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Idrissi S, Velucci V, Esposito M, Trinchillo A, Habestwallner F, Belvisi D, Fabbrini G, Ferrazzano G, Rizzo V, Terranova C, Girlanda P, Pellicciari R, Avanzino L, Di Biasio F, Marchese R, Bono F, Idone G, Laterza V, Lettieri C, Rinaldo S, Eleopra R, Castagna A, Altavista MC, Moschella V, Erro R, Barone P, Barbero P, Ceravolo R, Mazzucchi S, Mascia MM, Ercoli T, Muroni A, Zibetti M, Lopiano L, Scaglione CLM, Bentivoglio AR, Petracca M, Magistrelli L, Cotelli MS, Cossu G, Squintani GM, De Santis T, Schirinzi T, Misceo S, Pisani A, Berardelli A, Defazio G. Does thyroid diseases contribute to the natural history of idiopathic adult-onset dystonia? Data from the Italian Dystonia Registry. J Neural Transm (Vienna) 2024; 131:369-375. [PMID: 38376582 DOI: 10.1007/s00702-024-02753-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/08/2024] [Indexed: 02/21/2024]
Abstract
A few earlier observations and recent controlled studies pointed to the possible contribution of thyroid diseases in idiopathic adult-onset dystonia (IAOD). The aim of this study was to investigate the association between thyroid status and clinical characteristics of IAOD, focusing on dystonia localization, spread, and associated features such as tremors and sensory tricks. Patients were identified from those included in the Italian Dystonia Registry, a multicentre dataset of patients with adult-onset dystonia. The study population included 1518 IAOD patients. Patients with hypothyroidism and hyperthyroidism were compared with those without any thyroid disease. In the 1518 IAOD patients, 167 patients (11%; 95% CI 9.5-12.6%) were diagnosed with hypothyroidism and 42 (2.8%; 95% CI 1.99-3.74) with hyperthyroidism. The three groups were comparable in age at dystonia onset, but there were more women than men in the groups with thyroid disease. Analysing the anatomical distribution of dystonia, more patients with blepharospasm were present in the hyperthyroidism group, but the difference did not reach statistical significance after the Bonferroni correction. The remaining dystonia-affected body sites were similarly distributed in the three groups, as did dystonia-associated features and spread. Our findings provided novel information indicating that the high rate of thyroid diseases is not specific for any specific dystonia subpopulation and does not appear to influence the natural history of the disease.
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Affiliation(s)
- Sarah Idrissi
- Department of Translational Biomedicine and Neuroscience (DiBraiN), "Aldo Moro" University of Bari, Bari, Italy.
| | - Vittorio Velucci
- Department of Translational Biomedicine and Neuroscience (DiBraiN), "Aldo Moro" University of Bari, Bari, Italy
| | | | - Assunta Trinchillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II" University, Naples, Italy
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | | | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed Institute, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed Institute, Pozzilli, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Roberta Pellicciari
- Department of Translational Biomedicine and Neuroscience (DiBraiN), "Aldo Moro" University of Bari, Bari, Italy
| | - Laura Avanzino
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
- IRCCS, Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | - Francesco Bono
- Centre for Botulinum Toxin Therapy, Neurologic Unit, A.O.U. Mater Domini, Catanzaro, Italy
| | - Giovanni Idone
- Centre for Botulinum Toxin Therapy, Neurologic Unit, A.O.U. Mater Domini, Catanzaro, Italy
| | - Vincenzo Laterza
- Centre for Botulinum Toxin Therapy, Neurologic Unit, A.O.U. Mater Domini, Catanzaro, Italy
| | - Christian Lettieri
- Clinical Neurology Unit, "S. Maria della Misericordia" University-Hospital, Udine, Italy
| | - Sara Rinaldo
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Castagna
- IRCCS, Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | | | | | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Tommaso Ercoli
- Neurology Unit, University Hospital of Cagliari, Cagliari, Italy
| | - Antonella Muroni
- Neurology Unit, University Hospital of Cagliari, Cagliari, Italy
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | | | | | - Martina Petracca
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Magistrelli
- Department of Translational Medicine, Movement Disorders Centre, Neurology Unit, University of Eastern Piedmont, Novara, Italy
| | | | - Giovanni Cossu
- Neurology Service and Stroke Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy
| | - Giovanna Maddalena Squintani
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Tiziana De Santis
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Antonio Pisani
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed Institute, Pozzilli, Italy
| | - Giovanni Defazio
- Department of Translational Biomedicine and Neuroscience (DiBraiN), "Aldo Moro" University of Bari, Bari, Italy
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Silveri MC, Lo Monaco MR, Tondinelli A, Petracca M, Zinzi P, Fragapane S, Pozzi G, Pagnini F, Bentivoglio AR, Di Tella S. Social cognition in Parkinson's disease and functional movement disorders. Neurol Sci 2024:10.1007/s10072-024-07452-5. [PMID: 38521891 DOI: 10.1007/s10072-024-07452-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Functional movement disorders (FMD) can overlap with Parkinson's disease (PD), and distinguishing between the two clinical conditions can be complex. Framing social cognition (theory of mind) (TOM) disorder, attention deficit, and psychodynamic features of FMD and PD may improve diagnosis. METHODS Subjects with FMD and PD and healthy controls (HC) were administered tasks assessing TOM abilities and attention. The psychodynamic hypothesis of conversion disorder was explored by a questionnaire assessing dissociative symptoms. A comprehensive battery of neuropsychological tasks was also administered to FMD and PD. RESULTS Although both FMD and PD scored lower than HC on all TOM tests, significant correlations between TOM and neuropsychological tasks were found only in PD but not in FMD. Only PD showed a reduction in attentional control. Dissociative symptoms occurred only in FMD. DISCUSSION Cognitive-affective disturbances are real in FMD, whereas they are largely dependent on cognitive impairment in PD. Attentional control is preserved in FMD compared to PD, consistent with the hypothesis that overload of voluntary attentional orientation may be at the basis of the onset of functional motor symptoms. On a psychodynamic level, the confirmation of dissociative symptoms in FMD supports the conversion disorder hypothesis. CONCLUSION FMD and PD can be distinguished on an affective and cognitive level. At the same time, however, the objective difficulty often encountered in distinguishing between the two pathologies draws attention to how blurred the boundary between 'organic' and 'functional' can be.
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Affiliation(s)
- Maria Caterina Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Maria Rita Lo Monaco
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.
| | - Alice Tondinelli
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
| | - Martina Petracca
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Paola Zinzi
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Serena Fragapane
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Gino Pozzi
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
| | - Anna Rita Bentivoglio
- Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
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Di Lazzaro G, Picca A, Boldrini S, Bove F, Marzetti E, Petracca M, Piano C, Bentivoglio AR, Calabresi P. Differential profiles of serum cytokines in Parkinson's disease according to disease duration. Neurobiol Dis 2024; 190:106371. [PMID: 38061398 DOI: 10.1016/j.nbd.2023.106371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE Neurodegeneration and neuroinflammation are two intertwined mechanisms contributing to the pathophysiology of Parkinson's disease. Whether circulating biomarkers reflecting those two processes differ according to disease duration remains to be established. The present study was conducted to characterize the biomarkers individuals with PD with short (≤5 years) or long disease duration (>5 years). METHODS We consecutively enrolled 104 patients with Parkinson's disease and evaluated them using validated clinical scales (MDS-UPDRS, Hoehn and Yahr staging, MMSE). Serum samples were assayed for the following biomarkers: neurofilament light chain (NfL), brain-derived neurotrophic factor (BDNF), interleukin (IL-) 1β, 4, 5, 6, 10, 17, interferon-γ, and tumor necrosis factor α. RESULTS Mean age of participants was 66.0 ± 9.6 years and 45 (34%) were women. The average disease duration was 8 ± 5 years (range 1 to 19 years). Patients with short disease duration (≤ 5 years) showed a pro-inflammatory profile, with significantly higher levels of pro-inflammatory IL-1β and lower concentrations of IL-5, IL-10 and IL-17 (p < 0.05). NfL serum levels showed a positive correlation with disease duration and age (respectively rho = 0.248, p = 0.014 and rho = 0.559, p < 0.001) while an opposite pattern was detected for BDNF (respectively rho -0,187, p = 0.034 and rho = -0.245, p = 0.014). CONCLUSIONS Our findings suggest that a pro-inflammatory status may be observed in PD patients in the early phases of the disease, independently from age.
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Affiliation(s)
- Giulia Di Lazzaro
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
| | - Anna Picca
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; Department of Medicine and Surgery, LUM University, 70100 Casamassima, Italy
| | | | - Francesco Bove
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Martina Petracca
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Carla Piano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Calabresi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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4
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Geroin C, Petracca M, Di Tella S, Marcuzzo E, Erro R, Cuoco S, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Laterza V, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Albanese A, Ferrazzano G, Tessitore A, Lopiano L, Calandra‐Buonaura G, Morgante F, Esposito M, Pisani A, Manganotti P, Tesolin L, Teatini F, Camozzi S, Ercoli T, Stocchi F, Coletti Moja M, Defazio G, Tinazzi M. Elderly Onset of Functional Motor Disorders: Clinical Correlates from the Italian Registry. Mov Disord Clin Pract 2024; 11:38-44. [PMID: 38291844 PMCID: PMC10828615 DOI: 10.1002/mdc3.13916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/06/2023] [Accepted: 10/13/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Functional motor disorders (FMD) are a frequent neurological condition affecting patients with movement disorders. Commonly described in younger adults, their manifestation can be also associated to an elderly onset. OBJECTIVE To assess the prevalence and describe the clinical manifestations of FMD with elderly and younger onset and their relationship with demographical and clinical variables. METHODS We recruited patients with a "clinically definite" diagnosis of FMD from the Italian Registry of FMD. Patients underwent extensive clinical assessments. For elderly onset, we set a chronological cut-off at 65 years or older according to WHO definition. Multivariate regression models were implemented to estimate adjusted odds ratio of elderly FMD onset related to clinical characteristics. RESULTS Among the 410 patients, 34 (8.2%) experienced elderly-onset FMD, with a mean age at onset of 70.9 years. The most common phenotype was tremor (47.1%), followed by gait disorders, weakness, and dystonia (29.4%, 23.5%, 14.7%, respectively). Eleven elderly patients had a combined phenomenology: 9 exhibited two phenotypes, 2 had three phenotypes. Weakness was isolated in 3/8 patients and combined with another phenotype in 5/8, manifesting as paraplegia (n = 4); upper limb diplegia (n = 2), hemiparesis/hemiplegia (n = 1), and tetraparesis/tetraplegia (n= 1). Non-motor and other functional neurological disorders occurred more frequently in the younger group (89.1%) than the elderly (73.5%). Neurological and non-neurological comorbidities were more prevalent in the elderly group (82.4%) as opposed to the younger (32.7%). In a multivariate regression analysis, elderly-onset FMD was significantly associated with neurological comorbidities, including parkinsonism (OR 6.73) and cerebrovascular diseases (OR 5.48). CONCLUSIONS These results highlight the importance of achieving an accurate diagnosis of FMD in the elderly, as it is crucial for effectively managing FMD symptoms and addressing neurological comorbidities.
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Affiliation(s)
- Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of VeronaVeronaItaly
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Sonia Di Tella
- Department of PsychologyUniversità Cattolica del Sacro CuoreMilanItaly
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of VeronaVeronaItaly
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry‐Scuola Medica Salernitana, University of SalernoBaronissiItaly
| | - Sofia Cuoco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry‐Scuola Medica Salernitana, University of SalernoBaronissiItaly
| | - Roberto Ceravolo
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Sonia Mazzucchi
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- FERB Onlus, Ospedale S. Isidoro, Trescore BalnearioBergamoItaly
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Mario Zappia
- Department G.F. Ingrassia, Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of NeurosciencesUniversity of CataniaCataniaItaly
| | | | - Carla Arbasino
- Department of Medical AreaNeurology Unit, ASST PaviaPaviaItaly
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater DominiCatanzaroItaly
| | - Vincenzo Laterza
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater DominiCatanzaroItaly
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health SciencesUniversity of MilanMilanItaly
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health SciencesUniversity of MilanMilanItaly
| | | | | | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G. d'AnnunzioChieti‐PescaraItaly
| | - Alberto Albanese
- Department of NeurologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - Gina Ferrazzano
- Department of Human NeurosciencesUniversità La SapienzaRomeItaly
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgery SciencesUniversity of Campania—Luigi VanvitelliNaplesItaly
| | - Leonardo Lopiano
- Department of Neuroscience—Rita Levi MontalciniUniversity of TurinTurinItaly
| | - Giovanna Calandra‐Buonaura
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
- IRCCS Istituto delle Scienze Neurologiche di BolognaBolognaItaly
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of LondonLondonUnited Kingdom
- Department of Experimental and Clinical MedicineUniversity of MessinaMessinaItaly
| | | | - Antonio Pisani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- IRCCS Mondino FoundationPaviaItaly
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of TriesteTriesteItaly
| | - Lucia Tesolin
- Functional Movement Disorders Outpt.Clinic, Clinical Neurology and Stroke Unit Dep.Central Country HospitalBolzanoItaly
| | - Francesco Teatini
- Functional Movement Disorders Outpt.Clinic, Clinical Neurology and Stroke Unit Dep.Central Country HospitalBolzanoItaly
| | - Serena Camozzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of VeronaVeronaItaly
| | - Tommaso Ercoli
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele RomaRomeItaly
| | | | - Giovanni Defazio
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of VeronaVeronaItaly
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5
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Petracca M, Carotenuto A, Scandurra C, Moccia M, Rosa L, Arena S, Ianniello A, Nozzolillo A, Turrini M, Streito LM, Abbadessa G, Cellerino M, Bucello S, Ferraro E, Mattioli M, Chiodi A, Inglese M, Bonavita S, Clerico M, Cordioli C, Moiola L, Patti F, Lavorgna L, Filippi M, Borriello G, D'Amico E, Pozzilli C, Brescia Morra V, Lanzillo R. Sexual dysfunction in multiple sclerosis: The impact of different MSISQ-19 cut-offs on prevalence and associated risk factors. Mult Scler Relat Disord 2023; 78:104907. [PMID: 37523809 DOI: 10.1016/j.msard.2023.104907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Although multiple sclerosis (MS) Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a widely applied tool, no unique definition of sexual dysfunction (SD) based on its score exists. OBJECTIVE To explore the impact of different MSISQ-19 cut-offs on SD prevalence and associated risk factors, providing relevant information for its application in research and clinical settings. METHODS After defining SD according to two different MSISQ-19 cut-offs in 1155 people with MS (pwMS), we evaluated SD prevalence and association with sociodemographic and clinical features, mood status and disability via logistic regression. RESULTS Depending on the chosen cut-off, 45% to 54% of pwMS reported SD. SD defined as MSISQ-19 score >30 was predicted by age (OR=1.01, p=0.047), cognition (OR=0.96, p=0.004) and anxiety (OR=1.03, p=0.019). SD defined as a score >3 on any MSISQ-19 item was predicted by motor disability (OR=1.12, p=0.003) and cognition (OR= 0.96, p=0.002). CONCLUSION Applying different MSISQ-19 cut-offs influences both the estimated prevalence and the identification of risk factors for SD, a finding that should be considered during study planning and data interpretation. Preserved cognition exerts a protective effect towards SD regardless from the specific study setting, representing a key point for the implementation of preventive and therapeutic strategies.
