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Latorre A, Rocchi L, Paparella G, Manzo N, Bhatia KP, Rothwell JC. Changes in cerebellar output abnormally modulate cortical myoclonus sensorimotor hyperexcitability. Brain 2024; 147:1412-1422. [PMID: 37956080 PMCID: PMC10994547 DOI: 10.1093/brain/awad384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/07/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Cortical myoclonus is produced by abnormal neuronal discharges within the sensorimotor cortex, as demonstrated by electrophysiology. Our hypothesis is that the loss of cerebellar inhibitory control over the motor cortex, via cerebello-thalamo-cortical connections, could induce the increased sensorimotor cortical excitability that eventually causes cortical myoclonus. To explore this hypothesis, in the present study we applied anodal transcranial direct current stimulation over the cerebellum of patients affected by cortical myoclonus and healthy controls and assessed its effect on sensorimotor cortex excitability. We expected that anodal cerebellar transcranial direct current stimulation would increase the inhibitory cerebellar drive to the motor cortex and therefore reduce the sensorimotor cortex hyperexcitability observed in cortical myoclonus. Ten patients affected by cortical myoclonus of various aetiology and 10 aged-matched healthy control subjects were included in the study. All participants underwent somatosensory evoked potentials, long-latency reflexes and short-interval intracortical inhibition recording at baseline and immediately after 20 min session of cerebellar anodal transcranial direct current stimulation. In patients, myoclonus was recorded by the means of surface EMG before and after the cerebellar stimulation. Anodal cerebellar transcranial direct current stimulation did not change the above variables in healthy controls, while it significantly increased the amplitude of somatosensory evoked potential cortical components, long-latency reflexes and decreased short-interval intracortical inhibition in patients; alongside, a trend towards worsening of the myoclonus after the cerebellar stimulation was observed. Interestingly, when dividing patients in those with and without giant somatosensory evoked potentials, the increment of the somatosensory evoked potential cortical components was observed mainly in those with giant potentials. Our data showed that anodal cerebellar transcranial direct current stimulation facilitates-and does not inhibit-sensorimotor cortex excitability in cortical myoclonus syndromes. This paradoxical response might be due to an abnormal homeostatic plasticity within the sensorimotor cortex, driven by dysfunctional cerebello-thalamo-cortical input to the motor cortex. We suggest that the cerebellum is implicated in the pathophysiology of cortical myoclonus and that these results could open the way to new forms of treatment or treatment targets.
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Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari 09042, Italy
| | - Giulia Paparella
- Department of Neurology, IRCCS Neuromed, Pozzilli, IS 86077, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Italy
| | - Nicoletta Manzo
- Department of Neurology, IRCCS San Camillo Hospital, Venice 30126, Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
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Parrotta I, Cacciatore S, D'Andrea F, D'Anna M, Giancaterino G, Lazzaro G, Arcara G, Manzo N. Prevalence, treatment, and neural correlates of apathy in different forms of dementia: a narrative review. Neurol Sci 2024; 45:1343-1376. [PMID: 38015288 PMCID: PMC10942903 DOI: 10.1007/s10072-023-07197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES The aim of this review is to provide an overview on prevalence and clinical tools for the diagnosis of apathy, as well as on neurophysiological and neuroimaging findings obtained from studies in patients with apathy in different forms of dementia, including Alzheimer's disease (AD), vascular (VaD) and mixed dementia, frontotemporal dementia (FTD), and Parkinson's disease dementia (PDD). METHODS Randomized controlled trials, non-randomized controlled trials, controlled before-after studies, and interrupted time series from four databases (WebOfScience, Scopus, Pubmed, and PsycINFO) addressing apathy in adults or older people aged over 65 years of age affected by dementia were included. RESULTS The prevalence of apathy was 26-82% for AD, 28.6-91.7 for VaD, 29-97.5% in PDD, and 54.8-88.0 in FTD. The assessment of apathy was not consistent in the reviewed studies. Methylphenidate was the most successful pharmacological treatment for apathy. Neurobiological studies highlighted the relationship between both structural and functional brain areas and the presence or severity of apathy. CONCLUSION Apathy is a very common disorder in all types of dementia, although it is often underdiagnosed and undertreated. Further studies are needed to investigate its diagnosis and management. A consensus on the different evaluation scales should be achieved.
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Affiliation(s)
- Ilaria Parrotta
- Movement Control and Neuroplasticity Research Group, Tervuursevest 101, 3001, Louvain, Belgium
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
- Young Epidemiologists of the Italian Society of Gerontology and Geriatrics (SIGG) (YES) Working Group, Italian Society of Gerontology and Geriatrics, Via Giulio Cesare Vanini 5, 50129, Florence, Italy
| | - Stefano Cacciatore
- Young Epidemiologists of the Italian Society of Gerontology and Geriatrics (SIGG) (YES) Working Group, Italian Society of Gerontology and Geriatrics, Via Giulio Cesare Vanini 5, 50129, Florence, Italy.
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168, Rome, Italy.
| | - Flavio D'Andrea
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Marianna D'Anna
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giulia Giancaterino
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giovanni Lazzaro
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
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Ginatempo F, Manzo N, Spampinato DA, Loi N, Burgio F, Rothwell JC, Deriu F. A Novel Paired Somatosensory-Cerebellar Stimulation Induces Plasticity on Cerebellar-Brain Connectivity. Cerebellum 2023:10.1007/s12311-023-01622-5. [PMID: 37897625 DOI: 10.1007/s12311-023-01622-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
The cerebellum receives and integrates a large amount of sensory information that is important for motor coordination and learning. The aim of the present work was to investigate whether peripheral nerve and cerebellum paired associative stimulation (cPAS) could induce plasticity in both the cerebellum and the cortex. In a cross-over design, we delivered right median nerve electrical stimulation 25 or 10 ms before applying transcranial magnetic stimulation over the cerebellum. We assessed changes in motor evoked potentials (MEP), somatosensory evoked potentials (SEP), short-afferent inhibition (SAI), and cerebellum-brain inhibition (CBI) immediately, and 30 min after cPAS. Our results showed a significant reduction in CBI 30 minutes after cPAS, with no discernible changes in MEP, SEP, and SAI. Notably, cPAS10 did not produce any modulatory effects on these parameters. In summary, cPAS25 demonstrated the capacity to induce plasticity effects in the cerebellar cortex, leading to a reduction in CBI. This novel intervention may be used to modulate plasticity mechanisms and motor learning in healthy individuals and patients with neurological conditions.
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Affiliation(s)
- Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | | | - Danny A Spampinato
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Nicola Loi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | | | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
- Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU, Sassari, Sassari, Italy.
