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Trevisan L, Gaudio A, Monfrini E, Avanzino L, Di Fonzo A, Mandich P. Genetics in Parkinson's disease, state-of-the-art and future perspectives. Br Med Bull 2024; 149:60-71. [PMID: 38282031 PMCID: PMC10938543 DOI: 10.1093/bmb/ldad035] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder and is clinically characterized by the presence of motor (bradykinesia, rigidity, rest tremor and postural instability) and non-motor symptoms (cognitive impairment, autonomic dysfunction, sleep disorders, depression and hyposmia). The aetiology of PD is unknown except for a small but significant contribution of monogenic forms. SOURCES OF DATA No new data were generated or analyzed in support of this review. AREAS OF AGREEMENT Up to 15% of PD patients carry pathogenic variants in PD-associated genes. Some of these genes are associated with mendelian inheritance, while others act as risk factors. Genetic background influences age of onset, disease course, prognosis and therapeutic response. AREAS OF CONTROVERSY Genetic testing is not routinely offered in the clinical setting, but it may have relevant implications, especially in terms of prognosis, response to therapies and inclusion in clinical trials. Widely adopted clinical guidelines on genetic testing are still lacking and open to debate. Some new genetic associations are still awaiting confirmation, and selecting the appropriate genes to be included in diagnostic panels represents a difficult task. Finally, it is still under study whether (and to which degree) specific genetic forms may influence the outcome of PD therapies. GROWING POINTS Polygenic Risk Scores (PRS) may represent a useful tool to genetically stratify the population in terms of disease risk, prognosis and therapeutic outcomes. AREAS TIMELY FOR DEVELOPING RESEARCH The application of PRS and integrated multi-omics in PD promises to improve the personalized care of patients.
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Affiliation(s)
- L Trevisan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino – SS Centro Tumori Ereditari, Largo R. Benzi 10, Genova, 16132, Italy
| | - A Gaudio
- IRCCS Ospedale Policlinico San Martino- UOC Genetica Medica, Largo R. Benzi 10, Genova, 16132, Italy
| | - E Monfrini
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, Milan, 20122, Italy
- Neurology Unit, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via Festa del Perdono 7, Milan, 20122, Italy
| | - L Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Viale Benedetto XV/3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 3, Genova, 16132, Italy
| | - A Di Fonzo
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, Milan, 20122, Italy
- Neurology Unit, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via Festa del Perdono 7, Milan, 20122, Italy
| | - P Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino- UOC Genetica Medica, Largo R. Benzi 10, Genova, 16132, Italy
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Crisafulli O, Ravizzotti E, Mezzarobba S, Cosentino C, Bonassi G, Botta A, Abbruzzese G, Marchese R, Avanzino L, Pelosin E. A gait-based paradigm to investigate central body representation in cervical dystonia patients. Neurol Sci 2023; 44:1311-1318. [PMID: 36534193 DOI: 10.1007/s10072-022-06548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cervical dystonia (CD) is a common adult-onset idiopathic form of dystonia characterized by an abnormal head posture caused by an excessive activity of the neck muscles. The position of the head is important to direct viewpoint in the rounding environment, and the body orientation, during gait, must be coherent with the subjective straight ahead (SSA). An alteration of the SSA, as in the case of CD patients, could affect gait when visual input is not available. The aim of this study was to probe the behavior of patients with CD during blindfolded walking, investigating the ability to walk straight ahead based only on somatosensory and vestibular information. METHODS In this observational cross-sectional study, patients with CD and healthy control subjects (HC) were compared. All participants were evaluated through a gait analysis during blindfolded walking on a GAITRite carpet, relying on their own sense of straightness. RESULTS Patients with CD showed lower values of path length (p < 0.001), a lower number of steps on the carpet (p < 0.001). A higher number of CD patients deviated during the task, walking out of the carpet, (p < 0.005) compared to HS. No relation was found between the dystonic side and the gait trajectory deviation. A significant correlation was found between pain symptom and gait performance. CONCLUSIONS CD patients showed dysfunctions in controlling dynamic body location during walking without visual afferences, while the dystonic side does not seem to be related to the lateral deviation of the trajectory. Our results would assume that a general proprioceptive impairment could lead to an improper body position awareness in patients with CD.
