1
|
Comanducci A, Casarotto S, Rosanova M, Derchi CC, Viganò A, Pirastru A, Blasi V, Cazzoli M, Navarro J, Edlow BL, Baglio F, Massimini M. Unconsciousness or unresponsiveness in akinetic mutism? Insights from a multimodal longitudinal exploration. Eur J Neurosci 2024; 59:860-873. [PMID: 37077023 DOI: 10.1111/ejn.15994] [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: 12/30/2022] [Revised: 04/02/2023] [Accepted: 04/17/2023] [Indexed: 04/21/2023]
Abstract
The clinical assessment of patients with disorders of consciousness (DoC) relies on the observation of behavioural responses to standardised sensory stimulation. However, several medical comorbidities may directly impair the production of reproducible and appropriate responses, thus reducing the sensitivity of behaviour-based diagnoses. One such comorbidity is akinetic mutism (AM), a rare neurological syndrome characterised by the inability to initiate volitional motor responses, sometimes associated with clinical presentations that overlap with those of DoC. In this paper, we describe the case of a patient with large bilateral mesial frontal lesions, showing prolonged behavioural unresponsiveness and severe disorganisation of electroencephalographic (EEG) background, compatible with a vegetative state/unresponsive wakefulness syndrome (VS/UWS). By applying an unprecedented multimodal battery of advanced imaging and electrophysiology-based techniques (AIE) encompassing spontaneous EEG, evoked potentials, event-related potentials, transcranial magnetic stimulation combined with EEG and structural and functional MRI, we provide the following: (i) a demonstration of the preservation of consciousness despite unresponsiveness in the context of AM, (ii) a plausible neurophysiological explanation for behavioural unresponsiveness and its subsequent recovery during rehabilitation stay and (iii) novel insights into the relationships between DoC, AM and parkinsonism. The present case offers proof-of-principle evidence supporting the clinical utility of a multimodal hierarchical workflow that combines AIEs to detect covert signs of consciousness in unresponsive patients.
Collapse
Affiliation(s)
| | - Silvia Casarotto
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Rosanova
- Department Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | | | | | | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Marcello Massimini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| |
Collapse
|
2
|
Rovaris M, Toselli E, Mendozzi L, Di Tella S, Pirastru A, Blasi V, Baglio F, Ostacoli L, D'Abramo A, Incerti A, Fernandez I, Pagnini F, Cavalera C. Eye movement desensitization and reprocessing for depressed individuals with multiple sclerosis: A pilot study. Mult Scler 2024:13524585241230236. [PMID: 38372030 DOI: 10.1177/13524585241230236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS. OBJECTIVE to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS. METHODS We conducted a process-outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function. RESULTS The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found. CONCLUSION for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.
Collapse
Affiliation(s)
- Marco Rovaris
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milano, Italy
| | - Elena Toselli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milano, Italy
| | | | - Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milano, Italy
| | | | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milano, Italy
| | | | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Alessia Incerti
- CRSP, Centro di Ricerca e Studi in Psicotraumatologia, Milano, Italy
| | - Isabel Fernandez
- CRSP, Centro di Ricerca e Studi in Psicotraumatologia, Milano, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Cesare Cavalera
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| |
Collapse
|
3
|
Pirastru A, Di Tella S, Cazzoli M, Esposito F, Baselli G, Baglio F, Blasi V. The impact of emotional valence and stimulus habituation on fMRI signal reliability during emotion generation. Neuroimage 2023; 284:120457. [PMID: 37977407 DOI: 10.1016/j.neuroimage.2023.120457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The emotional domain is often impaired across many neurological diseases, for this reason it represents a relevant target of rehabilitation interventions. Functional changes in neural activity related to treatment can be assessed with functional MRI (fMRI) using emotion-generation tasks in longitudinal settings. Previous studies demonstrated that within-subject fMRI signal reliability can be affected by several factors such as repetition suppression, type of task and brain anatomy. However, the differential role of repetition suppression and emotional valence of the stimuli on the fMRI signal reliability and reproducibility during an emotion-generation task involving the vision of emotional pictures is yet to be determined. METHODS Sixty-two healthy subjects were enrolled and split into two groups: group A (21 subjects, test-retest reliability on same-day and with same-task-form), group B (30 subjects, test-retest reproducibility with 4-month-interval using two equivalent-parallel forms of the task). Test-retest reliability and reproducibility of fMRI responses and patterns were evaluated separately for positive and negative emotional valence conditions in both groups. The analyses were performed voxel-wise, using the general linear model (GLM), and via a region-of-interest (ROI)-based approach, by computing the intra-class correlation coefficient (ICC) on the obtained contrasts. RESULTS The voxel-wise GLM test yielded no significant differences for both conditions in reliability and reproducibility analyses. As to the ROI-based approach, across all areas with significant main effects of the stimuli, the reliability, as measured with ICC, was poor (<0.4) for the positive condition and ranged from poor to excellent (0.4-0.75) for the negative condition. The ICC-based reproducibility analysis, related to the comparison of two different parallel forms, yielded similar results. DISCUSSION The voxel-wise GLM analysis failed to capture the poor reliability of fMRI signal which was instead highlighted using the ROI-based ICC analysis. The latter showed higher signal reliability for negative valence stimuli with respect to positive ones. The implementation of two parallel forms allowed to exclude neural suppression as the predominant effect causing low signal reliability, which could be instead ascribed to the employment of different neural strategies to cope with emotional stimuli over time. This is an invaluable information for a better assessment of treatment and rehabilitation effects in longitudinal studies of emotional neural processing.
Collapse
Affiliation(s)
- Alice Pirastru
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy; Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Baselli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
| |
Collapse
|
4
|
Rossetto F, Isernia S, Realdon O, Borgnis F, Blasi V, Pagliari C, Cabinio M, Alberoni M, Mantovani F, Clerici M, Baglio F. A digital health home intervention for people within the Alzheimer's disease continuum: results from the Ability-TelerehABILITation pilot randomized controlled trial. Ann Med 2023; 55:1080-1091. [PMID: 36929703 PMCID: PMC10030155 DOI: 10.1080/07853890.2023.2185672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
PURPOSE This study tested the efficacy of digital-health home intervention for people within the Alzheimer's disease (AD)-continuum. METHODS Thirty people within the AD continuum were randomly assigned to a telerehabilitation (ABILITY; 6 males, Mage=78.2 ± 3.95) or treatment as usual (TAU; 8 males, Mage=77.13 ± 6.38), performing cognitive and physical activities at home for six weeks. The ABILITY intervention additionally included a digital platform enabling communication between the hospital and the patient's home. Efficiency, such as adherence, perceived fit of demands and skills, usability, and effectiveness measures, including neuropsychological level, neuropsychiatric symptoms, and autonomy in daily living, were collected before (T0), after the treatment (T1), and at the 1-year-follow-up (T2). RESULTS The ABILITY program was efficient, with a higher adherence (81% vs. 62%), a higher perceived fit of demands and skills than TAU (p<.05), and a good level of technology usability. In terms of effectiveness, a treatment effect (ABILITY > TAU) emerged on the global cognitive level, especially in language, executive functions, and memory domains. Moreover, a treatment carry-over effect (1-year follow-up) was observed in global cognitive functions (especially language) (ABILITY > TAU), behavioral symptoms, and caregiver distress (TAU > ABILITY). CONCLUSIONS Our preliminary findings suggest that ABILITY is a promising eHealth intervention to improve at-home treatment adherence and to preserve cognitive and behavioral abilities.
Collapse
Affiliation(s)
| | - Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Olivia Realdon
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milan, Italy
| | | | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | - Fabrizia Mantovani
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Physiopathology and Transplants, Università degli Studi di Milano, Milan, Italy
| | | |
Collapse
|
5
|
Isernia S, Blasi V, Baglio G, Cabinio M, Cecconi P, Rossetto F, Cazzoli M, Blasi F, Bruckmann C, Giunco F, Sorbi S, Clerici M, Baglio F. The key role of depression and supramarginal gyrus in frailty: a cross-sectional study. Front Aging Neurosci 2023; 15:1292417. [PMID: 38020757 PMCID: PMC10665836 DOI: 10.3389/fnagi.2023.1292417] [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: 09/15/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background The age-related decrease in reserve and resistance to stressors is recognized as frailty, one of the most significant challenges identified in recent years. Despite a well-acknowledged association of frailty with cognitive impairment, depression, and gray matter morphology, no clear data are available regarding the nature of this relationship. This cross-sectional study aims to disentangle the role of the behavioral, neuropsychological, and neural components as predictors or moderators of frailty. Methods Ninety-six older adults (mean age = 75.49 ± 6.62) were consecutively enrolled and underwent a clinical and MRI (3 T) evaluation to assess frailty, physical activity, global cognitive level, depression, wellbeing, autonomy in daily living, cortical thickness, and subcortical volumes. Results Results showed a full mediation of depression on the link between cortical thickness and frailty, while the cognitive level showed no significant mediating role. In particular, left supramarginal thickness had a predicting role on depression, that in turn impacted frailty occurrence. Finally, handgrip weakness was an early key indicator of frailty in this study's cohort. Conclusion These data substantiate the role of depression in mediating the link between neural integrity of the supramarginal gyrus and frailty. In the complexity of frailty, handgrip weakness seems to be an early key indicator. These results are relevant for the design of rehabilitation interventions aimed at reversing the frail condition.
