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Xie J, Yi Q, Wu Y, Zheng Y, Liu Y, Macerollo A, Fu H, Xu Y, Zhang J, Behera A, Fan C, Frangi AF, Liu J, Lu Q, Qi H, Zhao Y. Deep segmentation of OCTA for evaluation and association of changes of retinal microvasculature with Alzheimer's disease and mild cognitive impairment. Br J Ophthalmol 2024; 108:432-439. [PMID: 36596660 PMCID: PMC10894818 DOI: 10.1136/bjo-2022-321399] [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: 04/15/2022] [Accepted: 12/17/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Optical coherence tomography angiography (OCTA) enables fast and non-invasive high-resolution imaging of retinal microvasculature and is suggested as a potential tool in the early detection of retinal microvascular changes in Alzheimer's Disease (AD). We developed a standardised OCTA analysis framework and compared their extracted parameters among controls and AD/mild cognitive impairment (MCI) in a cross-section study. METHODS We defined and extracted geometrical parameters of retinal microvasculature at different retinal layers and in the foveal avascular zone (FAZ) from segmented OCTA images obtained using well-validated state-of-the-art deep learning models. We studied these parameters in 158 subjects (62 healthy control, 55 AD and 41 MCI) using logistic regression to determine their potential in predicting the status of our subjects. RESULTS In the AD group, there was a significant decrease in vessel area and length densities in the inner vascular complexes (IVC) compared with controls. The number of vascular bifurcations in AD is also significantly lower than that of healthy people. The MCI group demonstrated a decrease in vascular area, length densities, vascular fractal dimension and the number of bifurcations in both the superficial vascular complexes (SVC) and the IVC compared with controls. A larger vascular tortuosity in the IVC, and a larger roundness of FAZ in the SVC, can also be observed in MCI compared with controls. CONCLUSION Our study demonstrates the applicability of OCTA for the diagnosis of AD and MCI, and provides a standard tool for future clinical service and research. Biomarkers from retinal OCTA images can provide useful information for clinical decision-making and diagnosis of AD and MCI.
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Affiliation(s)
- Jianyang Xie
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Quanyong Yi
- Ningbo Eye Hospital, Ningbo, Zhejiang, China
| | - Yufei Wu
- Department of Ophthalmology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yalin Zheng
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Yonghuai Liu
- Department of Computer Science, Edge Hill University, Ormskirk, UK
| | - Antonella Macerollo
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Huazhu Fu
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Yanwu Xu
- Intelligent Healthcare Unit, Baidu Inc, Beijing, Haidian, China
| | - Jiong Zhang
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Ardhendu Behera
- Department of Computer Science, Edge Hill University, Ormskirk, UK
| | - Chenlei Fan
- Department of Neurology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | | | - Jiang Liu
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Qinkang Lu
- Department of Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hong Qi
- Ophthalmology, Peking University Third Hospital, Haidian, Beijing, China
| | - Yitian Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, Zhejiang, China
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Shepherd H, Heartshorne R, Osman-Farah J, Macerollo A. Dual target deep brain stimulation for complex essential and dystonic tremor - A 5-year follow up. J Neurol Sci 2024; 457:122887. [PMID: 38295533 DOI: 10.1016/j.jns.2024.122887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Essential tremor (ET) is characterized by action tremor of the upper limbs, head tremor and voice tremor. Dystonic tremor (DT) is produced by muscle contractions in a body affected by dystonia. Deep brain stimulation (DBS) of ventral intermediate nucleus of the thalamus (VIM) is the most well-known advanced treatment for medication-refractory tremor. However, decline in efficacy overtime has led to explore other targets. This study aimed to measure the efficacy of bilateral dual targeting ViM/caudal Zona Incerta (cZI) stimulation on tremor control. A secondary aim was to evaluate if there was a difference in the efficacy between ET and DT. METHODS 36 patients were retrospectively recruited at the Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and then at 1-year, 3-years, and 5-years post-operatively with the following scales: Fahn-Tolosa-Marin tremor rating (FTMTR) scale, EuroQol-5D, and Hospital Anxiety and Depression Scale. RESULTS Bilateral ViM-cZI DBS significantly improved overall tremor score by 45.1% from baseline to 3-years post-operatively (p < 0.001). It continued to show improvement in overall FTMTR score by 30.7% at 5-years but this failed to meet significance. However, there was no significant improvement of mood or quality of life (QoL) scores. ET group on average showed a significant better clinical outcome compared to the DT group (p > 0.001). CONCLUSIONS Our study found that bilateral ViM-cZI DBS treatment had a favourable effect on motor symptoms sustained over the 5-years in tremor patients, especially in ET group. There was limited effect on mood and QoL with similar trends in outcomes for both tremor types.