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Affiliation(s)
- M Petracca
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy
| | - A Carotenuto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy
| | - C Scandurra
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy
| | - M Moccia
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Italy; MS Unit, Federico II University Hospital, Naples, Italy
| | - L Rosa
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - S Arena
- Department "G.F. Ingrassia", MS Center, University of Catania, Catania, Italy
| | - A Ianniello
- MS Center, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - A Nozzolillo
- Multiple Sclerosis Center, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Turrini
- Centro Sclerosi Multipla, ASST Spedali Civili di Brescia, Ospedale di Montichiari, Brescia, Italy
| | - L M Streito
- San Luigi Gonzaga Academic Hospital, Orbassano, TO 10043, Italy
| | - G Abbadessa
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Cellerino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - S Bucello
- Multiple Sclerosis Centre, "E. Muscatello" Hospital - ASP8, Augusta, SR, Italy
| | - E Ferraro
- S. Filippo Neri Hospital, Rome, Italy
| | - M Mattioli
- NCL-Istituto di Neuroscienze Gruppo Neuromed, Rome, Italy
| | - A Chiodi
- Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Naples, Italy
| | - M Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - S Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Clerico
- San Luigi Gonzaga Academic Hospital, Orbassano, TO 10043, Italy; Department of Clinical and Biological Sciences, University of Torino, Torino 10128, Italy
| | - C Cordioli
- Centro Sclerosi Multipla, ASST Spedali Civili di Brescia, Ospedale di Montichiari, Brescia, Italy
| | - L Moiola
- Multiple Sclerosis Center, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Patti
- Department "G.F. Ingrassia", MS Center, University of Catania, Catania, Italy
| | - L Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Filippi
- Multiple Sclerosis Center, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - G Borriello
- MS Center, San Pietro Hospital Fatebenefratelli, Rome, Italy
| | - E D'Amico
- Department "G.F. Ingrassia", MS Center, University of Catania, Catania, Italy
| | - C Pozzilli
- Department of Human Neurosciences, Sapienza University, Rome, Italy
| | - V Brescia Morra
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy
| | - R Lanzillo
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy.
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Scaravilli A, Tranfa M, Pontillo G, Falco F, Criscuolo C, Moccia M, Monti S, Lanzillo R, Brescia Morra V, Palma G, Petracca M, Tedeschi E, Elefante A, Brunetti A, Cocozza S. MR Imaging Signs of Gadolinium Retention Are Not Associated with Long-Term Motor and Cognitive Outcomes in Multiple Sclerosis. AJNR Am J Neuroradiol 2023; 44:396-402. [PMID: 36863844 PMCID: PMC10084901 DOI: 10.3174/ajnr.a7807] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/04/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND AND PURPOSE The long-term impact of gadolinium retention in the dentate nuclei of patients undergoing administration of seriate gadolinium-based contrast agents is still widely unexplored. The aim of this study was to evaluate the impact of gadolinium retention on motor and cognitive disability in patients with MS during long-term follow-up. MATERIALS AND METHODS In this retrospective study, clinical data were obtained from patients with MS followed in a single center from 2013 to 2022 at different time points. These included the Expanded Disability Status Scale score to evaluate motor impairment and the Brief International Cognitive Assessment for MS battery to investigate cognitive performances and their respective changes with time. The association with qualitative and quantitative MR imaging signs of gadolinium retention (namely, the presence of dentate nuclei T1-weighted hyperintensity and changes in longitudinal relaxation R1 maps, respectively) was probed using different General Linear Models and regression analyses. RESULTS No significant differences in motor or cognitive symptoms emerged between patients showing dentate nuclei hyperintensity and those without visible changes on T1WIs (P = .14 and 0.92, respectively). When we tested possible relationships between quantitative dentate nuclei R1 values and both motor and cognitive symptoms, separately, the regression models including demographic, clinical, and MR imaging features explained 40.5% and 16.5% of the variance, respectively, without any significant effect of dentate nuclei R1 values (P = .21 and 0.30, respectively). CONCLUSIONS Our findings suggest that gadolinium retention in the brains of patients with MS is not associated with long-term motor or cognitive outcomes.
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Affiliation(s)
- A Scaravilli
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
| | - M Tranfa
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
| | - G Pontillo
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
- Electrical Engineering and Information Technology (G.P.)
| | - F Falco
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
| | - C Criscuolo
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
| | - M Moccia
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
| | - S Monti
- Institute of Biostructure and Bioimaging (S.M.), National Research Council, Naples, Italy
| | - R Lanzillo
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
| | - V Brescia Morra
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
| | - G Palma
- Institute of Nanotechnology (G.P.), National Research Council, Lecce, Italy
| | - M Petracca
- Neurosciences and Reproductive and Odontostomatological Sciences (F.F., C.C., M.M., R.L., V.B.M., M.P.), University of Naples "Federico II," Naples, Italy
- Department of Human Neurosciences (M.P.), Sapienza University of Rome, Rome, Italy
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
| | - A Elefante
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
| | - A Brunetti
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
| | - S Cocozza
- From the Departments of Advanced Biomedical Sciences (A.S., M.T., G.P., E.T., A.E., A.B., S.C.)
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Marchese MR, Vollono C, Rigon L, Almadori G, Bentivoglio AR, Petracca M. The Minor's test in Frey syndrome treated with botulinum toxin: Methodology and efficacy. Am J Otolaryngol 2023; 44:103818. [PMID: 36878174 DOI: 10.1016/j.amjoto.2023.103818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
In this paper, we aimed at methodologically presenting a video-case of Frey Syndrome occurred after parotidectomy, assessed by means of Minor's Test and treated with intradermic botulinum toxin A (BoNT-A) injection. Although largely described in the literature, a detailed explanation of both the procedures has not been previously elucidated. In a more original approach, we also highlighted the role of the Minor's test in identifying the most affected skin areas and new insight on the patient-tailored approach provided by multiple injections of botulinum toxin. Six months after the procedure, the patient's symptoms were resolved, and no evident signs of Frey syndrome were detectable through the Minor's test.
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Affiliation(s)
- M R Marchese
- Otorhinolaryngology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - C Vollono
- Neurofisiopathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - L Rigon
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Almadori
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A R Bentivoglio
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy; Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M Petracca
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Janiri D, Petracca M, Moccia L, Solito M, Lo Monaco MR, Cerbarano ML, Piano C, Imbimbo I, Di Nicola M, Simonetti A, Sani G, Bentivoglio AR. Functional Movement Disorders during COVID-19: Psychological Distress, Affective Temperament and Emotional Dysregulation. J Pers Med 2023; 13:jpm13020175. [PMID: 36836408 PMCID: PMC9960146 DOI: 10.3390/jpm13020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background and objective: Functional movement disorders (FMD) represent a spectrum of psychosomatic symptoms particularly sensitive to stress. The COVID-19 pandemic has increased psychological distress worldwide and may have worsened FMD. The study aimed to confirm this hypothesis and to test whether in FMD there is a relationship between affective temperament, emotional dysregulation and psychological distress due to the pandemic. Methods: We recruited individuals with FMD, diagnosed them according to validated criteria and matched them with healthy controls (HC). Psychological distress and temperament were obtained using the Kessler-10 and the Temperament Evaluation of Memphis, Pisa and San Diego Autoquestionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation on the effect of temperament on psychological distress. Results: The sample consisted of 96 individuals. During the pandemic, 31.3% of the patients reported the need for urgent neurological care, and 40.6% reported a subjective worsening neurological condition. Patients with FMD presented with more psychological distress during the COVID-19 pandemic (F = 30.15, df = 1, p ≤ 0.001) than HC. They also reported more emotional dysregulation (F = 15.80, df = 1, p ≤ 0.001) and more cyclothymic traits (F = 14.84, df = 1, p ≤ 0.001). Cyclothymic temperament showed an indirect effect on COVID-19-related psychological distress, mediated by deficits in emotion regulation mechanisms (Bootstrapped LLCI = 0.41, ULCI = 2.41). Conclusion: Our results suggest that emotional dysregulation may represent a dimension mediating cyclotimic temperament response to the stressful effect of the pandemic and provide insight for developing intervention policies.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry and Neurology, Sapienza University of Rome, 00100 Rome, Italy
| | - Martina Petracca
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-0630155633
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marcella Solito
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Maria Rita Lo Monaco
- Medicine of Ageing, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Luana Cerbarano
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Carla Piano
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Isabella Imbimbo
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alessio Simonetti
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Rita Bentivoglio
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Petracca M, Lo Monaco MR, Ialongo T, Di Stasio E, Cerbarano ML, Maggi L, De Biase A, Di Lazzaro G, Calabresi P, Bentivoglio AR. Efficacy and safety of long-term botulinum toxin treatment for acquired cervical dystonia: a 25-year follow-up. J Neurol 2023; 270:340-347. [PMID: 36068376 PMCID: PMC9813057 DOI: 10.1007/s00415-022-11343-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 01/09/2023]
Abstract
Botulinum toxin A (BoNT/A) is the first-line treatment for idiopathic cervical dystonia (ICD) and is widely used in the clinical setting. To date, scanty data are available on the effectiveness of BoNT in treating acquired cervical dystonia (ACD). Here we present a long-term follow-up of ACD patients treated with BoNT/A that focused on safety and efficacy. The study included subjects who had received at least six treatments of three commercially available BoNT/A drugs [abobotulinumtoxinA (A/Abo), incobotulinumtoxinA (A/Inco) and onabotulinumtoxinA (A/Ona)]. Safety and efficacy were assessed based on patients' self-reports regarding adverse effects (AE), duration of improvement of dystonia and/or pain relief. Global clinical improvement was measured on a six-point scale. 23 patients with ACD were administered 739 treatments (A/Abo in 235, A/Inco in 72, A/Ona in 432) with a mean number of treatments of 31 ± 20 (range 6-76) and duration of 10 ± 6 weeks (range 2-25). The mean dose was 737 ± 292 U for A/Abo, 138 ± 108 U for A/Inco and 158 ± 80 U for A/Ona. The average benefit duration was 89 ± 26 (A/Abo), 88 ± 30 days (A/Inco), and 99 ± 55 days (A/Ona) (p = 0.011); global clinical improvement for all sessions was 4 ± 1. ANOVA one-way analysis indicated that A/Ona had the best profile in terms of duration (p < 0.05), whereas A/Abo had the best pain relief effect (p = 0.002). Side effects were reported in 9% of treatments (67/739), with ten treatments (1%) complicated by two side effects. Most side effects were rated mild to moderate; severe side effects occurred following three treatments with the three different BoNT; two required medical intervention. No allergic reactions were reported. Even after 25 years of repeated treatments, all serotypes of BoNT demonstrate positive effects in treating ACD with long-lasting efficacy and safety.
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Affiliation(s)
- Martina Petracca
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Maria Rita Lo Monaco
- Medicine of the Ageing, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Largo A Gemelli, 8, 00168, Rome, Italy.
| | - Tamara Ialongo
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Enrico Di Stasio
- Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
- Rehabilitation and Physical Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Maria Luana Cerbarano
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Loredana Maggi
- Rehabilitation and Physical Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Alessandro De Biase
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giulia Di Lazzaro
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Rita Bentivoglio
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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10
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Tranfa M, Pontillo G, Petracca M, Brunetti A, Tedeschi E, Palma G, Cocozza S. Quantitative MRI in Multiple Sclerosis: From Theory to Application. AJNR Am J Neuroradiol 2022; 43:1688-1695. [PMID: 35680161 DOI: 10.3174/ajnr.a7536] [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] [Received: 01/12/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023]
Abstract
Quantitative MR imaging techniques allow evaluating different aspects of brain microstructure, providing meaningful information about the pathophysiology of damage in CNS disorders. In the study of patients with MS, quantitative MR imaging techniques represent an invaluable tool for studying changes in myelin and iron content occurring in the context of inflammatory and neurodegenerative processes. In the first section of this review, we summarize the physics behind quantitative MR imaging, here defined as relaxometry and quantitative susceptibility mapping, and describe the neurobiological correlates of quantitative MR imaging findings. In the second section, we focus on quantitative MR imaging application in MS, reporting the main findings in both the gray and white matter compartments, separately addressing macroscopically damaged and normal-appearing parenchyma.
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Affiliation(s)
- M Tranfa
- From the Departments of Advanced Biomedical Sciences (M.T., G. Pontillo, A.B., E.T., S.C.)
| | - G Pontillo
- From the Departments of Advanced Biomedical Sciences (M.T., G. Pontillo, A.B., E.T., S.C.) .,Electrical Engineering and Information Technology (G. Pontillo), University of Naples "Federico II," Naples, Italy
| | - M Petracca
- Department of Human Neurosciences (M.P.), Sapienza University of Rome, Rome, Italy
| | - A Brunetti
- From the Departments of Advanced Biomedical Sciences (M.T., G. Pontillo, A.B., E.T., S.C.)
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (M.T., G. Pontillo, A.B., E.T., S.C.)
| | - G Palma
- Institute of Nanotechnology (G. Palma), National Research Council, Lecce, Italy
| | - S Cocozza
- From the Departments of Advanced Biomedical Sciences (M.T., G. Pontillo, A.B., E.T., S.C.)
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11
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Bove F, Genovese D, Petracca M, Tufo T, Pisani D, Lo Monaco MR, Bentivoglio AR, Calabresi P, Piano C. STN-DBS does not increase the risk of sialorrhea in patients with advanced Parkinson’s disease. NPJ Parkinsons Dis 2022; 8:85. [PMID: 35768423 PMCID: PMC9243012 DOI: 10.1038/s41531-022-00348-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
The aims of this study were to assess the incidence rate and risk factors for sialorrhea in the long-term follow-up in a cohort of 132 patients with advanced Parkinson’s disease [88 with deep brain stimulation (DBS) and 44 on medical treatment]. The incidence rate of sialorrhea did not differ between the two groups; male sex, Hoehn and Yahr stage and dysphagia resulted risk factors for sialorrhea. These findings indicate that DBS does not increase the risk of developing sialorrhea.