Collapse
Affiliation(s)
- Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Francesco Blasi
- Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | | | | | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | |
Collapse
|
6
|
Anzuino I, Baglio F, Pelizzari L, Cabinio M, Biassoni F, Gnerre M, Blasi V, Silveri MC, Di Tella S. Production of emotions conveyed by voice in Parkinson's disease: Association between variability of fundamental frequency and gray matter volumes of regions involved in emotional prosody. Neuropsychology 2023; 37:883-894. [PMID: 37439736 DOI: 10.1037/neu0000912] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Parkinson's disease (PD) is associated with impairment in producing emotions conveyed by voice which could depend on motor limitations of the vocal apparatus and/or alterations in emotional processing. This study explores the relationship between the standard deviation of fundamental frequency (F0SD) of emotional speech and the volume of specific gray matter regions. METHOD Fifteen PD patients and 15 healthy controls (HC) were asked to produce different emotions vocally elicited by reading short stories. For each vocal track, the F0SD was calculated as index of variability. All subjects underwent a structural magnetic resonance imaging and a voxel-based morphometry analysis. An ad hoc mask of brain regions implicated in emotional prosody was constructed to test the relationship between F0SD and the level of brain atrophy. RESULTS PD patients showed lower F0SD values than HC in the expression of anger. Neuroimaging results showed brain atrophy in PD patients in a widespread bilateral network, including frontal areas, left cingulate cortex, parietal areas as well as occipital cortices. In the PD group, a positive correlation was observed between F0SD values of anger and volumes of the bilateral supramarginal gyrus, left thalamus, right inferior frontal gyrus, and amygdala. CONCLUSIONS The lower F0SD values observed in PD patients in anger production are consistent with their lower ability to express anger effectively through voice compared to HC. Our data demonstrated the involvement of right-lateralized areas, such as the inferior frontal gyrus and amygdala, which are typically involved in emotional prosody. Disturbances in emotion processing might contribute to speech production deficits in PD, probably in addition to the motor impairment of the articulatory system. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Francesca Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Organizzazione Non Lucrativa di Utilita Sociale
| | - Laura Pelizzari
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Organizzazione Non Lucrativa di Utilita Sociale
| | - Monia Cabinio
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Organizzazione Non Lucrativa di Utilita Sociale
| | | | | | - Valeria Blasi
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Organizzazione Non Lucrativa di Utilita Sociale
| | | | | |
Collapse
|
7
|
Bonilauri A, Pirastru A, Sangiuliano Intra F, Isernia S, Cazzoli M, Blasi V, Baselli G, Baglio F. Surface-based integration approach for fNIRS-fMRI reliability assessment. J Neurosci Methods 2023; 398:109952. [PMID: 37625649 DOI: 10.1016/j.jneumeth.2023.109952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Studies integrating functional near-infrared spectroscopy (fNIRS) with functional MRI (fMRI) employ heterogeneous methods in defining common regions of interest in which similarities are assessed. Therefore, spatial agreement and temporal correlation may not be reproducible across studies. In the present work, we address this issue by proposing a novel method for integration and analysis of fNIRS and fMRI over the cortical surface. MATERIALS AND METHODS Eighteen healthy volunteers (age mean±SD 30.55 ± 4.7, 7 males) performed a motor task during non-simultaneous fMRI and fNIRS acquisitions. First, fNIRS and fMRI data were integrated by projecting subject- and group-level source maps over the cortical surface mesh to define anatomically constrained functional ROIs (acfROI). Next, spatial agreement and temporal correlation were quantified as Dice Coefficient (DC) and Pearson's correlation coefficient between fNIRS-fMRI in the acfROIs. RESULTS Subject-level results revealed moderate to substantial spatial agreement (DC range 0.43 - 0.64), confirmed at the group-level only for blood oxygenation level-dependent (BOLD) signal vs. HbO2 (0.44 - 0.69), while lack of agreement was found for BOLD vs. HbR in some instances (0.05 - 0.49). Subject-level temporal correlation was moderate to strong (0.79 - 0.85 for BOLD vs. HbO2 and -0.62 to -0.72 for BOLD vs. HbR), while an overall strong correlation was found for group-level results (0.95 - 0.98 for BOLD vs. HbO2 and -0.91 to -0.94 for BOLD vs. HbR). CONCLUSION The proposed method directly compares fNIRS and fMRI by projecting individual source maps to the cortical surface. Our results indicate spatial and temporal correspondence between fNIRS and fMRI, and promotes the use of fNIRS when more ecological acquision settings are required, such as longitudinal monitoring of brain activity before and after rehabilitation.
Collapse
Affiliation(s)
- Augusto Bonilauri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Alice Pirastru
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy.
| | | | - Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | | |
Collapse
|
8
|
Isernia S, Rossetto F, Castelli F, Rovaris M, Blasi V, Baglio F. Beyond the simplicity of theory of mind deficit in multiple sclerosis: from kinetic perception to socio-emotional abstraction and mentalizing. Mult Scler Relat Disord 2023; 77:104894. [PMID: 37490809 DOI: 10.1016/j.msard.2023.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Theory of Mind (ToM) processing in Multiple Sclerosis (MS) is still poorly understood due to the difficulty of most tasks in qualifying the mentalizing deficit net of cognitive load. METHODS In this study, we administered the New False Belief Animation Task (NFBAT) to 50 MS and 33 healthy controls (HC) to investigate spontaneous mentalizing in ToM and goal-directed interactions. The global cognitive level was assessed by the Montreal Cognitive Assessment (MoCA). NFBAT appropriateness and intentionality scores were computed to investigate the ToM accuracy and intentionality attribution difficulties. NFBAT answers were qualitatively analyzed and categorized into kinetically and socially coherent/not coherent responses to test a low-level perceptual deficit. RESULTS The main result showed dysfunctional mentalizing reasoning in MS compared to HC in the NFBAT Intentionality score in ToM conditions (p = 0.028, d = 0.501), while the two groups were equally proficient in mentalization accuracy. The Intentionality underperformance in MS was related to social low-level perceptual processing (β =0.06, p < 0.001) and visuospatial functions (β =0.05, p =0.002). A predictive role of memory and executive functions on NFBAT Intentionality scores was not observed. CONCLUSION These results strengthen the hypothesis that ToM in MS is likely related to low-level social processing.
Collapse
Affiliation(s)
| | | | - Fulvia Castelli
- Brain and Behavioral Science Department, University of Pavia, Sezione di Psicologia Piazza Botta, Pavia, Italy
| | | | | | | |
Collapse
|
9
|
Cotelli M, Baglio F, Manenti R, Blasi V, Galimberti D, Gobbi E, Pagnoni I, Rossetto F, Rotondo E, Esposito V, De Icco R, Giudice C, Tassorelli C, Catricalà E, Perini G, Alaimo C, Campana E, Benussi L, Ghidoni R, Binetti G, Carandini T, Cappa SF. A Multimodal Approach for Clinical Diagnosis and Treatment of Primary Progressive Aphasia (MAINSTREAM): A Study Protocol. Brain Sci 2023; 13:1060. [PMID: 37508992 PMCID: PMC10377301 DOI: 10.3390/brainsci13071060] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Primary Progressive Aphasia (PPA) is a syndrome due to different neurodegenerative disorders selectively disrupting language functions. PPA specialist care is underdeveloped. There are very few specialists (neurologists, psychiatrists, neuropsychologists, and speech therapists) and few hospital- or community-based services dedicated to the diagnosis and continuing care of people with PPA. Currently, healthcare systems struggle to provide adequate coverage of care that is too often fragmented, uncoordinated, and unresponsive to the needs of people with PPA and their families. Recently, attention has been gained by non-invasive brain stimulation techniques that allow a personalized treatment approach, such as transcranial Direct Current Stimulation (tDCS). The MAINSTREAM trial looks forward to introducing and evaluating therapeutic innovations such as tDCS coupled with language therapy in rehabilitation settings. A Multimodal Approach for Clinical Diagnosis and Treatment of Primary Progressive Aphasia, MAINSTREAM (ID: 3430931) was registered in the clinicaltrials.gov database (identifier: NCT05730023) on 15 February 2023.
Collapse
Affiliation(s)
- Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | | | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Deparment of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | | | - Emanuela Rotondo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Carla Giudice
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Eleonora Catricalà
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, 27100 Pavia, Italy
| | - Giulia Perini
- Dementia Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Giuliano Binetti
- MAC-Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Tiziana Carandini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Stefano Francesco Cappa
- Dementia Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, 27100 Pavia, Italy
| |
Collapse
|
10
|
Isernia S, Cazzoli M, Baglio G, Cabinio M, Rossetto F, Giunco F, Baglio F, Blasi V. Differential Roles of Neural Integrity, Physical Activity and Depression in Frailty: Sex-Related Differences. Brain Sci 2023; 13:950. [PMID: 37371428 DOI: 10.3390/brainsci13060950] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/15/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The frailty sex paradox has recently gained attention. At all ages, females are more likely to be frail and show a more severe phenotype but have a higher survival rate compared to males. The main aim was to test sex-specific differences in frailty syndrome using a multimodal evaluation from clinical and imaging data to deepen the understanding of different underlying mechanisms involved in the two sexes, and thus understand the association with different risk factors. Ninety-six community-dwelling older adults were characterized by clinical underpinnings (Fried's frailty indicators: comorbidity, depression, global cognitive level, physical activity, autonomy), and neural integrity (T1-weighted brain 3T MRI). The frailty × sex interaction in clinical and neural profiles was tested. Additionally, frailty risk factors were identified in the two sexes separately. Results showed that fragility was associated with an increment of depressive symptomatology in females, while a decrement in physical activity was observed already in the pre-frail stage in males. Finally, different risk factors were observed in the two groups: significant frailty predictors were neural integrity and physical activity in males, and age and depression in females. These data support the starting hypothesis of at least partially different mechanisms involved in the frailty phenotype between men and women.
Collapse
Affiliation(s)
- Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Gisella Baglio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | | | - Fabrizio Giunco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | | | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| |
Collapse
|
11
|
Realdon O, Adorni R, Ginelli D, Micucci D, Blasi V, Bellavia D, Schettini F, Carradore R, Polsinelli P, D'Addario M, Gui M, Messina V, Foglia E, Steca P, Mantovani F, Baglio F. Embedding the Patient-Citizen Perspective into an Operational Framework for the Development and the Introduction of New Technologies in Rehabilitation Care: The Smart&Touch-ID Model. Healthcare (Basel) 2023; 11:healthcare11111604. [PMID: 37297744 DOI: 10.3390/healthcare11111604] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
To date, at least 2.41 billion people with Non-Communicable Diseases (NCDs) are in need of rehabilitation. Rehabilitation care through innovative technologies is the ideal candidate to reach all people with NCDs in need. To obtain these innovative solutions available in the public health system calls for a rigorous multidimensional evaluation that, with an articulated approach, is carried out through the Health Technology Assessment (HTA) methodology. In this context, the aim of the present paper is to illustrate how the Smart&TouchID (STID) model addresses the need to incorporate patients' evaluations into a multidimensional technology assessment framework by presenting a feasibility study of model application with regard to the rehabilitation experiences of people living with NCDs. After sketching out the STID model's vision and operational process, preliminary evidence on the experiences and attitudes of patients and citizens on rehabilitation care will be described and discussed, showing how they operate, enabling the co-design of technological solutions with a multi-stakeholder approach. Implications for public health are discussed including the view on the STID model as a tool to be integrated into public health governance strategies aimed at tuning the agenda-setting of innovation in rehabilitation care through a participatory methodology.
Collapse
Affiliation(s)
- Olivia Realdon
- Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Davide Ginelli
- Department of Informatics, Systems, and Communication, University of Milano-Bicocca, 20126 Milan, Italy
| | - Daniela Micucci
- Department of Informatics, Systems, and Communication, University of Milano-Bicocca, 20126 Milan, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Daniele Bellavia
- Centre for Health Economics, Social and Health Care Management, LIUC-Università Carlo Cattaneo, 20153 Castellanza (VA), Italy
| | - Fabrizio Schettini
- Centre for Health Economics, Social and Health Care Management, LIUC-Università Carlo Cattaneo, 20153 Castellanza (VA), Italy
| | - Roberto Carradore
- Department of Sociology and Social Research, University of Milano-Bicocca, 20126 Milan, Italy
| | | | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Marco Gui
- Department of Sociology and Social Research, University of Milano-Bicocca, 20126 Milan, Italy
| | - Vincenzina Messina
- Department of Informatics, Systems, and Communication, University of Milano-Bicocca, 20126 Milan, Italy
| | - Emanuela Foglia
- Centre for Health Economics, Social and Health Care Management, LIUC-Università Carlo Cattaneo, 20153 Castellanza (VA), Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
| | | |
Collapse
|
12
|
Rossetto F, Isernia S, Cabinio M, Pirastru A, Blasi V, Baglio F. Affective Theory of Mind as a residual ability to preserve mentalizing in amnestic Mild Cognitive Impairment: A 12-months longitudinal study. Front Neurol 2022; 13:1060699. [PMID: 36468066 PMCID: PMC9716015 DOI: 10.3389/fneur.2022.1060699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/07/2022] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION Theory of Mind (ToM) decline has been outlined in people with amnestic Mild Cognitive Impairment (aMCI), but evidence from longitudinal studies is lacking. This longitudinal study aims to investigate changes in cognitive and affective ToM performance in an aMCI sample (n = 28; 14 females, mean age = 76.54 ± 4.35). METHOD Participants underwent two steps of neurocognitive evaluation, at the baseline (T1) and 12-month follow-up (T2), to obtain their global cognitive level and both affective (Reading the Mind in the Eyes test, ET) and cognitive (Strange Stories, SS) ToM profile. Then, participants were categorized into two groups based on ToM changes: people who worsened (ETΔ < 0; SSΔ < 0) and people who did not (ETΔ≥0; SSΔ≥0) at follow-up. Differences between groups in cognitive functions and ToM profiles at baseline have been investigated. RESULTS Our results showed that 46% of subjects worsened in affective (ET) and 28% in cognitive (SS) ToM at follow-up. People who worsened in ET reported a statistically significantly higher performance in ET at baseline (p = 0.002) but not at follow-up than people who did not worsen. In contrast, subjects who worsened in SS showed a lower Immediate Free Recall (IFR, p = 0.026) and Delayed Free Recall (DFR, p = 0.028) score of the Free and Cued Selective Reminding test at baseline and at follow-up, a lower ET (p = 0.020) baseline score, a lower SS and MMSE level at follow-up than people who not worsened. About 71% of MCI subjects showed the same trend of evolution of the Mini-Mental State Examination and SS. Variables that significantly differed between groups have been inserted in a stepwise logistic regression to pilot explore predictors of affective and cognitive ToM evolution. Logistic regression showed ET at baseline (p = 0.015) as the only significant predictor of affective ToM evolution (R2 = 0.450), while both ET (p = 0.044) and memory performance (p = 0.045) at baseline significantly predicted cognitive ToM evolution (R2 = 0.746). DISCUSSION In conclusion, our results support the role of affective ToM as a residual mentalizing ability in preserving the mentalizing level in people with aMCI.
