences and f-MRI images were obtained by means of echo-planar imaging. Data was analysed using the BrainVoyager QX version 1.7.81 software package. In all patients, the data showed significant hypothalamic activation of the hypothalamus ipsilateral to the pain side, attributable to a headache attack. Overall, we have demonstrated the anatomical location of central nervous system activation by means the first f-MRI study in CH patients. f-MRI offers a good balance of spatial and temporal resolution, and this method of study appears appropriate for investigating the pathogenetic aspects of primary headaches. Positron emission tomography and f-MRI may be regarded as little or no importance in a clinical context, they do, however, offer great potential for the exploration of headache physiopathology and the effects of pharmacological treatment.
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Affiliation(s)
- Nicola Morelli
- University Centre for Adaptive Disorders and Headache (UCADH), Institute of Neurology, Department of Neurosciences, University of Pisa, Pisa, Italy.
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Esposito F, Aragri A, Pesaresi I, Cirillo S, Tedeschi G, Marciano E, Goebel R, Di Salle F. Independent component model of the default-mode brain function: combining individual-level and population-level analyses in resting-state fMRI. Magn Reson Imaging 2008; 26:905-13. [DOI: 10.1016/j.mri.2008.01.045] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Revised: 12/20/2007] [Accepted: 01/14/2008] [Indexed: 11/24/2022]
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