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Cocetta V, Giacomini I, Tinazzi M, Berretta M, Quagliariello V, Maurea N, Ragazzi E, Carnevali I, Montopoli M. Maintenance of intestinal epithelial barrier integrity by a combination of probiotics, herbal extract, and vitamins. Minerva Pediatr (Torino) 2023:S2724-5276.23.07128-8. [PMID: 37166776 DOI: 10.23736/s2724-5276.23.07128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) and Inflammatory bowel disease (IBD) are pathological conditions that severely hamper the quality of life of patients. Especially in pediatric and adolescent patients, the use of Complementary and alternative medicine is an appealing approach as an adjuvant for the management of symptoms, limiting the detrimental effect of the conventional therapy. In this work, we tested the effect of Enterokind Junior (EntJ), a mix of two probiotic strains Lactobacillus reuteri DSM 25175 and Lactobacillus acidophilus DSM 24936, Matricaria Chamomilla, and vitamins, in in vitro model of intestinal inflammation. Caco-2 cells were subjected to LPS treatment or THP-1 cells stimulated with LPS treatment, as paradigms of inflammatory conditions. METHODS The effect of the probiotic formulation was evaluated by measuring Caco-2 monolayer's Transepithelial Electrical resistance (TEER) and paracellular permeability alterations, tight junction proteins expression and localization by confocal microscopy, and release of pro-inflammatory cytokines (TNF-α and IL-8) by ELISA assay. RESULTS Results demonstrated that upon impairment of intestinal parameters induced by inflammatory stimuli, the combination of probiotic was able to prevent TEER decrease and paracellular permeability alterations and to maintain the tight junction expression and localization. Moreover, the release of proinflammatory cytokines induced by inflammation was reduced by EntJ treatment. CONCLUSIONS This work, in line with previous observations, supports a protective role of Lactobacillus reuteri DSM 25175, Lactobacillus acidophilus DSM 24936 and the other components in the maintenance of a healthy gut, holding up the use of this combination as an adjuvant for irritable bowel syndrome-related symptoms management.
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Affiliation(s)
- Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Isabella Giacomini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Mattia Tinazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vincenzo Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale of Napoli, Napoli, Italy
| | - Nicola Maurea
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale of Napoli, Napoli, Italy
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Ilaria Carnevali
- Scientific Department Schwabe Pharma Italia, Egna, Bolzano, Italy
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
- VIMM - Veneto Institute of Molecular Medicine, Padova, Italy
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2
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Giacomini I, Cortini M, Tinazzi M, Baldini N, Cocetta V, Ragazzi E, Avnet S, Montopoli M. Contribution of Mitochondrial Activity to Doxorubicin-Resistance in Osteosarcoma Cells. Cancers (Basel) 2023; 15:cancers15051370. [PMID: 36900165 PMCID: PMC10000149 DOI: 10.3390/cancers15051370] [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: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Osteosarcoma is considered the most common bone tumor affecting children and young adults. The standard of care is chemotherapy; however, the onset of drug resistance still jeopardizes osteosarcoma patients, thus making it necessary to conduct a thorough investigation of the possible mechanisms behind this phenomenon. In the last decades, metabolic rewiring of cancer cells has been proposed as a cause of chemotherapy resistance. Our aim was to compare the mitochondrial phenotype of sensitive osteosarcoma cells (HOS and MG-63) versus their clones when continuously exposed to doxorubicin (resistant cells) and identify alterations exploitable for pharmacological approaches to overcome chemotherapy resistance. Compared with sensitive cells, doxorubicin-resistant clones showed sustained viability with less oxygen-dependent metabolisms, and significantly reduced mitochondrial membrane potential, mitochondrial mass, and ROS production. In addition, we found reduced expression of TFAM gene generally associated with mitochondrial biogenesis. Finally, combined treatment of resistant osteosarcoma cells with doxorubicin and quercetin, a known inducer of mitochondrial biogenesis, re-sensitizes the doxorubicin effect in resistant cells. Despite further investigations being needed, these results pave the way for the use of mitochondrial inducers as a promising strategy to re-sensitize doxorubicin cytotoxicity in patients who do not respond to therapy or reduce doxorubicin side effects.
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Affiliation(s)
- Isabella Giacomini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy
| | - Margherita Cortini
- Biomedical Science and Technologies and Nanobiotechnology Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Mattia Tinazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy
| | - Nicola Baldini
- Biomedical Science and Technologies and Nanobiotechnology Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy
| | - Sofia Avnet
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
- Correspondence: (S.A.); (M.M.)
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy
- Veneto Institute of Molecular Medicine (VIMM), 35129 Padova, Italy
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), 6500 Bellinzona, Switzerland
- Correspondence: (S.A.); (M.M.)
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3
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Berretta M, Cazzavillan S, Tinazzi M, Peire AM, Santangà D, Bignucolo A, Montopoli M. Integrative oncology: evidence-based medicine - The multidisciplinary experience of the Integrative Medicine Research Group (IMRG). Eur Rev Med Pharmacol Sci 2022; 26:9457-9466. [PMID: 36591854 DOI: 10.26355/eurrev_202212_30697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purpose of this conference was to explain the relationship between the integrative and complementary medicine and cancer disease through evidence-based medicine. The topics covered are numerous and are characterized by the multidisciplinary approach of the researchers involved in this complex scenario. The Integrative Medicine Research Group (IMRG) studies the complementary and integrative approach in cancer patients with the aim to highlight the risk of drug and nutraceutical interactions and, at the same time, improve the quality of life in this particular set of patients. Our auspicious is to have an integrative medicine approach to all chronic diseases, oncological included.
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Affiliation(s)
- M Berretta
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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4
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Cocetta V, Tinazzi M, Giacomini I, Rosato B, Ragazzi E, Berretta M, Montopoli M. Clinical Evidence of Interaction Between Nutraceutical Supplementation and Platinum-based Chemotherapy. Curr Med Chem 2022; 30:2141-2164. [PMID: 35638272 DOI: 10.2174/0929867329666220527120237] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/16/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
Abstract
Platinum agents, which include cisplatin, oxaliplatin and carboplatin, are chemotherapeutic drugs which represent the first-line treatment for different types of solid tumors, such as ovarian, head and neck, testicular, and bladder cancers. Their beneficial effect is limited by the onset of drug resistance and by severe toxicities, involving mainly ototoxicity, neurotoxicity and nephrotoxicity. Recent studies highlighted the supplementation of herbal products, vitamins and minerals with antioxidant properties to prevent and protect from side effects. In particular, the introduction of nutraceuticals associated with chemotherapy has improved the patients' quality of life. However, if from one side, complementary and alternative medicine ameliorates chemotherapeutics-induced toxicities, from the other side it is important to take into consideration the possible interference with drug metabolism. This review aims to consider the current literature focusing on clinical trials that report association between nutraceutical supplementation and platinum-based chemotherapy to prevent toxicities, highlighting both beneficial and side effects.
