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Vecchio D, Puricelli C, Malucchi S, Virgilio E, Martire S, Perga S, Passarelli F, Valentino P, Di Sapio A, Cantello R, Dianzani U, Comi C. Serum and cerebrospinal fluid neurofilament light chains measured by SIMOA™, Ella™, and Lumipulse™ in multiple sclerosis naïve patients. Mult Scler Relat Disord 2024; 82:105412. [PMID: 38198989 DOI: 10.1016/j.msard.2023.105412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Neurofilament light chains (NfL) are cytoskeletal biomarkers of axonal damage, about 40-fold higher in cerebrospinal fluid (CSF) compared to serum, and requiring ultrasensitive techniques to be measured in this latter fluid. OBJECTIVES To compare CSF and serum NfL levels in multiple sclerosis (MS) patients using different platforms. METHODS 60 newly diagnosed relapsing-remitting MS patients (38 females; median age: 36.5 years, range: 15-60) were enrolled before steroid or disease-modifying treatments. CSF and serum NfL were measured with: the commercial Ella™ microfluidic platform (Bio-Techne), the Lumipulse™ Chemiluminescent Enzyme ImmunoAssay (Fujirebio), and the SIMOA™ on the SR-X instrument using NF-light assays (Quanterix). RESULTS CSF and serum NfL absolute levels strongly correlated between assays, although being more elevated with Ella™. Passing-Bablok regression showed high agreement in measuring CSF NfL between assays (with greater proportional difference using Ella™), and very high agreement for serum comparing SIMOA™ and Lumipulse™. Similarly, the Bland-Altman comparison evidenced lower biases for Lumipulse™ for both fluids. CONCLUSIONS CSF and serum NfL in naïve MS patients are reliably measured with all assays. Although not interchangeable, SIMOA™ and Lumipulse™ showed high agreement for serum and CSF values.
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Affiliation(s)
- D Vecchio
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, Novara 28100, Italy.
| | - C Puricelli
- Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore della Carità University Hospital, University of Piemonte Orientale, Novara, Italy
| | - S Malucchi
- Neurology Unit, CRESM University Hospital San Luigi Gonzaga, Orbassano, Italy
| | - E Virgilio
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, Novara 28100, Italy
| | - S Martire
- Neuroscience Institute Cavalieri Ottolenghi (NICO) and CRESM Biobank, University Hospital San Luigi Gonzaga, Orbassano, Italy
| | - S Perga
- Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore della Carità University Hospital, University of Piemonte Orientale, Novara, Italy
| | - F Passarelli
- Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore della Carità University Hospital, University of Piemonte Orientale, Novara, Italy
| | - P Valentino
- Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore della Carità University Hospital, University of Piemonte Orientale, Novara, Italy
| | - A Di Sapio
- Neurology Unit, CRESM University Hospital San Luigi Gonzaga, Orbassano, Italy
| | - R Cantello
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, Novara 28100, Italy
| | - U Dianzani
- Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore della Carità University Hospital, University of Piemonte Orientale, Novara, Italy
| | - C Comi
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, Novara 28100, Italy
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Valentino P, Malucchi S, Bava CI, Martire S, Capobianco M, Malentacchi M, Sperli F, Oggero A, Di Sapio A, Bertolotto A. Serum Neurofilaments are a reliable biomarker to early detect PML in Multiple Sclerosis patients. Mult Scler Relat Disord 2023; 77:104893. [PMID: 37481820 DOI: 10.1016/j.msard.2023.104893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The earliest detection of progressive multifocal leukoencephalopathy (PML) is crucial in Natalizumab (NTZ)-treated Multiple Sclerosis (MS) patients. This study aims to assess serum Neurofilaments (sNFL) ability to early detect PML in longitudinal patients' follow-up. METHODS NFL were retrospectively measured in four PML cases occurred at the Regional Referring Center for MS (CRESM, Italy), in samples collected since one year before PML diagnosis, at PML diagnosis, during PML and in post-PML follow-up. sNFL levels were interpreted according to previously defined reference values. Clinical examination and EDSS were performed at each NTZ infusion. Routinary MRI was undertaken every six months; after PML diagnosis, MRI was performed according to clinical evaluation. sNFL were also measured in 45 NTZ-treated patients experiencing NEDA-3 status for at least 12 months. RESULTS Patients showed different PML onsets and manifestations: in 3 patients routinary brain MRI revealed radiological signs of PML preceding different clinical manifestations, while in one patient brain MRI was performed after the clinical onset. PML diagnosis was defined at the time of the first detection of JCV DNA in cerebrospinal fluid. The following different PML phases were considered: 1. Basal (up to 4 months before PML diagnosis): sNFL values were in the normal range in all patients' samples, except for one (median 9.1 pg/ml, range 6.2-15.1 pg/ml) 2. Pre-PML (within 3 months before PML diagnosis): sNFL were elevated in all available samples (median 19.50 pg/ml, range 15.50-33.80 pg/ml). 3. PML diagnosis: sNFL were elevated in all patients (median 59.20 pg/ml, range 11.1-101.50 pg/ml). 4. PML/IRIS: during this phase, sNFL levels reached their peak (median 96.35 pg/ml, range 20.5-272.9) in all patients. 5. Post-PML (recovery phase, starting from the first MRI without enhancement, up to the end of follow-up): sNFL levels showed a decrease (median 12.80 pg/ml, range 9.30-30.60); however, based on reference values, sNFL were still elevated in 2 out of 4 patients at the end of their follow-up (622 and 887 days after PML diagnosis). sNFL were always elevated when MRI scan suggested a suspicious of PML. In NEDA-3 patients, sNFL levels were in the normal range in all patients' samples (median 4.7 pg/ml, range 1.4-8.6 pg/ml). CONCLUSION Elevated sNFL were observed not only at PML diagnosis, but also in pre-PML phase. At PML recovery, sNFL weren't normalized in all patients' samples, suggesting ongoing neuronal degeneration. sNFL represent a reliable biomarker and should be introduced in clinical practice as an additional/alternative parameter to MRI to early detect and monitor PML.
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Affiliation(s)
- P Valentino
- Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043 Orbassano, Italy; CRESM Biobank, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
| | - S Malucchi
- Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - C I Bava
- Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043 Orbassano, Italy
| | - S Martire
- Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043 Orbassano, Italy; Department of Neuroscience "Rita Levi Montalcini", University of Turin, Italy, Via Cherasco 15, 10100 Turin, Italy
| | - M Capobianco
- Department of Neurology, S. Croce e Carle Hospital, Via Michele Coppino, 26, 12100 Cuneo, Italy
| | - M Malentacchi
- Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - F Sperli
- Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - A Oggero
- Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - A Di Sapio
- CRESM Biobank, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy; Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy
| | - A Bertolotto
- Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043 Orbassano, Italy; Koelliker Hospital, C.so Galileo Ferraris, 247/255, 10134 Turin, Italy
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Pape S, Snijders RJALM, Gevers TJG, Chazouilleres O, Dalekos GN, Hirschfield GM, Lenzi M, Trauner M, Manns MP, Vierling JM, Montano-Loza AJ, Lohse AW, Schramm C, Drenth JPH, Heneghan MA, Alvarez F, Andrade R, Arikan C, Assis D, Bardou-Jacquet E, Biewenga M, Cancado E, Cazzagon N, Chazouillères O, Colloredo G, Cuarterolo M, Dalekos G, Debray D, Robles-Díaz M, Drenth J, Dyson J, Efe C, Engel B, Ferri S, Fontana R, Gatselis N, Gerussi A, Halilbasic E, Halliday N, Heneghan M, Hirschfield G, van Hoek B, Hørby Jørgensen M, Indolfini G, Iorio R, Jeong S, Jones D, Kelly D, Kerkar N, Lacaille F, Lammert C, Leggett B, Lenzi M, Levy C, Liberal R, Lleo A, Lohse A, Ines Lopez S, de Martin E, McLin V, Mieli-Vergani G, Milkiewicz P, Mohan N, Muratori L, Nebbia G, van Nieuwkerk C, Oo Y, Ortega A, Páres A, Pop T, Pratt D, Purnak T, Ranucci G, Rushbrook S, Schramm C, Stättermayer A, Swain M, Tanaka A, Taubert R, Terrabuio D, Terziroli B, Trauner M, Valentino P, van den Brand F, Villamil A, Wahlin S, Ytting H, Zachou K, Zeniya M. Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group. J Hepatol 2022; 76:841-849. [PMID: 35066089 DOI: 10.1016/j.jhep.2021.12.041] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/18/2021] [Accepted: 12/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Autoimmune hepatitis (AIH) has been well characterised and codified through the development of diagnostic criteria. These criteria have been adapted and simplified and are widely used in clinical practice. However, there is a need to update and precisely define the criteria for both treatment response and treatment. METHODS A systematic review was performed and a modified Delphi consensus process was used to identify and redefine the response criteria in autoimmune hepatitis. RESULTS The consensus process initiated by the International Autoimmune Hepatitis Group proposes that the term 'complete biochemical response' defined as 'normalization of serum transaminases and IgG below the upper limit of normal' be adopted to include a time point at 6 months after initiation of treatment. An insufficient response by 6 months was a failure to meet the above definition. Non-response was defined as '<50% decrease of serum transaminases within 4 weeks after initiation of treatment'. Remission is defined as liver histology with a Hepatitis Activity Index <4/18. Intolerance to treatment was agreed to stand for 'any adverse event possibly related to treatment leading to potential drug discontinuation'. CONCLUSIONS These definitions provide a simple and reproducible framework to define treatment response and non-response, irrespective of the therapeutic intervention. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable inter-study comparisons. Future prospective database studies are needed to validate these endpoints. LAY SUMMARY Consensus among international experts on response criteria and endpoints in autoimmune hepatitis is lacking. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable the comparison of results between clinical trials. Therefore, the International Autoimmune Hepatitis Group (IAIHG) herein presents a statement on 5 agreed response criteria and endpoints: complete biochemical response, insufficient response, non-response, remission, and intolerance to treatment, which can be used to guide future reporting.
