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Nanni A, Colonna M, Liberati G, Bonoli A. A novel process for the complete recycling of exhausted coffee capsules with a fully circular approach: Design of the industrial plant and Techno-Economic analysis of the process. Waste Manag 2024; 174:114-125. [PMID: 38041980 DOI: 10.1016/j.wasman.2023.11.029] [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] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/07/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
The objective of this paper is to present the technical and feasibility analysis of an innovative mechanical recycling system for exhausted coffee capsules. This recycling process involved the sorting of spent coffee grounds (SGC) and the subsequent drying and melt-mixing of a portion of these grounds with the remaining capsule components, mainly composed of polypropylene (PP), along with optional virgin PP. These newly developed composite materials exhibited mechanical and rheological properties comparable or even surpassing those of virgin PP. They were also successfully utilized for the injection of new capsule shells, thus alignin with the principles of the circular economy. In addition to the technical aspects, this paper present a comprehensive Techno-Economic Analysis (TEA) of the proposed recycling processes, considering the inclusion of virgin PP (0-20 %) and the initial moisture content (MSGC) of SGC(5-55 %) as varying factors. An industrial plant, designed to handle up to 190 million exhausted coffee capsules and produce up to 1500 tons of recycled compund was appropriately sized. The analysis revealed that processes are profitable across all examined scenarios and that the Net Present Value ranged between 800 k€ (for vPP = 20 % and MSGC = 55 %) and 2000 k€ (for vPP = 0 % and MSGC = 5 %).
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Affiliation(s)
- A Nanni
- SPORT TECHNOLOGY LAB - DICAM, University of Bologna, Via Terracini 28, 40131 Bologna, Italy; RE-SPORT srl, via G. Fanin 48, 40127 Bologna, Italy; AgroMateriae srl, Via Granarolo 177/3, 48018 Faenza RA, Italy.
| | - M Colonna
- SPORT TECHNOLOGY LAB - DICAM, University of Bologna, Via Terracini 28, 40131 Bologna, Italy; RE-SPORT srl, via G. Fanin 48, 40127 Bologna, Italy
| | - G Liberati
- Raw Materials Engineering and Circular Economy LAB - DICAM, University of Bologna, Via Terracini 28, 40131, Bologna, Italy
| | - A Bonoli
- Raw Materials Engineering and Circular Economy LAB - DICAM, University of Bologna, Via Terracini 28, 40131, Bologna, Italy
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2
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Leu C, Courtin A, Cussac C, Liberati G. The role of ongoing oscillation in pain perception: Absence of modulation by a concomitant arithmetic task. Cortex 2023; 168:114-129. [PMID: 37708762 DOI: 10.1016/j.cortex.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/06/2023] [Accepted: 08/09/2023] [Indexed: 09/16/2023]
Abstract
Sustained nociceptive stimuli have been shown to modulate the amplitude of ongoing neural oscillations in the theta, alpha and beta frequency bands at the frequency of stimulation, suggesting a relationship between these ongoing oscillations and pain perception. Yet, whether these ongoing oscillations are actually related to the pain experience remains unclear. If it were the case, then cognitive processes that are known to affect pain intensity should also affect these ongoing oscillations. To this end, we used electroencephalography (EEG) to investigate whether distraction - an attentional state known to affect pain perception - also modulates the amplitude of these neural oscillations. More specifically, we hypothesized that performing an unrelated arithmetic task during sustained nociceptive stimulation would lead to a decrease in the modulations of ongoing oscillations exerted by the stimulation. To assess the selectivity of this modulation for nociception, we compared the modulations of ongoing oscillations exerted by sustained periodic thermonociceptive and non-nociceptive vibrotactile stimulation (.2 Hz, 75 sec), while participants were either asked to solve an unrelated arithmetic task (distraction task) or received no specific instruction (baseline). The intensity of perception was significantly reduced by the arithmetic task in both the thermonociceptive and the vibrotactile modality, and the sustained periodic stimulation elicited a periodic response at the frequency of stimulation in both modalities. However, the distraction task did not show a differential effect for the two stimulation modalities in any of the frequency bands. The fact that, unlike pain perception, these oscillations did not appear to be affected by the task suggests that they are dissociable from pain perception. Whether a different task (leading to a stronger degree of distraction) could lead to different results is unclear.
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Affiliation(s)
- Chiara Leu
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
| | - Arthur Courtin
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium; Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Céline Cussac
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium; Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Vespa S, Stumpp L, Liberati G, Delbeke J, Nonclercq A, Mouraux A, El Tahry R. Corrigendum to "Characterization of vagus nerve stimulation-induced pupillary responses in epileptic patients" [Brain Stimul. 15 (2022) 1498-1507]. Brain Stimul 2023; 16:1461. [PMID: 37793267 DOI: 10.1016/j.brs.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- Simone Vespa
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium.
| | - Lars Stumpp
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Giulia Liberati
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Jean Delbeke
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | | | - André Mouraux
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Riëm El Tahry
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium; Department of Neurology, Saint Luc University Hospital, Brussels, Belgium
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Richie-Halford A, Cieslak M, Ai L, Caffarra S, Covitz S, Franco AR, Karipidis II, Kruper J, Milham M, Avelar-Pereira B, Roy E, Sydnor VJ, Yeatman JD, Abbott NJ, Anderson JAE, Gagana B, Bleile M, Bloomfield PS, Bottom V, Bourque J, Boyle R, Brynildsen JK, Calarco N, Castrellon JJ, Chaku N, Chen B, Chopra S, Coffey EBJ, Colenbier N, Cox DJ, Crippen JE, Crouse JJ, David S, Leener BD, Delap G, Deng ZD, Dugre JR, Eklund A, Ellis K, Ered A, Farmer H, Faskowitz J, Finch JE, Flandin G, Flounders MW, Fonville L, Frandsen SB, Garic D, Garrido-Vásquez P, Gonzalez-Escamilla G, Grogans SE, Grotheer M, Gruskin DC, Guberman GI, Haggerty EB, Hahn Y, Hall EH, Hanson JL, Harel Y, Vieira BH, Hettwer MD, Hobday H, Horien C, Huang F, Huque ZM, James AR, Kahhale I, Kamhout SLH, Keller AS, Khera HS, Kiar G, Kirk PA, Kohl SH, Korenic SA, Korponay C, Kozlowski AK, Kraljevic N, Lazari A, Leavitt MJ, Li Z, Liberati G, Lorenc ES, Lossin AJ, Lotter LD, Lydon-Staley DM, Madan CR, Magielse N, Marusak HA, Mayor J, McGowan AL, Mehta KP, Meisler SL, Michael C, Mitchell ME, Morand-Beaulieu S, Newman BT, Nielsen JA, O’Mara SM, Ojha A, Omary A, Özarslan E, Parkes L, Peterson M, Pines AR, Pisanu C, Rich RR, Sahoo AK, Samara A, Sayed F, Schneider JT, Shaffer LS, Shatalina E, Sims SA, Sinclair S, Song JW, Hogrogian GS, Tamnes CK, Tooley UA, Tripathi V, Turker HB, Valk SL, Wall MB, Walther CK, Wang Y, Wegmann B, Welton T, Wiesman AI, Wiesman AG, Wiesman M, Winters DE, Yuan R, Zacharek SJ, Zajner C, Zakharov I, Zammarchi G, Zhou D, Zimmerman B, Zoner K, Satterthwaite TD, Rokem A. Author Correction: An analysis-ready and quality controlled resource for pediatric brain white-matter research. Sci Data 2022; 9:709. [PMID: 36396653 PMCID: PMC9671885 DOI: 10.1038/s41597-022-01816-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Vespa S, Stumpp L, Liberati G, Delbeke J, Nonclercq A, Mouraux A, El Tahry R. Characterization of vagus nerve stimulation-induced pupillary responses in epileptic patients. Brain Stimul 2022; 15:1498-1507. [PMID: 36402376 DOI: 10.1016/j.brs.2022.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 07/03/2022] [Revised: 10/15/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Modulation of the locus coeruleus (LC)-noradrenergic system is a key mechanism of vagus nerve stimulation (VNS). Activation of the LC produces pupil dilation, and the VNS-induced change in pupil diameter was demonstrated in animals as a possible dose-dependent biomarker for treatment titration. OBJECTIVE This study aimed to characterize VNS-induced pupillary responses in epileptic patients. METHODS Pupil diameter was recorded in ten epileptic patients upon four stimulation conditions: three graded levels of VNS intensity and a somatosensory control stimulation (cutaneous electrical stimulation over the left clavicle). For each block, the patients rated the intensity of stimulation on a numerical scale. We extracted the latency of the peak pupil dilation and the magnitude of the early (0-2.5 s) and late components (2.5-5 s) of the pupil dilation response (PDR). RESULTS VNS elicited a peak dilation with longer latency compared to the control condition (p = 0.043). The magnitude of the early PDR was significantly correlated with the intensity of perception (p = 0.046), whereas the late PDR was not (p = 0.19). There was a significant main effect of the VNS level of intensity on the magnitude of the late PDR (p = 0.01) but not on the early PDR (p = 0.2). The relationship between late PDR magnitude and VNS intensity was best fit by a Gaussian model (inverted-U). CONCLUSIONS The late component of the PDR might reflect specific dose-dependent effects of VNS, as compared to control somatosensory stimulation. The inverted-U relationship of late PDR with VNS intensity might indicate the engagement of antagonist central mechanisms at high stimulation intensities.