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Affiliation(s)
- Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Mattia Tinazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Isabella Giacomini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Benedetta Rosato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, Messina Italy
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy.,VIMM - Veneto Institute of Molecular Medicine, Padova, Italy
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5
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Carullo G, Spizzirri UG, Montopoli M, Cocetta V, Armentano B, Tinazzi M, Sciubba F, Giorgi G, Enrica Di Cocco M, Bohn T, Aiello F, Restuccia D. Milk kefir enriched with inulin‐grafted seed extract from white wine pomace: chemical characterisation, antioxidant profile and
in vitro
gastrointestinal digestion. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Gabriele Carullo
- Department of Biotechnology, Chemistry and Pharmacy, DoE 2018‐2022 University of Siena Via Aldo Moro 2 53100 Siena Italy
| | - Umile Gianfranco Spizzirri
- Department of Pharmacy, Health and Nutritional Sciences, DoE 2018‐2022 University of Calabria Edificio Polifunzionale 87036 Rende Italy
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences University of Padova Largo Meneghetti 2 35131 Padova Italy
| | - Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences University of Padova Largo Meneghetti 2 35131 Padova Italy
| | - Biagio Armentano
- Società Agricola Campotenese Contrada Campotenese 64 87016 Morano Calabro Italy
| | - Mattia Tinazzi
- Department of Pharmaceutical and Pharmacological Sciences University of Padova Largo Meneghetti 2 35131 Padova Italy
| | - Fabio Sciubba
- Department of Environmental Biology University of Rome “La Sapienza” Piazzale Aldo Moro 5 00185 Rome Italy
- NMR‐Based Metabolomics Laboratory Sapienza University of Rome Piazzale Aldo Moro 5 00185 Rome Italy
| | - Gianluca Giorgi
- Department of Biotechnology, Chemistry and Pharmacy, DoE 2018‐2022 University of Siena Via Aldo Moro 2 53100 Siena Italy
| | - Maria Enrica Di Cocco
- NMR‐Based Metabolomics Laboratory Sapienza University of Rome Piazzale Aldo Moro 5 00185 Rome Italy
- Department of Chemistry University of Rome “La Sapienza” Piazzale Aldo Moro 5 00185 Rome Italy
| | - Torsten Bohn
- Nutrition and Health Research Group Department of Population Health Luxembourg Institute of Health 1A‐B, rue Thomas Edison L‐1445 Strassen Luxembourg
| | - Francesca Aiello
- Department of Pharmacy, Health and Nutritional Sciences, DoE 2018‐2022 University of Calabria Edificio Polifunzionale 87036 Rende Italy
| | - Donatella Restuccia
- Department of Pharmacy, Health and Nutritional Sciences, DoE 2018‐2022 University of Calabria Edificio Polifunzionale 87036 Rende Italy
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Cocetta V, Governa P, Borgonetti V, Tinazzi M, Peron G, Catanzaro D, Berretta M, Biagi M, Manetti F, Dall'Acqua S, Montopoli M. Cannabidiol Isolated From Cannabis sativa L. Protects Intestinal Barrier From In Vitro Inflammation and Oxidative Stress. Front Pharmacol 2021; 12:641210. [PMID: 33995048 PMCID: PMC8115937 DOI: 10.3389/fphar.2021.641210] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 12/13/2020] [Accepted: 04/08/2021] [Indexed: 12/11/2022] Open
Abstract
The relevance and incidence of intestinal bowel diseases (IBD) have been increasing over the last 50 years and the current therapies are characterized by severe side effects, making essential the development of new strategies that combine efficacy and safety in the management of human IBD. Herbal products are highly considered in research aimed at discovering new approaches for IBD therapy and, among others, Cannabis sativa L. has been traditionally used for centuries as an analgesic and anti-inflammatory remedy also in different gastrointestinal disorders. This study aims to investigate the effects of different C. sativa isolated compounds in an in vitro model of intestinal epithelium. The ability of treatments to modulate markers of intestinal dysfunctions was tested on Caco-2 intestinal cell monolayers. Our results, obtained by evaluation of ROS production, TEER and paracellular permeability measurements and tight junctions evaluation show Cannabidiol as the most promising compound against intestinal inflammatory condition. Cannabidiol is able to inhibit ROS production and restore epithelial permeability during inflammatory and oxidative stress conditions, suggesting its possible application as adjuvant in IBD management.
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Affiliation(s)
- Veronica Cocetta
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy
| | - Paolo Governa
- Department of Biotechnology, Chemistry and Pharmacy Department of Excellence 2018-2022, University of Siena, Siena, Italy
| | - Vittoria Borgonetti
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy
| | - Mattia Tinazzi
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy
| | - Gregorio Peron
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy
| | - Daniela Catanzaro
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marco Biagi
- Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - Fabrizio Manetti
- Department of Biotechnology, Chemistry and Pharmacy Department of Excellence 2018-2022, University of Siena, Siena, Italy
| | - Stefano Dall'Acqua
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy
| | - Monica Montopoli
- Department of Pharmaceutical Sciences, University of Padova, Padova, Italy.,Veneto Institute of Molecular Medicine, VIMM, Padova, Italy
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7
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Doppler K, Antelmi E, Kuzkina A, Donadio V, Incensi A, Plazzi G, Pizza F, Marelli S, Ferini-Strambi L, Tinazzi M, Mayer G, Sittig E, Booij J, Sedghi A, Oertel WH, Volkmann J, Sommer C, Janzen A, Liguori R. Consistent skin α-synuclein positivity in REM sleep behavior disorder - A two center two-to-four-year follow-up study. Parkinsonism Relat Disord 2021; 86:108-113. [PMID: 33895068 DOI: 10.1016/j.parkreldis.2021.04.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE/METHODS Phosphorylated alpha-synuclein (p-syn) in dermal nerves of patients with isolated REM sleep behavior disorder (iRBD) is detectable by immunofluorescence-labeling. Skin-biopsy-p-syn-positivity was recently postulated to be a prodromal marker of Parkinson's disease (PD) or related synucleinopathies. Here, we provide two-to four-year clinical and skin biopsy follow-up data of 33 iRBD patients, whose skin biopsy findings at baseline were reported in 2017. RESULTS Follow-up biopsies were available from 25 patients (18 positive at baseline) and showed consistent findings over time in 24 patients. One patient converted from skin-biopsy-negativity to -positivity. P-syn-positivity was observed in iRBD patients who still had a normal FP-CIT-SPECT two years later. Clinically, five of the 23 at baseline skin-biopsy-positive patients (21.7%) had converted to PD or dementia with Lewy bodies at follow-up, but none of the skin-biopsy-negative patients. CONCLUSIONS Dermal p-syn in iRBD is most probably an early consistent marker of synucleinopathy and may support other indicators of conversion to manifest disease state.
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Affiliation(s)
- K Doppler
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany.
| | - E Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - A Kuzkina
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - V Donadio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - A Incensi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - G Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - F Pizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - S Marelli
- Vita-Salute San Raffaele University, Milan, Italy, IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Centre, Milan, Italy
| | - L Ferini-Strambi
- Vita-Salute San Raffaele University, Milan, Italy, IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Centre, Milan, Italy
| | - M Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - G Mayer
- Department of Neurology, Philipps University Marburg, Germany
| | - E Sittig
- Department of Neurology, Philipps University Marburg, Germany
| | - J Booij
- Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, the Netherlands
| | - A Sedghi
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W H Oertel
- Department of Neurology, Philipps University Marburg, Germany; Institute for Neurogenomics, Helmholtz Center for Health and Environment, München-Neuherberg, Germany
| | - J Volkmann
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - C Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - A Janzen
- Department of Neurology, Philipps University Marburg, Germany
| | - R Liguori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
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8
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Emadi Andani M, Villa-Sánchez B, Raneri F, Dametto S, Tinazzi M, Fiorio M. P54 Cathodal cerebellar tDCS with concurrent visual feedback improves balance control. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Erro R, Bacchin R, Magrinelli F, Tomei P, Geroin C, Squintani G, Lupo A, Zaza G, Tinazzi M. Tremor induced by Calcineurin inhibitor immunosuppression: a single-centre observational study in kidney transplanted patients. J Neurol 2018; 265:1676-1683. [PMID: 29777361 DOI: 10.1007/s00415-018-8904-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/15/2018] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Tremor is the most frequent and disabling neurological side effect under Calcineurin inhibitor-induced immunosuppression, but no studies have defined its phenomenology, severity, distribution, the impact on quality of life, as well as of other neurological symptoms associated. METHODS 126 consecutive kidney-transplanted patients, under treatment with Cyclosporin A, Tacrolimus and non-Calcineurin inhibitors, within therapeutic range, were enrolled. Participants underwent a deep neurological examination by two blinded to the treatment raters, and a blood sampling to assess plasmatic immunosuppressant level and nephrological function tests. Tremor and cerebellar signs were scored according to the Fahn-Tolosa-Marin and the SARA scale. Parkinsonism was excluded applying the UPDRS (part III). RESULTS Tremor was more common and severe in the Tacrolimus group, similar to impairment in ADL. Regardless of treatment, tremor involved both upper and lower limbs and was activated by action, but in about 50% of cases presented in action and rest condition. Plasmatic level of Tacrolimus was higher in patients with tremor than in those without, while cholesterol was significantly lower. Cerebellar and neuropathic signs were overall mild and were not significantly different across the three groups comparing patients with and without tremor. CONCLUSIONS Non-Calcineurin inhibitors such as Sirolimus have the lowest propensity to induce tremor and with a milder severity, while Calcineurin inhibitors, especially Tacrolimus, the highest, and regardless of the formulation. Plasmatic concentration of Tacrolimus was higher in tremulous patients; further research needs to validate the role of cholesterol plasmatic concentration in predicting the occurrence of tremor in patients on Tacrolimus.