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Affiliation(s)
- Simon Pape
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Romée J A L M Snijders
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Tom J G Gevers
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht 6229HX, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Oliver Chazouilleres
- Hepatology Department, Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, Saint-Antoine Hospital Assistance Publique-Hôpitaux de Paris, Paris, France; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, University of Thessaly Medical School, Larissa, Greece
| | - Gideon M Hirschfield
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada
| | - Marco Lenzi
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - John M Vierling
- Departments of Medicine and Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Canada
| | - Ansgar W Lohse
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Christoph Schramm
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martin Zeitz Centre for Rare Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, London, United Kingdom; European Reference Network on Hepatological Diseases (ERN RARE-LIVER).
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Rapisarda L, Valentino P, Barone S, Torti C, La Gamba V, Fortunato F, Sammarra I, Gambardella A. Varicella zoster immunity loss in multiple sclerosis patient treated with ocrelizumab. Clin Immunol 2021; 223:108554. [DOI: 10.1016/j.clim.2020.108554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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D'Amico E, Zanghì A, Sciandra M, Borriello G, Callari G, Gallo A, Salemi G, Cottone S, Buccafusca M, Valentino P, Bossio RB, Grimaldi LME, Pozzilli C, Tedeschi G, Zappia M, Patti F. Discontinuation of teriflunomide and dimethyl fumarate in a large Italian multicentre population: a 24-month real-world experience. J Neurol 2018; 266:411-416. [PMID: 30515629 DOI: 10.1007/s00415-018-9144-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/07/2018] [Accepted: 11/26/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Teriflunomide (TRF) and Dimethyl fumarate (DMF) are licensed drugs for relapsing-remitting Multiple Sclerosis (RRMS). OBJECTIVES We aimed to compare the rate and the time to discontinuation among persons with RRMS (pwRRMS), newly treated with TRF and DMF. MATERIALS AND METHODS A retrospective study on prospectively collected data was performed in nine tertiary MS centers, in Italy. The 24-month discontinuation rate in the two cohorts was the primary study outcome. We also assessed the time to discontinuation and reasons of therapy withdrawn. Discontinuation of TRF and DMF was defined as a gap of treatment ≥ 60 days. RESULTS A cohort of 903 pwRRMS (316 on TRF and 587 on DMF) was analyzed. During 24 months of follow-up, pwRRMS on TRF and DMF showed similar discontinuation rates. The analysis of predictors with Cox regression model showed differences between the two groups (p for log-rank test = 0.007); male gender [HR 2.21 (1.00-4.90); p = 0.01] and the number of previous switches [HR 1.47 (1.16-1.86); p = 0.01] were associated with higher hazard of discontinuation in the DMF group. CONCLUSIONS In a real-world setting, pwRRMS on TRF and DMF had similar discontinuation rates over 24 months. Male pwRRMS on DMF with a previous history of therapeutic failure are at more risk of discontinuation therapy.
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Affiliation(s)
- E D'Amico
- Department "G.F. Ingrassia", MS centre University of Catania, Catania, Italy
| | - A Zanghì
- Department "G.F. Ingrassia", MS centre University of Catania, Catania, Italy
| | - M Sciandra
- Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
| | - G Borriello
- University of Rome "La Sapienza"-S. Andrea Hospital, Rome, Italy
| | - G Callari
- Institute Foundation "G. Giglio", Cefalù, Italy
| | - A Gallo
- University "Federico II"-I Neurologic Clinic, Naples, Italy
| | - G Salemi
- Policlinico "P. Giaccone", Palermo, Italy
| | - S Cottone
- Villa Sofia Cervello Hospital, Palermo, Italy
| | - M Buccafusca
- Azienda Ospedaliera Universitaria "G. Martino", Messina, Italy
| | - P Valentino
- Azienda Ospedaliera Universitaria "Mater Domini", Catanzaro, Italy
| | - R B Bossio
- Azienda Sanitaria Provinciale U. O. di Neurologia, Cosenza, Italy
| | | | - C Pozzilli
- University of Rome "La Sapienza"-S. Andrea Hospital, Rome, Italy
| | - G Tedeschi
- University "Federico II"-I Neurologic Clinic, Naples, Italy
| | - M Zappia
- Department "G.F. Ingrassia", MS centre University of Catania, Catania, Italy
| | - F Patti
- Department "G.F. Ingrassia", MS centre University of Catania, Catania, Italy.
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Patti F, Messina S, Solaro C, Amato MP, Bergamaschi R, Bonavita S, Bruno Bossio R, Brescia Morra V, Costantino GF, Cavalla P, Centonze D, Comi G, Cottone S, Danni M, Francia A, Gajofatto A, Gasperini C, Ghezzi A, Iudice A, Lus G, Maniscalco GT, Marrosu MG, Matta M, Mirabella M, Montanari E, Pozzilli C, Rovaris M, Sessa E, Spitaleri D, Trojano M, Valentino P, Zappia M. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity. J Neurol Neurosurg Psychiatry 2016; 87:944-51. [PMID: 27160523 PMCID: PMC5013116 DOI: 10.1136/jnnp-2015-312591] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/05/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. METHODS We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0-10 numerical rating scale (NRS) scale is available at baseline, after 1 month of treatment (trial period), and at 3 and 6 months. RESULTS A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5% of patients reaching a ≥20% improvement (initial response, IR) and 28.2% who had already reached a ≥30% improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6% (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95% CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95% CI 1.3-2.4 p<0.001). During the 6 months observation period, 631(39.5%) patients discontinued treatment. The main reasons for discontinuation were lack of effectiveness (n=375, 26.2%) and/or adverse events (n=268, 18.7%). CONCLUSIONS Sativex can be a useful and safe option for patients with MS with moderate to severe spasticity resistant to common antispastic drugs.