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Affiliation(s)
- Hilary Shepherd
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; University of Liverpool Medical School, Liverpool, UK.
| | - Rosie Heartshorne
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Jibril Osman-Farah
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
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Reilly S, Dhaliwal S, Arshad U, Macerollo A, Husain N, Costa AD. The effects of rivastigmine on neuropsychiatric symptoms in the early stages of Parkinson's disease: A systematic review. Eur J Neurol 2024; 31:e16142. [PMID: 37975761 DOI: 10.1111/ene.16142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/14/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND PURPOSE Neuropsychiatric symptoms including depression, apathy and psychosis occur frequently in patients with Parkinson's disease. A subgroup of patients develop cognitive impairment, which may increase the risk of falls due to reduced attention. The acetylcholinesterase inhibitor rivastigmine is beneficial in Parkinson's disease dementia, but whether the use of rivastigmine is effective earlier in the disease course is unclear. The aim of this systematic review was to assess the evidence for rivastigmine in the treatment of neuropsychiatric symptoms in Parkinson's disease without dementia. METHODS Embase, Medline, PsychINFO, Cochrane CENTRAL, NGLC, National Institute for Health and Care Excellence Evidence and medRxiv.org were searched for studies with terms relating to population (Parkinson's disease) and intervention (rivastigmine). Of 1922 references identified, 358 were duplications. Following title and abstract review, 1331 articles were excluded. After full-text review, nine articles remained. RESULTS Outcomes were heterogenous, therefore, the results are presented in narrative form. The articles included six randomized controlled trials, two open-label trials and one case series. Outcome measures included: time to develop psychosis; frequency of rapid eye movement sleep behaviour disorder (RBD) episodes; apathy; gait variability; falls; cognitive ability; Neuropsychiatric Inventory score; and regional spontaneous brain activity. CONCLUSIONS There is evidence that rivastigmine is beneficial for RBD and apathy in Parkinson's disease patients without dementia. There is high level evidence that rivastigmine reduces falls, which may be due to improved attention. The impact of rivastigmine on psychotic symptoms is less clear, but is supported by current theoretical models which involve acetylcholine dysfunction in the generation of visual hallucinations in Parkinson's disease.