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Affiliation(s)
- R Erro
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy
| | - Ruggero Bacchin
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy.
| | - F Magrinelli
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy
| | - P Tomei
- Renal Unit, Department of Medicine, University of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - C Geroin
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy
| | - G Squintani
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy
| | - A Lupo
- Renal Unit, Department of Medicine, University of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - G Zaza
- Renal Unit, Department of Medicine, University of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - M Tinazzi
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.a. Scuro 10, 37134, Verona, Italy
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10
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Defazio G, Esposito M, Abbruzzese G, Scaglione CL, Fabbrini G, Ferrazzano G, Peluso S, Pellicciari R, Gigante AF, Cossu G, Arca R, Avanzino L, Bono F, Mazza MR, Bertolasi L, Bacchin R, Eleopra R, Lettieri C, Morgante F, Altavista MC, Polidori L, Liguori R, Misceo S, Squintani G, Tinazzi M, Ceravolo R, Unti E, Magistrelli L, Coletti Moja M, Modugno N, Petracca M, Tambasco N, Cotelli MS, Aguggia M, Pisani A, Romano M, Zibetti M, Bentivoglio AR, Albanese A, Girlanda P, Berardelli A. 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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11
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Antonini A, Tinazzi M, Abbruzzese G, Berardelli A, Chaudhuri KR, Defazio G, Ferreira J, Martinez-Martin P, Trenkwalder C, Rascol O. Pain in Parkinson's disease: facts and uncertainties. Eur J Neurol 2018. [DOI: 10.1111/ene.13624] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | | | | | - A. Berardelli
- University of Rome; Rome
- IRCCS NEUROMED; Isernia Italy
| | | | | | | | | | - C. Trenkwalder
- University Medical Center Goettingen; Goettingen Germany
| | - O. Rascol
- Université de Toulouse; Toulouse France
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12
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Pizza F, Antelmi E, Vandi S, Meletti S, Erro R, Baumann C, Bhatia K, Dauvilliers Y, Edwards M, Iranzo A, Overeem S, Tinazzi M, Liguori R, Plazzi G. The distinguishing motor features of cataplexy: a study from video recorded attacks. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Erro R, Tinazzi M, Morgante F, Bhatia KP. Non-invasive brain stimulation for dystonia: therapeutic implications. Eur J Neurol 2017; 24:1228-e64. [PMID: 28782903 DOI: 10.1111/ene.13363] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 10/19/2016] [Accepted: 06/01/2017] [Indexed: 11/28/2022]
Abstract
Dystonia is characterized by excessive muscle contractions giving rise to abnormal posture and involuntary twisting movements. Although dystonia syndromes are a heterogeneous group of disorders, certain pathophysiological mechanisms have been consistently identified across different forms. These pathophysiological mechanisms have subsequently been exploited for the development of non-invasive brain stimulation (NIBS) techniques able to modulate neural activity in one or more nodes of the putative network that is altered in dystonia, and the therapeutic role of NIBS has hence been suggested. Here all studies that applied such techniques as a therapeutic intervention in any forms of dystonia, including the few works performed in children, are reviewed and emerging concepts and pitfalls of NIBS are discussed.
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Affiliation(s)
- R Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Neuroscience Section, University of Salerno, Salerno, Italy.,Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - M Tinazzi
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - F Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
| | - K P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
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14
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Defazio G, Antonini A, Tinazzi M, Gigante AF, Pietracupa S, Pellicciari R, Bloise M, Bacchin R, Marcante A, Fabbrini G, Berardelli A. Relationship between pain and motor and non-motor symptoms in Parkinson's disease. Eur J Neurol 2017; 24:974-980. [DOI: 10.1111/ene.13323] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/06/2017] [Indexed: 11/26/2022]
Affiliation(s)
- G. Defazio
- Department of Basic Medical Sciences; Neuroscience and Sense Organs; ‘Aldo Moro’ University of Bari; Bari Italy
| | - A. Antonini
- Parkinson and Movement Disorders Unit; IRCCS Hospital San Camillo; Venice Italy
| | - M. Tinazzi
- Department of Neurological and Movement Sciences; University of Verona; Verona Italy
| | - A. F. Gigante
- Department of Basic Medical Sciences; Neuroscience and Sense Organs; ‘Aldo Moro’ University of Bari; Bari Italy
| | | | - R. Pellicciari
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - M. Bloise
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - R. Bacchin
- Department of Neurological and Movement Sciences; University of Verona; Verona Italy
| | - A. Marcante
- Parkinson and Movement Disorders Unit; IRCCS Hospital San Camillo; Venice Italy
| | - G. Fabbrini
- IRCCS Neuromed Institute; Pozzilli Italy
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - A. Berardelli
- IRCCS Neuromed Institute; Pozzilli Italy
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
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15
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Defazio G, Esposito M, Abbruzzese G, Scaglione CL, Fabbrini G, Ferrazzano G, Peluso S, Pellicciari R, Gigante AF, Cossu G, Arca R, Avanzino L, Bono F, Mazza MR, Bertolasi L, Bacchin R, Eleopra R, Lettieri C, Morgante F, Altavista MC, Polidori L, Liguori R, Misceo S, Squintani G, Tinazzi M, Ceravolo R, Unti E, Magistrelli L, Coletti Moja M, Modugno N, Petracca M, Tambasco N, Cotelli MS, Aguggia M, Pisani A, Romano M, Zibetti M, Bentivoglio AR, Albanese A, Girlanda P, Berardelli A. The Italian Dystonia Registry: rationale, design and preliminary findings. Neurol Sci 2017; 38:819-825. [PMID: 28215037 DOI: 10.1007/s10072-017-2839-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/03/2017] [Indexed: 01/22/2023]
Abstract
The Italian Dystonia Registry is a multicenter data collection system that will prospectively assess the phenomenology and natural history of adult-onset dystonia and will serve as a basis for future etiological, pathophysiological and therapeutic studies. In the first 6 months of activity, 20 movement disorders Italian centres have adhered to the registry and 664 patients have been recruited. Baseline historical information from this cohort provides the first general overview of adult-onset dystonia in Italy. The cohort was characterized by a lower education level than the Italian population, and most patients were employed as artisans, builders, farmers, or unskilled workers. The clinical features of our sample confirmed the peculiar characteristics of adult-onset dystonia, i.e. gender preference, peak age at onset in the sixth decade, predominance of cervical dystonia and blepharospasm over the other focal dystonias, and a tendency to spread to adjacent body parts, The sample also confirmed the association between eye symptoms and blepharospasm, whereas no clear association emerged between extracranial injury and dystonia in a body site. Adult-onset dystonia patients and the Italian population shared similar burden of arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidemia, and hypothyroidism, while hyperthyroidism was more frequent in the dystonia population. Geographic stratification of the study population yielded no major difference in the most clinical and phenomenological features of dystonia. Analysis of baseline information from recruited patients indicates that the Italian Dystonia Registry may be a useful tool to capture the real world clinical practice of physicians that visit dystonia patients.
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Affiliation(s)
- Giovanni Defazio
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy.
| | - M Esposito
- Department of Neurosciences, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - G Abbruzzese
- Section of Human Physiology, Department of Experimental Medicine, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - C L Scaglione
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - G Fabbrini
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
| | - G Ferrazzano
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
| | - S Peluso
- Department of Neurosciences, Reproductive Science and Dentistry, Federico II University of Naples, Naples, Italy
| | - R Pellicciari
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy
| | - A F Gigante
- Department of Basic Science, Neuroscience and Sense Organs, Aldo Moro University of Bari, 70124, Bari, Italy
| | - G Cossu
- Department of Neurology, AOB "G. Brotzu" General Hospital, Cagliari, Italy
| | - R Arca
- Department of Neurology, AOB "G. Brotzu" General Hospital, Cagliari, Italy
| | - L Avanzino
- Section of Human Physiology, Department of Experimental Medicine, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - F Bono
- Neurology Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - M R Mazza
- Neurology Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - L Bertolasi
- Neurologic Unit, University Hospital, Verona, Italy
| | - R Bacchin
- Neurologic Unit, University Hospital, Verona, Italy
| | - R Eleopra
- Neurologic Unit, Department of Neuroscience, University Hospital "S. Maria della Misericordia", Udine, Italy
| | - C Lettieri
- Neurologic Unit, Department of Neuroscience, University Hospital "S. Maria della Misericordia", Udine, Italy
| | - F Morgante
- Department of Neuroscience, University of Messina, Messina, Italy
| | | | - L Polidori
- San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - R Liguori
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - S Misceo
- Neurologic Unit, San Paolo Hospital, Bari, Italy
| | - G Squintani
- Neurology Unit, Department of Neuroscience, University Hospital, University of Verona, Verona, Italy
| | - M Tinazzi
- Neurology Unit, Department of Neuroscience, University Hospital, University of Verona, Verona, Italy
| | - R Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Unti
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Magistrelli
- Section of Neurology, Department of Translational Medicine, University of Eastern Piedmont "Amedeo Avogadro", Novara, Italy
| | | | - N Modugno
- Neuromed Institute IRCCS, Pozzilli, IS, Italy
| | - M Petracca
- Movement Disorders Unit, Center for Parkinson's Disease and Extrapyramidal Disorders, Institute of Neurology, Catholic University, Rome, Italy
| | - N Tambasco
- Neurology Unit, University Hospital S. Andrea delle Fratte, University of Perugia, Perugia, Italy
| | | | - M Aguggia
- Neurology Department, Asti Hospital, Asti, Italy
| | - A Pisani
- Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Romano
- Neurology Unit, Villa Sofia Hospital, Palermo, Italy
| | - M Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - A R Bentivoglio
- Movement Disorders Unit, Center for Parkinson's Disease and Extrapyramidal Disorders, Institute of Neurology, Catholic University, Rome, Italy
| | - A Albanese
- Department of Neurology, Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - P Girlanda
- Department of Neuroscience, University of Messina, Messina, Italy
| | - A Berardelli
- Department of Neurology and Psychiatry, Neuromed Institute IRCCS, Sapienza University of Rome, Pozzilli, Italy
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16
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Gandolfi M, Dimitrova E, Nicolli F, Modenese A, Serina A, Waldner A, Tinazzi M, Squintani G, Smania N, Geroin C. Rehabilitation procedures in the management of gait disorders in the elderly. Minerva Med 2015; 106:287-307. [PMID: 26505839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gait disorders are common and very disabling in elderly people, leading to an increase of risk of falling and reductions in quality of life. So far, many clinical classifications of gait disorders in the elderly population have been proposed. Here we suggest a novel categorization of gait disorders in elderly people, which takes into account the several resources required during gait. The biomechanical constraints, movement and sensory strategies, orientation in space, control of dynamics and cognitive processing are essential to perform safely gait. Moreover, the strictly connection between gait and balance has been discussed. According to this perspective, a literature search was performed including studies investigating the rehabilitation procedures in the management of balance and gait disorders in elderly people. Training aimed at improving muscle strength and flexibility, movement strategies, sensorimotor integration and sensory reweighting processes, balance in static and dynamic conditions and cognitive strategies have been proposed as possible therapeutic approaches in elderly people affected by gait disorders. Moreover, the role of new technological devices in improving balance and gait control has been also described. A multidisciplinary and interdisciplinary approach is fundamental for the management of gait disorders in elderly people. Rehabilitation procedures should take into consideration all the potential constraints involved in gait disorders in order to select the most appropriate intervention.
