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Barucci E, Salvadori E, Magi S, Squitieri M, Fiore GM, Ramacciotti L, Formelli B, Pescini F, Poggesi A. Author Correction: Cognitive profile in cerebral small vessel disease: comparison between cerebral amyloid angiopathy and hypertension-related microangiopathy. Sci Rep 2024; 14:8792. [PMID: 38627411 PMCID: PMC11021488 DOI: 10.1038/s41598-024-59216-y] [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: 04/20/2024] Open
Affiliation(s)
- Eleonora Barucci
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Emilia Salvadori
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Simona Magi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Martina Squitieri
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giulio Maria Fiore
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Ramacciotti
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Benedetta Formelli
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesca Pescini
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
- Stroke Unit, Careggi University Hospital, Florence, Italy
| | - Anna Poggesi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
- Stroke Unit, Careggi University Hospital, Florence, Italy.
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Barucci E, Salvadori E, Magi S, Squitieri M, Fiore GM, Ramacciotti L, Formelli B, Pescini F, Poggesi A. Cognitive profile in cerebral small vessel disease: comparison between cerebral amyloid angiopathy and hypertension-related microangiopathy. Sci Rep 2024; 14:5922. [PMID: 38467658 PMCID: PMC10928167 DOI: 10.1038/s41598-024-55719-w] [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: 11/13/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024] Open
Abstract
Cerebral amyloid angiopathy (CAA) is recognized as a cause of cognitive impairment, but its cognitive profile needs to be characterized, also respect to hypertension-related microangiopathy (HA). We aimed at comparing difference or similarity of CAA and HA patients' cognitive profiles, and their associated factors. Participants underwent an extensive clinical, neuropsychological, and neuroimaging protocol. HA patients (n = 39) were more frequently males, with history of vascular risk factors than CAA (n = 32). Compared to HA, CAA patients presented worse performance at MoCA (p = 0.001) and semantic fluency (p = 0.043), and a higher prevalence of amnestic MCI (46% vs. 68%). In univariate analyses, multi-domain MCI was associated with worse performance at MoCA, Rey Auditory Verbal Learning Test (RAVLT), and semantic fluency in CAA patients, and with worse performance at Symbol Digit Modalities Test (SDMT) and phonemic fluency in HA ones. In multivariate models, multi-domain deficit remained as the only factor associated with RAVLT (β = - 0.574) in CAA, while with SDMT (β = - 0.364) and phonemic fluency (β = - 0.351) in HA. Our results highlight different patterns of cognitive deficits in CAA or HA patients. While HA patients' cognitive profile was confirmed as mainly attentional/executive, a complex cognitive profile, characterized also by deficit in semantic memory, seems the hallmark of CAA patients.
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Affiliation(s)
- Eleonora Barucci
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Emilia Salvadori
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Simona Magi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Martina Squitieri
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giulio Maria Fiore
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Ramacciotti
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Benedetta Formelli
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesca Pescini
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
- Stroke Unit, Careggi University Hospital, Florence, Italy
| | - Anna Poggesi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
- Stroke Unit, Careggi University Hospital, Florence, Italy.
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Giovannelli F, Borgheresi A, Lucidi G, Squitieri M, Gavazzi G, Suppa A, Berardelli A, Viggiano MP, Cincotta M. Language-related motor facilitation in Italian Sign Language signers. Cereb Cortex 2023:6988100. [PMID: 36646456 DOI: 10.1093/cercor/bhac536] [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: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 01/18/2023] Open
Abstract
Linguistic tasks facilitate corticospinal excitability as revealed by increased motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) in the dominant hand. This modulation of the primary motor cortex (M1) excitability may reflect the relationship between speech and gestures. It is conceivable that in healthy individuals who use a sign language this cortical excitability modulation could be rearranged. The aim of this study was to evaluate the effect of spoken language tasks on M1 excitability in a group of hearing signers. Ten hearing Italian Sign Language (LIS) signers and 16 non-signer healthy controls participated. Single-pulse TMS was applied to either M1 hand area at the baseline and during different tasks: (i) reading aloud, (ii) silent reading, (iii) oral movements, (iv) syllabic phonation and (v) looking at meaningless non-letter strings. Overall, M1 excitability during the linguistic and non-linguistic tasks was higher in LIS group compared to the control group. In LIS group, MEPs were significantly larger during reading aloud, silent reading and non-verbal oral movements, regardless the hemisphere. These results suggest that in hearing signers there is a different modulation of the functional connectivity between the speech-related brain network and the motor system.