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Affiliation(s)
- Siobhan Reilly
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Usman Arshad
- Pakistan Institute of Living and Learning, Karachi, Pakistan
- The University of Manchester, Manchester, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Nusrat Husain
- The University of Manchester, Manchester, UK
- Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Antonio Da Costa
- Peninsula Health, Frankston South, Melbourne, Victoria, Australia
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Ibrahim Y, Xie J, Macerollo A, Sardone R, Shen Y, Romano V, Zheng Y. A Systematic Review on Retinal Biomarkers to Diagnose Dementia from OCT/OCTA Images. J Alzheimers Dis Rep 2023; 7:1201-1235. [PMID: 38025800 PMCID: PMC10657718 DOI: 10.3233/adr-230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Background Traditional methods for diagnosing dementia are costly, time-consuming, and somewhat invasive. Since the retina shares significant anatomical similarities with the brain, retinal abnormalities detected via optical coherence tomography (OCT) and OCT angiography (OCTA) have been studied as a potential non-invasive diagnostic tool for neurodegenerative disorders; however, the most effective retinal changes remain a mystery to be unraveled in this review. Objective This study aims to explore the relationship between retinal abnormalities in OCT/OCTA images and cognitive decline as well as evaluating biomarkers' effectiveness in detecting neurodegenerative diseases. Methods A systematic search was conducted on PubMed, Web of Science, and Scopus until December 2022, resulted in 64 papers using agreed search keywords, and inclusion/exclusion criteria. Results The superior peripapillary retinal nerve fiber layer (pRNFL) is a trustworthy biomarker to identify most Alzheimer's disease (AD) cases; however, it is inefficient when dealing with mild AD and mild cognitive impairment (MCI). The global pRNFL (pRNFL-G) is another reliable biomarker to discriminate frontotemporal dementia from mild AD and healthy controls (HCs), moderate AD and MCI from HCs, as well as identifing pathological Aβ42/tau in cognitively healthy individuals. Conversely, pRNFL-G fails to realize mild AD and the progression of AD. The average pRNFL thickness variation is considered a viable biomarker to monitor the progression of AD. Finally, the superior and average pRNFL thicknesses are considered consistent for advanced AD but not for early/mild AD. Conclusions Retinal changes may indicate dementia, but further research is needed to confirm the most effective biomarkers for early and mild AD.
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Affiliation(s)
- Yehia Ibrahim
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
| | - Jianyang Xie
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
| | - Antonella Macerollo
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Rodolfo Sardone
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
- Statistics and Epidemiology Unit, Local Healthcare Authority of Taranto, Taranto, Italy
| | - Yaochun Shen
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, UK
| | - Vito Romano
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Yalin Zheng
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
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Khanom AA, Franceschini PR, Lane S, Osman-Farah J, Macerollo A. Bilateral globus pallidus internus (GPi) deep brain stimulation for cervical dystonia: Effects on motor and non-motor symptoms within 5 years follow. J Neurol Sci 2023; 452:120752. [PMID: 37542824 DOI: 10.1016/j.jns.2023.120752] [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: 05/03/2023] [Revised: 07/04/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Cervical Dystonia ("CD") is a movement disorder characterised by sustained muscle contractions in the neck, causing involuntary posturing. Deep brain stimulation ("DBS") of the globus pallidal internus (GPi) is advanced treatment for pharmaco-refractory patients. As CD is a rare disease, cohort studies are often limited to patients of heterogenous disease profile, small sample size or short follow-up. This study firstly aimed to measure the efficacy of GPi-DBS on motor and non-motor symptoms of CD. A secondary aim was to evaluate if clinical factors - such as age, disease duration and baseline disease severity - influence variability of motor outcomes. METHODS 37 idiopathic CD patients were recruited from movement disorders clinics at The Walton NHS Foundation Trust, Liverpool, UK. Patients were assessed pre-operatively, and 1 year, 3 years and 5 years post-operatively with the following clinical scales: Toronto Western Spasmodic Torticollis Rating Scale ("TWSTRS"), Hospital Anxiety and Depression Scale and EuroQuol-5D. RESULTS GPI-DBS significantly improved overall TWSTRS scores by 57% from baseline to 5Y FU (p < 0.001). It also significantly improved TWSTRS severity, disability, and pain sub-scores by 72%, 59% and 46% respectively. We did not find a significant improvement in mood or quality of life scores at 5 years. Similarly, clinical factors at baseline did not correlate with variability in motor outcome. CONCLUSION We concluded that GPi-DBS is an effective treatment for motor symptoms and pain in CD. There was limited effect on mood and QoL, and no clinical predictive factors of outcome were identified.