Collapse
Affiliation(s)
| | - Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | | | | |
Collapse
|
13
|
Isernia S, Rossetto F, Blasi V, Massaro D, Castelli I, Ricci C, Shamay-Tsoory S, Marchetti A, Baglio F. Measuring cognitive and affective Theory of Mind with the Italian Yoni task: normative data and short versions. Curr Psychol 2022. [DOI: 10.1007/s12144-022-03457-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractTheory of Mind (ToM), a high-order human social cognition skill, is relevant for mental health and wellbeing and frequently impaired in many clinical conditions. To detect ToM difficulties, validated and standardized measures need to be adopted in clinical practice. The Yoni task provides a comprehensive evaluation of first-order, second-order, affective and cognitive mentalistic inferences. However, the Yoni task remains a time-demanding tool without normative data. To fill this gap, we explored the convergent and discriminant validity, the inter-item reliability and provided normative data of the Italian version of the Yoni task (98 items), and developed two short versions (48 and 36 items). For the validation, internal consistency and convergent/discriminant validity have been considered. Then, the effects of demographical variables on 98 item Yoni were explored, and normative data were provided. Our data demonstrated high reliability and a good convergent validity in all the Yoni versions. Then, two composite scores were proposed to obtain: 1) a global ToM level and 2) the balance between affective and cognitive ToM components, whose alteration represents a signature of several clinical conditions. The future standardization of the short versions of Yoni will allow a comprehensive and quick examination of ToM abilities, suitable for both research and clinical settings.
Collapse
|
14
|
Tavazzi E, Bergsland N, Pirastru A, Cazzoli M, Blasi V, Baglio F. MRI markers of functional connectivity and tissue microstructure in stroke-related motor rehabilitation: A systematic review. Neuroimage Clin 2021; 33:102931. [PMID: 34995869 PMCID: PMC8741615 DOI: 10.1016/j.nicl.2021.102931] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Stroke-related disability is a major problem at individual and socio-economic levels. Neuromotor rehabilitation has a key role for its dual action on affected body segment and brain reorganization. Despite its known efficacy in clinical practice, the extent and type of effect at a brain level, mediated by neuroplasticity, are still under question. OBJECTIVE To analyze studies applying MRI markers of functional and structural connectivity in patients affected with stroke undergoing motor rehabilitation, and to evaluate the effect of rehabilitation on brain reorganization. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were applied to select studies applying quantitative non-conventional MRI techniques on patients undergoing motor rehabilitation, both physical and virtual (virtual reality, mental imagery). Literature search was conducted using MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE from inception to 30th June 2020. RESULTS Forty-one out of 6983 papers were included in the current review. Selected studies are heterogeneous in terms of patient characteristics as well as type, duration and frequency of rehabilitative approach. Neuromotor rehabilitation promotes neuroplasticity, favoring functional recovery of the ipsilesional hemisphere and activation of anatomically and functionally related brain areas in both hemispheres, to compensate for damaged tissue. CONCLUSIONS The evidence derived from the analyzed studies supports the positive impact of rehabilitation on brain reorganization, despite the high data heterogeneity. Advanced MRI techniques provide reliable markers of structural and functional connectivity that may potentially aid in helping to implement the most appropriate rehabilitation intervention.
Collapse
Affiliation(s)
- E Tavazzi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy; Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - N Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy; Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.
| | - A Pirastru
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - M Cazzoli
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - V Blasi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - F Baglio
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| |
Collapse
|
15
|
Di Tella S, Cabinio M, Isernia S, Blasi V, Rossetto F, Saibene FL, Alberoni M, Silveri MC, Sorbi S, Clerici M, Baglio F. Neuroimaging Biomarkers Predicting the Efficacy of Multimodal Rehabilitative Intervention in the Alzheimer's Dementia Continuum Pathology. Front Aging Neurosci 2021; 13:735508. [PMID: 34880742 PMCID: PMC8645692 DOI: 10.3389/fnagi.2021.735508] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022] Open
Abstract
In this work we aimed to identify neural predictors of the efficacy of multimodal rehabilitative interventions in AD-continuum patients in the attempt to identify ideal candidates to improve the treatment outcome. Subjects in the AD continuum who participated in a multimodal rehabilitative treatment were included in the analysis [n = 82, 38 Males, mean age = 76 ± 5.30, mean education years = 9.09 ± 3.81, Mini Mental State Examination (MMSE) mean score = 23.31 ± 3.81]. All subjects underwent an MRI acquisition (1.5T) at baseline (T0) and a neuropsychological evaluation before (T0) and after intervention (T1). All subjects underwent an intensive multimodal cognitive rehabilitation (8–10 weeks). The MMSE and Neuropsychiatric Inventory (NPI) scores were considered as the main cognitive and behavioral outcome measures, and Delta change scores (T1–T0) were categorized in Improved (ΔMMSE > 0; ΔNPI < 0) and Not Improved (ΔMMSE ≤ 0; ΔNPI ≥ 0). Logistic Regression (LR) and Random Forest classification models were performed including neural markers (Medial Temporal Brain; Posterior Brain (PB); Frontal Brain (FB), Subcortical Brain indexes), neuropsychological (MMSE, NPI, verbal fluencies), and demographical variables (sex, age, education) at baseline. More than 50% of patients showed a positive effect of the treatment (ΔMMSE > 0: 51%, ΔNPI < 0: 52%). LR model on ΔMMSE (Improved vs. Not Improved) indicate a predictive role for MMSE score (p = 0.003) and PB index (p = 0.005), especially the right PB (p = 0.002) at baseline. The Random Forest analysis correctly classified 77% of cognitively improved and not improved AD patients. Concerning the NPI, LR model on ΔNPI (Improved vs. Not Improved) showed a predictive role of sex (p = 0.002), NPI (p = 0.005), PB index (p = 0.006), and FB index (p = 0.039) at baseline. The Random Forest reported a classification accuracy of 86%. Our data indicate that cognitive and behavioral status alone are not sufficient to identify best responders to a multidomain rehabilitation treatment. Increased neural reserve, especially in the parietal areas, is also relevant for the compensatory mechanisms activated by rehabilitative treatment. These data are relevant to support clinical decision by identifying target patients with high probability of success after rehabilitative programs on cognitive and behavioral functioning.
Collapse
Affiliation(s)
- Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | | | - Maria Caterina Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Università degli Studi di Firenze, NEUROFARBA, Firenze, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Physiopathology and Transplants, Università degli Studi di Milano, Milan, Italy
| | | |
Collapse
|
16
|
Tavazzi E, Cazzoli M, Pirastru A, Blasi V, Rovaris M, Bergsland N, Baglio F. Neuroplasticity and Motor Rehabilitation in Multiple Sclerosis: A Systematic Review on MRI Markers of Functional and Structural Changes. Front Neurosci 2021; 15:707675. [PMID: 34690670 PMCID: PMC8526725 DOI: 10.3389/fnins.2021.707675] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/03/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Motor rehabilitation is routinely used in clinical practice as an effective method to reduce progressive disability gain in multiple sclerosis (MS), but rehabilitation approaches are typically unstandardized, and only few studies have investigated the impact of rehabilitation on brain neuroplasticity. Objective: To summarize and critically analyze studies applying MRI markers of functional connectivity and structural changes to assess the effect of motor rehabilitation on brain neuroplasticity in MS. Methods: Literature search was performed using PubMed and EMBASE, selecting studies having as a subject motor rehabilitation and advanced MRI techniques investigating neuroplasticity in adult patients affected by MS. Results: Seventeen out of 798 papers were selected, of which 5 applied structural MRI (4 diffusion tensor imaging, 1 volumetric measurements), 7 applied functional fMRI (5 task-related fMRI, 2 resting-state fMRI) whereas the remaining 5 applied both structural and functional imaging. Discussion: The considerable data heterogeneity and the small sample sizes characterizing the studies limit interpretation and generalization of the results. Overall, motor rehabilitation promotes clinical improvement, paralleled by positive adaptive brain changes, whose features and extent depend upon different variables, including the type of rehabilitation approach. MRI markers of functional and structural connectivity should be implemented in studies testing the efficacy of motor rehabilitation. They allow for a better understanding of neuroplastic mechanisms underlying rehabilitation-mediated clinical achievements, facilitating the identification of rehabilitation strategies tailored to patients' needs and abilities.
Collapse
Affiliation(s)
- Eleonora Tavazzi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Marta Cazzoli
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | - Valeria Blasi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Marco Rovaris
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Niels Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | | |
Collapse
|
17
|
Blasi V, Bolognesi E, Ricci C, Baglio G, Zanzottera M, Canevini MP, Walder M, Cabinio M, Zanette M, Baglio F, Clerici M, Guerini FR. SNAP-25 Single Nucleotide Polymorphisms, Brain Morphology and Intelligence in Children With Borderline Intellectual Functioning: A Mediation Analysis. Front Neurosci 2021; 15:715048. [PMID: 34512248 PMCID: PMC8427043 DOI: 10.3389/fnins.2021.715048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Borderline intellectual functioning (BIF) is a multifactorial condition in which both genetic and environmental factors are likely to contribute to the clinical outcome. Abnormal cortical development and lower IQ scores were shown to be correlated in BIF children, but the genetic components of this condition and their possible connection with intelligence and brain morphology have never been investigated in BIF. The synaptosomal-associated protein of 25 kD (SNAP-25) is involved in synaptic plasticity, neural maturation, and neurotransmission, affecting intellectual functioning. We investigated SNAP-25 polymorphisms in BIF and correlated such polymorphisms with intelligence and cortical thickness, using socioeconomic status and environmental stress as covariates as a good proxy of the variables that determine intellectual abilities. Thirty-three children with a diagnosis of BIF were enrolled in the study. SNAP-25 polymorphisms rs363050, rs363039, rs363043, rs3746544, and rs1051312 were analyzed by genotyping; cortical thickness was studied by MRI; intelligence was measured using the WISC-III/IV subscales; environmental stressors playing a role in neuropsychiatric development were considered as covariate factors. Results showed that BIF children carrying the rs363043(T) minor allele represented by (CT + TT) genotypes were characterized by lower performance Perceptual Reasoning Index and lower full-scale IQ scores (p = 0.04) compared to those carrying the (CC) genotype. This association was correlated with a reduced thickness of the left inferior parietal cortex (direct effect = 0.44) and of the left supramarginal gyrus (direct effect = 0.56). These results suggest a link between SNAP-25 polymorphism and intelligence with the mediation role of brain morphological features in children with BIF.
