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Plastino M, Gorgone G, Fava A, Ettore M, Iannacchero R, Scarfone R, Vaccaro A, De Bartolo M, Bosco D. Effects of safinamide on REM sleep behavior disorder in Parkinson disease: A randomized, longitudinal, cross-over pilot study. J Clin Neurosci 2021; 91:306-312. [PMID: 34373044 DOI: 10.1016/j.jocn.2021.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/24/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Rapid Eye Movement sleep behavior disorder (RBD) is characterized by dream enactment and loss of muscle atonia during REM-sleep. RBD as a premotor feature occurred souvent in patients who develop Parkinson's disease. The glutamatergic, glycinergic, and GABA-ergic systems appear to play a crucial role in the pathogenesis of RBD. METHODS The present exploratory longitudinal cross-over study aimed to observe the effect of safinamide on RBD symptoms. Thirty patients with PD and RBD were randomized into two groups (15 subjects each), those that received for a period of 3-months safinamide (50 mg/die) in addition (Group A + ) or in absence (Group B - ) to the usual antiparkinsonian therapy. Patients exploring the clinical and video-polysomnographic changes occurred during this pharmacological therapy. RESULTS Twenty-two of 30 patients reported clear improvement in symptoms during safinamide treatment, and 16 were absolutely free from clinical RBD-symptoms at the end of the treatment. Eight patients reported slight improvement in RBD-symptoms. In 6/30 patients no substantial improvement was recorded about clinical RBD-symptoms had frightening dreams or from the bed after 1-week of treatment. In addition, after safinamide, the mean UPDRS-II and III scores decreased, while PDSS-2 score indicating an improvement in both motor symptoms and nocturnal sleep features. A significant reduction of sleep behavior disorder by questionnaire-Hong Kong-score (RBDQ-HS), mainly for two individual RBDQ-HK-items (dream related movements and failing out of bed) was registered. CONCLUSIONS This pilot study indicated that safinamide is well tolerated and improves RBD-symptom in parkinsonian.
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Affiliation(s)
- Massimiliano Plastino
- Department of Neuroscience, "Pugliese-Ciaccio" Hospital Organization, 88100 Catanzaro, Italy
| | - Gaetano Gorgone
- Department of Neuroscience, "Jazzolino" Hospital, 89900 Vibo Valentia, Italy
| | - Antonietta Fava
- Endocrinology Unit, Villa Elisa, Soverato (Catanzaro) 88068, Italy
| | - Maria Ettore
- Department of Neuroscience, "Pugliese-Ciaccio" Hospital Organization, 88100 Catanzaro, Italy
| | - Rosario Iannacchero
- Department of Neuroscience, "Pugliese - Ciaccio" Hospital Organization, 88100 Catanzaro, Italy
| | - Rita Scarfone
- Department of Neuroscience, "Pugliese-Ciaccio" Hospital Organization, 88100 Catanzaro, Italy
| | - Antonio Vaccaro
- Department of Neuroscience, "Pugliese-Ciaccio" Hospital Organization, 88100 Catanzaro, Italy
| | - Matteo De Bartolo
- Neurophysiology Unit, General Hospital, 87067 Rossano, Cosenza, Italy
| | - Domenico Bosco
- Department of Neuroscience, "Pugliese - Ciaccio" Hospital Organization, 88100 Catanzaro, Italy.
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Fava A, Colica C, Plastino M, Messina D, Cristiano D, Opipari C, Vaccaro A, Gorgone G, Bosco F, Fratto A, De Bartolo M, Bosco D. Cognitive impairment is correlated with insulin resistance degree: the "PA-NICO-study". Metab Brain Dis 2017; 32:799-810. [PMID: 28229380 DOI: 10.1007/s11011-017-9977-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/15/2017] [Indexed: 12/23/2022]
Abstract
Several epidemiological studies have shown that Diabetes Mellitus (DM) or Insulin Resistance (IR) increases the risk of dementia. Besides, some authors suggested that poor glucose control to be associated with worse cognitive function. We aimed to assess cognitive functions and IR-degree over time in diabetic. We also evaluated whether a greater magnitude of cognitive decline could be related with their IR degree. We enrolled 335 diabetic patients and 142 non-diabetic subjects; participants were subdivided into three groups in accordance with their IRdegree assessed by Homa-Index (HI): Normal-HI (non-diabetic NHI < 2,6), Moderate-HI (MHI > 2,6 < 10) and High-HI (HHI > 10). Metabolic status and a comprehensive neuropsycological test battery (MMSE, ADAS-Cog, ACDS-ADL) were assessed at baseline and every 12-months during the follow-up (6,8 years). At the end of the study, the average MMSE decreased significantly in patients of HHI group (P = .001) compared to baseline. MMSE scores were also reduced both in MHI group and in controls, but the difference between two groups was not significant. In HHI group, similar effects were observed for the ADAS-Cog score compared to baseline (P = 0.001); instead, when ACDS-ADL was evaluated, no differences was observed among the three groups. These results remained unchanged also after adjustment for confounding variables (i.e. APOε-status, sex, BMI, education level, heart diseases and HbA1c). We suggest that higher IR-degree is associated with greater cognitive decline in diabetic patients; so we hypothesize that IR degree, more than IR status itself, could be related to the severity of cognitive impairment.