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Affiliation(s)
- O Crisafulli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - E Ravizzotti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - S Mezzarobba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - C Cosentino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - G Bonassi
- S.C. Medicina Fisica e Riabilitazione Ospedaliera, Azienda Sanitaria Locale Chiavarese, 16043, Chiavari, Italy
| | - A Botta
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - R Marchese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - L Avanzino
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Experimental Medicine (DIMES), Section of Human Physiology, University of Genoa, Genoa, Italy
| | - E Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy.
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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Galeoto G, Berardi A, Colalelli F, Pelosin E, Mezzarobba S, Avanzino L, Valente D, Tofani M, Fabbrini G. Correlation between Quality of Life and severity of Parkinson's Disease by assessing an optimal cut-off point on the Parkinson's Disease questionnaire (PDQ-39) as related to the Hoehn & Yahr (H&Y) scale. Clin Ter 2022; 173:243-248. [PMID: 35612339 DOI: 10.7417/ct.2022.2427] [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: 06/15/2023]
Abstract
PURPOSE Strong evidence shows that symptoms in individuals with Parkinson's Disease (PD) restrict both their independence and social participation, leading to a low Quality of Life (QoL). Conversely, a reduced QoL has a negative impact on symptoms. The aim is to evaluate the correlation between QoL and severity of PD by assessing the presence of an optimal cut-off point on the Parkinson's disease questionnaire (PDQ-39) as related to the Hoehn &Yahr (H&Y) scale in a cohort of Italian adults with PD. METHODS A multicenter, cross-sectional study was performed. This study was conducted on a cohort of consecutive individuals. All participants were evaluated with the PDQ-39, and the severity of PD was recorded according to the H&Y scale by a neurologist. Receiver op-erating characteristic (ROC) curves and coordinates, visually inspected, were used to find cut-off points with optimal sensitivity and specificity. These were in turn used to determine the optimal PDQ-39 cut-off score for identifying disease severity according to H&Y stages. RESULTS 513 individuals were included in the study. The ROC curve analysis showed that QoL worsened with an increase in disease severity and age. Moreover, QoL was worse in females. CONCLUSIONS The results of this study allowed for the correlation of QoL and disease severity in a cohort of individuals with PD. With this cut-off point, it is now possible to make a determination of QoL of an individual with PD at a certain stage of the disease, in a specific age range, and of a particular gender.
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Affiliation(s)
- G Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, IS, Italy
| | - A Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - F Colalelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - E Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genova, Italy
| | - S Mezzarobba
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - L Avanzino
- Ospedale Policlinico San Martino, IRCSS, Genova, Italy
- Department of Experimental Medicine, Section of Human, Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genova, Italy
| | - D Valente
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCSS Neuromed, Pozzilli, IS, Italy
| | - M Tofani
- Department of Public Health and Infection disease, Sapienza University of Rome, Rome, Italy
| | - G Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCSS Neuromed, Pozzilli, IS, Italy
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Biggio M, Bisio A, Avanzino L, Ruggeri P, Bove M. Familiarity with a Tool Influences Peripersonal Space and Primary Motor Cortex Excitability of Muscles Involved in Haptic Contact. Cereb Cortex Commun 2021; 1:tgaa065. [PMID: 34296128 PMCID: PMC8152949 DOI: 10.1093/texcom/tgaa065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/04/2020] [Accepted: 09/06/2020] [Indexed: 01/24/2023] Open
Abstract
Long-term experience with a tool stably enlarges peripersonal space (PPS). Also, gained experience with a tool modulates internal models of action. The aim of this work was to understand whether the familiarity with a tool influences both PPS and motor representation. Toward this goal, we tested in 13 expert fencers through a multisensory integration paradigm the embodiment in their PPS of a personal (pE) or a common (cE) épée. Then, we evaluated the primary motor cortex excitability of proximal (ECR) and distal (APB) muscles during a motor imagery (MI) task of an athletic gesture when athletes handled these tools. Results showed that pE enlarges subjects' PPS, while cE does not. Moreover, during MI, handling tools increased cortical excitability of ECR muscle. Notably, APB's cortical excitability during MI only increased with pE as a function of its embodiment in PPS. These findings indicate that the familiarity with a tool specifically enlarges PPS and modulates the cortical motor representation of those muscles involved in the haptic contact with it.