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Affiliation(s)
- Anjum Aarifa Khanom
- University of Liverpool Medical School, Liverpool, UK; The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Paulo Roberto Franceschini
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; Functional Neurosurgery Department, Universidade de Caxias do Sul, Brazil
| | - Steven Lane
- Institute of Data Health Sciences, University of Liverpool, UK
| | - Jibril Osman-Farah
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.
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Martino D, Karnik V, Bhidayasiri R, Hall DA, Hauser RA, Macerollo A, Pringsheim TM, Truong D, Factor SA, Skorvanek M, Schrag A. Scales for Antipsychotic-Associated Movement Disorders: Systematic Review, Critique, and Recommendations. Mov Disord 2023; 38:1008-1026. [PMID: 37081740 DOI: 10.1002/mds.29392] [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: 11/14/2022] [Revised: 02/13/2023] [Accepted: 03/13/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Antipsychotic-associated movement disorders remain common and disabling. Their screening and assessment are challenging due to clinical heterogeneity and different use of nomenclature between psychiatrists and neurologists. OBJECTIVE An International Parkinson and Movement Disorder Society subcommittee aimed to rate psychometric quality of severity and screening instruments for antipsychotic-associated movement disorders. METHODS Following the methodology adopted by previous International Parkinson and Movement Disorders Society subcommittee papers, instruments for antipsychotic-associated movement disorders were reviewed, applying a classification as "recommended," "recommended with caveats," "suggested," or "listed." RESULTS Our review identified 23 instruments. The highest grade of recommendation reached is "recommended with caveats," assigned to seven severity rating instruments (Extrapyramidal Symptoms Rating Scale, Barnes Akathisia Rating Scale, Abnormal Involuntary Movements Scale, Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre involuntary movements scale, Simpson Angus Scale, and Matson Evaluation of Drug Side effects). Only three of these seven (Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre, Matson Evaluation of Drug Side effects) were also screening instruments. Their main caveats are insufficient demonstration of psychometric properties (internal consistency, skewing, responsiveness to change) and long duration of administration. Eight "suggested" instruments did not meet requirements for the "recommended" grade also because of insufficient psychometric validation. Other limitations shared by several instruments are lack of comprehensiveness in assessing the spectrum of antipsychotic-associated movement disorders and ambiguous nomenclature. CONCLUSIONS The high number of instruments "recommended with caveats" does not support the need for developing new instruments for antipsychotic-associated movement disorders. However, addressing the caveats with new psychometric studies and revising existing instruments to improve the clarity of their nomenclature are recommended next steps. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Vikram Karnik
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Deborah A Hall
- Division of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert A Hauser
- Parkinson's Disease and Movement Disorders Center, Parkinson Foundation Center of Excellence, Department of Neurology, University of South Florida, Tampa, Florida, USA
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada
| | - Daniel Truong
- The Parkinson's and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, California, USA
| | - Stewart A Factor
- Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matej Skorvanek
- Department of Neurology, P.J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Anette Schrag
- Department of Clinical Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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Andrews L, Keller SS, Osman-Farah J, Macerollo A. A structural magnetic resonance imaging review of clinical motor outcomes from deep brain stimulation in movement disorders. Brain Commun 2023; 5:fcad171. [PMID: 37304793 PMCID: PMC10257440 DOI: 10.1093/braincomms/fcad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/05/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
Patients with movement disorders treated by deep brain stimulation do not always achieve successful therapeutic alleviation of motor symptoms, even in cases where surgery is without complications. Magnetic resonance imaging (MRI) offers methods to investigate structural brain-related factors that may be predictive of clinical motor outcomes. This review aimed to identify features which have been associated with variability in clinical post-operative motor outcomes in patients with Parkinson's disease, dystonia, and essential tremor from structural MRI modalities. We performed a literature search for articles published between 1 January 2000 and 1 April 2022 and identified 5197 articles. Following screening through our inclusion criteria, we identified 60 total studies (39 = Parkinson's disease, 11 = dystonia syndromes and 10 = essential tremor). The review captured a range of structural MRI methods and analysis techniques used to identify factors related to clinical post-operative motor outcomes from deep brain stimulation. Morphometric markers, including volume and cortical thickness were commonly identified in studies focused on patients with Parkinson's disease and dystonia syndromes. Reduced metrics in basal ganglia, sensorimotor and frontal regions showed frequent associations with reduced motor outcomes. Increased structural connectivity to subcortical nuclei, sensorimotor and frontal regions was also associated with greater motor outcomes. In patients with tremor, increased structural connectivity to the cerebellum and cortical motor regions showed high prevalence across studies for greater clinical motor outcomes. In addition, we highlight conceptual issues for studies assessing clinical response with structural MRI and discuss future approaches towards optimizing individualized therapeutic benefits. Although quantitative MRI markers are in their infancy for clinical purposes in movement disorder treatments, structural features obtained from MRI offer the powerful potential to identify candidates who are more likely to benefit from deep brain stimulation and provide insight into the complexity of disorder pathophysiology.