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Affiliation(s)
- F Patti
- Department of Medical, Surgical Science and Advanced Technology "GF Ingrassia", University of Catania, Catania, Italy
| | - S Messina
- Department of Medical, Surgical Science and Advanced Technology "GF Ingrassia", University of Catania, Catania, Italy
| | - C Solaro
- Neurology Unit, Department Head and Neck, ASL3 Genova, Genova, Italy
| | - M P Amato
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - R Bergamaschi
- Department of Neurology, Neurology Institute C Mondino, Pavia, Italy
| | - S Bonavita
- I Clinic Neurology, II University of Naples, Naples, Italy
| | - R Bruno Bossio
- Neurology Operating Unit, Multiple Sclerosis Center, Provincial Health Authority of Cosenza, Cosenza, Italy
| | - V Brescia Morra
- Multiple Sclerosis Centre, University Federico II, Naples, Italy
| | - G F Costantino
- Demyelinating Diseases Centre, Foggia Hospital, Foggia, Italy
| | - P Cavalla
- Multiple Sclerosis Centre, S. Giovanni Battista, Molinette Hospital, Turin, Italy
| | - D Centonze
- Department of Systems Medicine, Multiple Sclerosis Clinical and Research Center, Tor Vergata University, Rome, Italy Unit of Neurology and of Neurorehabilitation, IRCCS Neuromed, Pozzilli (IS), Italy
| | - G Comi
- Department of Neurology, San Raffaele Hospital, Milan, Italy
| | - S Cottone
- Neuroimmunology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Danni
- Neurology Clinic, Ancona Hospital, Ancona, Italy
| | - A Francia
- Department Neurol Psich, Multiple Sclerosis Center, Sapienza University, Rome, Italy
| | - A Gajofatto
- Multiple Sclerosis Centre, University of Verona, Verona, Italy
| | - C Gasperini
- Neurology Division, San Camillo Hospital, Rome, Italy
| | - A Ghezzi
- Multiple Sclerosis Centre, Sant'Antonio Abate Hospital, Gallarate, Italy
| | - A Iudice
- Multiple Sclerosis Centre, University Hospital Pisa, Pisa, Italy
| | - G Lus
- Multiple Sclerosis Center, Second University of Naples, Naples, Italy
| | - G T Maniscalco
- Multiple Sclerosis Centre, Cardarelli Hospital, Naples, Italy
| | - M G Marrosu
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - M Matta
- Multiple Sclerosis Centre (CRESM), San Luigi Gonzaga Hospital, Orbassano, Italy
| | - M Mirabella
- Multiple Sclerosis Centre, Cattolica University, Rome, Italy
| | - E Montanari
- Multiple Sclerosis Centre, Vaio Hospital, Fidenza, Italy
| | - C Pozzilli
- Multiple Sclerosis Centre, S. Andrea Hospital, Rome, Italy
| | - M Rovaris
- Multiple Sclerosis Centre, IRCCS Don Gnocchi Foundation, Milan, Italy
| | - E Sessa
- Multiple Sclerosis Centre, IRCCS-Bonino Pulejo Centre, Messina, Italy
| | - D Spitaleri
- Multiple Sclerosis Centre, San G. Moscati Hospital, Avellino, Italy
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - P Valentino
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - M Zappia
- Department of Medical, Surgical Science and Advanced Technology "GF Ingrassia", University of Catania, Catania, Italy
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Gilli F, Hoffmann F, Sala A, Marnetto F, Caldano M, Valentino P, Kappos L, Bertolotto A, Lindberg RLP. Qualitative and quantitative analysis of antibody response against IFNβ in patients with multiple sclerosis. Mult Scler 2016; 12:738-46. [PMID: 17263001 DOI: 10.1177/1352458506070968] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To date, inter-and intra-laboratory consistency of binding assays for measuring anti-interferon (IFN)β antibodies has not been assessed. In this investigation, two independent laboratories tested a library of 80 serum specimens obtained from multiple sclerosis (MS) patients treated with IFNβ. For binding antibodies (BAbs) evaluations, each laboratory used both a capture-ELISA (cELISA) and an enzyme-immuno-assay (EIA), which is commercially available. Samples were also tested for neutralizing antibodies (NAbs). Data demonstrated good intra-laboratory reliability (rpearson≥0.86), and a good overall agreement between the results obtained from the two centers, using both the cELISA (69/80 of observed agreements) and the EIA (67/80). Accordingly, kappa coefficients (K) showed good concurrence (K ≥ 0.651). There was also substantial agreement between cELISA and EIA measurements, as performed in both centers (Orbassano, 66/80, K = 0.631; Basel, 70/80, K = 0.717). However, by comparing NAbs and BAbs titers obtained with both assays, we found that a high degree of BAb-negative samples were positive in NAb-assay. Thus, our study does not support the usefulness of ELISA-based BAb assays as a screening tool for NAbs. Otherwise, BAb-assays can be used as a confirmation test, indicating that the decrease of the biological effects is due to antibodies. In this context, both ELISA-based assays are equally reliable techniques.
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Affiliation(s)
- F Gilli
- Centro di Riferimento Regionale Sclerosi Multipla (CReSM) and Neurobiologia Clinica, ASO S. Luigi Gonzaga, Orbassano, Torino, Italy.
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Bertolotto A, Granieri L, Marnetto F, Valentino P, Sala A, Capobianco M, Malucchi S, Di Sapio A, Malentacchi M, Matta M, Caldano M. Biological monitoring of IFN-β therapy in Multiple Sclerosis. Cytokine Growth Factor Rev 2015; 26:241-8. [DOI: 10.1016/j.cytogfr.2014.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 11/26/2022]
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10
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Giordano A, Lugaresi A, Confalonieri P, Granella F, Radice D, Trojano M, Martinelli V, Solari A, Giordano A, Martinelli V, Lugaresi A, Pucci E, Granella F, Trojano M, Solari A, Martinelli V, Pucci E, Messmer Uccelli M, Lugaresi A, Giordano A, Granella F, Solari A, Giordano A, Ferrari G, Martini F, Solari A, Radice D, D’Annunzio G, Lugaresi A, Farina D, Travaglini D, Pietrolongo E, Onofrj M, Torri Clerici V, Bonanno S, Brambilla L, Confalonieri P, Martinelli V, Radaelli M, Messina J, Comi G, Tortorella C, Luciannatelli E, Trojano M, Senesi C, Tsantes E, Granella F, Conti MZ, Rottoli MR, Bellantonio P, Fischetti M, Fantozzi R, Pala A, Traccis S, Di Battista G, Bianchi M, Benedetti MD, Gaetani L, Di Filippo M, Carolei A, Totaro R, Lanzillo R, Brescia Morra V, Coppola R, Cottone S, Chiavazza C, Cavalla P, Leonardi C, Aguglia U, Ziuliani C, Valla P, Sasanelli F, Valentino P, Quattrone A, Martino PG, Russo M, Vita G, Immovilli P. Implementation of the ‘Sapere Migliora’ information aid for newly diagnosed people with multiple sclerosis in routine clinical practice: a late-phase controlled trial. Mult Scler 2014; 20:1234-43. [DOI: 10.1177/1352458513519180] [Citation(s) in RCA: 12] [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: 08/01/2013] [Accepted: 12/11/2013] [Indexed: 11/16/2022]
Abstract
Background: The SIMS-Trial showed that the ‘Sapere Migliora’ information aid (IA) for newly diagnosed people with multiple sclerosis (PwMS) effectively improved patient knowledge and satisfaction with care. Objectives: The objectives of this paper are to assess the effectiveness of the IA in clinical practice and to compare the whole IA with the take-home booklet/website component alone. Methods: After updating the IA and replacing the CD with a website, a prospective, open-label non-randomised controlled trial compared the whole IA (group A, five SIMS-Trial centres) to take-home (group B, 16 centres). One month after the intervention, participants completed the MS Knowledge Questionnaire (MSKQ), care satisfaction questionnaire (COSM-R) (primary study outcomes), Hospital and Anxiety Depression Scale, and ad hoc questionnaire appraising the IA. Results: We enrolled 159 newly diagnosed PwMS (May 2012–March 2013). Drop-outs were four of 77 (5%, group A) and 11/82 (13%, group B). Primary endpoint (highest tertile both for MSKQ and COSM-R section 2 scores) was achieved by 38/77 (49%) group A and 33/82 (40%) group B ( p = 0.25). Attainment of secondary outcomes was also similar between groups. Conclusions: This study shows that the entire IA is not superior to the booklet/website alone, and that both are comparable in efficacy to the intervention arm of the SIMS-Trial. Trial registration number: ISRCTN78940214.
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Affiliation(s)
- A Giordano
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Italy
| | - A Lugaresi
- Department of Neuroscience and Imaging, University G. d’Annunzio of Chieti-Pescara, Italy
| | - P Confalonieri
- Department of Neuroimmunology, Foundation IRCCS Neurological Institute C. Besta, Italy
| | - F Granella
- Department of Neurosciences, Neurology Unit, University of Parma, Italy
| | - D Radice
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Italy
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Martinelli
- Department of Neurology, Scientific Institute Hospital San Raffaele, Italy
| | - A Solari
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Italy
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Lavorgna L, Bonavita S, Ippolito D, Lanzillo R, Salemi G, Patti F, Valentino P, Coniglio G, Buccafusca M, Paolicelli D, d'Ambrosio A, Bresciamorra V, Savettieri G, Zappia M, Alfano B, Gallo A, Simone I, Tedeschi G. Clinical and magnetic resonance imaging predictors of disease progression in multiple sclerosis: a nine-year follow-up study. Mult Scler 2013; 20:220-6. [PMID: 23838177 DOI: 10.1177/1352458513494958] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 11/17/2022]
Abstract
OBJECTIVE The objective of this paper is to identify clinical or magnetic resonance imaging (MRI) predictors of long-term clinical progression in a large cohort of multiple sclerosis (MS) patients. METHODS A total of 241 relapsing-remitting (RR) MS patients were included in a nine-year follow-up (FU) study. The reference MRIs were acquired at baseline (BL) as part of a multicenter, cross-sectional, clinical-MRI study. Volumetric MRI metrics were measured by a fully automated, operator-independent, multi-parametric segmentation method. Clinical progression was evaluated as defined by: conversion from RR to secondary progressive (SP) disease course; progression of Expanded Disability Status Scale (EDSS); achievement and time to reach EDSS 4. RESULTS We concluded that conversion from RR to SP (OR 0.79; CI 0.7-0.9), progression of EDSS (OR 0.85; CI 0.77-0.93), achievement of EDSS 4 (OR 0.8; CI 0.7-0.9), and time to reach EDSS 4 (HR 0.88; CI 0.82-0.94) were all predicted by BL gray matter (GM) volume and, except for progression of EDSS, by BL EDSS (respectively: (OR 2.88; CI 1.9-4.36), (OR 2.7; CI 1.7-4.2), (HR 3.86; CI 1.94-7.70)). CONCLUSIONS BL GM volume and EDSS are the best long-term predictors of disease progression in RRMS patients with a relatively long and mild disease.
