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Malandrone F, Catrambone V, Carletto S, Rossini PG, Coletti Moja M, Oliva F, Pagani M, Valenza G, Ostacoli L. Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder. J Affect Disord 2024; 351:143-150. [PMID: 38281599 DOI: 10.1016/j.jad.2024.01.172] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/18/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes. METHODS We enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment. RESULTS We found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment. CONCLUSIONS TF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.
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Affiliation(s)
- F Malandrone
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - V Catrambone
- NeuroCardiovascular Intelligence Lab, Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - S Carletto
- Department of Clinical and Biological Sciences, University of Turin, Italy.
| | - P G Rossini
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - M Coletti Moja
- Neurology Department, Ospedale degli Infermi, Ponderano, Italy
| | - F Oliva
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - M Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - G Valenza
- NeuroCardiovascular Intelligence Lab, Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - L Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Italy
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Alvino FG, Gini S, Minetti A, Pagani M, Sastre-Yagüe D, Barsotti N, De Guzman E, Schleifer C, Stuefer A, Kushan L, Montani C, Galbusera A, Papaleo F, Lombardo MV, Pasqualetti M, Bearden CE, Gozzi A. Synaptic-dependent developmental dysconnectivity in 22q11.2 deletion syndrome. bioRxiv 2024:2024.03.29.587339. [PMID: 38585897 PMCID: PMC10996624 DOI: 10.1101/2024.03.29.587339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Chromosome 22q11.2 deletion is among the strongest known genetic risk factors for neuropsychiatric disorders, including autism and schizophrenia. Brain imaging studies have reported disrupted large-scale functional connectivity in people with 22q11 deletion syndrome (22q11DS). However, the significance and biological determinants of these functional alterations remain unclear. Here, we use a cross-species design to investigate the developmental trajectory and neural underpinnings of brain dysconnectivity in 22q11DS. We find that LgDel mice, an established mouse model of 22q11DS, exhibit age-specific patterns of functional MRI (fMRI) dysconnectivity, with widespread fMRI hyper-connectivity in juvenile mice reverting to focal hippocampal hypoconnectivity over puberty. These fMRI connectivity alterations are mirrored by co-occurring developmental alterations in dendritic spine density, and are both transiently normalized by developmental GSK3β inhibition, suggesting a synaptic origin for this phenomenon. Notably, analogous hyper- to hypoconnectivity reconfiguration occurs also in human 22q11DS, where it affects hippocampal and cortical regions spatially enriched for synaptic genes that interact with GSK3β, and autism-relevant transcripts. Functional dysconnectivity in somatomotor components of this network is predictive of age-dependent social alterations in 22q11.2 deletion carriers. Taken together, these findings suggest that synaptic-related mechanisms underlie developmentally mediated functional dysconnectivity in 22q11DS.
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Affiliation(s)
- F G Alvino
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - S Gini
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - A Minetti
- Department of Biology, Unit of Cell and Developmental Biology, University of Pisa, Pisa, Italy
| | - M Pagani
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- IMT School for Advanced Studies, Lucca, Italy
| | - D Sastre-Yagüe
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - N Barsotti
- Centro per l'Integrazione della Strumentazione Scientifica dell'Universita di Pisa (CISUP), Pisa, Italy
| | - E De Guzman
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - C Schleifer
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - A Stuefer
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - L Kushan
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - C Montani
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - F Papaleo
- Genetics of Cognition Laboratory, Neuroscience area, Istituto Italiano di Tecnologia, Genova, Italy
| | - M V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - M Pasqualetti
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Centro per l'Integrazione della Strumentazione Scientifica dell'Universita di Pisa (CISUP), Pisa, Italy
| | - C E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - A Gozzi
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
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3
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Zerbi V, Pagani M, Markicevic M, Matteoli M, Pozzi D, Fagiolini M, Bozzi Y, Galbusera A, Scattoni ML, Provenzano G, Banerjee A, Helmchen F, Basson MA, Ellegood J, Lerch JP, Rudin M, Gozzi A, Wenderoth N. Correction: Brain mapping across 16 autism mouse models reveals a spectrum of functional connectivity subtypes. Mol Psychiatry 2022; 27:3920-3921. [PMID: 35322201 PMCID: PMC9708546 DOI: 10.1038/s41380-022-01510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- V Zerbi
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Pagani
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M Markicevic
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Matteoli
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- CNR Institute of Neuroscience, Milano, Italy
| | - D Pozzi
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Fagiolini
- F.M. Kirby Neurobiology Department, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Bozzi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M L Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - G Provenzano
- Department of Cellular, Computational and Integrative Biology. (CIBIO), University of Trento, Trento, Italy
| | - A Banerjee
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - F Helmchen
- Brain Research Institute, University of Zurich, Zurich, Switzerland
| | - M A Basson
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College, London, London, UK
| | - J Ellegood
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
| | - J P Lerch
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Rudin
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Gozzi
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy.
| | - N Wenderoth
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
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Savioli G, Ceresa I, Novelli V, Pagani M, Belliato M, Grulli F, Fumoso F, Lapia F, Brattoli M, Bressan M. P277 SECRET BEYOND THE DOOR. TRIAGE ANALYSIS AND RECOGNITION AT THE DOOR OF ELDERLY PATIENTS WITH PULMONARY EMBOLISM WHO ARRIVE IN THE EMERGENCY ROOM. THE REAL–LIFE EXPERIENCE OF 5 YEARS IN THE EMERGENCY ROOM. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
The range of symptoms of pulmonary embolism is wide and its recognition difficult.
Purpose
to analyze the efficiency of triage in the EP.
Methods
Single–center retrospective observational study, on all geriatric patients (>75 years) who entered our ED, where they were diagnosed with acute PE. Enrollment began in 2015 and ended in 2019. We analyzed means of presentation, priority codes for medical examination, exit code, hospitalization needs. We collected data from medical history, physical examination, laboratory tests, imaging, outcomes.
Results
We enrolled 247 patients, all in need of hospitalization. 44% came for dyspnea, 17% for chest pain, 16% for signs of DVT, 8% for syncope. 5% had only atypical symptoms (dizziness, general malaise, low–grade fever, neurological symptoms …). 45% had concomitant deep vein thrombosis. 50% showed alteration of the ECG tracing, 49% alteration of the shock index. Only 4% showed hypotension, 13% tachycardia and 8% desaturation. 39% arrived with their own vehicle. 32% was allocated to the area with low intensity of care, 68% to the area with medium–high intensity of care. As regards the priority code for the visit, 0% received a non–urgency code (white code or code 5), 27.9% a minor urgency code (green code or code 4) and 3.6% a high priority to the visit with assignment to low intensity of care (low intensity yellow or code 3). 63.15% received an emergency code (urgency or code 2) and 5.3% an emergency code (red code or code 1). The severity code at discharge, given on clinical criteria, was a low severity code (white or green) in 18% of cases, while 76% was considered high severity (urgency, yellow code) and in 6% for very high gravity (red code). 34% showed massive PE, 32% showed organ damage. 41% were considered to be at high risk of short–term mortality according to European guidelines, 8% required intensive care and in–hospital mortality was 7.7%. Under triage is 32%.
Conclusions
The population that arrives in ED due to pulmonary embolism presents extremely varied symptomatological pictures, and an overall high degree of clinical risk and care and therapeutic complexity in spite of the symptoms complained of and vital parameters. Under–riage remains a real problem for ED for this category of patients.
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Affiliation(s)
- G Savioli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - I Ceresa
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - V Novelli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Pagani
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Belliato
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Grulli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Fumoso
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Lapia
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Brattoli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Bressan
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
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Zerbi V, Pagani M, Markicevic M, Matteoli M, Pozzi D, Fagiolini M, Bozzi Y, Galbusera A, Scattoni ML, Provenzano G, Banerjee A, Helmchen F, Basson MA, Ellegood J, Lerch JP, Rudin M, Gozzi A, Wenderoth N. Brain mapping across 16 autism mouse models reveals a spectrum of functional connectivity subtypes. Mol Psychiatry 2021; 26:7610-7620. [PMID: 34381171 PMCID: PMC8873017 DOI: 10.1038/s41380-021-01245-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/30/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
Autism Spectrum Disorder (ASD) is characterized by substantial, yet highly heterogeneous abnormalities in functional brain connectivity. However, the origin and significance of this phenomenon remain unclear. To unravel ASD connectopathy and relate it to underlying etiological heterogeneity, we carried out a bi-center cross-etiological investigation of fMRI-based connectivity in the mouse, in which specific ASD-relevant mutations can be isolated and modeled minimizing environmental contributions. By performing brain-wide connectivity mapping across 16 mouse mutants, we show that different ASD-associated etiologies cause a broad spectrum of connectional abnormalities in which diverse, often diverging, connectivity signatures are recognizable. Despite this heterogeneity, the identified connectivity alterations could be classified into four subtypes characterized by discrete signatures of network dysfunction. Our findings show that etiological variability is a key determinant of connectivity heterogeneity in ASD, hence reconciling conflicting findings in clinical populations. The identification of etiologically-relevant connectivity subtypes could improve diagnostic label accuracy in the non-syndromic ASD population and paves the way for personalized treatment approaches.
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Affiliation(s)
- V Zerbi
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Pagani
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M Markicevic
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Matteoli
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- CNR Institute of Neuroscience, Milano, Italy
| | - D Pozzi
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Fagiolini
- F.M. Kirby Neurobiology Department, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Bozzi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M L Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - G Provenzano
- Department of Cellular, Computational and Integrative Biology. (CIBIO), University of Trento, Trento, Italy
| | - A Banerjee
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - F Helmchen
- Brain Research Institute, University of Zurich, Zurich, Switzerland
| | - M A Basson
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College, London, London, UK
| | - J Ellegood
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
| | - J P Lerch
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Rudin
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Gozzi
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy.
| | - N Wenderoth
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
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Lucini D, Malacarne M, Pagani M, Morizzo C, Kozakova M, Nannipieri M, Palombo C. A four-week prehabilitation program in candidates for bariatric surgery improves hemodynamic load, metabolism and cardiac autonomic regulation. Acta Diabetol 2021; 58:517-520. [PMID: 33515099 DOI: 10.1007/s00592-020-01645-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/23/2020] [Indexed: 12/01/2022]
Affiliation(s)
- D Lucini
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy.