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Affiliation(s)
- Simone Vespa
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium.
| | - Lars Stumpp
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Giulia Liberati
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Jean Delbeke
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | | | - André Mouraux
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium
| | - Riëm El Tahry
- Institute of NeuroScience, Catholic University of Louvain, Brussels, Belgium; Department of Neurology, Saint Luc University Hospital, Brussels, Belgium
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Vespa S, Heyse J, Stumpp L, Liberati G, Santos SF, Rooijakkers H, Nonclercq A, Mouraux A, van Mierlo P, El Tahry R. Vagus Nerve Stimulation elicits sleep EEG desynchronization and network changes in responder patients in epilepsy. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Vespa S, Heyse J, Stumpp L, Liberati G, Ferrao Santos S, Rooijakkers H, Nonclercq A, Mouraux A, van Mierlo P, El Tahry R. Vagus Nerve Stimulation Elicits Sleep EEG Desynchronization and Network Changes in Responder Patients in Epilepsy. Neurotherapeutics 2021; 18:2623-2638. [PMID: 34668148 PMCID: PMC8804116 DOI: 10.1007/s13311-021-01124-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
Neural desynchronization was shown as a key mechanism of vagus nerve stimulation (VNS) action in epilepsy, and EEG synchronization measures are explored as possible response biomarkers. Since brain functional organization in sleep shows different synchrony and network properties compared to wakefulness, we aimed to explore the effects of acute VNS on EEG-derived measures in the two different states of vigilance. EEG epochs were retrospectively analyzed from twenty-four VNS-treated epileptic patients (11 responders, 13 non-responders) in calm wakefulness and stage N2 sleep. Weighted Phase Lag Index (wPLI) was computed as connectivity measure of synchronization, for VNS OFF and VNS ON conditions. Global efficiency (GE) was computed as a network measure of integration. Ratios OFF/ON were obtained as desynchronization/de-integration index. Values were compared between responders and non-responders, and between EEG states. ROC curve and area-under-the-curve (AUC) analysis was performed for response classification. In responders, stronger VNS-induced theta desynchronization (p < 0.05) and decreased GE (p < 0.05) were found in sleep, but not in wakefulness. Theta sleep wPLI Ratio OFF/ON yielded an AUC of 0.825, and 79% accuracy as a response biomarker if a cut-off value is set at 1.05. Considering all patients, the VNS-induced GE decrease was significantly more important in sleep compared to awake EEG state (p < 0.01). In conclusion, stronger sleep EEG desynchronization in theta band distinguishes responders to VNS therapy from non-responders. VNS-induced reduction of network integration occurs significantly more in sleep than in wakefulness.
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Affiliation(s)
- Simone Vespa
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium.
| | - Jolan Heyse
- Medical Image and Signal Processing Group (MEDISIP), Ghent University, Ghent, Belgium
| | - Lars Stumpp
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium
| | - Giulia Liberati
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium
| | - Susana Ferrao Santos
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium
- Centre for Refractory Epilepsy, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Herbert Rooijakkers
- Centre for Refractory Epilepsy, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Antoine Nonclercq
- Bio, Electro and Mechanical Systems (BEAMS), Université Libre de Bruxelles, Brussels, Belgium
| | - André Mouraux
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium
| | - Pieter van Mierlo
- Medical Image and Signal Processing Group (MEDISIP), Ghent University, Ghent, Belgium
| | - Riëm El Tahry
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Avenue Mounier, 53 - 1200, Brussels, Belgium
- Centre for Refractory Epilepsy, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Liberati G, Mulders D, Algoet M, van den Broeke EN, Santos SF, Ribeiro Vaz JG, Raftopoulos C, Mouraux A. Insular responses to transient painful and non-painful thermal and mechanical spinothalamic stimuli recorded using intracerebral EEG. Sci Rep 2020; 10:22319. [PMID: 33339884 PMCID: PMC7749115 DOI: 10.1038/s41598-020-79371-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022] Open
Abstract
Brief thermo-nociceptive stimuli elicit low-frequency phase-locked local field potentials (LFPs) and high-frequency gamma-band oscillations (GBOs) in the human insula. Although neither of these responses constitute a direct correlate of pain perception, previous findings suggest that insular GBOs may be strongly related to the activation of the spinothalamic system and/or to the processing of thermal information. To disentangle these different features of the stimulation, we compared the insular responses to brief painful thermonociceptive stimuli, non-painful cool stimuli, mechano-nociceptive stimuli, and innocuous vibrotactile stimuli, recorded using intracerebral electroencephalograpic activity in 7 epileptic patients (9 depth electrodes, 58 insular contacts). All four types of stimuli elicited consistent low-frequency phase-locked LFPs throughout the insula, possibly reflecting supramodal activity. The latencies of thermo-nociceptive and cool low-frequency phase-locked LFPs were shorter in the posterior insula compared to the anterior insula, suggesting a similar processing of thermal input initiating in the posterior insula, regardless of whether the input produces pain and regardless of thermal modality. In contrast, only thermo-nociceptive stimuli elicited an enhancement of insular GBOs, suggesting that these activities are not simply related to the activation of the spinothalamic system or to the conveyance of thermal information.
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Affiliation(s)
- Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
| | - Dounia Mulders
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Maxime Algoet
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | | | | | | | | | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Mulders D, de Bodt C, Lejeune N, Courtin A, Liberati G, Verleysen M, Mouraux A. Dynamics of the perception and EEG signals triggered by tonic warm and cool stimulation. PLoS One 2020; 15:e0231698. [PMID: 32324752 PMCID: PMC7179871 DOI: 10.1371/journal.pone.0231698] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 03/31/2020] [Indexed: 12/27/2022] Open
Abstract
Thermosensation is crucial for humans to probe the environment and detect threats arising from noxious heat or cold. Over the last years, EEG frequency-tagging using long-lasting periodic radiant heat stimulation has been proposed as a means to study the cortical processes underlying tonic heat perception. This approach is based on the notion that periodic modulation of a sustained stimulus can elicit synchronized periodic activity in the neuronal populations responding to the stimulus, known as a steady-state response (SSR). In this paper, we extend this approach using a contact thermode to generate both heat- and cold-evoked SSRs. Furthermore, we characterize the temporal dynamics of the elicited responses, relate these dynamics to perception, and assess the effects of displacing the stimulated skin surface to gain insight on the heat- and cold-sensitive afferents conveying these responses. Two experiments were conducted in healthy volunteers. In both experiments, noxious heat and innocuous cool stimuli were applied during 75 seconds to the forearm using a Peltier-based contact thermode, with intensities varying sinusoidally at 0.2 Hz. Displacement of the thermal stimulation on the skin surface was achieved by independently controlling the Peltier elements of the thermal probe. Continuous intensity ratings to sustained heat and cold stimulation were obtained in the first experiment with 14 subjects, and the EEG was recorded in the second experiment on 15 subjects. Both contact heat and cool stimulation elicited periodic EEG responses and percepts. Compared to heat stimulation, the responses to cool stimulation had a lower magnitude and shorter latency. All responses tended to habituate along time, and this response attenuation was most pronounced for cool compared to warm stimulation, and for stimulation delivered using a fixed surface compared to a variable surface.