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Affiliation(s)
- L Lavorgna
- Second University of Naples, II Clinic of Neurology, Italy
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Nisticò R, Pirritano D, Salsone M, Valentino P, Novellino F, Condino F, Bono F, Quattrone A. Blink reflex recovery cycle in patients with dystonic tremor: a cross-sectional study. Neurology 2012; 78:1363-5. [PMID: 22496196 DOI: 10.1212/wnl.0b013e3182518316] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [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] Open
Affiliation(s)
- R Nisticò
- University Magna Graecia, Neuroimaging Research Unit, National Research Council, Catanzaro, Italy
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13
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Conforti FL, Sproviero W, Simone IL, Mazzei R, Valentino P, Ungaro C, Magariello A, Patitucci A, La Bella V, Sprovieri T, Tedeschi G, Citrigno L, Gabriele AL, Bono F, Monsurrò MR, Muglia M, Gambardella A, Quattrone A. TARDBP gene mutations in south Italian patients with amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2011; 82:587-8. [PMID: 20959352 DOI: 10.1136/jnnp.2009.198309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Valentino P, Nisticò R, Pirritano D, Bilotti G, Del Giudice F, Sturniolo M, Quattrone A. Lamotrigine therapy for paroxysmal dysarthria caused by multiple sclerosis: a case report. J Neurol 2011; 258:1349-50. [PMID: 21264473 DOI: 10.1007/s00415-011-5901-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/23/2010] [Accepted: 01/03/2011] [Indexed: 11/27/2022]
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Nisticò R, Pirritano D, Salsone M, Novellino F, Del Giudice F, Morelli M, Trotta M, Bilotti G, Condino F, Cherubini A, Valentino P, Quattrone A. Synchronous pattern distinguishes resting tremor associated with essential tremor from rest tremor of Parkinson's disease. Parkinsonism Relat Disord 2010; 17:30-3. [PMID: 21071257 DOI: 10.1016/j.parkreldis.2010.10.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/01/2010] [Accepted: 10/11/2010] [Indexed: 11/30/2022]
Abstract
Rest tremor associated with essential tremor (ET) is a condition that poses challenges in diagnosing Parkinson's disease (PD). We investigated tremor parameters in PD and ET patients with rest tremor. Fifteen patients with PD and 15 patients with ET underwent electrophysiological examination to evaluate characteristics of muscle bursting in rest postures. Rest tremor amplitude of PD patients was significantly higher than that of patients with ET (p = 0.002), whereas burst duration and frequency were significantly higher in ET than in PD group (p = 0.002, p < 0.001, respectively). Patients with PD, however, showed some overlap of these electrophysiological values with values from patients with ET. By contrast, rest tremor pattern showed no overlap between the two diseases, because all patients with ET presented a synchronous pattern whereas PD patients had an alternating pattern (p < 0.001), a finding that differentiated the patients on an individual basis. The electromyographic pattern of rest tremor may help to differentiate PD from ET.
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Affiliation(s)
- R Nisticò
- Neuroimaging Research Unit, National Research Council, Catanzaro, Italy
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16
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Nocentini U, Tedeschi G, Migliaccio R, Dinacci D, Lavorgna L, Bonavita S, Bresciamorra V, Comanducci G, Coniglio G, Livrea P, Mannu R, Orefice G, Paciello M, Patti F, Quattrone A, Salemi G, Savettieri G, Simone I, Valentino P, Zappia M, Bonavita V, Musicco M, Caltagirone C. An exploration of anger phenomenology in multiple sclerosis. Eur J Neurol 2009; 16:1312-7. [DOI: 10.1111/j.1468-1331.2009.02727.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Valentino P, Cerasa A, Chiriaco C, Nisticò R, Pirritano D, Gioia MC, Lanza P, Canino M, Del Giudice F, Gallo O, Condino F, Torchia G, Quattrone A. Cognitive deficits in multiple sclerosis patients with cerebellar symptoms. Mult Scler 2009; 15:854-9. [DOI: 10.1177/1352458509104589] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Cerebellar dysfunction is common in patients with multiple sclerosis (MS). However, neuropsychological studies of this clinical feature are lacking. Objective We investigate the neuropsychological features in relapsing-remitting MS (RR-MS) patients with and without cerebellar dysfunction. Methods Twenty-one RR-MS patients with cerebellar dysfunction (RR-MSc), characterized by prevalent ataxic gait and nystagmus, and 21 RR-MS patients without any cerebellar manifestation (RR-MSnc) pair-matched for demographical and clinical variables were studied. All patients from each group underwent an extensive battery of neuropsychological tests. Magnetic resonance imaging analysis included hyperintense fast fluid-attenuated inversion-recovery lesion load in the whole brain as well as in the four lobes separately. Results Any significant differences were detected in total and regional lesion load measurements between the two groups. RR-MSc group performed equally as well as the RR-MSnc group on many of the cognitive exploration measures. Nevertheless, the RR-MSc group performed more poorly than the RR-MSnc group on attention tests (Symbol Digit Modalities Test) and verbal fluency tests (Controlled Oral Word Association Test); neither of the test results proved to be affected by regional lesion loads. Conclusion These results highlight the importance of considering cognitive deficits associated with the presence of cerebellar symptoms in RR-MS.
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Affiliation(s)
- P Valentino
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - A Cerasa
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - C Chiriaco
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - R Nisticò
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - D Pirritano
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - MC Gioia
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - P Lanza
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - M Canino
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - F Del Giudice
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - O Gallo
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - F Condino
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - G Torchia
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
| | - A Quattrone
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy; Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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Andreoli V, Trecroci F, La Russa A, Valentino P, Condino F, Latorre V, Nisticò R, Pirritano D, Del Giudice F, Canino M, Cittadella R, Quattrone A. CASP-9: A susceptibility locus for multiple sclerosis in Italy. J Neuroimmunol 2009; 210:100-3. [PMID: 19359048 DOI: 10.1016/j.jneuroim.2009.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 02/24/2009] [Accepted: 03/05/2009] [Indexed: 11/17/2022]
Abstract
Caspase-9 is a primary effector CASP that executes programmed cell death, which plays an important role in the development of multiple sclerosis (MS). Polymorphisms in the CASP-9 gene may influence its activity, thereby modulating the susceptibility to MS. To test this hypothesis, we evaluated a SNP in the CASP-9 gene in a set of Italian patients from Southern Italy and healthy control subjects. Our results suggest that the presence of the G/G genotype represents a higher risk factor in our MS population and a differential production of CASP-9 might be a contributory factor in determining the severity of MS.
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Affiliation(s)
- V Andreoli
- Institute of Neurological Sciences, National Research Council, Pianolago di Mangone, Cosenza, Italy.
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Valentino P, Labate A, Nisticò R, Pirritano D, Cerasa A, Liguori M, Bastone L, Crescibene L, Quattrone A. Anti-GM1 antibodies are not associated with cerebral atrophy in patients with multiple sclerosis. Mult Scler 2009; 15:114-5. [DOI: 10.1177/1352458508096685] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to correlate the brain atrophy with serum levels of anti-GM1 antibodies in patients with relapsing–remitting multiple sclerosis (RRMS). Methods Plasma sample from 52 patients with RRMS and 65 healthy controls were examined for anti-GM1 antibodies. Patients with RRMS underwent to MRI study with automated method called SIENAX that calculated an estimate of gray matter (GMV) and white matter (WMV) volumes. Results The percentage of RRMS patients with increased anti-GM1 was 37.8%. Elevated levels of anti-GM1 antibodies did not correlate with brain atrophy. Conclusions Anti-GM1 antibodies do not represent a marker of axonal damage in patients with RRMS.
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Affiliation(s)
- P Valentino
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy
| | - A Labate
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy; Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - R Nisticò
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - D Pirritano
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy
| | - A Cerasa
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - M Liguori
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - L Bastone
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - L Crescibene
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
| | - A Quattrone
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy; Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy
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Gilli F, Valentino P, Caldano M, Granieri L, Capobianco M, Malucchi S, Sala A, Marnetto F, Bertolotto A. Expression and regulation of IFN / receptor in IFN -treated patients with multiple sclerosis. Neurology 2008; 71:1940-7. [DOI: 10.1212/01.wnl.0000327340.50284.8d] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tedeschi G, Dinacci D, Comerci M, Lavorgna L, Savettieri G, Quattrone A, Livrea P, Patti F, Brescia Morra V, Servillo G, Orefice G, Paciello M, Prinster A, Coniglio G, Bonavita S, Di Costanzo A, Bellacosa A, Valentino P, Quarantelli M, Brunetti A, Salemi G, D’Amelio M, Simone I, Salvatore M, Bonavita V, Alfano B. Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study. Mult Scler 2008; 15:204-11. [DOI: 10.1177/1352458508098270] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression. Methods Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points. Results The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression. Conclusions In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.