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Mostile G, Geroin C, Erro R, Luca A, Marcuzzo E, Barone P, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Dallocchio C, Arbasino C, Bono F, Bruno PA, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Albanese A, Ferrazzano G, De Micco R, Zibetti M, Calandra-Buonaura G, Petracca M, Morgante F, Esposito M, Pisani A, Manganotti P, Stocchi F, Coletti Moja M, Di Vico IA, Tesolin L, De Bertoldi F, Ercoli T, Defazio G, Zappia M, Nicoletti A, Tinazzi M. Data-driven clustering of combined Functional Motor Disorders based on the Italian registry. Front Neurol 2022; 13:987593. [PMID: 36518193 PMCID: PMC9742245 DOI: 10.3389/fneur.2022.987593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
IntroductionFunctional Motor Disorders (FMDs) represent nosological entities with no clear phenotypic characterization, especially in patients with multiple (combined FMDs) motor manifestations. A data-driven approach using cluster analysis of clinical data has been proposed as an analytic method to obtain non-hierarchical unbiased classifications. The study aimed to identify clinical subtypes of combined FMDs using a data-driven approach to overcome possible limits related to “a priori” classifications and clinical overlapping.MethodsData were obtained by the Italian Registry of Functional Motor Disorders. Patients identified with multiple or “combined” FMDs by standardized clinical assessments were selected to be analyzed. Non-hierarchical cluster analysis was performed based on FMDs phenomenology. Multivariate analysis was then performed after adjustment for principal confounding variables.ResultsFrom a study population of n = 410 subjects with FMDs, we selected n = 188 subjects [women: 133 (70.7%); age: 47.9 ± 14.4 years; disease duration: 6.4 ± 7.7 years] presenting combined FMDs to be analyzed. Based on motor phenotype, two independent clusters were identified: Cluster C1 (n = 82; 43.6%) and Cluster C2 (n = 106; 56.4%). Cluster C1 was characterized by functional tremor plus parkinsonism as the main clinical phenotype. Cluster C2 mainly included subjects with functional weakness. Cluster C1 included older subjects suffering from anxiety who were more treated with botulinum toxin and antiepileptics. Cluster C2 included younger subjects referring to different associated symptoms, such as pain, headache, and visual disturbances, who were more treated with antidepressants.ConclusionUsing a data-driven approach of clinical data from the Italian registry, we differentiated clinical subtypes among combined FMDs to be validated by prospective studies.
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Affiliation(s)
- Giovanni Mostile
- Section of Neurosciences, Department “G.F. Ingrassia”, University of Catania, Catania, Italy
- Oasi Research Institute—IRCCS, Troina, Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Christian Geroin
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry—Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Antonina Luca
- Section of Neurosciences, Department “G.F. Ingrassia”, University of Catania, Catania, Italy
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry—Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- FERB Onlus, Ospedale S. Isidoro, Bergamo, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Carlo Dallocchio
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Carla Arbasino
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | | | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G. d'Annunzio, Chieti, Italy
- Department of Medicine and Aging Sciences, University G. d'Annunzio, Pescara, Italy
| | | | - Gina Ferrazzano
- Department of Human Neurosciences, Università La Sapienza, Rome, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgery Sciences, University of Campania—Luigi Vanvitelli, Naples, Italy
| | - Maurizio Zibetti
- Department of Neuroscience—Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
- Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
| | - Marcello Esposito
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples—Federico II, Naples, Italy
| | - Antonio Pisani
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele, Rome, Italy
| | | | - Ilaria Antonella Di Vico
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | | | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mario Zappia
- Section of Neurosciences, Department “G.F. Ingrassia”, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Section of Neurosciences, Department “G.F. Ingrassia”, University of Catania, Catania, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- *Correspondence: Michele Tinazzi
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Di Tella S, Lo Monaco MR, Petracca M, Zinzi P, Solito M, Piano C, Calabresi P, Silveri MC, Bentivoglio AR. Correction to: Beyond the CAG triplet number: exploring potential predictors of delayed age of onset in Huntington's disease. J Neurol 2022; 269:6641. [PMID: 36205795 DOI: 10.1007/s00415-022-11392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
| | - Maria Rita Lo Monaco
- Medicine of Ageing, Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy. .,Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Martina Petracca
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Paola Zinzi
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.,Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Marcella Solito
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Carla Piano
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Paolo Calabresi
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Maria Caterina Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy.,Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Anna Rita Bentivoglio
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Ercoli T, Tinazzi M, Geroin C, Marcuzzo E, Erro R, Cuoco S, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Spano G, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Albanese A, Ferrazzano G, Tessitore A, Lopiano L, Calandra-Buonaura G, Petracca M, Morgante F, Esposito M, Pisani A, Manganotti P, Tesolin L, Teatini F, Stocchi F, Defazio G. Do demographic and clinical features and comorbidities affect the risk of spread to an additional body site in functional motor disorders? J Neural Transm (Vienna) 2022; 129:1271-1276. [PMID: 35972697 PMCID: PMC9468120 DOI: 10.1007/s00702-022-02537-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study is to assess changes in the body distribution and the semeiology of functional motor disorder (FMD) in patients who reported only one or more than one body site affected at FMD onset. Data were obtained from the Italian Registry of Functional Motor Disorders, which included patients with a diagnosis of clinically definite FMDs. The relationship between FMD features and spread to other body sites was estimated by multivariate Cox regression analysis. We identified 201 (49%) patients who reported only one body site affected at FMD onset and 209 (51%) who reported multiple body sites affected at onset. FMD spread from the initial site to another site in 43/201 (21.4%) patients over 5.7 ± 7.1 years in those with only one site affected at FMD onset; FMD spread to an another body site in 29/209 (13.8%) over 5.5 ± 6.5 years. The spread of FMD was associated with non-motor functional symptoms and psychiatric comorbidities only in the patients with one body site affected at FMD onset. Our findings provide novel insight into the natural history of FMD. The number of body sites affected at onset does not seem to have a consistent influence on the risk of spread. Furthermore, our findings suggest that psychiatric comorbidities and non-motor functional symptoms may predict the spread of FMD symptoms, at least in patients with one body site affected at onset.
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Affiliation(s)
- Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy.
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy.
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Sofia Cuoco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Roberto Ceravolo
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Carlo Dallocchio
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Carla Arbasino
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Giorgio Spano
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti-Pescara, Italy
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgery Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy
| | - Leonardo Lopiano
- Department of Neuroscience-Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
| | | | - Antonio Pisani
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Lucia Tesolin
- Functional Movement Disorders Outpatient Clinic, Clinical Neurology and Stroke Unit, Central Country Hospital, Bolzano, Italy
| | - Francesco Teatini
- Functional Movement Disorders Outpatient Clinic, Clinical Neurology and Stroke Unit, Central Country Hospital, Bolzano, Italy
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele Roma, Rome, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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15
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Di Tella S, Lo Monaco MRI, Petracca M, Zinzi P, Solito M, Piano C, Calabresi P, Silveri MC, Bentivoglio AR. Beyond the CAG triplet number: exploring potential predictors of delayed age of onset in Huntington's disease. J Neurol 2022; 269:6634-6640. [PMID: 35915275 DOI: 10.1007/s00415-022-11297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Huntington's disease (HD) is a genetic neurodegenerative disease characterized by cognitive, motor, and psychiatric dysfunction. It is caused by an expansion of the trinucleotide repeat sequence cytosine-adenine-guanine (CAG) in the Huntingtin gene on chromosome 4. Onset typically occurs in the fourth or fifth decade, ranging from childhood to late adulthood. The CAG triplet number is generally inversely proportional to the age of onset (AOO), but the repeat number only accounts for ∼70% of the variability in AOO. Several studies demonstrated the impact of genetic modifiers on age of disease onset. In addition to genetics, we also explored the demographic, anamnestic, and socio-environmental factors that can affect AOO, to help us understand the non-genetic variability of age of onset in HD. METHODS We analyzed the retrospective data of the ENROLL-HD global registry study, particularly focusing on the continuum of ages, to include sociodemographic, genetic, and anamnestic psychobehavioral variables in a multivariate regression model aimed at identifying the potential predictors of age of motor onset (n = 5053). We ran the same regression model in the sample of subjects who had the same number of triplets (41 CAG, n = 593) and in the sample whose family history was absent/unknown (n = 630). RESULTS Patients with delayed onset more frequently have unknown/missing family history, are married or widowed, live in larger urbanized contexts and have a lower educational level. Individuals with earlier onset more frequently develop psychobehavioral symptoms. CONCLUSIONS In the past, the HD gene was considered the epitome of genetic determinism. Our results are consistent with recent evidence that other factors might modulate its impact. These findings allow characterizing the determinants of AOO beyond the CAG expansions and provide valuable information for stratifying patients for future clinical trial designs.
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Affiliation(s)
- Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
| | - Maria RIta Lo Monaco
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy. .,Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Martina Petracca
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Paola Zinzi
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Marcella Solito
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Carla Piano
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Paolo Calabresi
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Maria Caterina Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy.,Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Silveri MC, Di Tella S, Lo Monaco MR, Petracca M, Tondinelli A, Antonucci G, Pozzi G, Di Lazzaro G, Calabresi P, Bentivoglio AR. Theory of mind: A clue for the interpretation of functional movement disorders. Acta Neurol Scand 2022; 145:571-578. [PMID: 35112347 PMCID: PMC9303374 DOI: 10.1111/ane.13585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 11/27/2022]
Abstract
Objectives Functional movement disorders (FMD) refer to a heterogeneous group of manifestations incongruent with known neurological diseases. Functional neuroimaging studies in FMD indicate the overlap between cerebral regions in which abnormal activation occurs and those considered crucial for theory of mind (ToM), the ability to attribute mental states. The aim of this study was to explore whether FMD might be related to ToM disorders to the extent that they reduce the ability to make inferences about the mental states underlying motor behaviour during social interaction. Materials & Methods Eighteen subjects with FMD and 28 matched healthy controls (HC) were given a ToM battery. The severity of FMD was rated by the Simplified‐FMD Rating Scale (S‐FMDRS). Dissociative symptoms were evaluated by the Dissociative Experiences Scale (DES‐II). Results FMD scored worse than the HC in most ToM tasks: second‐order False Beliefs (p = .005), Faux‐Pas Recognition Test (p < .001) and Reading the Mind in the Eyes Test (p = .020); control questions elicited normal scores. The DES‐II indicated dissociative‐borderline psychopathology and negatively correlated with accuracy on the second‐order False Belief (Spearman's rho = −.444; p = .032); the positive correlation between DES‐II and severity of motor symptoms (S‐FMDRS) approached significance (Spearman's rho test = .392; p = .054). ToM disorders were not correlated with S‐FMDRS, due to the typical variability in FMD over time with regard to the severity of symptoms and the district of body involved. Conclusions Our results are consistent with the hypothesis that FMD are related to ToM deficits, and future studies are needed to define the specific nature of this relationship.
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Affiliation(s)
- Maria Caterina Silveri
- Department of Psychology Università Cattolica del Sacro Cuore Milan Italy
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
| | - Sonia Di Tella
- Department of Psychology Università Cattolica del Sacro Cuore Milan Italy
| | - Maria Rita Lo Monaco
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
- Institute of Internal Medicine and Geriatrics Università Cattolica del Sacro Cuore Rome Italy
| | - Martina Petracca
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
| | - Alice Tondinelli
- Department of Psychology Università Cattolica del Sacro Cuore Milan Italy
| | - Gabriella Antonucci
- Department of Psychology Sapienza Università di Roma and IRCCS Fondazione Santa Lucia Rome Italy
| | - Gino Pozzi
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
- Department of Neurosciences Section of Psychiatry Università Cattolica del Sacro Cuore Rome Italy
| | - Giulia Di Lazzaro
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
- Department of Systems Medicine University Tor Vergata Rome Italy
| | - Paolo Calabresi
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
- Institute of Neurology Università Cattolica del Sacro Cuore Rome Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCSS Rome Italy
- Institute of Neurology Università Cattolica del Sacro Cuore Rome Italy
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Petracca M, Di Tella S, Solito M, Zinzi P, Lo Monaco MR, Di Lazzaro G, Calabresi P, Silveri MC, Bentivoglio AR. Clinical and genetic characteristics of late-onset Huntington's disease in a large European cohort. Eur J Neurol 2022; 29:1940-1951. [PMID: 35357736 PMCID: PMC9324106 DOI: 10.1111/ene.15340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/15/2022] [Accepted: 03/24/2022] [Indexed: 11/28/2022]
Abstract
Background and purpose Huntington's disease (HD) is an autosomal dominant condition caused by CAG‐triplet repeat expansions. CAG‐triplet repeat expansion is inversely correlated with age of onset in HD and largely determines the clinical features. The aim of this study was to examine the phenotypic and genotypic correlates of late‐onset HD (LoHD) and to determine whether LoHD is a more benign expression of HD. Methods This was a retrospective observational study of 5053 White European HD patients from the ENROLL‐HD database. Sociodemographic, genetic and phenotypic variables at baseline evaluation of subjects with LoHD, common‐onset HD (CoHD) and young‐onset HD (YoHD) were compared. LoHD subjects were compared with healthy subjects (HS) aged ≥60 years. Differences between the CoHD and LoHD groups were also explored in subjects with 41 CAG triplets, a repeat number in the lower pathological expansion range associated with wide variability in age at onset. Results Late‐onset HD presented predominantly as motor‐onset disease, with a lower prevalence of both psychiatric history and current symptomatology. Absent/unknown HD family history was significantly more common in the LoHD group (31.2%) than in the other groups. The LoHD group had more severe motor and cognitive deficits than the HS group. Subjects with LoHD and CoHD with 41 triplets in the larger allele were comparable with regard to cognitive impairment, but those with LoHD had more severe motor disorders, less problematic behaviors and more often an unknown HD family history. Conclusions It is likely that cognitive disorders and motor symptoms of LoHD are at least partly age‐related and not a direct expression of the disease. In addition to CAG‐triplet repeat expansion, future studies should investigate the role of other genetic and environmental factors in determining age of onset.