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Affiliation(s)
- Dounia Mulders
- ICTEAM institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- IONS institute, Université Catholique de Louvain, Brussels, Belgium
- * E-mail:
| | - Cyril de Bodt
- ICTEAM institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Nicolas Lejeune
- IONS institute, Université Catholique de Louvain, Brussels, Belgium
| | - Arthur Courtin
- IONS institute, Université Catholique de Louvain, Brussels, Belgium
| | - Giulia Liberati
- IONS institute, Université Catholique de Louvain, Brussels, Belgium
| | - Michel Verleysen
- ICTEAM institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - André Mouraux
- IONS institute, Université Catholique de Louvain, Brussels, Belgium
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Ramos-Murguialday A, Curado MR, Broetz D, Yilmaz Ö, Brasil FL, Liberati G, Garcia-Cossio E, Cho W, Caria A, Cohen LG, Birbaumer N. Brain-Machine Interface in Chronic Stroke: Randomized Trial Long-Term Follow-up. Neurorehabil Neural Repair 2019; 33:188-198. [PMID: 30722727 DOI: 10.1177/1545968319827573] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Brain-machine interfaces (BMIs) have been recently proposed as a new tool to induce functional recovery in stroke patients. OBJECTIVE Here we evaluated long-term effects of BMI training and physiotherapy in motor function of severely paralyzed chronic stroke patients 6 months after intervention. METHODS A total of 30 chronic stroke patients with severe hand paresis from our previous study were invited, and 28 underwent follow-up assessments. BMI training included voluntary desynchronization of ipsilesional EEG-sensorimotor rhythms triggering paretic upper-limb movements via robotic orthoses (experimental group, n = 16) or random orthoses movements (sham group, n = 12). Both groups received identical physiotherapy following BMI sessions and a home-based training program after intervention. Upper-limb motor assessment scores, electromyography (EMG), and functional magnetic resonance imaging (fMRI) were assessed before (Pre), immediately after (Post1), and 6 months after intervention (Post2). RESULTS The experimental group presented with upper-limb Fugl-Meyer assessment (cFMA) scores significantly higher in Post2 (13.44 ± 1.96) as compared with the Pre session (11.16 ± 1.73; P = .015) and no significant changes between Post1 and Post2 sessions. The Sham group showed no significant changes on cFMA scores. Ashworth scores and EMG activity in both groups increased from Post1 to Post2. Moreover, fMRI-BOLD laterality index showed no significant difference from Pre or Post1 to Post2 sessions. CONCLUSIONS BMI-based rehabilitation promotes long-lasting improvements in motor function of chronic stroke patients with severe paresis and represents a promising strategy in severe stroke neurorehabilitation.
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Affiliation(s)
- Ander Ramos-Murguialday
- 1 University of Tubingen, Tübingen, Germany.,2 TECNALIA Health Technologies, Neurotechnology Laboratory, San Sebastian, Spain
| | - Marco R Curado
- 1 University of Tubingen, Tübingen, Germany.,3 AbbVie Pharmaceuticals, Ludwigshafen, Germany
| | | | - Özge Yilmaz
- 1 University of Tubingen, Tübingen, Germany.,4 Bahcesehir University, Istanbul, Turkey
| | - Fabricio L Brasil
- 1 University of Tubingen, Tübingen, Germany.,5 Santos Dumont Institute, Macaiba, Brazil
| | - Giulia Liberati
- 1 University of Tubingen, Tübingen, Germany.,6 Université catholique de Louvain, Brussels, Belgium
| | - Eliana Garcia-Cossio
- 1 University of Tubingen, Tübingen, Germany.,7 NeuroCare Group, Mental Health Care, Munich, Germany
| | - Woosang Cho
- 1 University of Tubingen, Tübingen, Germany.,8 g.tec Medical Engineering GmbH, Schiedlberg, Austria
| | | | | | - Niels Birbaumer
- 1 University of Tubingen, Tübingen, Germany.,10 WYSS-Center of Bio- and Neuroengineering, Geneva, Switzerland
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Liberati G, Algoet M, Santos SF, Ribeiro-Vaz JG, Raftopoulos C, Mouraux A. Tonic thermonociceptive stimulation selectively modulates ongoing neural oscillations in the human posterior insula: Evidence from intracerebral EEG. Neuroimage 2018; 188:70-83. [PMID: 30529399 DOI: 10.1016/j.neuroimage.2018.11.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/15/2018] [Accepted: 11/30/2018] [Indexed: 01/18/2023] Open
Abstract
The human insula is an important target for spinothalamic input, but there is still no consensus on its role in pain perception and nociception. In this study, we show that the human insula exhibits activity preferential for sustained thermonociception. Using intracerebral EEG recorded from the insula of 8 patients (2 females) undergoing a presurgical evaluation of focal epilepsy (53 contacts: 27 anterior, 26 posterior), we "frequency-tagged" the insular activity elicited by sustained thermonociceptive and vibrotactile stimuli, by periodically modulating stimulation intensity at a fixed frequency of 0.2 Hz during 75 s. Both types of stimuli elicited an insular response at the frequency of stimulation (0.2 Hz) and its harmonics, whose magnitude was significantly greater in the posterior insula compared to the anterior insula. Compared to vibrotactile stimulation, thermonociceptive stimulation exerted a markedly greater 0.2 Hz modulation of ongoing theta-band (4-8 Hz) and alpha-band (8-12 Hz) oscillations. These modulations were also more prominent in the posterior insula compared to the anterior insula. The identification of oscillatory activities preferential for thermonociception could lead to new insights into the physiological mechanisms of nociception and pain perception in humans.
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Affiliation(s)
- Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium.
| | - Maxime Algoet
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium
| | | | | | | | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium
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12
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Liberati G, Klöcker A, Algoet M, Mulders D, Maia Safronova M, Ferrao Santos S, Ribeiro Vaz JG, Raftopoulos C, Mouraux A. Gamma-Band Oscillations Preferential for Nociception can be Recorded in the Human Insula. Cereb Cortex 2018; 28:3650-3664. [PMID: 29028955 PMCID: PMC6366557 DOI: 10.1093/cercor/bhx237] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 04/14/2017] [Indexed: 12/17/2022] Open
Abstract
Transient nociceptive stimuli elicit robust phase-locked local field potentials (LFPs) in the human insula. However, these responses are not preferential for nociception, as they are also elicited by transient non-nociceptive vibrotactile, auditory, and visual stimuli. Here, we investigated whether another feature of insular activity, namely gamma-band oscillations (GBOs), is preferentially observed in response to nociceptive stimuli. Although nociception-evoked GBOs have never been explored in the insula, previous scalp electroencephalography and magnetoencephalography studies suggest that nociceptive stimuli elicit GBOs in other areas such as the primary somatosensory and prefrontal cortices, and that this activity could be closely related to pain perception. Furthermore, tracing studies showed that the insula is a primary target of spinothalamic input. Using depth electrodes implanted in 9 patients investigated for epilepsy, we acquired insular responses to brief thermonociceptive stimuli and similarly arousing non-nociceptive vibrotactile, auditory, and visual stimuli (59 insular sites). As compared with non-nociceptive stimuli, nociceptive stimuli elicited a markedly stronger enhancement of GBOs (150-300 ms poststimulus) at all insular sites, suggesting that this feature of insular activity is preferential for thermonociception. Although this activity was also present in temporal and frontal regions, its magnitude was significantly greater in the insula as compared with these other regions.