- Exercise Medicine Unit, Humanitas Clinical and Research Center, Rozzano, Italy.
| | - M Malacarne
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy
- Exercise Medicine Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - M Pagani
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy
| | - C Morizzo
- Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
| | - M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
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Atenza A, Tamain M, Pereira B, Tiple A, Egret A, Garrouste C, Pagani M, Heng A. Utilisation du rituximab par voie sous-cutanée dans le traitement des syndromes néphrotiques idiopathiques à lésions glomérulaires minimes et de la hyalinose segmentaire et focale primitive chez l’adulte : étude pilote. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.150] [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: 11/24/2022]
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Gerosa M, Facciotti F, Larghi P, Bosotti R, Vasco C, Gagliani N, Cordiglieri C, Rottoli E, Penatti AE, Argolini LM, Karnani B, Kobayashi Y, Bombaci M, Van Hamburg JP, Gualtierotti R, Gatti S, Torretta S, Pignataro L, Tas SW, Caporali R, Abrignani S, Pagani M, Grassi F, Meroni PL, Flavell R, Geginat J. THU0221 EVIDENCE FOR A PATHOGENIC ROLE OF EXTRA-FOLLICULAR, IL-10 PRODUCING CCR6+B-HELPER T-CELLS IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1532] [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: 11/04/2022]
Abstract
Background:IL-10 plays a key role in systemic lupus erythematosus (SLE) pathogenesis, promoting B-cell response. IL10 is mainly secreted by regulatory T-cells, but follicular helper T-cells (TFH), also produce it. We previously identified a subset of CCR6+IL-7R+T-cells in human tonsils providing IL-10-dependent B-cell help. These CCR6+T-cells were able to produce IL-10, inducing IgG production.Objectives:to investigate a possible role of CD4+CCR6+IL7R+T-cells in SLE pathogenesis.Methods:37 patients fulfilling the ACR criteria for SLE have been included. Disease activity was assessed by 2k-SLEDAI. PBMC were analyzed by flow cytometry, using specific lineage markers. CCR6+IL7R+T-cells purified from total PBMC of SLE patients or healthy donors (HD) were co-cultured with autologous CD20+B-cells. IL-10, Il-17, total IgG and anti-dsDNA antibodies titers in patients serum and culture supernatants were assessed by ELISA. Embedded sections of lymph nodes from 8 SLE patients were analyzed by immunofluorescence (IF).Results:IL10 levels were significantly higher in SLE patients (Fig 1A). CD4+CCR6+IL7R+T-cells were significantly increased in SLE, in particular in those with higher disease activity and higher IL10 levels. CD4+CCR6+IL7R+T-cells levels associated with anti-dsDNA positivity. CCR6+IL7R+T-cells of SLE patients induced production of IgG and anti-dsDNA IgG (in anti-dsDNA + patients) from autologous B-cells, providing spontaneous help for autoantibody productionex vivo(Fig 1B-C). The IF study of lymph nodes of SLE patients showed that IL-10-producing CCR6+T-cells were highly abundant and co-localized with B-cells at follicle margins.Fig 1Conclusion:our study revealed a novel population of extra-follicular B-helper T-cells, which produce IL-10 and could play a prominent pathogenic role in SLE. Further studies will clarify if this potentially pathogenic cell population might represent a possible future therapeutic target.References:[1]Facciotti F. J Allergy Clin Immunol. 2016; Geginat J. Semin Immunol. 2019; Tsokos GC. Nat Rev Rheumatol. 2019Tab 1:SLE patients characteristics(n=37)DemographicsFemale/Male, n37/5Age, years, median (IQR)44 (38-49)Disease duration, years, median (IQR)19 (11-26)Lab testsANA86%*anti-dsDNA (%)46% medium/high titre41%Disease activity and clinical manifestations SLEDAI-2K, median (min-max)3.5 (0-24) Moderate/high activity19%Ongoing therapyPrednisone dose mg/day, median (IQR)7,5 mg (2,5 – 20)hydroxychloroquine78%Immunosuppressants87%Fig 2Disclosure of Interests: :Maria Gerosa: None declared, Federica Facciotti: None declared, Paola Larghi: None declared, Roberto Bosotti: None declared, Chiara Vasco: None declared, Nicola Gagliani: None declared, Chiara Cordiglieri: None declared, Elsa Rottoli: None declared, Alessandra Emiliana Penatti: None declared, Lorenza Maria Argolini: None declared, Bhavna Karnani: None declared, Yasushi Kobayashi: None declared, Mauro Bombaci: None declared, Jan Piet Van Hamburg: None declared, Roberta Gualtierotti: None declared, Stefano Gatti: None declared, Sara Torretta: None declared, Lorenzo Pignataro: None declared, Sander W. Tas: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB, Sergio Abrignani: None declared, Massimiliano Pagani: None declared, Fabio Grassi: None declared, Pier Luigi Meroni: None declared, Richard Flavell: None declared, Jens Geginat: None declared
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Geginat J, Vasco M, Gerosa M, Tas SW, Pagani M, Grassi F, Flavell RA, Meroni P, Abrignani S. IL-10 producing regulatory and helper T-cells in systemic lupus erythematosus. Semin Immunol 2019; 44:101330. [PMID: 31735515 DOI: 10.1016/j.smim.2019.101330] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease characterised by the production of pathogenic autoantibodies against nuclear self-antigens. The anti-inflammatory and tolerogenic cytokine Interleukin-10 appears to play a paradoxical pathogenic role in SLE and is therefore currently therapeutically targeted in clinical trials. It is generally assumed that the pathogenic effect of IL-10 in SLE is due to its growth and differentiation factor activity on autoreactive B-cells, but effects on other cells might also play a role. To date, a unique cellular source of pathogenic IL-10 in SLE has not been identified. In this review, we focus on the contribution of different CD4+T-cell subsets to IL-10 and autoantibody production in SLE. In particular, we discuss that IL-10 produced by different subsets of adaptive regulatory T-cells, follicular helper T-cells and extra-follicular B-helper T-cells is likely to have different effects on autoreactive B-cell responses. A better understanding of the role of IL-10 in B-cell responses and lupus would allow to identify the most promising therapies for individual SLE patients in the future.
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Affiliation(s)
- J Geginat
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy.
| | - M Vasco
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy
| | - M Gerosa
- DISCCO, Department of Clinical Science and Community Health, University of Milan, Italy; ASST Istituto G. Pini, Milan, Italy
| | - S W Tas
- Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Infection & Immunity Institute and Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, the Netherlands
| | - M Pagani
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Infection & Immunity Institute and Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, the Netherlands; Department of Medical Biotechnology and Translational Medicine, University of Milan, Italy
| | - F Grassi
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; Institute for Research in Biomedicine, Bellinzona, Switzerland
| | - R A Flavell
- Department of Immunobiology, and Howard Hughes Medical Institute, School of Medicine, Yale University, New Haven, USA
| | - Pl Meroni
- Istituto Auxologico Italiano, Milano, Italy
| | - S Abrignani
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; DISCCO, Department of Clinical Science and Community Health, University of Milan, Italy
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Bocchialini G, Braggio C, Ventura L, Pagani M, Carbognani P, Rusca M, Ampollini L. EP1.17-14 Less Is More: An Unusual Case of Benign Emptying of the Post - Pneumonectomy Space. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2424] [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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Baldi E, Buratti S, Contri E, Canevari S, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, Palo A, Oltrona Visconti L, De Ferrari GM, Savastano S. P2828Survival after an out-of-hospital cardiac arrest decrease over time in all Utstein categories. The importance of a long follow-up. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Survival beyond 1-month after an out-of-hospital cardiac arrest (OHCA) is still considered a challenge for OHCA registries and it is often unexplored. However, a longer follow-up could help to better comprehend the long-term issues of OHCA survivors.
Purpose
Our aim was to evaluate the long-term outcome after OHCA via an Utstein-based cardiac arrest registry with a long follow-up (up to 5 years).
Methods
We enrolled all the people with an OHCA of any aetiology in our Province (about 55ehz748.1138 inhabitants in northern Italy) in whom CPR was attempted. The primary endpoint was the survival at 1 month, and the secondary endpoints were the survival at 6 months and then every year until 5 years after OHCA.
Results
In the first 45 months (October 2014–June 2018) 1774 resuscitation attempts for confirmed OHCAs were enrolled. Baseline characteristics: male 59.7%; mean age of 73.4±16 years; mean EMS response time was 11:31±5:09 mins; home location 78.8%; bystander-witnessed events were 56.1%; EMS witnessed event 15.6%; bystander CPR 39.5%; AED use before EMS arrival 2.5%; medical etiology 93%; first shockable rhythm 18.2% (90.7% VF, 2.5% VT without pulse, 6.8% AED shockable). When considering survival from the event (Figure 1 – left panel), survival was significantly higher for shockable Utstein categories (p<0.001). Considering only those patients discharged alive (Figure 1 – right panel) long term survival was significantly higher (p<0.01) once again for shockable rhythms. Interestingly, in this category survival continued to decrease over time ranging about from 90% in the first year to about 80% at four years.
Figure 1
Conclusions
Our results demonstrated that survival after OHCA can change over the time in all the Utstein categories, so we believe that a longer follow-up should be encouraged by next Utstein style revision.
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Affiliation(s)
- E Baldi
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - S Buratti
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - E Contri
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - S Canevari
- Azienda Regionale Emergenza Urgenza (AREU), SOREU Pianura, Milano, Italy
| | - S Molinari
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - M Pagani
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - B Lusona
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - F Mojoli
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - R Bertona
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Vigevano, Italy
| | - R Osti
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Voghera, Italy
| | - A Palo
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - S Savastano
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
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Canosa A, Pagani M, Brunetti M, Barberis M, Iazzolino B, Ilardi A, Cammarosano S, Manera U, Moglia C, Calvo A, Cistaro A, Chiò A. Correlation between Apolipoprotein E genotype and brain metabolism in amyotrophic lateral sclerosis. Eur J Neurol 2018; 26:306-312. [PMID: 30240096 DOI: 10.1111/ene.13812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/22/2018] [Accepted: 09/10/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE The aim of the study was to evaluate the metabolic correlates of Apolipoprotein E (APOE) genotype in amyotrophic lateral sclerosis (ALS) and to investigate the role of ε2 as a risk factor for cognitive impairment. METHODS A total of 159 ALS cases underwent APOE and ALS-related genes analysis, neuropsychological assessment and cerebral 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography. The APOE genotype was regressed against whole brain metabolism as assessed by 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography, with age, sex, education, type of onset and C9orf72 status as covariates. RESULTS Brain metabolism was significantly positively correlated with APOE genotype from ε2/ε2 to ε3/ε4 in the left prefrontal [Brodmann area (BA) 10], orbitofrontal (BAs 11, 45, 47) and anterior cingulate (BA 32) cortices. There was a tendency to a relative hypometabolism going towards the ε2/ε2 extreme. CONCLUSIONS We found a highly significant, relatively lower metabolism in association with the ε2 allele in extra-motor areas typically affected in frontotemporal dementia (left prefrontal, orbitofrontal and anterior cingulate cortices), strengthening the finding of a role of ε2 as a risk factor for cognitive impairment in ALS. Our data suggested a link between cholesterol homeostasis and neurodegeneration.