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Affiliation(s)
- Antonietta Fava
- Department of Clinical and Experimental Medicine, University of Catanzaro, 88100, Catanzaro, Italy
| | - Carmen Colica
- Institute of Neurological Science - National Research Council, Roccelletta di Borgia, 88100, Catanzaro, Italy
| | - Massimiliano Plastino
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | - Demetrio Messina
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
- Institute of Neurological Science - National Research Council, UVS-IBFM, 02, Milan, Italy
| | - Dario Cristiano
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | - Carlo Opipari
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | - Antonio Vaccaro
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | - Gaetano Gorgone
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | - Francesca Bosco
- University of Pharmacology, loc. Roccelletta, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Alessandra Fratto
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy
| | | | - Domenico Bosco
- Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
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Gallo M, Frangipane F, Cupidi C, De Bartolo M, Turone S, Ferrari C, Nacmias B, Grimaldi G, Laganà V, Colao R, Bernardi L, Anfossi M, Conidi ME, Vasso F, Curcio SAM, Mirabelli M, Smirne N, Torchia G, Muraca MG, Puccio G, Di Lorenzo R, Piccininni M, Tedde A, Maletta RG, Sorbi S, Bruni AC. The novel PSEN1 M84V mutation associated to frontal dysexecutive syndrome, spastic paraparesis, and cerebellar atrophy in a dominant Alzheimer's disease family. Neurobiol Aging 2017; 56:213.e7-213.e12. [PMID: 28532646 DOI: 10.1016/j.neurobiolaging.2017.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 01/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 12/30/2022]
Abstract
We identified the novel PSEN1 pathogenic mutation M84V in 3 patients belonging to a large kindred affected by autosomal dominant Alzheimer's disease (AD). The clinical phenotype was characterized by early onset dementia in 14 affected subjects over 3 generations. Detailed clinical, imaging and genetic assessment was performed. We highlighted the presence of unusual symptoms such as frontal executive syndrome, psychosis and spastic paraparesis in these patients. Spastic paraparesis has been reported in other PSEN1 mutations in adjacent codons, suggesting that the position of the genetic defect may affect the clinical expression, although this phenotype can occur in mutations throughout the whole PSEN1 gene. Brain magnetic resonance imaging showed diffuse cortical atrophy, but also atrophy of cerebellar lobules, mainly involving Crus I, in 2 patients without cerebellar motor deficits. These neuroimaging results were consistent with recent findings about the association between sporadic AD and distinct and circumscribed cerebellar atrophy. The present work acknowledged the novel PSEN1 pathogenic mutation M84V and might contribute to the ongoing debate about the involvement of cerebellum in AD.