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Affiliation(s)
- Fabio Giovannelli
- Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), Section of Psychology, University of Florence, Florence 50135, Italy
| | - Alessandra Borgheresi
- Unit of Neurology of Florence, Central Tuscany Local Health Authority, Florence 50143, Italy
| | - Giulia Lucidi
- Unit of Neurology of Florence, Central Tuscany Local Health Authority, Florence 50143, Italy
| | - Martina Squitieri
- Unit of Neurology of Florence, Central Tuscany Local Health Authority, Florence 50143, Italy
| | - Gioele Gavazzi
- Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), Section of Psychology, University of Florence, Florence 50135, Italy
| | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Italy.,IRCCS Neuromed, Pozzilli (IS) 86077, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Italy.,IRCCS Neuromed, Pozzilli (IS) 86077, Italy
| | - Maria Pia Viggiano
- Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), Section of Psychology, University of Florence, Florence 50135, Italy
| | - Massimo Cincotta
- Unit of Neurology of Florence, Central Tuscany Local Health Authority, Florence 50143, Italy
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Pescini F, Torricelli S, Squitieri M, Giacomucci G, Poggesi A, Puca E, Bianchi S, Ragno M, Pantoni L. Intravenous thrombolysis in CADASIL: report of two cases and a systematic review. Neurol Sci 2023; 44:491-498. [PMID: 36255541 PMCID: PMC9842556 DOI: 10.1007/s10072-022-06449-2] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/08/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetic small vessel disease responsible for recurrent ischemic strokes, often with a progressive course leading to dementia and disability. On MRI, lacunes, microbleeds, and severe white matter alterations are typical features of the disease. In case of acute stroke, because of the bleeding risk associated with the disease and the doubtful efficacy of fibrinolytic treatment in a disease with poor evidence of thrombosis, the efficacy of intravenous thrombolysis remains unproven. Nevertheless, stroke is a frequent occurrence in CADASIL patients, and clinicians not unlikely may face in the emergency room the situation of a CADASIL patient with an acute stroke within the time window for thrombolysis. OBJECTIVE We report on two CADASIL patients treated with intravenous alteplase for acute ischemic stroke, and we present a review of literature aimed to report epidemiological data, efficacy and safety of intravenous thrombolysis in CADASIL patients. METHODS We performed a systematic review of medical literature published until August 2, 2022. Case reports and series in English language reporting on CADASIL patients and acute stroke were included. RESULTS Both patients were treated with intravenous thrombolysis without complications and had a good clinical outcome. The systematic review identified three case reports of CADASIL patients who were treated with intravenous alteplase for acute ischemic stroke; no bleedings complications were described. CONCLUSIONS Available data on intravenous thrombolysis in CADASIL patients are scarce but suggest that this treatment can be taken into consideration for these patients.
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Affiliation(s)
- Francesca Pescini
- Emergency Department, Stroke Unit, AOU Careggi, Florence, Italy
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Sara Torricelli
- NEUROFARBA Department, University of Florence, Florence, Italy
| | | | | | - Anna Poggesi
- Emergency Department, Stroke Unit, AOU Careggi, Florence, Italy
- NEUROFARBA Department, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Emanuele Puca
- Division of Neurology, Madonna del Soccorso Hospital, ASUR Marche, Ascoli Piceno, San Benedetto del Tronto, Italy
| | - Silvia Bianchi
- Neurology and Neurometabolic Unit, Department of Medical Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | | | - Leonardo Pantoni
- Stroke and Dementia Lab, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Alessiani M, Petolicchio B, De Sanctis R, Squitieri M, Di Giambattista R, Puma M, Franzese C, Toscano M, Derchi CC, Gilliéron E, Viganò A, Di Piero V. A Propensity Score Matching Study on the Effect of OnabotulinumtoxinA Alone versus Short-Term Psychodynamic Psychotherapy Plus Drug-of-Choice as Preventive Therapy in Chronic Migraine: Effects and Predictive Factors. Eur Neurol 2022; 85:453-459. [PMID: 35772386 DOI: 10.1159/000525152] [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: 12/14/2021] [Accepted: 04/11/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to test the superiority of multidisciplinary approach, that is, Short-Term Psychodynamic Psychotherapy (STPP) plus drug of choice, versus monotherapy, that is, OnabotulinumtoxinA (OnaBoNT-A). METHOD We consecutively recorded data from chronic migraine (CM) patients, with or without medication overuse headache (MOH), who underwent STPP or OnaBoNT-A, with a 3-month follow-up schedule. Headache days and analgesics intake were monitored as primary outcome measures. Propensity score matching (PSM) was used to eliminate discrepancies between groups. Discriminant function analysis (DFA) was used to pinpoint predictive factors associated with the clinical response. RESULTS 96 patients with CM (64% with MOH) were treated with STPP and 54 (59% with MOH) with OnaBoNT-A. At baseline, OnaBoNT-A patients had more failed preventive therapies, more years of illness and chronicity, and were older; STPP patients were more depressed and had a higher HIT-6. Both STPP and OnaBoNT-A patients showed a significant reduction of headache days (STPP: -14 vs. OnaBoNT-A:-14.3) and analgesics intake (STPP: -12,3 vs. OnaBoNT-A -13.5 pills/month), respectively. MOH diminished more in STPP, adherence was higher in OnaBoNT-A. Results were confirmed after PSM balancing of the groups for those variables that resulted as different (but age). CONCLUSION OnaBoNT-A monotherapy produced similar results to psychotherapy plus medication, after correcting for baseline differences.
