1
|
Ferrari C, Ingannato A, Matà S, Ramat S, Caremani L, Bagnoli S, Bessi V, Sorbi S, Nacmias B. Parkinson-ALS with a novel MAPT variant. Neurol Sci 2024; 45:1051-1055. [PMID: 37730935 PMCID: PMC10857966 DOI: 10.1007/s10072-023-07081-4] [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: 06/21/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
The mutations on microtubule associated protein tau (MAPT) gene manifest clinically with behavioural frontotemporal dementia (FTD), parkinsonism, such as progressive supranuclear palsy and corticobasal degeneration, and rarely with amyotrophic lateral sclerosis (ALS). FTD-parkinsonism and FTD-ALS are clinical overlaps included in the spectrum of MAPT mutation's phenotypes. The mutations on MAPT gene cause the dysfunction of tau protein determining its accumulation in neurofibrillary tangles. Recent data describe frequently the co-occurrence of the aggregation of tau protein and α-synuclein in patients with parkinsonism and Parkinson disease (PD), suggesting an interaction of the two proteins in determining neurodegenerative process. The sporadic description of PD-ALS clinical complex, known as Brait-Fahn-Schwarz disease, supports the hypothesis of common neuropathological pathways between different disorders. Here we report the case of a 54-year-old Italian woman with idiopathic PD later complicated by ALS carrying a novel MAPT variant (Pro494Leu). The variant is characterized by an amino acid substitution and is classified as damaging for MAPT functions. The case supports the hypothesis of tau dysfunction as the basis of multiple neurodegenerative disorders.
Collapse
Affiliation(s)
- Camilla Ferrari
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy.
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy
| | - Sabrina Matà
- Neuromuscular-Skeletal and Sensory Organs Department, AOU Careggi, Florence, Italy
| | - Silvia Ramat
- Parkinson Unit, Neuromuscular-Skeletal and Sensory Organs Department, AOU Careggi, Florence, Italy
| | - Luca Caremani
- Parkinson Unit, Neuromuscular-Skeletal and Sensory Organs Department, AOU Careggi, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 50143, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 50143, Florence, Italy
| |
Collapse
|
2
|
Lombardi G, Baccini M, Gualerzi A, Pancani S, Campagnini S, Doronzio S, Longo D, Maselli A, Cherubini G, Piazzini M, Ciapetti T, Polito C, Pinna S, De Santis C, Bedoni M, Macchi C, Ramat S, Cecchi F. Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson's disease: the VIRTREAD-PD randomized controlled trial protocol. Front Neurol 2024; 15:1338609. [PMID: 38327625 PMCID: PMC10847255 DOI: 10.3389/fneur.2024.1338609] [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: 11/14/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Background Intensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson's Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients' performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on gait performances of TT + AVR versus TT alone in II-III stage PD patients with gait disturbance. Secondary aims are to assess the effects on balance, gait parameters and other motor and non-motor symptoms, and patient's satisfaction and adherence to the treatment. As an exploratory aim, the study attempts to identify biomarkers of neuroplasticity detecting changes in Neurofilament Light Chain concentration T0-T1 and to identify prognostic biomarkers associated to blood-derived Extracellular Vesicles. Methods Single-center, randomized controlled single-blind trial comparing TT + AVR vs. TT in II-III stage PD patients with gait disturbances. Assessment will be performed at baseline (T0), end of training (T1), 3 (T2) and 6 months (T3, phone interview) from T1. The primary outcome is difference in gait performance assessed with the Tinetti Performance-Oriented Mobility Assessment gait scale at T1. Secondary outcomes are differences in gait performance at T2, in balance and spatial-temporal gait parameters at T1 and T2, patients' satisfaction and adherence. Changes in falls, functional mobility, functional autonomy, cognition, mood, and quality of life will be also assessed at different timepoints. The G*Power software was used to estimate a sample size of 20 subjects per group (power 0.95, α < 0.05), raised to 24 per group to compensate for potential drop-outs. Both interventions will be customized and progressive, based on the participant's performance, according to a predefined protocol. Conclusion This study will provide data on the possible superiority of AVR-associated TT over conventional TT in improving gait and other motor and non-motor symptoms in persons with PD and gait disturbances. Results of the exploratory analysis could add information in the field of biomarker research in PD rehabilitation.
Collapse
Affiliation(s)
- Gemma Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | - Marco Baccini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | - Stefano Doronzio
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Diego Longo
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Maselli
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Technical-Health Professions, Rehabilitation, and Prevention, Campostaggia Hospital, Poggibonsi (SI), USL Toscana Sudest, Italy
| | - Giulio Cherubini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | | | - Samuele Pinna
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara De Santis
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marzia Bedoni
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Silvia Ramat
- Parkinson Unit, Department of NeuroMuscular-Skeletal and Sensorial Organs, AOU Careggi, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| |
Collapse
|
3
|
Arnone A, Allocca M, Di Dato R, Puccini G, Laghai I, Rubino F, Nerattini M, Ramat S, Lombardi G, Ferrari C, Bessi V, Sorbi S, De Cristofaro MT, Polito C, Berti V. FDG PET in the differential diagnosis of degenerative parkinsonian disorders: usefulness of voxel-based analysis in clinical practice. Neurol Sci 2022; 43:5333-5341. [PMID: 35697965 PMCID: PMC9385817 DOI: 10.1007/s10072-022-06166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
Abstract
Background
The early differential diagnosis among neurodegenerative parkinsonian disorders becomes essential to set up the correct clinical-therapeutic approach. The increased utilization of [18F] fluoro-deoxy-glucose positron emission tomography (FDG PET) and the pressure for cost-effectiveness request a systematic evaluation and a validation of its utility in clinical practice. This retrospective study aims to consider the contribution, in terms of increasing accuracy and increasing diagnostic confidence, of voxel-based FDG PET analyses in the differential diagnosis of these disorders, including Parkinson’s disease, multiple system atrophy, progressive supranuclear palsy, and cortico-basal syndrome.
Method
Eighty-three subjects with a clinically confirmed diagnosis of degenerative parkinsonian disorders who underwent FDG brain PET/CT were selected. A voxel-based analysis was set up using statistical parametric mapping (SPM) on MATLAB to produce maps of brain hypometabolism and relative hypermetabolism. Four nuclear physicians (two expert and two not expert), blinded to the patients’ symptoms, other physicians’ evaluations, and final clinical diagnosis, independently evaluated all data by visual assessment and by adopting metabolic maps.
Results
In not-expert evaluators, the support of both hypometabolism and hypermetabolism maps results in a significant increase in diagnostic accuracy as well as clinical confidence. In expert evaluators, the increase in accuracy and in diagnostic confidence is mainly supported by hypometabolism maps alone.
Conclusions
In this study, we demonstrated the additional value of combining voxel-based analyses with qualitative assessment of brain PET images. Moreover, maps of relative hypermetabolism can also make their contribution in clinical practice, particularly for less experienced evaluators.
Collapse
Affiliation(s)
- Annachiara Arnone
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy.
| | - Michela Allocca
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Rossella Di Dato
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Giulia Puccini
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Iashar Laghai
- Department of Nuclear Medicine, Hospital of Prato, Via Suor Niccolina Infermiera, 20/22, 59100, Prato, Italy
| | - Federica Rubino
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Matilde Nerattini
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Silvia Ramat
- Parkinson Unit, Department of NeuroMuscular- Skeletal and Sensorial Organs, AOU Careggi, Florence, Italy
| | - Gemma Lombardi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Camilla Ferrari
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Maria Teresa De Cristofaro
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Cristina Polito
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Valentina Berti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| |
Collapse
|
4
|
Vissani M, Micheli F, Pecchioli G, Ramat S, Mazzoni A. Impulsivity is associated with firing regularity in parkinsonian ventral subthalamic nucleus. Ann Clin Transl Neurol 2022; 9:552-557. [PMID: 35233976 PMCID: PMC8994976 DOI: 10.1002/acn3.51530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Impulsive–compulsive behaviors (ICB) are over‐represented in Parkinson's disease (PD) patients. Neurons in the ventral subthalamic nucleus (STN) might play a predominant role in the modulation of impulsivity. We characterized the firing regularity of 742 subthalamic neurons from 24 PD patients (12 ICB+ and 12 ICB‐) in an OFF medication state. We computed the firing regularity in the dorsal and ventral STN regions, and we compared their performance in discriminating ICB patients. Regularity of ventral neurons in ICB+ patients is higher and supports a significant discrimination between the two cohorts. These results substantiate a ventral location of neurons involved in impulsivity.