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Affiliation(s)
- A Canosa
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - M Pagani
- Institute of Cognitive Sciences and Technologies (CNR), Rome, Italy.,Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - M Brunetti
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - M Barberis
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - B Iazzolino
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - A Ilardi
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - S Cammarosano
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - U Manera
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - C Moglia
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin
| | - A Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin.,Neuroscience Institute of Turin (NIT), Turin
| | - A Cistaro
- PET Centre AFFIDEA IRMET, Turin, Italy
| | - A Chiò
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Institute of Cognitive Sciences and Technologies (CNR), Rome, Italy.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin.,Neuroscience Institute of Turin (NIT), Turin
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Baldi E, Palo A, Danza AI, Canevari F, Mosca C, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, De Ferrari GM, Oltrona Visconti L, Savastano S. P264Long-term survival after an out-of-hospital cardiac arrest: beyond 1 month follow-up. Our three years experience. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Baldi
- IRCCS Polyclinic San Matteo Foundation, University of Pavia, School of Cardiovascular Disease, Pavia, Italy
| | - A Palo
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - A I Danza
- IRCCS Polyclinic San Matteo Foundation, University of Pavia, School of Cardiovascular Disease, Pavia, Italy
| | - F Canevari
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - C Mosca
- University of Pavia, Pavia, Italy
| | - S Molinari
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - M Pagani
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - B Lusona
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - F Mojoli
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - R Bertona
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Vigevano, Italy
| | - R Osti
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Voghera, Italy
| | - G M De Ferrari
- IRCCS Polyclinic San Matteo Foundation, Cardiac Intensive Care Unit, Pavia, Italy
| | - L Oltrona Visconti
- IRCCS Polyclinic San Matteo Foundation, Division of Cardiology, Pavia, Italy
| | - S Savastano
- IRCCS Polyclinic San Matteo Foundation, Division of Cardiology, Pavia, Italy
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Aitini E, Rabbi C, Mambrini A, Cavazzini G, Pari F, Zamagni D, Cantore M, Pagani M, Sorio M, Lusenti A, Adami F, Smerieri F. Epirubicin, Cisplatin and Continuous Infusion 5-Fluorouracil (ECF) in Locally Advanced or Metastatic Gastric Cancer: A Single Institution Experience. Tumori 2018; 87:20-4. [PMID: 11669552 DOI: 10.1177/030089160108700105] [Citation(s) in RCA: 4] [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] [Indexed: 11/15/2022]
Abstract
Aims and Background The role of chemotherapy in locally advanced or metastatic gastric cancer has been controversial, but chemotherapy has recently been shown to relieve tumor-related symptoms, improve quality of life and prolong survival when compared with best supportive care. Furthermore, palliative chemotherapy is also cost-effective. “Second-generation” combination chemotherapy regimens were developed in the 1980s with high activity in advanced or metastatic gastric cancer (EAP, FAMTX, PELF, ECF). In randomized studies, EAP demonstrated no difference in activity but a significantly higher overall toxicity and toxic death rate than FAMTX, and the ECF (epirubicin, cisplatin, 5-fluorouracil) regimen gave a survival and response advantage, tolerable toxicity, better quality of life and was more cost-effective than FAMTX. Methods Sixty patients with locally advanced or metastatic gastric cancer were treated with the ECF regimen (21 weeks of 5-fluorouracil given by continuous infusion through a central line at 200 mg/m2 for 24-hr combined with cisplatin at 60 mg/m2 iv and epirubicin at 50 mg/m2 iv beginning on day 1 and repeated every 3 weeks for 8 courses). There were 42 males and 18 females, with a median age of 64 years (range, 40-74). The median performance status was 1. The histologic type was adenocarcinoma in 44 patients and undifferentiated carcinoma in 16 (27%). Three patients had locally advanced disease (5%) and 57 had metastatic disease (95%). Seven patients (12%) had received prior chemotherapy for advanced disease. Results All patients were assessable for toxicity and 55 for response (5 had insufficient treatment). Toxicity was mild or moderate, and there was no toxic death. Incidence of WHO toxicity ≥ 2 was nausea and vomiting in 3%, mucositis in 3%, leukopenia in 7%, anemia in 3%, and thrombocytopenia in 2%. Port-a-Cath toxicity was thrombosis in 4, dislocation in 2 and infection in 3 patients. Seven complete responses and 13 partial responses (overall response rate, 36%) were achieved, with a response rate of 39% in untreated and 17% in pretreated patients. Nine patients (16%) had stable disease and 26 (47%) progressive disease. Most patients felt symptomatically improved on ECF. Conclusions Our study confirms that the ECF regimen has a favorable pattern of toxicity and is feasible on an outpatient basis. However, it did not confirm the high response rate reported in other phase II trials.
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Affiliation(s)
- E Aitini
- Medical Oncology and Hematology Department, Carlo Poma Hospital, Mantua, Italy.
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Savastano S, Baldi E, Raimondi M, Guerci M, Canevari F, Danza A, Mosca C, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, Oltrona Visconti L. P2750The challenge of long-term survival after an out-of-hospital cardiac arrest: one month is not enough. Our two years experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S. Savastano
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - E. Baldi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M. Raimondi
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - M. Guerci
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - F. Canevari
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - A.I. Danza
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - C. Mosca
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S. Molinari
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - M. Pagani
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - B. Lusona
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - F. Mojoli
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - R. Bertona
- Ospedale Civile, Cardiology, Vigevano, Italy
| | - R. Osti
- Ospedale Civile, Cardiology, Voghera, Italy
| | - L. Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
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Bonadonna P, Passalacqua G, Reccardini F, Rizzini FL, Mauro M, Franchini M, Pagani M, Roncallo C, Costantino MT, Zanotti R. Severe Anaphylactic Reactions after Stopping Hymenoptera Venom Immunotherapy. a Clonal Mast Cell Disorder Should be Suspected. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.738] [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: 10/20/2022]
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De Agostini G, Bonetti L, Moleri C, Belotti L, Colombo S, Pagani M, Cabiddu M, Borgonovo K, Ruggeri L, Rossi F, Coinu A, Cavalleri M, Astori A, Ghilardi M, Aceti A, Peccati M, Petrelli F, Losi M, Barni S. Find yourself with a smile. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv347.26] [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: 11/12/2022] Open
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Bonadonna P, Pagani M, Aberer W, Bilò MB, Brockow K, Oude Elberink H, Garvey L, Mosbech H, Romano A, Zanotti R, Torres MJ. Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper. Allergy 2015; 70:755-63. [PMID: 25824492 DOI: 10.1111/all.12617] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 01/08/2023]
Abstract
Mastocytosis is a clonal disorder characterized by the proliferation and accumulation of mast cells (MC) in different tissues, with a preferential localization in skin and bone marrow (BM). The excess of MC in mastocytosis as well as the increased releasability of MC may lead to a higher frequency and severity of immediate hypersensitivity reactions. Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. Fatal anaphylaxis has been described particularly following hymenoptera stings, but also occasionally after the intake of drugs such as nonsteroidal anti-inflammatory drugs, opioids and drugs in the perioperative setting. However, data on the frequency of drug hypersensitivity in mastocytosis and vice versa are scarce and evidence for an association appears to be limited. Nevertheless, clonal MC disorders should be ruled out in cases of severe anaphylaxis: basal serum tryptase determination, physical examination for cutaneous mastocytosis lesions, and clinical characteristics of anaphylactic reaction might be useful for differential diagnosis. In this position paper, the ENDA group performed a literature search on immediate drug hypersensitivity reactions in clonal MC disorders using MEDLINE, EMBASE, and Cochrane Library, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation.
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Affiliation(s)
- P. Bonadonna
- Allergy Unit; Azienda Ospedaliera Universitaria Intergrata of Verona; Verona Italy
| | - M. Pagani
- Medicine Ward; Pieve di Coriano Hospital Azienda Ospedaliera Carlo Poma Mantova; Mantova Italy
| | - W. Aberer
- Department of Dermatology and Venerology; Medizinische Universitat Graz; Graz Austria
| | - M. B. Bilò
- Allergy Unit; Department of Internal Medicine; Ospedali Riuniti di Ancona; Ancona Italy
| | - K. Brockow
- Department of Dermatology and Allergy Biederstein; Technische Universität München; Munich Germany
| | - H. Oude Elberink
- Department of Allergology; GRIAC Research Institute; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - L. Garvey
- Allergy Clinic; Copenhagen University Hospital; Gentofte Denmark
| | - H. Mosbech
- Allergy Clinic; Copenhagen University Hospital; Gentofte Denmark
| | - A. Romano
- Allergy Unit Complesso Integrato Columbus; Rome and IRCCS Oasi Maria S.S.; Troina Italy
| | - R. Zanotti
- Department of Medicine; Hematology Section; Azienda Ospedaliera Universitaria Intergrata of Verona; Verona Italy
| | - M. J. Torres
- Allergy Unit; Regional University Hospital-IBIMA; UMA; Málaga Spain
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Di Lorenzo G, Monaco L, Daverio A, Santarnecchi E, Verrdo A, Niolu C, Fernandez I, Pagani M, Siracusano A. Emdr Therapy Changes the Resting-state Eeg. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30537-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Salvioli B, Pellegatta G, Malacarne M, Pace F, Malesci A, Pagani M, Lucini D. Autonomic nervous system dysregulation in irritable bowel syndrome. Neurogastroenterol Motil 2015; 27:423-30. [PMID: 25581440 DOI: 10.1111/nmo.12512] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 12/17/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Autonomic nervous system (ANS) regulation may be altered in functional diseases, including irritable bowel syndrome (IBS), but published data are not clear to date. The aim of the study was to analyze ANS function in IBS subjects classified by Rome III criteria and healthy controls using standardized technique. METHODS ANS activity was evaluated by autoregressive spectral analysis of RR interval and systolic arterial pressure variabilities, to obtain indices of sympatho-vagal modulation of the heart and of spontaneous cardiac baroreflex (α index). A symptom list was used to score 18 somatic complaints (score 0-180) (4SQ). Fatigue and stress were assessed through the use of a global scoring index (0-10). KEY RESULTS We enrolled 41 IBS subjects (29 F, age 40 ± 2 years) and 42 healthy matched controls. Heart rate was higher in IBS than control subjects (69 ± 2 vs 61 ± 1; p < 0.001). The total variance of RR interval variability, and α index, were significantly lower in IBS compared to controls (1983.12 ± 384.64 ms(2) vs 4184.55 ± 649.59 ms(2) ; 18.1 ± 2 ms/mmHg vs 29 ± 3 ms/mmHg; p < 0.01). The α index results showed an inverse correlation with stress scores and somatic symptoms. CONCLUSIONS & INFERENCES IBS subjects display a significant reduction in α index, an established marker of cardiac baroreflex. ANS dysfunction appears to be involved in the pathophysiology of IBS and its assessment may open new perspectives for clinical management of patients suffering from IBS.