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Ginatempo F, Manzo N, Loi N, Belvisi D, Cutrona C, Conte A, Berardelli A, Deriu F. Abnormalities in the face primary motor cortex in oromandibular dystonia. Clin Neurophysiol 2023; 151:151-160. [PMID: 37150654 DOI: 10.1016/j.clinph.2023.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/17/2023] [Accepted: 04/15/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To comprehensively investigate excitability in face and hand M1 and sensorimotor integration in oromandibular dystonia (OMD) patients. METHODS Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), short (SAI) and long (LAI) afferent inhibition were investigated in face and hand M1 using transcranial magnetic stimulation protocols in 10 OMD patients. Data were compared with those obtained in 10 patients with focal hand dystonia (FHD), in 10 patients with blepharospasm (BSP), and 10 matched healthy subjects (HS). RESULTS Results demonstrated that in OMD patients SICI was reduced in face M1 (p < 0.001), but not in hand M1, compared to HS. In FHD, SICI was significantly impaired in hand M1 (p = 0.029), but not in face M1. In BSP, SICI was normal in both face and hand M1 while ICF and LAI were normal in all patient groups and cortical area tested. SAI was significantly reduced (p = 0.003) only in the face M1 of OMD patients. CONCLUSIONS In OMD, SICI and SAI were significantly reduced. These abnormalities are specific to the motor cortical area innervating the muscular district involved in focal dystonia. SIGNIFICANCE In OMD, the integration between sensory inflow and motor output seem to be disrupted at cortical level with topographic specificity.
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Affiliation(s)
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy; IRCCS San Camillo Hospital, Via Alberoni 70, Venice 30126, Italy
| | - Nicola Loi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy
| | - Carolina Cutrona
- Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy.
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Manzo N, Ginatempo F, Belvisi D, Arcara G, Parrotta I, Leodori G, Deriu F, Celletti C, Camerota F, Conte A. Investigating the Effects of a Focal Muscle Vibration Protocol on Sensorimotor Integration in Healthy Subjects. Brain Sci 2023; 13:brainsci13040664. [PMID: 37190629 DOI: 10.3390/brainsci13040664] [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: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Background: The ability to perceive two tactile stimuli as asynchronous can be measured using the somatosensory temporal discrimination threshold (STDT). In healthy humans, the execution of a voluntary movement determines an increase in STDT values, while the integration of STDT and movement execution is abnormal in patients with basal ganglia disorders. Sensorimotor integration can be modulated using focal muscle vibration (fMV), a neurophysiological approach that selectively activates proprioceptive afferents from the vibrated muscle. Method: In this study, we investigated whether fMV was able to modulate STDT or STDT-movement integration in healthy subjects by measuring them before, during and after fMV applied over the first dorsalis interosseous, abductor pollicis brevis and flexor radialis carpi muscles. Results: The results showed that fMV modulated STDT-movement integration only when applied over the first dorsalis interosseous, namely, the muscle performing the motor task involved in STDT-movement integration. These changes occurred during and up to 10 min after fMV. Differently, fMV did not influence STDT at rest. We suggest that that fMV interferes with the STDT-movement task processing, possibly disrupting the physiological processing of sensory information. Conclusions: This study showed that FMV is able to modulate STDT-movement integration when applied over the muscle involved in the motor task. This result provides further information on the mechanisms underlying fMV, and has potential future implications in basal ganglia disorders characterized by altered sensorimotor integration.
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Affiliation(s)
- Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Ilaria Parrotta
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
- Movement Contral and Neuroplasticity Research Group, Tervuursevest 101, 3001 Leuven, Belgium
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
- Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, 07100 Sassari, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
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De Bartolo MI, Vivacqua G, Belvisi D, Mancinelli R, Fabbrini A, Manzo N, Costanzo M, Leodori G, Conte A, Fabbrini G, Morini S, Berardelli A. A Combined Panel of Salivary Biomarkers in de novo Parkinson's Disease. Ann Neurol 2023; 93:446-459. [PMID: 36385395 DOI: 10.1002/ana.26550] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate molecular biomarkers of a-synuclein and tau aggregation, autophagy, and inflammation in the saliva of de novo Parkinson's disease (PD) patients in comparison to healthy subjects (HS), and to correlate molecular data with clinical features of PD patients, in order to establish whether abnormalities of these parameters are associated with specific clusters of de novo PD patients, and their potential diagnostic power in differentiating PD patients from HS. METHODS We measured total and oligomeric a-synuclein, total-tau and phosphorylated-tau, microtubule-associated protein light chain 3 beta (MAP-LC3beta), and tumor necrosis factor alpha (TNFalpha) in the saliva of 80 de novo PD patients and 62 HS, using quantitative enzyme-linked immunosorbent Assay analysis. RESULTS Oligomeric a-synuclein, total-tau, MAP-LC3beta, and TNFalpha levels resulted significantly higher in patients with respect to HS, while no significant differences were detected for total a-synuclein or phosphorylated-tau. Phosphorylated-tau directly correlated with MAP-LC3beta, whereas it inversely correlated with TNFalpha in PD patients. An inverse correlation was detected between MAP-LC3beta and non-motor symptoms severity. Principal Component Analysis showed that molecular and clinical parameters were independent of each other in de novo PD patients. Receiver operating characteristic curve analysis reported an accurate diagnostic performance of oligomeric a-synuclein and MAP-LC3beta. The diagnostic accuracy of total a-synuclein increased when it was combined with other salivary biomarkers targeting different molecular pathways. INTERPRETATION Our study proposes a novel biomarker panel using saliva, a non-invasive biofluid, in de novo PD patients, with implications in understanding the molecular pathways involved in PD pathogenesis and the relevance of different molecular pathways in determining clinical PD subtypes. ANN NEUROL 2023;93:446-459.
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Affiliation(s)
| | - Giorgio Vivacqua
- Department of Experimental Morphology and Microscopy - Integrated Research Center (PRAAB) - Campus Biomedico University of Rome, Rome, Italy.,Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Belvisi
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Romina Mancinelli
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS San Camillo Hospital, Venice, Italy
| | | | - Giorgio Leodori
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Sergio Morini
- Department of Experimental Morphology and Microscopy - Integrated Research Center (PRAAB) - Campus Biomedico University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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D’Onofrio V, Manzo N, Guerra A, Landi A, Baro V, Määttä S, Weis L, Porcaro C, Corbetta M, Antonini A, Ferreri F. Combining Transcranial Magnetic Stimulation and Deep Brain Stimulation: Current Knowledge, Relevance and Future Perspectives. Brain Sci 2023; 13:brainsci13020349. [PMID: 36831892 PMCID: PMC9954740 DOI: 10.3390/brainsci13020349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Deep brain stimulation (DBS) has emerged as an invasive neuromodulation technique for the treatment of several neurological disorders, but the mechanisms underlying its effects remain partially elusive. In this context, the application of Transcranial Magnetic Stimulation (TMS) in patients treated with DBS represents an intriguing approach to investigate the neurophysiology of cortico-basal networks. Experimental studies combining TMS and DBS that have been performed so far have mainly aimed to evaluate the effects of DBS on the cerebral cortex and thus to provide insights into DBS's mechanisms of action. The modulation of cortical excitability and plasticity by DBS is emerging as a potential contributor to its therapeutic effects. Moreover, pairing DBS and TMS stimuli could represent a method to induce cortical synaptic plasticity, the therapeutic potential of which is still unexplored. Furthermore, the advent of new DBS technologies and novel treatment targets will present new research opportunities and prospects to investigate brain networks. However, the application of the combined TMS-DBS approach is currently limited by safety concerns. In this review, we sought to present an overview of studies performed by combining TMS and DBS in neurological disorders, as well as available evidence and recommendations on the safety of their combination. Additionally, we outline perspectives for future research by highlighting knowledge gaps and possible novel applications of this approach.