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Affiliation(s)
- M Biggio
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale Scienze Motorie, University of Genoa, 16132 Genoa, Italy
| | - A Bisio
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale Scienze Motorie, University of Genoa, 16132 Genoa, Italy
| | - L Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale Scienze Motorie, University of Genoa, 16132 Genoa, Italy
| | - P Ruggeri
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale Scienze Motorie, University of Genoa, 16132 Genoa, Italy
| | - M Bove
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale Scienze Motorie, University of Genoa, 16132 Genoa, Italy
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Bisio A, Avanzino L, Biggio M, Canepa P, Ruggeri P, Bove M. P108 Combining action observation with kinesthetic illusion of movement shapes primary motor cortex plasticity. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.219] [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: 11/28/2022]
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Semprini M, Barban F, Bonassi G, Carè M, Pelosin E, Mantini D, Chiappalone M, Avanzino L. P113 Investigating the neural correlates of brain modulation. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.224] [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: 10/24/2022]
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Esposito M, Fabbrini G, Ferrazzano G, Berardelli A, Peluso S, Cesari U, Gigante AF, Bentivoglio AR, Petracca M, Erro R, Barone P, Schirinzi T, Eleopra R, Avanzino L, Romano M, Scaglione CL, Cossu G, Morgante F, Minafra B, Zibetti M, Coletti Moja M, Turla M, Fadda L, Defazio G. Spread of dystonia in patients with idiopathic adult-onset laryngeal dystonia. Eur J Neurol 2018; 25:1341-1344. [DOI: 10.1111/ene.13731] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - G. Fabbrini
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| | | | - A. Berardelli
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| | - S. Peluso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - U. Cesari
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - A. F. Gigante
- Department of Basic Science, Neuroscience and Sense Organs; Aldo Moro University of Bari; Bari Italy
| | - A. R. Bentivoglio
- Movement Disorders Unit; Center for Parkinson's Disease and Extrapyramidal Disorders; Institute of Neurology; Catholic University; Rome Italy
- Don Carlo Gnocchi Onlus Foundation; Milan Italy
| | - M. Petracca
- Movement Disorders Unit; Center for Parkinson's Disease and Extrapyramidal Disorders; Institute of Neurology; Catholic University; Rome Italy
| | - R. Erro
- Center for Neurodegenerative Diseases (CEMAND); Neuroscience Section; University of Salerno; Salerno Italy
| | - P. Barone
- Center for Neurodegenerative Diseases (CEMAND); Neuroscience Section; University of Salerno; Salerno Italy
| | - T. Schirinzi
- Department of Systems Medicine; University of Rome ‘Tor Vergata’; Rome Italy
| | - R. Eleopra
- IRCCS Foundation C. Besta Neurological Institute; Milan Italy
| | - L. Avanzino
- Section of Human Physiology; Department of Experimental Medicine; University of Genoa; Genoa Italy
| | - M. Romano
- Neurology Unit; Villa Sofia Hospital; Palermo Italy
| | | | - G. Cossu
- Department of Neurology; AOB ‘G. Brotzu’ General Hospital; Cagliari Italy
| | - F. Morgante
- Department of Neuroscience; University of Messina; Messina Italy
| | - B. Minafra
- Parkinson's Disease and Movement Disorders Unit; C. Mondino National Neurological Institute; IRCCS; Pavia Italy
| | - M. Zibetti
- Department of Neuroscience ‘Rita Levi Montalcini’; University of Turin; Turin Italy
| | | | - M. Turla
- Neurology Unit; Valle Camonica Hospital; Brescia Italy
| | - L. Fadda
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - G. Defazio
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
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8
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Defazio G, Esposito M, Abbruzzese G, Scaglione CL, Fabbrini G, Ferrazzano G, Peluso S, Pellicciari R, Gigante AF, Cossu G, Arca R, Avanzino L, Bono F, Mazza MR, Bertolasi L, Bacchin R, Eleopra R, Lettieri C, Morgante F, Altavista MC, Polidori L, Liguori R, Misceo S, Squintani G, Tinazzi M, Ceravolo R, Unti E, Magistrelli L, Coletti Moja M, Modugno N, Petracca M, Tambasco N, Cotelli MS, Aguggia M, Pisani A, Romano M, Zibetti M, Bentivoglio AR, Albanese A, Girlanda P, Berardelli A. Correction to: The Italian Dystonia Registry: rationale, design and preliminary findings. Neurol Sci 2018; 39:975. [DOI: 10.1007/s10072-018-3395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Martino D, Delorme C, Pelosin E, Hartmann A, Worbe Y, Avanzino L. Abnormal lateralization of fine motor actions in Tourette syndrome persists into adulthood. PLoS One 2017; 12:e0180812. [PMID: 28708864 PMCID: PMC5510833 DOI: 10.1371/journal.pone.0180812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 04/07/2017] [Accepted: 06/21/2017] [Indexed: 12/14/2022] Open
Abstract