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Affiliation(s)
- Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain,
1200 Brussels, Belgium
| | - Anne Klöcker
- Institute of Neuroscience, Université catholique de Louvain,
1200 Brussels, Belgium
| | - Maxime Algoet
- Institute of Neuroscience, Université catholique de Louvain,
1200 Brussels, Belgium
| | - Dounia Mulders
- Institute of Neuroscience, Université catholique de Louvain,
1200 Brussels, Belgium
| | - Marta Maia Safronova
- Department of Radiology, Neuroradiology Clinic, Erasme Hospital,
1070 Brussels, Belgium
| | | | | | | | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain,
1200 Brussels, Belgium
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Liberati G, Algoet M, Klöcker A, Ferrao Santos S, Ribeiro-Vaz JG, Raftopoulos C, Mouraux A. Habituation of phase-locked local field potentials and gamma-band oscillations recorded from the human insula. Sci Rep 2018; 8:8265. [PMID: 29844373 PMCID: PMC5974133 DOI: 10.1038/s41598-018-26604-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/15/2018] [Indexed: 01/18/2023] Open
Abstract
Salient nociceptive and non-nociceptive stimuli elicit low-frequency local field potentials (LFPs) in the human insula. Nociceptive stimuli also elicit insular gamma-band oscillations (GBOs), possibly preferential for thermonociception, which have been suggested to reflect the intensity of perceived pain. To shed light on the functional significance of these two responses, we investigated whether they would be modulated by stimulation intensity and temporal expectation - two factors contributing to stimulus saliency. Insular activity was recorded from 8 depth electrodes (41 contacts) implanted in the left insula of 6 patients investigated for epilepsy. Thermonociceptive, vibrotactile, and auditory stimuli were delivered using two intensities. To investigate the effects of temporal expectation, the stimuli were delivered in trains of three identical stimuli (S1-S2-S3) separated by a constant 1-s interval. Stimulation intensity affected intensity of perception, the magnitude of low-frequency LFPs, and the magnitude of nociceptive GBOs. Stimulus repetition did not affect perception. In contrast, both low-frequency LFPs and nociceptive GBOs showed a marked habituation of the responses to S2 and S3 as compared to S1 and, hence, a dissociation with intensity of perception. Most importantly, although insular nociceptive GBOs appear to be preferential for thermonociception, they cannot be considered as a correlate of perceived pain.
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Affiliation(s)
- Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium.
| | - Maxime Algoet
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium
| | - Anne Klöcker
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium
| | | | | | | | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain, 1200, Brussels, Belgium
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Liberati G, Algoet M, Ferrao Santos S, Ribeiro-Vaz JG, Raftopoulos C, Mouraux A. Thermonociceptive stimuli preferentially modulate theta and alpha oscillations in the human posterior insula: evidence from intracerebral recordings. Front Neurosci 2018. [DOI: 10.3389/conf.fnins.2018.95.00032] [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: 11/13/2022] Open
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Neri I, Liberati G, Virdi A, Patrizi A. Congenital molluscum contagiosum. Paediatr Child Health 2017; 22:241-242. [DOI: 10.1093/pch/pxw009] [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: 11/14/2022] Open
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16
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Neri I, Liberati G, Piraccini BM, Patrizi A. Poliosis and Neurofibromatosis Type 1: Two Familiar Cases and Review of the Literature. Skin Appendage Disord 2017; 3:219-221. [PMID: 29177153 DOI: 10.1159/000477445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/10/2017] [Indexed: 11/19/2022] Open
Abstract
Two brothers were referred to our clinic for reevaluation of neurofibromatosis type 1 (NF1). Both brothers presented a peculiarity that is not so common in NF1: poliosis overlying plexiform neurofibromas on the scalp. Poliosis overlying plexiform neurofibromas is rarely reported in the literature. The peculiarity of our cases is the familiarity and the presence of poliosis in the same location.
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Affiliation(s)
- Iria Neri
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giulia Liberati
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Liberati G, Algoet M, Van Den Broeke E, Ferrao Santos S, Ribeiro Vaz JG, Raftopoulos C, Mouraux A. Nociceptive gamma-band oscillations recorded from the human insula are related to the activation of the spinothalamic tract. Front Neurosci 2017. [DOI: 10.3389/conf.fnins.2017.94.00083] [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: 11/13/2022] Open
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Liberati G, Colon E, Algoet M, Ferrao Santos S, Ribeiro Vaz JG, Raftopoulos C, Mouraux A. Frequency tagging insular activity related to tonic heat pain: evidence from intracerebral recordings. Front Neurosci 2017. [DOI: 10.3389/conf.fnins.2017.94.00081] [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: 11/13/2022] Open
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Colon E, Liberati G, Mouraux A. EEG frequency tagging using ultra-slow periodic heat stimulation of the skin reveals cortical activity specifically related to C fiber thermonociceptors. Neuroimage 2016; 146:266-274. [PMID: 27871921 DOI: 10.1016/j.neuroimage.2016.11.045] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 10/25/2016] [Accepted: 11/17/2016] [Indexed: 11/29/2022] Open
Abstract
The recording of event-related brain potentials triggered by a transient heat stimulus is used extensively to study nociception and diagnose lesions or dysfunctions of the nociceptive system in humans. However, these responses are related exclusively to the activation of a specific subclass of nociceptive afferents: quickly-adapting thermonociceptors. In fact, except if the activation of Aδ fibers is avoided or if A fibers are blocked, these responses specifically reflect activity triggered by the activation of Type 2 quickly-adapting A fiber mechano-heat nociceptors (AMH-2). Here, we propose a novel method to isolate, in the human electroencephalogram (EEG), cortical activity related to the sustained periodic activation of heat-sensitive thermonociceptors, using very slow (0.2Hz) and long-lasting (75s) sinusoidal heat stimulation of the skin between baseline and 50°C. In a first experiment, we show that when such long-lasting thermal stimuli are applied to the hand dorsum of healthy volunteers, the slow rises and decreases of skin temperature elicit a consistent periodic EEG response at 0.2Hz and its harmonics, as well as a periodic modulation of the magnitude of theta, alpha and beta band EEG oscillations. In a second experiment, we demonstrate using an A fiber block that these EEG responses are predominantly conveyed by unmyelinated C fiber nociceptors. The proposed approach constitutes a novel mean to study C fiber function in humans, and to explore the cortical processing of tonic heat pain in physiological and pathological conditions.
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Affiliation(s)
- Elisabeth Colon
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium; Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Molinelli E, Ricotti F, Campanati A, Cataldi I, Ganzetti G, Liberati G, Bianchelli T, Offidani A. Kaposi-Juliusberg varicelliform eruption in patients suffering from Darier-White Disease: a case report and review of the literature. GIORN ITAL DERMAT V 2016; 151:558-561. [PMID: 25502366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Darier-White Disease (DW), otherwise known as keratosis follicularis, is a rare genodermatosis with autosomal dominant inheritance, characterized by loss of adhesion between epidermal cells and abnormal keratinization. The distinctives lesions of DW Disease include rough papules in seborrheic areas, palmoplantar pits, mucosal involvement, and nail changes. DW Disease can be occasionally associated with bacterial complications, but rarely with viral ones. Kaposi's varicelliform eruption (KVE) is a secondary herpes simplex virus infection that affects patients in the setting of primary dermatologic conditions. KVE, frequently misdiagnosed as impetigo, can be severe, progressing to disseminated infections and potentially life threatening. It occurs with a variety of skin disorders, although association with DW Disease has rarely been reported in the literature. This report describes a case of KVE in a patient suffering from DW Disease, focusing on its clinical course. A review of the literature on KVE including disease associations, pathogenesis, and treatment has been also reported.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytehnic Marche University, Ancona, Italy -
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Abstract
A 4-day-old boy was referred for evaluation of an oval patch of occipital alopecia associated with caput succedaneum and ipsilateral eyelid ecchymoses. Based on the history of a prolonged, difficult labor with vacuum-assisted delivery, the diagnosis of neonatal alopecia associated with birth trauma was made. Trichoscopy showed purple dots corresponding to blood extravasation and follicular ostia. We also review the trichoscopic differential diagnosis of focal neonatal alopecia.