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Affiliation(s)
- B Salvioli
- University of Bologna, Bologna, Italy; Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Italy
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Pagani M, Sonni I, Capriotti G. Functional imaging in neurodegenerative disorders: past, present and future. Q J Nucl Med Mol Imaging 2014; 58:329-331. [PMID: 25519924] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- M Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
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Quartuccio N, Van Weehaeghe D, Cistaro A, Jonsson C, Van Laere K, Pagani M. Positron emission tomography neuroimaging in amyotrophic lateral sclerosis: what is new? Q J Nucl Med Mol Imaging 2014; 58:344-54. [PMID: 25375229 DOI: pmid/25375229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving upper and lower motor neurons, extra-motor neurons, microglia and astrocytes. The neurodegenerative process results in progressive muscle paralysis and even in cognitive impairment. Within the complex diagnostic work-up, positron emission tomography (PET) represents a valuable imaging tool in the assessment of patients with ALS. PET, by means of different radiotracers (i.e. 18F-fluorodeoxyglucose, 6-[18F]fluoro-L-dopa, [11C]flumazenil) can assess the status of the wide range of brain regions and neural circuits, which can be affected by ALS. Furthermore, experimental radiocompounds have been developed for the evaluation of white matter, which plays a role in the progression of the disease. Here we present a comprehensive review including in different sections the most relevant PET studies: studies investigating ALS and ALS-mimicking conditions (especially primary lateral sclerosis and other neurodegenerative diseases), articles selecting specific subsets of patients (with bulbar or spinal onset), studies investigating patients with familial type of ALS, studies evaluating the role of the white matter in ALS and papers evaluating the diagnostic sensitivity of PET in ALS patients.
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Affiliation(s)
- N Quartuccio
- Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphologic and Functional Images University of Messina, Italy -
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Tassorelli C, Jensen RH, De Icco R, Allena M, Katzarava Z, Lainez JM, Leston JA, Fadic R, Spadafora S, Pagani M, Giuseppe N. EHMTI-0327. Information and communication technology for improving the management of medication overuse headache: results of the comoestas multicentric, multinational study. J Headache Pain 2014. [PMCID: PMC4182052 DOI: 10.1186/1129-2377-15-s1-d63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Pagani M, De Carli F, Morbelli S, Öberg J, Chincarini A, Frisoni GB, Galluzzi S, Perneczky R, Drzezga A, van Berckel BNM, Ossenkoppele R, Didic M, Guedj E, Brugnolo A, Picco A, Arnaldi D, Ferrara M, Buschiazzo A, Sambuceti G, Nobili F. Volume of interest-based [18F]fluorodeoxyglucose PET discriminates MCI converting to Alzheimer's disease from healthy controls. A European Alzheimer's Disease Consortium (EADC) study. Neuroimage Clin 2014; 7:34-42. [PMID: 25610765 PMCID: PMC4299956 DOI: 10.1016/j.nicl.2014.11.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [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: 09/22/2014] [Revised: 10/14/2014] [Accepted: 11/11/2014] [Indexed: 01/18/2023]
Abstract
An emerging issue in neuroimaging is to assess the diagnostic reliability of PET and its application in clinical practice. We aimed at assessing the accuracy of brain FDG-PET in discriminating patients with MCI due to Alzheimer's disease and healthy controls. Sixty-two patients with amnestic MCI and 109 healthy subjects recruited in five centers of the European AD Consortium were enrolled. Group analysis was performed by SPM8 to confirm metabolic differences. Discriminant analyses were then carried out using the mean FDG uptake values normalized to the cerebellum computed in 45 anatomical volumes of interest (VOIs) in each hemisphere (90 VOIs) as defined in the Automated Anatomical Labeling (AAL) Atlas and on 12 meta-VOIs, bilaterally, obtained merging VOIs with similar anatomo-functional characteristics. Further, asymmetry indexes were calculated for both datasets. Accuracy of discrimination by a Support Vector Machine (SVM) and the AAL VOIs was tested against a validated method (PALZ). At the voxel level SMP8 showed a relative hypometabolism in the bilateral precuneus, and posterior cingulate, temporo-parietal and frontal cortices. Discriminant analysis classified subjects with an accuracy ranging between .91 and .83 as a function of data organization. The best values were obtained from a subset of 6 meta-VOIs plus 6 asymmetry values reaching an area under the ROC curve of .947, significantly larger than the one obtained by the PALZ score. High accuracy in discriminating MCI converters from healthy controls was reached by a non-linear classifier based on SVM applied on predefined anatomo-functional regions and inter-hemispheric asymmetries. Data pre-processing was automated and simplified by an in-house created Matlab-based script encouraging its routine clinical use. Further validation toward nonconverter MCI patients with adequately long follow-up is needed. 18F-FDG-PET/CT analysis of metabolic differences between MCI converting to AD and HC Large and very well controlled cohorts from EADC-Consortium were investigated. Data were analyzed by a friendly-to-use Matlab-based script and Support Vector Machine. Excellent discrimination between MCI and HC (sensitivity 92%; specificity 91%) Highest accuracy reported so far in MCI and promising implementation in clinical routine
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Affiliation(s)
- M Pagani
- Institute of Cognitive Sciences and Technologies, Rome, Italy ; Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - F De Carli
- Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale delle Ricerche (CNR), Genoa, Italy
| | - S Morbelli
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - J Öberg
- Department of Hospital Physics, Karolinska Hospital, Stockholm, Sweden
| | - A Chincarini
- National Institute for Nuclear Physics (INFN), Genoa, Italy
| | - G B Frisoni
- LENITEM Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio-FBF, Brescia, Italy ; University Hospitals and University of Geneva, Geneva, Switzerland
| | - S Galluzzi
- LENITEM Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio-FBF, Brescia, Italy
| | - R Perneczky
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College London of Science, Technology and Medicine, London, UK ; West London Cognitive Disorders Treatment and Research Unit, London, UK ; Department of Psychiatry and Psychotherapy, Technische Universität, Munich, Germany
| | - A Drzezga
- Department of Nuclear Medicine, Technische Universität, Munich, Germany
| | - B N M van Berckel
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
| | - R Ossenkoppele
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
| | - M Didic
- APHM, CHU Timone, Service de Neurologie et Neuropsychologie, Aix-Marseille University, INSERM U 1106, Marseille, France
| | - E Guedj
- APHM, CHU Timone, Service de Médecine Nucléaire, CERIMED, INT CNRS UMR7289 , Aix-Marseille University, Marseille 13005, France
| | - A Brugnolo
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - A Picco
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - D Arnaldi
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - M Ferrara
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - A Buschiazzo
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - G Sambuceti
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - F Nobili
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
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Pagani M, Marpaung D, Eggleton BJ. Ultra-wideband microwave photonic phase shifter with configurable amplitude response. Opt Lett 2014; 39:5854-5857. [PMID: 25361102 DOI: 10.1364/ol.39.005854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We introduce a new principle that enables separate control of the amplitude and phase of an optical carrier, simply by controlling the power of two stimulated Brillouin scattering (SBS) pumps. This technique is used to implement a microwave photonic phase shifter with record performance, which solves the bandwidth limitation of previous gain-transparent SBS-based phase shifters, while achieving unprecedented minimum power fluctuations, as a function of phase shift. We demonstrate 360° continuously tunable phase shift, with less than 0.25 dB output power fluctuations, over a frequency band from 1.5 to 31 GHz, limited only by the measurement equipment.
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Pagani M, Giovannetti AM, Covelli V, Sattin D, Leonardi M. Caregiving for Patients in Vegetative and Minimally Conscious States: Perceived Burden as a Mediator in Caregivers’ Expression of Needs and Symptoms of Depression and Anxiety. J Clin Psychol Med Settings 2014; 21:214-22. [DOI: 10.1007/s10880-014-9399-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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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Sattin D, Covelli V, Pagani M, Giovannetti AM, Raggi A, Meucci P, Cerniauskaite M, Quintas R, Schiavolin S, Leonardi M. Do diagnostic differences between vegetative state and minimally conscious state patients correspond to differences in functioning and disability profiles? Results from an observational multi-center study on patients with DOC. Eur J Phys Rehabil Med 2014; 50:309-321. [PMID: 24518146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Patients in vegetative (VS) and minimally conscious state (MCS) have different degrees of consciousness recovery but both display severe levels of disability. AIM To describe and compare VS and MCS patients' functioning and disability according to ICF model (International Classification of Functioning, Disability and Health). DESIGN Observational cross-sectional multi-center study involving sixty-nine Italian centers. SETTING Patients recruited in post-acute, long-term care facilities and at home in Italy. POPULATION Adult patients in VS and MCS. METHODS ICF Functioning profiles were completed and, for each ICF chapter and domain, extension and severity indexes were developed. Indexes have been compared between VS and MCS patients with Mann Whitney U test. Descriptive statistics have been applied to describe the most relevant categories that had a percentage of missing below 25% and that were reported as a problem by at least 50% of patients. RESULTS A total of 564 patients were enrolled: 396 in VS (mean age 56.8), 168 in MCS (mean age 54.2). Fifty-eight ICF categories were selected: of them, 24 were from Activity and Participation (A&P). Few differences between patients in VS and MCS were reported in Body Functions (BF), mostly referred to mental, sensory and digestive functions; among A&P, differences were found only in learning chapter. For VS patients less environmental barriers were reported than MCS patients. CONCLUSION Patients in VS and MCS have similar functioning and disability profiles and similar needs thus levels of care and assistance should not be different across the two conditions. CLINICAL REHABILITATION IMPACT An ICF-based methodology of data collection enables to describe VS and MCS patients' functioning and disability: this is helpful when rehabilitation programs based on the features of single patients with DOC need to be planned.