Collapse
Affiliation(s)
- Matteo Vissani
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, 56025, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56025, Italy
| | - Federico Micheli
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, 56025, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56025, Italy
| | - Guido Pecchioli
- AOU Careggi, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Florence, Italy
| | - Silvia Ramat
- AOU Careggi, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Florence, Italy
| | - Alberto Mazzoni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, 56025, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56025, Italy
| |
Collapse
|
5
|
Stefani A, Tessitore A, Tambasco N, Cossu G, Ceravolo MG, Defazio G, Morgante F, Ramat S, Melzi G, Gualberti G, Merolla R, Onuk K, Lopiano L. Criteria for identification of advanced Parkinson’s disease: the results of the Italian subgroup of OBSERVE-PD observational study. BMC Neurol 2022; 22:41. [PMID: 35090406 PMCID: PMC8796340 DOI: 10.1186/s12883-022-02554-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Background Frequency of Advanced Parkinson’s Disease (APD) and its clinical characteristics are still not well defined. Here, we aimed to assess APD prevalence in the Italian OBSERVE-PD cohort, as well as treatment eligibility to device-aided therapies (DAT), and to compare the APD clinical judgment with the established Delphi criteria. Methods This sub-group analysis of the OBSERVE-PD study was performed on patients enrolled by 9 Movement Disorders centers in Italy. Motor and non-motor symptoms, PD characteristics, activities of daily living, and quality of life were assessed. Patient eligibility for DAT, response to current PD treatments, referral process, and the concordance between APD physician’s judgment and Delphi criteria were also assessed. Results According to physician’s judgment, 60 out of 140 patients (43%) had APD. The correlation between physician’s judgment and the overall APD Delphi criteria was substantial (K = 0.743; 95%CI 0.633–0.853), mainly driven by a discrete concordance found for the presence of ≥ 2 h of daily OFF time, presence of troublesome dyskinesia, ≥ 5 times daily oral levodopa dosing, and activities of daily living limitation. Forty-four (73%) APD patients were considered eligible to DAT but only 18 of them (41%) used these therapies, while most patients, independently from their eligibility, continued to use 3–5 oral daily medications, due to fear of invasive solutions and need to have a longer time to decide. Conclusion APD was frequent in the Italian OBSERVE-PD population. DAT in the eligible APD population proved to be underused, in spite of unsatisfactory symptoms control with oral medications in 67% of patients.
Collapse
|
6
|
Anastasio T, Demer J, Leigh R, Luebke A, von Opstal A, Optican L, Ramat S, Zee D. Preface. Progress in Brain Research 2022; 267:xvii-xviii. [DOI: 10.1016/s0079-6123(22)00029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
7
|
Grassi G, Albani G, Terenzi F, Razzolini L, Ramat S. New pharmacological and neuromodulation approaches for impulsive-compulsive behaviors in Parkinson's disease. Neurol Sci 2021; 42:2673-2682. [PMID: 33852081 DOI: 10.1007/s10072-021-05237-8] [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: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A significant proportion of patients with Parkinson's disease (PD) display a set of impulsive-compulsive behaviors at some point during the course of illness. These behaviors range from the so-called behavioral addictions to dopamine dysregulation syndrome, punding and hoarding disorders. These behaviors have been consistently linked to the use of dopaminergic medications used to treat PD motor symptoms (dopamine agonists, levodopa, and other agents) and less consistently to neuromodulation techniques such as deep brain stimulation (DBS). Since there are still no approved treatments for these conditions, their pharmacological management is still a big challenge for clinicians. METHODS We conducted an extensive review of current pharmacological and neuromodulation literature for the management of impulsive-compulsive disorders in PD patients. RESULTS Pharmacological treatment approaches for impulsive-compulsive behaviors and DDS in PD patients include reduction of levodopa (LD), reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies (apomorphine infusion and duodopa). Also, atomoxetine, a noradrenergic agent approved for the treatment of attention deficit hyperactivity disorder, showed some interesting preliminary results but there is still a lack of controlled longitudinal studies. Finally, while DBS effects on impulsive-compulsive disorders are still controversial, non-invasive techniques (such as transcranial magnetic stimulation and transcranial direct current stimulation) could have a potential positive effect but, again, there is still a lack of controlled trials. CONCLUSION Managing impulsivity and compulsivity in PD patients is still a non-evidence-based challenge for clinicians. Controlled trials on promising approaches such as atomoxetine and non-invasive neuromodulation techniques are needed.
Collapse
Affiliation(s)
- Giacomo Grassi
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.
| | | | | | - Lorenzo Razzolini
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.,University of Florence, Florence, Italy
| | | |
Collapse
|
8
|
Micheli F, Vissani M, Pecchioli G, Terenzi F, Ramat S, Mazzoni A. Impulsivity Markers in Parkinsonian Subthalamic Single-Unit Activity. Mov Disord 2021; 36:1435-1440. [PMID: 33453079 DOI: 10.1002/mds.28497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Impulsive-compulsive behaviors are common in Parkinson's disease (PD) patients. However, the basal ganglia dysfunctions associated with high impulsivity have not been fully characterized. The objective of this study was to identify the features associated with impulsive-compulsive behaviors in single neurons of the subthalamic nucleus (STN). METHODS We compared temporal and spectral features of 412 subthalamic neurons from 12 PD patients with impulsive-compulsive behaviors and 330 neurons from 12 PD patients without. Single-unit activities were extracted from exploratory microrecordings performed during deep brain stimulation (DBS) implant surgery in an OFF medication state. RESULTS Patients with impulsive-compulsive behaviors displayed decreased firing frequency during bursts and a larger fraction of tonic neurons combined with weaker beta coherence. Information carried by these features led to the identification of patients with impulsive-compulsive behaviors with an accuracy greater than 80%. CONCLUSIONS Impulsive-compulsive behaviors in PD patients are associated with decreased bursts in STN neurons in the OFF medication state. © 2021 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Federico Micheli
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Matteo Vissani
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Guido Pecchioli
- Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
| | - Federica Terenzi
- Dipartimento di Neuroscienze, Psicologia, Università degli Studi di Firenze, Area del Farmaco e Salute del Bambino, Florence, Italy
| | - Silvia Ramat
- Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
| | - Alberto Mazzoni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| |
Collapse
|
9
|
Del Prete E, Francesconi A, Palermo G, Mazzucchi S, Frosini D, Morganti R, Coleschi P, Raglione LM, Vanni P, Ramat S, Novelli A, Napolitano A, Battisti C, Giuntini M, Rossi C, Menichetti C, Ulivelli M, De Franco V, Rossi S, Bonuccelli U, Ceravolo R. Prevalence and impact of COVID-19 in Parkinson's disease: evidence from a multi-center survey in Tuscany region. J Neurol 2020; 268:1179-1187. [PMID: 32880722 PMCID: PMC7471534 DOI: 10.1007/s00415-020-10002-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022]
Abstract
Background If Parkinson’s Disease (PD) may represent a risk factor for Coronavirus disease 2019 (COVID-19) is debated and there are few data on the direct and indirect effects of this pandemic in PD patients. Objective In the current study we evaluated the prevalence, mortality and case-fatality of COVID-19 in a PD cohort, also exploring possible risk factors. We also aimed to investigate the effect of lockdown on motor/non-motor symptoms in PD patients as well as their acceptability/accessibility to telemedicine. Method A case-controlled survey about COVID-19 and other clinical features in PD patients living in Tuscany was conducted. In non-COVID-19 PD patients motor/non-motor symptoms subjective worsening during the lockdown as well as feasibility of telemedicine were explored. Results Out of 740 PD patients interviewed, 7 (0.9%) were affected by COVID-19, with 0.13% mortality and 14% case-fatality. COVID-19 PD patients presented a higher presence of hypertension (p < 0.001) and diabetes (p = 0.049) compared to non-COVID-19. In non-COVID-19 PD population (n = 733) about 70% did not experience a subjective worsening of motor symptoms or mood, anxiety or insomnia. In our population 75.2% of patients was favorable to use technology to perform scheduled visits, however facilities for telemedicine were available only for 51.2% of cases. Conclusion A higher prevalence of COVID-19 respect to prevalence in Tuscany and Italy was found in the PD population. Hypertension and diabetes, as for general population, were identified as risk factors for COVID-19 in PD. PD patients did not experience a subjective worsening of symptoms during lockdown period and they were also favorable to telemedicine, albeit we reported a reduced availability to perform it.