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Affiliation(s)
- M Gandolfi
- Department of Neurological, Biomedical and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy -
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17
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Stocchi F, Antonini A, Barone P, Tinazzi M, Zappia M, Onofrj M, Ruggieri S, Morgante L, Bonuccelli U, Lopiano L, Pramstaller P, Albanese A, Attar M, Posocco V, Colombo D, Abbruzzese G. Corrigendum to “Early detection of wearing off in Parkinson disease: The DEEP study” [Parkinsonism Relat Disorder 20 (2014) 204–211]. Parkinsonism Relat Disord 2015. [DOI: 10.1016/j.parkreldis.2015.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Barone P, Santangelo G, Morgante L, Onofrj M, Meco G, Abbruzzese G, Bonuccelli U, Cossu G, Pezzoli G, Stanzione P, Lopiano L, Antonini A, Tinazzi M. A randomized clinical trial to evaluate the effects of rasagiline on depressive symptoms in non-demented Parkinson's disease patients. Eur J Neurol 2015; 22:1184-91. [PMID: 25962410 PMCID: PMC4676931 DOI: 10.1111/ene.12724] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 02/26/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Depressed mood is a common psychiatric problem associated with Parkinson's disease (PD), and studies have suggested a benefit of rasagiline treatment. METHODS ACCORDO (see the ) was a 12-week, double-blind, placebo-controlled trial to evaluate the effects of rasagiline 1 mg/day on depressive symptoms and cognition in non-demented PD patients with depressive symptoms. The primary efficacy variable was the change from baseline to week 12 in depressive symptoms measured by the Beck Depression Inventory (BDI-IA) total score. Secondary outcomes included change from baseline to week 12 in cognitive function as assessed by a comprehensive neuropsychological battery; Parkinson's disease quality of life questionnaire (PDQ-39) scores; Apathy Scale scores; and Unified Parkinson's Disease Rating Scale (UPDRS) subscores. RESULTS One hundred and twenty-three patients were randomized. At week 12 there was no significant difference between groups for the reduction in total BDI-IA score (primary efficacy variable). However, analysis at week 4 did show a significant difference in favour of rasagiline (marginal means difference ± SE: rasagiline -5.46 ± 0.73 vs. placebo -3.22 ± 0.67; P = 0.026). There were no significant differences between groups on any cognitive test. Rasagiline significantly improved UPDRS Parts I (P = 0.03) and II (P = 0.003) scores versus placebo at week 12. Post hoc analyses showed the statistical superiority of rasagiline versus placebo in the UPDRS Part I depression item (P = 0.04) and PDQ-39 mobility (P = 0.007) and cognition domains (P = 0.026). CONCLUSIONS Treatment with rasagiline did not have significant effects versus placebo on depressive symptoms or cognition in PD patients with moderate depressive symptoms. Although limited by lack of correction for multiple comparisons, post hoc analyses signalled some improvement in patient-rated cognitive and depression outcomes.
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Affiliation(s)
- P Barone
- University of Salerno, Baronissi, Italy
| | | | | | - M Onofrj
- University of Chieti-Pescara, Chieti, Italy
| | - G Meco
- 'Sapienza' University of Rome, Rome, Italy
| | | | | | | | | | | | | | - A Antonini
- IRCCS Ospedale San Camillo, Venice, Italy
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19
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Amboni M, Stocchi F, Abbruzzese G, Morgante L, Onofrj M, Ruggieri S, Tinazzi M, Zappia M, Attar M, Colombo D, Simoni L, Ori A, Barone P, Antonini A. Prevalence and associated features of self-reported freezing of gait in Parkinson disease: The DEEP FOG study. Parkinsonism Relat Disord 2015; 21:644-9. [PMID: 25899545 DOI: 10.1016/j.parkreldis.2015.03.028] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 11/28/2022]
Abstract
Freezing of Gait (FOG) is a common and disabling symptom in patients with Parkinson disease (PD). The relationship between FOG and dopaminergic medication is complex. The aim of the present study was to estimate the prevalence of self-reported FOG, its associated clinical features, and its relationship with wearing-off in a wide PD population. This is an observational multicenter study of 634 consecutive non-demented PD patients. Patients were identified either as freezers or non-freezers based on item-3 of the Freezing of Gait-Questionnaire. FOG was then classified as on, off and onoff freezing based on its relationship with wearing-off. Patients were assessed with Unified Parkinson's Disease Rating Scale, Hoehn and Yahr scale, 8-item Parkinson's disease Questionnaire, Mini-Mental State Examination. Data from 593 patients were analyzed, 325 (54.3%) were freezers of whom 200 (61.6%) experienced FOG only during off state (off-freezers), 6 (1.8%) only during on state and 119 (36.6%) either in on and off states or independently of dopaminergic response-related symptoms (onoff-freezers). Overall, freezers vs non-freezers had longer disease duration, more advanced disease and greater disability. Moreover, freezers more frequently reported wearing-off and experienced worse quality of life. Onoff-freezers vs off-freezers were older, more severely disabled, less likely to experience wearing-off, treated with lower levodopa equivalent daily dose and with poorer cognitive performance. Self-reported FOG is mainly recognizable in advanced PD and is associated with more disability and worse quality of life. Onoff-FOG may represent the result of under-treatment or rather interpretable as a distinct clinical entity.
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Affiliation(s)
- M Amboni
- IDC Hermitage-Capodimonte - Napoli, Italy; Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
| | - F Stocchi
- Department of Neurology, Institute of Research and Medical Care, IRCCS San Raffaele, Rome, Italy.
| | - G Abbruzzese
- Department of Neurosciences, University of Genoa, Genoa, Italy.
| | - L Morgante
- Department of Neurosciences University of Messina, Messina, Italy.
| | - M Onofrj
- CeSI-Centro Studi Invecchiamento Fondazione Università Gabriele D'Annunzio, Chieti, Italy.
| | - S Ruggieri
- Neurologia Istituto Mediterraneo Neuromed, Isernia, Italy.
| | - M Tinazzi
- U.O. Neurologia Ospedale Civile Maggiore, Borgo Trento, Verona, Italy.
| | - M Zappia
- Clinica Neurologica I Policlinico Universitario, Catania, Italy.
| | - M Attar
- Novartis Pharma Italia, Medical Department, Origgio, Italy.
| | - D Colombo
- Novartis Pharma Italia, Medical Department, Origgio, Italy.
| | | | - A Ori
- Medidata srl, Modena, Italy.
| | - P Barone
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
| | - A Antonini
- Department for Parkinson's Disease, IRCCS San Camillo, Venice, Italy.