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Affiliation(s)
- M Petracca
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome
| | - S Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan
| | - M Solito
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome
| | - P Zinzi
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome.,Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome
| | - M R Lo Monaco
- Geriatric Day-Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome.,Medicine of the Ageing, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome
| | - G Di Lazzaro
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome.,Department of Systems Medicine, University of Rome Tor Vergata, Rome
| | - P Calabresi
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome
| | - M C Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123, Milan.,Medicine of the Ageing, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome
| | - A R Bentivoglio
- Movement Disorders Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome
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Ercoli T, Defazio G, Geroin C, Marcuzzo E, Fabbrini G, Bono F, Mechelli A, Ceravolo R, Romito LM, Albanese A, Pisani A, Zibetti M, Altavista MC, Maderna L, Petracca M, Girlanda P, Mascia MM, Berardelli A, Tinazzi M. Sudden Onset, Fixed Dystonia and Acute Peripheral Trauma as Diagnostic Clues for Functional Dystonia. Mov Disord Clin Pract 2021; 8:1107-1111. [PMID: 34631946 PMCID: PMC8485608 DOI: 10.1002/mdc3.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022] Open
Abstract
Background The differentiation of functional dystonia from idiopathic dystonia may be clinically challenging. Objective To identify clinical features suggestive of functional dystonia to guide physicians to distinguish functional dystonia from idiopathic dystonia. Methods Patient data were extracted from the Italian Registry of Functional Motor Disorders and the Italian Registry of Adult Dystonia. Patients with functional and idiopathic dystonia were followed up at the same clinical sites, and they were similar in age and sex. Results We identified 113 patients with functional dystonia and 125 with idiopathic dystonia. Sudden onset of dystonia, evidence of fixed dystonia, and acute peripheral trauma before dystonia onset were more frequent in the functional dystonia group. No study variable alone achieved satisfactory sensitivity and specificity, whereas a combination of variables yielded 85% sensitivity and 98% specificity. A diagnostic algorithm was developed to reduce the risk of misclassifying functional dystonia. Conclusion Our findings extend the current diagnostic approach to functional dystonia by showing that clinical information about symptom onset, fixed dystonia, and history of peripheral trauma may provide key clues in the diagnosis of functional dystonia.
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Affiliation(s)
- Tommaso Ercoli
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences Sapienza University of Rome Rome Italy.,IRCCS Neuromed Pozzilli Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini Catanzaro Italy
| | | | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Alberto Albanese
- Department of Neurology IRCCS Humanitas Research Hospital Rozzano Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy.,IRCCS Mondino Foundation Pavia Italy
| | - Maurizio Zibetti
- Department of Neuroscience-Rita Levi Montalcini University of Turin Turin Italy
| | | | - Luca Maderna
- Department of Neurology-Stroke Unit and Laboratory of Neurosciences Istituto Auxologico Italiano, IRCCS Milan Italy
| | - Martina Petracca
- Fondazione Policlinico Universitario 'Agostino Gemelli'-IRCCS Rome Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine University of Messina Messina Italy
| | - Marcello Mario Mascia
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences Sapienza University of Rome Rome Italy.,IRCCS Neuromed Pozzilli Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy
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Zinzi P, Di Tella S, Solito M, Monaco MRL, Petracca M, Silveri C, Bentivoglio AR. Clinical progression over 2 years of 220 patients with late onset Huntington's disease. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117835] [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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20
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Di Tella S, Silveri MC, Monaco RL, Petracca M, Alice T, Gabriella A, Pozzi G, Di Lazzaro G, Calabresi P, Bentivoglio AR. Theory of mind: A clue to functional movement disorders diagnosis. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117681] [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: 10/20/2022]
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Ercoli T, Erro R, Fabbrini G, Pellicciari R, Girlanda P, Terranova C, Avanzino L, Di Biasio F, Barone P, Esposito M, De Joanna G, Eleopra R, Bono F, Manzo L, Bentivoglio AR, Petracca M, Mascia MM, Albanese A, Castagna A, Ceravolo R, Altavista MC, Scaglione C, Magistrelli L, Zibetti M, Bertolasi L, Moja MC, Cotelli MS, Cossu G, Minafra B, Pisani A, Misceo S, Modugno N, Romano M, Cassano D, Berardelli A, Defazio G. Spread of segmental/multifocal idiopathic adult-onset dystonia to a third body site, data from the Italian dystonia registry. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117641] [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: 10/20/2022]
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22
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Muroni A, Murru MR, Ulgheri L, Sechi MM, Ercoli T, Marrosu F, Scaglione C, Bentivoglio AR, Petracca M, Soliveri P, Cocco E, Cuccu S, Deriu M, Zuccato C, Defazio G. Epidemiology of Huntington's disease in Sardinia, Italy. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118237] [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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Pontillo G, Tommasin S, Cuocolo R, Petracca M, Petsas N, Ugga L, Carotenuto A, Pozzilli C, Iodice R, Lanzillo R, Quarantelli M, Brescia Morra V, Tedeschi E, Pantano P, Cocozza S. A Combined Radiomics and Machine Learning Approach to Overcome the Clinicoradiologic Paradox in Multiple Sclerosis. AJNR Am J Neuroradiol 2021; 42:1927-1933. [PMID: 34531195 DOI: 10.3174/ajnr.a7274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 07/12/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Conventional MR imaging explains only a fraction of the clinical outcome variance in multiple sclerosis. We aimed to evaluate machine learning models for disability prediction on the basis of radiomic, volumetric, and connectivity features derived from routine brain MR images. MATERIALS AND METHODS In this retrospective cross-sectional study, 3T brain MR imaging studies of patients with multiple sclerosis, including 3D T1-weighted and T2-weighted FLAIR sequences, were selected from 2 institutions. T1-weighted images were processed to obtain volume, connectivity score (inferred from the T2 lesion location), and texture features for an atlas-based set of GM regions. The site 1 cohort was randomly split into training (n = 400) and test (n = 100) sets, while the site 2 cohort (n = 104) constituted the external test set. After feature selection of clinicodemographic and MR imaging-derived variables, different machine learning algorithms predicting disability as measured with the Expanded Disability Status Scale were trained and cross-validated on the training cohort and evaluated on the test sets. The effect of different algorithms on model performance was tested using the 1-way repeated-measures ANOVA. RESULTS The selection procedure identified the 9 most informative variables, including age and secondary-progressive course and a subset of radiomic features extracted from the prefrontal cortex, subcortical GM, and cerebellum. The machine learning models predicted disability with high accuracy (r approaching 0.80) and excellent intra- and intersite generalizability (r ≥ 0.73). The machine learning algorithm had no relevant effect on the performance. CONCLUSIONS The multidimensional analysis of brain MR images, including radiomic features and clinicodemographic data, is highly informative of the clinical status of patients with multiple sclerosis, representing a promising approach to bridge the gap between conventional imaging and disability.
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Affiliation(s)
- G Pontillo
- From the Departments of Advanced Biomedical Sciences (G.P., L.U., E.T., S.C.).,Electrical Engineering and Information Technology (G.P., M.Q.)
| | - S Tommasin
- Department of Human Neuroscience (S.T., C.P., P.P.), Sapienza University of Rome, Rome, Italy
| | - R Cuocolo
- Clinical Medicine and Surgery (R.C.) .,Laboratory of Augmented Reality for Health Monitoring (R.C.)
| | - M Petracca
- Department of Electrical Engineering and Information Technology, and Department of Neurosciences and Reproductive and Odontostomatological Sciences (M.P., A.C., R.I., R.L., V.B.M.), University of Naples "Federico II," Naples, Italy
| | - N Petsas
- Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Mediterraneo (N.P., P.P.), Pozzilli, Italy
| | - L Ugga
- From the Departments of Advanced Biomedical Sciences (G.P., L.U., E.T., S.C.)
| | - A Carotenuto
- Department of Electrical Engineering and Information Technology, and Department of Neurosciences and Reproductive and Odontostomatological Sciences (M.P., A.C., R.I., R.L., V.B.M.), University of Naples "Federico II," Naples, Italy
| | - C Pozzilli
- Department of Human Neuroscience (S.T., C.P., P.P.), Sapienza University of Rome, Rome, Italy
| | - R Iodice
- Department of Electrical Engineering and Information Technology, and Department of Neurosciences and Reproductive and Odontostomatological Sciences (M.P., A.C., R.I., R.L., V.B.M.), University of Naples "Federico II," Naples, Italy
| | - R Lanzillo
- Department of Electrical Engineering and Information Technology, and Department of Neurosciences and Reproductive and Odontostomatological Sciences (M.P., A.C., R.I., R.L., V.B.M.), University of Naples "Federico II," Naples, Italy
| | - M Quarantelli
- Electrical Engineering and Information Technology (G.P., M.Q.).,Institute of Biostructure and Bioimaging (M.Q.), National Research Council, Naples, Italy
| | - V Brescia Morra
- Department of Electrical Engineering and Information Technology, and Department of Neurosciences and Reproductive and Odontostomatological Sciences (M.P., A.C., R.I., R.L., V.B.M.), University of Naples "Federico II," Naples, Italy
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (G.P., L.U., E.T., S.C.)
| | - P Pantano
- Department of Human Neuroscience (S.T., C.P., P.P.), Sapienza University of Rome, Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Mediterraneo (N.P., P.P.), Pozzilli, Italy
| | - S Cocozza
- From the Departments of Advanced Biomedical Sciences (G.P., L.U., E.T., S.C.)
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24
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Tinazzi M, Pilotto A, Morgante F, Marcuzzo E, Cuoco S, Ceravolo R, Mazzucchi S, Padovani A, Romito LM, Eleopra R, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Magro G, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Zanolin E, Albanese A, Ferrazzano G, Tessitore A, Lopiano L, Calandra-Buonaura G, Petracca M, Esposito M, Pisani A, Manganotti P, Tesolin L, Teatini F, Defazio G, Ercoli T, Stocchi F, Erro R, Zappia M, Geroin C. Functional gait disorders: Demographic and clinical correlations. Parkinsonism Relat Disord 2021; 91:32-36. [PMID: 34479056 DOI: 10.1016/j.parkreldis.2021.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/23/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to describe the prevalence and clinical-demographical features of patients with functional gait disorders (FGDs) and to compare them to patients with functional motor disorders (FMDs) without FGDs (No-FGDs). METHODS In this multicenter observational study, we enrolled patients with a clinically definite diagnosis of FMDs in 25 tertiary movement disorders centers in Italy. Each subject with FMDs underwent a comprehensive clinical assessment, including screening for different subtypes of functional gait disorders. Multivariate regression models were implemented in order to estimate the adjusted odds ratio (OR; 95% confidence interval) of having FGDs in relation to sociodemographic and clinical characteristics. RESULTS Out of 410 FMDs, 26.6% (n = 109) of patients exhibited FGDs. The most frequent FGDs were slow gait (n = 43, 39.4%), astasia-abasia (n = 26, 23.8%), and knee buckling (n = 24, 22%). They exhibited single FGDs in 51.4% (n = 56) or complex FGDs (more than one type of FGDs) in 48.6% (n = 53) of cases. On multivariate regression analysis, the presence of FGDs was more likely associated with older age (OR 1.03, 95% CI 1.01-1.04), functional visual symptoms (OR 2.19, 95% CI 1.08-4.45), and the diagnosis of somatic symptoms disorder (OR 2.97, 95% CI 1.08-8.17). FGDs were also more likely to undergo physiotherapy (OR 1.81, 95% CI 1.08-3.03). CONCLUSIONS People with FMDs may present with different and overlapping types of FGDs, which may occur in older age. The association of FGDs with functional visual symptoms and somatic symptoms disorder opens up to new avenues to the understanding of the neural mechanisms of these disorders.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom; Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sofia Cuoco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry -Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Roberto Ceravolo
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Sonia Mazzucchi
- Center for NeuroDegenerative Diseases Parkinson and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | | | - Carla Arbasino
- Department of Medical Area, Neurology Unit, ASST Pavia, Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Giuseppe Magro
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano Milan, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Università La Sapienza, Rome, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgery Sciences, University of Campania - Luigi Vanvitelli, Naples, Italy
| | - Leonardo Lopiano
- Department of Neuroscience - Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Antonio Pisani
- IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Lucia Tesolin
- Functional Movement Disorders Outpt.Clinic, Clinical Neurology and Stroke Unit Dep., Central Country Hospital, Bolzano, Italy
| | - Francesco Teatini
- Functional Movement Disorders Outpt.Clinic, Clinical Neurology and Stroke Unit Dep., Central Country Hospital, Bolzano, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele Roma, Rome, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry -Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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25
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Tinazzi M, Geroin C, Marcuzzo E, Cuoco S, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Magro G, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Zanolin E, Albanese A, Ferrazzano G, De Micco R, Lopiano L, Calandra-Buonaura G, Petracca M, Esposito M, Pisani A, Manganotti P, Tesolin L, Teatini F, Ercoli T, Morgante F, Erro R. Functional motor phenotypes: to lump or to split? J Neurol 2021; 268:4737-4743. [PMID: 33961091 PMCID: PMC8563631 DOI: 10.1007/s00415-021-10583-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Functional motor disorders (FMDs) are usually categorized according to the predominant phenomenology; however, it is unclear whether this phenotypic classification mirrors the underlying pathophysiologic mechanisms. OBJECTIVE To compare the characteristics of patients with different FMDs phenotypes and without co-morbid neurological disorders, aiming to answer the question of whether they represent different expressions of the same disorder or reflect distinct entities. METHODS Consecutive outpatients with a clinically definite diagnosis of FMDs were included in the Italian registry of functional motor disorders (IRFMD), a multicenter data collection platform gathering several clinical and demographic variables. To the aim of the current work, data of patients with isolated FMDs were extracted. RESULTS A total of 176 patients were included: 58 with weakness, 40 with tremor, 38 with dystonia, 23 with jerks/facial FMDs, and 17 with gait disorders. Patients with tremor and gait disorders were older than the others. Patients with functional weakness had more commonly an acute onset (87.9%) than patients with tremor and gait disorders, a shorter time lag from symptoms onset and FMDs diagnosis (2.9 ± 3.5 years) than patients with dystonia, and had more frequently associated functional sensory symptoms (51.7%) than patients with tremor, dystonia and gait disorders. Patients with dystonia complained more often of associated pain (47.4%) than patients with tremor. No other differences were noted between groups in terms of other variables including associated functional neurological symptoms, psychiatric comorbidities, and predisposing or precipitating factors. CONCLUSIONS Our data support the evidence of a large overlap between FMD phenotypes.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy.
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy.