Collapse
Affiliation(s)
- Eleonora Del Prete
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
| | - Alessio Francesconi
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
| | - Giovanni Palermo
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
| | - Sonia Mazzucchi
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
| | - Daniela Frosini
- Department of Medical Specialties, Neurology Unit, AOUP, Pisa, Italy
| | | | - Piero Coleschi
- Unit of Neurology, Ospedale San Donato Arezzo, Arezzo, Italy
| | - Laura Maria Raglione
- Unit of Neurology of Florence, Central Tuscany Local Health Authority, San Giovanni Di Dio Hospital, Firenze, Italy
| | - Paola Vanni
- Ospedale S. Maria Annunziata, ASL Centro, Firenze, Italy
| | - Silvia Ramat
- Parkinson Unit, Department of NeuroMuscular- Skeletal and Sensorial Organs, AO Careggi-Firenze, Firenze, Italy
| | - Alessio Novelli
- Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Firenze, Italy
| | | | - Carla Battisti
- Department of Medical-Surgical Science and Neuroscience, University of Siena, Siena, Italy
| | - Martina Giuntini
- Unit of Neurology, S. Stefano Prato Hospital, Azienda Toscana Centro, Pisa, Italy
| | - Carlo Rossi
- Unit of Neurology, Pontedera Hospital, Azienda Toscana nord-ovest, Pisa, Italy
| | | | - Monica Ulivelli
- Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, University of Siena, Siena, Italy
| | - Valentino De Franco
- Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, University of Siena, Siena, Italy
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, University of Siena, Siena, Italy
| | - Ubaldo Bonuccelli
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
| | - Roberto Ceravolo
- Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy.
| | | |
Collapse
|
10
|
Terenzi F, Locatello LG, Novelli A, Gallo O, Ramat S. Recurrent laryngospasm as the only presenting feature of multiple system atrophy. Neurol Sci 2020; 41:2629-2630. [PMID: 32239345 DOI: 10.1007/s10072-020-04373-x] [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] [Received: 11/12/2019] [Accepted: 03/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Federica Terenzi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Largo Pieraccini 6, 50139, Florence, Italy.
| | - Luca Giovanni Locatello
- Clinic of Otorhinolaryngology, Department of Surgery and Translational Medicine, University of Florence, Florence, FI, Italy
| | - Alessio Novelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Largo Pieraccini 6, 50139, Florence, Italy
| | - Oreste Gallo
- Clinic of Otorhinolaryngology, Department of Surgery and Translational Medicine, University of Florence, Florence, FI, Italy
| | - Silvia Ramat
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Largo Pieraccini 6, 50139, Florence, Italy
| |
Collapse
|
11
|
Izzo VA, Donati MA, Torre E, Ramat S, Primi C. Impulse control disorders in Parkinson's disease versus in healthy controls: A different predictive model. J Neuropsychol 2019; 14:318-332. [PMID: 31423741 DOI: 10.1111/jnp.12193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 07/22/2019] [Indexed: 01/26/2023]
Abstract
Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behaviour and eating, are not only a severe disorder that can affect the general, non-clinical population, but also a serious, increasingly recognized psychiatric complication in Parkinson's disease (PD). Previous research detected some risk factors for their occurrence in PD patients and in the general population, including impulsivity. However, impulsivity is a multidimensional construct that comprises several aspects, including reflection impulsivity and delay discounting. The present work assessed different facets of impulsivity in both PD patients and in the healthy controls (HCs) to examine whether they scored differently, and if the occurrence of ICDs in PD patients and in the HCs was predicted by different aspects of impulsivity. The results showed that ICDs in PD patients were predicted by a strong preference for immediate rewards, whereas ICDs in the HCs were predicted by a deficient reflective ability. The present findings may help clinicians in the early identification of PD patients who could develop ICDs by simply assessing their impulsivity in terms of delay discounting. Furthermore, this work contributed to identify another risk factor for ICDs in the non-clinical population.
Collapse
Affiliation(s)
- Viola Angela Izzo
- NEUROFARBA Department - Section of Psychology, University of Florence, Italy
| | - Maria Anna Donati
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Elena Torre
- Azienda Usl 4 di Prato - U. O. Neurologia, Prato, Italy
| | | | - Caterina Primi
- NEUROFARBA Department - Section of Psychology, University of Florence, Italy
| |
Collapse
|
12
|
Gallo V, Vineis P, Cancellieri M, Chiodini P, Barker RA, Brayne C, Pearce N, Vermeulen R, Panico S, Bueno-de-Mesquita B, Vanacore N, Forsgren L, Ramat S, Ardanaz E, Arriola L, Peterson J, Hansson O, Gavrila D, Sacerdote C, Sieri S, Kühn T, Katzke VA, van der Schouw YT, Kyrozis A, Masala G, Mattiello A, Perneczky R, Middleton L, Saracci R, Riboli E. Exploring causality of the association between smoking and Parkinson's disease. Int J Epidemiol 2019; 48:912-925. [PMID: 30462234 PMCID: PMC6659366 DOI: 10.1093/ije/dyy230] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait. METHODS A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset. RESULTS Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking <20 years were 0.84 [95% confidence interval (CI) 0.67-1.07], 20-29 years 0.73 (95% CI 0.56-0.96) and >30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding. CONCLUSIONS These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.
Collapse
Affiliation(s)
- Valentina Gallo
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
- School of Public Health, Imperial College London, London, UK
- Epidemiology and Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
| | - Paolo Vineis
- School of Public Health, Imperial College London, London, UK
| | - Mariagrazia Cancellieri
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
- School of Hygiene and Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
- Hygiene and Public Health Unit, Department of Public Health, AUSL Imola, Bologna, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Roger A Barker
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Neil Pearce
- Epidemiology and Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Division of Epidemiology, Institute for Risk Assessment Science, Utrecht University, Utrecht, The Netherlands
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- School of Public Health, Imperial College London, London, UK
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Lars Forsgren
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Silvia Ramat
- Department of Neuroscience, Psychology, Drug Research, and Child Health, University of Florence, Careggi Hospital-University, Florence, Italy
| | - Eva Ardanaz
- Navarra Public Health Institute, IdiSNA, Pamplona, Spain
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
| | - Larraitz Arriola
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
- Public Health Department of Gipuzkoa, Basque Government, Vitoria-Gasteiz, Spain
- Biodonostia Research Institute, Neurosciences Area, Hospital Universitario Donostia, Donostia, Spain
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Diana Gavrila
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Centre for Cancer Prevention (CPO-Piemonte), Turin, Italy
- Human Genetic Foundation (HuGeF), Turin, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andreas Kyrozis
- Hellenic Health Foundation, Athens, Greece
- First Department of Neurology, University of Athens, Athens, Greece
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Robert Perneczky
- School of Public Health, Imperial College London, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
- German Centre for Neurodegenerative Disorders (DZNE), Munich, Germany
- Munich Cluster for System Neurology (SyNergy), Munich, Germany
| | | | - Rodolfo Saracci
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK
| |
Collapse
|
13
|
Novelli A, Di Vico IA, Terenzi F, Sorbi S, Ramat S. Dyskinesia-Hyperpyrexia Syndrome in Parkinson's disease with Deep Brain Stimulation and high-dose levodopa/carbidopa and entacapone. Parkinsonism Relat Disord 2019; 64:352-353. [PMID: 31101554 DOI: 10.1016/j.parkreldis.2019.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/05/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Alessio Novelli
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
| | - Ilaria Antonella Di Vico
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Federica Terenzi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Silvia Ramat
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| |
Collapse
|
14
|
van Dooren TS, Lucieer FMP, Duijn S, Janssen AML, Guinand N, Pérez Fornos A, Van Rompaey V, Kingma H, Ramat S, van de Berg R. The Functional Head Impulse Test to Assess Oscillopsia in Bilateral Vestibulopathy. Front Neurol 2019; 10:365. [PMID: 31105632 PMCID: PMC6499172 DOI: 10.3389/fneur.2019.00365] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 11/10/2018] [Accepted: 03/25/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction: Bilateral vestibulopathy (BV) is a chronic condition in which vestibular function is severely impaired or absent on both ears. Oscillopsia is one of the main symptoms of BV. Oscillopsia can be quantified objectively by functional vestibular tests, and subjectively by questionnaires. Recently, a new technique for testing functionally effective gaze stabilization was developed: the functional Head Impulse Test (fHIT). This study compared the fHIT with the Dynamic Visual Acuity assessed on a treadmill (DVAtreadmill) and Oscillopsia Severity Questionnaire (OSQ) in the context of objectifying the experience of oscillopsia in patients with BV. Methods: Inclusion criteria comprised: (1) summated slow phase velocity of nystagmus of <20°/s during bithermal caloric tests, (2) torsion swing tests gain of <30% and/or phase <168°, and (3) complaints of oscillopsia and/or imbalance. During the fHIT (Beon Solutions srl, Italy) patients were seated in front of a computer screen. During a passive horizontal head impulse a Landolt C optotype was shortly displayed. Patients reported the seen optotype by pressing the corresponding button on a keyboard. The percentage correct answers was registered for leftwards and rightwards head impulses separately. During DVAtreadmill patients were positioned on a treadmill in front of a computer screen that showed Sloan optotypes. Patients were tested in static condition and in dynamic conditions (while walking on the treadmill at 2, 4, and 6 km/h). The decline in LogMAR between static and dynamic conditions was registered for each speed. Every patient completed the Oscillopsia Severity Questionnaire (OSQ). Results: In total 23 patients were included. This study showed a moderate correlation between OSQ outcomes and the fHIT [rightwards head rotations (rs = −0.559; p = 0.006) leftwards head rotations (rs = −0.396; p = 0.061)]. No correlation was found between OSQ outcomes and DVAtreadmill, or between DVAtreadmill and fHIT. All patients completed the fHIT, 52% of the patients completed the DVAtreadmill on all speeds. Conclusion: The fHIT seems to be a feasible test to quantify oscillopsia in BV since, unlike DVAtreadmill, it correlates with the experienced oscillopsia measured by the OSQ, and more BV patients are able to complete the fHIT than DVAtreadmill.