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20
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Squintani G, Turri M, Donato F, Tinazzi M, Masotto B, Tramontano V, Talacchi A, Sala F, Moretto G, Valeriani M. Trigeminal laser-evoked potentials: A neurophysiological tool to detect post-surgical outcome in trigeminovascular contact neuralgia. Eur J Pain 2014; 19:253-9. [DOI: 10.1002/ejp.543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/11/2022]
Affiliation(s)
- G. Squintani
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - M. Turri
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences; Section of Clinical Neurology; University of Verona; Italy
| | - F. Donato
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
- Department of Pharmacology; University of Messina; Italy
| | - M. Tinazzi
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences; Section of Clinical Neurology; University of Verona; Italy
| | - B. Masotto
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - V. Tramontano
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - A. Talacchi
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - F. Sala
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - G. Moretto
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - M. Valeriani
- Department of Neuroscience; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Denmark
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21
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Tinazzi M. S85: Deficiency of inhibition in sensory function. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50084-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Brigo F, Matinella A, Erro R, Tinazzi M. [¹²³I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis. Eur J Neurol 2014; 21:1369-e90. [PMID: 24779862 DOI: 10.1111/ene.12444] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [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: 11/19/2013] [Accepted: 03/03/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating idiopathic Parkinson's disease from secondary parkinsonian syndromes is crucial since their management and prognosis differ considerably. Functional imaging of the dopaminergic pathway by means of [¹²³I]FP-CIT SPECT (DaTSCAN) might be useful in this regard, but its role is still controversial. The accuracy of DaTSCAN in the differential diagnosis between Parkinson's disease and vascular or drug-induced parkinsonism was therefore systematically reviewed. METHODS MEDLINE and CENTRAL were searched for studies aiming to determine accuracy measures (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism. RESULTS Five studies were included. Pooled accuracy measures in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism were relatively high, with sensitivity and specificity values above 85% and 80%, respectively. CONCLUSIONS DaTSCAN might accurately differentiate between early Parkinson's disease and secondary parkinsonian conditions, namely vascular or drug-induced, in patients with clinically unclear parkinsonism. However, all the studies reviewed here show several methodological limits, which prevent definitive conclusions on the role of DaTSCAN being drawn in this context. Further studies are needed to confirm our results and definitely evaluate the utility of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism.
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Affiliation(s)
- F Brigo
- Divisione di Neurologia, Ospedale 'Franz Tappeiner', Merano, Italy; Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy
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23
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Stocchi F, Antonini A, Barone P, Tinazzi M, Zappia M, Onofrj M, Ruggieri S, Morgante L, Bonuccelli U, Lopiano L, Pramstaller P, Albanese A, Attar M, Posocco V, Colombo D, Abbruzzese G. Early DEtection of wEaring off in Parkinson disease: The DEEP study. Parkinsonism Relat Disord 2014; 20:204-11. [DOI: 10.1016/j.parkreldis.2013.10.027] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 10/23/2013] [Accepted: 10/25/2013] [Indexed: 11/25/2022]
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Fiorio M, Recchia S, Corrà F, Tinazzi M. Behavioral and neurophysiological investigation of the influence of verbal suggestion on tactile perception. Neuroscience 2014; 258:332-9. [DOI: 10.1016/j.neuroscience.2013.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/19/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
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Affiliation(s)
- G. Defazio
- Department of Basic Medical Sciences; Neurosciences and Sense Organs; ‘Aldo Moro’ University of Bari; Bari Italy
| | - M. Tinazzi
- Department of Neurological, Neuropsychological, Morphological and Motor Sciences; University of Verona; Verona Italy
| | - A. Berardelli
- Department of Neurology and Psychiatry; Sapienza University of Rome and Neuromed Institute; IRCCS; Rome Italy
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26
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Brigo F, Bovi T, Ferigo L, Musso A, Gambina G, Tinazzi M, Moretto G, Fiaschi A, Squintani G. Head drop in progressive supranuclear palsy: an unusual association with amyotrophic lateral sclerosis. Parkinsonism Relat Disord 2012; 19:467-8. [PMID: 23102427 DOI: 10.1016/j.parkreldis.2012.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 09/24/2012] [Accepted: 10/01/2012] [Indexed: 11/17/2022]
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Fiorio M, Recchia S, Corrà F, Simonetto S, Garcia-Larrea L, Tinazzi M. Enhancing non-noxious perception: behavioural and neurophysiological correlates of a placebo-like manipulation. Neuroscience 2012; 217:96-104. [PMID: 22569155 DOI: 10.1016/j.neuroscience.2012.04.066] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 04/27/2012] [Accepted: 04/28/2012] [Indexed: 10/28/2022]
Abstract
Sensory perception can be influenced by cognitive functions like attention and expectation. An emblematic case of this is the placebo effect, where a reduction in pain perception can be obtained by inducing expectation of benefit following a treatment. The current study assessed the behavioural and brain activity correlates of a placebo procedure inducing an enhancement of non-noxious somatic sensation. An experimental group was verbally suggested and surreptitiously conditioned about the effect of an inert cream in enhancing tactile perception, while a control group was informed about the actual inefficacy of the cream. Both groups received non-noxious electric shocks activating A-Beta fibres on the right index finger, before and after application of the cream in the same site. The behavioural and neurophysiological effects of this procedure were measured by a numerical rating scale of subjective perception and by recording cortical and subcortical somatosensory-evoked potentials (SEPs). Although the intensity of stimulation was physically identical in the two sessions, the experimental group reported stronger tactile sensation after cream treatment than before. In parallel, the experimental group showed enhanced somatosensory cortical responses (N140, P200) after treatment, whereas subcortical and early-cortical SEP components did not change. We suggest that these findings reflect top-down modulation on tactile perception probably due to an interplay between expectation and attention and might rely on interactions between prefrontal and parietal brain regions.
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Affiliation(s)
- M Fiorio
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, I-37131 Verona, Italy.
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Squintani G, Bovi T, Ferigo L, Musso A, Ottaviani S, Moretto G, Morgante F, Tinazzi M. Efficacy of pregabalin in a case of stiff-person syndrome: Clinical and neurophysiological evidence. J Neurol Sci 2012; 314:166-8. [DOI: 10.1016/j.jns.2011.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 10/10/2011] [Accepted: 10/18/2011] [Indexed: 11/30/2022]
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Morgante F, Tinazzi M, Squintani G, Martino D, Defazio G, Romito L, Albanese A, Di Matteo A, Quartarone A, Girlanda P, Fiorio M, Berardelli A. Abnormal tactile temporal discrimination in psychogenic dystonia. Neurology 2011; 77:1191-7. [DOI: 10.1212/wnl.0b013e31822f0449] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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30
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Defazio G, Abbruzzese G, Aniello MS, Bloise M, Crisci C, Eleopra R, Fabbrini G, Girlanda P, Liguori R, Macerollo A, Marinelli L, Martino D, Morgante F, Santoro L, Tinazzi M, Berardelli A. Environmental risk factors and clinical phenotype in familial and sporadic primary blepharospasm. Neurology 2011; 77:631-7. [PMID: 21775731 DOI: 10.1212/wnl.0b013e3182299e13] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although environmental and genetic factors may contribute to the etiology of blepharospasm, their relative contribution in causing familial and sporadic blepharospasm is unknown. METHODS First-degree relatives of 122 patients with primary blepharospasm were examined with a validated 2-step diagnostic procedure, including a screening questionnaire and examination of some relatives. Examiners were blinded to the questionnaire data for family history of probands. Data for demographic and clinical features, prior ophthalmologic complaints, and nondecaffeinated coffee intake were collected from probands before family investigation. RESULTS Dystonia was diagnosed in 27 relatives from 23 families (20% rate of family history for dystonia). No significant differences were found between familial and sporadic cases in the frequency of coffee drinking and eye diseases or in sex, age at onset, or tendency to spread. Multivariable conditional logistic analysis testing of 67 case patients and 127 family-matched unaffected siblings yielded a significant positive association between blepharospasm and prior eye diseases (adjusted odds ratio [OR] 2.5; 95% confidence interval [CI] 1.1-6.1; p = 0.03) and a significant inverse association between case status and ever coffee drinking (adjusted OR 0.23; 95% CI 0.1-0.8; p = 0.02). CONCLUSIONS The new information from this large family-based study on primary blepharospasm strongly supports eye diseases and coffee as risk factors for blepharospasm. The finding that the 2 environmental exposures exerted a similar influence on familial and sporadic blepharospasm, together with the convergent phenotypic expression in familial and sporadic cases, implies that familial and sporadic blepharospasm probably share a common etiologic background.
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Affiliation(s)
- G Defazio
- Department of Neurologic and Psychiatric Sciences and School of Motor Sciences, Aldo Moro University of Bari, Bari, Italy.