Collapse
Affiliation(s)
- Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | - Cristian Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | | | - Maria Paola Canevini
- Epilepsy Center, ASST S. Paolo and S. Carlo Hospital, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
| | - Mauro Walder
- Child Neuropsychiatry Unit - ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | |
Collapse
|
18
|
Valle A, Baglio G, Zanette M, Massaro D, Baglio F, Marchetti A, Blasi V. A New Perspective on the Role of Self-Confidence and Confidence in the Evaluation and Rehabilitation of Children With Adverse Life Experience and Borderline Intellectual Functioning: A Preliminary Study. Front Psychol 2021; 12:720219. [PMID: 34504465 PMCID: PMC8421546 DOI: 10.3389/fpsyg.2021.720219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
The borderline intellectual functioning (BIF) is a neurodevelopmental condition characterized by a borderline intelligence quotient (range 70-85) with difficulties in cognitive and social domains. Children with BIF often live in adverse conditions and show academic and behavioral difficulties. Rehabilitation programs for these children focus mainly on cognitive aspects, sometimes with the aid of new technologies that are able to engage and motivate. In this framework, the affective development of children with BIF and its possible role both in the difficulties they manifest and in the rehabilitation is still poorly investigated. In this work, we investigate the characteristics of the internal working models of these children by applying the separation anxiety test, using both the classical and a new coding system to identify the specific features of the attachment representation. Results delineate a profile characterized by low self-confidence and high separation anxiety, with a tendency to somatization. In the light of these results, we suggest that this attachment profile has an impact on the therapeutic relationships and on the efficacy in the use of technological devices. We propose a new perspective in which the interpersonal relationship with the psychologist and the support of the self-confidence of children are crucial to treating cognitive and behavioral difficulties in children with BIF. Only in this case, the use of new technologies and tools may be effective in promoting the greatest possible benefit from therapeutic interventions.
Collapse
Affiliation(s)
- Annalisa Valle
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Davide Massaro
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Antonella Marchetti
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Valeria Blasi
- IRCCS Don Carlo Gnocchi Foundation ONLUS, Milan, Italy
| |
Collapse
|
19
|
Di Tella S, Blasi V, Cabinio M, Bergsland N, Buccino G, Baglio F. How Do We Motorically Resonate in Aging? A Compensatory Role of Prefrontal Cortex. Front Aging Neurosci 2021; 13:694676. [PMID: 34393758 PMCID: PMC8358457 DOI: 10.3389/fnagi.2021.694676] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/18/2021] [Indexed: 12/05/2022] Open
Abstract
Aging is the major risk factor for chronic age-related neurological diseases such as neurodegenerative disorders and neurovascular injuries. Exploiting the multimodal nature of the Mirror Neuron System (MNS), rehabilitative interventions have been proposed based on motor-resonance mechanisms in recent years. Despite the considerable evidence of the MNS’ functionality in young adults, further investigation of the action-observation matching system is required in aging, where well-known structural and functional brain changes occur. Twenty-one healthy young adults (mean age 26.66y) and 19 healthy elderly participants (mean age 71.47y) underwent a single MRI evaluation including a T1-3D high-resolution and functional MRI (fMRI) with mirror task. Morphological and functional BOLD data were derived from MRI images to highlight cortical activations associated with the task; to detect differences between the two groups (Young, Elderly) in the two MRI indexes (BOLD and thickness z-scores) using mixed factorial ANOVA (Group∗Index analyses); and to investigate the presence of different cortical lateralization of the BOLD signal in the two groups. In the entire sample, the activation of a bilateral MNS fronto-parietal network was highlighted. The mixed ANOVA (pFDR-corr < 0.05) revealed significant interactions between BOLD signal and cortical thickness in left dorsal premotor cortex, right ventral premotor and prefrontal cortices. A different cortical lateralization of the BOLD signal in frontal lobe activity between groups was also found. Data herein reported suggest that age-related cortical thinning of the MNS is coupled with increased interhemispheric symmetry along with premotor and prefrontal cortex recruitment. These physiological changes of MNS resemble the aging of the motor and cognitive neural systems, suggesting specific but also common aging and compensatory mechanisms.
Collapse
Affiliation(s)
- Sonia Di Tella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Valeria Blasi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Monia Cabinio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Niels Bergsland
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Giovanni Buccino
- Divisione di Neuroscienze, Università Vita e Salute San Raffaele e Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, Italy
| | - Francesca Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| |
Collapse
|
20
|
Ferrara P, Sandullo F, Vecchio M, DI Ruscio F, Franceschini G, Peronti B, Blasi V, Nonni G, Bietolini S. Length-weight growth analysis up to 12 months of age in three groups according to the dietary pattern followed from pregnant mothers and children during the first year of life. Minerva Pediatr (Torino) 2021:S2724-5276.21.06262-5. [PMID: 33861051 DOI: 10.23736/s2724-5276.21.06262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the present study is to analyse the length-weight growth up to 12 months of age in three groups considering the respective dietary pattern followed from the pregnant mothers and from the infants during the first year of the life. Moreover, the cultural inference of vegetarianism has been studied. METHODS Between September 2017 and May 2018, more than 100 mothers have been proposed to participate in this study. As a result of preliminary evaluation, which ensures the presence of inclusion criteria and the absence of exclusion criteria, 55 mothers and their 63 children have been enrolled and assessed with a questionnaire previously created for the study. RESULTS A statistically significant difference has emerged between the omnivorous and the vegan group from the comparison for the weight of children at birth, 6 months and 12 months, both when expressed in grams and when expressed in growth percentiles. Furthermore, between the two children groups just mentioned, a significant difference has emerged from the comparison for the length expressed in growth percentiles at 12 months and for the body mass index at 6 months. No statistically significant differences have emerged between the omnivorous group and the lacto-ovo/lactovegetarian group and between the latter and the vegan one. CONCLUSIONS Although differences between the three groups of children have emerged with regard to some anthropometric parameters, their length-weight growth during the first year of life has been harmonic and physiological regardless of the type of planned diet.
Collapse
Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy -
- Pediatric Unit, Campus Bio-Medico University, Rome, Italy -
| | | | | | | | | | - Benedetta Peronti
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Valeria Blasi
- Food Sciences and Human Nutrition Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Gaia Nonni
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | | |
Collapse
|
21
|
Ferrara P, Sandullo F, Di Ruscio F, Franceschini G, Peronti B, Blasi V, Bietolini S, Ruggiero A. The impact of lacto-ovo-/lacto-vegetarian and vegan diets during pregnancy on the birth anthropometric parameters of the newborn. J Matern Fetal Neonatal Med 2020; 33:3900-3906. [PMID: 30909771 DOI: 10.1080/14767058.2019.1590330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: The data in the literature on the appropriateness of vegetarian diets during pregnancy and the impact on the birth anthropometric parameters of the newborn are divergent and conflicting. The aim of the present study is to compare the birth anthropometric parameters of three groups of children distinguished according to the dietary pattern followed by their mothers during pregnancy. Moreover, the second aim is to study the cultural inference of vegetarianism.Materials and methods: Between September 2017 and May 2018, from the Pediatric Service of the Campus Bio-Medico University Hospital of Rome and vegetarian-oriented societies, detailed information have been provided to all mothers who showed interest in participating in the study. More than 100 mothers gave their consent, but in consideration of the criteria of inclusion and exclusion only 55 with the respective children (for a total of 63 kids) have been enlisted in the study. Based on the dietary pattern followed by women during pregnancy, the participants have been divided into three groups: vegan group, lacto-ovo-/lacto-vegetarian group, and omnivorous group. The data necessary for the study have been collected through a questionnaire previously created and sent electronically to 55 enrolled mothers.Results: From our statistical analysis, it has emerged that birth weight, both when expressed in grams and when expressed in growth percentiles, of the vegan mothers' children is lower than that of the omnivorous mothers' children. No significant difference has emerged from the comparison for the length, cranial circumference and BMI at birth between the three groups.Conclusion: Although from our study statistically significant differences in birth weight between the vegan group and the omnivorous one has emerged, the values of this anthropometric parameter were all included within the physiological range decided by the experts in the field. From this, it emerges that the planning of any type of diet with experts in the field is indispensable to ensure a physiological development of the fetus, but given the limited number of participants we cannot draw unequivocal and certain conclusions on this subject.
Collapse
Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy.,Service of Pediatrics, Campus Bio-Medico University, Rome, Italy
| | | | | | | | - Benedetta Peronti
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Valeria Blasi
- Food Sciences and Human Nutrition Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | - Antonio Ruggiero
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy
| |
Collapse
|
22
|
Blasi V, Zanette M, Baglio G, Giangiacomo A, Di Tella S, Canevini MP, Walder M, Clerici M, Baglio F. Intervening on the Developmental Course of Children With Borderline Intellectual Functioning With a Multimodal Intervention: Results From a Randomized Controlled Trial. Front Psychol 2020; 11:679. [PMID: 32373025 PMCID: PMC7186416 DOI: 10.3389/fpsyg.2020.00679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/20/2020] [Indexed: 01/12/2023] Open
Abstract
An adverse social environment is a major risk factor for borderline intellectual functioning (BIF), a condition characterized by an intelligence quotient (IQ) within the low range of normality (70-85) with difficulties in the academic achievements and adaptive behavior. Children with BIF show impairments in planning, language, movement, emotion regulation, and social abilities. Moreover, the BIF condition exposes children to an increased risk of school failures and the development of mental health problems, and poverty in adulthood. Thus, an early and effective intervention capable of improving the neurodevelopmental trajectory of children with BIF is of great relevance. AIM The present work aims to report the results of a randomized controlled trial (RCT) in which an intensive, integrated and innovative intervention, the movement cognition and narration of the emotions (MCNT) was compared to standard speech therapy (SST) for the treatment of children with BIF. METHODS This was a multicenter, interventional, single blind RCT with two groups of children with BIF: the experimental treatment (MCNT) and the treatment as usual (SST). A mixed factorial ANOVA was carried out to assess differences in the effectiveness between treatments. Primary outcome measures were: WISC III, Child Behavior Checklist (CBCL), Vineland II, and Movement ABC. RESULTS MCNT proved to be more effective than SST in the increment of full-scale IQ (p = 0.0220), performance IQ (p < 0.0150), socialization abilities (p = 0.0220), and behavior (p = 0.0016). No improvement was observed in motor abilities. Both treatments were linked to improvements in verbal memory, selective attention, planning, and language comprehension. Finally, children in the SST group showed a significant worsening in their behavior. CONCLUSION Our data show that an intensive and multimodal treatment is more effective than a single domain treatment for improving intellectual, adaptive and behavioral functioning in children with BIF. These improvements are relevant as they might represent protective factors against the risk of school failure, poverty and psychopathology to which children with BIF are exposed in the adult age. Limitations of the study are represented by the small number of subjects and the lack of a no-treatment group. CLINICAL TRIAL REGISTRATION ISRCTN Registry (isrctn.com), identifier ISRCTN81710297.