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Affiliation(s)
- D Sattin
- Neurology Public Health and Disability Unit Scientific Directorate Neurological Institute C. Besta IRCCS Foundation Milan, Italy -
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Tassorelli C, Jensen R, Allena M, De Icco R, Sances G, Katsarava Z, Lainez M, Leston J, Fadic R, Spadafora S, Pagani M, Nappi G. A consensus protocol for the management of medication-overuse headache: Evaluation in a multicentric, multinational study. Cephalalgia 2014; 34:645-655. [PMID: 24558185 DOI: 10.1177/0333102414521508] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [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: 11/16/2022]
Abstract
INTRODUCTION The management of medication-overuse headache (MOH) is often difficult and no specific guidelines are available as regards the most practical and effective approaches. In this study we defined and tested a consensus protocol for the management of MOH on a large population of patients distributed in different countries. SUBJECTS AND METHODS The protocol was based on evidence from the literature and on consolidated expertise of the members of the consensus group. The study was conducted according to a multicentric interventional design with the enrolment of 376 MOH subjects in four centres from Europe and two centres in Latin America. The majority of patients were treated according to an outpatient detoxification programme. The post-detoxification follow-up lasted six months. RESULTS At the final evaluation, two-thirds of the subjects were no longer overusers and in 46.5% of subjects headache had reverted back to an episodic pattern of headache. When comparing the subjects who underwent out-patient detoxification vs those treated with in-patient detoxification, both regimens proved effective, although the drop-out rate was higher in the out-patient approach. CONCLUSIONS The present findings support the effectiveness and usability of the proposed consensus protocol in different countries with different health care modalities.
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Affiliation(s)
- C Tassorelli
- Headache Science Center, C. Mondino National Neurological Institute, Pavia Dept. of Brain and Behaviour, University of Pavia, Italy
| | - R Jensen
- Danish Headache Centre, Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - M Allena
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
| | - R De Icco
- Headache Science Center, C. Mondino National Neurological Institute, Pavia Dept. of Brain and Behaviour, University of Pavia, Italy
| | - G Sances
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
| | - Z Katsarava
- Department of Neurology, University of Essen, Germany
| | - M Lainez
- Foundation of the Valencian Community, University Clinical Hospital, Spain
| | - Ja Leston
- Foundation for Combating Neurological Diseases of Childhood, Argentina
| | - R Fadic
- Department of Neurology, Pontificia Catolica University of Chile, Chile
| | | | - M Pagani
- Bioengeneering and Medical Informatics Consortium (CBIM), Italy
| | - G Nappi
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
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Di Lorenzo G, Monaco L, Daverio A, Giannoudas I, Verardo A, La Porta P, Niolu C, Fernandez I, Pagani M, Siracusano A. EPA-1793 – Enhancement of right hemisphere eeg functional connectivity after emdr therapy. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78912-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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He BJ, Nolte G, Nagata K, Takano D, Yamazaki T, Fujimaki Y, Maeda T, Satoh Y, Heckers S, George MS, Lopes da Silva F, de Munck JC, Van Houdt PJ, Verdaasdonk RM, Ossenblok P, Mullinger K, Bowtell R, Bagshaw AP, Keeser D, Karch S, Segmiller F, Hantschk I, Berman A, Padberg F, Pogarell O, Scharnowski F, Karch S, Hümmer S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O, Razavi N, Jann K, Koenig T, Kottlow M, Hauf M, Strik W, Dierks T, Gotman J, Vulliemoz S, Lu Y, Zhang H, Yang L, Worrell G, He B, Gruber O, Piguet C, Hubl D, Homan P, Kindler J, Dierks T, Kim K, Steinhoff U, Wakai R, Koenig T, Kottlow M, Melie-García L, Mucci A, Volpe U, Prinster A, Salvatore M, Galderisi S, Linden DEJ, Brandeis D, Schroeder CE, Kayser C, Panzeri S, Kleinschmidt A, Ritter P, Walther S, Haueisen J, Lau S, Flemming L, Sonntag H, Maess B, Knösche TR, Lanfer B, Dannhauer M, Wolters CH, Stenroos M, Haueisen J, Wolters C, Aydin U, Lanfer B, Lew S, Lucka F, Ruthotto L, Vorwerk J, Wagner S, Ramon C, Guan C, Ang KK, Chua SG, Kuah WK, Phua KS, Chew E, Zhou H, Chuang KH, Ang BT, Wang C, Zhang H, Yang H, Chin ZY, Yu H, Pan Y, Collins L, Mainsah B, Colwell K, Morton K, Ryan D, Sellers E, Caves K, Throckmorton S, Kübler A, Holz EM, Zickler C, Sellers E, Ryan D, Brown K, Colwell K, Mainsah B, Caves K, Throckmorton S, Collins L, Wennberg R, Ahlfors SP, Grova C, Chowdhury R, Hedrich T, Heers M, Zelmann R, Hall JA, Lina JM, Kobayashi E, Oostendorp T, van Dam P, Oosterhof P, Linnenbank A, Coronel R, van Dessel P, de Bakker J, Rossion B, Jacques C, Witthoft N, Weiner KS, Foster BL, Miller KJ, Hermes D, Parvizi J, Grill-Spector K, Recanzone GH, Murray MM, Haynes JD, Richiardi J, Greicius M, De Lucia M, Müller KR, Formisano E, Smieskova R, Schmidt A, Bendfeldt K, Walter A, Riecher-Rössler A, Borgwardt S, Fusar-Poli P, Eliez S, Schmidt A, Sekihara K, Nagarajan SS, Schoffelen JM, Guggisberg AG, Nolte G, Balazs S, Kermanshahi K, Kiesenhofer W, Binder H, Rattay F, Antal A, Chaieb L, Paulus W, Bodis-Wollner I, Maurer K, Fein G, Camchong J, Johnstone J, Cardenas-Nicolson V, Fiederer LDJ, Lucka F, Yang S, Vorwerk J, Dümpelmann M, Cosandier-Rimélé D, Schulze-Bonhage A, Aertsen A, Speck O, Wolters CH, Ball T, Fuchs M, Wagner M, Kastner J, Tech R, Dinh C, Haueisen J, Baumgarten D, Hämäläinen MS, Lau S, Vogrin SJ, D'Souza W, Haueisen J, Cook MJ, Custo A, Van De Ville D, Vulliemoz S, Grouiller F, Michel CM, Malmivuo J, Aydin U, Vorwerk J, Küpper P, Heers M, Kugel H, Wellmer J, Kellinghaus C, Scherg M, Rampp S, Wolters C, Storti SF, Boscolo Galazzo I, Del Felice A, Pizzini FB, Arcaro C, Formaggio E, Mai R, Manganotti P, Koessler L, Vignal J, Cecchin T, Colnat-Coulbois S, Vespignani H, Ramantani G, Maillard L, Rektor I, Kuba R, Brázdil M, Chrastina J, Rektorova I, van Mierlo P, Carrette E, Strobbe G, Montes-Restrepo V, Vonck K, Vandenberghe S, Ahmed B, Brodely C, Carlson C, Kuzniecky R, Devinsky O, French J, Thesen T, Bénis D, David O, Lachaux JP, Seigneuret E, Krack P, Fraix V, Chabardès S, Bastin J, Jann K, Gee D, Kilroy E, Cannon T, Wang DJ, Hale JR, Mayhew SD, Przezdzik I, Arvanitis TN, Bagshaw AP, Plomp G, Quairiaux C, Astolfi L, Michel CM, Mayhew SD, Mullinger KJ, Bagshaw AP, Bowtell R, Francis ST, Schouten AC, Campfens SF, van der Kooij H, Koles Z, Lind J, Flor-Henry P, Wirth M, Haase CM, Villeneuve S, Vogel J, Jagust WJ, Kambeitz-Ilankovic L, Simon-Vermot L, Gesierich B, Duering M, Ewers M, Rektorova I, Krajcovicova L, Marecek R, Mikl M, Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S, Surmeli T, Ertem A, Eralp E, Kos IH, Skrandies W, Flüggen S, Klein A, Britz J, Díaz Hernàndez L, Ro T, Michel CM, Lenartowicz A, Lau E, Rodriguez C, Cohen MS, Loo SK, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A, Flor-Henry P, Lind J, Koles Z, Bollmann S, Ghisleni C, O'Gorman R, Poil SS, Klaver P, Michels L, Martin E, Ball J, Eich-Höchli D, Brandeis D, Salisbury DF, Murphy TK, Butera CD, Mathalon DH, Fryer SL, Kiehl KA, Calhoun VC, Pearlson GD, Roach BJ, Ford JM, McGlashan TH, Woods SW, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Gonzalez Andino S, Grave de Peralta Menendez R, Grave de Peralta Menendez R, Sanchez Vives M, Rebollo B, Gonzalez Andino S, Frølich L, Andersen TS, Mørup M, Belfiore P, Gargiulo P, Ramon C, Vanhatalo S, Cho JH, Vorwerk J, Wolters CH, Knösche TR, Watanabe T, Kawabata Y, Ukegawa D, Kawabata S, Adachi Y, Sekihara K, Sekihara K, Nagarajan SS, Wagner S, Aydin U, Vorwerk J, Herrmann C, Burger M, Wolters C, Lucka F, Aydin U, Vorwerk J, Burger M, Wolters C, Bauer M, Trahms L, Sander T, Faber PL, Lehmann D, Gianotti LRR, Pascual-Marqui RD, Milz P, Kochi K, Kaneko S, Yamashita S, Yana K, Kalogianni K, Vardy AN, Schouten AC, van der Helm FCT, Sorrentino A, Luria G, Aramini R, Hunold A, Funke M, Eichardt R, Haueisen J, Gómez-Aguilar F, Vázquez-Olvera S, Cordova-Fraga T, Castro-López J, Hernández-Gonzalez MA, Solorio-Meza S, Sosa-Aquino M, Bernal-Alvarado JJ, Vargas-Luna M, Vorwerk J, Magyari L, Ludewig J, Oostenveld R, Wolters CH, Vorwerk J, Engwer C, Ludewig J, Wolters C, Sato K, Nishibe T, Furuya M, Yamashiro K, Yana K, Ono T, Puthanmadam Subramaniyam N, Hyttinen J, Lau S, Güllmar D, Flemming L, Haueisen J, Sonntag H, Vorwerk J, Wolters CH, Grasedyck L, Haueisen J, Maeß B, Freitag S, Graichen U, Fiedler P, Strohmeier D, Haueisen J, Stenroos M, Hauk O, Grigutsch M, Felber M, Maess B, Herrmann B, Strobbe G, van Mierlo P, Vandenberghe S, Strobbe G, Cárdenas-Peña D, Montes-Restrepo V, van Mierlo P, Castellanos-Dominguez G, Vandenberghe S, Lanfer B, Paul-Jordanov I, Scherg M, Wolters CH, Ito Y, Sato D, Kamada K, Kobayashi T, Dalal SS, Rampp S, Willomitzer F, Arold O, Fouladi-Movahed S, Häusler G, Stefan H, Ettl S, Zhang S, Zhang Y, Li H, Kong X, Montes-Restrepo V, Strobbe G, van Mierlo P, Vandenberghe S, Wong DDE, Bidet-Caulet A, Knight RT, Crone NE, Dalal SS, Birot G, Spinelli L, Vulliémoz S, Seeck M, Michel CM, Emory H, Wells C, Mizrahi N, Vogrin SJ, Lau S, Cook MJ, Karahanoglu FI, Grouiller F, Caballero-Gaudes C, Seeck M, Vulliemoz S, Van De Ville D, Spinelli L, Megevand P, Genetti M, Schaller K, Michel C, Vulliemoz S, Seeck M, Genetti M, Tyrand R, Grouiller F, Vulliemoz S, Spinelli L, Seeck M, Schaller K, Michel CM, Grouiller F, Heinzer S, Delattre B, Lazeyras F, Spinelli L, Pittau F, Seeck M, Ratib O, Vargas M, Garibotto V, Vulliemoz S, Vogrin SJ, Bailey CA, Kean M, Warren AE, Davidson A, Seal M, Harvey AS, Archer JS, Papadopoulou M, Leite M, van Mierlo P, Vonck K, Boon P, Friston K, Marinazzo D, Ramon C, Holmes M, Koessler L, Rikir E, Gavaret M, Bartolomei F, Vignal JP, Vespignani H, Maillard L, Centeno M, Perani S, Pier K, Lemieux L, Clayden J, Clark C, Pressler R, Cross H, Carmichael DW, Spring A, Bessemer R, Pittman D, Aghakhani Y, Federico P, Pittau F, Grouiller F, Vulliémoz S, Gotman J, Badier JM, Bénar CG, Bartolomei F, Cruto C, Chauvel P, Gavaret M, Brodbeck V, van Leeuwen T, Tagliazzuchi E, Melloni L, Laufs H, Griskova-Bulanova