Youth with Tourette syndrome (TS) exhibit, compared to healthy, abnormal ability to lateralize digital sequential tasks. It is unknown whether this trait is related to inter-hemispheric connections, and whether it is preserved or lost in patients with TS persisting through adult life. We studied 13 adult TS patients and 15 age-matched healthy volunteers. All participants undertook: 1) a finger opposition task, performed with the right hand (RH) only or with both hands, using a sensor-engineered glove in synchrony with a metronome at 2 Hz; we calculated a lateralization index [(single RH-bimanual RH)/single RH X 100) for percentage of correct movements (%CORR); 2) MRI-based diffusion tensor imaging and probabilistic tractography of inter-hemispheric corpus callosum (CC) connections between supplementary motor areas (SMA) and primary motor cortices (M1). We confirmed a significant increase in the %CORR in RH in the bimanual vs. single task in TS patients (p<0.001), coupled to an abnormal ability to lateralize finger movements (significantly lower lateralization index for %CORR in TS patients, p = 0.04). The %CORR lateralization index correlated positively with tic severity measured with the Yale Global Tic Severity Scale (R = 0.55;p = 0.04). We detected a significantly higher fractional anisotropy (FA) in both the M1-M1 (p = 0.036) and the SMA-SMA (p = 0.018) callosal fibre tracts in TS patients. In healthy subjects, the %CORR lateralization index correlated positively with fractional anisotropy of SMA-SMA fibre tracts (R = 0.63, p = 0.02); this correlation was not significant in TS patients. TS patients exhibited an abnormal ability to lateralize finger movements in sequential tasks, which increased in accuracy when the task was performed bimanually. This abnormality persists throughout different age periods and appears dissociated from the transcallosal connectivity of motor cortical regions. The altered interhemispheric transfer of motor abilities in TS may be the result of compensatory processes linked to self-regulation of motor control.
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Affiliation(s)
- D. Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - C. Delorme
- UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC University Paris 06, Paris, France
- Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47–83 boulevard de l'Hôpital, Paris, France, and French National Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - E. Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa Genoa, Italy
| | - A. Hartmann
- UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC University Paris 06, Paris, France
- Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47–83 boulevard de l'Hôpital, Paris, France, and French National Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Y. Worbe
- UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC University Paris 06, Paris, France
- Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47–83 boulevard de l'Hôpital, Paris, France, and French National Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Department of Neurophysiology, Saint-Antoine Hospital, Paris, France
| | - L. Avanzino
- Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, Department of Experimental Medicine, University of Genoa Genoa, Italy
- * E-mail:
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10
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Defazio G, Esposito M, Abbruzzese G, Scaglione CL, Fabbrini G, Ferrazzano G, Peluso S, Pellicciari R, Gigante AF, Cossu G, Arca R, Avanzino L, Bono F, Mazza MR, Bertolasi L, Bacchin R, Eleopra R, Lettieri C, Morgante F, Altavista MC, Polidori L, Liguori R, Misceo S, Squintani G, Tinazzi M, Ceravolo R, Unti E, Magistrelli L, Coletti Moja M, Modugno N, Petracca M, Tambasco N, Cotelli MS, Aguggia M, Pisani A, Romano M, Zibetti M, Bentivoglio AR, Albanese A, Girlanda P, Berardelli A. The Italian Dystonia Registry: rationale, design and preliminary findings. Neurol Sci 2017; 38:819-825. [PMID: 28215037 DOI: 10.1007/s10072-017-2839-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/03/2017] [Indexed: 01/22/2023]
Abstract
The Italian Dystonia Registry is a multicenter data collection system that will prospectively assess the phenomenology and natural history of adult-onset dystonia and will serve as a basis for future etiological, pathophysiological and therapeutic studies. In the first 6 months of activity, 20 movement disorders Italian centres have adhered to the registry and 664 patients have been recruited. Baseline historical information from this cohort provides the first general overview of adult-onset dystonia in Italy. The cohort was characterized by a lower education level than the Italian population, and most patients were employed as artisans, builders, farmers, or unskilled workers. The clinical features of our sample confirmed the peculiar characteristics of adult-onset dystonia, i.e. gender preference, peak age at onset in the sixth decade, predominance of cervical dystonia and blepharospasm over the other focal dystonias, and a tendency to spread to adjacent body parts, The sample also confirmed the association between eye symptoms and blepharospasm, whereas no clear association emerged between extracranial injury and dystonia in a body site. Adult-onset dystonia patients and the Italian population shared similar burden of arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidemia, and hypothyroidism, while hyperthyroidism was more frequent in the dystonia population. Geographic stratification of the study population yielded no major difference in the most clinical and phenomenological features of dystonia. Analysis of baseline information from recruited patients indicates that the Italian Dystonia Registry may be a useful tool to capture the real world clinical practice of physicians that visit dystonia patients.