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Affiliation(s)
- G Tedeschi
- Department of Neurological Sciences, Second University of Naples, Naples, Italy; Institute Hermitage Capodimonte, Naples, Italy
| | - D Dinacci
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - M Comerci
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - L Lavorgna
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - G Savettieri
- Department of Neurology, University of Palermo, Palermo, Italy
| | - A Quattrone
- Department of Neurology, University of Catanzaro, Catanzaro, Italy
| | - P Livrea
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - F Patti
- Department of Neurology, University of Catania, Catania, Italy
| | - V Brescia Morra
- Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - G Servillo
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - G Orefice
- Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - M Paciello
- Department of Neurology, San Carlo Hospital, Potenza, Italy
| | - A Prinster
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - G Coniglio
- Department of Neurology, San Carlo Hospital, Potenza, Italy
| | - S Bonavita
- Department of Neurological Sciences, Second University of Naples, Naples, Italy; Institute Hermitage Capodimonte, Naples, Italy
| | - A Di Costanzo
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - A Bellacosa
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - P Valentino
- Department of Neurology, University of Catanzaro, Catanzaro, Italy
| | - M Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - A Brunetti
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy; Department of Diagnostic Imaging, University of Naples “Federico II,” Naples, Italy
| | - G Salemi
- Department of Neurology, University of Palermo, Palermo, Italy
| | - M D’Amelio
- Department of Neurology, University of Palermo, Palermo, Italy
| | - I Simone
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - M Salvatore
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy; Department of Diagnostic Imaging, University of Naples “Federico II,” Naples, Italy
| | - V Bonavita
- Institute Hermitage Capodimonte, Naples, Italy; Department of Neurological Sciences, University of Naples “Federico II,” Naples, Italy
| | - B Alfano
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
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22
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Malucchi S, Gilli F, Caldano M, Marnetto F, Valentino P, Granieri L, Sala A, Capobianco M, Bertolotto A. Predictive markers for response to interferon therapy in patients with multiple sclerosis. Neurology 2008; 70:1119-27. [DOI: 10.1212/01.wnl.0000304040.29080.7b] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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23
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Andreoli V, Cittadella R, Valentino P, Condino F, La Russa A, Liguori M, Manna I, Spadafora P, Nisticò R, Pirritano D, Clodomiro A, Quattrone A. The role of VLA4 polymorphisms in multiple sclerosis: An association study. J Neuroimmunol 2007; 189:125-8. [PMID: 17609118 DOI: 10.1016/j.jneuroim.2007.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 05/29/2007] [Accepted: 06/20/2007] [Indexed: 11/24/2022]
Abstract
Lymphocyte and monocyte brain infiltration determines inflammation in multiple sclerosis. The trafficking of these cells into the CNS results from the VLA-4 binding with its ligand on brain endothelial cells. MS patients treated with an antibody against the alpha-4 subunit, which inhibits this interaction, prevents brain lesion development. We investigated the association between VLA-4 gene polymorphisms and MS in a study on 275 patients and 255 controls. No differences were detected, thus suggesting that these polymorphisms are not a significant genetic risk factor for susceptibility to MS in Italy.
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Affiliation(s)
- V Andreoli
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy.
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24
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Conforti FL, Sprovieri T, Mazzei R, Ungaro C, La Bella V, Tessitore A, Patitucci A, Magariello A, Gabriele AL, Tedeschi G, Simone IL, Majorana G, Valentino P, Condino F, Bono F, Monsurrò MR, Muglia M, Quattrone A. A novel Angiogenin gene mutation in a sporadic patient with amyotrophic lateral sclerosis from southern Italy. Neuromuscul Disord 2007; 18:68-70. [PMID: 17703939 DOI: 10.1016/j.nmd.2007.07.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 07/12/2007] [Accepted: 07/16/2007] [Indexed: 11/28/2022]
Abstract
Mutations in the Angiogenin gene (ANG) linked to 14q11.2 have been recently discovered to be associated with Amyotrophic Lateral Sclerosis (ALS) in Irish and Scottish populations. In our study we investigated the role of ANG gene in ALS patients from southern Italy. We found a novel mutation in the signal peptide of the ANG gene in a sporadic patient with ALS (SALS). The molecular analysis of the ANG gene also demonstrated an allelic association with the rs11701 single nucleotide polymorphism (SNP) in familial ALS (FALS) but not in SALS patients. Our finding supports the evidence that the ANG gene is involved in ALS.
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Affiliation(s)
- F L Conforti
- Institute of Neurological Sciences, National Research Council, Mangone, Cosenza, Italy
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25
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Liguori M, Fera F, Gioia MC, Valentino P, Manna I, Condino F, Cerasa A, La Russa A, Clodomiro A, Paolillo A, Nisticò R, Vercillo L, Cittadella R, Quattrone A. Investigating the role of brain-derived neurotrophic factor in relapsing-remitting multiple sclerosis. Genes Brain Behav 2007; 6:177-83. [PMID: 16740142 DOI: 10.1111/j.1601-183x.2006.00245.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Multiple sclerosis (MS) is a common, heterogeneous disorder of the central nervous system with a complex trait composed of both genetic and environmental factors. Recently, scientific interest has increased in defining factors that possibly contribute to brain functional plasticity; the results might be useful to assess the relationship between MS lesion burden and clinical events, as well as explaining the well-known phenotypic heterogeneity of the disease. In this study, we explored the effect of the Val66Met brain-derived neurotrophic factor (BDNF) functional polymorphism on cognitive performances and volumetric measurements obtained by magnetic resonance imaging of the brain in a selected population of relapsing-remitting MS (RRMS) patients, with relatively short disease duration and minimal clinical disability, compared to gender, age and educational-level matched healthy subjects. We found that in the RRMS group, the BDNF Met-allele was significantly associated with the lower volume of cerebral grey matter (GM) (P = 0.005). Furthermore, a significant (P = 0.013) interaction effect between 'MS-status' and the BDNF genotype was found for GM volumes, with the result that patients carrying the BDNF Met-allele showed a higher risk of developing global GM atrophy than the homozygous Val/Val. No BDNF-related impact on global neuropsychological functions resulted in either RRMS patients or controls. Our data seem to be consistent with the reported influence of BDNF in neuronal plasticity, thus suggesting that the Met-allele might have a negative prognostic effect on cortical morphometry in RRMS patients.
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Affiliation(s)
- M Liguori
- Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy.
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26
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Padua L, Nociti V, Bartalini S, Patti F, Quattrone A, Tonali P, Ulivelli M, Valentino P, Zappia M, Batocchi AP. Reply to “Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients”. J Neurol Sci 2007; 253:106. [PMID: 17215006 DOI: 10.1016/j.jns.2006.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Accepted: 11/22/2006] [Indexed: 11/20/2022]
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27
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Bonavita S, Dinacci D, Lavorgna L, Savettieri G, Quattrone A, Livrea P, Bresciamorra V, Orefice G, Paciello M, Coniglio G, Di Costanzo A, Valentino P, Patti F, Salemi G, Simone I, Tedeschi G. Treatment of multiple sclerosis with interferon beta in clinical practice: 2-year follow-up data from the South Italy Mobile MRI Project. Neurol Sci 2006; 27 Suppl 5:S365-8. [PMID: 16998722 DOI: 10.1007/s10072-006-0696-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This follow-up study assessed the 2-year clinical and magnetic resonance imaging (MRI) outcomes of patients with multiple sclerosis (MS) originally enrolled in an MRI study conducted at eight centres in south Italy (the South Italy Mobile MRI Project). Of the 597 MS patients recruited at baseline, 391 returned for the follow-up study. Of these, 363 provided 2-year clinical and MRI follow-up data, and 215 were still undergoing treatment with one of four interferon beta regimens: Avonex, 30 mcg intramuscularly once weekly; Betaferon, 250 mcg subcutaneously (sc) every other day; Rebif 22 mcg sc three times weekly (tiw; Rebif 22); or Rebif 44 mcg sc tiw (Rebif 44). Over the 2-year follow-up period, patients receiving the higher dose of Rebif were more likely to remain free from relapses [odds ratio (OR) = 2.23] and from developing both new T2 (OR = 0.15) and new T1 black hole lesions (OR = 0.22), when compared with patients in the Avonex group. Despite some limitations in the trial design, the results from this follow-up study provide helpful clinical and MRI data on the efficacy of interferon beta regimens in MS patients treated in the clinical setting.
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Affiliation(s)
- S Bonavita
- Department of Neurological Sciences, Second University of Naples, Piazza Miraglia 2, I-80138 Naples, Italy
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28
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Nocentini U, Pasqualetti P, Bonavita S, Buccafusca M, De Caro MF, Farina D, Girlanda P, Le Pira F, Lugaresi A, Quattrone A, Reggio A, Salemi G, Savettieri G, Tedeschi G, Trojano M, Valentino P, Caltagirone C. Cognitive dysfunction in patients with relapsing-remitting multiple sclerosis. Mult Scler 2006; 12:77-87. [PMID: 16459723 DOI: 10.1191/135248506ms1227oa] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cognitive dysfunction is considered one of the clinical markers of multiple sclerosis (MS). However, in the literature there are inconsistent reports on the prevalence of cognitive dysfunction, and separate data for the relapsing-remitting (RR) type of the disease are not always presented. In this study, we submitted 461 RRMS patients to a battery of neuropsychological tests to investigate their impairment in various cognitive domains. As a consequence of the exclusion criteria, the sample is not fully representative of the entire population of RRMS patients. In this selected sample, when only the eight scores of a core battery (Mental Deterioration Battery) were considered (with respective cutoffs), it emerged that 31% of the patients were affected by some degree of cognitive deficit. In particular, 15% had mild, 11.2% moderate and 4.8% had severe impairment. Information processing speed was the most frequently impaired area, followed by memory. When two other tests (SDMT and MCST) were added and cognitive domains were considered, it emerged that 39.3% of the patients were impaired in two or more domains. When four subgroups were obtained by means of cluster analysis and then compared, it emerged that information processing speed and memory deficits differentiated the still cognitively unimpaired from the mildly impaired MS patients. Significant associations were found between cognitive and clinical characteristics. However, due to the large sample size, clinically irrelevant relationships may also have emerged. Even with the limitations imposed by the sample selection and the possible underestimation of the prevalence and severity of cognitive dysfunction, these results seem to provide further evidence that information processing speed deficit may be an early and important marker of cognitive impairment in MS patients.