I, Dapsys K, Klein C, Hänggi J, Jäncke L, Ehinger BV, Fischer P, Gert AL, Kaufhold L, Weber F, Marchante Fernandez M, Pipa G, König P, Sekihara K, Hiyama E, Koga R, Iannilli E, Michel CM, Bartmuss AL, Gupta N, Hummel T, Boecker R, Holz N, Buchmann AF, Blomeyer D, Plichta MM, Wolf I, Baumeister S, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M, Natahara S, Ueno M, Kobayashi T, Kottlow M, Bänninger A, Koenig T, Schwab S, Koenig T, Federspiel A, Dierks T, Jann K, Natsukawa H, Kobayashi T, Tüshaus L, Koenig T, Kottlow M, Achermann P, Wilson RS, Mayhew SD, Assecondi S, Arvanitis TN, Bagshaw AP, Darque A, Rihs TA, Grouiller F, Lazeyras F, Ha-Vinh Leuchter R, Caballero C, Michel CM, Hüppi PS, Hauser TU, Hunt LT, Iannaccone R, Stämpfli P, Brandeis D, Dolan RJ, Walitza S, Brem S, Graichen U, Eichardt R, Fiedler P, Strohmeier D, Freitag S, Zanow F, Haueisen J, Lordier L, Grouiller F, Van de Ville D, Sancho Rossignol A, Cordero I, Lazeyras F, Ansermet F, Hüppi P, Schläpfer A, Rubia K, Brandeis D, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, Verardo AR, La Porta P, Niolu C, Fernandez I, Siracusano A, Tamura K, Karube C, Mizuba T, Matsufuji M, Takashima S, Iramina K, Assecondi S, Ostwald D, Bagshaw AP, Marecek R, Brazdil M, Lamos M, Slavícek T, Marecek R, Jan J, Meier NM, Perrig W, Koenig T, Minami T, Noritake Y, Nakauchi S, Azuma K, Minami T, Nakauchi S, Rodriguez C, Lenartowicz A, Cohen MS, Rodriguez C, Lenartowicz A, Cohen MS, Iramina K, Kinoshita H, Tamura K, Karube C, Kaneko M, Ide J, Noguchi Y, Cohen MS, Douglas PK, Rodriguez CM, Xia HJ, Zimmerman EM, Konopka CJ, Epstein PS, Konopka LM, Giezendanner S, Fisler M, Soravia L, Andreotti J, Wiest R, Dierks T, Federspiel A, Razavi N, Federspiel A, Dierks T, Hauf M, Jann K, Kamada K, Sato D, Ito Y, Okano K, Mizutani N, Kobayashi T, Thelen A, Murray M, Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G, Coito A, Macku P, Tyrand R, Astolfi L, He B, Wiest R, Seeck M, Michel C, Plomp G, Vulliemoz S, Fischmeister FPS, Glaser J, Schöpf V, Bauer H, Beisteiner R, Deligianni F, Centeno M, Carmichael DW, Clayden J, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny S, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Dürschmid S, Zaehle T, Pannek H, Chang HF, Voges J, Rieger J, Knight RT, Heinze HJ, Hinrichs H, Tsatsishvili V, Cong F, Puoliväli T, Alluri V, Toiviainen P, Nandi AK, Brattico E, Ristaniemi T, Grieder M, Crinelli RM, Jann K, Federspiel A, Wirth M, Koenig T, Stein M, Wahlund LO, Dierks T, Atsumori H, Yamaguchi R, Okano Y, Sato H, Funane T, Sakamoto K, Kiguchi M, Tränkner A, Schindler S, Schmidt F, Strauß M, Trampel R, Hegerl U, Turner R, Geyer S, Schönknecht P, Kebets V, van Assche M, Goldstein R, van der Meulen M, Vuilleumier P, Richiardi J, Van De Ville D, Assal F, Wozniak-Kwasniewska A, Szekely D, Harquel S, Bougerol T, David O, Bracht T, Jones DK, Horn H, Müller TJ, Walther S, Sos P, Klirova M, Novak T, Brunovsky M, Horacek J, Bares M, Hoschl C C, Fellhauer I, Zöllner FG, Schröder J, Kong L, Essig M, Schad LR, Arrubla J, Neuner I, Hahn D, Boers F, Shah NJ, Neuner I, Arrubla J, Hahn D, Boers F, Jon Shah N, Suriya Prakash M, Sharma R, Kawaguchi H, Kobayashi T, Fiedler P, Griebel S, Biller S, Fonseca C, Vaz F, Zentner L, Zanow F, Haueisen J, Rochas V, Rihs T, Thut G, Rosenberg N, Landis T, Michel C, Moliadze V, Schmanke T, Lyzhko E, Bassüner S, Freitag C, Siniatchkin M, Thézé R, Guggisberg AG, Nahum L, Schnider A, Meier L, Friedrich H, Jann K, Landis B, Wiest R, Federspiel A, Strik W, Dierks T, Witte M, Kober SE, Neuper C, Wood G, König R, Matysiak A, Kordecki W, Sieluzycki C, Zacharias N, Heil P, Wyss C, Boers F, Arrubla J, Dammers J, Kawohl W, Neuner I, Shah NJ, Braboszcz C, Cahn RB, Levy J, Fernandez M, Delorme A, Rosas-Martinez L, Milne E, Zheng Y, Urakami Y, Kawamura K, Washizawa Y, Hiyoshi K, Cichocki A, Giroud N, Dellwo V, Meyer M, Rufener KS, Liem F, Dellwo V, Meyer M, Jones-Rounds JD, Raizada R, Staljanssens W, Strobbe G, van Mierlo P, Van Holen R, Vandenberghe S, Pefkou M, Becker R, Michel C, Hervais-Adelman A, He W, Brock J, Johnson B, Ohla K, Hitz K, Heekeren K, Obermann C, Huber T, Juckel G, Kawohl W, Gabriel D, Comte A, Henriques J, Magnin E, Grigoryeva L, Ortega JP, Haffen E, Moulin T, Pazart L, Aubry R, Kukleta M, Baris Turak B, Louvel J, Crespo-Garcia M, Cantero JL, Atienza M, Connell S, Kilborn K, Damborská A, Brázdil M, Rektor I, Kukleta M, Koberda JL, Bienkiewicz A, Koberda I, Koberda P, Moses A, Tomescu M, Rihs T, Britz J, Custo A, Grouiller F, Schneider M, Debbané M, Eliez S, Michel C, Wang GY, Kydd R, Wouldes TA, Jensen M, Russell BR, Dissanayaka N, Au T, Angwin A, O'Sullivan J, Byrne G, Silburn P, Marsh R, Mellic G, Copland D, Bänninger A, Kottlow M, Díaz Hernàndez L, Koenig T, Díaz Hernàndez L, Bänninger A, Koenig T, Hauser TU, Iannaccone R, Mathys C, Ball J, Drechsler R, Brandeis D, Walitza S, Brem S, Boeijinga PH, Pang EW, Valica T, Macdonald MJ, Oh A, Lerch JP, Anagnostou E, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Verardo AR, Giannoudas I, La Porta P, Niolu C, Fernandez I, Siracusano A, Shimada T, Matsuda Y, Monkawa A, Monkawa T, Hashimoto R, Watanabe K, Kawasaki Y, Matsuda Y, Shimada T, Monkawa T, Monkawa A, Watanabe K, Kawasaki Y, Stegmayer K, Horn H, Federspiel A, Razavi N, Bracht T, Laimböck K, Strik W, Dierks T, Wiest R, Müller TJ, Walther S, Koorenhof LJ, Swithenby SJ, Martins-Mourao A, Rihs TA, Tomescu M, Song KW, Custo A, Knebel JF, Murray M, Eliez S, Michel CM, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Laimboeck K, Jann K, Walther S, Federspiel A, Wiest R, Strik W, Horn H. Abstracts of Presentations at the International Conference on Basic and Clinical Multimodal Imaging (BaCI), a Joint Conference of the International Society for Neuroimaging in Psychiatry (ISNIP), the International Society for Functional Source Imaging (ISFSI), the International Society for Bioelectromagnetism (ISBEM), the International Society for Brain Electromagnetic Topography (ISBET), and the EEG and Clinical Neuroscience Society (ECNS), in Geneva, Switzerland, September 5-8, 2013. Clin EEG Neurosci 2013; 44:1550059413507209. [PMID: 24368763 DOI: 10.1177/1550059413507209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B J He
- National Institutes of Health, Bethesda, MD, USA
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Geginat J, Paroni M, Facciotti F, Gruarin P, Kastirr I, Caprioli F, Pagani M, Abrignani. S. The CD4-centered universe of human T cell subsets. Semin Immunol 2013; 25:252-62. [DOI: 10.1016/j.smim.2013.10.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Sattin D, Pagani M, Covelli V, Giovannetti A, Schiavolin S, Meucci P, Raggi A, Cerniauskaite M, Quintas R, Leonardi M. Italian study on functioning and disability of people with disorder of consciousness. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Covelli V, Pagani M, Giovannetti A, Sattin D, Meucci P, Cerniauskaite M, Quintas R, Schiavolin S, Raggi A, Leonardi M. Pathways of care of Italian patients in vegetative state and minimally conscious state: Results from a national study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2451] [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: 11/30/2022]
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Schiavolin S, Quintas R, Pagani M, Raggi A, Covelli V, Giovannetti A, Cerniauskaite M, Meucci P, Sattin D, Brock S, Ferroli P, Leonardi M. Disability, quality of life and well-being in patients undergoing brain surgery. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2454] [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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Giovannetti A, Quintas R, Cerniauskaite M, Covelli V, Raggi A, Schiavolin S, Meucci P, Pagani M, Sattin D, Sabariego C, Cieza A, Coenen M, Leonardi M. Horizontal epidemiology approach: Functioning and disability in patients with neurological disorders. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2453] [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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Raggi A, Quintas R, Giovannetti A, Schiavolin S, Cerniauskaite M, Meucci P, Covelli V, Pagani M, Sattin D, D'Amico D, Grazzi L, Usai S, Curone M, Di Fiore P, Bussone G, Leonardi M. Predictors of disability in patients with chronic migraine. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1722] [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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Pagani M, Covelli V, Sattin D, Giovannetti A, Schiavolin S, Meucci P, Raggi A, Cerniauskaite M, Quintas R, Leonardi M. Elderly patients in vegetative state and minimally conscious state. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2450] [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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Meucci P, Covelli V, Cerniauskaite M, Quintas R, Pagani M, Giovannetti A, Sattin D, Schiavolin S, Raggi A, Leonardi M. Neurological diseases of ageing people with Down syndrome: A review from 1960 to 2011. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2455] [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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Micarelli A, Jacobsson H, Larsson SA, Jonsson C, Pagani M. Neurobiological insight into hyperbaric hyperoxia. Acta Physiol (Oxf) 2013; 209:69-76. [PMID: 23692702 DOI: 10.1111/apha.12116] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 03/14/2013] [Revised: 05/02/2013] [Accepted: 05/15/2013] [Indexed: 11/29/2022]
Abstract
AIM Hyperbaric hyperoxia (HBO) is known to modulate aerobic metabolism, vasoreactivity and blood flow in the brain. Nevertheless, mechanisms underlying its therapeutic effects, especially in traumatic brain injury (TBI) and stroke patients, are debated. The present study aimed at investigating regional cerebral blood flow (rCBF) distribution during acute HBO exposure. METHODS Regional cerebral blood flow response was investigated in seven healthy subjects exposed to either normobaric normoxia or HBO with ambient pressure/inspired oxygen pressure of 101/21 and 250/250 kPa respectively. After 40 min at the desired pressure, they were injected a perfusion tracer and subsequently underwent brain single photon emission computed tomography. rCBF distribution changes in the whole brain were assessed by Statistical Parametric Mapping. RESULTS During HBO, an increased relative rCBF distribution was found in sensory-motor, premotor, visual and posterior cingulate cortices as well as in superior frontal gyrus, middle/inferior temporal and angular gyrus and cerebellum, mainly in the dominant hemisphere. During normobaric normoxia, a higher (99m) Tc-HMPAO distribution in the right insula and subcortical structures as well as in bilateral hippocampi and anterior cingulated cortex was found. CONCLUSIONS The present study firstly confirmed the rCBF distribution increase during HBO in sensory-motor and visual cortices, and it showed for the first time a higher perfusion tracer distribution in areas encompassed in dorsal attention system and in default mode network. These findings unfold both the externally directed cognition performance improvement related to the HBO and the internally directed cognition states during resting-state conditions, suggesting possible beneficial effects in TBI and stroke patients.