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31
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Fasano A, Di Matteo A, Squintani G, Ricciardi L, Bovi T, Fiaschi A, Barone P, Tinazzi M. P6.18 Pisa Syndrome in Parkinson's disease: EMG features disclose two different underlying pathophysiological mechanisms. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60307-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Le Pera D, Di Cesare A, De Armas L, Stocchi F, Tinazzi M, Valeriani M. S16.5 Neurophysiological evaluation of pain pathways in Parkinson's disease. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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33
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Morgante F, Fiorio M, Squintani G, Romito L, Albanese A, Martino D, Defazio G, Di Matteo A, Quartarone A, Girlanda P, Berardelli A, Tinazzi M. W2.3 Somatosensory dysfunction in psychogenic dystonia. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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34
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Fiorio M, Cesari P, Bresciani M, Tinazzi M. Expertise with pathological actions modulates a viewer's motor system. Neuroscience 2010; 167:691-9. [DOI: 10.1016/j.neuroscience.2010.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 02/03/2010] [Accepted: 02/04/2010] [Indexed: 11/29/2022]
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Walter M, Bonin M, Pullman RS, Valente EM, Loi M, Gambarin M, Raymond D, Tinazzi M, Kamm C, Glöckle N, Poths S, Gasser T, Bressman SB, Klein C, Ozelius LJ, Riess O, Grundmann K. Expression profiling in peripheral blood reveals signature for penetrance in DYT1 dystonia. Neurobiol Dis 2010; 38:192-200. [PMID: 20053375 DOI: 10.1016/j.nbd.2009.12.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 12/14/2009] [Accepted: 12/20/2009] [Indexed: 11/27/2022] Open
Abstract
DYT1 dystonia is an autosomal-dominantly inherited movement disorder, which is usually caused by a GAG deletion in the TOR1A gene. Due to the reduced penetrance of approximately 30-40%, the determination of the mutation in a subject is of limited use with regard to actual manifestation of symptoms. In the present study, we used Affymetrix oligonucleotide microarrays to analyze global gene expression in blood samples of 15 manifesting and 15 non-manifesting mutation carriers in order to identify a susceptibility profile beyond the GAG deletion which is associated with the manifestation of symptoms in DYT1 dystonia. We identified a genetic signature which distinguished between asymptomatic mutation carriers and symptomatic DYT1 patients with 86.7% sensitivity and 100% specificity. This genetic signature could correctly predict the disease state in an independent test set with a sensitivity of 87.5% and a specificity of 85.7%. Conclusively, this genetic signature might provide a possibility to distinguish DYT1 patients from asymptomatic mutation carriers.
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Affiliation(s)
- M Walter
- Department of Medical Genetics, Institute of Human Genetics, University of Tuebingen, Tuebingen, Germany
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Smania N, Aglioti SM, Cosentino A, Camin M, Gandolfi M, Tinazzi M, Fiaschi A, Faccioli S. A modified constraint-induced movement therapy (CIT) program improves paretic arm use and function in children with cerebral palsy. Eur J Phys Rehabil Med 2009; 45:493-500. [PMID: 20032907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Constraint-induced movement therapy (CIT) is a rehabilitation intervention put forward by Taub and colleagues for sensorimotor disorders in children with hemiparesis, comprising consisting of the restraint of the unaffected arm and concurrent intensive training of the affected arm for six hours/day for two weeks. The aim of this study was to evaluate the effectiveness of a modified CIT program (mCIT) characterized by restraining the unaffected hand with a cotton mitten during daily activities and a reduced intensity training program for two h/week for five weeks. METHODS Ten children (age: 1-9 years) with hemiparetic cerebral palsy were enrolled in a randomized, cross-over study in which the effects of a mCIT and a conventional physiotherapy program were compared. The amount of use and the functional performance of the affected arm were evaluated by means of two specifically devised tests (Use and Function Test). A further test evaluated functional performance during bimanual tasks. These measures showed a good inter-rater and inter-session reliability. All tests were administered before, at the end and four weeks after treatment. RESULTS Significant differences between the two therapeutic approaches were evidenced in both affected arm use (P=0.008) and function (P=0.018). These improvements maintained at the follow-up (Use Test P=0.07; paretic arm function P=0.012). Bimanual function performance showed a trend towards improvement in both post-treatment and follow-up testing. The conventional physiotherapy group did not show any improvement in any outcome measure. CONCLUSIONS The mCIT program proposed in the present study showed to be a promising rehabilitative procedure in children with congenital arm paresis after cerebral palsy.
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Affiliation(s)
- N Smania
- Department of Neurological and Vision Sciences, University of Verona, Verona, Italy.
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Scontrini A, Conte A, Defazio G, Fiorio M, Fabbrini G, Suppa A, Tinazzi M, Berardelli A. Somatosensory temporal discrimination in patients with primary focal dystonia. J Neurol Neurosurg Psychiatry 2009; 80:1315-9. [PMID: 19541688 DOI: 10.1136/jnnp.2009.178236] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSES To determine whether somatosensory temporal discrimination will reliably detect subclinical sensory impairment in patients with various forms of primary focal dystonia. METHODS The somatosensory temporal discrimination threshold (STDT) was tested in 82 outpatients affected by cranial, cervical, laryngeal and hand dystonia. Results were compared with those for 61 healthy subjects and 26 patients with hemifacial spasm, a non-dystonic disorder. STDT was tested by delivering paired stimuli starting with an interstimulus interval of 0 ms followed by a progressively increasing interstimulus interval. RESULTS STDT was abnormal in all the different forms of primary focal dystonias in all three body regions (eye, hand and neck), regardless of the distribution and severity of motor symptoms. Receiver operating characteristic curve analysis calculated in the three body regions yielded high diagnostic sensitivity and specificity for STDT abnormalities. CONCLUSIONS These results provide definitive evidence that STDT abnormalities are a generalised feature of patients with primary focal dystonias and are a valid tool for screening subclinical sensory abnormalities.
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Affiliation(s)
- A Scontrini
- Department of Neurological Sciences, Sapienza, University of Rome, Rome, Italy
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Smania N, Gambarin M, Tinazzi M, Picelli A, Fiaschi A, Moretto G, Bovi P, Paolucci S. Are indexes of arm recovery related to daily life autonomy in patients with stroke? Eur J Phys Rehabil Med 2009; 45:349-354. [PMID: 19396056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM The level of daily life autonomy in patients with stroke may be related to recovery of affected arm function. The aim of the study was to assess whether four simple bedside indexes of arm recovery can predict levels of autonomy in daily life activities. METHODS A consecutive sample of 48 patients presenting with upper limb paresis/plegia in the acute stage after stroke was selected. Patients underwent five evaluation sessions at 7, 14, 30, 90 and 180 days after stroke. Forward stepwise multiple regression analysis was used to clarify the role of four potential predictors of upper limb recovery (active finger extension, shoulder abduction, shoulder shrug and hand movement scales). Dependent variables in these models were the Barthel Index score and sub-items of the Burke-Fahn-Marsden Scale. RESULTS The active finger extension scale showed a highly significant statistical correlation with patient performance in nearly all outcome measures. The shoulder shrug correlated with the BI score, and with the dressing and hygiene Burke-Fahn-Marsden Scale sub-items. Shoulder abduction and hand movement scale played only a minor role. CONCLUSIONS The active finger extension scale proved to be a strong early predictor of recovery of daily life autonomy in patients with stroke. This finding could be important in order to planning a specific rehabilitation treatment after the onset.
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Affiliation(s)
- N Smania
- Department of Neurological and Visual Sciences, University of Verona, Italy.
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Marceglia S, Fiorio M, Foffani G, Mrakic-Sposta S, Tiriticco M, Locatelli M, Caputo E, Tinazzi M, Priori A. Modulation of beta oscillations in the subthalamic area during action observation in Parkinson's disease. Neuroscience 2009; 161:1027-36. [DOI: 10.1016/j.neuroscience.2009.04.018] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 04/06/2009] [Accepted: 04/06/2009] [Indexed: 11/30/2022]
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40
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Draganski B, Schneider SA, Fiorio M, Klöppel S, Gambarin M, Tinazzi M, Ashburner J, Bhatia KP, Frackowiak RSJ. Genotype-phenotype interactions in primary dystonias revealed by differential changes in brain structure. Neuroimage 2009; 47:1141-7. [PMID: 19344776 PMCID: PMC2741581 DOI: 10.1016/j.neuroimage.2009.03.057] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Revised: 01/12/2009] [Accepted: 03/19/2009] [Indexed: 11/28/2022] Open
Abstract
Our understanding of how genotype determines phenotype in primary dystonia is limited. Familial young-onset primary dystonia is commonly due to the DYT1 gene mutation. A critical question, given the 30% penetrance of clinical symptoms in DYT1 mutation carriers, is why the same genotype leads to differential clinical expression and whether non-DYT1 adult-onset primary dystonia, with and without family history share pathophysiological mechanisms with DYT1 dystonia. This study examines the relationship between dystonic phenotype and the DYT1 gene mutation by monitoring whole-brain structure using voxel-based morphometry. We acquired magnetic resonance imaging data of symptomatic and asymptomatic DYT1 mutation carriers, of non-DYT1 primary dystonia patients, with and without family history and control subjects with normal DYT1 alleles. By crossing the factors genotype and phenotype we demonstrate a significant interaction in terms of brain anatomy confined to the basal ganglia bilaterally. The explanation for this effect differs according to both gene and dystonia status: non-DYT1 adult-onset dystonia patients and asymptomatic DYT1 carriers have significantly larger basal ganglia compared to healthy subjects and symptomatic DYT1 mutation carriers. There is a significant negative correlation between severity of dystonia and basal ganglia size in DYT1 mutation carriers. We propose that differential pathophysiological and compensatory mechanisms lead to brain structure changes in non-DYT1 primary adult-onset dystonias and DYT1 gene carriers. Given the range of age of onset, there may be differential genetic modulation of brain development that in turn determines clinical expression. Alternatively, a DYT1 gene dependent primary defect of motor circuit development may lead to stress-induced remodelling of the basal ganglia and hence dystonia.