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Affiliation(s)
- U Nocentini
- Department of Neurology, University of Rome 'Tor Vergata' and IRCCS 'S. Lucia' Foundation, Rome, 00179 Italy.
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29
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Manna I, Valentino P, La Russa A, Condino F, Nisticò R, Liguori M, Clodomiro A, Andreoli V, Pirritano D, Cittadella R, Quattrone A. Genetic variation in the myeloperoxidase gene and cognitive impairment in multiple sclerosis. J Negat Results Biomed 2006; 5:3. [PMID: 16504169 PMCID: PMC1420327 DOI: 10.1186/1477-5751-5-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 02/27/2006] [Indexed: 11/10/2022] Open
Abstract
There is evidence that multiple sclerosis (MS) may associated with cognitive impairment in 25 to 40% of cases. The gene encoding myeloperoxidase (MPO) is involved in molecular pathways leading to beta-amyloid deposition. We investigated a functional biallelic (G/A) polymorphism in the promoter region (-463) of the MPO gene in 465 patients affected by MS, divided into 204 cognitively normal and 261 impaired. We did not find significant differences in allele or genotype distributions between impaired and preserved MS patients. Our findings suggest that MPO polymorphism is not a risk factor for cognitive impairment in MS.
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Affiliation(s)
- I Manna
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - P Valentino
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - A La Russa
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - F Condino
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - R Nisticò
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - M Liguori
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - A Clodomiro
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - V Andreoli
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - D Pirritano
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - R Cittadella
- Institute of Neurological Science, National Research Council, Cosenza, Italy
| | - A Quattrone
- Institute of Neurological Science, National Research Council, Cosenza, Italy
- Department of Medical Sciences, Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
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30
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Tedeschi G, Lavorgna L, Russo P, Prinster A, Dinacci D, Savettieri G, Quattrone A, Livrea P, Messina C, Reggio A, Bresciamorra V, Orefice G, Paciello M, Brunetti A, Coniglio G, Bonavita S, Di Costanzo A, Bellacosa A, Valentino P, Quarantelli M, Patti F, Salemi G, Cammarata E, Simone IL, Salvatore M, Bonavita V, Alfano B. Brain atrophy and lesion load in a large population of patients with multiple sclerosis. Neurology 2006; 65:280-5. [PMID: 16043800 DOI: 10.1212/01.wnl.0000168837.87351.1f] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method. METHODS The study population consisted of 597 patients with MS and 104 control subjects. The MRI parameters were abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f). RESULTS Significant differences between patients with MS and control subjects included higher AWM-f and reduced gWM-f and GM-f. MRI data showed significant differences between patients with relapsing-remitting and secondary progressive forms of MS. Significant correlations between MRI parameters and between MRI and clinical data were found. CONCLUSIONS Patients with multiple sclerosis have significant atrophy of both white matter (WM) and gray matter (GM); secondary progressive patients have significantly more atrophy of both WM and GM than do relapsing-remitting patients and a significantly higher lesion load (abnormal WM fraction); lesion load is related to both WM and even more to GM atrophy; lesion load and WM and GM atrophy are significantly related to Expanded Disability Status Scale score and age at onset (suggesting that the younger the age at disease onset, the worse the lesion load and brain atrophy); and GM atrophy is the most significant MRI variable in determining the final disability.
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Affiliation(s)
- G Tedeschi
- Department of Neurological Sciences, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy.
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31
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Pugliese P, Annesi G, Cutuli N, Arabia G, Nicoletti G, Annesi F, Tarantino P, Gambardella A, Valentino P, Zappia M, Quattrone A. The fragile X premutation presenting as postprandial hypotension. Neurology 2005; 63:2188-9. [PMID: 15596781 DOI: 10.1212/01.wnl.0000145709.61117.08] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P Pugliese
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
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32
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Valentino P, Conforti FL, Pirritano D, Nisticò R, Mazzei R, Patitucci A, Sprovieri T, Gabriele AL, Muglia M, Clodomiro A, Gambardella A, Zappia M, Quattrone A. Brachial amyotrophic diplegia associated with a novel SOD1 mutation (L106P). Neurology 2005; 64:1477-8. [PMID: 15851752 DOI: 10.1212/01.wnl.0000158679.47281.03] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P Valentino
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
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33
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Conforti FL, Muglia M, Mazzei R, Patitucci A, Valentino P, Magariello A, Sprovieri T, Bono F, Bergmann C, Gabriele AL, Peluso G, Nisticò R, Senderek J, Quattrone A. A new SBF2 mutation in a family with recessive demyelinating Charcot-Marie-Tooth (CMT4B2). Neurology 2004; 63:1327-8. [PMID: 15477569 DOI: 10.1212/01.wnl.0000140617.02312.80] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F L Conforti
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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34
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Mazzei R, Conforti FL, Lanza PL, Sprovieri T, Lupo MR, Gallo O, Patitucci A, Magariello A, Caracciolo M, Gabriele AL, Fera F, Valentino P, Bono F, Cenacchi G, Santoro G, Muglia M, Quattrone A. A novel Notch3 gene mutation not involving a cysteine residue in an Italian family with CADASIL. Neurology 2004; 63:561-4. [PMID: 15304596 DOI: 10.1212/01.wnl.0000133399.37716.84] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebrovascular disease leading to accumulating neurologic deficits and dementia. CADASIL has been linked to nucleotide substitutions and deletions in the Notch3 gene. All the mutations described until now lead to unpaired cysteine residue in the epidermal growth factor-like repeats. The authors report a family with CADASIL carrying a deletion in the Notch3 gene that did not involve a cysteine residue.
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Affiliation(s)
- R Mazzei
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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35
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Conforti FL, Muglia M, Mazzei R, Valentino P, Patitucci A, Bono F, Magariello A, Sprovieri T, Senderek J, Bergmann C, Nistico R, Gabriele AL, Peluso G, Quattrone A. A splice-junction mutation in SBF2 gene causes autosomal recessive charcot-marie-tooth disease (CMT4B2) in a family from southern italy. J Peripher Nerv Syst 2004. [DOI: 10.1111/j.1085-9489.2004.009209bn.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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36
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Muglia M, Criscuolo C, Magariello A, De Michele G, Scarano V, D'Adamo P, Ambrosio G, Gabriele AL, Patitucci A, Mazzei R, Conforti FL, Sprovieri T, Morgante L, Epifanio A, La Spina P, Valentino P, Gasparini P, Filla A, Quattrone A. Narrowing of the critical region in autosomal recessive spastic paraplegia linked to the SPG5 locus. J Peripher Nerv Syst 2004. [DOI: 10.1111/j.1085-9489.2004.009209bo.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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37
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Mazzei R, Gambardella A, Conforti FL, Magariello A, Patitucci A, Gabriele AL, Sprovieri T, Labate A, Valentino P, Bono F, Bonavita S, Zappia M, Muglia M, Quattrone A. Gene conversion events in adult-onset spinal muscular atrophy. Acta Neurol Scand 2004; 109:151-4. [PMID: 14705979 DOI: 10.1034/j.1600-0404.2003.00181.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the possible occurrence of a conversion event in three patients with adult-onset spinal muscular atrophy (SMA) type IV, which represents the mildest form within the spectrum of the SMA phenotype. MATERIAL AND METHODS We observed three patients with adult onset SMA and apparent isolated deletion of telomeric survival motor neuron (SMN1) exon 7. To distinguish between a deletion and a sequence conversion event of exon 7, these patients were analyzed in greater detail by a simple PCR-based assay. RESULTS Analysis by DdeI digestion showed products for both telomeric and centromeric copies of exon 8. These findings indicated a gene conversion event as the site for primer R111 was retained at least in one of two alleles. CONCLUSIONS These results provide first evidence that a conversion event may be also associated with adult-onset SMA, and further support the notion that a gene conversion event is usually associated with a milder SMA phenotype and a later onset of disease.