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy
| | - Sofia Cuoco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Carlo Dallocchio
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Carla Arbasino
- Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Giuseppe Magro
- Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano Milan, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Università La Sapienza, Rome, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgery Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy
| | - Leonardo Lopiano
- Department of Neuroscience-Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Antonio Pisani
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Lucia Tesolin
- Functional Movement Disorders Outpt. Clinic, Clinical Neurology and Stroke Unit Department, Central Country Hospital, Bolzano, Italy
| | - Francesco Teatini
- Functional Movement Disorders Outpt. Clinic, Clinical Neurology and Stroke Unit Department, Central Country Hospital, Bolzano, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
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26
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Pontillo G, Petracca M, Monti S, Quarantelli M, Criscuolo C, Lanzillo R, Tedeschi E, Elefante A, Brescia Morra V, Brunetti A, Cocozza S, Palma G. Unraveling Deep Gray Matter Atrophy and Iron and Myelin Changes in Multiple Sclerosis. AJNR Am J Neuroradiol 2021; 42:1223-1230. [PMID: 33888456 DOI: 10.3174/ajnr.a7093] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Modifications of magnetic susceptibility have been consistently demonstrated in the subcortical gray matter of MS patients, but some uncertainties remain concerning the underlying neurobiological processes and their clinical relevance. We applied quantitative susceptibility mapping and longitudinal relaxation rate relaxometry to clarify the relative contribution of atrophy and iron and myelin changes to deep gray matter damage and disability in MS. MATERIALS AND METHODS Quantitative susceptibility mapping and longitudinal relaxation rate maps were computed for 91 patients and 55 healthy controls from MR images acquired at 3T. Applying an external model, we estimated iron and myelin concentration maps for all subjects. Subsequently, changes of deep gray matter iron and myelin concentration (atrophy-dependent) and content (atrophy-independent) were investigated globally (bulk analysis) and regionally (voxel-based and atlas-based thalamic subnuclei analyses). The clinical impact of the observed MRI modifications was evaluated via regression models. RESULTS We identified reduced thalamic (P < .001) and increased pallidal (P < .001) mean iron concentrations in patients with MS versus controls. Global myelin and iron content in the basal ganglia did not differ between the two groups, while actual iron depletion was present in the thalamus (P < .001). Regionally, patients showed increased iron concentration in the basal ganglia (P ≤ .001) and reduced iron and myelin content in thalamic posterior-medial regions (P ≤ .004), particularly in the pulvinar (P ≤ .001). Disability was predicted by thalamic volume (B = -0.341, P = .02), iron concentration (B = -0.379, P = .005) and content (B = -0.406, P = .009), as well as pulvinar iron (B = -0.415, P = .003) and myelin (B = -0.415, P = .02) content, independent of atrophy. CONCLUSIONS Quantitative MRI suggests an atrophy-related iron increase within the basal ganglia of patients with MS, along with an atrophy-independent reduction of thalamic iron and myelin correlating with disability. Absolute depletions of thalamic iron and myelin may represent sensitive markers of subcortical GM damage, which add to the clinical impact of thalamic atrophy in MS.
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Affiliation(s)
- G Pontillo
- From the Departments of Advanced Biomedical Sciences (G.P., E.T., A.E., A.B., S.C.)
| | - M Petracca
- Neurosciences and Reproductive and Odontostomatological Sciences (M.P., C.C., R.L., V.B.M.), University "Federico II," Naples, Italy
| | - S Monti
- Institute of Biostructure and Bioimaging, (S.M., M.Q., G.P.) National Research Council, Naples, Italy
| | - M Quarantelli
- Institute of Biostructure and Bioimaging, (S.M., M.Q., G.P.) National Research Council, Naples, Italy
| | - C Criscuolo
- Neurosciences and Reproductive and Odontostomatological Sciences (M.P., C.C., R.L., V.B.M.), University "Federico II," Naples, Italy
| | - R Lanzillo
- Neurosciences and Reproductive and Odontostomatological Sciences (M.P., C.C., R.L., V.B.M.), University "Federico II," Naples, Italy
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (G.P., E.T., A.E., A.B., S.C.)
| | - A Elefante
- From the Departments of Advanced Biomedical Sciences (G.P., E.T., A.E., A.B., S.C.)
| | - V Brescia Morra
- Neurosciences and Reproductive and Odontostomatological Sciences (M.P., C.C., R.L., V.B.M.), University "Federico II," Naples, Italy
| | - A Brunetti
- From the Departments of Advanced Biomedical Sciences (G.P., E.T., A.E., A.B., S.C.)
| | - S Cocozza
- From the Departments of Advanced Biomedical Sciences (G.P., E.T., A.E., A.B., S.C.)
| | - G Palma
- Institute of Biostructure and Bioimaging, (S.M., M.Q., G.P.) National Research Council, Naples, Italy
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27
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Muroni A, Murru MR, Ulgheri L, Sechi M, Ercoli T, Marrosu F, Scaglione CL, Bentivoglio AR, Petracca M, Soliveri P, Cocco E, Cuccu S, Deriu M, Zuccato C, Defazio G. Geographic differences in the incidence of Huntington's disease in Sardinia, Italy. Neurol Sci 2021; 42:5177-5181. [PMID: 33792825 DOI: 10.1007/s10072-021-05217-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)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The frequency of Huntington's disease (HD) may vary considerably, with higher estimates in non-Asian populations. We have recently examined the prevalence of HD in the southern part of Sardinia, a large Italian Mediterranean island that is considered a genetic isolate. We observed regional microgeographic differences in the prevalence of HD across the study area similar to those recently reported in other studies conducted in European countries. To explore the basis for this variability, we undertook a study of the incidence of HD in Sardinia over a 10-year period, 2009 to 2018. METHODS Our research was conducted in the 5 administrative areas of Sardinia island. Case patients were ascertained through multiple sources in Sardinia and Italy. RESULTS During the incidence period 53 individuals were diagnosed with clinically manifested HD. The average annual incidence rate 2009-2018 was 2.92 per 106 persons-year (95% CI, 2.2 to 3.9). The highest incidence rate was observed in South Sardinia (6.3; 95% CI, 4.2-9.5). This rate was significantly higher (p<0.01) than the rates from Cagliari, Oristano, and Sassari provinces but did not significantly differ (p = 0.38) from the Nuoro rate. CONCLUSIONS The overall incidence of HD in Sardinia is close to the correspondent estimates in Mediterranean countries. Our findings highlight also the possibility of local microgeographic variations in the epidemiology of HD that might reflect several factors, including a possible founder effect in the rural areas of South Sardinia and Nuoro.
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Affiliation(s)
- Antonella Muroni
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, 09124, Cagliari, Italy.
| | - Maria R Murru
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Lucia Ulgheri
- S.S.D. di Genetica e Biologia dello Sviluppo, University Hospital, Sassari, Italy
| | - Margherita Sechi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Marrosu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Cesa L Scaglione
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Martina Petracca
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola Soliveri
- Unit of Neurology I, Parkinson and Movement Disorders Unit, Fondazione IRCSS Istituto Neurologico Carlo Basta, Milan, Italy.,Parkinson Institute - CTO, Milan, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefania Cuccu
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marcello Deriu
- Neurology Service, Nostra Signora della Mercede Hospital, ATS Sardegna, San Gavino Monreale, Italy
| | - Chiara Zuccato
- Department of Biosciences, University of Milan, Milan, Italy.,Istituto Nazionale di Genetica Molecolare "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Giovanni Defazio
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, 09124, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Lo Monaco MR, Di Stasio E, Ricciardi D, Solito M, Petracca M, Fusco D, Onder G, Landi G, Zuccalà G, Liperoti R, Cipriani MC, Brisi C, Bernabei R, Silveri MC, Bentivoglio AR. What about the caregiver? A journey into Parkinson's disease following the burden tracks. Aging Clin Exp Res 2021; 33:991-996. [PMID: 32488473 DOI: 10.1007/s40520-020-01600-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate caregivers and patients characteristics related to different dimensions of burden in Parkinson's disease (PD). METHODS 55 pairs of PD patients and caregivers were recruited. The burden was evaluated with the Caregiver Burden Inventory (CBI). Multivariate analysis was applied to evaluate the impact of caregivers' and patients' characteristics on the varying aspects of burden. RESULTS ADL score was the dominant predictor for the total score and all dimensions of CBI, except for the social burden, which is strongly predicted by the motor severity of PD. As one can easily imagine, the Total CBI decreases as the ADL score increases. DISCUSSION An increased appreciation for characteristics of caregiver burden is a fundamental aspect of the patient's global evaluation. Clinicians may need to directly probe for these factors in the caregiver as they may not be elicited routinely.
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Affiliation(s)
- Maria Rita Lo Monaco
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Enrico Di Stasio
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Biochimica E Biochimica Clinica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Marcella Solito
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Petracca
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico Fusco
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Landi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Zuccalà
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Camilla Cipriani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Caterina Brisi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Roberto Bernabei
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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29
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Vaisfeld A, Bruno G, Petracca M, Bentivoglio AR, Servidei S, Vita MG, Bove F, Straccia G, Dato C, Di Iorio G, Sampaolo S, Peluso S, De Rosa A, De Michele G, Barghigiani M, Galatolo D, Tessa A, Santorelli F, Chiurazzi P, Melone MAB. Neuroacanthocytosis Syndromes in an Italian Cohort: Clinical Spectrum, High Genetic Variability and Muscle Involvement. Genes (Basel) 2021; 12:genes12030344. [PMID: 33652783 PMCID: PMC7996727 DOI: 10.3390/genes12030344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 01/12/2023] Open
Abstract
Neuroacanthocytosis (NA) syndromes are a group of genetically defined diseases characterized by the association of red blood cell acanthocytosis, progressive degeneration of the basal ganglia and neuromuscular features with characteristic persistent hyperCKemia. The main NA syndromes include autosomal recessive chorea-acanthocytosis (ChAc) and X-linked McLeod syndrome (MLS). A series of Italian patients selected through a multicenter study for these specific neurological phenotypes underwent DNA sequencing of the VPS13A and XK genes to search for causative mutations. Where it has been possible, muscle biopsies were obtained and thoroughly investigated with histochemical assays. A total of nine patients from five different families were diagnosed with ChAC and had mostly biallelic changes in the VPS13A gene (three nonsense, two frameshift, three splicing), while three patients from a single X-linked family were diagnosed with McLeod syndrome and had a deletion in the XK gene. Despite a very low incidence (only one thousand cases of ChAc and a few hundred MLS cases reported worldwide), none of the 8 VPS13A variants identified in our patients is shared by two families, suggesting the high genetic variability of ChAc in the Italian population. In our series, in line with epidemiological data, McLeod syndrome occurs less frequently than ChAc, although it can be easily suspected because of its X-linked mode of inheritance. Finally, histochemical studies strongly suggest that muscle pathology is not simply secondary to the axonal neuropathy, frequently seen in these patients, but primary myopathic alterations can be detected in both NA syndromes.
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Affiliation(s)
- Alessandro Vaisfeld
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Giorgia Bruno
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Martina Petracca
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Serenella Servidei
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurofisiopatologia, 00168 Rome, Italy
| | - Maria Gabriella Vita
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
| | - Francesco Bove
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Neurologia, 00168 Roma, Italy; (M.P.); (A.R.B.); (M.G.V.); (F.B.)
- Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giulia Straccia
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Clemente Dato
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Giuseppe Di Iorio
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Simone Sampaolo
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
| | - Silvio Peluso
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Giuseppe De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (S.P.); (A.D.R.); (G.D.M.)
| | - Melissa Barghigiani
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Daniele Galatolo
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Alessandra Tessa
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Filippo Santorelli
- Molecular Medicine, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (M.B.); (D.G.); (A.T.); (F.S.)
| | - Pietro Chiurazzi
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC Genetica Medica, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-338-8361006
| | - Mariarosa Anna Beatrice Melone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Interuniversity Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.B.); (G.S.); (C.D.); (G.D.I.); (S.S.); (M.A.B.M.)