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Affiliation(s)
- Michele Alessiani
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Barbara Petolicchio
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,"Enzo Borzomati" Pain Medicine Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - Rita De Sanctis
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | | | | | - Marta Puma
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy
| | - Ciro Franzese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.,Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Hospital (IRCCS), Rozzano, Italy
| | - Massimiliano Toscano
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | | | | | | | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.,"Enzo Borzomati" Pain Medicine Unit, University Hospital Policlinico Umberto I, Rome, Italy.,Istituto Europeo di Psicoterapia Psicoanalitica, IREP, Rome, Italy
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Abstract
All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from 'conventional' stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.
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Affiliation(s)
- Leonardo Ulivi
- Stroke Research Centre, University College London Queen Square Institute of Neurology, London WC1B 5EH, UK
| | - Martina Squitieri
- Stroke Research Centre, University College London Queen Square Institute of Neurology, London WC1B 5EH, UK
| | - Hannah Cohen
- Haemostasis Research Unit, University College London, London, UK.,Haematology, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
| | - Peter Cowley
- Stroke Research Centre, University College London Queen Square Institute of Neurology, London WC1B 5EH, UK.,Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - David J Werring
- Stroke Research Centre, University College London Queen Square Institute of Neurology, London WC1B 5EH, UK .,Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
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Salvadori E, Poggesi A, Donnini I, Rinnoci V, Chiti G, Squitieri M, Tudisco L, Fierini F, Melone A, Pescini F, Pantoni L. Association of nimodipine and choline alphoscerate in the treatment of cognitive impairment in patients with cerebral small vessel disease: study protocol for a randomized placebo-controlled trial-the CONIVaD trial. Aging Clin Exp Res 2020; 32:449-457. [PMID: 31148099 DOI: 10.1007/s40520-019-01229-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/14/2019] [Accepted: 05/18/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vascular cognitive impairment (VCI) is an extremely disabling condition that includes post-stroke dementia and VCI caused by cerebral small vessel disease (SVD). Currently, there is no approved treatment for this condition. Drugs active on the cholinergic pathway have been tested in VCI patients showing positive but limited efficacy. The calcium-antagonist nimodipine also showed some moderate positive effects in VCI patients. AIMS CONIVaD (choline alphoscerate and nimodipine in vascular dementia) is a pilot, single-center, double-blinded, randomized trial aimed to assess whether the association of choline alphoscerate and nimodipine is more effective than nimodipine alone in reducing cognitive decline in patients with SVD and mild-to-moderate cognitive impairment. METHODS All patients are evaluated at baseline and after 12 months with: (1) clinical, daily functions, quality of life, and mood assessment and (2) extensive neuropsychological evaluation. After the baseline evaluation, patients are randomly assigned to one of the two arms of treatment: (1) nimodipine 90 mg/die t.i.d plus placebo b.i.d and (2) nimodipine 90 mg t.i.d plus choline alphoscerate 1200 mg/die b.i.d. for a total of 12 months. The primary endpoint is cognitive decline, expressed as the loss of at least two points on the Montreal Cognitive Assessment at 12 months. Secondary endpoints include safety and tolerability, functional, quality of life, and neuropsychological measures. DISCUSSION CONIVaD study is the first randomized controlled trial to examine the cognitive efficacy of combined choline alphoscerate-nimodipine treatment in VCI patients. Results of this pilot study will serve as a methodological basis for other clinical controlled, multicentric, double-blinded, and randomized trials. TRIAL REGISTRATION Clinical Trial NCT03228498. Registered 25 July 2017.
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Affiliation(s)
| | - Anna Poggesi
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Ida Donnini
- NEUROFARBA Department, University of Florence, Florence, Italy
| | | | - Guido Chiti
- NEUROFARBA Department, University of Florence, Florence, Italy
| | | | - Laura Tudisco
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Fabio Fierini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Anna Melone
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Francesca Pescini
- Stroke Unit, Emergency Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Leonardo Pantoni
- Department of Biomedical and Clinical Sciences, 'L. Sacco' Hospital, University of Milan, Via Giovanni Battista Grassi 74, 20157, Milan, Italy.