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Affiliation(s)
- Giovanni Defazio
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy.
| | - M Esposito
- Department of Neurosciences, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - G Abbruzzese
- Section of Human Physiology, Department of Experimental Medicine, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - C L Scaglione
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - G Fabbrini
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
| | - G Ferrazzano
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
| | - S Peluso
- Department of Neurosciences, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - R Pellicciari
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy
| | - A F Gigante
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy
| | - G Cossu
- Department of Neurology, AOB "G. Brotzu" General Hospital, Cagliari, Italy
| | - R Arca
- Department of Neurology, AOB "G. Brotzu" General Hospital, Cagliari, Italy
| | - L Avanzino
- Section of Human Physiology, Department of Experimental Medicine, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - F Bono
- Neurology Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - M R Mazza
- Neurology Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - L Bertolasi
- Neurologic Unit, University Hospital, Verona, Italy
| | - R Bacchin
- Neurologic Unit, University Hospital, Verona, Italy
| | - R Eleopra
- Neurologic Unit, Department of Neuroscience, University Hospital "S. Maria della Misericordia", Udine, Italy
| | - C Lettieri
- Neurologic Unit, Department of Neuroscience, University Hospital "S. Maria della Misericordia", Udine, Italy
| | - F Morgante
- Department of Neuroscience, University of Messina, Messina, Italy
| | | | - L Polidori
- San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - R Liguori
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - S Misceo
- Neurologic Unit, San Paolo Hospital, Bari, Italy
| | - G Squintani
- Neurology Unit, Department of Neuroscience, University Hospital, University of Verona, Verona, Italy
| | - M Tinazzi
- Neurology Unit, Department of Neuroscience, University Hospital, University of Verona, Verona, Italy
| | - R Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Unti
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Magistrelli
- Section of Neurology, Department of Translational Medicine, University of Eastern Piedmont "Amedeo Avogadro", Novara, Italy
| | | | - N Modugno
- Neuromed Institute IRCCS, Pozzilli, IS, Italy
| | - M Petracca
- Movement Disorders Unit, Center for Parkinson's Disease and Extrapyramidal Disorders, Institute of Neurology, Catholic University, Rome, Italy
| | - N Tambasco
- Neurology Unit, University Hospital S. Andrea delle Fratte, University of Perugia, Perugia, Italy
| | | | - M Aguggia
- Neurology Department, Asti Hospital, Asti, Italy
| | - A Pisani
- Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Romano
- Neurology Unit, Villa Sofia Hospital, Palermo, Italy
| | - M Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - A R Bentivoglio
- Movement Disorders Unit, Center for Parkinson's Disease and Extrapyramidal Disorders, Institute of Neurology, Catholic University, Rome, Italy
| | - A Albanese
- Department of Neurology, Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - P Girlanda
- Department of Neuroscience, University of Messina, Messina, Italy
| | - A Berardelli
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
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11
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Bisio A, Avanzino L, Gueugneau N, Pozzo T, Ruggeri P, Bove M. LP38: A new paradigm to induce plasticity in human motor cortex: action observation combined with peripheral electrical nerve stimulation. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50775-4] [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: 10/25/2022]
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12
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Avanzino L, Lagravinese G, Bisio A, Perasso L, Ruggeri P, Bove M. LP64: Action perception: the mirror neuron system recognizes the temporal properties of movement. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)51120-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Bisio A, Avanzino L, Ruggeri P, Bove M. The tool as the last piece of the athlete’s gesture imagery puzzle. Neuroscience 2014; 265:196-203. [DOI: 10.1016/j.neuroscience.2014.01.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 01/09/2014] [Accepted: 01/26/2014] [Indexed: 10/25/2022]
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14
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Russo M, Crupi D, Dattola V, Avanzino L, Buccafusca M, Sottile F, Bove M, Quartarone A. P22.24 Central fatigue in multiple sclerosis: from motor preparation to motor execution. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60585-3] [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: 10/17/2022]
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15
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Rizzo V, Bove M, Naro A, Tacchino A, Mastroeni C, Avanzino L, Crupi D, Morgante F, Siebner H, Quartarone A. Associative cortico-cortical plasticity may affect ipsilateral finger opposition movements. Behav Brain Res 2011; 216:433-9. [DOI: 10.1016/j.bbr.2010.08.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 08/06/2010] [Accepted: 08/24/2010] [Indexed: 11/29/2022]
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16