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Temple University, Philadelphia, PA 19122-6078, USA
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30
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Tinazzi M, Geroin C, Erro R, Marcuzzo E, Cuoco S, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Pascarella A, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Antelmi E, Zanolin E, Albanese A, Ferrazzano G, de Micco R, Lopiano L, Calandra-Buonaura G, Petracca M, Esposito M, Pisani A, Manganotti P, Stocchi F, Coletti Moja M, Antonini A, Ercoli T, Morgante F. Functional motor disorders associated with other neurological diseases: Beyond the boundaries of "organic" neurology. Eur J Neurol 2021; 28:1752-1758. [PMID: 33300269 DOI: 10.1111/ene.14674] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE The aims of this study were to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases ("comorbid FMDs"), and to compare comorbid FMDs with FMDs not overlapping with other neurological diseases ("pure FMDs"). METHODS For this multicenter observational study, we enrolled outpatients with a definite FMD diagnosis attending 25 tertiary movement disorder centers in Italy. Each patient with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Group comparisons (comorbid FMDs vs. pure FMDs) were performed in order to compare demographic and clinical variables. Logistic regression models were created to estimate the adjusted odds ratios (95% confidence intervals) of comorbid FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables). RESULTS Out of 410 FMDs, 21.7% of patients (n = 89) had comorbid FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%), FMDs appeared after the diagnosis of a neurological disease. Patients with comorbid FMDs were older, and more frequently had tremor, non-neurological comorbidities, paroxysmal non-epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid FMDs was more likely associated with longer time lag until the final diagnosis of FMD, presence of tremor and non-neurological comorbidities. CONCLUSIONS Our findings highlight the need for prompt diagnosis of FMDs, given the relatively high frequency of associated neurological and non-neurological diseases.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry -Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Baronissi, SA, Italy
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sofia Cuoco
- Department of Medicine, Surgery and Dentistry -Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Baronissi, SA, Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mario Zappia
- Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Catania, Italy
| | - Carlo Dallocchio
- Neurology Unit, Department of Medical Area, ASST Pavia, Pavia, Italy
| | - Carla Arbasino
- Neurology Unit, Department of Medical Area, ASST Pavia, Pavia, Italy
| | - Francesco Bono
- Botulinum Toxin Center, Neurology Unit, A.O.U. Mater Domini, Catanzaro, Italy
| | - Angelo Pascarella
- Botulinum Toxin Center, Neurology Unit, A.O.U. Mater Domini, Catanzaro, Italy
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics - Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics - Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti-Pescara, Italy
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Università La Sapienza, Rome, Italy
| | - Rosa de Micco
- Department of Advanced Medical and Surgery Sciences, University of Campania - Luigi Vanvitelli, Naples, Italy
| | - Leonardo Lopiano
- Department of Neuroscience - Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences of Bologna, IRCCS, Bologna, Italy
| | - Martina Petracca
- Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele, Roma, Italy
| | | | - Angelo Antonini
- Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
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31
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Janiri D, Petracca M, Moccia L, Tricoli L, Piano C, Bove F, Imbimbo I, Simonetti A, Di Nicola M, Sani G, Calabresi P, Bentivoglio AR. COVID-19 Pandemic and Psychiatric Symptoms: The Impact on Parkinson's Disease in the Elderly. Front Psychiatry 2020; 11:581144. [PMID: 33329124 PMCID: PMC7728715 DOI: 10.3389/fpsyt.2020.581144] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic represents a condition of increased vulnerability and frailty for elderly patients with Parkinson's disease (PD). Social isolation may worsen the burden of the disease and specifically exacerbate psychiatric symptoms, often comorbid with PD. This study aimed at identifying risk/protective factors associated with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak in a sample of individuals with PD aged 65 years or older. Methods: Patients with PD routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for subjective worsening of psychiatric symptoms through a dedicated telephone survey, after Italy COVID-19 lockdown. Patients' medical records were reviewed to collect sociodemographic and clinical data, including lifetime psychiatric symptoms and pharmacological treatment. Results: Overall, 134 individuals were assessed and 101 (75.4%) reported lifetime psychiatric symptoms. Among those, 23 (22.8%) presented with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak. In this group, the most frequent symptom was depression (82.6%), followed by insomnia (52.2%). Subjective worsening of neurological symptoms (Wald = 24.03, df = 1, p = 0.001) and lifetime irritability (Wald = 6.35, df = 1, p = 0.020), together with younger age (Wald = 5.06, df = 1, p = 0.038) and female sex (Wald = 9.07 df = 1, p = 0.007), resulted as specific risk factors for ingravescence of psychiatric presentation. Lifetime pre-existing delusions, having received antipsychotics, and not having received mood stabilizer were also associated with subjective worsening of psychiatric symptomatology due to the COVID-19 pandemic. Conclusions: Individuals with PD and lifetime history of psychiatric symptoms may be exposed to increased vulnerability to the stressful effect of COVID-19 outbreak. Interventions aimed at reducing irritability and mood instability might have an indirect effect on the health of patients with PD during the COVID-19 pandemic.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Martina Petracca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tricoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carla Piano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Bove
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Alessio Simonetti
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Rita Bentivoglio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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32
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Tinazzi M, Morgante F, Marcuzzo E, Erro R, Barone P, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Pascarella A, Demartini B, Gambini O, Modugno N, Olivola E, Di Stefano V, Albanese A, Ferrazzano G, Tessitore A, Zibetti M, Calandra-Buonaura G, Petracca M, Esposito M, Pisani A, Manganotti P, Stocchi F, Coletti Moja M, Antonini A, Defazio G, Geroin C. Clinical Correlates of Functional Motor Disorders: An Italian Multicenter Study. Mov Disord Clin Pract 2020; 7:920-929. [PMID: 33163563 DOI: 10.1002/mdc3.13077] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 12/21/2022] Open
Abstract
Background Functional motor disorders (FMDs) are abnormal movements that are significantly altered by distractive maneuvers and are incongruent with movement disorders seen in typical neurological diseases. Objective The objectives of this article are to (1) describe the clinical manifestations of FMDs, including nonmotor symptoms and occurrence of other functional neurological disorders (FND); and (2) to report the frequency of isolated and combined FMDs and their relationship with demographic and clinical variables. Methods For this multicenter, observational study, we enrolled consecutive outpatients with a definite diagnosis of FMDs attending 25 tertiary movement disorders centers in Italy. Each patient underwent a detailed clinical evaluation with a definition of the phenotype and number of FMDs (isolated, combined) and an assessment of associated neurological and psychiatric symptoms. Results Of 410 FMDs (71% females; mean age, 47 ± 16.1 years) the most common phenotypes were weakness and tremor. People with FMDs had higher educational levels than the general population and frequent nonmotor symptoms, especially anxiety, fatigue, and pain. Almost half of the patients with FMDs had other FNDs, such as sensory symptoms, nonepileptic seizures, and visual symptoms. Patients with combined FMDs showed a higher burden of nonmotor symptoms and more frequent FNDs. Multivariate regression analysis showed that a diagnosis of combined FMDs was more likely to be delivered by a movement disorders neurologist. Also, FMD duration, pain, insomnia, diagnosis of somatoform disease, and treatment with antipsychotics were all significantly associated with combined FMDs. Conclusions Our findings highlight the need for multidimensional assessments in patients with FMDs given the high frequency of nonmotor symptoms and other FNDs, especially in patients with combined FMDs.
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Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London London United Kingdom.,Department of Experimental and Clinical Medicine University of Messina Messina Italy
| | - Enrico Marcuzzo
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana University of Salerno Baronissi Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana University of Salerno Baronissi Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Sonia Mazzucchi
- Neurology Unit, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences University of Brescia Brescia Italy.,FERB Onlus, Ospedale S. Isidoro, Trescore Balneario Bergamo Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - Luigi M Romito
- Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences University of Catania Catania Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences University of Catania Catania Italy
| | - Carlo Dallocchio
- Department of Medical Area Neurology Unit, ASST Pavia Pavia Italy
| | - Carla Arbasino
- Department of Medical Area Neurology Unit, ASST Pavia Pavia Italy
| | - Francesco Bono
- Botulinum Toxin Center Neurology Unit A.O.U. Mater Domini Catanzaro Italy
| | - Angelo Pascarella
- Botulinum Toxin Center Neurology Unit A.O.U. Mater Domini Catanzaro Italy
| | - Benedetta Demartini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences University of Milan Milan Italy
| | - Orsola Gambini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences University of Milan Milan Italy
| | | | | | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging and Clinical Sciences University G. d'Annunzio Chieti-Pescara Italy
| | - Alberto Albanese
- Department of Neurology IRCCS Humanitas Research Hospital Rozzano Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences Università La Sapienza Rome Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgery Sciences University of Campania - Luigi Vanvitelli Naples Italy
| | - Maurizio Zibetti
- Department of Neuroscience-Rita Levi Montalcini University of Turin Turin Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy.,IRCCS, Institute of Neurological Sciences of Bologna Bologna Italy
| | - Martina Petracca
- Movement Disorder Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Marcello Esposito
- Clinical Neurophysiology Unit Cardarelli Hospital Naples Italy.,Department of Neurosciences Reproductive and Odontostomatological Sciences, University of Naples-Federico II Naples Italy
| | - Antonio Pisani
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical Surgical and Health Services, University of Trieste Trieste Italy
| | - Fabrizio Stocchi
- University and Institute of Research and Medical Care San Raffaele Roma Rome Italy
| | | | - Angelo Antonini
- Movement Disorders Unit, Department of Neuroscience University of Padua Padua Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences Biomedicine and Movement Sciences University of Verona Verona Italy
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Muroni A, Murru MR, Sechi M, Ercoli T, Marrosu F, Bentivoglio AR, Petracca M, Maria Scaglione CL, Soliveri P, Cocco E, Pedron M, Murgia M, Deriu M, Cuccu S, Ulgheri L, Zuccato C, Defazio G. Prevalence of Huntington's disease in Southern Sardinia, Italy. Parkinsonism Relat Disord 2020; 80:54-57. [PMID: 32956974 DOI: 10.1016/j.parkreldis.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND The frequency of Huntington's disease (HD) may vary considerably, with higher estimates in non Asian populations. In Italy, two recent studies performed in Ferrara county and Molise provided different prevalence estimates, varying from 4.2 × 105 to 10.8 × 105. Here we present a study performed in the Southern part of Sardinia, a large Italian mediterranean island that is considered a genetic isolate. METHODS The study area included the two neighbouring counties of South Sardinia and Cagliari with 353,830 and 431,955 inhabitants respectively on December 31st, 2017 (prevalence date). Case-patients were ascertained through multiple sources in Sardinia and Italy. RESULTS We identified 54 individuals with HD, of whom 47 were alive on prevalence date. The resulting prevalence rate was 5.98 × 105 in the overall study area, however with marked variations between South Sardinia and Cagliari (9.6 × 105 vs. 3.0 × 105, p = 0.02). In the two study areas, we found similar CAG repeat length in normal alleles (17.5 ± 2.1 vs. 17.7 ± 2.2, p = 0.5). CONCLUSIONS The overall prevalence of HD in Sardinia is close to the correspondent estimates in Europeans. Our findings also highlighted the possibility of local microgeographic variations in the epidemiology of HD.
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Affiliation(s)
- Antonella Muroni
- Neurology Unit, Azienda Ospedaliero-Universitaria, Cagliari, Italy.
| | - Maria Rita Murru
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Margherita Sechi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Marrosu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Martina Petracca
- Institute of Neurology, Università Cattolica Del Sacro Cuore, Rome, Italy
| | | | - Paola Soliveri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Pedron
- Medical Services Management, Azienda Ospedaliero-Universitaria, Cagliari, Italy
| | - Moreno Murgia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marcello Deriu
- Neurology Service, Nostra Signora Della Mercede Hospital, ATS Sardegna, S. Gavino Monreale, Italy
| | - Stefania Cuccu
- Multiple Sclerosis Centre, Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Lucia Ulgheri
- S.S.D. di Genetica e Biologia Dello Sviluppo, University Hospital, Sassari, Italy
| | - Chiara Zuccato
- Department of Biosciences, University of Milan, Milan, Italy, Istituto Nazionale di Genetica Molecolare "Romeo Ed Enrica Invernizzi", Milan, Italy
| | - Giovanni Defazio
- Neurology Unit, Azienda Ospedaliero-Universitaria, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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34
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Pontillo G, Petracca M, Cocozza S, Brunetti A. The Development of Subcortical Gray Matter Atrophy in Multiple Sclerosis: One Size Does Not Fit All. AJNR Am J Neuroradiol 2020; 41:E80-E81. [PMID: 32646951 DOI: 10.3174/ajnr.a6698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- G Pontillo
- Department of Advanced Biomedical Sciences
| | - M Petracca
- Department of Neurosciences and Reproductive and Odontostomatological Sciences
| | - S Cocozza
- Department of Advanced Biomedical Sciences
| | - A Brunetti
- Department of Advanced Biomedical Sciences
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35
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Di Biasio F, Marchese R, Abbruzzese G, Baldi O, Esposito M, Silvestre F, Tescione G, Berardelli A, Fabbrini G, Ferrazzano G, Pellicciari R, Eleopra R, Devigili G, Bono F, Santangelo D, Bertolasi L, Altavista MC, Moschella V, Barone P, Erro R, Albanese A, Scaglione C, Liguori R, Cotelli MS, Cossu G, Ceravolo R, Coletti Moja M, Zibetti M, Pisani A, Petracca M, Tinazzi M, Maderna L, Girlanda P, Magistrelli L, Misceo S, Romano M, Minafra B, Modugno N, Aguggia M, Cassano D, Defazio G, Avanzino L. Motor and Sensory Features of Cervical Dystonia Subtypes: Data From the Italian Dystonia Registry. Front Neurol 2020; 11:906. [PMID: 33013628 PMCID: PMC7493687 DOI: 10.3389/fneur.2020.00906] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/14/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Cervical dystonia (CD) is one of the most common forms of adult-onset isolated dystonia. Recently, CD has been classified according to the site of onset and spread, in different clinical subgroups, that may represent different clinical entities or pathophysiologic subtypes. In order to support this hypothesis, in this study we have evaluated whether different subgroups of CD, that clinically differ for site of onset and spread, also imply different sensorimotor features. Methods: Clinical and demographic data from 842 patients with CD from the Italian Dystonia Registry were examined. Motor features (head tremor and tremor elsewhere) and sensory features (sensory trick and neck pain) were investigated. We analyzed possible associations between motor and sensory features in CD subgroups [focal neck onset, no spread (FNO-NS); focal neck onset, segmental spread (FNO-SS); focal onset elsewhere with segmental spread to neck (FOE-SS); segmental neck involvement without spread (SNI)]. Results: In FNO-NS, FOE-SS, and SNI subgroups, head tremor was associated with the presence of tremor elsewhere. Sensory trick was associated with pain in patients with FNO-NS and with head tremor in patients with FNO-SS. Conclusion: The frequent association between head tremor and tremor elsewhere may suggest a common pathophysiological mechanism. Two mechanisms may be hypothesized for sensory trick: a gating mechanism attempting to reduce pain and a sensorimotor mechanism attempting to control tremor.