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Affiliation(s)
- Giulia Liberati
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Michela Starace
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Giuliodori K, Campanati A, Liberati G, Ganzetti G, Giangiacomi M, Marinelli K, Cataldi I, Marconi B, Offidani A. Lifelong widespread warts associated with human papillomavirus type 70/85: a new diagnostic entity? Acta Dermatovenerol Alp Pannonica Adriat 2016; 25:11-3. [PMID: 27014773 DOI: 10.15570/actaapa.2016.3] [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] [Indexed: 11/15/2022]
Abstract
We present a patient with HPV 70/85-positive widespread cutaneous warts characterized by clinical and histological features atypical for classic generalized verrucosis or epidermodysplasia verruciformis. The cutaneous HPV infection is characterized by verrucous papules or plaques variable in size, number, and distribution depending on the genotype of HPV involved and the immune status of the patient. Human papillomaviruses comprise five genera (alpha, beta, gamma, mu, and nu papillomavirus) with different life-cycle characteristics, epithelial tropisms, and disease associations. Epidermodysplasia verruciformis (EV) is a rare, lifelong, autosomal recessive skin disease characterized by persistent cutaneous human papillomavirus infection not necessarily associated with immune system defects. The disease results from an unusual genetic susceptibility to infections with various types of HPVs (especially β-HPV), some of which cause malignant transformation. Conversely, generalized verrucosis has been more typically associated with generalized warts, which are associated with immunocompromised conditions.
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Affiliation(s)
- Katia Giuliodori
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Giulia Liberati
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Giulia Ganzetti
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Mirella Giangiacomi
- Pathological Anatomy Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Katia Marinelli
- Virology Unit, Department of Services, United Hospital of Ancona, Ancona, Italy
| | - Ivana Cataldi
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Barbara Marconi
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, United Hospital of Ancona, Polytechnic Marche University, Ancona, Italy
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Campanati A, Giuliodori K, Ganzetti G, Liberati G, Cellini A, Giangiacomi M, Marconi B, Lemme G, Offidani A. Hidradenoma papilliferum: diagnostic challenge. GIORN ITAL DERMAT V 2016; 151:112-114. [PMID: 25387849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Polytechnic Marche University, Ancona, Italy -
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Liberati G, Federici S, Pasqualotto E. Extracting neurophysiological signals reflecting users’ emotional and affective responses to BCI use: A systematic literature review. NeuroRehabilitation 2015; 37:341-58. [DOI: 10.3233/nre-151266] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giulia Liberati
- Université Catholique de Louvain, Institute of Neuroscience, Louvain, Belgium
| | - Stefano Federici
- Università di Perugia, Department of Philosophy, Social & Human Sciences and Education, Perugia, Italy
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25
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Curado MR, Cossio EG, Broetz D, Agostini M, Cho W, Brasil FL, Yilmaz O, Liberati G, Lepski G, Birbaumer N, Ramos-Murguialday A. Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training. PLoS One 2015; 10:e0140161. [PMID: 26495971 PMCID: PMC4619686 DOI: 10.1371/journal.pone.0140161] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/19/2015] [Indexed: 02/08/2023] Open
Abstract
Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.
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Affiliation(s)
- Marco Rocha Curado
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
- International Max Planck Research School for Neural & Behavioral Sciences, Tübingen, Germany
- * E-mail:
| | - Eliana Garcia Cossio
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
- International Max Planck Research School for Neural & Behavioral Sciences, Tübingen, Germany
| | - Doris Broetz
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
| | - Manuel Agostini
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
| | - Woosang Cho
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
| | - Fabricio Lima Brasil
- Edmond and Lily Safra International Institute of Neuroscience, Institute Santos Dumond, Natal, Brazil
| | - Oezge Yilmaz
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
- International Max Planck Research School for Neural & Behavioral Sciences, Tübingen, Germany
| | - Giulia Liberati
- Institute of Neuroscience, Université catholique de Louvain, Louvain la Neuve, Belgium
| | - Guilherme Lepski
- Department of Neurology, University of São Paulo, São Paulo, Brazil
- Department of Neurosurgery, University of Tübingen, Tübingen, Germany
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
- Ospedale San Camillo, IRCCS, Venice, Italy
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, University of Tübingen, Tübingen, Germany
| | - Ander Ramos-Murguialday
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
- TECNALIA Health Technologies, San Sebastian, Spain
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Liberati G, Pizzimenti A, Simione L, Riccio A, Schettini F, Inghilleri M, Mattia D, Cincotti F. Developing brain-computer interfaces from a user-centered perspective: Assessing the needs of persons with amyotrophic lateral sclerosis, caregivers, and professionals. Appl Ergon 2015; 50:139-146. [PMID: 25959328 DOI: 10.1016/j.apergo.2015.03.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 02/05/2015] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
Abstract
By focus group methodology, we examined the opinions and requirements of persons with ALS, their caregivers, and health care assistants with regard to developing a brain-computer interface (BCI) system that fulfills the user's needs. Four overarching topics emerged from this analysis: 1) lack of information on BCI and its everyday applications; 2) importance of a customizable system that supports individuals throughout the various stages of the disease; 3) relationship between affectivity and technology use; and 4) importance of individuals retaining a sense of agency. These findings should be considered when developing new assistive technology. Moreover, the BCI community should acknowledge the need to bridge experimental results and its everyday application.
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Affiliation(s)
- Giulia Liberati
- Fondazione Santa Lucia, Rome, Italy; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
| | - Alessia Pizzimenti
- Fondazione Santa Lucia, Rome, Italy; Crossing Dialogues Association, Rome, Italy; ALS Center, Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Luca Simione
- Fondazione Santa Lucia, Rome, Italy; Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
| | - Angela Riccio
- Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Italy
| | - Francesca Schettini
- Fondazione Santa Lucia, Rome, Italy; DIAG, Sapienza University of Rome, Italy
| | - Maurizio Inghilleri
- ALS Center, Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | | | - Febo Cincotti
- Fondazione Santa Lucia, Rome, Italy; DIAG, Sapienza University of Rome, Italy
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Schettini F, Riccio A, Simione L, Liberati G, Caruso M, Frasca V, Calabrese B, Mecella M, Pizzimenti A, Inghilleri M, Mattia D, Cincotti F. Assistive device with conventional, alternative, and brain-computer interface inputs to enhance interaction with the environment for people with amyotrophic lateral sclerosis: a feasibility and usability study. Arch Phys Med Rehabil 2015; 96:S46-53. [PMID: 25721547 DOI: 10.1016/j.apmr.2014.05.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 10/03/2013] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the feasibility and usability of an assistive technology (AT) prototype designed to be operated with conventional/alternative input channels and a P300-based brain-computer interface (BCI) in order to provide users who have different degrees of muscular impairment resulting from amyotrophic lateral sclerosis (ALS) with communication and environmental control applications. DESIGN Proof-of-principle study with a convenience sample. SETTING An apartment-like space designed to be fully accessible by people with motor disabilities for occupational therapy, placed in a neurologic rehabilitation hospital. PARTICIPANTS End-users with ALS (N=8; 5 men, 3 women; mean age ± SD, 60 ± 12 y) recruited by a clinical team from an ALS center. INTERVENTIONS Three experimental conditions based on (1) a widely validated P300-based BCI alone; (2) the AT prototype operated by a conventional/alternative input device tailored to the specific end-user's residual motor abilities; and (3) the AT prototype accessed by a P300-based BCI. These 3 conditions were presented to all participants in 3 different sessions. MAIN OUTCOME MEASURES System usability was evaluated in terms of effectiveness (accuracy), efficiency (written symbol rate, time for correct selection, workload), and end-user satisfaction (overall satisfaction) domains. A comparison of the data collected in the 3 conditions was performed. RESULTS Effectiveness and end-user satisfaction did not significantly differ among the 3 experimental conditions. Condition III was less efficient than condition II as expressed by the longer time for correct selection. CONCLUSIONS A BCI can be used as an input channel to access an AT by persons with ALS, with no significant reduction of usability.