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Affiliation(s)
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 0126 Venice, Italy
| | - Andrea Guerra
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Landi
- Academic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy
| | - Valentina Baro
- Academic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy
| | - Sara Määttä
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, 70211 Kuopio, Finland
| | - Luca Weis
- Parkinson’s Disease and Movement Disorders Unit, Department of Neuroscience, Centre for Rare Neurological Diseases (ERN-RND), University of Padova, 35128 Padova, Italy
| | - Camillo Porcaro
- Padova Neuroscience Center (PNC), University of Padova, 35129 Padova, Italy
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Institute of Cognitive Sciences, and Technologies (ISTC)-National Research Council (CNR), 00185 Rome, Italy
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Maurizio Corbetta
- Padova Neuroscience Center (PNC), University of Padova, 35129 Padova, Italy
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Venetian Institute of Molecular Medicine, 35129 Padova, Italy
| | - Angelo Antonini
- Parkinson’s Disease and Movement Disorders Unit, Department of Neuroscience, Centre for Rare Neurological Diseases (ERN-RND), University of Padova, 35128 Padova, Italy
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Department of Neurology, Washington University, St. Louis, MO 63108, USA
- Department of Neuroscience, Washington University, St. Louis, MO 63108, USA
- Correspondence: (A.A.); (F.F.)
| | - Florinda Ferreri
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, 70211 Kuopio, Finland
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Correspondence: (A.A.); (F.F.)
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8
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Pietracupa S, Belvisi D, Piervincenzi C, Tommasin S, Pasqua G, Petsas N, De Bartolo MI, Fabbrini A, Costanzo M, Manzo N, Berardelli A, Pantano P. White and gray matter alterations in de novo PD patients: which matter most? J Neurol 2023; 270:2734-2742. [PMID: 36773059 DOI: 10.1007/s00415-023-11607-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES This paper aimed to identify white matter (WM) and gray matter (GM) abnormalities in a sample of early PD patients, and their correlations with motor and non-motor symptom severity. METHODS We enrolled 62 de novo PD patients and 31 healthy subjects. Disease severity and non-motor symptom burden were assessed by the Unified Parkinson's Disease Rating Scale part III and the Non-Motor Symptoms Scale, respectively. Cognitive performance was assessed using Montreal Cognitive Assessment and Frontal Assessment Battery. All subjects underwent a 3-Tesla MRI protocol. MRI analyses included tract-based spatial statistics, cortical thickness, and subcortical and cerebellar volumetry. RESULTS In comparison to control subjects, PD patients exhibited lower fractional anisotropy and higher mean, axial, and radial diffusivity in most WM bundles, including corticospinal tracts, the internal and external capsule, the anterior and posterior thalamic radiations, the genu and body of the corpus callosum, cerebellar peduncles, and superior and inferior longitudinal and fronto-occipital fasciculi. Correlations between Montreal Cognitive Assessment scores and fractional anisotropy values in the right posterior thalamic radiation, left superior corona radiata, right inferior-fronto-occipital fasciculus, left inferior longitudinal fasciculus, bilateral anterior thalamic radiations, and bilateral superior longitudinal fasciculi were found. Smaller cerebellar volumes in early PD patients in the left and right crus I were also found. No GM changes were present in subcortical or cortical regions. CONCLUSION The combined evaluation of WM and GM in the same patient sample demonstrates that WM microstructural abnormalities precede GM structural changes in early PD patients.
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Affiliation(s)
| | - Daniele Belvisi
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | - Silvia Tommasin
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Gabriele Pasqua
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | | | - Andrea Fabbrini
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | | | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pantano
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
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9
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Manzo N, Leodori G, Ruocco G, Belvisi D, Merchant SHI, Fabbrini G, Berardelli A, Conte A. Cortical mechanisms of sensory trick in cervical dystonia. Neuroimage Clin 2023; 37:103348. [PMID: 36791488 PMCID: PMC9950946 DOI: 10.1016/j.nicl.2023.103348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/11/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
Patients with cervical dystonia (CD) often show an improvement in dystonic posture after sensory trick (ST), though the mechanisms underlying ST remain unclear. In this study, we aimed to investigate the effects of ST on cortical activity in patients with CD and to explore the contribution of motor and sensory components to ST mechanisms. To this purpose, we studied 15 CD patients with clinically effective ST, 17 without ST, and 14 healthy controls (HCs) who mimicked the ST. We used electroencephalographic (EEG) recordings and electromyography (EMG) data from bilateral sternocleidomastoid (SCM) muscles. We compared ST-related EEG spectral changes from sensorimotor and posterior parietal areas and EMG power changes between groups. To better understand the contribution of motor and sensory components to ST, we tested EEG and EMG correlates of three different conditions mimicking ST, the first without skin touch ("no touch" condition), the second without voluntary movements ("passive" condition), and finally without arm movements ("examiner touch" condition). Results showed ST-related alpha desynchronization in the sensorimotor cortex and theta desynchronization in the sensorimotor and posterior parietal cortex. Both spectral changes were more significant during maneuver execution in CD patients with ST than in CD patients without ST and HCs who mimicked the ST. Differently, the "no touch", "passive", or "examiner touch" conditions did not show significant differences in EEG or EMG changes determined by ST execution/mimicking between CD patients with or without ST. A higher desynchronization within alpha and theta bands in the sensorimotor and posterior parietal areas correlated with a more significant activity decrease in the contralateral SCM muscle, Findings from this study suggest that ST-related changes in the activity of sensorimotor and posterior parietal areas may restore dystonic posture and that both motor and sensory components contribute to the ST effect.
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Affiliation(s)
- Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS San Camillo Hospital, Via Alberoni 70, Venice 30126, Italy
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Giulia Ruocco
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | | | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy.