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Avanzino L, Martino D, Marchese R, Aniello MS, Minafra B, Superbo M, Defazio G, Abbruzzese G. Quality of sleep in primary focal dystonia: a case-control study. Eur J Neurol 2009; 17:576-81. [PMID: 20039936 DOI: 10.1111/j.1468-1331.2009.02884.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep disturbances are common in patients with movement disorders. Evaluating quality of sleep is of primary importance because of the effect that nocturnal and daytime sleep abnormalities exert on general health status. However, quality of sleep has never been addressed in detail in patients with dystonia. The aim of this case-control study was to analyse quality of sleep in patients with the two most common forms of primary focal dystonia, blepharospasm (BSP) and cervical dystonia (CD). METHODS We evaluated quality of sleep (Pittsburgh Sleep Quality Index, PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale, ESS) in 98 patients with focal adult-onset dystonia (52 with BSP; 46 with CD) and in a group of 56 age-and gender-matched healthy subjects. The Beck Depression Inventory (BDI) was used for the evaluation of depressive symptomatology. RESULTS Quality of sleep was impaired (significantly higher PSQI scores) in both groups of patients. However, differences in PSQI scores between patients with CD and control subjects were partly confounded by BDI scores, whereas differences in PSQI scores between patients with BSP and control subjects were not influenced by BDI. Excessive daytime sleepiness was not significantly more frequent than in control subjects in either patients with BSP or patients with CD. CONCLUSIONS This study suggests that the assessment and treatment of insomnia-related complaints should be considered in global management plans of patients with focal dystonia, particularly in those affected by BSP.
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Affiliation(s)
- L Avanzino
- Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy
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17
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Trompetto C, Avanzino L, Bove M, Marinelli L, Molfetta L, Trentini R, Abbruzzese G. External shock waves therapy in dystonia: preliminary results. Eur J Neurol 2009; 16:517-21. [DOI: 10.1111/j.1468-1331.2008.02525.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Vitale C, Gulli R, Ciotti P, Scaglione C, Bellone E, Avanzino L, Lantieri F, Abbruzzese G, Martinelli P, Barone P, Mandich P. DRD3 Ser9Gly variant is not associated with essential tremor in a series of Italian patients. Eur J Neurol 2008; 15:985-7. [DOI: 10.1111/j.1468-1331.2008.02164.x] [Citation(s) in RCA: 18] [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] [Indexed: 10/22/2022]
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19
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Avanzino L, Bove M, Tacchino A, Trompetto C, Giannini A, Ghilardi M, Quartarone A, Abbruzzese G. Fatiguing exercises based on repetitive finger opposition movements can influence corticospinal excitability and motor behavior: a time course study. Brain Stimul 2008. [DOI: 10.1016/j.brs.2008.06.127] [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: 10/21/2022] Open
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20
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Abbruzzese G, Berardelli A, Girlanda P, Marchese R, Martino D, Morgante F, Avanzino L, Colosimo C, Defazio G. Long-term assessment of the risk of spread in primary late-onset focal dystonia. J Neurol Neurosurg Psychiatry 2008; 79:392-6. [PMID: 17635969 DOI: 10.1136/jnnp.2007.124594] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [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: 11/04/2022]
Abstract
BACKGROUND Primary late-onset focal dystonias may spread over time to adjacent body regions, but differences in the risk of spread over time among the various focal forms and the influence of age at dystonia onset on the risk of spread are not well established. METHODS Patients presenting with primary late-onset focal blepharospasm (BSP, n = 124), cervical dystonia (CD, n = 73) and focal hand dystonia (FHD, n = 24) with 10 years or more of disease duration (mean +/- SD, 15.3 (SD 4.9) years) were included in the study. The relationship between demographic/clinical variables and spread of dystonia was assessed by Kaplan-Meier survival curves and Cox proportional hazard regression models. RESULTS Patients starting with BSP, CD and FHD had similar age, sex and disease duration. Age at dystonia onset, age at initial spread and the risk of initial spread were significantly higher, whereas time elapsing from onset to initial spread was significantly lower in the BSP group than in those with onset in the neck or in the upper extremities. Conversely, these parameters were similar in the CD and FHD groups. The greater risk of spread in the BSP group was mainly evident in the first 5 years of history; thereafter, it declined and became similar to that of patients with CD/FHD. The difference in the risk of initial spread by site of onset was partly confounded by age at dystonia onset. Site of and age at dystonia onset, and age at first spread, were not significant predictors of the risk of a second spread. CONCLUSION This study adds new insights into the phenomenon of spread of primary late-onset focal dystonia and provides the framework for future studies aimed at an indepth investigation of the mechanism(s) of spread.