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Affiliation(s)
- Francesca Schettini
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy.
| | - Angela Riccio
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Luca Simione
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
| | - Giulia Liberati
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Institute of Neuroscience, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Mario Caruso
- Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy
| | - Vittorio Frasca
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Barbara Calabrese
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Massimo Mecella
- Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy
| | | | - Maurizio Inghilleri
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Donatella Mattia
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Febo Cincotti
- Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy
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Giannoni M, Consales V, Campanati A, Ganzetti G, Giuliodori K, Postacchini V, Liberati G, Azzaretto L, Vichi S, Guanciarossa F, Offidani A. Homocysteine plasma levels in psoriasis patients: our experience and review of the literature. J Eur Acad Dermatol Venereol 2015; 29:1781-5. [PMID: 25809089 DOI: 10.1111/jdv.13023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/12/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND People with psoriasis are at higher cardiovascular risk. Plasma levels of homocysteine over the normal range have been recognized as marker of cardiovascular risk. Psoriasis patients express higher levels of plasma homocysteine than healthy people. OBJECTIVE Our study aims to investigate the correlation between homocysteinaemia, severity and duration of psoriasis and psoriasis arthritis, and to evaluate the effect of a 12-week administration of a target therapy for psoriasis on homocysteinaemia. METHODS Fifty-two psoriasis patients (study group) submitted to different kind of therapy for psoriasis (biological, systemic not biological and topical) and 24 healthy Italian subject (control group) were evaluated for their plasmatic homocysteine levels, both at baseline (T0) and 12 weeks after they a specific therapy for psoriasis. RESULTS A significant difference between the homocysteinaemia of psoriasis patients (mean 19.71 ± 11.16) and control group (13.90 ± 11.18), P < 0.05 (Fig. 1), was found at baseline (T0). The mean plasma levels of homocysteine were directly correlated with disease severity (P = 0.0401), but not with disease duration (P = 0.6018) or presence of arthritis (P = 0.6221) at baseline. None among the treatments administered to psoriasis patients caused a significant reduction in homocysteinaemia after 12 weeks of treatment. CONCLUSION Our results confirm that psoriasis patients with more severe disease, can have hyperhomocysteinaemia, without regard to disease duration or joint involvement. Hyperhomocysteinaemia is not influenced by a target therapy for psoriasis and it is as greater as psoriasis severity. However, limitation of our study is the relatively small number of cases. Homocysteine plasmatic levels should be advisable as a further independent risk factor for cardiovascular disease in psoriasis patients.
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Affiliation(s)
- M Giannoni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - V Consales
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Ganzetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - K Giuliodori
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - V Postacchini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Liberati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - L Azzaretto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - S Vichi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - F Guanciarossa
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
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Liberati G, Hünefeldt T, Olivetti Belardinelli M. Questioning the dichotomy between vegetative state and minimally conscious state: a review of the statistical evidence. Front Hum Neurosci 2014; 8:865. [PMID: 25404905 PMCID: PMC4217390 DOI: 10.3389/fnhum.2014.00865] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/07/2014] [Indexed: 01/24/2023] Open
Abstract
Given the enormous consequences that the diagnosis of vegetative state (VS) vs. minimally conscious state (MCS) may have for the treatment of patients with disorders of consciousness, it is particularly important to empirically legitimate the distinction between these two discrete levels of consciousness. Therefore, the aim of this contribution is to review all the articles reporting statistical evidence concerning the performance of patients in VS vs. patients in MCS, on behavioral or neurophysiological measures. Twenty-three articles matched these inclusion criteria, and comprised behavioral, electroencephalographic (EEG), positron emission tomography (PET) and magnetic resonance imaging (MRI) measures. The analysis of these articles yielded 47 different statistical findings. More than half of these findings (n = 24) did not reveal any statistically significant difference between VS and MCS. Overall, there was no combination of variables that allowed reliably discriminating between VS and MCS. This pattern of results casts doubt on the empirical validity of the distinction between VS and MCS.
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Affiliation(s)
- Giulia Liberati
- Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium
| | - Thomas Hünefeldt
- ECONA - Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems, "Sapienza" University of Rome Rome, Italy ; Department of Philosophy, Catholic University of Eichstätt-Ingolstadt Eichstätt, Germany
| | - Marta Olivetti Belardinelli
- ECONA - Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems, "Sapienza" University of Rome Rome, Italy ; Department of Psychology, Sapienza, University of Rome Rome, Italy
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Ganzetti G, Campanati A, Scocco V, Brugia M, Tocchini M, Liberati G, Giuliodori K, Brisigotti V, Offidani A. The potential effect of the tumour necrosis factor-α inhibitors on vitamin D status in psoriatic patients. Acta Derm Venereol 2014; 94:715-7. [PMID: 24789007 DOI: 10.2340/00015555-1801] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Giulia Ganzetti
- Dermatology Clinic, Polytechnic University of Marche, , Italy.
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van der Heiden L, Liberati G, Sitaram R, Kim S, Jaśkowski P, Raffone A, Olivetti Belardinelli M, Birbaumer N, Veit R. Insula and inferior frontal triangularis activations distinguish between conditioned brain responses using emotional sounds for basic BCI communication. Front Behav Neurosci 2014; 8:247. [PMID: 25100958 PMCID: PMC4104703 DOI: 10.3389/fnbeh.2014.00247] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 03/12/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022] Open
Abstract
In order to enable communication through a brain-computer interface (BCI), it is necessary to discriminate between distinct brain responses. As a first step, we probed the possibility to discriminate between affirmative (“yes”) and negative (“no”) responses using a semantic classical conditioning paradigm, within an fMRI setting. Subjects were presented with congruent and incongruent word-pairs as conditioned stimuli (CS), respectively eliciting affirmative and negative responses. Incongruent word-pairs were associated to an unpleasant unconditioned stimulus (scream, US1) and congruent word-pairs were associated to a pleasant unconditioned stimulus (baby-laughter, US2), in order to elicit emotional conditioned responses (CR). The aim was to discriminate between affirmative and negative responses, enabled by their association with the positive and negative affective stimuli. In the late acquisition phase, when the US were not present anymore, there was a strong significant differential activation for incongruent and congruent word-pairs in a cluster comprising the left insula and the inferior frontal triangularis. This association was not found in the habituation phase. These results suggest that the difference in affirmative and negative brain responses was established as an effect of conditioning, allowing to further investigate the possibility of using this paradigm for a binary choice BCI.
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Affiliation(s)
- Linda van der Heiden
- Department of Cognitive Psychology, University of Finance and Management Pawia, Warsaw, Poland ; Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany
| | - Giulia Liberati
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany ; Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA) Rome, Italy ; Institute of Neuroscience, Université Catholique de Louvain Brussels, Louvain-la-Neuve, Belgium
| | - Ranganatha Sitaram
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany ; Department of Biomedical Engineering, University of Florida Gainesville, FL, USA ; Biomedical Engineering, Sri Chitra Tirunal Institute of Medical Sciences and Technology Trivandrum, India
| | - Sunjung Kim
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany
| | - Piotr Jaśkowski
- Department of Cognitive Psychology, University of Finance and Management Pawia, Warsaw, Poland
| | - Antonino Raffone
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA) Rome, Italy ; Department of Psychology, University "Sapienza" of Rome Rome, Italy
| | - Marta Olivetti Belardinelli
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA) Rome, Italy ; Department of Psychology, University "Sapienza" of Rome Rome, Italy
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany ; Ospedale San Camillo-IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico Venezia Lido, Italy
| | - Ralf Veit
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University Tübingen, Germany
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Bacchetti T, Campanati A, Ferretti G, Simonetti O, Liberati G, Offidani AM. Oxidative stress and psoriasis: the effect of antitumour necrosis factor-α inhibitor treatment. Br J Dermatol 2013; 168:984-9. [PMID: 23614561 DOI: 10.1111/bjd.12144] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Psoriasis is a chronic, inflammatory skin condition associated with a high frequency of cardiovascular events. Modifications of plasma lipids, and an increase in the levels of biochemical markers of inflammation and lipid peroxidation have been reported in subjects with psoriasis, suggesting a relationship between psoriasis, inflammation and oxidative damage. OBJECTIVES To investigate whether modulation of inflammatory activity by tumour necrosis factor-α inhibitors in patients with psoriasis is associated with modification of lipid profiles, oxidative stress and paraoxonase (PON)1 activity. METHODS The levels of plasma lipids and lipoprotein(a), and the levels of the markers of inflammation and lipid peroxidation were evaluated in subjects with psoriasis (n=23) before and after 24 weeks of treatment with etanercept. In the same subjects plasma total antioxidant capacity and the activity of PON1, an antioxidant and anti-inflammatory enzyme associated with the high-density lipoproteins (HDLs), were investigated. RESULTS The results showed that clinical improvement in patients with psoriasis treated with etanercept is associated with a reduction in the levels of inflammatory markers [C-reactive protein (CRP)] and lipid peroxidation, and also with increased antioxidant capacity in the serum of patients with psoriasis. These modifications are associated with a significant increase in the activity of PON1. A significant increase in the PON1/CRP ratio has also been observed in patients with psoriasis after treatment. The significant inverse correlation between CRP and PON1 activity suggests a relationship between PON1 activity and inflammation. CONCLUSIONS Treatment with etanercept is associated with a reduction in lipid peroxidation and an improvement in HDL antioxidant and anti-inflammatory properties.