Collapse
Affiliation(s)
- T S van Dooren
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - F M P Lucieer
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - S Duijn
- Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - A M L Janssen
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Centre, Maastricht, Netherlands.,Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - N Guinand
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands.,Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - A Pérez Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - V Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - H Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - S Ramat
- Department of Computer, Electric and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - R van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| |
Collapse
|
15
|
Maremmani C, Cavallo F, Purcaro C, Rossi G, Salvadori S, Rovini E, Esposito D, Pieroni A, Ramat S, Vanni P, Fattori B, Meco G. Combining olfactory test and motion analysis sensors in Parkinson's disease preclinical diagnosis: a pilot study. Acta Neurol Scand 2018; 137:204-211. [PMID: 29082509 DOI: 10.1111/ane.12862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Preclinical diagnosis of Parkinson's disease (PD) is nowadays a topic of interest as the neuropathological process could begin years before the appearance of motor symptoms. Several symptoms, among them hyposmia, could precede motor features in PD. In the preclinical phase of PD, a subclinical reduction in motor skills is highly likely. In this pilot study, we investigate a step-by-step method to achieve preclinical PD diagnosis. MATERIAL AND METHODS We used the IOIT (Italian Olfactory Identification Test) to screen a population of healthy subjects. We identified 20 subjects with idiopathic hyposmia. Hyposmic subjects underwent an evaluation of motor skills, at baseline and after 1 year, using motion analysis sensors previously created by us. RESULTS One subject showed significant worsening in motor measurements. In this subject, we further conducted a dopaminergic challenge test monitored with the same sensors and, finally, he underwent [123 I]-FP/CIT (DaTscan) SPECT brain imaging. The results show that he is probably affected by preclinical PD. CONCLUSIONS Our pilot study suggests that the combined use of an olfactory test and motor sensors for motion analysis could be useful for a screening of healthy subjects to identify those at a high risk of developing PD.
Collapse
Affiliation(s)
- C. Maremmani
- Unità Operativa di Neurologia, Ospedale delle Apuane Azienda USL Toscana Nord Ovest Massa Italy
| | - F. Cavallo
- Istituto di Biorobotica Scuola Superiore Sant'Anna Pisa Italy
| | - C. Purcaro
- Dipartimento di Neurologia e Psichiatria, e Centro di Ricerca per le Malattie Sociali (CIMS) “Sapienza” Università degli Studi di Roma Roma Italy
| | - G. Rossi
- Unità di Epidemiologia e Biostatistica Istituto di Fisiologia Clinica Consiglio Nazionale delle Ricerche Area della Ricerca di Pisa Pisa Italy
| | - S. Salvadori
- Unità di Epidemiologia e Biostatistica Istituto di Fisiologia Clinica Consiglio Nazionale delle Ricerche Area della Ricerca di Pisa Pisa Italy
| | - E. Rovini
- Istituto di Biorobotica Scuola Superiore Sant'Anna Pisa Italy
| | - D. Esposito
- Istituto di Biorobotica Scuola Superiore Sant'Anna Pisa Italy
| | - A. Pieroni
- Educazione alla Salute Azienda USL Toscana Nord Ovest Carrara Italy
| | - S. Ramat
- Dipartimento di Neuroscienze Azienda Ospedaliero Universitaria Careggi Firenze Italy
| | - P. Vanni
- Unità Operativa di Neurologia Ospedale Santa Maria Annunziata, Azienda USL Toscana Centro Firenze Italy
| | - B. Fattori
- Unità di Audiologia e Foniatria Medicina Interna e Sperimentale Università degli Studi di Pisa Pisa Italy
| | - G. Meco
- Dipartimento di Neurologia e Psichiatria, e Centro di Ricerca per le Malattie Sociali (CIMS) “Sapienza” Università degli Studi di Roma Roma Italy
- NCL [Neurological Centre of Latium (Gruppo NEUROMED)] Centro Studi Clinici Malattia di Parkinson Roma Italy
| |
Collapse
|
16
|
Colnaghi S, Colagiorgio P, Versino M, Koch G, D'Angelo E, Ramat S. A role for NMDAR-dependent cerebellar plasticity in adaptive control of saccades in humans. Brain Stimul 2017; 10:817-827. [PMID: 28501325 DOI: 10.1016/j.brs.2017.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Saccade pulse amplitude adaptation is mediated by the dorsal cerebellar vermis and fastigial nucleus. Long-term depression at the parallel fibre-Purkinjie cell synapses has been suggested to provide a cellular mechanism for the corresponding learning process. The mechanisms and sites of this plasticity, however, are still debated. OBJECTIVE To test the role of cerebellar plasticity phenomena on adaptive saccade control. METHODS We evaluated the effect of continuous theta burst stimulation (cTBS) over the posterior vermis on saccade amplitude adaptation and spontaneous recovery of the initial response. To further identify the substrate of synaptic plasticity responsible for the observed adaptation impairment, subjects were pre-treated with memantine, an N-methyl-d-aspartate receptor (NMDAR) antagonist. RESULTS Amplitude adaptation was altered by cTBS, suggesting that cTBS interferes with cerebellar plasticity involved in saccade adaptation. Amplitude adaptation and spontaneous recovery were not affected by cTBS when recordings were preceded by memantine administration. CONCLUSION The effects of cTBS are NMDAR-dependent and are likely to involve long-term potentiation or long-term depression at specific synaptic connections of the granular and molecular layer, which could effectively take part in cerebellar motor learning.
Collapse
Affiliation(s)
- S Colnaghi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy; Laboratory of Neuro-otology and Neuro-ophtalmology, C. Mondino National Neurological Institute, via Mondino 2, 27100 Pavia, Italy.
| | - P Colagiorgio
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, via Ferrata 5, 27100 Pavia, Italy
| | - M Versino
- Laboratory of Neuro-otology and Neuro-ophtalmology, C. Mondino National Neurological Institute, via Mondino 2, 27100 Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, via Forlanini 6, 27100 Pavia, Italy
| | - G Koch
- Laboratorio di Neurologia Clinica e Comportamentale, Fondazione S. Lucia IRCCS, via Ardeatina 306, 00179 Rome, Italy; Dipartimento di Neurologia, Policlinico Tor Vergata, viale Oxford 81, 00133 Rome, Italy
| | - E D'Angelo
- Department of Brain and Behavioral Sciences, University of Pavia, via Forlanini 6, 27100 Pavia, Italy; Brain Connectivity Center, C. Mondino National Neurological Institute, via Mondino 2, 27100 Pavia, Italy
| | - S Ramat
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, via Ferrata 5, 27100 Pavia, Italy
| |
Collapse
|
17
|
Cristiani A, Bertolotti GM, Dainotti M, Colagiorgio P, Romano F, Ramat S. A wearable system for measuring limb movements and balance control abilities based on a modular and low-cost inertial unit. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:3496-9. [PMID: 25570744 DOI: 10.1109/embc.2014.6944376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Monitoring balance and movement has proven useful in many applications ranging from fall risk assessment, to quantifying exercise, studying people habits and monitoring the elderly. Here we present a versatile, wearable instrument capable of providing objective measurements of limb movements for the assessment of motor and balance control abilities. The proposed device allows measuring linear accelerations, angular velocities and heading either online, through wireless connection to a computer, or for long-term monitoring, thanks to its local storage abilities. One or more body parts may be simultaneously monitored in a single or multiple sensors configuration.
Collapse
|
18
|
Gallo V, Brayne C, Forsgren L, Barker RA, Petersson J, Hansson O, Lindqvist D, Ruffmann C, Ishihara L, Luben R, Arriola L, Bergareche A, Gavrila D, Erro ME, Vanacore N, Sacerdote C, Bueno-de-Mesquita B, Vermeulen R, Seelen M, Sieri S, Masala G, Ramat S, Kyrozis A, Thricopolou A, Panico S, Mattiello A, Kaaks R, Teucher B, Katzke V, Kloss M, Curry L, Calboli F, Riboli E, Vineis P, Middleton L. Parkinson's Disease Case Ascertainment in the EPIC Cohort: The NeuroEPIC4PD Study. NEURODEGENER DIS 2015; 15:331-8. [PMID: 26375921 DOI: 10.1159/000381857] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 03/19/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Large epidemiological prospective studies represent an important opportunity for investigating risk factors for rare diseases such as Parkinson's disease (PD). Here we describe the procedures we used for ascertaining PD cases in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. METHODS The following three-phase procedure was used: (1) elaboration of a NeuroEPIC4PD template for clinical data collection, (2) identification of all potential PD cases via record linkage and (3) validation of the diagnosis through clinical record revision, in a population of 220,494 subjects recruited in 7 European countries. All cases were labelled with the NeuroEPIC4PD diagnoses of 'definite', 'very likely', 'probable', or 'possible' PD. RESULTS A total of 881 PD cases were identified, with over 2,741,780 person-years of follow-up (199 definite, 275 very likely, 146 probable, and 261 possible). Of these, 734 were incident cases. The mean age at diagnosis was 67.9 years (SD 9.2) and 458 patients (52.0%) were men. Bradykinesia was the most frequent presenting motor sign (76.5%). Tremor-dominant and akinetic rigid forms of PD were the most common types of PD. A total of 289 patients (32.8%) were dead at the time of the last follow-up. CONCLUSIONS This exercise proved that it is feasible to ascertain PD in large population-based cohort studies and offers a potential framework to be replicated in similar studies.