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Affiliation(s)
- B Draganski
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, UCL, UK.
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41
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Fiorio M, Gambarin M, Defazio G, Valente EM, Stanzani C, Moretto G, Loi M, Soliveri P, Nardocci N, Albanese A, Fiaschi A, Tinazzi M. Impaired body movement representation in DYT1 mutation carriers. Clin Neurophysiol 2008; 119:1864-1869. [PMID: 18571468 DOI: 10.1016/j.clinph.2008.04.292] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 04/23/2008] [Accepted: 04/26/2008] [Indexed: 11/16/2022]
Affiliation(s)
- M Fiorio
- Department of Neurological and Vision Sciences, Section of Rehabilitative Neurology, University of Verona, Via Casorati 43, 37131 Verona, Italy.
| | - M Gambarin
- Department of Neurological and Vision Sciences, Section of Rehabilitative Neurology, University of Verona, Via Casorati 43, 37131 Verona, Italy
| | - G Defazio
- Institute of Neurology, University of Bari, Italy
| | - E M Valente
- IRCCS CSS, Mendel Institute, Rome, Italy; Operative Unit of Pediatric Genetics and Immunology, Department of Medical and Surgical Pediatric Sciences, University of Messina, Italy
| | - C Stanzani
- Department of Neurological and Vision Sciences, Section of Rehabilitative Neurology, University of Verona, Via Casorati 43, 37131 Verona, Italy
| | - G Moretto
- Neurology Unit, Borgo Trento Hospital, Verona, Italy
| | - M Loi
- Neuropsychiatry Department, G. Brotzu Hospital, Cagliari, Italy
| | - P Soliveri
- National Neurology Institute, "C. Besta", Milan, Italy
| | - N Nardocci
- National Neurology Institute, "C. Besta", Milan, Italy
| | - A Albanese
- National Neurology Institute, "C. Besta", Milan, Italy
| | - A Fiaschi
- Department of Neurological and Vision Sciences, Section of Rehabilitative Neurology, University of Verona, Via Casorati 43, 37131 Verona, Italy
| | - M Tinazzi
- Department of Neurological and Vision Sciences, Section of Rehabilitative Neurology, University of Verona, Via Casorati 43, 37131 Verona, Italy; Neurology Unit, Borgo Trento Hospital, Verona, Italy
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Fiorio M, Tinazzi M, Scontrini A, Stanzani C, Gambarin M, Fiaschi A, Moretto G, Fabbrini G, Berardelli A. Tactile temporal discrimination in patients with blepharospasm. J Neurol Neurosurg Psychiatry 2008; 79:796-8. [PMID: 17986501 DOI: 10.1136/jnnp.2007.131524] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [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] [Indexed: 11/04/2022]
Abstract
BACKGROUND Blepharospasm is an adult-onset focal dystonia that causes involuntary blinking and eyelid spasms. Studies have shown the presence of sensory deficits associated with dystonia. AIM To rule out any confounding effect of muscle spasms on sensory performance in affected and unaffected body regions of patients with blepharospasm and with hemifacial spasm. METHODS Participants (19 patients with blepharospasm, 19 patients with hemifacial spasm and 19 control subjects) were asked to discriminate between two stimuli that were either simultaneous or sequential (temporal discrimination threshold, TDT). Pairs of tactile stimuli were delivered with increasing or decreasing inter-stimulus intervals from 0 to 400 ms (in 10-ms steps) to the hands or on the skin over the orbicularis oculi muscle. RESULTS Tactile stimuli elicited similar TDTs in control subjects and patients with hemifacial spasm, but significantly higher TDTs in patients with blepharospasm, regardless of whether stimuli were applied to the orbicularis muscle or the hand. CONCLUSIONS As TDT was abnormal in unaffected body regions of patients with blepharospasm, and patients with hemifacial spasm processed tactile stimuli normally, TDT deficits in blepharospasm depend on central rather than peripheral factors. This study further supports the link between focal dystonia and impaired temporal processing of somatosensory inputs.
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Affiliation(s)
- M Fiorio
- Dipartimento di Scienze Neurologiche e della Visione, Sez. Neurologia Riabilitativa, Universitè di Verona, Via Casorati 43, 37131 Verona, Italy.
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Defazio G, Martino D, Abbruzzese G, Girlanda P, Tinazzi M, Fabbrini G, Colosimo C, Aniello MS, Avanzino L, Buccafusca M, Majorana G, Trompetto C, Livrea P, Berardelli A. Influence of coffee drinking and cigarette smoking on the risk of primary late onset blepharospasm: evidence from a multicentre case control study. J Neurol Neurosurg Psychiatry 2007; 78:877-9. [PMID: 17578856 PMCID: PMC2117757 DOI: 10.1136/jnnp.2007.119891] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 04/20/2007] [Accepted: 04/20/2007] [Indexed: 11/03/2022]
Abstract
Prior coffee and smoking habits were investigated in a multicentre case control study involving 166 patients presenting with primary late onset blepharospasm (BSP), 228 hospital control patients with primary hemifacial spasm and 187 population control subjects from five Italian centres. Information on age at disease onset, smoking and coffee drinking status at the reference age and average number of cups of coffee drunk/cigarettes smoked per day reached high and similar test-retest reproducibility in case and control patients. Unadjusted logistic regression analysis yielded a significant inverse association of prior coffee drinking and cigarette smoking with case status for the control groups. After adjustment for age, sex, referral centre, disease duration, years of schooling and ever coffee drinking/cigarette smoking, as appropriate, the smoking estimate lacked significance whereas the association of coffee intake and BSP did not (cases vs hospital control patients: OR 0.37 (95% CI 0.20 to 0.67); cases vs population control subjects: OR 0.44 (95% CI 0.23 to 0.85)). The strength of the inverse association between BSP and coffee intake tended to increase with the average number of cups drunk per day. There was a significant correlation between age of BSP onset and number of cups per day (adjusted regression coefficient 1.73; p = 0.001) whereas no correlation was found with number of packs of cigarettes per day. Coffee drinking may be inversely associated with the development of primary BSP and this association may partly depend on the amount consumed.
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Affiliation(s)
- G Defazio
- Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy.
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Smania N, Aglioti SM, Girardi F, Tinazzi M, Fiaschi A, Cosentino A, Corato E. Rehabilitation of limb apraxia improves daily life activities in patients with stroke. Neurology 2006; 67:2050-2. [PMID: 17159119 DOI: 10.1212/01.wnl.0000247279.63483.1f] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.
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Affiliation(s)
- N Smania
- Neuropsychological Rehabilitation Unit, G.B. Rossi University Hospital, Verona, Italy.
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Ottaviani S, Tinazzi M, Pasquin I, Nothdurfter W, Tomelleri G, Fincati E, Nordera G, Moretto G, Fiaschi A, Smania N, Giorgetti P, Antonini A. Comparative analysis of visual and semi-quantitative assessment of striatal [123I]FP-CIT-SPET binding in Parkinson's disease. Neurol Sci 2006; 27:397-401. [PMID: 17205224 DOI: 10.1007/s10072-006-0718-4] [Citation(s) in RCA: 29] [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] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 09/13/2006] [Indexed: 10/23/2022]
Abstract
We used qualitative visual assessment and semiquantitative measures of striatal DAT binding using [(123)I]FP-CIT-SPET in 85 patients with Parkinson's disease (PD). We compared these two assessments and their correlation with PD clinical progression. SPET imaging was visually classified by a nuclear medicine physician as normal or abnormal pattern grade I, II and III, in relation to a different degree of radioligand reduction uptake. Nineteen patients presented abnormal grade I (group 1), 53 grade II (group 2) and 13 grade III (group 3). The UPDRS III motor score, the H-Y score, the rigidity and bradykinesia subscores were significantly different among the three groups. Post hoc analysis showed that all values of these clinical parameters were higher in group 3 than in 2 and 1. All clinical indices were also significantly higher in group 2 than in group 1. This means that groups 3 and 2 were clinically more severely affected. No significant differences among the 3 groups were observed for age or duration of disease. Values of the mean striatum uptake were also significantly different among the three groups. Post hoc analysis revealed significantly lower values of the mean striatum uptake in group 3 with respect to groups 2 and 1; values were also significantly lower in group 2 than in group 1. We conclude that our findings of good consistency between visual and semi-quantitative assessment may help simplify the evaluation of striatal DAT binding in PD in a clinical routine setting.