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Affiliation(s)
- A. Micarelli
- Department of Medical Sciences and Translational Medicine; ‘Tor Vergata’ University; Rome; Italy
| | - H. Jacobsson
- Department of Nuclear Medicine; Karolinska University Hospital; Stockholm; Sweden
| | - S. A. Larsson
- Department of Nuclear Medicine; Karolinska University Hospital; Stockholm; Sweden
| | - C. Jonsson
- Department of Nuclear Medicine; Karolinska University Hospital; Stockholm; Sweden
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Nardo D, Högberg G, Lanius RA, Jacobsson H, Jonsson C, Hällström T, Pagani M. Gray matter volume alterations related to trait dissociation in PTSD and traumatized controls. Acta Psychiatr Scand 2013; 128:222-33. [PMID: 23113800 DOI: 10.1111/acps.12026] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study used voxel-based morphometry (VBM) to investigate brain structural alterations related to trait dissociation and its relationship with post-traumatic stress disorder (PTSD). METHOD Thirty-two subjects either developing (N = 15) or non-developing (N = 17) PTSD underwent MRI scanning and were assessed with the Dissociative Experience Scale (DES), subscales for pathological (DES-T) and non-pathological trait (DES-A) dissociation, and other clinical measures. Gray matter volume (GMV) was analyzed using VBM as implemented in SPM. PTSD and non-PTSD subjects were compared to assess brain alterations related to PTSD pathology, whereas correlation analyses between dissociation measures and GMV were performed on the whole sample (N = 32), irrespective of PTSD diagnosis, to identify alterations related to trait dissociation. RESULTS As compared to traumatized controls, PTSD subjects showed reduced GMV in the prefrontal cortex, hippocampus and lingual gyrus. Correlations with dissociation measures (DES, DES-T, and DES-A) consistently showed increased GMV in the medial and lateral prefrontal, orbitofrontal, parahippocampal, temporal polar, and inferior parietal cortices. CONCLUSION PTSD and dissociation seem to be associated with opposite volumetric patterns in the prefrontal cortex. Trait dissociation appears to involve increased GMV in prefrontal, paralimbic, and parietal cortices, with negligible differences between pathological and non-pathological dissociation.
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Affiliation(s)
- D Nardo
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy.
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Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, Bircher A, Blanca M, Bonadonna B, Campi P, Castro E, Cernadas JR, Chiriac AM, Demoly P, Grosber M, Gooi J, Lombardo C, Mertes PM, Mosbech H, Nasser S, Pagani M, Ring J, Romano A, Scherer K, Schnyder B, Testi S, Torres M, Trautmann A, Terreehorst I. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy 2013; 68:702-12. [PMID: 23617635 DOI: 10.1111/all.12142] [Citation(s) in RCA: 541] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2013] [Indexed: 12/15/2022]
Abstract
Skin tests are of paramount importance for the evaluation of drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of drug allergy is often based on history alone, which is an unreliable indicator of true hypersensitivity.To promote and standardize reproducible skin testing with safe and nonirritant drug concentrations in the clinical practice, the European Network and European Academy of Allergy and Clinical Immunology (EAACI) Interest Group on Drug Allergy has performed a literature search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group.We recommend drug concentration for skin testing aiming to achieve a specificity of at least 95%. It has been possible to recommend specific drug concentration for betalactam antibiotics, perioperative drugs, heparins, platinum salts and radiocontrast media. For many other drugs, there is insufficient evidence to recommend appropriate drug concentration. There is urgent need for multicentre studies designed to establish and validate drug skin test concentration using standard protocols. For most drugs, sensitivity of skin testing is higher in immediate hypersensitivity compared to nonimmediate hypersensitivity.
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Affiliation(s)
- K. Brockow
- Department of Dermatology und Allergology Biederstein; Division Environmental Dermatology and Allergology Helmholtz Zentrum München/TUM; Technical University Munich; Munich; Germany
| | - L. H. Garvey
- Allergy Clinic; Copenhagen University Hospital; Gentofte; Denmark
| | - W. Aberer
- Department of Dermatology; Medical University of Graz; Graz; Austria
| | | | - A. Barbaud
- Dermatology Department and EA 72-98 INGRES; Brabois Hospital; University Hospital of Nancy; Lorraine University; Vandoeuvre les Nancy; France
| | - M. B. Bilo
- Department of Immunology, Allergy and Respiratory Diseases; Allergy Unit; University Hospital Ospedali Riuniti; Ancona; Italy
| | - A. Bircher
- Dermatologische Universitätsklinik Kantonsspital; Basel; Switzerland
| | - M. Blanca
- Allergy Service; Carlos Haya Hospital; Malaga; Spain
| | - B. Bonadonna
- Allergy Unit; Verona University Hospital; Verona; Italy
| | - P. Campi
- Allergy and Clinical Immunology Unit; San Giovanni di Dio Hospital; Florence; Italy
| | - E. Castro
- Department of Allergy and Clinical Immunology; Medical University; H. S. Joao; Porto; Portugal
| | - J. R. Cernadas
- Department of Allergy and Clinical Immunology; Medical University; H. S. Joao; Porto; Portugal
| | - A. M. Chiriac
- Allergy Department; University Hospital of Montpellier and INSERM U657; Montpellier; France
| | - P. Demoly
- Allergy Department; University Hospital of Montpellier and INSERM U657; Montpellier; France
| | - M. Grosber
- Department of Dermatology und Allergology Biederstein; Division Environmental Dermatology and Allergology Helmholtz Zentrum München/TUM; Technical University Munich; Munich; Germany
| | - J. Gooi
- Department of Immunology; Beaumont Hospital; Dublin; Ireland
| | - C. Lombardo
- Allergy Unit; Verona University Hospital; Verona; Italy
| | - P. M. Mertes
- Service d'anesthésie-réanimation chirurgicale; Hôpitaux Universitaires de Strasbourg; Strasbourg; France
| | - H. Mosbech
- Allergy Clinic; Copenhagen University Hospital; Gentofte; Denmark
| | - S. Nasser
- Department of Allergy; Addenbrooke's Hospital; Cambridge; UK
| | - M. Pagani
- Allergology and Oncology Service; Civil Hospital of Asola; Mantova; Italy
| | - J. Ring
- Department of Dermatology und Allergology Biederstein; Division Environmental Dermatology and Allergology Helmholtz Zentrum München/TUM; Technical University Munich; Munich; Germany
| | - A. Romano
- Allergy Unit; C. I. Columbus; Rome and IRCCS Oasi Maria S. S.; Troina; Italy
| | - K. Scherer
- Dermatologische Universitätsklinik Kantonsspital; Basel; Switzerland
| | - B. Schnyder
- Department of Rheumatology; Clinical Immunology and Allergology; Bern; Switzerland
| | - S. Testi
- Allergy and Clinical Immunology Unit; San Giovanni di Dio Hospital; Florence; Italy
| | - M. Torres
- Allergy Service; Carlos Haya Hospital; Malaga; Spain
| | - A. Trautmann
- Department of Dermatology and Allergology; University of Würzburg; Würzburg; Germany
| | - I. Terreehorst
- Department of ENT and Pediatrics; AMC; Amsterdam; The Netherlands
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Pagani M, Giovannetti AM, Covelli V, Sattin D, Raggi A, Leonardi M. Physical and mental health, anxiety and depressive symptoms in caregivers of patients in vegetative state and minimally conscious state. Clin Psychol Psychother 2013; 21:420-6. [PMID: 23712507 DOI: 10.1002/cpp.1848] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 04/19/2013] [Accepted: 04/23/2013] [Indexed: 12/13/2022]
Abstract
UNLABELLED Caregivers of patients in vegetative state and minimally conscious state play a crucial role in the process of taking care and, as previous studies reported, they can suffer of high burden and negative health outcomes. The aim of this national cross-sectional study was to assess whether physical and mental health of caregivers, considering gender differences, is related to the presence of depressive symptoms, anxiety, age and patient's disease duration. Four-hundred and eighteen caregivers, 294 women and 124 men, completed the State Trait Anxiety Inventory-Y, Beck Depression Inventory, second version and Short Form-12. Hierarchical multiple regression analyses were performed to evaluate to which extent depressive and anxiety symptoms predict physical and mental health. Men reported higher levels of mental health state, whereas physical health was not different across gender. High levels of anxiety symptoms were associated to negative mental health outcomes in both genders, whereas depressive symptoms were found to impact on female's mental and physical health only. A comprehensive and cost-effective screening of anxiety and depressive symptoms may help to identify determinants of health worsening in order to plan, when necessary, caregivers' support. KEY PRACTITIONER MESSAGES Female caregivers of patients in vegetative state and minimally conscious state have poorer levels of mental health, whereas physical health is similar to men's. Anxiety symptoms are related to negative mental health outcomes in both male and female caregivers, whereas depressive symptoms are found to impact on female mental and physical health only. It is essential to consider and assess depressive and anxiety symptoms as they may contribute to caregivers' health worsening. This knowledge can lead to plan more comprehensive and tailored caregivers' supports and a better care for patients.