Collapse
Affiliation(s)
- Valentina Gallo
- School of Public Health, Imperial College London, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Romano F, Colagiorgio P, Buizza A, Sardi F, Ramat S. Extraction of traditional COP-based features from COM sway in postural stability evaluation. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:3715-3718. [PMID: 26737100 DOI: 10.1109/embc.2015.7319200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Postural control during quiet standing is evaluated by analyzing CoP sway, easily measured using a force platform. However, recent proliferation of motion tracking systems made easily available an estimate of the CoM location. Traditional CoP-based measures presented in literature provide information about age-related changes in postural stability and fall risk. We investigated, on an age-matched group of subjects, the relationship between classical CoP-based measures computed on sway path and statistical mechanics parameters on diffusion plot, with those extracted from CoM time-series. Our purpose is to understand which of these parameters, computed on CoM sway, can discriminate postural abnormalities, in order to use a video tracking system to evaluate balance in addition to motor capabilities.
Collapse
|
20
|
Cusmano I, Sterpi I, Mazzone A, Ramat S, Delconte C, Pisano F, Colombo R. Evaluation of upper limb sense of position in healthy individuals and patients after stroke. J Healthc Eng 2014; 5:145-62. [PMID: 24918181 DOI: 10.1260/2040-2295.5.2.145] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aims of this study were to develop and evaluate reliability of a quantitative assessment tool for upper limb sense of position on the horizontal plane. We evaluated 15 healthy individuals (controls) and 9 stroke patients. A robotic device passively moved one arm of the blindfolded participant who had to actively move his/her opposite hand to the mirror location in the workspace. Upper-limb's position was evaluated by a digital camera. The position of the passive hand was compared with the active hand's 'mirror' position. Performance metrics were then computed to measure the mean absolute errors, error variability, spatial contraction/expansion, and systematic shifts. No significant differences were observed between dominant and non-dominant active arms of controls. All performance parameters of the post-stroke group differed significantly from those of controls. This tool can provide a quantitative measure of upper limb sense of position, therefore allowing detection of changes due to rehabilitation.
Collapse
Affiliation(s)
- I Cusmano
- IRCCS, Service of Bioengineering, "Salvatore Maugeri" Foundation, Pavia, Italy
| | - I Sterpi
- IRCCS, Service of Bioengineering, "Salvatore Maugeri" Foundation, Pavia, Italy
| | - A Mazzone
- IRCCS, Service of Bioengineering, "Salvatore Maugeri" Foundation, Veruno (NO), Italy
| | - S Ramat
- Department of Computer and Systems Science, University of Pavia, Pavia, Italy
| | - C Delconte
- IRCCS, Division of Neurology, "Salvatore Maugeri" Foundation, Veruno (NO), Italy
| | - F Pisano
- IRCCS, Division of Neurology, "Salvatore Maugeri" Foundation, Veruno (NO), Italy
| | - R Colombo
- IRCCS, Service of Bioengineering, "Salvatore Maugeri" Foundation, Pavia, Italy IRCCS, Service of Bioengineering, "Salvatore Maugeri" Foundation, Veruno (NO), Italy
| |
Collapse
|
21
|
Ramaioli C, Colagiorgio P, Sağlam M, Heuser F, Schneider E, Ramat S, Lehnen N. Covert saccades improve dynamic visual stability in bilateral vestibular dysfunction. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371226] [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: 10/25/2022]
|
22
|
Colagiorgio P, Romano F, Sardi F, Moraschini M, Sozzi A, Bejor M, Ricevuti G, Buizza A, Ramat S. Affordable, automatic quantitative fall risk assessment based on clinical balance scales and Kinect data. Annu Int Conf IEEE Eng Med Biol Soc 2014; 2014:3500-3503. [PMID: 25570745 DOI: 10.1109/embc.2014.6944377] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The problem of a correct fall risk assessment is becoming more and more critical with the ageing of the population. In spite of the available approaches allowing a quantitative analysis of the human movement control system's performance, the clinical assessment and diagnostic approach to fall risk assessment still relies mostly on non-quantitative exams, such as clinical scales. This work documents our current effort to develop a novel method to assess balance control abilities through a system implementing an automatic evaluation of exercises drawn from balance assessment scales. Our aim is to overcome the classical limits characterizing these scales i.e. limited granularity and inter-/intra-examiner reliability, to obtain objective scores and more detailed information allowing to predict fall risk. We used Microsoft Kinect to record subjects' movements while performing challenging exercises drawn from clinical balance scales. We then computed a set of parameters quantifying the execution of the exercises and fed them to a supervised classifier to perform a classification based on the clinical score. We obtained a good accuracy (~82%) and especially a high sensitivity (~83%).
Collapse
|
23
|
Giganti F, Guidi S, Ramat S, Zilli I, Raglione LM, Sorbi S, Salzarulo P. Yawning: A behavioural marker of sleepiness in de novo PD patients. Parkinsonism Relat Disord 2013; 19:703-4. [DOI: 10.1016/j.parkreldis.2013.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 03/18/2013] [Accepted: 03/25/2013] [Indexed: 10/26/2022]
|
24
|
Giganti F, Ramat S, Zilli I, Guidi S, Raglione LM, Sorbi S, Salzarulo P. Daytime course of sleepiness in de novo Parkinson's disease patients. J Sleep Res 2012; 22:197-200. [PMID: 23137353 DOI: 10.1111/jsr.12000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Abstract
Normal subjects show an increase of sleepiness in the morning, early afternoon and before sleep. In the advanced stages of Parkinson's disease (PD) the mean level of sleepiness is quite high, while with respect to healthy subjects it seems to be unchanged in the early stages. The aim of this study was to evaluate the time-course of the sleepiness level during the wakefulness period in untreated patients with early-stage Parkinson's disease. Eighteen Parkinson's disease patients who had never been treated before with dopaminergic drugs (male = 9, female = 9, age: 68.39 ± 1.89, mean ± standard error) and 18 healthy subjects (male = 9, female = 9, age: 67.22 ± 1.98) were recruited for this study. All subjects underwent continuous actigraphic recording for three consecutive days, during which they also completed the Karolinska Sleepiness Scale (KSS) once an hour throughout wakefulness. Our results showed a higher level of sleepiness in the patients than the controls in the hours following awakening and in the early afternoon, specifically at 08:00 and 14:00 hours (08:00 hours, PD patients, KSS: 3 ± 0.3 versus healthy subjects, KSS: 2 ± 0.2, P < 0.05; 14:00 hours, PD patients, KSS: 4.4 ± 0.5 versus healthy subjects, KSS: 3 ± 0.3, P < 0.05). We suggest that some daytime hours are sensitive windows showing the first increase of sleepiness which will spread later to the whole daytime.
Collapse
Affiliation(s)
- Fiorenza Giganti
- Sleep Laboratory, Department of Psychology, University of Florence, Florence, Italy.
| | | | | | | | | | | | | |
Collapse
|
25
|
Antonini A, Barone P, Marconi R, Morgante L, Zappulla S, Pontieri FE, Ramat S, Ceravolo MG, Meco G, Cicarelli G, Pederzoli M, Manfredi M, Ceravolo R, Mucchiut M, Volpe G, Abbruzzese G, Bottacchi E, Bartolomei L, Ciacci G, Cannas A, Randisi MG, Petrone A, Baratti M, Toni V, Cossu G, Del Dotto P, Bentivoglio AR, Abrignani M, Scala R, Pennisi F, Quatrale R, Gaglio RM, Nicoletti A, Perini M, Avarello T, Pisani A, Scaglioni A, Martinelli PE, Iemolo F, Ferigo L, Simone P, Soliveri P, Troianiello B, Consoli D, Mauro A, Lopiano L, Nastasi G, Colosimo C. The progression of non-motor symptoms in Parkinson’s disease and their contribution to motor disability and quality of life. J Neurol 2012; 259:2621-31. [DOI: 10.1007/s00415-012-6557-8] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 05/13/2012] [Accepted: 05/14/2012] [Indexed: 11/28/2022]
|
26
|
Berti V, Polito C, Borghammer P, Ramat S, Mosconi L, Vanzi E, De Cristofaro MT, De Leon M, Sorbi S, Pupi A. Alternative normalization methods demonstrate widespread cortical hypometabolism in untreated de novo Parkinson's disease. Q J Nucl Med Mol Imaging 2012; 56:299-308. [PMID: 22695340 PMCID: PMC3846292] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Previous positron emission tomography (PET) [18F]fluorodeoxyglucose ([18F]FDG) studies in Parkinson's disease (PD) demonstrated that moderate to late stage patients display widespread cortical hypometabolism, whereas early stage PD patients exhibit little or no cortical changes. However, recent studies suggested that conventional data normalization procedures may not always be valid, and demonstrated that alternative normalization strategies better allow detection of low magnitude changes. We hypothesized that these alternative normalization procedures would disclose more widespread metabolic alterations in de novo PD. METHODS [18F]FDG PET scans of 26 untreated de novo PD patients (Hoehn & Yahr stage I-II) and 21 age-matched controls were compared using voxel-based analysis. Normalization was performed using gray matter (GM), white matter (WM) reference regions and Yakushev normalization. RESULTS Compared to GM normalization, WM and Yakushev normalization procedures disclosed much larger cortical regions of relative hypometabolism in the PD group with extensive involvement of frontal and parieto-temporal-occipital cortices, and several subcortical structures. Furthermore, in the WM and Yakushev normalized analyses, stage II patients displayed more prominent cortical hypometabolism than did stage I patients. CONCLUSION The use of alternative normalization procedures, other than GM, suggests that much more extensive cortical hypometabolism is present in untreated de novo PD patients than hitherto reported. The finding may have implications for our understanding of the basic pathophysiology of early-stage PD.