Collapse
Affiliation(s)
| | | | | | | | | | - Maria Paola Canevini
- Department of Health Sciences, University of Milan, Milan, Italy
- ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - Mauro Walder
- ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | |
Collapse
|
23
|
Sanvito F, Caverzasi E, Riva M, Jordan KM, Blasi V, Scifo P, Iadanza A, Crespi SA, Cirillo S, Casarotti A, Leonetti A, Puglisi G, Grimaldi M, Bello L, Gorno-Tempini ML, Henry RG, Falini A, Castellano A. fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients. Front Neurosci 2020; 14:225. [PMID: 32296301 PMCID: PMC7136614 DOI: 10.3389/fnins.2020.00225] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/02/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND MR Tractography enables non-invasive preoperative depiction of language subcortical tracts, which is crucial for the presurgical work-up of brain tumors; however, it cannot evaluate the exact function of the fibers. PURPOSE A systematic pipeline was developed to combine tractography reconstruction of language fiber bundles, based on anatomical landmarks (Anatomical-T), with language fMRI cortical activations. A fMRI-targeted Tractography (fMRI-T) was thus obtained, depicting the subsets of the anatomical tracts whose endpoints are located inside a fMRI activation. We hypothesized that fMRI-T could provide additional functional information regarding the subcortical structures, better reflecting the eloquent white matter structures identified intraoperatively. METHODS Both Anatomical-T and fMRI-T of language fiber tracts were performed on 16 controls and preoperatively on 16 patients with left-hemisphere brain tumors, using a q-ball residual bootstrap algorithm based on High Angular Resolution Diffusion Imaging (HARDI) datasets (b = 3000 s/mm2; 60 directions); fMRI ROIs were obtained using picture naming, verbal fluency, and auditory verb generation tasks. In healthy controls, normalized MNI atlases of fMRI-T and Anatomical-T were obtained. In patients, the surgical resection of the tumor was pursued by identifying eloquent structures with intraoperative direct electrical stimulation mapping and extending surgery to the functional boundaries. Post-surgical MRI allowed to identify Anatomical-T and fMRI-T non-eloquent portions removed during the procedure. RESULTS MNI Atlases showed that fMRI-T is a subset of Anatomical-T, and that different task-specific fMRI-T involve both shared subsets and task-specific subsets - e.g., verbal fluency fMRI-T strongly involves dorsal frontal tracts, consistently with the phonogical-articulatory features of this task. A quantitative analysis in patients revealed that Anatomical-T removed portions of AF-SLF and IFOF were significantly greater than verbal fluency fMRI-T ones, suggesting that fMRI-T is a more specific approach. In addition, qualitative analyses showed that fMRI-T AF-SLF and IFOF predict the exact functional limits of resection with increased specificity when compared to Anatomical-T counterparts, especially the superior frontal portion of IFOF, in a subcohort of patients. CONCLUSION These results suggest that performing fMRI-T in addition to the 'classic' Anatomical-T may be useful in a preoperative setting to identify the 'high-risk subsets' that should be spared during the surgical procedure.
Collapse
Affiliation(s)
- Francesco Sanvito
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Eduardo Caverzasi
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Marco Riva
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
- Neurosurgical Oncology Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Kesshi M. Jordan
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Paola Scifo
- Nuclear Medicine Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Iadanza
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Sofia Allegra Crespi
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Cirillo
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandra Casarotti
- Neurosurgical Oncology Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Antonella Leonetti
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Guglielmo Puglisi
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Marco Grimaldi
- Neuroradiology Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
| | - Lorenzo Bello
- Neurosurgical Oncology Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Maria Luisa Gorno-Tempini
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Roland G. Henry
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Andrea Falini
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonella Castellano
- Neuroradiology Unit and CERMAC, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
24
|
Blasi V, Pirastru A, Cabinio M, Di Tella S, Laganà MM, Giangiacomo A, Baglio G, Zanette M, Canevini MP, Walder M, Clerici M, Baglio F. Early Life Adversities and Borderline Intellectual Functioning Negatively Impact Limbic System Connectivity in Childhood: A Connectomics-Based Study. Front Psychiatry 2020; 11:497116. [PMID: 33061912 PMCID: PMC7518022 DOI: 10.3389/fpsyt.2020.497116] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
Early life adversity (ELA) in childhood is a major risk factor for borderline intellectual functioning (BIF). BIF affects both adaptive and intellectual abilities, commonly leading to school failure and to an increased risk to develop mental and social problems in the adulthood. This study aimed to investigate the neurobiological underpinnings of ELA associated with BIF in terms of global topological organization and structural connectivity and their relation with intellectual functioning. BIF (N=32) and age-matched typical development (TD, N=14) children were evaluated for intelligence quotient (IQ), behavioral competencies, and ELA. Children underwent an anatomical and diffusion-weighted MR imaging (DWI) protocol. Global brain topological organization was assessed measuring segregation and integration indexes. Moreover, structural matrices, measuring normalized number of fibers (NFn), were compared between the 2 groups using network-based statistics. Finally, a linear regression model was used to explore the relationship between network parameters and clinical measures. Results showed increased behavioral difficulties and ELA, together with decreased network integration in BIF children. Moreover, significantly lower NFn was observed in the BIF group (p=.039) in a sub-network comprising anterior and posterior cingulate, the pericallosal sulcus, the orbital frontal areas, amygdala, basal ganglia, the accumbens nucleus, and the hippocampus. Linear regression showed that NFn significantly predicted IQ (p<.0001). This study demonstrated that ELA in children with BIF is associated with a decreased information integration at the global level, and with an altered structural connectivity within the limbic system strictly related to the intellectual functioning.
Collapse
Affiliation(s)
- Valeria Blasi
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Alice Pirastru
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Monia Cabinio
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Sonia Di Tella
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Maria Marcella Laganà
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Alice Giangiacomo
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Gisella Baglio
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Michela Zanette
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Maria Paola Canevini
- Department of Health Sciences, University of Milan, Milan, Italy.,Epilepsy Centre, ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - Mauro Walder
- Epilepsy Centre, ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - Mario Clerici
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Francesca Baglio
- CADiTeR - Center of Advanced Diagnostic, Therapy and Rehabilitation, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| |
Collapse
|
25
|
Baglio G, Zanette M, Di Cesare M, Di Tella S, Clerici M, Baglio F, Blasi V. Rehabilitation and Disability Spectrum From Adverse Childhood Experience: The Impact of the Movement Cognition and Narration of Emotions Treatment (MCNT) Version 2.0. Front Psychiatry 2020; 11:609819. [PMID: 33569016 PMCID: PMC7868411 DOI: 10.3389/fpsyt.2020.609819] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/14/2020] [Indexed: 11/20/2022] Open
Abstract
Adverse Childhood Experiences (ACE) are associated with an increased risk of cerebral, behavioral, and cognitive outcomes, and vulnerability to develop a Borderline Intellectual Functioning (BIF). BIF is characterized by an intelligence quotient (IQ) in the range 70-85, poor executive functioning, difficulties in emotion processing, and motor competencies. All these difficulties can lead to mental and/or neurodevelopmental disorders that require long-term care. Accordingly, we developed an intensive and multidomain rehabilitation program for children with ACE and BIF, termed the Movement Cognition and Narration of emotions Treatment (MCNT1.0). The efficacy of MCNT1.0 on cognitive and social functioning was demonstrated with a previously reported randomized controlled trial (RCT). To extend the impact of the treatment also to the motor domain a new version, called MCNT2.0, was implemented. The present study aims to verify the feasibility of MCNT2.0 and its effects on the motor domain. A quasi-experimental approach was used in which a group of 18 children with ACE and BIF were consecutively recruited and participated in the MCNT 2.0 program. Participants were compared with the MCNT1.0 group as an active comparator, using the dataset of the RCT. The two groups received a full evaluation comprising: the Wechsler Intelligent Scale for Children-IV (WISC-IV), the Movement-ABC (M-ABC), the Test of Gross Motor Development (TGMD), the Social Skills from Vineland Adaptive Behavioral Scale-II (VABS-II) and the Child Behavior Check List 6-18 (CBCL). An ANCOVA was carried out on changes in the scale scores from baseline with age and baseline score as covariates. Results showed a mean adherence to treatment of 0.85 (sd = 0.07), with no differences between groups in IQ, and Social Skills changes, while greater improvements for motor abilities were shown in the MCNT 2.0 group: M-ABC (p = 0.002), and TGMD (p = 0.002). Finally, greater improvement in the CBCL scale was observed in the MCNT 1.0 group (p = 0.002). Results indicate that due to its positive effects on cognitive, social participation and motor domains, MCNT2.0 may represent a protective factor against maladaptive outcomes of children with ACE and BIF.
Collapse
Affiliation(s)
- Gisella Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Michela Zanette
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Monica Di Cesare
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Sonia Di Tella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Mario Clerici
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Francesca Baglio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| | - Valeria Blasi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy
| |
Collapse
|
26
|
Di Tella S, Pagliari C, Blasi V, Mendozzi L, Rovaris M, Baglio F. Integrated telerehabilitation approach in multiple sclerosis: A systematic review and meta-analysis. J Telemed Telecare 2019; 26:385-399. [PMID: 31132909 DOI: 10.1177/1357633x19850381] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system and a major cause of disability in young adults. Recently, there has been a growing interest in the development of innovative ways to deliver rehabilitation care outside of a hospital setting. The aim was to conduct a systematic review and a meta-analysis of the efficacy of an integrated telerehabilitation approach (ITA) on motor, cognitive and participation outcomes delivered to people with MS (pwMS). METHODS We systematically searched for original manuscripts regarding ITA in pwMS. Efficacy on motor, cognitive and participation outcomes was measured as the standardized mean difference (Hedges' g) of pre and post training. RESULTS Nine studies encompassing 716 pwMS diagnosis were included. The overall effect of ITA was: large for motor outcomes (g = 1.05; p = 0.013); small for cognitive performance outcomes (g = 0.16; p = 0.237); and small for participation outcomes (g = 0.15; p = 0.259). Domain-specific results showed that the effect on motor disability was large (g = 1.18), while on gait and balance was medium (g = 0.32 and g = 0.48, respectively). Moreover, all effects on single cognitive domains were small. Finally, among the single participation outcomes considered (depression, fatigue, daily functioning, quality of life and self-efficacy) only depression showed a nearly medium effect (g = 0.30). CONCLUSIONS PwMS can benefit from ITA in the treatment of motor symptoms according to the current model of continuity of care. However, the low efficacy of ITA on cognition and participation domains suggests the necessity to develop intervention models that include a broader spectrum of needs and objectives.