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Affiliation(s)
- R Mazzei
- Institutes of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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Muglia M, Criscuolo C, Magariello A, De Michele G, Scarano V, D'Adamo P, Ambrosio G, Gabriele AL, Patitucci A, Mazzei R, Conforti FL, Sprovieri T, Morgante L, Epifanio A, La Spina P, Valentino P, Gasparini P, Filla A, Quattrone A. Narrowing of the critical region in autosomal recessive spastic paraplegia linked to the SPG5 locus. Neurogenetics 2003; 5:49-54. [PMID: 14658060 DOI: 10.1007/s10048-003-0167-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2003] [Accepted: 11/06/2003] [Indexed: 01/07/2023]
Abstract
Hereditary spastic paraplegias are neurodegenerative disorders characterized clinically by progressive spasticity of the lower limbs. They are inherited as autosomal dominant, autosomal recessive, and X-linked traits. Four Italian families with autosomal recessive pure spastic paraplegia are reported. We show evidence of linkage to the SPG5 locus on chromosome 8p and our data reduce the candidate interval for SPG5 to the11-cM interval spanned by D8S285 and D8S544. We also report the search for mutations in five genes located in the region and their exclusion as candidates for SPG5.
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Affiliation(s)
- M Muglia
- Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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Labate A, Gambardella A, Messina D, Tammaro S, Le Piane E, Pirritano D, Cosco C, Doldo P, Mazzei R, Oliveri RL, Bosco D, Zappia M, Valentino P, Aguglia U, Quattrone A. Silent celiac disease in patients with childhood localization-related epilepsies. Epilepsia 2001; 42:1153-5. [PMID: 11580763 DOI: 10.1046/j.1528-1157.2001.45700.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate how many patients with a clinical picture of idiopathic childhood localization-related epilepsies may also have silent celiac disease (CD). This will help determine whether investigation for CD should be restricted to those patients with childhood partial epilepsy with occipital paroxysms (CPEO) or should be extended to all patients with childhood partial epilepsy (CPE) regardless of seizure type and electroencephalographic (EEG) paroxysms. METHODS The study group consisted of 72 patients (31 girls and 41 boys; mean age, 12.6 +/- 4.28 years; age at onset, 6.4 +/- 3.7 years) who were observed consecutively over a 5-year period and who received an initial diagnosis of idiopathic CPE. A diagnosis of CD was confirmed by using enzyme-linked immunosorbent assay (ELISA) to assess the presence of antigliadin antibodies and the immunofluorescent undirected test to assess the presence of antiendomysium antibodies. RESULTS Twenty-five patients had CPEO, whereas the remaining 47 had CPE with centrotemporal spikes (CPEC). None of the patients with CPEC had positive antibody tests. Of the 25 patients with CPEO, two (8%) had antiendomysium immunoglobulin (Ig) A antibodies. In both of these patients, the jejunal biopsy showed atrophy of the villi and hyperplasia of the crypts, consistent with a diagnosis of CD. Brain computed tomography (CT) was normal in one of these patients and revealed occipital corticosubcortical calcifications in the other. CONCLUSIONS Our study indicates that CD screening should be performed routinely only in patients with CPEO.
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Affiliation(s)
- A Labate
- Institute of Neurology, University Magna Graecia of Catanzaro, Italy
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40
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Gambardella A, Muglia M, Labate A, Magariello A, Gabriele AL, Mazzei R, Pirritano D, Conforti FL, Patitucci A, Valentino P, Zappia M, Quattrone A. Juvenile Huntington's disease presenting as progressive myoclonic epilepsy. Neurology 2001; 57:708-11. [PMID: 11524486 DOI: 10.1212/wnl.57.4.708] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 9-year-old girl, who had no family history of neurologic diseases in the first-degree relatives, had a 3-year history of progressive myoclonus epilepsy (PME). A thorough laboratory investigation was normal. As two sisters of her paternal grandmother were said to have Huntington's disease (HD), the authors looked for HD and found a CAG repeat expansion of 115 repeats. This diagnosis should be considered in addition to other causes in patients with PME. Moreover, the current case further supports the notion that HD should be considered even when a family history is not obvious.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine, Catanzaro, Italy
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41
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Quattrone A, Bono F, Oliveri RL, Gambardella A, Pirritano D, Labate A, Lucisano A, Valentino P, Zappia M, Aguglia U, Lavano A, Fera F, Pardatscher K. Cerebral venous thrombosis and isolated intracranial hypertension without papilledema in CDH. Neurology 2001; 57:31-6. [PMID: 11445624 DOI: 10.1212/wnl.57.1.31] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is evidence that patients with chronic daily headache (CDH) may have isolated intracranial hypertension without papilledema (IHWOP). Recent studies have emphasized that isolated IH may be due to cerebral venous thrombosis (CVT). OBJECTIVE To detect the occurrence of CVT in patients with CDH. METHODS The authors investigated the occurrence of CVT in 114 consecutive patients with CDH by using MR venography (MRV). A portion of these patients underwent a lumbar puncture (LP) to measure CSF pressure. MRV and LP were also performed in 28 age-matched control subjects. RESULTS In all the control subjects, both MRV and CSF pressure were normal. One hundred three of the 114 patients with CDH had normal MRV. Twenty-seven (Group 1) of these 103 patients underwent LP, and all of them had normal CSF pressure. Eleven (9.6%) of the 114 patients with CDH had CVT of one or both transverse sinuses. Six of these 11 patients had flowing abnormalities of one transverse sinus (Group 2), whereas the remaining five patients showed involvement of both transverse sinuses (Group 3). The CSF pressure of Group 2 was higher than that of either Group 1 or the control subjects, and one of the six patients showed isolated IHWOP. Patients of Group 3 displayed the highest CSF pressure, and four of five had isolated IHWOP. The headache profiles of patients with CDH and CVT did not differ from those of patients with CDH but normal MRV. CONCLUSIONS CVT, as detected by MRV, occurred in 9.6% of patients who presented with CDH. Almost half of the patients with CVT had isolated IHWOP. These results suggest that MRV may be a useful tool for selecting patients with CDH who should have LP to exclude isolated IHWOP.
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Affiliation(s)
- A Quattrone
- Institutes of Neurology, University Magna Graecia, Catanzaro, Italy.
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42
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Muglia M, Zappia M, Timmerman V, Valentino P, Gabriele AL, Conforti FL, De Jonghe P, Ragno M, Mazzei R, Sabatelli M, Nicoletti G, Patitucci AM, Oliveri RL, Bono F, Gambardella A, Quattrone A. Clinical and genetic study of a large Charcot-Marie-Tooth type 2A family from southern Italy. Neurology 2001; 56:100-3. [PMID: 11148244 DOI: 10.1212/wnl.56.1.100] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors report a large pedigree from southern Italy with Charcot-Marie-Tooth disease type 2A (CMT2A). The clinical picture was uniform and characterized by distal muscular weakness and atrophy in the lower limbs, reduced or absent tendon reflexes mainly in the lower limbs, and mild sensory impairment in the feet. Significant linkage to the CMT2A locus on chromosome 1p35-p36 was detected. Based on informative recombination in affected individuals, the authors mapped the CMT2A gene between D1S160 and D1S170.
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Affiliation(s)
- M Muglia
- Institute of Experimental Medicine and Biotechnology, National Research Council, Piano Lago di Mangone-Cosenza, Italy
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43
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Gambardella A, Annesi G, De Fusco M, Patrignani A, Aguglia U, Annesi F, Pasqua AA, Spadafora P, Oliveri RL, Valentino P, Zappia M, Ballabio A, Casari G, Quattrone A. A new locus for autosomal dominant nocturnal frontal lobe epilepsy maps to chromosome 1. Neurology 2000; 55:1467-71. [PMID: 11094099 DOI: 10.1212/wnl.55.10.1467] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is caused by mutations in the alpha4 subunit of the neuronal nicotinic acetylcholine receptor (CHRNA4) gene, mapping on chromosome 20q13.2. A second ADNFLE locus was mapped on chromosome 15q24. OBJECTIVE To report a new third ADNFLE locus on chromosome 1 in a large Italian family. METHODS The authors performed a clinical and genetic study in a large, three-generation ADNFLE family from southern Italy, including eight affected individuals and three obligate carriers. RESULTS The age at onset of seizures was around 9 years of age and all affected individuals manifested nocturnal partial seizures of frontal lobe origin. Interictal awake and sleep EEG recordings showed no definite epileptiform abnormalities in most patients. Ictal video-EEG showed that the attacks were partial seizures with a frontal lobe semiology. Intellectual and neurologic examinations, and brain CT or MRI results were always normal. Carbamazepine was effective in all treated patients. Exclusion mapping of the known loci linked to ADNFLE-ENFL1, and ENFL2, on chromosomes 20q13.2 and 15q24-was performed on the pedigree before starting the genome-wide linkage analysis. The whole genome scan mapping allowed the identification of a new ADNFLE locus spanning the pericentromeric region of chromosome 1. CONCLUSIONS The authors provided evidence for a third locus associated to autosomal dominant nocturnal frontal lobe epilepsy on chromosome 1. Among the known genes mapping within this critical region, the ss2 subunit of the nicotinic receptor (CHRNB2) represents the most obvious candidate.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine, Catanzaro, Italy
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44
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Donato G, Valentino P, Santucci M, Amorosi A, Pittelli M, Maltese L, Volpentesta G, Lavano A, Chirchiglia D, Iannello AN, Ferraro G, Signorelli CD. Calf pseudohypertrophy in a patient with double neurogenic pathology. Clin Neuropathol 2000; 19:142-4. [PMID: 14606588] [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: 04/27/2023] Open
Abstract
A pseudohypertrophy of the calf can be rarely associated with neurogenic pathologies as S-1 radiculopathy, poliomyelitis, spinal muscular atrophy, traumatic lesions of peripheral nerves, intraspinal neurinoma. The causes of this particular phenomenon are unknown. The authors present the case of a 52-year-old man with an enlargement of the left calf suffering from a mild form of spinal paralytic poliomyelitis in the early childhood and episodes of severe left sciatica in the last four years. Electromyography demonstrated a pattern of denervation in both legs and an H-reflex absent when the left tibial nerve was stimulated. An open muscle biopsy of the left calf was performed. Light microscopic and ultrastructural examination of the muscle confirmed the presence of a pattern of "neurogenic type" pseudohypertrophy. Our results could be interesting for the understanding of the mechanism of neurogenic pseudohypertrophy. This case suggests that timing of stimulus or "dose" of denervation may be important factors in such a phenomenon.