Collapse
Affiliation(s)
- V Berti
- Department of Clinical Pathophysiology, Nuclear Medicine Division, University of Florence, Florence, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Federighi P, Ramat S, Zee D, Leigh R, Piu P, Rufa A. Dynamic Properties of Saccades Identify Forms of Spinocerebellar Ataxia (S48.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s48.005] [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] Open
|
28
|
Maremmani C, Rossi G, Tambasco N, Fattori B, Pieroni A, Ramat S, Napolitano A, Vanni P, Serra P, Piersanti P, Zanetti M, Coltelli M, Orsini M, Marconi R, Purcaro C, Rossi A, Calabresi P, Meco G. The validity and reliability of the Italian Olfactory Identification Test (IOIT) in healthy subjects and in Parkinson's disease patients. Parkinsonism Relat Disord 2012; 18:788-93. [PMID: 22510205 DOI: 10.1016/j.parkreldis.2012.03.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 08/05/2011] [Revised: 03/14/2012] [Accepted: 03/23/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Olfactory function can be rapidly evaluated by means of standardized olfactory tests. Multiple-choice smell identification tests can be conditioned by cultural background. To investigate a new tool for detecting olfactory deficit in Italian subjects we developed a multiple-choice identification test prepared with odorants belonging to the Italian culture. METHODS The Italian Olfactory Identification Test (IOIT) was developed with 33 microencapsulated odorants with intensity of odors and headspace Gas Chromatography being tested. Test-retest reliability of the IOIT was evaluated. The IOIT was administered to 511 controls and 133 Parkinson's patients. RESULTS In healthy subjects the number of IOIT errors increased with age for both females (p < 0.0001) and males (p < 0.0001), while in the Parkinson's disease group the number of IOIT errors was significantly greater where compared to healthy subjects (p < 0.0001 in all age groups). The reference limits applied to all age groups revealed an IOIT sensitivity of 93% and a specificity of 99%. The test-retest reliability was excellent. CONCLUSION The IOIT is highly reliable, disposable, easy to administer, not fragile, and has a long shelf-life. All these features make the IOIT suitable for clinical use as well as for population screening and to discriminate Parkinson's patients from healthy subjects.
Collapse
Affiliation(s)
- Carlo Maremmani
- Unità Operativa di Neurologia, Asl 1 Massa Carrara, Carrara, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Morgante L, Colosimo C, Antonini A, Marconi R, Meco G, Pederzoli M, Pontieri FE, Cicarelli G, Abbruzzese G, Zappulla S, Ramat S, Manfredi M, Bottacchi E, Abrignani M, Berardelli A, Cozzolino A, Paradiso C, De Gaspari D, Morgante F, Barone P. Psychosis associated to Parkinson's disease in the early stages: relevance of cognitive decline and depression. J Neurol Neurosurg Psychiatry 2012; 83:76-82. [PMID: 21836035 DOI: 10.1136/jnnp-2011-300043] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [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: 12/19/2022]
Abstract
OBJECTIVE To evaluate the prevalence of psychosis associated with Parkinson's disease (PSY-PD) in its early stages, its incidence over a 24 month follow-up period and the association with motor and non-motor clinical features. METHODS PRIAMO is a 2 year longitudinal observational study that has enrolled patients with parkinsonism in 55 Italian centres. A cohort of 495 patients with early disease stage PD (baseline Hoehn and Yahr score ≤ 2, disease's duration (median) 3.4 years) were followed for 2 years. PSY-PD was evaluated by means of a clinician rated questionnaire and defined as the presence of at least one of the following symptoms occurring for at least 1 month: illusions, hallucinations, jealousy ideas and persecutory ideas. Patients with and without PSY-PD were compared on several clinical variables, encompassing motor and non-motor features. RESULTS The prevalence of PSY-PD at baseline was 3%; the incidences at 12 and 24 months were 5.2% and 7.7%, respectively. Longer disease duration and prescription of dopamine agonists at baseline were associated with the development of PSY-PD over the 24 month period. At this follow-up time, worse disease severity, decline in cognitive performances, presence of depressive symptoms and anxiety were more frequently observed in PSY-PD. CONCLUSIONS Psychotic type symptoms may occur in the early stages of PD although less frequently than in later stages. Beyond dopaminergic treatment, there are disease related factors, such as disease severity and the occurrence of cognitive and depressive symptoms, which may underlie the onset of psychotic type symptoms from the earliest stages.
Collapse
Affiliation(s)
- Letterio Morgante
- Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Università di Messina, Via Consolare Valeria 1, 98125 Messina, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Marconi R, Antonini A, Barone P, Colosimo C, Avarello TP, Bottacchi E, Cannas A, Ceravolo MG, Ceravolo R, Cicarelli G, Gaglio RM, Giglia L, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Del Dotto P, De Gaspari D, Grasso L, Morgante F, Santangelo G, Fabbrini G, Morgante L. Frontal assessment battery scores and non-motor symptoms in parkinsonian disorders. Neurol Sci 2011; 33:585-93. [PMID: 22048791 DOI: 10.1007/s10072-011-0807-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 09/17/2011] [Indexed: 10/16/2022]
Abstract
Using data from the PRIAMO study, we investigated non-motor symptoms (NMS) versus frontal lobe dysfunction in patients with idiopathic Parkinson disease (PD); 808 patients with PD and 118 with atypical parkinsonisms (AP) were consecutively enrolled at 55 Centers in Italy. Twelve categories of NMS were investigated. Cognitive impairment was defined as a Mini-Mental Status Evaluation score ≤ 23.8 and frontal lobe dysfunction as a Frontal Assessment Battery (FAB) score ≤ 3.48. Multivariable logistic regression was used to identify predictor of frontal lobe dysfunction in 524 PD patients, and a generalized linear model was used for each of the six FAB items. Not only the total FAB scores but also the single FAB items were lower in AP versus PD (p ≤ 0.005). Age (OR = 1.05), cognitive impairment (OR = 9.54), lack of cardiovascular symptoms (OR = 3.25), attention or memory problems (OR = 0.59) and treatment with L: -DOPA (OR = 5.58) were predictors of frontal lobe dysfunction. MMSE was negatively associated with all FAB items (β ≤ -0.16) and age with all FAB items but prehension behavior (β ≤ -0.01). Previous use of L: -DOPA was negatively associated with verbal fluency (β = -0.32) possibly acting as surrogate marker of disease duration. Cognitive impairment is a predictor of frontal lobe dysfunction. Among NMS, lack of attention or memory problems were negatively associated with frontal impairment. Further studies are nonetheless needed to better identify the predictors of frontal impairment in PD patients.
Collapse
Affiliation(s)
- Roberto Marconi
- Dipartimento di Neuroscienze, Ospedale Misericordia, Via Senese, 171, 58100, Grosseto, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Manzari L, Colletti V, Mandalà M, Manganotti P, Ramat S, Colletti L. W3.4 Intraoperative observation of changes in cochlear nerve action potentials during exposure to electromagnetic fields generated by mobile phones. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60031-x] [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]
|
32
|
Bertolini G, Ramat S. Velocity storage in the human vertical rotational vestibulo-ocular reflex. Exp Brain Res 2010; 209:51-63. [PMID: 21170706 DOI: 10.1007/s00221-010-2518-6] [Citation(s) in RCA: 15] [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: 09/10/2010] [Accepted: 12/02/2010] [Indexed: 11/29/2022]
Abstract
Human horizontal rotational vestibulo-ocular reflex (rVOR) has been extensively investigated: the horizontal semicircular canals sense yaw rotations with high-pass filter dynamics and a time constant (TC) around 5 s, yet the rVOR response shows a longer TC due to a central processing stage, known as velocity storage mechanism (VSM). It is generally assumed that the vertical rVOR behaves similarly to the horizontal one; however, VSM processing of the human vertical rVOR is still to be proven. We investigated the vertical rVOR in eight healthy human subjects using three experimental paradigms: (1) per- and post-rotatory around an earth-vertical axis (ear down rotations, EDR), (2) post-rotatory around an earth-horizontal axis with different stopping positions (static otolith stimulation), (3) per-rotatory around an earth-horizontal axis (dynamic otolith stimulation). We found that the TC of vertical rVOR responses ranged 3-10 s, depending both on gravity and on the direction of rotation. The shortest TC were found in response to post-rotatory earth-horizontal stimulation averaging 3.6 s, while they were prolonged in EDR stimulation, i.e. when the head angular velocity vector is aligned with gravity, with a mean value of about 6.0 s. Overall, the longest TC were observed in per-rotatory earth-horizontal stimulation, averaging 7.8 s. The finding of longer TC in EDR than in post-rotatory earth-horizontal stimulation indicates a role for the VSM in the vertical rVOR, although its contribution appears to be weaker than on the horizontal rVOR and may be directionally asymmetric. The results from per-rotatory earth-horizontal stimulation, instead, imply a role for the otoliths in controlling the duration of the vertical rVOR response. We found no reorientation of the response toward earth horizontal, indicating a difference between human and monkey rVOR.