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
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Ferreri F, Francesca M, Fabrizio V, Manzo N, Maria C, Elda J, Rossini PM. EEG, ERPs, and EROs in patients with neurodegenerative dementing disorders: A window into the cortical neurophysiology of cognition and behavior. Int J Psychophysiol 2022; 181:85-94. [PMID: 36055410 DOI: 10.1016/j.ijpsycho.2022.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/20/2022] [Accepted: 08/18/2022] [Indexed: 10/31/2022]
Abstract
In the human brain, physiological aging is characterized by progressive neuronal loss, leading to disruption of synapses and to a degree of failure in neurotransmission and information flow. However, there is increasing evidence to support the notion that the aged brain has a remarkable level of resilience (i.s. ability to reorganize itself), with the aim of preserving its physiological activity. It is therefore of paramount interest to develop objective markers able to characterize the biological processes underlying brain aging in the intact human, and to distinguish them from brain degeneration associated to age-related neurological progressive diseases like Alzheimer's disease. EEG, alone and combined with transcranial magnetic stimulation (TMS-EEG), is particularly suited to this aim, due to the functional nature of the information provided, and thanks to the ease with which it can be integrated in ecological scenarios including behavioral tasks. In this review, we aimed to provide the reader with updated information about the role of modern methods of EEG and TMS-EEG analysis in the investigation of physiological brain aging and Alzheimer's disease. In particular, we focused on data about cortical connectivity obtained by using readouts such graph theory network brain organization and architecture, and transcranial evoked potentials (TEPs) during TMS-EEG. Overall, findings in the literature support an important potential contribution of such neurophysiological techniques to the understanding of the mechanisms underlying normal brain aging and the early (prodromal/pre-symptomatic) stages of dementia.
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Affiliation(s)
- Florinda Ferreri
- Unit of Neurology, Unit of Clinical Neurophysiology and Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy; Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Miraglia Francesca
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy; Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Como, Italy.
| | - Vecchio Fabrizio
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy; Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Como, Italy
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Lido di Venezia, Venice, Italy
| | - Cotelli Maria
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di DioFatebenefratelli, Brescia, Italy
| | - Judica Elda
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy
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Masina F, Montemurro S, Marino M, Manzo N, Pellegrino G, Arcara G. State-dependent tDCS modulation of the somatomotor network: A MEG study. Clin Neurophysiol 2022; 142:133-142. [PMID: 36037749 DOI: 10.1016/j.clinph.2022.07.508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Transcranial direct current stimulation (tDCS) is a non-invasive technique widely used to investigate brain excitability and activity. However, the variability in both brain and behavioral responses to tDCS limits its application for clinical purposes. This study aims to shed light on state-dependency, a phenomenon that contributes to the variability of tDCS. METHODS To this aim, we investigated changes in spectral activity and functional connectivity in somatomotor regions after Real and Sham tDCS using generalized additive mixed models (GAMMs), which allowed us to investigate how modulation depends on the initial state of the brain. RESULTS Results showed that changes in spectral activity, but not connectivity, in the somatomotor regions depend on the initial state of the brain, confirming state-dependent effects. Specifically, we found a non-linear interaction between stimulation conditions (Real vs Sham) and initial state: a reduction of alpha and beta power was observed only in participants that had higher alpha and beta power before Real tDCS. CONCLUSIONS This study highlights the importance of considering state-dependency to tDCS and shows how it can be taken into account with appropriate statistical models. SIGNIFICANCE Our findings bear insight into tDCS mechanisms, potentially leading to discriminate between tDCS responders and non-responders.
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Affiliation(s)
| | | | - Marco Marino
- IRCCS San Camillo Hospital, Venice, Italy; Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU Leuven, Belgium.
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Venice, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.
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Fabbrini A, Guerra A, Giangrosso M, Manzo N, Leodori G, Pasqualetti P, Conte A, Di Lazzaro V, Berardelli A. Transcranial alternating current stimulation modulates cortical processing of somatosensory information in a frequency- and time-specific manner. Neuroimage 2022; 254:119119. [PMID: 35321858 DOI: 10.1016/j.neuroimage.2022.119119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 10/28/2021] [Revised: 02/16/2022] [Accepted: 03/19/2022] [Indexed: 10/18/2022] Open
Abstract
Neural oscillations can be modulated by non-invasive brain stimulation techniques, including transcranial alternating current stimulation (tACS). However, direct evidence of tACS effects at the cortical level in humans is still limited. In a tACS-electroencephalography co-registration setup, we investigated the ability of tACS to modulate cortical somatosensory information processing as assessed by somatosensory-evoked potentials (SEPs). To better elucidate the neural substrates of possible tACS effects we also recorded peripheral and spinal SEPs components, high-frequency oscillations (HFOs), and long-latency reflexes (LLRs). Finally, we studied whether changes were limited to the stimulation period or persisted thereafter. SEPs, HFOs, and LLRs were recorded during tACS applied at individual mu and beta frequencies and at the theta frequency over the primary somatosensory cortex (S1). Sham-tACS was used as a control condition. In a separate experiment, we assessed the time course of mu-tACS effects by recording SEPs before (T0), during (T1), and 1 min (T2) and 10 min (T3) after stimulation. Mu-tACS increased the amplitude of the N20 component of SEPs compared to both sham and theta-tACS. No differences were found between sham, beta-, and theta-tACS conditions. Also, peripheral and spinal SEPs, P25, HFOs, and LLRs did not change during tACS. Finally, mu-tACS-induced modulation of N20 amplitude specifically occurred during stimulation (T1) and vanished afterwards (i.e., at T2 and T3). Our findings suggest that TACS applied at the individual mu frequency is able to modulate early somatosensory information processing at the S1 level and the effect is limited to the stimulation period.
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Affiliation(s)
- Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy
| | - Andrea Guerra
- IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Margherita Giangrosso
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS San Camillo Hospital, Via Alberoni 70, Venice 30126, Italy
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Patrizio Pasqualetti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Via Álvaro Del Portillo 21, Rome 00128, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy.
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Manzo N, Celletti C, Conte A, Camerota F. Comment to paper by Moggio et al “vibration therapy role in neurological diseases rehabilitation: an umbrella review of systematic reviews”. Disabil Rehabil 2022; 44:4947-4948. [DOI: 10.1080/09638288.2022.2030810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Claudia Celletti
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Piazza Aldo Moro 3,00185 Rome, Italy
| | - Antonella Conte
- IRCCS NEUROMED, 18, 86077 Pozzilli (IS), Pozzilli, Italy
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Piazza Aldo Moro 3,00185 Rome, Italy
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Manzo N, Ginatempo F, Belvisi D, Defazio G, Conte A, Deriu F, Berardelli A. Pathophysiological mechanisms of oromandibular dystonia. Clin Neurophysiol 2021; 134:73-80. [PMID: 34979293 DOI: 10.1016/j.clinph.2021.11.075] [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: 08/28/2021] [Revised: 11/03/2021] [Accepted: 11/28/2021] [Indexed: 11/03/2022]
Abstract
Oromandibular dystonia (OMD) is a rare form of focal idiopathic dystonia. OMD was clinically identified at the beginning of the 20th century, and the main clinical features have been progressively described over the years. However, OMD has several peculiarities that still remain unexplained, including the high rate of oral trauma, which is often related to the onset of motor symptoms. The purpose of this paper was to formulate a hypothesis regarding the pathophysiology of OMD, starting from the neuroanatomical basis of the masticatory and facial systems and highlighting the features that differentiate this condition from other forms of focal idiopathic dystonia. We provide a brief review of the clinical and etiological features of OMD as well as neurophysiological and neuroimaging findings obtained from studies in patients with OMD. We discuss possible pathophysiological mechanisms underlying OMD and suggest that abnormalities in sensory input processing may play a prominent role in OMD pathophysiology, possibly triggering a cascade of events that results in sensorimotor cortex network dysfunction. Finally, we identify open questions that future studies should address, including the effect of abnormal sensory input processing and oral trauma on the peculiar neurophysiological abnormalities observed in OMD.