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Affiliation(s)
| | | | - Giovanni Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Ottavia Baldi
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Marcello Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Francesco Silvestre
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Girolamo Tescione
- "Salvatore Maugeri" Foundation, Institute of Telese Terme (BN), Benevento, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCSS Neuromed, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCSS Neuromed, Pozzilli, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Roberta Pellicciari
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, Bari, Italy
| | - Roberto Eleopra
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, UOC Neurologia 1, Milan, Italy
| | - Grazia Devigili
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, UOC Neurologia 1, Milan, Italy
| | - Francesco Bono
- Neurology Unit, Center for Botulinum Toxin Therapy, A.O.U. Mater Domini, Catanzaro, Italy
| | - Domenico Santangelo
- Neurology Unit, Center for Botulinum Toxin Therapy, A.O.U. Mater Domini, Catanzaro, Italy
| | | | | | | | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, Universitá di Salerno, Baronissi, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, Universitá di Salerno, Baronissi, Italy
| | | | - Cesa Scaglione
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Rocco Liguori
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | - Giovanni Cossu
- Neurology Service and Stroke Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Maurizio Zibetti
- Department of Neuroscience 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Antonio Pisani
- Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Martina Petracca
- Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Tinazzi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Luca Maderna
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Luca Magistrelli
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, Italy
| | | | | | - Brigida Minafra
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | | | | | | | - Giovanni Defazio
- Neurology Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Avanzino
- IRCCS Policlinico San Martino, Genoa, Italy.,Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
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Defazio G, Ercoli T, Erro R, Pellicciari R, Mascia MM, Fabbrini G, Albanese A, Lalli S, Eleopra R, Barone P, Marchese R, Ceravolo R, Scaglione C, Liguori R, Esposito M, Bentivoglio AR, Bertolasi L, Altavista MC, Bono F, Pisani A, Girlanda P, Berardelli A, Cimino P, Ferrazzano G, Devigili G, Scannapieco S, Di Biasio F, Mazzucchi S, Habetswallner F, Petracca M, Zivelonghi C, Polidori L, Manzo L, Di Lazzaro G, Terranova C, Cotelli MS, Castagna A, Minafra B, Misceo S, Magistrelli L, Zibetti M, Cossu G, Coletti Moja M. Idiopathic
Non‐task‐Specific
Upper Limb Dystonia, a Neglected Form of Dystonia. Mov Disord 2020; 35:2038-2045. [DOI: 10.1002/mds.28199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/30/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Giovanni Defazio
- Department of Medical Science and Public Health Institute of Neurology, University of Cagliari Cagliari Italy
| | - Tommaso Ercoli
- Department of Medical Science and Public Health Institute of Neurology, University of Cagliari Cagliari Italy
| | - Roberto Erro
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno Baronissi (SA) Italy
| | - Roberta Pellicciari
- Department of Basic Science, Neuroscience and Sense Organs Aldo Moro University of Bari Bari Italy
| | - Marcello Mario Mascia
- Department of Medical Science and Public Health Institute of Neurology, University of Cagliari Cagliari Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
- IRCSS Neuromed Pozzili Italy
| | - Alberto Albanese
- Department of Neurology IRCCS Istituto Clinico Humanitas Rozzano, Milan Italy
| | - Stefania Lalli
- Department of Neurology IRCCS Istituto Clinico Humanitas Rozzano, Milan Italy
| | | | - Paolo Barone
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno Baronissi (SA) Italy
| | | | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Cesa Scaglione
- IRCCS ‐ Institute of Neurological Sciences Bologna Italy
| | - Rocco Liguori
- IRCCS ‐ Institute of Neurological Sciences Bologna Italy
| | | | - Anna Rita Bentivoglio
- Gemelli University Hospital ‐ IRCCS Rome Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore Rome Italy
| | | | | | - Francesco Bono
- Center for Botulinum Toxin Therapy, Neurologic Unit Mater Domini University Hospital Catanzaro Italy
| | - Antonio Pisani
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine University of Messina Messina Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
- IRCSS Neuromed Pozzili Italy
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37
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Petrucci S, Ginevrino M, Trezzi I, Monfrini E, Ricciardi L, Albanese A, Avenali M, Barone P, Bentivoglio AR, Bonifati V, Bove F, Bonanni L, Brusa L, Cereda C, Cossu G, Criscuolo C, Dati G, De Rosa A, Eleopra R, Fabbrini G, Fadda L, Garbellini M, Minafra B, Onofrj M, Pacchetti C, Palmieri I, Pellecchia MT, Petracca M, Picillo M, Pisani A, Vallelunga A, Zangaglia R, Di Fonzo A, Morgante F, Valente EM. GBA-Related Parkinson's Disease: Dissection of Genotype-Phenotype Correlates in a Large Italian Cohort. Mov Disord 2020; 35:2106-2111. [PMID: 32658388 DOI: 10.1002/mds.28195] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/17/2020] [Accepted: 06/03/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Variants in GBA are the most common genetic risk factor for Parkinson's disease (PD). The impact of different variants on the PD clinical spectrum is still unclear. OBJECTIVES We determined the frequency of GBA-related PD in Italy and correlated GBA variants with motor and nonmotor features and their occurrence over time. METHODS Sanger sequencing of the whole GBA gene was performed. Variants were classified as mild, severe, complex, and risk. β-glucocerebrosidase activity was measured. The Kaplan-Meier method and Cox proportional hazard regression models were performed. RESULTS Among 874 patients with PD, 36 variants were detected in 14.3%, including 20.4% early onset. Patients with GBA-PD had earlier and more frequent occurrence of several nonmotor symptoms. Patients with severe and complex GBA-PD had the highest burden of symptoms and a higher risk of hallucinations and cognitive impairment. Complex GBA-PD had the lowest β-glucocerebrosidase activity. CONCLUSIONS GBA-PD is highly prevalent in Italy. Different types of mutations underlie distinct phenotypic profiles. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Simona Petrucci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Department of Clinical and Molecular Medicine, S. Andrea University Hospital, Rome, Italy
| | - Monia Ginevrino
- Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy.,Institute of Genomic Medicine, Catholic University, Rome, Italy
| | - Ilaria Trezzi
- Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.,Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Edoardo Monfrini
- Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.,Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, United Kingdom
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Micol Avenali
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "ScuolaMedicaSalernitana," University of Salerno, Baronissi, SA, Italy
| | - Anna Rita Bentivoglio
- Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Francesco Bove
- Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Livia Brusa
- Parkinson Center, Neurology Complex Operative Unit, Sant'Eugenio Hospital, Rome, Italy
| | | | | | - Chiara Criscuolo
- Department of Neuroscience, Reproductive, and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanna Dati
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "ScuolaMedicaSalernitana," University of Salerno, Baronissi, SA, Italy
| | - Anna De Rosa
- Department of Neuroscience, Reproductive, and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giovanni Fabbrini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (Isernia), Italy
| | - Laura Fadda
- Department of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Manuela Garbellini
- Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.,Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Ilaria Palmieri
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "ScuolaMedicaSalernitana," University of Salerno, Baronissi, SA, Italy
| | - Martina Petracca
- Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy.,Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marina Picillo
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "ScuolaMedicaSalernitana," University of Salerno, Baronissi, SA, Italy
| | - Antonio Pisani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Annamaria Vallelunga
- Center for Neurodegenerative Diseases, Department of Medicine, Surgery and Dentistry "ScuolaMedicaSalernitana," University of Salerno, Baronissi, SA, Italy
| | | | - Alessio Di Fonzo
- Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.,Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, United Kingdom.,Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy
| | - Enza Maria Valente
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Lo Monaco MR, Petracca M, Vetrano DL, Di Stasio E, Fusco D, Ricciardi D, Laudisio A, Zuccalà G, Onder G, Bentivoglio AR. Safinamide as an adjunct therapy in older patients with Parkinson's disease: a retrospective study. Aging Clin Exp Res 2020; 32:1369-1373. [PMID: 31981101 DOI: 10.1007/s40520-020-01469-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Safinamide, as a levodopa adjunct, is effective in reducing motor fluctuations in Parkinson's disease (PD) patients; however, scarce evidence is available regarding its use in older PD patients. AIM To evaluate the safety and tolerability of safinamide as an adjunct therapy in patients aged ≥ 60 years with advanced PD. METHODS A retrospective study including 203 PD patients admitted to a geriatric day hospital, who were evaluated following an extensive clinical protocol. Safinamide use was categorized as never used, ongoing, and withdrawn. Potential correlations of Safinamide withdrawal were investigated in stepwise backward logistic regression models. RESULTS A total of 44 out of 203 participants were current or former users of Safinamide. Overall, 14 (32%) patients discontinued due to treatment-emergent adverse events (TEAEs). Withdrawal was not associated with older age. CONCLUSIONS Safinamide as an adjunct therapy in patients aged ≥ 60 years with advanced PD was found to be safe and well-tolerated in older patients. There were no specific demographic or clinical characteristics associated with suspension.
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Affiliation(s)
- Maria Rita Lo Monaco
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy.
| | - Martina Petracca
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Davide Liborio Vetrano
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Aging Research Centre, Karolinska Institutet, Stockholm, Sweden
| | - Enrico Di Stasio
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
- Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Domenico Fusco
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy
| | - Giuseppe Zuccalà
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Graziano Onder
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario "Agostino Gemelli"-IRCSS, Largo A Gemelli, 8, 00168, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Piano C, Di Stasio E, Primiano G, Janiri D, Luigetti M, Frisullo G, Vollono C, Lucchini M, Brunetti V, Monforte M, Guglielmi V, Della Marca G, Evoli A, Marra C, Mirabella M, Quaranta D, Ricci E, Servidei S, Silvestri G, Bellavia S, Bortolani S, Bove F, Di Iorio R, Di Paolantonio A, Genovese D, Ialongo T, Lo Monaco MR, Marotta J, Patanella AK, Perna A, Petracca M, Presicce G, Riso V, Rollo E, Romano A, Romozzi M, Sancricca C, Scala I, Spagni G, Solito M, Tricoli L, Zinzi P, Calabresi P, Bentivoglio AR. An Italian Neurology Outpatient Clinic Facing SARS-CoV-2 Pandemic: Data From 2,167 Patients. Front Neurol 2020; 11:564. [PMID: 32574249 PMCID: PMC7273723 DOI: 10.3389/fneur.2020.00564] [Citation(s) in RCA: 21] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: Neurological sequelae of SARS-CoV-2 infection have already been reported, but there is insufficient data about the impact of the pandemic on the management of the patients with chronic neurological diseases. We aim to analyze the effect of COVID-19 pandemic and social restriction rules on these fragile patients. Methods: Patients with chronic neurologic diseases routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for symptoms suggestive of SARS-CoV-2 infection in the pandemic period, consequences of social restrictions, and neurological disease features, concomitant medical conditions, current medical and disease-specific treatments. Data source: a dedicated telephone survey designed to encompass questions on COVID-19 symptoms and on pandemic effects in chronic neurologic conditions. Results: Overall, 2,167 individuals were analyzed: 63 patients reported contact with COVID-19 positive cases, 41 performed the swab, and 2 symptomatic patients tested positive for COVID-19 (0.09%). One hundred fifty-eight individuals (7%) needed urgent neurological care, deferred due to the pandemic; 641 patients (30%) suspended hospital treatments, physiotherapy or other support interventions; 405 individuals (19%) reported a subjective worsening of neurological symptoms. Conclusions: In our population, the presence of neurological chronic diseases did not increase the prevalence of COVID-19 infection. Nevertheless, the burden of neurological disorders has been worsened by the lockdown.
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Affiliation(s)
- Carla Piano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Enrico Di Stasio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Primiano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Delfina Janiri
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Marco Luigetti
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Frisullo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Lucchini
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Brunetti
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mauro Monforte
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valeria Guglielmi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Della Marca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Amelia Evoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Camillo Marra
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Mirabella
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Quaranta
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Enzo Ricci
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serenella Servidei
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriella Silvestri
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simone Bellavia
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sara Bortolani
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Bove
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Riccardo Di Iorio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Di Paolantonio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Genovese
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Tamara Ialongo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Rita Lo Monaco
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jessica Marotta
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessia Perna
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Petracca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgia Presicce
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittorio Riso
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Marina Romozzi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina Sancricca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Irene Scala
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gregorio Spagni
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marcella Solito
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Tricoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Zinzi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Rita Bentivoglio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
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Petracca M, Schiavi S, Battocchio M, El Mendili MM, Fleysher L, Daducci A, Inglese M. Streamline density and lesion volume reveal a postero–anterior gradient of corpus callosum damage in multiple sclerosis. Eur J Neurol 2020; 27:1076-1082. [DOI: 10.1111/ene.14214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/26/2019] [Accepted: 02/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- M. Petracca
- Department of Neurology Icahn School of Medicine at Mount Sinai New York NY USA
| | - S. Schiavi
- Department of Computer Science University of Verona Verona Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research University of Genoa Genoa Italy
| | - M. Battocchio
- Department of Computer Science University of Verona Verona Italy
| | - M. M. El Mendili
- Department of Neurology Icahn School of Medicine at Mount Sinai New York NY USA
| | - L. Fleysher
- Department of Radiology Icahn School of Medicine at Mount Sinai New York NY USA
| | - A. Daducci
- Department of Computer Science University of Verona Verona Italy
| | - M. Inglese
- Department of Neurology Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Neurosciences, Rehabilitation, Ophthalmology Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research University of Genoa Genoa Italy
- Ospedale Policlinico San Martino – IRCCS Genoa Italy
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41
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Lo Monaco MR, Di Stasio E, Zuccalà G, Petracca M, Genovese D, Fusco D, Silveri MC, Liperoti R, Ricciardi D, Cipriani MC, Laudisio A, Bentivoglio AR. Prevalence of Obsessive-Compulsive Symptoms in Elderly Parkinson Disease Patients: A Case-Control Study. Am J Geriatr Psychiatry 2020; 28:167-175. [PMID: 31558346 DOI: 10.1016/j.jagp.2019.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/03/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The clinical picture of obsessive-compulsive disorder encompasses a broad range of symptoms that are related to multiple psychological domains, including perception, cognition, emotion, and social relatedness. As obsessive-compulsive symptoms (OCS) frequently have an early onset, there are limited data about OCS in older populations (≥65 years) and, in particular, in elderly subjects with Parkinson disease (PD). OBJECTIVE This study aimed to estimate the prevalence of OCS using a self-report measure (Obsessive-Compulsive Inventory-Revised) and to identify associated sociodemographic and clinical factors in a sample of elderly PD patients compared to a comparison group of similarly aged healthy volunteers. RESULTS The mean age was 74 ± 6 years in the PD patients and 73 ± 7 years in the comparison group. The mean disease duration was 9.6 ± 5.8 years. Among the PD patients, 30.7% reported at least one OCS or a related disorder compared to 21.1% in the comparison group. Hoarding was significantly more common in PD patients than in the comparison group. CONCLUSIONS Subclinical OCS were present at a high percentage in both PD patients and comparison group. The OCS phenotype in PD may present differently, as hoarding was more common in PD patients.
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Affiliation(s)
- Maria Rita Lo Monaco
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore (MRLM, GZ, DF, RL, MCC), Rome, Italy.
| | - Enrico Di Stasio
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore (EDS), Rome, Italy
| | - Giuseppe Zuccalà
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore (MRLM, GZ, DF, RL, MCC), Rome, Italy
| | - Martina Petracca
- Institute of Neurology, Università Cattolica del Sacro Cuore (MP, DG, ARB), Rome, Italy
| | - Danilo Genovese
- Institute of Neurology, Università Cattolica del Sacro Cuore (MP, DG, ARB), Rome, Italy
| | - Domenico Fusco
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore (MRLM, GZ, DF, RL, MCC), Rome, Italy
| | | | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore (MRLM, GZ, DF, RL, MCC), Rome, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy
| | - Maria Camilla Cipriani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore (MRLM, GZ, DF, RL, MCC), Rome, Italy
| | - Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University (AL), Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS (MRLM, EDS, GZ, DF, RL, DR, MCC, ARB), Rome, Italy; Institute of Neurology, Università Cattolica del Sacro Cuore (MP, DG, ARB), Rome, Italy
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42
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Lo Monaco MR, Petracca M, Weintraub D, Fusco D, Liperoti R, Zuccalà G, La Carpia D, Vetrano DL, Genovese D, Pisciotta MS, Brandi V, Padua L, Imbimbo I, Ricciardi D, Bernabei R, Silveri MC, Laudisio A, Bentivoglio AR. Prevalence of Impulsive-Compulsive Symptoms in Elderly Parkinson's Disease Patients: A Case-Control Study. J Clin Psychiatry 2019; 79. [PMID: 29702754 DOI: 10.4088/jcp.17m11612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Received: 03/29/2017] [Accepted: 09/05/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND Impulse-control disorders (ICDs) are frequently described in patients with Parkinson's disease (PD), particularly among those treated with dopaminergic medications, but data on the prevalence of ICDs in elderly populations are lacking. OBJECTIVE The aim of this study was to estimate the prevalence of ICDs by using an Italian validation of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) and to identify associated sociodemographic and clinical factors in a sample of elderly PD patients and in a control group of similarly aged healthy volunteers. METHODS Using the United Kingdom Parkinson's Disease Society Brain Bank diagnostic criteria, we included 115 consecutive PD and 105 healthy controls. They were recruited from June 2014 to December 2015. All participants completed the self-administered QUIP-Anytime for assessment of ICDs occurring any time during the course of PD. RESULTS Mean ± SD age was 75.7 ± 7.0 years in the PD patients and 76.1 ± 7.0 years in the control group. The mean disease duration was 6.8 years (range, 1-26 years). Among the PD patients, 44.7% (n = 51) had at least 1 ICD or related disorder compared to 25.2% (n = 26) in the control group (between-group difference: P = .003). Hypersexuality and compulsive shopping were significantly more common in the PD group than in the control group (P < .05). The prevalence of other compulsive behaviors was 42.5% in the PD group and 38.9% in the control group (P = NS). The Italian version of the QUIP-Anytime showed high test-retest reliability (κ > 0.70 for all items). CONCLUSIONS Our data confirm a high prevalence of ICD symptoms in elderly PD patients, approximately twice that seen in the general population.