Collapse
Affiliation(s)
- G Bertolini
- Department of Computer and Systems Science, University of Pavia, Pavia, Italy
| | | |
Collapse
|
33
|
Abstract
The vestibulo-ocular reflex (VOR) uses head angular acceleration information transduced by the semicircular canals in the inner ear in order to drive eye movements that compensate for head rotations, and thus stabilize the visual scene on the retina. Peripheral and central vestibular pathologies may impair the function of the VOR, so that compensation becomes incomplete, making clear vision during head movement impossible. Powerful adaptive mechanisms quickly allow the central nervous system to use residual vestibular information or information provided through other senses to supplement the deficient VOR. Such recovery makes the clinical diagnosis difficult to classical testing techniques, yet the head impulse test allows to reveal vestibular deficits even in adapted patients. A compensatory saccade at the end of the head movement is the clinical sign of a vestibular deficit, and may be spotted by the experienced clinician. Here we describe the rationale and the software program driving a new computerized technique for reliably assessing vestibular function at different head angular accelerations, based on evaluating the ability of the patient in reading a character on the screen while the head is being rotated.
Collapse
Affiliation(s)
- A Bohler
- Upper Austria University for Applied Sciences, Linz, Austria.
| | | | | |
Collapse
|
34
|
Bertolini G, Ramat S, Laurens J, Bockisch CJ, Marti S, Straumann D, Palla A. Velocity storage contribution to vestibular self-motion perception in healthy human subjects. J Neurophysiol 2010; 105:209-23. [PMID: 21068266 DOI: 10.1152/jn.00154.2010] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Self-motion perception after a sudden stop from a sustained rotation in darkness lasts approximately as long as reflexive eye movements. We hypothesized that, after an angular velocity step, self-motion perception and reflexive eye movements are driven by the same vestibular pathways. In 16 healthy subjects (25-71 years of age), perceived rotational velocity (PRV) and the vestibulo-ocular reflex (rVOR) after sudden decelerations (90°/s(2)) from constant-velocity (90°/s) earth-vertical axis rotations were simultaneously measured (PRV reported by hand-lever turning; rVOR recorded by search coils). Subjects were upright (yaw) or 90° left-ear-down (pitch). After both yaw and pitch decelerations, PRV rose rapidly and showed a plateau before decaying. In contrast, slow-phase eye velocity (SPV) decayed immediately after the initial increase. SPV and PRV were fitted with the sum of two exponentials: one time constant accounting for the semicircular canal (SCC) dynamics and one time constant accounting for a central process, known as velocity storage mechanism (VSM). Parameters were constrained by requiring equal SCC time constant and VSM time constant for SPV and PRV. The gains weighting the two exponential functions were free to change. SPV were accurately fitted (variance-accounted-for: 0.85 ± 0.10) and PRV (variance-accounted-for: 0.86 ± 0.07), showing that SPV and PRV curve differences can be explained by a greater relative weight of VSM in PRV compared with SPV (twofold for yaw, threefold for pitch). These results support our hypothesis that self-motion perception after angular velocity steps is be driven by the same central vestibular processes as reflexive eye movements and that no additional mechanisms are required to explain the perceptual dynamics.
Collapse
Affiliation(s)
- G Bertolini
- Neurology Department, Zurich University Hospital, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
35
|
Pallanti S, Bernardi S, Raglione LM, Marini P, Ammannati F, Sorbi S, Ramat S. Complex repetitive behavior: punding after bilateral subthalamic nucleus stimulation in Parkinson's disease. Parkinsonism Relat Disord 2010; 16:376-80. [PMID: 20346726 DOI: 10.1016/j.parkreldis.2010.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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: 02/27/2009] [Revised: 02/12/2010] [Accepted: 02/22/2010] [Indexed: 10/19/2022]
Abstract
"Punding" is the term used to describe a stereotyped motor behavior characterized by an intense fascination with repetitive purposeless movements, such as taking apart mechanical objects, handling common objects as if they were new and entertaining, constantly picking at oneself, etc. As a phenomenon with both impulsive and compulsive features, the phenomenology of punding is currently being questioned. In order to investigate the pathophysiology of this phenomenon, we screened a population of Parkinson's disease (PD) outpatients who underwent subthalamic nucleus deep brain stimulation (STN DBS). We conducted a patient-and-relative-completed survey with 24 consecutive patients in an academic outpatient care center, using a modified version of a structured interview. Patients were administered the Unified Parkinson's Disease Rating Scale (UPDRS), the Obsessive-Compulsive Inventory and the Sheehan Disability Scale. Five (20.8%) of the 24 subjects were identified as punders, including three men (60%) and two women. The punders were comparable to the non-punders in terms of clinical and demographic factors. The punder and non-punder groups only differed statistically with regard to the length of time from DBS implantation. Those findings suggest that punding might be induced by STN DBS, and its rate of occurrence in DBS population seems to be more common than previously suspected.
Collapse
Affiliation(s)
- Stefano Pallanti
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY 10029, USA.
| | | | | | | | | | | | | |
Collapse
|
36
|
Sestini S, Pupi A, Ammannati F, Ramat S, Sorbi S, Sciagrà R, Mansi L, Castagnoli A. Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation. Eur J Nucl Med Mol Imaging 2010; 37:12-22. [PMID: 19582450 DOI: 10.1007/s00259-009-1198-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 06/03/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson's disease (PD) patients treated with subthalamic nucleus (STN) stimulation. METHODS Ten patients underwent rCBF SPECT and motor Unified Parkinson's Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses. RESULTS Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors. CONCLUSION This study shows that PD patients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease.
Collapse
Affiliation(s)
- Stelvio Sestini
- Department of Diagnostic Imaging, Nuclear Medicine Unit, Ospedale Misericordia e Dolce, Piazza Ospedale 5, 59100 Prato, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Single-unit recordings of vestibular afferents from the semicircular canals of squirrel monkeys have shown that the cupular time constant (T(c)) is between 5 and 6 sec. Such recordings obviously cannot be performed in humans, and the corresponding values have thus been inferred to be somewhat longer based on their size and on the cupula-endolymph system. The ocular motor response of the rotational vestibulo-ocular reflex (rVOR) is characterized by longer time constants, typically between 15 and 20 sec, due to the so-called velocity storage mechanism (VSM), which prolongs the time constant of the afferents through central processing. Recent studies have attempted to determine the time constant of the cupula by fitting the slow phase velocity (SPV) of the response to postrotational stimuli using a mathematical model of the rVOR processing. To this goal they considered the processing of head velocity due to the peripheral vestibular organs and to the VSM. The resulting estimates of T(c) are lower than expected, averaging about 4 sec. These modeling approaches, though, neglect both the processing of the final common pathway and the adaptation shown by the discharge of primary vestibular afferents. Here we argue that such an approach may be bound to underestimate the duration of the rVOR time constants.
Collapse
Affiliation(s)
- S Ramat
- Dipartimento di Informatica e Sistemistica, Università di Pavia, Pavia, Italy.
| | | |
Collapse
|
38
|
Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, Bottacchi E, Cannas A, Ceravolo G, Ceravolo R, Cicarelli G, Gaglio RM, Giglia RM, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Dotto PD. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord 2009; 24:1641-9. [PMID: 19514014 DOI: 10.1002/mds.22643] [Citation(s) in RCA: 937] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Paolo Barone
- Università Federico II and IDC-Hermitage-Capodimonte, Napoli, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Colosimo C, Morgante L, Antonini A, Barone P, Avarello TP, Bottacchi E, Cannas A, Ceravolo MG, Ceravolo R, Cicarelli G, Gaglio RM, Giglia L, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Del Dotto P, Simoni L, Marconi R. Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study. J Neurol 2009; 257:5-14. [DOI: 10.1007/s00415-009-5255-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 06/12/2009] [Accepted: 07/08/2009] [Indexed: 10/20/2022]
|
40
|
Bertolini G, Bockisch CJ, Straumann D, Zee DS, Ramat S. Estimating the time constant of pitch rVOR by separation of otoliths and semicircular canals contributions. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2008:1060-3. [PMID: 19162845 DOI: 10.1109/iembs.2008.4649342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The rotational vestibulo-ocular reflex (rVOR) contributes to gaze stabilitization by compensating head rotational movements sensed by the semicircular canals (SCC). The CNS improves the performance of the horizontal rVOR through the so called velocity storage mechanism (VSM). However the properties of the VSM in response to pitch rotations are less well known. We recorded eye movements evoked by whole-body constant-velocity pitch rotations about an earth-horizontal, interaural axis in four healthy human subjects. Subjects were tumbled forward, and backward, at 60 deg/s for over one minute using a 3D turntable. In these conditions also the otoliths contribute to the perception of head rotation because they sense the changes in direction of the gravity vector. The vertical slow phase velocity (SPV) responses show the typical exponential decay of the rVOR and a residual, otolith-driven sinusoidal modulation with a bias. Here the estimates of the contributions coming from the otoliths and from the canals are based on a linear summation hypothesis. The time constants of the canal-driven vertical component of the SPV ranged from 6 to 9 seconds. These values are closer to those produced by the SCC alone than the typical 20 s produced by the VSM in the horizontal plane, confirming the relatively small contribution of the VSM to these vertical responses. We also show that the estimation method, while it may be not physiologically accurate, is easy to implement and leads to reliable results.