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Affiliation(s)
| | | | - Daniele Belvisi
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy
| | - Giovanni Defazio
- Movement Disorders Center, Department of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy
| | - Antonella Conte
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale S. Pietro, 43c, 07100 Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, 07100 Sassari, Italy
| | - Alfredo Berardelli
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli, IS, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Viale Dell' Università 30, 00185 Rome, Italy.
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Spampinato D, Manzo N, Ginatempo F, Conte A, Berardelli A, Deriu F. Investigating the effects of paired somatosensory - cerebellar stimulation on cortical and cerebellar excitability: a TMS study. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.099] [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: 10/19/2022] Open
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Manzo N, Tocco P, Ginatempo F, Bertolasi L, Rocchi L. Brainstem Reflexes in Idiopathic Cervical Dystonia: Does Medullary Dysfunction Play a Role? Mov Disord Clin Pract 2021; 8:377-384. [PMID: 33816666 PMCID: PMC8015899 DOI: 10.1002/mdc3.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/08/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Neurophysiological markers in dystonia have so far not been sistematically applied in clinical practice due to limited reproducibility of results and low correlations with clinical findings. Exceptions might be represented by the blink reflex (BR), including its recovery cycle (BRRC) and the trigemino‐cervical reflex (TCR) which, compared to other neurophysiological methods, have shown more consistent alterations in cervical dystonia (CD). However, a comparison between the two techniques, and their possible correlation with disease symptoms, have not been thoroughly investigated. Objectives To assess the role of BR, BRCC and TCR in the pathophysiology of idiopathic cervical dystonia. Methods Fourteen patients and 14 age‐matched healthy controls (HC) were recruited. Neurophysiological outcome measures included latency of R1 and R2 components of the BR, R2 amplitude, BRRC, latency and amplitude of P19/N31 complex of TCR. Clinical and demographic features of patients were also collected, including age at disease onset, disease duration, presence of tremor, sensory trick and pain. The Toronto Western Spasmodic Torticollis Rating Scale was used to characterize dystonia. Results Compared to HC, CD patients showed increased latency of the BR R2 and decreased suppression of the BRRC. They also showed increased latency of the P19 and decreased amplitude of P19/N31 complex of TCR. The latency of P19 component of TCR was positively correlated with disease duration. Conclusions We propose that the increased latency of R2 and P19 observed here might be reflective of brainstem dysfunction, mediated either by local interneuronal excitability changes or by subtle structural damage.
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Affiliation(s)
| | - Pierluigi Tocco
- Department of Neuroscience, Biomedicine and Movement Sciences University of Verona Verona Italy
| | | | - Laura Bertolasi
- Department of Neuroscience, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movements Neurosciences, UCL Queen Square Institute of Neurology University College London London United Kingdom
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Belvisi D, Fabbrini A, De Bartolo MI, Costanzo M, Manzo N, Fabbrini G, Defazio G, Conte A, Berardelli A. The Pathophysiological Correlates of Parkinson's Disease Clinical Subtypes. Mov Disord 2020; 36:370-379. [PMID: 33037859 DOI: 10.1002/mds.28321] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 06/18/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Possible pathophysiological mechanisms underlying Parkinson's disease (PD) clinical subtypes are unknown. The objective of this study was to identify pathophysiological substrate of PD subtypes using neurophysiological techniques. METHODS One hundred de novo PD patients participated. We collected patient demographic and clinical data, which were used to perform a hierarchical cluster analysis. The neurophysiological assessment tested primary motor cortex excitability and plasticity using transcranial magnetic stimulation. To evaluate motor performance, we performed a kinematic analysis of fast index finger abduction. To investigate sensory function and sensorimotor mechanisms, we measured the somatosensory temporal discrimination threshold at rest and during movement, respectively. RESULTS Hierarchical cluster analysis identified 2 clinical clusters. Cluster I ("mild motor-predominant") included patients who had milder motor and nonmotor symptoms severity than cluster II patients, who had a combination of severe motor and nonmotor manifestations (diffuse malignant). We observed that the diffuse malignant subtype had increased cortical excitability and reduced plasticity compared with the mild motor-predominant subtype. Kinematic analysis of motor performance demonstrated that the diffuse malignant subtype was significantly slower than the mild motor-predominant subtype. Conversely, we did not observe any significant differences in sensory function or sensorimotor integration between the two PD subtypes. CONCLUSIONS De novo PD subtypes showed different patterns of motor system dysfunction, whereas sensory function and sensorimotor integration mechanisms did not differ between subtypes. Our findings suggest that the subtyping of PD patients is not a mere clinical classification but reflects different pathophysiological mechanisms. Neurophysiological parameters may represent promising biomarkers to evaluate PD subtypes and their progression. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Daniele Belvisi
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Matteo Costanzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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De Bartolo MI, Manzo N, Ferrazzano G, Baione V, Belvisi D, Fabbrini G, Berardelli A, Conte A. Botulinum Toxin Effects on Sensorimotor Integration in Focal Dystonias. Toxins (Basel) 2020; 12:toxins12050277. [PMID: 32344856 PMCID: PMC7290883 DOI: 10.3390/toxins12050277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/04/2022] Open
Abstract
(1) Background: In dystonia, the somatosensory temporal discrimination threshold (STDT) is abnormally increased at rest and higher and longer-lasting during movement execution in comparison with healthy subjects (HS), suggesting an abnormal sensorimotor integration. These abnormalities are thought to depend on abnormal proprioceptive input coming from dystonic muscles. Since Botulinum toxin-A (BT-A) reduces proprioceptive input in the injected muscles, our study investigated the effects of BT-A on STDT tested at rest and during voluntary movement execution in patients with focal dystonia. (2) Methods: We enrolled 35 patients with focal dystonia: 14 patients with cervical dystonia (CD), 11 patients with blepharospasm (BSP), and 10 patients with focal hand dystonia (FHD); and 12 age-matched HS. STDT tested by delivering paired stimuli was measured in all subjects at rest and during index finger abductions. (3) Results: Patients with dystonia had higher STDT values at rest and during movement execution than HS. While BT-A did not modify STDT at rest, it reduced the abnormal values of STDT during movement in CD and FHD patients, but not in BSP patients. (4) Conclusions: BT-A improved abnormal sensorimotor integration in CD and FHD, most likely by decreasing the overflow of proprioceptive signaling from muscle dystonic activity to the thalamus.