Collapse
|
27
|
Cintoni M, Rinninella E, Fagotti A, Basso L, Leone S, Blasi V, Scambia G, Miggiano G, Gasbarrini A, Mele M. MON-P278: May High Complexity Surgery, in Gynecological Oncology Patients, Worsen Nutritional Status During Hospital Stay? A Cross-Sectional Study in an Italian University Hospital. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30811-7] [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: 10/18/2022]
|
28
|
Ferrara P, Gatto A, Blasi V, Di Ruscio F, Battaglia D. The impact of valproic acid treatment on weight gain in pediatric patients with epilepsy. Minerva Pediatr (Torino) 2017. [DOI: 10.23736/s0026-4946.17.04938-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
29
|
Blasi V, Baglio G, Baglio F, Canevini MP, Zanette M. Movement cognition and narration of the emotions treatment versus standard speech therapy in the treatment of children with borderline intellectual functioning: a randomized controlled trial. BMC Psychiatry 2017; 17:146. [PMID: 28427388 PMCID: PMC5397820 DOI: 10.1186/s12888-017-1309-z] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 04/11/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Borderline intellectual functioning (BIF) is defined as a "health meta-condition… characterized by various cognitive dysfunctions associated with an intellectual quotient (IQ) between 71 and 85 which determines a deficit in the individual's functioning both in the restriction of activities and in the limitation of social participation". It can be caused by many factors, including a disadvantaged background and prematurity. BIF affects 7-12% of primary school children that show academic difficulties due to poor executive functioning. In many children with BIF, language, movement and social abilities are also affected, making it difficult to take part in daily activities. Dropping out of school and psychological afflictions such as anxiety and depression are common in children with BIF. This study investigates whether an intensive rehabilitation program that involves all of the areas affected in children with BIF (Movement, Cognition and Narration of emotions, MCNT) is more effective than Standard Speech Therapy (SST). METHODS This is a multicenter interventional single blind randomized controlled study. Children aged between 6 to 11 years who attend a mainstream primary school and have multiple learning difficulties, behavioral problems and an IQ ranging between 85 to 70 have been enrolled. Participants are randomly allocated to one of three groups. The first group receives individual treatment with SST for 45 min, twice a week for 9 months. The second group receives the experimental treatment MCNT for 3 h per day, 5 days/ week for 9 months and children work in small groups. The third group consists of children on a waiting list for the SST for nine months. DISCUSSION BIF is a very frequent condition with no ad hoc treatment. Over the long term, there is a high risk to develop psychiatric disorders in adulthood. Due to its high social impact, we consider it very important to intervene during childhood so as to intercept the remarkable plasticity of the developing brain. TRIAL REGISTRATION "Study Let them grow: A new intensive and multimodal Treatment for children with borderline intellectual functioning based on Movement, Cognition and Narration of emotions", retrospectively registered in ISRCTN Register with ISRCTN81710297 at 2017-01-09.
Collapse
Affiliation(s)
- V Blasi
- IRCCS, Fondazione don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy.
| | - G Baglio
- 0000 0001 1090 9021grid.418563.dIRCCS, Fondazione don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy
| | - F Baglio
- 0000 0001 1090 9021grid.418563.dIRCCS, Fondazione don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy
| | - MP Canevini
- 0000 0004 1757 2822grid.4708.bDepartment of Health Sciences, University of Milan, Milan, Italy; ASST S. Paolo and S. Carlo Hospital, Milan, Italy
| | - M Zanette
- 0000 0001 1090 9021grid.418563.dIRCCS, Fondazione don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy
| |
Collapse
|
30
|
Blasi V, Zanette M, Ferro A. Mentalization as alphabetization of the emotions: Oscillation between the opening and closing of possible worlds. International Forum of Psychoanalysis 2017. [DOI: 10.1080/0803706x.2016.1245440] [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: 10/20/2022]
|
31
|
Baglio G, Blasi V, Sangiuliano Intra F, Castelli I, Massaro D, Baglio F, Valle A, Zanette M, Marchetti A. Social Competence in Children with Borderline Intellectual Functioning: Delayed Development of Theory of Mind Across All Complexity Levels. Front Psychol 2016; 7:1604. [PMID: 27818637 PMCID: PMC5073279 DOI: 10.3389/fpsyg.2016.01604] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/03/2016] [Indexed: 11/24/2022] Open
Abstract
Borderline intellectual functioning (BIF) is characterized by heterogeneous cognitive difficulties, with an intelligence quotient (IQ) between 70 and 85 points, and a failure to meet the developmental and sociocultural standards for personal independence and social responsibility required in daily life. The fact that this population still remain a marginal clinical category, with no ad hoc diagnostic and therapeutic approaches, has stimulated the present research. Our goal was to study children with BIF investigating the development of Theory of Mind (ToM) as a pillar of social competence. Children with BIF (N = 28, 16 male/12 female, and mean age 9.46 ± 1.26 years) and children with typical development (TD; N = 31, 17 male/14 female; mean age 8.94 years ± 0.99) underwent a neurocognitive assessment and a ToM assessment. Children with BIF showed a significant lower performance across all the levels of ToM development investigated compared to the control group, and a correlation between executive functions and the advanced levels of ToM reasoning. These results constitute a first step in the direction of defining the clinical profile of children with BIF concerning ToM development, opening the way to future interventions in order to support the developmental evolution of this population in an adaptive direction.
Collapse
Affiliation(s)
| | - Valeria Blasi
- IRCCS, Don Carlo Gnocchi Foundation Onlus Milan, Italy
| | - Francesca Sangiuliano Intra
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Ilaria Castelli
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy; Department of Human and Social Sciences, Università degli Studi di BergamoBergamo, Italy
| | - Davide Massaro
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | | | - Annalisa Valle
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | | | - Antonella Marchetti
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| |
Collapse
|
32
|
Cabinio M, Rossetto F, Blasi V, Savazzi F, Castelli I, Massaro D, Valle A, Nemni R, Clerici M, Marchetti A, Baglio F. Mind-Reading Ability and Structural Connectivity Changes in Aging. Front Psychol 2015; 6:1808. [PMID: 26635702 PMCID: PMC4659903 DOI: 10.3389/fpsyg.2015.01808] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 11/09/2015] [Indexed: 11/17/2022] Open
Abstract
The Mind-Reading ability through the eyes is an important component of the affective Theory of Mind (ToM), which allows people to infer the other’s mental state from the eye gaze. The aim of the present study was to investigate to which extent age-associated structural brain changes impact this ability and to determine if this association is related to executive functions in elderly subjects. For this purpose, Magnetic Resonance Imaging was used to determine both gray matter and white matter (WM) areas associated with aging. The resulting areas have been included in a subsequent correlation analysis to detect the brain regions whose structure was associated with the Mind-Reading ability through the eyes, assessed with the Italian version of the “Reading the Mind in the Eyes” (RME) test, in a sample of 36 healthy subjects ranging from 24 to 79 years of age. The analysis resulted in three important findings: (1) the performance to the RME test is relatively stable across the decades 20–70 (despite a slight decrease of this ability with aging) and independent from executive functions; (2) structural brain imaging demonstrated the involvement of a great number of cortical ToM areas for the execution of the RME test: the bilateral precentral gyrus, the bilateral posterior insula, the left superior temporal gyrus and the left inferior frontal gyrus, which also showed a significant volume decrease with age; (3) an age and task-related decline in WM connectivity on left fronto-temporal portion of the brain. Our results confirm the age-related structural modifications of the brain and show that these changes have an influence on the Mind-Reading ability through the eyes.
Collapse
Affiliation(s)
- Monia Cabinio
- IRCCS Fondazione don Carlo Gnocchi ONLUS Milan, Italy
| | - Federica Rossetto
- IRCCS Fondazione don Carlo Gnocchi ONLUS Milan, Italy ; Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Valeria Blasi
- IRCCS Fondazione don Carlo Gnocchi ONLUS Milan, Italy
| | | | - Ilaria Castelli
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy ; Dipartimento di Scienze Umane e Sociali, Università degli Studi di Bergamo Bergamo, Italy
| | - Davide Massaro
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Annalisa Valle
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Raffaello Nemni
- IRCCS Fondazione don Carlo Gnocchi ONLUS Milan, Italy ; Università degli Studi di Milano Milan, Italy
| | - Mario Clerici
- IRCCS Fondazione don Carlo Gnocchi ONLUS Milan, Italy ; Università degli Studi di Milano Milan, Italy
| | - Antonella Marchetti
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | | |
Collapse
|
33
|
Caronni A, Sciumé L, Ferpozzi V, Blasi V, Castellano A, Falini A, Perucca L, Cerri G. Mirror Movements After Stroke Suggest Facilitation From Nonprimary Motor Cortex: A Case Presentation. PM R 2015; 8:479-83. [PMID: 26514789 DOI: 10.1016/j.pmrj.2015.10.009] [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: 05/20/2015] [Revised: 10/12/2015] [Accepted: 10/18/2015] [Indexed: 11/29/2022]
Abstract
When stroke occurs in adulthood, mirror movements (MMs; involuntary movements occurring in 1 hand when performing unilateral movements with the contralateral hand) in the paretic hand rarely occur. We present a case of an apparently healthy 54-year-old man presenting with MMs in his left (nondominant) hand. Further evaluation revealed diminished strength and dexterity in left hand, increased spinal excitability, decreased corticospinal excitability, occurrence of ipsilateral motor responses, enlarged cortical motor representation, and imaging findings consistent with a previously undiagnosed right-subcortical stroke. MMs and ipsilateral motor responses may reflect the increased spinal motor neurons' excitability sustained by the spared nonprimary ipsilesional motor areas.
Collapse
Affiliation(s)
- Antonio Caronni
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144 Milan, Italy(∗).
| | - Luciana Sciumé
- Residency Program in Physical and Rehabilitation Medicine, Università degli Studi di Milano, Milan, Italy(†)
| | - Valentina Ferpozzi
- Department of Medical Biotechnologies and Translational Medicine, Università degli Studi di Milano Italy; Humanitas Clinical and Research Center, Rozzano, Milan, Italy(‡)
| | - Valeria Blasi
- Scientific Institute and University, Ospedale San Raffaele, Neuroradiology, CERMAC, Milano, Italy(§)
| | - Antonella Castellano
- Scientific Institute and University, Ospedale San Raffaele, Neuroradiology, CERMAC, Milano, Italy(‖)
| | - Andrea Falini
- Scientific Institute and University, Ospedale San Raffaele, Neuroradiology, CERMAC, Milano, Italy(¶)
| | - Laura Perucca
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy; Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milano, Italy(#)
| | - Gabriella Cerri
- Department of Medical Biotechnologies and Translational Medicine, Università degli Studi di Milano Italy; Humanitas Clinical and Research Center, Rozzano, Milan, Italy(∗∗)
| |
Collapse
|
34
|
Spinelli EG, Caso F, Agosta F, Gambina G, Magnani G, Canu E, Blasi V, Perani D, Comi G, Falini A, Gorno-Tempini ML, Filippi M. A multimodal neuroimaging study of a case of crossed nonfluent/agrammatic primary progressive aphasia. J Neurol 2015; 262:2336-45. [PMID: 26194195 DOI: 10.1007/s00415-015-7845-x] [Citation(s) in RCA: 19] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 11/21/2022]
Abstract
Crossed aphasia has been reported mainly as post-stroke aphasia resulting from brain damage ipsilateral to the dominant right hand. Here, we described a case of a crossed nonfluent/agrammatic primary progressive aphasia (nfvPPA), who developed a corticobasal syndrome (CBS). We collected clinical, cognitive, and neuroimaging data for four consecutive years from a 55-year-old right-handed lady (JV) presenting with speech disturbances. 18-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) and DaT-scan with (123)I-Ioflupane were obtained. Functional MRI (fMRI) during a verb naming task was acquired to characterize patterns of language lateralization. Diffusion tensor MRI was used to evaluate white matter damage within the language network. At onset, JV presented with prominent speech output impairment and right frontal atrophy. After 3 years, language deficits worsened, with the occurrence of a mild agrammatism. The patient also developed a left-sided mild extrapyramidal bradykinetic-rigid syndrome. The clinical picture was suggestive of nfvPPA with mild left-sided extrapyramidal syndrome. At this time, voxel-wise SPM analyses of (18)F-FDG PET and structural MRI showed right greater than left frontal hypometabolism and damage, which included the Broca's area. DaT-scan showed a reduced uptake in the right striatum. FMRI during naming task demonstrated bilateral language activations, and tractography showed right superior longitudinal fasciculus (SLF) involvement. Over the following year, JV became mute and developed frank left-sided motor signs and symptoms, evolving into a CBS clinical picture. Brain atrophy worsened in frontal areas bilaterally, and extended to temporo-parietal regions, still with a right-sided asymmetry. Tractography showed an extension of damage to the left SLF and right inferior longitudinal fasciculus. We report a case of crossed nfvPPA followed longitudinally and studied with advanced neuroimaging techniques. The results highlight a complex interaction between individual premorbid developmental differences and the clinical phenotype.