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Affiliation(s)
- G Abbruzzese
- Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Via De Toni 5, Genoa, Italy.
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21
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Trompetto C, Bove M, Avanzino L, Francavilla G, Berardelli A, Abbruzzese G. Intrafusal effects of botulinum toxin in post-stroke upper limb spasticity. Eur J Neurol 2008; 15:367-70. [PMID: 18266870 DOI: 10.1111/j.1468-1331.2008.02076.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A previous study in subjects with focal dystonia suggested that the greater and longer-lasting effect induced by botulinum toxin type A (BoNT-A) on the tonic vibration reflex (TVR) than on the maximal M-wave (M-max) might be the physiological marker of the toxin's action at the level of intrafusal muscle fibres. With this approach, we investigated the possible effect of BoNT-A on fusimotor synapses in eight patients with post-stroke spasticity (four with no residual motor capacity before treatment and four with partially spared muscle strength and residual motor capacity). TVR and M-max were recorded from the wrist and finger flexor muscles before treatment and at 1, 4 and 7 months afterwards. The TVR reduction was greater than the M-max reduction and remained fairly constant over time only in the subjects with a residual motor capacity before the treatment. This pilot study suggests that some degree of strength and active movement is necessary for the action of BoNT-A on intrafusal fibres.
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Affiliation(s)
- C Trompetto
- Department of Neurosciences, Ophthalmology & Genetics, University of Genoa, Genoa, Italy
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22
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Defazio G, Martino D, Abbruzzese G, Girlanda P, Tinazzi M, Fabbrini G, Colosimo C, Aniello MS, Avanzino L, Buccafusca M, Majorana G, Trompetto C, Livrea P, Berardelli A. Influence of coffee drinking and cigarette smoking on the risk of primary late onset blepharospasm: evidence from a multicentre case control study. J Neurol Neurosurg Psychiatry 2007; 78:877-9. [PMID: 17578856 PMCID: PMC2117757 DOI: 10.1136/jnnp.2007.119891] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 04/20/2007] [Accepted: 04/20/2007] [Indexed: 11/03/2022]
Abstract
Prior coffee and smoking habits were investigated in a multicentre case control study involving 166 patients presenting with primary late onset blepharospasm (BSP), 228 hospital control patients with primary hemifacial spasm and 187 population control subjects from five Italian centres. Information on age at disease onset, smoking and coffee drinking status at the reference age and average number of cups of coffee drunk/cigarettes smoked per day reached high and similar test-retest reproducibility in case and control patients. Unadjusted logistic regression analysis yielded a significant inverse association of prior coffee drinking and cigarette smoking with case status for the control groups. After adjustment for age, sex, referral centre, disease duration, years of schooling and ever coffee drinking/cigarette smoking, as appropriate, the smoking estimate lacked significance whereas the association of coffee intake and BSP did not (cases vs hospital control patients: OR 0.37 (95% CI 0.20 to 0.67); cases vs population control subjects: OR 0.44 (95% CI 0.23 to 0.85)). The strength of the inverse association between BSP and coffee intake tended to increase with the average number of cups drunk per day. There was a significant correlation between age of BSP onset and number of cups per day (adjusted regression coefficient 1.73; p = 0.001) whereas no correlation was found with number of packs of cigarettes per day. Coffee drinking may be inversely associated with the development of primary BSP and this association may partly depend on the amount consumed.
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Affiliation(s)
- G Defazio
- Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy.