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Affiliation(s)
- Maria Rita Lo Monaco
- Department of Geriatrics, Neurosciences and Orthopaedics, Teaching Hospital "Agostino Gemelli," Catholic University of the Sacred Heart School of Medicine, Largo A. Gemelli, 1, 00168, Rome, Italy. .,Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Martina Petracca
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Domenico Fusco
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Rosa Liperoti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Giuseppe Zuccalà
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Domenico La Carpia
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Davide Liborio Vetrano
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Danilo Genovese
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Stella Pisciotta
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Vincenzo Brandi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Luca Padua
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy.,Don Carlo Gnocchi Onlus Foundation, Milan, Italy
| | | | - Diego Ricciardi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Maria Caterina Silveri
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli," Rome, Italy
| | - Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Anna Rita Bentivoglio
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy.,Don Carlo Gnocchi Onlus Foundation, Milan, Italy
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Erra C, Mileti I, Germanotta M, Petracca M, Imbimbo I, De Biase A, Rossi S, Ricciardi D, Pacilli A, Di Sipio E, Palermo E, Bentivoglio AR, Padua L. Immediate effects of rhythmic auditory stimulation on gait kinematics in Parkinson's disease ON/OFF medication. Clin Neurophysiol 2019; 130:1789-1797. [PMID: 31401487 DOI: 10.1016/j.clinph.2019.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/21/2019] [Accepted: 07/05/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Gait impairment is a highly disabling symptom for Parkinson's disease (PD) patients. Rhythmic auditory stimulation (RAS), has shown to improve spatio-temporal gait parameters in PD, but only a few studies have focused on their effects on gait kinematics, and the ideal stimulation frequency has still not been identified. METHODS We enrolled 30 PD patients and 18 controls. Patients were evaluated under two conditions (with (ON), and without (OFF) medications) with three different RAS frequencies (90%, 100%, and 110% of the patient's preferred walking cadence). Spatial-temporal parameters, joint angles and gait phases distribution were evaluated. A novel global index (GPQI) was used to quantify the difference in gait phase distribution. RESULTS Along with benefits in spatial-temporal parameters, GPQI improved significantly with RAS at a frequency of 110% for both ON and OFF medication conditions. In the most severe patients, the same result was observed also with RAS at 100%. CONCLUSIONS RAS administration, at a frequency of 110% of the preferred walking frequency, can be beneficial in improving the gait pattern in PD patients. SIGNIFICANCE When rhythmic auditory stimulation is provided to patients with PD, the selection of an adequate frequency of stimulation can optimize their effects on gait pattern.
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Affiliation(s)
- Carmen Erra
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria Mileti
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | | | - Martina Petracca
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Alessandro De Biase
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, 01100 Viterbo, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - Alessandra Pacilli
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | | | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Padua
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Margoni M, Petracca M, Schiavi S, Fabian M, Miller A, Lublin FD, Inglese M. Axonal water fraction as marker of white matter injury in primary-progressive multiple sclerosis: a longitudinal study. Eur J Neurol 2019; 26:1068-1074. [PMID: 30761708 DOI: 10.1111/ene.13937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 02/05/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND PURPOSE Diffuse white matter (WM) injury is prominent in primary-progressive multiple sclerosis (PP-MS) pathology and is a potential biomarker of disease progression. Diffusion kurtosis imaging allows the quantification of non-Gaussian water diffusion, providing metrics with high WM pathological specificity. The aim of this study was to characterize the pathological changes occurring in the normal-appearing WM of patients with PP-MS at baseline and at 1-year follow-up and to assess their impact on disability and short-term disease progression. METHODS A total of 26 patients with PP-MS and 20 healthy controls were prospectively enrolled. Diffusion kurtosis imaging single-shot echo-planar imaging (EPI) was acquired on a 3-T scanner (Philips Achieva, Best, The Netherlands) (voxel size, 2 × 2 × 2 mm3 , 30 directions for each b-value = 1000, 2000 s/mm2 and one b = 0 s/mm2 ). A two-compartment biophysical model of WM tract integrity was used to derive spatial maps of axonal water fraction (AWF), intra-axonal diffusivity, extra-axonal axial and radial diffusivities (De,axial , De,radial ) and tortuosity from the following WM tracts: corpus callosum (CC), corticospinal tract (CST) and posterior thalamic radiation (PTR). RESULTS At baseline, patients with PP-MS showed a widespread decrease of AWF, tortuosity and De,axial and an increase of De,radial in CC, CST and PTR (P ranging from 0.001 to 0.036). At 1-year follow-up, a significant AWF decrease was detected in the body of CC (P = 0.048), PTR (P = 0.008) and CST (P = 0.044). Baseline AWF values in CST significantly discriminated progressed from non-progressed patients (P = 0.021; area under the curve, 0.854). CONCLUSION Based on its change over time and its relationship with disease progression, among the analyzed metrics, AWF seems the most sensitive metric of WM tissue damage in PP-MS and therefore it could be considered as a marker for monitoring disease progression.
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Affiliation(s)
- M Margoni
- Multiple Sclerosis Centre, Department of Neuroscience DNS, University Hospital, University of Padua, Padua, Italy.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Schiavi
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa.,IRCSS Azienda Ospedale Università San Martino-IST, Genoa, Italy
| | - M Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F D Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa.,IRCSS Azienda Ospedale Università San Martino-IST, Genoa, Italy.,Department of Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Luciani E, Consorti G, van Dun PLS, Merdy O, Lunghi C, Petracca M, Esteves JE, Cerritelli F. An overview of osteopathy graduates' perceived preparedness at transition from educational environment to clinic environment one year after graduation: a cross sectional study. BMC Med Educ 2018; 18:319. [PMID: 30577828 PMCID: PMC6303955 DOI: 10.1186/s12909-018-1429-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND This study investigated perceived preparedness to practice, one year after graduation across osteopathic education institutions (OEIs) and explored possible differences between countries where osteopathy is regulated (Reg) and countries where it is not (Unreg). METHODS Two hundred forty-five graduates from 7 OEIs in 4 European countries, already assessed in a previous study, were contacted one year after their graduation to complete the survey. Survey tools included a questionnaire to assess perceived preparedness to practice: Association of American Medical Colleges (AAMC) questionnaire, and a questionnaire to collect socio-demographic information and practice characteristics. RESULTS One hundred sixty-eight graduates (68.6%) completed the survey. The AAMC mean score one year after the graduation (23.19; confidence interval 22.81-23.58) was significantly higher than in the previous study (17.58; 16.90-18.26) (p < 0.001). A difference was also found between Reg (23.49; 23.03-23.95) and Unreg (22.34; 21.74-22.94) (p = 0.004). Osteopaths with a previous healthcare degree scored significantly higher on AAMC score (25.53; 24.88-26.19) than osteopaths without a previous healthcare degree (22.33; 21.97-22.69) (p < 0.001). Regulation and a previous degree were the only significant independent variables in the most predictive multivariate linear model. The model had an r2 = 0.33. CONCLUSIONS Graduates from OEIs where osteopathy is regulated felt significantly better prepared to practice than Unreg. Systematic information searches about graduates' perception of preparedness to practice, may enable OEIs to strengthen their existing curricula to ensure their graduates are effectively prepared to practice.
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Affiliation(s)
- E. Luciani
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
- I.F.O.P. Chinesis, Rome, Italy
| | - G. Consorti
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
- Centre pour l’Etude, la Recherche et la Diffusion Osteopathiques (CERDO), Rome, Italy
- Società Italiana di Pedagogia Medica (SIPeM), Via Capitinzano 33, 00178 Rome, Italy
| | | | - O. Merdy
- Institut des Hautes Etudes Ostéopathiques (IdHEO), Saint-Herblain, France
| | - C. Lunghi
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
- Centro Ricerche Olistiche per la Medicina Osteopatica e Naturale (CROMON), Rome, Italy
| | - M. Petracca
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
- Centre pour l’Etude, la Recherche et la Diffusion Osteopathiques (CERDO), Rome, Italy
| | - J. E. Esteves
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
- British School of Osteopathy (BSO), London, UK
- Instituto Piaget, Lisbon, Portugal
| | - F. Cerritelli
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy
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Petracca M, De Biase A, Ialongo T, Mulas D, Cerbarano ML, Lo Monaco MR, Di Stasio E, Bentivoglio AR. Long-term botulinum toxin A treatment in non-primary cervical dystonia. Toxicon 2018. [DOI: 10.1016/j.toxicon.2018.11.220] [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: 11/16/2022]
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Esposito M, Fabbrini G, Ferrazzano G, Berardelli A, Peluso S, Cesari U, Gigante AF, Bentivoglio AR, Petracca M, Erro R, Barone P, Schirinzi T, Eleopra R, Avanzino L, Romano M, Scaglione CL, Cossu G, Morgante F, Minafra B, Zibetti M, Coletti Moja M, Turla M, Fadda L, Defazio G. Spread of dystonia in patients with idiopathic adult-onset laryngeal dystonia. Eur J Neurol 2018; 25:1341-1344. [DOI: 10.1111/ene.13731] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - G. Fabbrini
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| | | | - A. Berardelli
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| | - S. Peluso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - U. Cesari
- Department of Neurosciences, Reproductive Sciences and Odontostomatology; Federico II University of Naples; Naples Italy
| | - A. F. Gigante
- Department of Basic Science, Neuroscience and Sense Organs; Aldo Moro University of Bari; Bari Italy
| | - A. R. Bentivoglio
- Movement Disorders Unit; Center for Parkinson's Disease and Extrapyramidal Disorders; Institute of Neurology; Catholic University; Rome Italy
- Don Carlo Gnocchi Onlus Foundation; Milan Italy
| | - M. Petracca
- Movement Disorders Unit; Center for Parkinson's Disease and Extrapyramidal Disorders; Institute of Neurology; Catholic University; Rome Italy
| | - R. Erro
- Center for Neurodegenerative Diseases (CEMAND); Neuroscience Section; University of Salerno; Salerno Italy
| | - P. Barone
- Center for Neurodegenerative Diseases (CEMAND); Neuroscience Section; University of Salerno; Salerno Italy
| | - T. Schirinzi
- Department of Systems Medicine; University of Rome ‘Tor Vergata’; Rome Italy
| | - R. Eleopra
- IRCCS Foundation C. Besta Neurological Institute; Milan Italy
| | - L. Avanzino
- Section of Human Physiology; Department of Experimental Medicine; University of Genoa; Genoa Italy
| | - M. Romano
- Neurology Unit; Villa Sofia Hospital; Palermo Italy
| | | | - G. Cossu
- Department of Neurology; AOB ‘G. Brotzu’ General Hospital; Cagliari Italy
| | - F. Morgante
- Department of Neuroscience; University of Messina; Messina Italy
| | - B. Minafra
- Parkinson's Disease and Movement Disorders Unit; C. Mondino National Neurological Institute; IRCCS; Pavia Italy
| | - M. Zibetti
- Department of Neuroscience ‘Rita Levi Montalcini’; University of Turin; Turin Italy
| | | | - M. Turla
- Neurology Unit; Valle Camonica Hospital; Brescia Italy
| | - L. Fadda
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - G. Defazio
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
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Defazio G, Esposito M, Abbruzzese G, Scaglione CL, Fabbrini G, Ferrazzano G, Peluso S, Pellicciari R, Gigante AF, Cossu G, Arca R, Avanzino L, Bono F, Mazza MR, Bertolasi L, Bacchin R, Eleopra R, Lettieri C, Morgante F, Altavista MC, Polidori L, Liguori R, Misceo S, Squintani G, Tinazzi M, Ceravolo R, Unti E, Magistrelli L, Coletti Moja M, Modugno N, Petracca M, Tambasco N, Cotelli MS, Aguggia M, Pisani A, Romano M, Zibetti M, Bentivoglio AR, Albanese A, Girlanda P, Berardelli A. Correction to: The Italian Dystonia Registry: rationale, design and preliminary findings. Neurol Sci 2018; 39:975. [DOI: 10.1007/s10072-018-3395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Petracca M, Sumowski J, Fabian M, Miller A, Lublin F, Inglese M. Looking into cognitive impairment in primary-progressive multiple sclerosis. Eur J Neurol 2017; 25:192-195. [PMID: 29053884 DOI: 10.1111/ene.13489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/16/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive impairment in primary-progressive multiple sclerosis (PP-MS) is correlated with global brain atrophy. Unfortunately, brain volume computation requires processing resources that are not widely available in clinical practice. Therefore, we decided to test the predictive role of retinal atrophy metrics on cognitive decline, applying them as a proxy of gray matter atrophy in PP-MS. METHODS Twenty-five patients with PP-MS completed the Brief International Cognitive Assessment for Multiple Sclerosis and underwent spectral-domain optical coherence tomography (OCT) and 3.0-T magnetic resonance imaging. We tested, through a stepwise logistic regression, whether OCT metrics [retinal nerve fiber layer, ganglion cell + inner plexiform layer (GCIPL) and total macular volume] predicted cognitive impairment and explored the role of gray matter atrophy in mediating these correlations. RESULTS Among OCT metrics, only GCIPL was associated with cognitive impairment (rp = 0.448, P = 0.036) and predictive of objective cognitive impairment (Wald [1] = 4.40, P = 0.036). Controlling for demographics, normalized brain volume and thalamic volume were correlated with GCIPL (rp = 0.427, P = 0.047 and rp = 0.674, P = 0.001, respectively) and cognitive scores (rp = 0.593, P = 0.004 and rp = 0.501, P = 0.017, respectively), with thalamic volume nearly mediating the association between GCIPL and cognition (Sobel z = 1.86, P = 0.063). CONCLUSIONS The GCIPL thickness is a suitable measure of neurodegeneration. In comparison with brain atrophy, GCIPL offers higher histopathological specificity, being a pure correlate of neuronal loss, and may be a non-invasive, easy-to-perform way to quantitatively evaluate and monitor neuronal loss related to cognitive impairment in PP-MS.
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Affiliation(s)
- M Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, University of Naples 'Federico II', Naples, Italy
| | - J Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Mother-Child Health, University of Genoa, Genoa, Italy
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Inglese M, Petracca M, Cocozza S, Tedeschi E, Lanzillo R, Brunetti A, Brescia Morra V, Lublin F. Unicuique suum: Investigating cerebellar lobules contribution to clinical disability in progressive multiple sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.743] [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: 10/18/2022]
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