Collapse
Affiliation(s)
- Edoardo G Spinelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Caso
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Giuseppe Gambina
- SSO Centro Alzheimer e Disturbi Cognitivi, DAI di Neuroscienze, UOC di Neurologia d.O., Azienda Ospedaliera Integrata Verona, Verona, Italy
| | - Giuseppe Magnani
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Valeria Blasi
- Department of Neuroradiology and CERMAC, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Daniela Perani
- Nuclear Medicine Unit, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology and CERMAC, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy. .,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| |
Collapse
|
35
|
Cerri G, Cabinio M, Blasi V, Borroni P, Iadanza A, Fava E, Fornia L, Ferpozzi V, Riva M, Casarotti A, Martinelli Boneschi F, Falini A, Bello L. The mirror neuron system and the strange case of Broca's area. Hum Brain Mapp 2014; 36:1010-27. [PMID: 25366580 DOI: 10.1002/hbm.22682] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/03/2014] [Accepted: 10/21/2014] [Indexed: 11/10/2022] Open
Abstract
Mirror neurons, originally described in the monkey premotor area F5, are embedded in a frontoparietal network for action execution and observation. A similar Mirror Neuron System (MNS) exists in humans, including precentral gyrus, inferior parietal lobule, and superior temporal sulcus. Controversial is the inclusion of Broca's area, as homologous to F5, a relevant issue in light of the mirror hypothesis of language evolution, which postulates a key role of Broca's area in action/speech perception/production. We assess "mirror" properties of this area by combining neuroimaging and intraoperative neurophysiological techniques. Our results show that Broca's area is minimally involved in action observation and has no motor output on hand or phonoarticulatory muscles, challenging its inclusion in the MNS. The presence of these functions in premotor BA6 makes this area the likely homologue of F5 suggesting that the MNS may be involved in the representation of articulatory rather than semantic components of speech.
Collapse
Affiliation(s)
- Gabriella Cerri
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy; Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Baglio F, Cabinio M, Ricci C, Baglio G, Lipari S, Griffanti L, Preti MG, Nemni R, Clerici M, Zanette M, Blasi V. Abnormal development of sensory-motor, visual temporal and parahippocampal cortex in children with learning disabilities and borderline intellectual functioning. Front Hum Neurosci 2014; 8:806. [PMID: 25360097 PMCID: PMC4197777 DOI: 10.3389/fnhum.2014.00806] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 09/22/2014] [Indexed: 11/13/2022] Open
Abstract
Borderline intellectual functioning (BIF) is a condition characterized by an intelligence quotient (IQ) between 70 and 85. BIF children present with cognitive, motor, social, and adaptive limitations that result in learning disabilities and are more likely to develop psychiatric disorders later in life. The aim of this study was to investigate brain morphometry and its relation to IQ level in BIF children. Thirteen children with BIF and 14 age- and sex-matched typically developing (TD) children were enrolled. All children underwent a full IQ assessment (WISC-III scale) and a magnetic resonance (MR) examination including conventional sequences to assess brain structural abnormalities and high resolution 3D images for voxel-based morphometry analysis. To investigate to what extent the group influenced gray matter (GM) volumes, both univariate and multivariate generalized linear model analysis of variance were used, and the varimax factor analysis was used to explore variable correlations and clusters among subjects. Results showed that BIF children, compared to controls have increased regional GM volume in bilateral sensorimotor and right posterior temporal cortices and decreased GM volume in the right parahippocampal gyrus. GM volumes were highly correlated with IQ indices. The present work is a case study of a group of BIF children showing that BIF is associated with abnormal cortical development in brain areas that have a pivotal role in motor, learning, and behavioral processes. Our findings, although allowing for little generalization to the general population, contribute to the very limited knowledge in this field. Future longitudinal MR studies will be useful in verifying whether cortical features can be modified over time even in association with rehabilitative intervention.
Collapse
Affiliation(s)
| | - Monia Cabinio
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Pathophysiology and Transplantation, University of Milan Milan, Italy
| | - Cristian Ricci
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Epidemiology and Preventive Medicine, University of Regensburg Germany
| | - Gisella Baglio
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy
| | - Susanna Lipari
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy
| | - Ludovica Griffanti
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Electronics, Information and Bioengineering Politecnico di Milano, Milan, Italy
| | - Maria G Preti
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Electronics, Information and Bioengineering Politecnico di Milano, Milan, Italy
| | - Raffaello Nemni
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Pathophysiology and Transplantation, University of Milan Milan, Italy
| | - Mario Clerici
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy ; Department of Pathophysiology and Transplantation, University of Milan Milan, Italy
| | | | - Valeria Blasi
- IRCCS, Don Carlo Gnocchi Foundation - ONLUS Milan, Italy
| |
Collapse
|
37
|
Baldoli C, Scola E, Della Rosa PA, Pontesilli S, Longaretti R, Poloniato A, Scotti R, Blasi V, Cirillo S, Iadanza A, Rovelli R, Barera G, Scifo P. Maturation of preterm newborn brains: a fMRI–DTI study of auditory processing of linguistic stimuli and white matter development. Brain Struct Funct 2014; 220:3733-51. [DOI: 10.1007/s00429-014-0887-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 09/08/2014] [Indexed: 11/30/2022]
|
38
|
Gonzalez-Rosa JJ, Inuggi A, Blasi V, Cursi M, Annovazzi P, Comi G, Falini A, Leocani L. Response competition and response inhibition during different choice-discrimination tasks: Evidence from ERP measured inside MRI scanner. Int J Psychophysiol 2013; 89:37-47. [DOI: 10.1016/j.ijpsycho.2013.04.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 01/23/2023]
|
39
|
Baglio F, Castelli I, Alberoni M, Blasi V, Griffanti L, Falini A, Nemni R, Marchetti A. Theory of mind in amnestic mild cognitive impairment: an FMRI study. J Alzheimers Dis 2012; 29:25-37. [PMID: 22156049 DOI: 10.3233/jad-2011-111256] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Theory of Mind (ToM) undergoes changes at the behavioral level in pathological aging (Alzheimer's disease (AD)) and at the neural level in physiological aging. The aim was to determine if there are changes in ToM in the behavioral and neural domains in old subjects with high risk of switching from successful to unsuccessful neurocognitive aging. Patients with amnestic mild cognitive impairment (aMCI) syndrome were studied, since aMCI was proposed to fill the gap between normal aging and dementia. Sixteen aMCI patients (mean age 71 years) and fifteen healthy controls (mean age 67 years) with no differences in age or education were subjected to increasingly complex ToM tasks and to fMRI scanning while performing the Reading the Mind in the Eyes test (RME), which attributes mental states by focusing on eye-gaze. aMCI subjects had worse performances in two second order false belief tasks, confirming the decay of ToM on the behavioral level. Despite a minor activation of some components (posterior end of the superior temporal sulcus and temporal pole) of the ToM neural circuit, no significant differences in the behavioral performances to the RME was found in aMCI compared to controls. Probably the preservation of the mirror neuron system (precentral gyrus-BA 6; Broca area - BA 44) and the stronger involvement of frontal areas (middle and medial frontal cortex and anterior cingulate cortex) supplemented the decay of part of the mentalizing neural circuit, preserving task performance.
Collapse
Affiliation(s)
- Francesca Baglio
- Don Carlo Gnocchi Foundation, Scientific Institute and University, IRCCS, Milano, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Carlomagno S, Blasi V, Labruna L, Santoro A. The role of communication models in assessment and therapy of language disorders in aphasic adults. Neuropsychol Rehabil 2010. [DOI: 10.1080/096020100389183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
41
|
Cabinio M, Blasi V, Borroni P, Montagna M, Iadanza A, Falini A, Cerri G. The shape of motor resonance: Right- or left-handed? Neuroimage 2010; 51:313-23. [DOI: 10.1016/j.neuroimage.2010.01.103] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/28/2010] [Accepted: 01/28/2010] [Indexed: 10/19/2022] Open
|
42
|
Cerasa A, Gioia MC, Tarantino P, Labate A, Arabia G, Annesi G, Lanza P, Di Palma G, Blasi V, Quattrone A. The DRD2 TaqIA polymorphism associated with changed midbrain volumes in healthy individuals. Genes, Brain and Behavior 2009; 8:459-63. [DOI: 10.1111/j.1601-183x.2009.00492.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
43
|
Baglio F, Blasi V, Falini A, Farina E, Mantovani F, Olivotto F, Scotti G, Nemni R, Bozzali M. Functional brain changes in early Parkinson's disease during motor response and motor inhibition. Neurobiol Aging 2009; 32:115-24. [PMID: 19188005 DOI: 10.1016/j.neurobiolaging.2008.12.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 10/10/2008] [Accepted: 12/15/2008] [Indexed: 10/21/2022]
Abstract
Motor impairment represents the main clinical feature of Parkinson's disease (PD). Cognitive deficits are also frequently observed in patients with PD, with a prominent involvement of executive functions and visuo-spatial abilities. We used event-related functional MRI (fMRI) and a paradigm based on visual attention and motor inhibition (Go/NoGO-task) to investigate brain activations in 13 patients with early PD in comparison with 11 healthy controls. The two groups did not report behavioural differences in task performance. During motor inhibition (NoGO-effect), PD patients compared to controls showed an increased activation in the prefrontal cortex and in the basal ganglia. They also showed a reduced and less coherent hemodynamic response in the occipital cortex. These results indicate that specific cortico-subcortical functional changes, involving not only the fronto-striatal network but also the temporal-occipital cortex, are already present in patients with early PD and no clinical evidence of cognitive impairment. We discuss our findings in terms of compensatory mechanisms (fronto-striatal changes) and preclinical signs of visuo-perceptual deficits and visual hallucinations.
Collapse
Affiliation(s)
- Francesca Baglio
- Don Carlo Gnocchi Foundation, Scientific Institute and University, IRCCS, 20148 Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Blasi V, Longaretti R, Giovanettoni C, Baldoli C, Pontesilli S, Vigone C, Saccuman C, Nigro F, Chiumello G, Scotti G, Weber G. Decreased parietal cortex activity during mental rotation in children with congenital hypothyroidism. Neuroendocrinology 2009; 89:56-65. [PMID: 18698134 DOI: 10.1159/000151397] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 04/11/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND The ability to detect the spatial characteristics of objects and to rotate them mentally is frequently impaired in early treated congenital hypothyroidism (CH) children. AIMS To explore the neural substrate of the visuospatial difficulty in children with CH, we studied 15 children with CH (8-10 years) and 13 age-matched control children with functional magnetic resonance imaging (fMRI) using a mental rotation task (VST). RESULTS Performance at VST was significantly different between the two groups. Moreover, fMRI data showed greater activation in the superior parietal cortex in control children while children with CH had greater activation in the bilateral SMA and the opercular region of the precentral gyrus, the adjacent insula and the left somatosensory parietal cortex. Furthermore, children with CH deactivated the inferior parietal cortex (Brodmann area 40) more than controls. CONCLUSION We suggest that the poorer performance of children with CH on VST task is related to the decreased activation in brain areas important for the mental representation of the objects' spatial characteristics, with increased recruitment of regions involved in the representation of somatosensory whole-body information. More studies will be necessary to understand if this different effectiveness in VST reflects immaturity of the neural system or its actual impairment.