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Affiliation(s)
- S Ottaviani
- Unità Operativa Neurologia, Ospedale Civile Borgo Trento, Piazzale Stefani 1, I-37100, Verona, Italy.
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Le Pera D, Armas LD, Tinazzi M, Restuccia D, Arendt-Nielsen L, Valeriani M. P17.1 Short-term changes of the human nociceptive system induced by experimental cutaneous, subcutaneous and muscle tonic pain. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tinazzi M, Del Vesco C, Fincati E, Ottaviani S, Smania N, Moretto G, Fiaschi A, Martino D, Defazio G. Pain and motor complications in Parkinson's disease. J Neurol Neurosurg Psychiatry 2006; 77:822-5. [PMID: 16549416 PMCID: PMC2117476 DOI: 10.1136/jnnp.2005.079053] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.6] [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] [Indexed: 11/04/2022]
Abstract
AIMS To study the association of pain with motor complications in 117 patients with Parkinson's disease. METHODS Patients were asked to refer any pain they experienced at the time of study and lasting since at least 2 months. Basic parkinsonian signs and motor complications (including motor fluctuations and dyskinesia) were assessed and Unified Parkinson's Disease Rating Scale (UPDRS) motor score part III (during on) and part IV were calculated. Information on age, sex, duration of disease, use of dopamine agonists and levodopa, years of levodopa treatment and current levodopa dosage, medical conditions possibly associated with pain, and depression were collected. Single and multiple explanatory variable logistic regression models were used to check the association of pain with the investigated variables. RESULTS Pain was described by 47 patients (40%) and could be classified into dystonic (n.19) and non dystonic pain (n.16); in 12 patients both types coexisted. Multiple explanatory variable logistic regression models indicated a significant association of pain with motor complications (adjusted OR, 5.7; 95% CI, 2 to 16.5; p = 0.001). No association was found between pain, dystonic or non dystonic, and the other investigated variables including medical conditions known to be associated to pain in the general population. There was a significant correlation (r = 0.31, p<0.05) between severity of pain (measured on a Visual Analogue Scale) and severity of motor complications (UPDRS part IV). CONCLUSIONS Pain may be a representative feature of Parkinson's disease frequently associated with motor complications. The association is independent of a number of potentially relevant demographic and clinical variables.
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Affiliation(s)
- M Tinazzi
- Dipartimento di Scienze Neurologiche e della Visione, Sezione di Neurologia Riabilitativa, Università di Verona, Verona, Italy.
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Bonifati V, Rohé CF, Breedveld GJ, Fabrizio E, De Mari M, Tassorelli C, Tavella A, Marconi R, Nicholl DJ, Chien HF, Fincati E, Abbruzzese G, Marini P, De Gaetano A, Horstink MW, Maat-Kievit JA, Sampaio C, Antonini A, Stocchi F, Montagna P, Toni V, Guidi M, Dalla Libera A, Tinazzi M, De Pandis F, Fabbrini G, Goldwurm S, de Klein A, Barbosa E, Lopiano L, Martignoni E, Lamberti P, Vanacore N, Meco G, Oostra BA. Early-onset parkinsonism associated with PINK1 mutations: frequency, genotypes, and phenotypes. Neurology 2006; 65:87-95. [PMID: 16009891 DOI: 10.1212/01.wnl.0000167546.39375.82] [Citation(s) in RCA: 255] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the prevalence, nature, and associated phenotypes of PINK1 gene mutations in a large series of patients with early-onset (<50 years) parkinsonism. METHODS The authors studied 134 patients (116 sporadic and 18 familial; 77% Italian) and 90 Italian controls. The whole PINK1 coding region was sequenced from genomic DNA; cDNA was analyzed in selected cases. RESULTS Homozygous pathogenic mutations were identified in 4 of 90 Italian sporadic cases, including the novel Gln456Stop mutation; single heterozygous truncating or missense mutations were found in another 4 Italian sporadic cases, including two novel mutations, Pro196Leu and Gln456Stop. Pathogenic mutations were not identified in the familial cases. Novel (Gln115Leu) and known polymorphisms were identified with similar frequency in cases and controls. In cases carrying single heterozygous mutation, cDNA analysis detected no additional mutations, and revealed a major pathogenic effect at mRNA level for the mutant C1366T/Gln456Stop allele. All patients with homozygous mutations had very early disease onset, slow progression, and excellent response to l-dopa, including, in some, symmetric onset, dystonia at onset, and sleep benefit, resembling parkin-related disease. Phenotype in patients with single heterozygous mutation was similar, but onset was later. CONCLUSIONS PINK1 homozygous mutations are a relevant cause of disease among Italian sporadic patients with early-onset parkinsonism. The role of mutations found in single heterozygous state is difficult to interpret. Our study suggests that, at least in some patients, these mutations are disease causing, in combination with additional, still unknown factors.
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Affiliation(s)
- V Bonifati
- Department of Clinical Genetics, Erasmus MC Rotterdam, The Netherlands.
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Valeriani M, Tonali P, Le Pera D, Restuccia D, De Armas L, Del Vesco C, Miliucci R, Fiaschi A, Vigevano F, Arendt-Nielsen L, Tinazzi M. Modulation of laser-evoked potentials by experimental cutaneous tonic pain. Neuroscience 2006; 140:1301-10. [PMID: 16626874 DOI: 10.1016/j.neuroscience.2006.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2005] [Revised: 02/14/2006] [Accepted: 03/05/2006] [Indexed: 02/08/2023]
Abstract
The present study aimed to investigate whether tonic cutaneous pain exerts any effect on the cortical processing of nociceptive input and if this effect may involve only body parts in pain. Tonic cutaneous pain was obtained in nine healthy human subjects by infusion of a hypertonic saline (5%) in the s.c. tissue over the hypothenar muscles (10 ml/h for 20 min). Nociceptive cutaneous CO2 laser-evoked potentials were recorded after stimulation of the right hand dorsum, which was adjacent to the painful area, and the right perioral region, corresponding to the adjacent cortical sensory area. Laser-evoked potentials were obtained before saline injection, at the peak pain and 20 min after pain disappeared. During saline infusion, the laser-evoked pain to right hand stimulation was reduced and the vertex laser-evoked potentials (N2a-P2, mean latency 181 ms and 319 ms for the N2a and the P2 potentials, respectively), which are generated in the anterior cingulate cortex, were significantly decreased in amplitude compared with the baseline. Moreover, the topography of these potentials was modified by cutaneous pain, shifting from the central toward the parietal region. Dipolar modeling showed that the dipolar source in the anterior cingulate cortex moved backward during saline infusion. This result suggests that cutaneous pain may modify the relative activities of the anterior and posterior anterior cingulate cortex parts, which are thought to be devoted to encode different aspects of pain sensation. No laser-evoked potential change was observed after stimulation of the right perioral region, suggesting that functional changes in the nociceptive system are selective for the painful regions and not for areas with cortical proximity.
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Affiliation(s)
- M Valeriani
- Divisione di Neurologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Piazza Sant'Onofrio 4, 00165 Roma, Italy.
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Tinazzi M, Farina S, Bhatia K, Fiaschi A, Moretto G, Bertolasi L, Zarattini S, Smania N. TENS for the treatment of writer's cramp dystonia: A randomized, placebo-controlled study. Neurology 2005; 64:1946-8. [PMID: 15955950 DOI: 10.1212/01.wnl.0000163851.70927.7e] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Manipulation of afferent inputs may temporarily modulate dystonic spasms. Ten patients with writer's cramp were enrolled in a double-blind, randomized, crossover study in which the effects of transcutaneous electrical stimulation (TENS) and placebo treatment were compared. Patients were evaluated using four measures of dystonic impairment. The TENS group showed a significant improvement that persisted for 3 weeks in three of the four measures.
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Affiliation(s)
- M Tinazzi
- Unità Operativa di Neurologia, Azienda Ospedaliera di Verona, Verona, Italy.
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