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Affiliation(s)
- Maria Ilenia De Bartolo
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Nicoletta Manzo
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Gina Ferrazzano
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Viola Baione
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Daniele Belvisi
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Giovanni Fabbrini
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Alfredo Berardelli
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
- Correspondence:
| | - Antonella Conte
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
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Manzo N, Ginatempo F, Spampinato D. P208 Understanding the interactions between somatosensory and cerebellar stimulation in humans. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.319] [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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Ginatempo F, Manzo N, Ibanez-Pereda J, Rocchi L, Rothwell JC, Deriu F. Happy faces selectively increase the excitability of cortical neurons innervating frowning muscles of the mouth. Exp Brain Res 2020; 238:1043-1049. [PMID: 32200403 DOI: 10.1007/s00221-020-05777-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
Although facial muscles are heavily involved in emotional expressions, there is still a lack of evidence about the role of face primary motor cortex (face M1) in the processing of facial recognition and expression. This work investigated the effects of the passive viewing of different facial expressions on face M1 and compared data with those obtained from the hand M1. Thirty healthy subjects were randomly assigned to two groups undergoing transcranial magnetic stimulation (TMS) of face or hand M1. In both groups, short-latency intracortical inhibition (SICI) and intracortical facilitation (ICF) were probed in the depressor anguli oris (DAO) and first dorsal interosseous (FDI) muscles 300 ms after presentation of a picture of a face that expressed happy, sad or neutral emotions. Statistical analysis of SICI showed a non-significant effect of muscle (F1,28 = 1.903, p = 0.179), but a significant effect of emotion (F2,56 = 6.860, p = 0.004) and a significant interaction between muscle and emotion (F2,56 = 5.072, p = 0.015). Post hoc analysis showed that there was a significant reduction of SICI in the DAO muscle after presentation of a face with a happy expression compared with a neutral face (p < 0.001). In the FDI, a significant difference was observed between neutral and sad expressions (p = 0.010) No clear differences in ICF were detected. The different responses of face and hand muscles to emotional stimuli may be due to their functional roles in emotional expression versus protection of the body.
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Affiliation(s)
- Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | | | - Jaime Ibanez-Pereda
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK.,Department of Bioengineering, Faculty of Engineering, Imperial College, London, UK
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
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Ginatempo F, Spampinato DA, Manzo N, Rothwell JC, Deriu F. Exploring the connectivity between the cerebellum and facial motor cortex. Brain Stimul 2019; 12:1586-1587. [PMID: 31331790 DOI: 10.1016/j.brs.2019.07.012] [Citation(s) in RCA: 5] [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] [Received: 07/01/2019] [Accepted: 07/12/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | - Danny A Spampinato
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | | | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
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22
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Conte A, Belvisi D, De Bartolo MI, Manzo N, Cortese FN, Tartaglia M, Ferrazzano G, Fabbrini G, Berardelli A. Abnormal sensory gating in patients with different types of focal dystonias. Mov Disord 2018; 33:1910-1917. [DOI: 10.1002/mds.27530] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/08/2018] [Accepted: 08/23/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | | | | | - Nicoletta Manzo
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Matteo Tartaglia
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Giovanni Fabbrini
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
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23
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Belvisi D, Conte A, Cortese FN, Tartaglia M, Manzo N, Li Voti P, Suppa A, Berardelli A. Voluntary Movement Takes Shape: The Link Between Movement Focusing and Sensory Input Gating. Front Hum Neurosci 2018; 12:330. [PMID: 30174597 PMCID: PMC6108059 DOI: 10.3389/fnhum.2018.00330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/26/2018] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to investigate the relationship between motor surround inhibition (mSI) and the modulation of somatosensory temporal discrimination threshold (STDT) induced by voluntary movement. Seventeen healthy volunteers participated in the study. To assess mSI, we delivered transcranial magnetic stimulation (TMS) single pulses to record motor evoked potentials (MEPs) from the right abductor digiti minimi (ADM; “surround muscle”) during brief right little finger flexion. mSI was expressed as the ratio of ADM MEP amplitude during movement to MEP amplitude at rest. We preliminarily measured STDT values by assessing the shortest interval at which subjects were able to recognize a pair of electric stimuli, delivered over the volar surface of the right little finger, as separate in time. We then evaluated the STDT by using the same motor task used for mSI. mSI and STDT modulation were evaluated at the same time points during movement. mSI and STDT modulation displayed similar time-dependent changes during index finger movement. In both cases, the modulation was maximally present at the onset of the movement and gradually vanished over about 200 ms. Our study provides the first neurophysiological evidence about the relationship between mSI and tactile-motor integration during movement execution.
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Affiliation(s)
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Matteo Tartaglia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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24
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Uzun P, Masucci F, Serrapica F, Napolitano F, Braghieri A, Romano R, Manzo N, Esposito G, Di Francia A. The inclusion of fresh forage in the lactating buffalo diet affects fatty acid and sensory profile of mozzarella cheese. J Dairy Sci 2018; 101:6752-6761. [DOI: 10.3168/jds.2018-14710] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/20/2018] [Indexed: 01/04/2023]
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25
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Manzo N, Troise A, Fogliano V, Pizzolongo F, Montefusco I, Cirillo C, Romano R. Impact of traditional and microwave roasting on chemical composition of hazelnut cultivar ‘Tonda di Giffoni’. Quality Assurance and Safety of Crops & Foods 2017. [DOI: 10.3920/qas2016.0959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- N. Manzo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
| | - A.D. Troise
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
| | - V. Fogliano
- Food Quality and Design Group, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, the Netherlands
| | - F. Pizzolongo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
| | - I. Montefusco
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
| | - C. Cirillo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
| | - R. Romano
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, Italy
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26
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Conte A, Belvisi D, Manzo N, Bologna M, Barone F, Tartaglia M, Upadhyay N, Berardelli A. Understanding the link between somatosensory temporal discrimination and movement execution in healthy subjects. Physiol Rep 2017; 4:4/18/e12899. [PMID: 27650249 PMCID: PMC5037912 DOI: 10.14814/phy2.12899] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023] Open
Abstract
The somatosensory temporal discrimination threshold (STDT) is the shortest interval at which an individual recognizes paired stimuli as separate in time. We investigated whether and how voluntary movement modulates STDT in healthy subjects. In 17 healthy participants, we tested STDT during voluntary index‐finger abductions at several time‐points after movement onset and during motor preparation. We then tested whether voluntary movement‐induced STDT changes were specific for the body segment moved, depended on movement kinematics, on the type of movement or on the intensity for delivering paired electrical stimuli for STDT. To understand the mechanisms underlying STDT modulation, we also tested STDT during motor imagery and after delivering repetitive transcranial magnetic stimulation to elicit excitability changes in the primary somatosensory cortex (S1). When tested on the moving hand at movement onset and up to 200 msec thereafter, STDT values increased from baseline, but during motor preparation remained unchanged. STDT values changed significantly during fast and slow index‐finger movements and also, though less, during passive index‐finger abductions, whereas during tonic index‐finger abductions they remained unchanged. STDT also remained unchanged when tested in body parts other than those engaged in movement and during imagined movement. Nor did testing STDT at increased intensity influence movement‐induced STDT changes. The cTBS‐induced S1 cortical changes left movement‐induced STDT changes unaffected. Our findings suggest that movement execution in healthy subjects may alter STDT processing.