Collapse
Affiliation(s)
- Valeria Blasi
- Neuroradiology, CERMAC, Vita-Salute San Raffaele University, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Bizzi A, Blasi V, Falini A, Ferroli P, Cadioli M, Danesi U, Aquino D, Marras C, Caldiroli D, Broggi G. Presurgical Functional MR Imaging of Language and Motor Functions: Validation with Intraoperative Electrocortical Mapping. Radiology 2008; 248:579-89. [DOI: 10.1148/radiol.2482071214] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
46
|
Bello L, Gambini A, Castellano A, Carrabba G, Acerbi F, Fava E, Giussani C, Cadioli M, Blasi V, Casarotti A, Papagno C, Gupta AK, Gaini S, Scotti G, Falini A. Motor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas. Neuroimage 2007; 39:369-82. [PMID: 17911032 DOI: 10.1016/j.neuroimage.2007.08.031] [Citation(s) in RCA: 285] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 08/11/2007] [Accepted: 08/20/2007] [Indexed: 11/20/2022] Open
Abstract
Preoperative DTI Fiber Tracking (DTI-FT) reconstruction of functional tracts combined with intraoperative subcortical mapping (ISM) is potentially useful to improve surgical procedures in gliomas located in eloquent areas. Aims of the study are: (1) to evaluate the modifications of fiber trajectory induced by the tumor; (2) to validate preoperative DTI-FT results with intraoperative identification of functional subcortical sites through direct subcortical stimulation; (3) to evaluate the impact of preoperative DTI-FT reconstructions in a neuronavigational setup combined with ISM technique on duration and modalities of surgical procedures, and on functional outcome of the patients. Data are available on 64 patients (52 low-grade and 12 high-grade gliomas). DTI-FT was acquired by a 3-T MR scanner with a single-shot EPI sequence (TR/TE 8986/80 ms, b=1000 s/mm) with gradients applied along 32 non-collinear directions. 3D Fast Field Echo (FFE) T1-weighted imaging (TR/TE 8/4 ms) was performed for anatomic guidance. The corticospinal tract (CST), superior longitudinal, inferior fronto-occipital and uncinatus fasciculi were reconstructed. Data were transferred to the neuronavigational system. Functional subcortical sites identified during ISM were correlated with fiber tracts depicted by DTI-FT. In high-grade gliomas, DTI-FT depicted tracts mostly at the tumor periphery; in low-grade gliomas, fibers were frequently located inside the tumor mass. There was a high correlation between DTI-FT and ISM (sensitivity for CST=95%, language tracts=97%). For a proper reconstruction of the tracts, it was necessary to use a low FA threshold of fiber tracking algorithm and to position additional regions of interest (ROIs). The combination of DTI-FT and ISM decreased the duration of surgery, patient fatigue, and intraoperative seizures. Combination of DTI-FT and ISM allows accurate identification of eloquent fiber tracts and enhances surgical performance and safety maintaining a high rate of functional preservation.
Collapse
Affiliation(s)
- Lorenzo Bello
- Neurosurgery, Department of Neurological Sciences, University of Milano, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via Francesco Sforza 35, 20122, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Benedetti F, Bernasconi A, Blasi V, Cadioli M, Colombo C, Falini A, Lorenzi C, Radaelli D, Scotti G, Smeraldi E. Neural and Genetic Correlates of Antidepressant Response to Sleep Deprivation. ACTA ACUST UNITED AC 2007; 64:179-87. [PMID: 17283285 DOI: 10.1001/archpsyc.64.2.179] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
CONTEXT Total sleep deprivation combined with light therapy causes rapid amelioration of bipolar depression. A polymorphism in the promoter for the serotonin transporter influences both antidepressant response and the structure and function of specific brain areas. OBJECTIVE To determine whether antidepressant therapy or the genotype of the serotonin transporter influence the pattern of neural response to a task targeting the depressive biases in information processing (moral valence decision). DESIGN Before-and-after trial studying the biologic correlates of response to treatment. SETTING University hospital. Patients Twenty inpatients with bipolar depression. Intervention Repeated total sleep deprivation combined with light therapy for 1 week. MAIN OUTCOME MEASURES Brain blood oxygen level-dependent functional magnetic resonance imaging using a 3.0-T scanner before and after treatment. Self-ratings and observer ratings of mood (visual analog scale 3 times daily and Hamilton Depression Rating Scale) before and after treatment. RESULTS We found significant interactions of treatment (before and after), response to treatment (Hamilton Depression Rating Scale score <8), and moral valence of the stimuli (positive or negative) in the anterior cingulate cortex, dorsolateral prefrontal cortex, insula, and parietal cortex. In these areas, responders changed their blood oxygen level-dependent responses to emotional stimuli in a pattern opposite of that in nonresponders. Genotype of the promoter for the serotonin transporter predicted response to treatment and influenced baseline neural responses in the anterior cingulate cortex and the dorsolateral prefrontal cortex. CONCLUSION Multiple factors that affect or are affected at the individual level by major depressive episodes in the course of bipolar disorder significantly interact in influencing brain cortical activity in specific areas.
Collapse
Affiliation(s)
- Francesco Benedetti
- Department of Neuropsychiatric Sciences and Neuroradiology, San Raffaele Scientific Institute, Department of Neuropsychiatric Sciences, San Raffaele Turro, Via Stamira d'Ancona 20, Milano, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Connor LT, DeShazo Braby T, Snyder AZ, Lewis C, Blasi V, Corbetta M. Cerebellar activity switches hemispheres with cerebral recovery in aphasia. Neuropsychologia 2005; 44:171-7. [PMID: 16019040 DOI: 10.1016/j.neuropsychologia.2005.05.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Revised: 05/10/2005] [Accepted: 05/12/2005] [Indexed: 01/24/2023]
Abstract
The right postero-lateral cerebellum participates with the left frontal lobe in the selection and production of words. Using fMRI, we examined whether cerebellar activity switches hemispheres in parallel with recruitment of putative compensatory right homologous frontal regions in post-stroke aphasia. Re-examining the data of Blasi et al. [Blasi, V., Young, A. C., Tansy, A. P., Petersen, S. E., Snyder, A. Z., & Corbetta, M. (2002). Word retrieval learning modulates right frontal cortex in patients with left frontal damage. Neuron, 36(1), 159-170], we asked: (1) if activity in the right cerebellum was disrupted by a left frontal lesion, (2) if activity switched to the left cerebellum, and (3) if activity in the left cerebellum was modulated by learning, as was right frontal cortex. Fourteen age-matched controls and eight mildly aphasic stroke patients participated. Aphasic participants all had lesions due to unilateral left hemisphere stroke at or near Broca's area. Subjects silently performed a word stem completion task with either novel or repeated items. Activity in right cerebellum of aphasic individuals was minimal and was not modulated by learning, as for controls. However, we observed robust learning-related attenuation of the BOLD signal in the left postero-lateral cerebellum consistent with learning-related effects in right frontal cortex. These findings support the hypothesis that right frontal and left cerebellar circuits are likely to be functionally relevant to recovered/residual verbal function.
Collapse
Affiliation(s)
- Lisa Tabor Connor
- Department of Radiology, Box 8225, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110, USA, and Neuroradiology Institute, San Raffaele Hospital, Milan, Italy.
| | | | | | | | | | | |
Collapse
|
49
|
Comi E, Annovazzi P, Silva AM, Cursi M, Blasi V, Cadioli M, Inuggi A, Falini A, Comi G, Leocani L. Visual evoked potentials may be recorded simultaneously with fMRI scanning: A validation study. Hum Brain Mapp 2005; 24:291-8. [PMID: 15678479 PMCID: PMC6871709 DOI: 10.1002/hbm.20087] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Integrating electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) data may help to optimize anatomical and temporal resolution in the investigation of cortical function. Successful removal of fMRI scanning artifacts from continuous EEG in simultaneous recordings has been reported. We assessed the feasibility of recording reliable visual evoked potentials (VEPs) during fMRI scanning using available artifact removing procedures. EEG during administration of visual stimuli was recorded using MRI-compatible 32-channel equipment in nine normal subjects (mean age, 23.9 +/- 2.5 years), with and without fMRI acquisition. fMRI scanning and cardioballistographic artifacts were removed after subtraction of averaged artifact waveforms. Consistency between VEPs waveforms and of P1 and N1 peak latencies and amplitudes in the two conditions was assessed. Good correlation was found between VEP waveforms (Pearson's correlation coefficient: r(P) between 0.76-0.94 across subjects; P < 0.0001) and between latency or amplitude of P1 and N1 peaks (latencies: r = 0.7, P < 0.035; amplitudes: r > 0.65, P < 0.05; Spearman rank correlation coefficient) in the two recording conditions. No significant differences were found between P1 and N1 parameters in the two conditions (Wilcoxon signed rank test). Consistent VEP waveforms, latencies, and amplitudes with and without fMRI scanning indicate that reliable VEPs may be obtained simultaneously with fMRI recording. This possibility might be helpful by shortening recording times and reducing variability from learning, habituation, and fatigue phenomena from separate recordings for the integration of event-related EEG and fMRI data.
Collapse
Affiliation(s)
- Eleonora Comi
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Pietro Annovazzi
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Ana Martins Silva
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Marco Cursi
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Valeria Blasi
- Department of Neuroradiology, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Marcello Cadioli
- Department of Neuroradiology, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Alberto Inuggi
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Letizia Leocani
- Department of Neurology and Clinical Neurophysiology, University Vita‐Salute, Scientific Institute Hospital San Raffaele, Milan, Italy
| |
Collapse
|
50
|
Abstract
Regional cerebral blood flow (rCBF) PET scans were used to study the physiological bases of lipreading, a natural skill of extracting language from mouth movements, which contributes to speech perception in everyday life. Viewing connected mouth movements that could not be lexically identified and that evoke perception of isolated speech sounds (nonlexical lipreading) was associated with bilateral activation of the auditory association cortex around Wernicke's area, of left dorsal premotor cortex, and left opercular-premotor division of the left inferior frontal gyrus (Broca's area). The supplementary motor area was active as well. These areas have all been implicated in phonological processing, speech and mouth motor planning, and execution. In addition, nonlexical lipreading also differentially activated visual motion areas. Lexical access through lipreading was associated with a similar pattern of activation and with additional foci in ventral- and dorsolateral prefrontal cortex bilaterally and in left inferior parietal cortex. Linear regression analysis of cerebral blood flow and proficiency for lexical lipreading further clarified the role of these areas in gaining access to language through lipreading. The results suggest cortical activation circuits for lipreading from action representations that may differentiate lexical access from nonlexical processes.
Collapse
Affiliation(s)
- E Paulesu
- Psychology Department, University of Milano-Bicocca, 20126 Milan, Italy.
| | | | | | | | | | | | | | | |
Collapse
|