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Affiliation(s)
- M Pagani
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Giovannetti AM, Leonardi M, Pagani M, Sattin D, Raggi A. Burden of caregivers of patients in Vegetative state and minimally conscious state. Acta Neurol Scand 2013; 127:10-8. [PMID: 22509952 DOI: 10.1111/j.1600-0404.2012.01666.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess differences in the burden of caregivers of patients in Vegetative state (VS) and minimally conscious state (MCS). MATERIALS AND METHODS The Family Strain Questionnaire, Coping Orientations to Problem Experiences, Caregiver Needs Assessment, Short Form-12, Beck Depression Inventory and State-Trait Anxiety Inventory were used. Differences in psychological condition between caregivers of VS and MCS patients, with different disease duration and hosting facility were assessed with Kruskall-Wallis test and factors associated with the overall levels of burden with UNIANOVA. RESULTS In total, 487 participants were enrolled. Daily hours of care-giving is significantly associated with the overall level of burden perceived by caregivers (F = 4.099; P = 0.018). Strain, needs and frequency of use of coping strategies are substantially similar regardless of the patient's condition and distance from the acute event. Caregivers of post-acute patients reported low scores in mental health (median = 33.8; IQR = 23.1-47.6) and higher state of anxiety (median = 54; IQR = 45-62), whereas caregivers of long-term patients expressed more needs in social involvement (median = 19; IQR = 15-22). CONCLUSIONS Burden and distress were high for all caregivers of VS and MCS patients. As care-giving is a long-term commitment process, support to the caregiver should be guaranteed throughout the duration of the relative's disease despite the patient's diagnosis or place where the patient is hosted.
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Affiliation(s)
- A. M. Giovannetti
- Neurology; Public Health and Disability Unit, Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan; Italy
| | - M. Leonardi
- Neurology; Public Health and Disability Unit, Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan; Italy
| | - M. Pagani
- Neurology; Public Health and Disability Unit, Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan; Italy
| | - D. Sattin
- Neurology; Public Health and Disability Unit, Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan; Italy
| | - A. Raggi
- Neurology; Public Health and Disability Unit, Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan; Italy
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Abstract
Earth system climate sensitivity (ESS) is the long-term (>10³ year) response of global surface temperature to doubled CO₂ that integrates fast and slow climate feedbacks. ESS has energy policy implications because global temperatures are not expected to decline appreciably for at least 10³ year, even if anthropogenic greenhouse gas emissions drop to zero. We report provisional ESS estimates of 3 °C or higher for some of the Cretaceous and Cenozoic based on paleo-reconstructions of CO₂ and temperature. These estimates are generally higher than climate sensitivities simulated from global climate models for the same ancient periods (approximately 3 °C). Climate models probably do not capture the full suite of positive climate feedbacks that amplify global temperatures during some globally warm periods, as well as other characteristic features of warm climates such as low meridional temperature gradients. These absent feedbacks may be related to clouds, trace greenhouse gases (GHGs), seasonal snow cover, and/or vegetation, especially in polar regions. Better characterization and quantification of these feedbacks is a priority given the current accumulation of atmospheric GHGs.
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Affiliation(s)
- D L Royer
- Department of Earth and Environmental Sciences and College of the Environment, Wesleyan University, Middletown, CT, USA.
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Leonardi M, Giovannetti AM, Pagani M, Raggi A, Sattin D, on behalf of the National Consortiu. Burden and needs of 487 caregivers of patients in vegetative state and in minimally conscious state: Results from a national study. Brain Inj 2012; 26:1201-10. [DOI: 10.3109/02699052.2012.667589] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pagani M, Venemalm L, Bonnadona P, Vescovi PP, Botelho C, Cernadas JR. An Experimental Biological Test to Diagnose Hypersensitivity Reactions to Carboplatin: New Horizons for an Old Problem. Jpn J Clin Oncol 2012; 42:347-50. [DOI: 10.1093/jjco/hys006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giovannetti AM, Pagani M, Sattin D, Covelli V, Raggi A, Strazzer S, Castelli E, Trabacca A, Martinuzzi A, Leonardi M. Children in vegetative state and minimally conscious state: patients' condition and caregivers' burden. ScientificWorldJournal 2012; 2012:232149. [PMID: 22454603 PMCID: PMC3290454 DOI: 10.1100/2012/232149] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 12/07/2011] [Indexed: 11/30/2022] Open
Abstract
Caring for children in vegetative state (VS) or minimally conscious state (MCS) challenges parents and impacts on their well-being. This study aims to evaluate caregivers' health condition, coping, anxiety and depression levels, and how these issues relate to children's disability.
35 children with VS and MCS were administered the disability rating scale (DRS) and 35 caregivers completed the Coping Orientations to Problem Experiences, Short Form-12, Beck Depression Inventory, and the Spielberger State-Trait Anxiety Inventory-Y. Children were mainly males (68.6%), hosted at domicile (77.1%), and diagnosed with VS (60%), with anoxic aetiology (45.7%). Caregivers were mainly mothers (85.7%), married (82.9%), and housewives (51.4%); 60% declared financial difficulties, and 82.9% provided full-time assistance. 57.2% reported depressive symptoms, poor mental health, and high level of state and trait anxiety. “Problem-oriented” (P < 0.001) and “emotional-oriented” (P < 0.001), were more adopted than “potentially dysfunctional” ones. DRS scores (mean = 22.0; SD = 1.9) did not significantly correlate to any psychological measure. Rehabilitative programs for children with SV and SMC should also provide interventions on surrounding systems: improving the network of psychological support and social assistance may decrease the burden of caregivers and, in turn, improve caring abilities and children quality of life.
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Affiliation(s)
- A M Giovannetti
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, 20133 Milan, Italy.
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Pagani M, Nardo D, Hogberg G, Lanius R, Bravo T, Jacobsson H, Jonsson C, Hallstrom T. P-973 - Gray matter volume alterations associated with dissociative traits in PTSD and traumatized controls. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75140-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Pagani M, Di Lorenzo G, Verardo A, Nicolais G, Lauretti G, Russo R, Cogolo P, Niolu C, Ammaniti M, Siracusano A, Fernandez I. P-1162 - Pre- intra- and post-treatment eeg imaging of EMDR - neurobiological bases of treatment efficacy. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75329-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Nardo D, Högberg G, Flumeri F, Jacobsson H, Larsson SA, Hällström T, Pagani M. Self-rating scales assessing subjective well-being and distress correlate with rCBF in PTSD-sensitive regions. Psychol Med 2011; 41:2549-2561. [PMID: 21672299 DOI: 10.1017/s0033291711000912] [Citation(s) in RCA: 23] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to investigate the distribution of the regional cerebral blood flow (rCBF) in occupational-related post-traumatic stress disorder (PTSD) subjects and to seek possible correlations between brain perfusion and self-rating scales (SRS) in order to cross-check their diagnostic value and to look for their neural correlates. METHOD A total of 13 traumatized underground and long-distance train drivers developing (S) and 17 not developing (NS) PTSD who had experienced a 'person under train' accident or who had been assaulted at work underwent clinical assessment and 99mTc-HMPAO SPECT imaging during autobiographical trauma scripts. Statistical parametric mapping was applied to analyse rCBF changes in S as compared with NS and to search for correlations between rCBF and the administered SRS scores, modelling age, months to SPECT and the ratio 'grey matter/intra-cranial volume' as nuisance variables. RESULTS Significantly higher activity was observed during trauma script in left posterior and anterior insula, posterior cingulate, inferior parietal lobule, precuneus, caudate and putamen in PTSD subjects as compared with the trauma-exposed control group. Impact of Event Scale and World Health Organisation (10) Well-Being Index scores highly correlated with tracer uptake to a great extent in the same regions in which rCBF differences between S and NS were found. CONCLUSIONS These findings support the involvement of insular, cingulate and parietal cortices (as well as the basal ganglia) in the pathogenesis of PTSD and in the processing of related subjective well-being and distress.
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Affiliation(s)
- D Nardo
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy.
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