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23
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Abstract
Previous results using paired-pulse transcranial magnetic stimulation (TMS) have suggested that the excitability of transcallosal (TC) connections between the hand areas of the two motor cortices is modulated by intracortical inhibitory circuits in the same way as corticospinal tract (CTS) projections to spinal motoneurons. Here we describe two further similarities in TC and CTS control using (1) an I-wave facilitation protocol and (2) preconditioning with rTMS. In experiment 1, excitability of TC pathways was measured using interhemispheric inhibition (IHI) and the ipsilateral silent period (iSP), whilst excitability of CTS pathways was measured by recording the EMG response evoked in the first dorsal interosseous muscle contralateral to the conditioning stimulus (cMEP). The intensity of the conditioning stimulus was first adjusted to threshold for evoking IHI and iSP, then pairs of conditioning stimuli were applied randomly at interstimulus intervals (ISIs) from 1.3 to 4.3 ms. IHI and iSP were facilitated at ISI=1.5 ms and 3.0 ms, respectively, as was the MEP evoked by the conditioning stimuli in the contralateral hand. We suggest that TC projections receive I-wave-like facilitation similar to that seen in CTS projections. In experiment 2, short interval inhibition of the iSP (SICIiSP), and short interval intracortical inhibition of the cMEP (SICIcMEP) were examined before and after 600 pulses of 5 Hz rTMS at 90% resting motor threshold. Both SICIiSP and SICIcMEP were reduced, as was the iSP; the cMEP was unchanged. This shows that the population of inhibitory interneurons that control TC neurons respond in the same way to 5 Hz rTMS as those that control CTS neurons. Taken together, the data from the two experiments suggest that the layer III and layer V pyramidal neurons that give rise to TC and CTS pathways, respectively, are controlled by neuronal circuitry with similar properties.
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Affiliation(s)
- L Avanzino
- Sobell Department of Motor Neuroscience and Movement Disorders, Box 66, Institute of Neurology, Queen Square, London WC1N 3BG, UK
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24
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Avanzino L, Marinelli L, Buccolieri A, Trompetto C, Abbruzzese G. Creutzfeldt-Jakob disease presenting as corticobasal degeneration: a neurophysiological study. Neurol Sci 2006; 27:118-21. [PMID: 16816909 DOI: 10.1007/s10072-006-0611-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 12/24/2005] [Accepted: 02/27/2006] [Indexed: 11/27/2022]
Abstract
Creutzfeldt-Jakob disease (CJD) can occasionally present with a clinical picture resembling a corticobasal degeneration (CBD). Transcallosal inhibition, as tested by focal transcranial magnetic stimulation, is frequently absent or highly disrupted in CBD patients. We report a case of CJD presenting at the beginning of the disease as a CBD in which the ipsilateral silent period (iSP) was present and well detectable. This brief report shows that study of the iSP may be a useful diagnostic tool in order to differentiate CBD from syndromes presenting with similar clinical features.
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Affiliation(s)
- L Avanzino
- Department of Neurosciences, Ophthalmology & Genetics, University of Genoa, Via de Toni 5, I-16132, Genoa, Italy
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25
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Abstract
OBJECTIVE To investigate whether the same mechanisms underlie muscle relaxation in proximal and distal arm muscles of normal subjects. METHODS Fourteen healthy subjects were studied using a simple visual reaction time paradigm. Relaxation reaction time (R-RT) and contraction reaction time (C-RT) were compared across different tasks involving distal (first dorsal interosseus, FDI, flexor carpi radialis, FCR) and proximal (biceps brachii, BB, triceps brachii, TR) arm muscles. Changes of FCR H-reflex before and during voluntary relaxation were investigated in two subjects. RESULTS No significant difference was observed between R-RT and C-RT in the distal muscles. The R-RT was significantly shorter than C-RT in both the BB and TR muscles. The relaxation latency (R-RT) was significantly correlated to the subjects' age in all the muscles except the FDI. No inhibition of the FCR H-reflex could be observed in the 20 ms preceding muscle relaxation. CONCLUSIONS Our findings suggest that neural mechanisms contribute differently to the relaxation of muscles with a different functional role. Voluntary relaxation in distal arm muscles is mainly related to the reduction of motor cortical output, while in proximal muscles a spinal disfacilitation is also present and possibly sustained by the modulation of presynaptic inhibition.
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Affiliation(s)
- A Buccolieri
- Department of Neurosciences, Ophthalmology and Genetics, Section of Neurology, University of Genoa, Italy
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