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Affiliation(s)
| | | | - Nicoletta Manzo
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | | | - Francesca Barone
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Matteo Tartaglia
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Neeraj Upadhyay
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli (IS), Italy Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
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27
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Conte A, Ferrazzano G, Manzo N, Leodori G, Fabbrini G, Fasano A, Tinazzi M, Berardelli A. Somatosensory temporal discrimination in essential tremor and isolated head and voice tremors. Mov Disord 2015; 30:822-7. [PMID: 25736856 DOI: 10.1002/mds.26163] [Citation(s) in RCA: 24] [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: 09/25/2014] [Revised: 01/09/2015] [Accepted: 01/15/2015] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate the somatosensory temporal discrimination threshold in patients with essential tremor (sporadic and familial) and to evaluate whether somatosensory temporal discrimination threshold values differ depending on the body parts involved by tremor. We also investigated the somatosensory temporal discrimination in patients with isolated voice tremor. We enrolled 61 patients with tremor: 48 patients with essential tremor (31 patients with upper limb tremor alone, nine patients with head tremor alone, and eight patients with upper limb plus head tremor; 22 patients with familial vs. 26 sporadic essential tremor), 13 patients with isolated voice tremor, and 45 healthy subjects. Somatosensory temporal discrimination threshold values were normal in patients with familial essential tremor, whereas they were higher in patients with sporadic essential tremor. When we classified patients according to tremor distribution, somatosensory temporal discrimination threshold values were normal in patients with upper limb tremor and abnormal only in patients with isolated head tremor. Temporal discrimination threshold values were also abnormal in patients with isolated voice tremor. Somatosensory temporal discrimination processing is normal in patients with familial as well as in patients with sporadic essential tremor involving the upper limbs. By contrast, somatosensory temporal discrimination is altered in patients with isolated head tremor and voice tremor. This study with somatosensory temporal discrimination suggests that isolated head and voice tremors might possibly be considered as separate clinical entities from essential tremor.
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Affiliation(s)
- Antonella Conte
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Gina Ferrazzano
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Nicoletta Manzo
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Leodori
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfonso Fasano
- Movement Disorders Center, TWH, UHN, Division of Neurology, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Michele Tinazzi
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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28
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Miossec C, Jacob S, Manzo N, Ferge JL, Molinie V, Roze B, Desbois N. Premier cas de phaeohyphomycose cérébrale due a Neoscytalidium dimidiatum en Martinique. J Mycol Med 2014. [DOI: 10.1016/j.mycmed.2014.06.030] [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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29
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Esposito G, Masucci F, Napolitano F, Braghieri A, Romano R, Manzo N, Di Francia A. Fatty acid and sensory profiles of Caciocavallo cheese as affected by management system. J Dairy Sci 2014; 97:1918-28. [PMID: 24534504 DOI: 10.3168/jds.2013-7292] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 11/15/2013] [Indexed: 11/19/2022]
Abstract
The effect of season of the year associated with changes in feeding and management system (pasture-based vs. confinement) on milk and cheese fatty acid profile and on sensory properties of Caciocavallo cheese was evaluated on 3 mountain dairy farms. Each farm used a pasture-based feeding system from April to June and from September to October (PS), and a confinement system for the rest of the year (CS). As a consequence of grazing, PS milk showed higher percentages of C18:3, cis-9,trans-11 conjugated linoleic acid, and trans-11 C18:1, and a reduced percentage of C16:0. The fatty acid profile of cheese largely reflected that of the corresponding raw milk from which cheese was made. This led to a significant decrease of atherogenic index in cheeses produced from cows on pasture. Based on sensory analysis, cheese from animals kept on pasture was more yellow and had a lower intensity of butter and smoked odors than did CS cheese. In addition, grazing induced a lower intensity of bitter and a higher intensity of spicy flavors compared with cheese from CS animals. In regard to texture, pasture feeding resulted in higher intensity of friability and graininess. All cheeses performed well in consumer tests; the panel found all samples more than acceptable for overall liking, and for liking according to appearance, taste/flavor, and texture. Overall liking of Caciocavallo cheese, as assessed by slope analysis, was affected primarily by taste/flavor (raw slope k=0.88) and texture (k=0.97), whereas appearance had a lesser effect (k=0.72). The acidic and sensory profiles of cheese were well discriminated, with healthier cheeses produced by grazing cows. Therefore, wider use of pasture should be promoted to accentuate this favorable feature. Based on the specific nutritional and sensory characteristics of mountain Caciocavallo cheese, particularly that obtained from grazing animals, efforts should be made to indicate the quality of this cheese to the consumer and improve product recognition.
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Affiliation(s)
- G Esposito
- University of Pretoria, Faculty of Veterinary Sciences, Department of Production Animal Studies, 0110, Onderstepoort, South Africa
| | - F Masucci
- Dipartimento di Agraria, Università di Napoli "Federico II," Via Università 100, 80055 Portici (Napoli), Italy.
| | - F Napolitano
- Scuola di Scienze Agrarie, Forestali, Alimentari ed Ambientali, Università degli Studi della Basilicata, Via dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - A Braghieri
- Scuola di Scienze Agrarie, Forestali, Alimentari ed Ambientali, Università degli Studi della Basilicata, Via dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - R Romano
- Dipartimento di Agraria, Università di Napoli "Federico II," Via Università 100, 80055 Portici (Napoli), Italy
| | - N Manzo
- Dipartimento di Agraria, Università di Napoli "Federico II," Via Università 100, 80055 Portici (Napoli), Italy
| | - A Di Francia
- Dipartimento di Agraria, Università di Napoli "Federico II," Via Università 100, 80055 Portici (Napoli), Italy
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Preuß M, Renner C, Krupp W, Christiansen H, Fischer L, Merkenschlager A, Kieß W, Müller W, Manzo N, Meixensberger J, Nestler U. The use of 5-aminolevulinic acid fluorescence guidance in resection of pediatric brain tumors. Childs Nerv Syst 2013; 29:1263-7. [PMID: 23708867 DOI: 10.1007/s00381-013-2159-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/11/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Whereas in the adult population 5-Aminolevulinic acid (5-ALA) fluorescence guidance has been widely accepted for improving the extent of tumor resection, the application in children remains an off-label use. Even though most pediatric study protocols require a complete resection for improving outcome parameters, only few pediatric patients have been operated with fluorescence guidance, and it remains questionable, whether and which pediatric tumors show useful fluorescence. We present casuistic reports of application of 5-ALA in children collected from three different neurosurgical departments. PATIENTS AND METHODS In children with suspected malignant intracerebral tumor or recurrence, individual informed consent was obtained in each case from the parents. 5-ALA was administered according to the adult protocol, with 20 mg/kg, 2 h before induction of anesthesia. We retrospectively analyzed 18 patients (13 male, 5 female; age 3-18 years), using the intraoperative neurosurgical protocol, the postoperative MRI results, and the follow-up clinical examinations. RESULTS The use of 5-ALA fluorescence guidance proved to be safe in our group of pediatric patients. Fluorescence guidance was most useful for recurrent glioblastoma resection. Medulloblastoma tissue displayed fluorescence only inconsistently, and most pilocytic astrocytoma remained without staining. Ganglioglioma showed partial staining in the central tumor areas, without allowing the use for circumferent resection. CONCLUSION The off-label use of 5-ALA fluorescence guidance in pediatric patients appears to be most useful in recurrent high-grade gliomas. Fluorescence accumulation in other pediatric brain tumor entities is not predictable and should be evaluated in future clinical studies before being integrated into the current treatment protocols.