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Affiliation(s)
- T Bacchetti
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
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Ramos-Murguialday A, Broetz D, Rea M, Läer L, Yilmaz O, Brasil FL, Liberati G, Curado MR, Garcia-Cossio E, Vyziotis A, Cho W, Agostini M, Soares E, Soekadar S, Caria A, Cohen LG, Birbaumer N. Brain-machine interface in chronic stroke rehabilitation: a controlled study. Ann Neurol 2013; 74:100-8. [PMID: 23494615 DOI: 10.1002/ana.23879] [Citation(s) in RCA: 518] [Impact Index Per Article: 47.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 02/12/2013] [Accepted: 03/01/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Chronic stroke patients with severe hand weakness respond poorly to rehabilitation efforts. Here, we evaluated efficacy of daily brain-machine interface (BMI) training to increase the hypothesized beneficial effects of physiotherapy alone in patients with severe paresis in a double-blind sham-controlled design proof of concept study. METHODS Thirty-two chronic stroke patients with severe hand weakness were randomly assigned to 2 matched groups and participated in 17.8 ± 1.4 days of training rewarding desynchronization of ipsilesional oscillatory sensorimotor rhythms with contingent online movements of hand and arm orthoses (experimental group, n = 16). In the control group (sham group, n = 16), movements of the orthoses occurred randomly. Both groups received identical behavioral physiotherapy immediately following BMI training or the control intervention. Upper limb motor function scores, electromyography from arm and hand muscles, placebo-expectancy effects, and functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent activity were assessed before and after intervention. RESULTS A significant group × time interaction in upper limb (combined hand and modified arm) Fugl-Meyer assessment (cFMA) motor scores was found. cFMA scores improved more in the experimental than in the control group, presenting a significant improvement of cFMA scores (3.41 ± 0.563-point difference, p = 0.018) reflecting a clinically meaningful change from no activity to some in paretic muscles. cFMA improvements in the experimental group correlated with changes in fMRI laterality index and with paretic hand electromyography activity. Placebo-expectancy scores were comparable for both groups. INTERPRETATION The addition of BMI training to behaviorally oriented physiotherapy can be used to induce functional improvements in motor function in chronic stroke patients without residual finger movements and may open a new door in stroke neurorehabilitation.
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Affiliation(s)
- Ander Ramos-Murguialday
- Institute of Medical Psychology and Behavioral Neurobiology and Magnetoencephalography Center, University of Tübingen, Tübingen, Germany; Health Technologies Department, Tecnalia, San Sebastian, Spain
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Campanati A, Moroncini G, Ganzetti G, Pozniak K, Goteri G, Giuliano A, Martina E, Liberati G, Ricotti F, Gabrielli A, Offidani A. Adalimumab Modulates Angiogenesis in Psoriatic Skin. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100218] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- A. Campanati
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - G. Moroncini
- Internal Medicine, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - G. Ganzetti
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - K.N. Pozniak
- Internal Medicine, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - G. Goteri
- Anatomic Pathology Institute, Ancona Hospital, Department of Neurosciences, Polytechnic University of Marche Region, Ancona, Italy
| | - A. Giuliano
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - E. Martina
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - G. Liberati
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - F. Ricotti
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - A. Gabrielli
- Internal Medicine, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
| | - A. Offidani
- Dermatological Clinic, Department of Clinical and Molecular Medicine, Ancona Hospital, Polytechnic University of Marche Region, Ancona, Italy
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Liberati G, da Rocha JLD, van der Heiden L, Raffone A, Birbaumer N, Olivetti Belardinelli M, Sitaram R. Toward a Brain-Computer Interface for Alzheimer's Disease Patients by Combining Classical Conditioning and Brain State Classification. ACTA ACUST UNITED AC 2012; 31 Suppl 3:S211-20. [DOI: 10.3233/jad-2012-112129] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giulia Liberati
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA), Rome, Italy
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University, Tübingen, Germany
| | - Josué Luiz Dalboni da Rocha
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University, Tübingen, Germany
- Graduate Training Centre of Neuroscience, International Max Planck Research School, Tübingen, Germany
| | - Linda van der Heiden
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University, Tübingen, Germany
- Department of Cognitive Psychology, University of Finance and Management, Warsaw, Poland
| | - Antonino Raffone
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA), Rome, Italy
- Department of Psychology, University “Sapienza” of Rome, Rome, Italy
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University, Tübingen, Germany
- Ospedale San Camillo—IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico, Venezia, Lido, Italy
| | - Marta Olivetti Belardinelli
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial Systems (ECONA), Rome, Italy
- Department of Psychology, University “Sapienza” of Rome, Rome, Italy
| | - Ranganatha Sitaram
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls-University, Tübingen, Germany
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Sri Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, India
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Liberati G, Birbaumer N. Using brain–computer interfaces to overcome the extinction of goal-directed thinking in minimally conscious state patients. Cogn Process 2012; 13 Suppl 1:S239-41. [DOI: 10.1007/s10339-012-0497-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ferretti G, Bacchetti T, Campanati A, Simonetti O, Liberati G, Offidani A. Correlation between lipoprotein(a) and lipid peroxidation in psoriasis: role of the enzyme paraoxonase-1. Br J Dermatol 2012; 166:204-7. [PMID: 21790517 DOI: 10.1111/j.1365-2133.2011.10539.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psoriasis is a chronic, inflammatory skin disease associated with abnormal plasma lipid metabolism and with a high frequency of cardiovascular events. Modifications of plasma lipids and an increase in the levels of biochemical markers of lipid peroxidation have been reported in subjects with psoriasis, suggesting a relationship between psoriasis, lipoproteins and oxidative damage. OBJECTIVES To investigate further the relationship between lipoproteins and oxidative stress in psoriasis. METHOD The levels of plasma lipids, lipoprotein(a) [Lp(a)] and markers of lipid peroxidation were evaluated in subjects with psoriasis (n=23) and in controls (n=25). In the same subjects, the activity of paraoxonase-1 (PON1), an antioxidant and an anti-inflammatory enzyme associated with high-density lipoproteins, was investigated. RESULTS The results showed higher levels of Lp(a) in the serum of patients with psoriasis compared with controls (P<0·001). Higher levels of lipid hydroperoxides (P<0·001) and lower PON1 activity were observed in the serum of patients compared with healthy subjects, confirming that psoriasis is associated with oxidative stress. The imbalance between oxidative stress and antioxidant enzymes, and the increase of Lp(a) serum levels was related to the extent and severity of psoriasis. Finally, our results demonstrated that Lp(a) levels were positively correlated with markers of lipid peroxidation and negatively related to PON1 activity, suggesting that subjects with higher levels of Lp(a) are more exposed to oxidative damage. CONCLUSIONS Our results provide further evidence that oxidative stress and impairment of the antioxidant system in the plasma of patients may play a role in pathogenesis and progression of psoriasis and related complications.
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Affiliation(s)
- G Ferretti
- Department of Biochemistry, Biology and Genetics and Dermatological Clinic, Department of Clinical Medicine and Applied Biotechnologies, Polytechnic Marche University, Via Ranieri, 60100 Ancona, Italy.
