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Tepedino MF, Avallone AR, Abate F, Serio M, Caterino M, Erro R, Pellecchia MT, Barone P, Picillo M. Longitudinal change of energy expenditure, body composition and dietary habits in Progressive Supranuclear Palsy patients. Neurol Sci 2024:10.1007/s10072-024-07533-5. [PMID: 38639893 DOI: 10.1007/s10072-024-07533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Alterations in metabolic status, body composition, and food intake are present in all neurodegenerative diseases. Aim of this study was to detect the progression of these changes in Progressive Supranuclear Palsy (PSP). METHODS We conducted a longitudinal study of 15 patients with PSP. The assessments were performed at baseline (T0) and after 7(IQR = 5) months of follow-up (T1). We collected anthropometric measures including body weight, height, body mass index and waist circumference, metabolic parameters through indirect calorimeters, body composition using bioimpedance analysis, and dietary habits with a validated questionnaire. PSP-rating scale (PSP-rs) was used to evaluate disease severity and dysphagia. RESULTS The majority of patients (66.66%) presented PSP-Richardson Syndrome and 33.33% the other variant syndromes of the disease. At T1 there was a decrease in intake of total daily calories (p < 0.001), proteins (p < 0.001), fibers (p = 0.001), calcium (p = 0.008), iron (p < 0.001), zinc (0.034), vitamin E (p = 0.006) and folates (p = 0.038) compared to T0. No other changes were found. As for T1 data, no significant differences were shown according to disease phenotypes or the presence of clinically significant dysphagia for solids. CONCLUSIONS Within a mid-term follow up, PSP patients presented reduced caloric and proteins intake regardless the presence of dysphagia. The PSP-rs is likely not adequate to assess dysphagia, which should be investigated by specific clinical scales or instrumental examinations. With the goal of maintaining adequate nutritional status, the administration of protein and vitamin supplements should be considered even in the absence of dysphagia evidenced by the rating scales.
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Affiliation(s)
- Maria Francesca Tepedino
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Anna Rosa Avallone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Filomena Abate
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Marina Serio
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Miriam Caterino
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Via Allende, 84081, Baronissi, Salerno, Italy.
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Cappiello A, Abate F, Adamo S, Tepedino MF, Donisi L, Ricciardi C, Avallone AR, Caterino M, Cuoco S, Pellecchia MT, Amboni M, Barone P, Erro R, Picillo M. Direct Current Stimulation of Prefrontal Cortex Is Not Effective in Progressive Supranuclear Palsy: A Randomized Trial. Mov Disord 2024. [PMID: 38468604 DOI: 10.1002/mds.29774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is a rare 4R-tauopathy. Transcranial direct current stimulation (tDCS) may improve specific symptoms. OBJECTIVES This randomized, double-blinded, sham-controlled trial aimed at verifying the short-, mid-, and long-term effect of multiple sessions of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) cortex in PSP. METHODS Twenty-five patients were randomly assigned to active or sham stimulation (2 mA for 20 minute) for 5 days/week for 2 weeks. Participants underwent assessments at baseline, after the 2-week stimulation protocol, then after 45 days and 3 months from baseline. Primary outcomes were verbal and semantic fluency. The efficacy was verified with analysis of covariance. RESULTS We failed to detect a significant effect of active stimulation on primary outcomes. Stimulation was associated to worsening of specific behavioral complaints. CONCLUSIONS A 2-week protocol of anodal left DLPFC tDCS is not effective in PSP. Specific challenges in running symptomatic clinical trials with classic design are highlighted. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Arianna Cappiello
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Filomena Abate
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Sarah Adamo
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Maria Francesca Tepedino
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Leandro Donisi
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Anna Rosa Avallone
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Miriam Caterino
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Sofia Cuoco
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Marianna Amboni
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
- IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Roberto Erro
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Marina Picillo
- Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
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Cuoco S, Blundo C, Ricci M, Cappiello A, Bisogno R, Carotenuto I, Avallone AR, Erro R, Pellecchia MT, Amboni M, Barone P, Picillo M. Psychometric properties of the Caregiver's inventory neuropsychological diagnosis dementia (CINDD) in mild cognitive impairment and dementia. J Neural Transm (Vienna) 2024; 131:173-180. [PMID: 38200268 PMCID: PMC10791830 DOI: 10.1007/s00702-023-02728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The Caregiver's Inventory Neuropsychological Diagnosis Dementia (CINDD) is an easy tool designed to quantify cognitive, behavioural and functional deficits of patients with cognitive impairment. Aim of the present study was to analyse the psychometric properties of the CINDD in Mild Cognitive Impairment (MCI) and Dementia (D). DESIGN, SETTING AND PARTICIPANTS The CINDD, composed by 9 sub-domains, was administered to fifty-six caregivers of patients with different types of dementia (D) and 44 caregivers of patients with MCI. All patients underwent an extensive neuropsychological assessment, the Neuropsychiatric Inventory (NPI) and functional autonomy scales. The reliability, convergent construct validity and possible cut-off of CINND were measured by Cronbach's alpha (α), Pearson's correlation and ROC analysis, respectively. RESULTS The D and MCI patients differed only for age (p=0.006). The internal consistency of CINDD was high (α= 0.969). The α-value for each CINDD domain was considered acceptable, except the mood domain (α=0.209). The CINDD total score correlated with cognitive screening tests; each domain of the CINDD correlated with the corresponding score from either tests or NPI (p<0.05), except for visuo-spatial perception skills and apathy. A screening cut-off equal to 59, can be used discriminate D from MCI (Sensitivity=0.70, Specificity=0.57). CONCLUSION The CINDD is a feasible, accurate and reliable tool for the assessment of cognitive and behavioural difficulties in patients with different degree of cognitive impairment. It may be used to quantify and monitor caregiver-reported ecological data in both clinical and research settings.
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Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Carlo Blundo
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Monica Ricci
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Arianna Cappiello
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Rossella Bisogno
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Immacolata Carotenuto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Anna Rosa Avallone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marianna Amboni
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
- IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy.
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