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Affiliation(s)
- G Donato
- Department of Neurosurgery, University of Catanzaro, School of Medicine, Catanzaro, Italy
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45
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Aguglia U, Annesi G, Pasquinelli G, Spadafora P, Gambardella A, Annesi F, Pasqua AA, Cavalcanti F, Crescibene L, Bagalà A, Bono F, Oliveri RL, Valentino P, Zappia M, Quattrone A. Vitamin E deficiency due to chylomicron retention disease in Marinesco-Sjögren syndrome. Ann Neurol 2000. [PMID: 10665502 DOI: 10.1002/1531-8249(200002)47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report on 2 brothers (aged 19 and 12 years) with Marinesco-Sjögren syndrome who also had very low serum vitamin E concentrations with an absence of postprandial chylomicrons. The molecular study ruled out ataxia with isolated vitamin E deficiency, abetalipoproteinemia, and hypobetalipoproteinemia. The electron microscopy of the intestinal mucosa was consistent with a chylomicron retention disease. We speculate that both chylomicron retention disease and Marinesco-Sjögren syndrome are related to defects in a gene crucial for the assembly or secretion of the chylomicron particles, leading to very low serum levels of vitamin E.
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Affiliation(s)
- U Aguglia
- Institute of Neurology, School of Medicine, University of Catanzaro, Italy
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46
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Oliveri RL, Cittadella R, Sibilia G, Manna I, Valentino P, Gambardella A, Aguglia U, Zappia M, Romeo N, Andreoli V, Bono F, Caracciolo M, Quattrone A. APOE and risk of cognitive impairment in multiple sclerosis. Acta Neurol Scand 1999; 100:290-5. [PMID: 10536914 DOI: 10.1111/j.1600-0404.1999.tb00398.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The APOE gene polymorphism and the -491 A/T polymorphism in its regulatory region have been associated with an increased risk for developing Alzheimer's disease. We examined these polymorphisms in multiple sclerosis (MS) patients, to determine if a genetic predisposition may explain the risk for developing cognitive decline in MS. MATERIAL AND METHODS Eighty-nine relapsing-remitting and secondary progressive MS patients underwent to a full neuropsychological battery as well as to determination of APOE and -491 A/T polymorphisms. Genetic analysis was also performed in 107 population controls. RESULTS The APOE polymorphism was not associated with the risk of cognitive impairment in MS patients. The AA genotype of the -491 A/T polymorphism in the APOE regulatory region was more frequent in cognitively impaired than in cognitively preserved MS subjects. CONCLUSION The AA homozygous state of the -491 A/T polymorphism of the APOE regulatory region is associated with cognitive impairment in patients with MS.
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Affiliation(s)
- R L Oliveri
- Institute of Neurology, Department of Medical Sciences, University of Catanzaro, Italy
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47
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Gambardella A, Bono F, Muglia M, Valentino P, Quattrone A. Autosomal recessive hereditary motor and sensory neuropathy with focally folded myelin sheaths (CMT4B). Ann N Y Acad Sci 1999; 883:47-55. [PMID: 10586229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Hereditary motor and sensory neuropathy with focally folded myelin sheaths, or Charcot-Marie-Tooth neuropathy type 4B (CMT4B), is a distinct clinical and genetic entity belonging to the heterogeneous group of autosomal recessive demyelinating neuropathies. We first described a large inbred pedigree with 10 patients affected by CMT4B, which enabled us to uncover the genetic findings, clinical spectrum, and natural history of such a disorder. The clinical picture was characterized by infantile onset with progressive symmetric distal and proximal muscular weakness. Using homozygosity mapping and haplotype sharing analysis, we found evidence of linkage of chromosome 11q23. We then identified a second unrelated family in which two individuals were affected with CMT4B. Although the clinical findings were similar to those previously reported, we excluded the disease locus segregating in this smaller pedigree from the 11q23 region. We thus provided evidence for a second locus causing the CMT4B phenotype. All these findings indicate that CMT4B seems to be phenotypically quite homogeneous, but is genetically heterogeneous.
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Affiliation(s)
- A Gambardella
- Institute of Neurology School of Medicine Catanzaro, Italy
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48
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Gambardella A, Valentino P, Annesi G, Oliveri RL, Bono F, Mazzei RL, Conforti FL, Aguglia U, Zappia M, Pardatscher K, Quattrone A. Hyperekplexia in a patient with a brainstem vascular anomaly. Acta Neurol Scand 1999; 99:255-9. [PMID: 10225359 DOI: 10.1111/j.1600-0404.1999.tb07358.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe a patient with a clinical picture suggestive of idiopathic hyperekplexia (IH), who was later found to harbour a subtle brainstem vascular anomaly. PATIENT A 35-year-old man, 4 years earlier, developed sudden jumping and falling in response to unexpected sensory stimuli. RESULTS Neurological examination was normal. Electromyography showed an excessively large and non-habituating motor startle response. There were no mutations of the alpha1 subunit of the inhibitory glycine receptor which cause hereditary hyperekplexia. Although all these findings were consistent with a diagnosis of IH, a blink reflex study showed an enhanced recovery curve suggestive of a brainstem lesion. A detailed MRI study revealed a subtle vascular anomaly involving the lower brainstem. CONCLUSION This is the first report of sporadic hyperekplexia related to a brainstem vascular anomaly. Subtle damage to the brainstem should always be excluded in patients with sporadic hyperekplexia, regardless of the coexistence of additional clear-cut neurological symptoms.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine, University of Catanzaro, Italy
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49
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Gambardella A, Mazzei R, Toscano A, Annesi G, Pasqua A, Annesi F, Quattrone F, Oliveri RL, Valentino P, Bono F, Aguglia U, Zappia M, Vita G, Quattrone A. Spinal muscular atrophy due to an isolated deletion of exon 8 of the telomeric survival motor neuron gene. Ann Neurol 1998; 44:836-9. [PMID: 9818944 DOI: 10.1002/ana.410440522] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patients with autosomal recessive spinal muscular atrophy (SMA) usually carry a homozygous deletion of exons 7 and 8 of the telomeric survival motor neuron (SMN(T)) gene, although an isolated deletion of SMN(T) exon 8 has never been found. We now report on 2 patients with the typical features of SMA types II and III, who carried a homozygous deletion of SMN(T) exon 8 but retained SMN(T) exon 7. Importantly, to exclude a sequence conversion event of telomeric exon 8, we amplified a fragment that spanned exons 7 and 8 of the SMN gene. The resulting 1,010-base pair (bp) fragments were subjected to nested polymerase chain reaction (PCR) of exon 7. The subsequent restriction analysis failed to show any products of telomeric exon 7, as the site for primer 541C1120 was lost in both alleles. These findings indicate a homozygous deletion of SMN(T) exon 8. Direct sequencing of the cloned 1,010-bp fragment further confirmed that these 2 SMA patients did not possess telomeric exon 8. The more severely affected child also showed a deletion of the neuronal apoptosis inhibitory protein (NAIP) gene. The present findings provide evidence that an isolated deletion of SMN(T) exon 8 is associated with the milder subtypes of SMA. Our data also demonstrate that the additional deletion of the NAIP gene exacerbates the severity of the disease.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine, Catanzaro, Italy
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50
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Gambardella A, Pasquinelli G, Cittadella R, Bono F, Oliveri RL, Valentino P, Zappia M, Quattrone A, Aguglia U. Kufs' disease presenting as late-onset epilepsia partialis continua. Neurology 1998; 51:1180-2. [PMID: 9781553 DOI: 10.1212/wnl.51.4.1180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 64-year-old woman, who had no personal or family history of neurologic diseases, had an 18-month history of epilepsia partialis continua (EPC) associated with a moderate intellectual deterioration and subtle extrapyramidal rigidity. There was no photosensitive response. A thorough laboratory investigation was unremarkable. A biopsy of the rectal mucosa revealed abundant fingerprint profiles diagnostic of Kufs' disease (KD). Our case expands the clinical picture of KD and suggests that such a diagnosis should be considered in adult-onset EPC.
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Affiliation(s)
- A Gambardella
- Institute of Neurology, School of Medicine Catanzaro, Italy
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