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Liberati G, Heiden L, Sitaram R, Kim S, Rana M, Raffone A, Birbaumer N, Belardinelli MO. P4‐062: Classical conditioning of the BOLD signal as a paradigm for basic BCI communication in Alzheimer patients. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.2082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Giulia Liberati
- Interuniversity Centre for Research on Cognitive Processing in Natural and Artificial SystemsRomeItaly
| | - Linda Heiden
- University of Finance and ManagementWarsawPoland
| | - Ranganatha Sitaram
- Institute of Medical Psychology and Behavioral Neurobiology, University of TübingenTübingenGermany
| | - Sunjung Kim
- Institute of Medical Psychology and Behavioral Neurobiology, University of TübingenTübingenGermany
| | - Mohit Rana
- Institute of Medical Psychology and Behavioral Neurobiology, University of TübingenTübingenGermany
| | | | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of TübingenTübingenGermany
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Abstract
Psoriasis is a chronic, immune-mediated, inflammatory dermatosis whose aetiopathogenesis remains unclear, although tumour necrosis factor alpha (TNFalpha) appears to play a crucial role. The biological potential of TNFalpha inhibitors, such as etanercept, which reduce the inflammatory cascade, has radically changed the therapeutic management of patients with psoriasis and other immunomediated inflammatory diseases, associated with TNFalpha. The pathogenesis of the selective destruction of melanocytes in vitiligo is not fully understood, although there is growing evidence that several T helper type 1 cytokines, particularly TNFalpha, may be involved in the depigmentation process. A patient is described who presented with both psoriasis and vitiligo, and was treated with etanercept. After 24 weeks of therapy, the patient's psoriasis had improved markedly and the patient noted a mild improvement of vitiligo, with a reduction in macules and repigmentation in the scapular region.
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Affiliation(s)
- Anna Campanati
- Dermatological Clinic, Department of Biostatistics and Medical Information Technology Polytechnic Marche University, Via Conca 71, Ancona, Italy.
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Petraccia L, Fraioli A, Liberati G, Lopalco M, Grassi M. Gout and related morbid conditions: pharmacological and SPA therapy. Minerva Med 2008; 99:203-212. [PMID: 18431328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Gouty arthritis is estimated to be the most frequent manifestation of inflammatory arthritis in men aged over 40. Hyperuricemia occurs because of both exogenous and genetic factors, which are particularly influential in some populations such as Taiwan aborigines. Current understanding of the disease etiopathogenesis, its clinical manifestations and the stages of its progression are presented here. The criteria for a correct diagnosis of the disease are also reported, pointing out how to distinguish gout from clinical events of different origin but with a very similar symptomatology. A distinction is made between the agents used to relieve the acute attack (colchicine, nonsteroidal anti-inflammatory drugs, corticosteroids) and those used with the purpose of correcting hyperuricemia and preventing recurrences and complications (allopurinol, uricosurics). Mecha-nisms of action, administration routes, doses, side effects and contraindications of every drug are described. Besides pharmacological therapy, the importance and the efficacy of spa therapy is underlined. Finally, perspectives opened by gene therapy are mentioned.
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Affiliation(s)
- L Petraccia
- Department of Clinics and Medical Therapy, Umberto I Hospital, University of Rome, La Sapienza, Rome, Italy
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Petraccia L, Onori P, Sferra R, Lucchetta MC, Liberati G, Grassi M, Gaudio E. [MDR (multidrug resistance) in hepatocarcinoma clinical-therapeutic implications]. Clin Ter 2003; 154:325-35. [PMID: 14994922] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Our purpose was to summarize current knowledge on "multidrug resistance", or MDR, an intrinsic or acquired cross resistance to a variety of structurally and functionally unrelated drugs, still representing one of the major problems in the therapy of cancer and other diseases. MDR depends on various mechanisms, the best known being the activity of ABC transport proteins, mainly Pgp, MDR1 gene product,and MRPs; but also other transporters can cause resistance, for example TAP, a peptide transporter, CFTR, cystic fibrosis transmembrane regulator, ABCG2, or breast cancer resistance protein (BCRP) and LRP, lung resistance protein. MDR has been detected in nearly all types of cancer, because it affects many organs and can occur against a wide number of drugs; it is frequent even in other diseases, such as epilepsy and HIV. We focused on MDR phenomenon in HCC, one of the commonest tumors in the world, and one of the most resistant to pharmacological treatment. This characteristic might be partly determined by a link between MDR and angiogenic phenotypes. The relationship between MDR in hepatocellular carcinoma and the effectiveness of therapeutic treatments has been particularly examined. Finally, the importance to overcome the strong chemoresistance of hepatocellular carcinoma with methods alternative to drugs, namely gene therapy, which makes use of antisense oligonucleotides and anti-MDR1 ribozymes, has been pointed out.
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Affiliation(s)
- L Petraccia
- Dipartimento di Clinica e Terapia Medica Applicata Università di Roma La Sapienza, Roma, Italia
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Liberati G, Lucchetta MC, Petraccia L, Nocchi S, Rosentzwig R, De Matteis A, Grassi M. [Meta-analytical study of gastrointestinal stromal tumors (GIST)]. Clin Ter 2003; 154:85-91. [PMID: 12856366] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the gut wall. GIST have still today controversial aspects of their histogenesis that are reflected on the classification, clinical behaviour and prognosis. The authors analyzed 14 studies observed between 2000 and 2001; also the tumors early classified as leiomyomas, leiomyosarcomas and schwannomas were included in these studies because, on the basis of immunohistochemical analysis, their cells were c-Kit positive. The GIST occurred in 728 patients with the age range of 12 days-96 years with a male predominance (59.3%). The most common symptoms were abdominal pain (25.4%) and gastrointestinal bleeding (23.4%). CT scan was the most important diagnostic technique. Surgery was the only useful treatment; in this study completeness of resection predicted for longer survival. Overall survival was between 21.4% and 88.8%; the percentage of deaths was between 11.1% and 78.5%. Distant metastases, localised in liver and lungs, and locoregional recurrences developed in a percentage between 9% and 68%.
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Affiliation(s)
- G Liberati
- Dipartimento di Clinica e Terapia Medica Applicata, Università degli Studi di Roma La Sapienza, Roma, Italia
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Mastropaolo G, Liberati G, Kusstatscher S, Galeazzi F, Lucà MG, Naccarato R. [Collection, survey and interpretation of pH-metry data]. MINERVA CHIR 1991; 46:71-6. [PMID: 2067699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
24-hour oesophageal pH monitoring is a necessary tool to diagnose Gastro-Oesophageal Reflux Disease. The technical characteristics of the available equipments have been improved and standard criteria to identify reflux episodes have been defined, increasing the sensitivity and specificity of the test. The state of the art on the technical features of prolonged pHmetry will be reviewed in this paper.
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Affiliation(s)
- G Mastropaolo
- Cattedra di malattie dell'Apparato Digerente, Università degli Studi di Padova
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Zammarchi E, Bougleux T, Biadaioli R, Liberati G, De Nigris L, Maffei C. [Blood tyrosine in the newborn. IV. Behavior of phenylalanine in relation to birth weight, to blood tyrosine and protein supply]. Minerva Pediatr 1978; 30:681-5. [PMID: 580795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Zammarchi E, Biadaioli R, Liberati G, Maffei C, Bougleux T, Rosati M. [Tyrosine in the blood of newborn infants. III. Effect of protein intake on blood levels of tyrosine]. Minerva Pediatr 1978; 30:619-26. [PMID: 661770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Zammarchi E, Maffei C, Dabizzi S, Liberati G, Bougleux T, Rosati M. [Tyrosine in the blood of newborn infants. II. Correlation between blood levels of bilirubin and tyrostine in a group of premature infants]. Minerva Pediatr 1978; 30:615-8. [PMID: 661769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Zammarchi E, Maffei C, Bougleux T, Rosati M, Dabizzi S, Liberati G. [Blood tyrosine levels in the newborn. I. Results of the study of 172 premature infants subdivided into groups according to weight, gestational age and prematurity index]. Minerva Pediatr 1978; 30:545-54. [PMID: 661760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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