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Affiliation(s)
- M Preuß
- Department of Neurosurgery, Pediatric Neurosurgery, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
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Manzo N. La chirurgie des gliomes cérébraux avec le Gliolan (acide 5-amino-lévulinique) au CHU de Fort-de-France et à Giessen (Allemagne). Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.085] [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: 10/27/2022]
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Nestler U, Warter A, Cabre P, Manzo N. A case of late-onset multiple sclerosis mimicking glioblastoma and displaying intraoperative 5-aminolevulinic acid fluorescence. Acta Neurochir (Wien) 2012; 154:899-901. [PMID: 22402878 PMCID: PMC3337409 DOI: 10.1007/s00701-012-1319-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 02/23/2012] [Indexed: 11/24/2022]
Affiliation(s)
- U. Nestler
- Department of Neurosurgery, Service 6B, Centre Hospitalier Universitaire, BP 632, 97200 Fort-de-France, France
| | - A. Warter
- Department of Pathology, Centre Hospitalier Universitaire de Fort de France, Fort-de-France, France
| | - P. Cabre
- Department of Neurology, Centre Hospitalier Universitaire de Fort de France, Fort-de-France, France
| | - N. Manzo
- Department of Neurosurgery, Service 6B, Centre Hospitalier Universitaire, BP 632, 97200 Fort-de-France, France
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Manzo N, Nestler U, Salloum N, Memia-Zolo D, Mejdoubi-Lengelle S, Stegaru C. Empyème sous-dural par sinusite nasale compliqué par une drépanocytose chez un enfant de dix ans : à propos d’un cas. Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.155] [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: 12/01/2022]
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34
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Manzo N, Salloum N, Nestler U, Memia-Zolo D, Warter A, Aveillan M, Medjoubi M. Notre expérience avec l’acide 5-aminolévulinique dans la résection des tumeurs cérébrales malignes. Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Manzo N, Salloum N, Nestler U, Memia-Zolo D, Warter A, Fagour C. Les adénomes hypophysaires opérés avec 5-Ala et microscope PENTERO ne montrent guère de fluorescence. Étude conjointe : neurosurgery (France) et neurosurgery (Allemagne). Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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36
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Manzo N, Nestler U, Salloum N, Memia-Zolo D, Mejdoubi M, Aveillan M. Céphalocèle atrétique pariétale chez un nouveau-né : à propos d’un cas. Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.156] [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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37
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Memia Zolo D, Mostofi K, Ischac R, Saint-Prix C, Warter P, Manzo N. Le chordome intracrânien : analyse d’un cas à la lumière de la revue de la littérature. Neurochirurgie 2008. [DOI: 10.1016/j.neuchi.2008.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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38
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Mostofi K, Mémia-Zolo D, Tyburne B, Saint-Prix C, Ishac R, Manzo N, Smadja D. Hématome sous-dural chronique : traitement par ponction percutanée. À propos de 14 cas. Neurochirurgie 2008. [DOI: 10.1016/j.neuchi.2008.08.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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39
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Stecken J, Bardaxoglou E, Touquet S, Manzo N, Cherki E, Dorwling-Carter D, Muckensturm B. [Giant sacral schwannoma with pelvic extension. Therapeutic strategy. Apropos of a case]. Neurochirurgie 1996; 42:294-9. [PMID: 9161536] [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: 02/04/2023]
Abstract
A 48-year-old woman was admitted for acute urinary retention. Clinical pelvic examination disclosed a voluminous retro-rectal mass. Plain X-rays, pelvic echography, computerized tomography and MRI were all consistent demonstrating the presence of a 15cm-diameter lesion in the pelvic space with sacral erosion at S3-S4 and extension in the sacral canal up to S2. After a preoperative embolization, the tumor was removed in a two-stage procedure. First, an anterior transabdominal approach dissected the superior and lateral aspects of the tumor. To make easier the intra-abdominal dissection and to avoid any rectosigmoid necrosis, hysterectomy and rectosigmoid section with an end-colostomy were performed. Lastly, a piecemeal removal of the whole tumor was achieved using a posterior approach. At 6 months postoperatively, she recovered a satisfactory urinary control and the colo-rectal anastomosis was then successfully performed. Clinically only a slight hypesthesia of the left perineum was present. In the recent literature, 21 cases were described with similar clinical presentation and similar technical problems to achieve a complete treatment. In the discussion, details of the surgical anterior and posterior approaches are given. Before deciding the most appropriate surgical approach for such a mass, a biopsy is useful to determine whether total removal is relevant. A preoperative embolization can help to reduce the duration of the procedure and the loss of blood.
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Affiliation(s)
- J Stecken
- Service de Neurochirurgie, CHR d'Orléans
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Stecken J, Manzo N, Cherki EH, Dorwling-Carter D, Muckensturm B. [Thoracic spondylotic myelopathies. Apropos of 4 new cases]. Neurochirurgie 1996; 42:147-52. [PMID: 9084741] [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: 02/04/2023]
Abstract
Four cases of thoracic spondylotic myelopathy are reported, one man and three women, respectively 61, 66, 67 and 76 years old. Clinical presentation was numbness and weakness in the lower limbs in two cases, weakness alone in one and numbness alone in the last one. Diagnosis was settled by both myelography and CT-myelogram in three cases, by both MRI and CT-scan in the other one. The involved thoracic levels were both T9-T10 and T10-T11 for two cases and T11-T12 for the other one. The stenosis was due to hypertrophic ossification of the ligamentum flavum in three cases and to osteophytic changes in one. A laminectomy was performed for each patient and three patients had a significant recovery and the fourth a mild one. Thoracic myelopathy is an uncommon disease which requires a meticulous study of myelogram and now MRI to be recognized and to be cured by laminectomy. As for cervical myelopathy, it results from mechanical and ischemic factors which can lead to a definitive myelomalacia.
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Affiliation(s)
- J Stecken
- Service de Neurochirurgie (Dr Stecken), CHR d'Orléans
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