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Affiliation(s)
- Maura Gallo
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Chiara Cupidi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Matteo De Bartolo
- Neurofisiopatologia, Distretto Ionio Sud, ASP CS, Rossano (CS), Italy
| | - Sabina Turone
- Neurofisiopatologia, Distretto Ionio Sud, ASP CS, Rossano (CS), Italy
| | - Camilla Ferrari
- IRCCS Don Gnocchi, Florence, Italy; Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Giuliana Grimaldi
- Groupe de Recherche Interdisciplinaire du Mouvement, ULB, Erasme, Brussels, Belgium
| | - Valentina Laganà
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Rosanna Colao
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Livia Bernardi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Maria Anfossi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Franca Vasso
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Maria Mirabelli
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Nicoletta Smirne
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Giusi Torchia
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Gianfranco Puccio
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | | | - Maristella Piccininni
- Department of Neurology, San Giovanni di Dio Hospital, USL Toscana Centro-Florence, Florence, Italy
| | - Andrea Tedde
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Sandro Sorbi
- IRCCS Don Gnocchi, Florence, Italy; Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Fava A, Plastino M, Cristiano D, Spanò A, Cristofaro S, Opipari C, Chillà A, Casalinuovo F, Colica C, De Bartolo M, Pirritano D, Bosco D. Insulin resistance possible risk factor for cognitive impairment in fibromialgic patients. Metab Brain Dis 2013; 28:619-27. [PMID: 23892884 DOI: 10.1007/s11011-013-9421-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 07/11/2013] [Indexed: 01/28/2023]
Abstract
To evaluate glucose metabolism and/or insulin resistance (IR) in 96 patients with Fibromyalgia (FM), associated or not to cognitive impairment. We investigated glucose metabolism in 96 FM patients. Enrolled patients were divided into two groups: 48 patients with memory deficit (group A) and 48 without memory deficit (control group). We evaluated glucose and insulin levels after a 2 h-Oral-Glucose-Tolerance-Test (2 h-OGTT) and insulin resistance (IR) by the homeostasis model assessment formula (HOMA). Body Mass Index (BMI), waist-to-hip-ratio (WHR), anxiety level, fasting plasma insulin and Non-Steroidal Anti-Inflammatory agents use were higher in patients with FM with memory impairment; while age, sex, waist circumference, education level, fasting plasma glucose, glycate hemoglobin, triglycerides, blood lipid profile, C- Reactivity-Protein (CRP), blood pressure and smoking habits were similar in both groups. Following OGTT the prevalence of glucose metabolism abnormalities was significantly higher in group A. IR was present in 79% patients, of whom 23% had also impaired glucose tolerance, 4% newly diagnosed diabetes mellitus and 52% IR only. Obesity and overweight prevailed in group A. IR, but not BMI or WHR was associated to an increased risk of memory impairment (OR = 2,6; 95% CI: 1,22-3,7). The results of this study suggest that IR may represent a risk factor for memory impairment in fibromialgic patients.
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Fava A, Pirritano D, Plastino M, Cristiano D, Puccio G, Colica C, Ermio C, De Bartolo M, Mauro G, Bosco D. The Effect of Lipoic Acid Therapy on Cognitive Functioning in Patients with Alzheimer's Disease. J Neurodegener Dis 2013; 2013:454253. [PMID: 26316990 PMCID: PMC4437336 DOI: 10.1155/2013/454253] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 02/27/2013] [Accepted: 03/13/2013] [Indexed: 01/21/2023]
Abstract
Diabetes mellitus (DM) is an important risk factor for Alzheimer's disease (AD). Most diabetic patients have insulin resistance (IR) that is associated with compensatory hyperinsulinemia, one of the mechanisms suggested for increased AD risk in patients with DM. Alpha-lipoic acid (ALA) is a disulfide molecule with antioxidant properties that has positive effects on glucose metabolism and IR. This study evaluated the effect of ALA treatment (600 mg/day) on cognitive performances in AD patients with and without DM. One hundred and twenty-six patients with AD were divided into two groups, according to DM presence (group A) or absence (group B). Cognitive functions were assessed by MMSE, Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Clinician's Interview-Based Impression of Severity (CIBIC), Clinical Dementia Rating (CDR), and Alzheimer's Disease Functional and Change Scale (ADFACS). IR was assessed by HOMA index. At the end of the study, MMSE scores showed a significant improvement in 43% patients of group A (26 subjects) and 23% of group B (15 subjects), compared to baseline (P = .001). Also ADAS-Cog, CIBIC, and ADFACS scores showed a significant improvement in group A versus group B. IR was higher in group A. Our study suggests that ALA therapy could be effective in slowing cognitive decline in patients with AD and IR.
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Affiliation(s)
- Antonietta Fava
- Department of Clinical and Experimental Medicine, University of Catanzaro, 88100 Catanzaro, Italy
| | - Domenico Pirritano
- Department of Neuroscience, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
| | | | - Dario Cristiano
- Department of Neuroscience, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
| | - Giovanna Puccio
- Department of Neuroscience, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
| | - Carmen Colica
- Institute of Neurological Science, National Research Council, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Caterina Ermio
- Department of Neuroscience, “S. Giovanni Paolo II” Hospital, 88046 Lamezia Terme, Catanzaro, Italy
| | - Matteo De Bartolo
- Neurophysiology Unit, General Hospital, 87067 Rossano, Cosenza, Italy
| | - Gaetano Mauro
- General Medicine Unit, General Hospital, 87055 San Giovanni in Fiore, Cosenza, Italy
| | - Domenico Bosco
- Department of Neuroscience, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
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Plastino M, Fava A, Carmela C, De Bartolo M, Ermio C, Cristiano D, Ettore M, Abenavoli L, Bosco D. Insulin resistance increases risk of carpal tunnel syndrome: a case-control study. J Peripher Nerv Syst 2011; 16:186-90. [DOI: 10.1111/j.1529-8027.2011.00344.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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