Collapse
Affiliation(s)
- G Bertolini
- Dip. Informatica e Sistemistica, Università degli Studi di Pavia, Via Ferrata, Pavia 1 - 27100, Italy.
| | | | | | | | | |
Collapse
|
41
|
Bernardi S, Ramat S, Raglione L, Marini P, Sorbi S, Ammannati F, Pallanti S. Punding after bilateral subthalamic nucleus stimulation in Parkinson' disease. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.1212] [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: 10/22/2022] Open
|
42
|
Abstract
INTRODUCTION Patients with cervical dystonia (CD) often have limb tremor that is clinically indistinguishable from essential tremor (ET). Whether a common central mechanism underlies the tremor in these conditions is unknown. We addressed this issue by quantifying limb tremor in 19 patients with CD and 35 patients with ET. METHOD Postural, resting and kinetic tremors were quantified (amplitude, mean frequency and regularity) using a three-axis accelerometer. RESULTS The amplitude of limb tremor in ET was significantly higher than in CD, but the mean frequency was not significantly different between the groups. The cycle-to-cycle variability of the frequency (ie the tremor irregularity), however, was significantly greater (approximately 50%) in CD. Analysis of covariance excluded the possibility that the increased irregularity was related to the smaller amplitude of tremor in CD (ANCOVA: p = 0.007, F = 5.31). DISCUSSION We propose that tremor in CD arises from oscillators with different dynamic characteristics, producing a more irregular output, whereas the tremor in ET arises from oscillators with similar dynamic characteristics, producing a more regular output. We suggest that variability of tremor is an important parameter for distinguishing tremor mechanisms. It is possible that changes in membrane kinetics based on the pattern of ion channel expression underlie the differences in tremor in some diseases.
Collapse
Affiliation(s)
- A G Shaikh
- Department of Neurology, The Johns Hopkins Hospital, 600 North Wolfe Street, Pathology 2-210, Baltimore, MD 21287, USA.
| | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
Saccadic oscillations are unwanted back-to-back saccades occurring one upon the other that produce a high-frequency oscillation of the eyes (usually 15-30 Hz). These may occur transiently in normal subjects, for example, around the orthogonal axis of a purely horizontal or vertical saccade, during combined saccade-vergence gaze shifts or during blinks. Some subjects may produce saccadic oscillations at will, usually with convergence. Pathological, involuntary saccadic oscillations such as flutter and opsoclonus are prominent in certain diseases. Our recent mathematical model of the premotor circuit for generating saccades includes brainstem burst neurons in the paramedian pontine reticular formation (PPRF), which show the physiological phenomenon of post-inhibitory rebound (PIR). This model makes saccadic oscillations because of the positive feedback among excitatory and inhibitory burst neurons. Here we review our recent findings and hypotheses and show how they may be reproduced using our lumped model of the saccadic premotor circuitry by reducing the inhibitory efficacy of omnipause neurons.
Collapse
Affiliation(s)
- S Ramat
- Dipartimento di Informatica e Sistemistica, Università degli Studi di Pavia, Pavia, Italy.
| | | | | | | | | |
Collapse
|
44
|
Abstract
The question of how the central nervous system can distinguish tilt with respect to gravity from inertial acceleration due to translation in a horizontal plane using vestibular information has long been debated by the scientific community over the past ten years. Recently, it was hypothesized that such discrimination may be based on the multisensory integration of information provided by the otolith organs and the semicircular canals. Some evidence of such processing was found in the neural activity of cells in the fastigial nuclei and vestibular nuclei. To investigate the ability of the central nervous system to build an internal model of self motion based on vestibular signals, we developed an artificial vestibular sensor composed of accelerometers and gyroscopes providing movement data of the same nature as that transduced by the otoliths and canals, respectively. Here we show that the processing of these signals based on the multisensory integration hypothesis can be successfully used to discriminate tilt from translation and that the internal model based on such processing can successfully track angular and linear displacements over short periods of time.
Collapse
Affiliation(s)
- S Ramat
- Dipt. di Informatica e Sistemistica, Pavia Univ., Italy.
| | | | | |
Collapse
|
45
|
Vanzi E, De Cristofaro MT, Ramat S, Sotgia B, Mascalchi M, Formiconi AR. A direct ROI quantification method for inherent PVE correction: accuracy assessment in striatal SPECT measurements. Eur J Nucl Med Mol Imaging 2007; 34:1480-9. [PMID: 17390134 DOI: 10.1007/s00259-007-0404-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 08/04/2006] [Accepted: 01/19/2007] [Indexed: 11/27/2022]
Abstract
PURPOSE The clinical potential of striatal imaging with dopamine transporter (DAT) SPECT tracers is hampered by the limited capability to recover activity concentration ratios due to partial volume effects (PVE). We evaluated the accuracy of a least squares method that allows retrieval of activity in regions of interest directly from projections (LS-ROI). METHODS An Alderson striatal phantom was filled with striatal to background ratios of 6:1, 9:1 and 28:1; the striatal and background ROIs were drawn on a coregistered X-ray CT of the phantom. The activity ratios of these ROIs were derived both with the LS-ROI method and with conventional SPECT EM reconstruction (EM-SPECT). Moreover, the two methods were compared in seven patients with motor symptoms who were examined with N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) (FP-CIT) SPECT, calculating the binding potential (BP). RESULTS In the phantom study, the activity ratios obtained with EM-SPECT were 3.5, 5.3 and 17.0, respectively, whereas the LS-ROI method resulted in ratios of 6.2, 9.0 and 27.3, respectively. With the LS-ROI method, the BP in the seven patients was approximately 60% higher than with EM-SPECT; a linear correlation between the LS-ROI and the EM estimates was found (r=0.98, p=0.03). CONCLUSION The LS-ROI PVE correction capability is mainly due to the fact that the ill-conditioning of the LS-ROI approach is lower than that of the EM-SPECT one. The LS-ROI seems to be feasible and accurate in the examination of the dopaminergic system. This approach can be fruitful in monitoring of disease progression and in clinical trials of dopaminergic drugs.
Collapse
Affiliation(s)
- Eleonora Vanzi
- Clinical Pathophysiology, University of Florence, Viale Morgagni, 85, Florence, 50134, Italy.
| | | | | | | | | | | |
Collapse
|
46
|
|
47
|
Raglione L, Ammannati F, Ramat S, Marini P, Paganini M, Molteni S, Scotto di Luzio A, Mennonna P, Sorbi S. 3.214 Nine-year follow up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70852-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
48
|
Polito C, Ramat S, De Cristofaro M, Marini P, Paganini M, Sorbi S, Pupi A. 3.116 Set-shifting deficit and fronto-temporal hypometabolism in early Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70824-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
49
|
Polito C, Ramat S, Paganini M, Merli L, Marini P, Raglione L, Ammannati F, Mennonna P, Sorbi S. 3.225 Neuropsychological outcome of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70863-0] [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: 11/26/2022]
|
50
|
Righi S, Viggiano MP, Paganini M, Ramat S, Marini P. Recognition of category-related visual stimuli in Parkinson's disease: Before and after pharmacological treatment. Neuropsychologia 2007; 45:2931-41. [PMID: 17662314 DOI: 10.1016/j.neuropsychologia.2007.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 10/11/2006] [Revised: 06/01/2007] [Accepted: 06/08/2007] [Indexed: 11/25/2022]
Abstract
Visual-sensory dysfunctions and semantic processing impairments are widely reported in Parkinson's disease (PD) research. The present study investigated the category-specific deficit in object recognition as a function of both the semantic category and spatial frequency content of stimuli. In the first experiment, the role of dopamine in object-recognition processing was assessed by comparing PD drug naïve (PD-DN), PD receiving levodopa treatment (PD-LD), and control subjects. Experiment 2 consisted of a retest session for PD drug naïve subjects after a period of pharmacological treatment. All participants completed an identification task which displayed animals and tools at nine levels of filtering. Each object was revealed in a sequence of frames whereby the object was presented at increasingly less-filtered images up to a complete version of the image. Results indicate an impaired identification pattern for PD-DN subjects solely for animal category stimuli. This differential pharmacological therapy effect was also confirmed at retest (experiment 2). Thus, our data suggest that dopaminergic loss has a specific role in category-specific impairment. Two possible hypotheses are discussed that may account for the defective recognition of semantically different objects in PD.
Collapse
Affiliation(s)
- S Righi
- Dipartimento di Psicologia, Università degli Studi di Firenze, Via s. Niccolò 93, 50125 Firenze, Italy.
| | | | | | | | | |
Collapse
|