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8
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Bonifacio G, Chan E, Squitieri M, Islam S, Werring D. Cognitive and imaging correlates in cerebral amyloid angiopathy subtypes. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.746] [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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Prestipino E, Squitieri M, Razzolini L, Pastò L, Forleo P, Amato MP. Corrigendum to: "A case of Takotsubo syndrome during a multiple sclerosis brainstem relapse" [Mult. Scler. Relat. Disord. 24 (2018) 1-2]. Mult Scler Relat Disord 2019; 30:292. [PMID: 30987753 DOI: 10.1016/j.msard.2019.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elio Prestipino
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy
| | - Martina Squitieri
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy
| | - Lorenzo Razzolini
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy.
| | - Luisa Pastò
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy
| | - Paolo Forleo
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy
| | - Maria Pia Amato
- University of Florence, NUEROFARBA Department, Neuroscience section, Viale Pieraccini 6, 50139, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
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Sodero A, Squitieri M, Mazzeo S, Pasca M, Matà S, Pieri F, Bessi V, Sorbi S. Acute Symptomatic Sinus Bradycardia in High-Dose Methylprednisolone Therapy in a Woman With Inflammatory Myelitis: A Case Report and Review of the Literature. Clin Med Insights Case Rep 2019; 12:1179547619831026. [PMID: 30828250 PMCID: PMC6390212 DOI: 10.1177/1179547619831026] [Citation(s) in RCA: 5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/02/2022]
Abstract
High dose corticosteroid therapy is widely used as attack therapy of inflammatory
central nervous system disorders and can induce several adverse reactions.
Bradycardia is an infrequent event after corticosteroids administration and is
often asymptomatic. We report a case of a woman admitted to the neurological
department of our hospital for paraesthesias of the lower limbs. She received
adiagnosis of inflammatory myelitis and high dose corticosteroid therapy was
prescribed. During the therapy she complained of chest tightness, dyspnoea,
weakness and malaise. An electrocardiogram revealed sinus bradycardia. A
significant increase in body weight, probably due to plasma volume expansion,
was detected. Bradycardia and high blood pressure spontaneously resolved in few
days. We provide a collection and a statistical analysis of literature data
about steroid induced bradycardia. We found that higher total doses are
associated with lower pulse rate and symptomatic bradycardia. Bradycardia is
more frequent in older patients and those with underlying cardiac disease or
with autonomic disturbance. However clinicians must be aware about the
occurrence of symptomatic bradycardia in all patients who undergo high dose
corticosteroid therapy, not only in those at risk, to early detect and treat
this potentially dangerous condition.
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Affiliation(s)
- Alessandro Sodero
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Martina Squitieri
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Salvatore Mazzeo
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Matteo Pasca
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Sabrina Matà
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Francesco Pieri
- Department of Cardiology, Careggi University Hospital, Florence, Italy
| | - Valentina Bessi
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy
| | - Sandro Sorbi
- Department of Neurological and Psychiatric sciences (NEUROFARBA), University of Florence, Florence, Italy.,Careggi University Hospital, Neurology unit, Florence, Italy.,IRCCS Don Carlo Gnocchi, Florence, Italy
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11
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Prestipino E, Squitieri M, Razzolini L, Pastò L, Forleo P, Amato MP. A case of Takotsubo syndrome during a multiple sclerosis brainstem relapse. Mult Scler Relat Disord 2018; 24:1-2. [DOI: 10.1016/j.msard.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 04/29/2018] [Accepted: 05/06/2018] [Indexed: 01/27/2023]
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Petolicchio B, Toscano M, Squitieri M, Viganò A, Vicenzini E, Di Piero V. P053. An Italian study on the actual cost/benefit of onabotulinumtoxinA (BT-A) in chronic migraine: preliminary results. J Headache Pain 2015; 16:A112. [PMID: 28132276 PMCID: PMC4759242 DOI: 10.1186/1129-2377-16-s1-a112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Petolicchio B, Squitieri M, Viganò A, Toscano M, Sirolli A, Aielli S, Di Giambattista R, Vicenzini E, Gilliéron E, Di Piero V. O049. Psychodynamic functioning in chronic headache patients: a short term psychodynamic psychotherapy (STPP) study. J Headache Pain 2015; 16:A105. [PMID: 28132283 PMCID: PMC4715059 DOI: 10.1186/1129-2377-16-s1-a105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Barbara Petolicchio
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
| | - Martina Squitieri
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Alessandro Viganò
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Toscano
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Arianna Sirolli
- Istituto Europeo di Psicoterapia Psicoanalitica (IREP) of Rome, Rome, Italy
| | - Sara Aielli
- Istituto Europeo di Psicoterapia Psicoanalitica (IREP) of Rome, Rome, Italy
| | | | - Edoardo Vicenzini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Edmond Gilliéron
- Istituto Europeo di Psicoterapia Psicoanalitica (IREP) of Rome, Rome, Italy
| | - Vittorio Di Piero
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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