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Affiliation(s)
- Luke Andrews
- Correspondence to: Luke Andrews The BRAIN Lab, University of Liverpool Cancer Research Centre 200 London Rd, Liverpool L3 9TA, United Kingdom E-mail:
| | - Simon S Keller
- The Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L3 9TA, UK
| | - Jibril Osman-Farah
- Department of Neurology and Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool L97LJ, UK
| | - Antonella Macerollo
- Correspondence may also be sent to: Antonella Macerollo. The Walton Centre NHS Trust, Lower Lane Liverpool L9 7LJ, United Kingdom E-mail:
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Beudel M, Macerollo A, Brown MJN, Chen R. Editorial: The role of the basal ganglia in somatosensory-motor interactions: evidence from neurophysiology and behavior, volume II. Front Hum Neurosci 2023; 17:1211465. [PMID: 37266324 PMCID: PMC10230070 DOI: 10.3389/fnhum.2023.1211465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 06/03/2023] Open
Affiliation(s)
- Martijn Beudel
- Department of Neurology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands
| | - Antonella Macerollo
- The Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Matt J. N. Brown
- Department of Kinesiology, California State University Sacramento, Sacramento, CA, United States
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Bergamino M, Keeling EG, Ray NJ, Macerollo A, Silverdale M, Stokes AM. Structural connectivity and brain network analyses in Parkinson's disease: A cross-sectional and longitudinal study. Front Neurol 2023; 14:1137780. [PMID: 37034088 PMCID: PMC10076650 DOI: 10.3389/fneur.2023.1137780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Parkinson's disease (PD) is an idiopathic disease of the central nervous system characterized by both motor and non-motor symptoms. It is the second most common neurodegenerative disease. Magnetic resonance imaging (MRI) can reveal underlying brain changes associated with PD. Objective In this study, structural connectivity and white matter networks were analyzed by diffusion MRI and graph theory in a cohort of patients with PD and a cohort of healthy controls (HC) obtained from the Parkinson's Progression Markers Initiative (PPMI) database in a cross-sectional analysis. Furthermore, we investigated longitudinal changes in the PD cohort over 36 months. Result Compared with the control group, participants with PD showed lower structural connectivity in several brain areas, including the corpus callosum, fornix, and uncinate fasciculus, which were also confirmed by a large effect-size. Additionally, altered connectivity between baseline and after 36 months was found in different network paths inside the white matter with a medium effect-size. Network analysis showed trends toward lower network density in PD compared with HC at baseline and after 36 months, though not significant after correction. Significant differences were observed in nodal degree and strength in several nodes. Conclusion In conclusion, altered structural and network metrics in several brain regions, such as corpus callosum, fornix, and cingulum were found in PD, compared to HC. We also report altered connectivity in the PD group after 36 months, reflecting the impact of both PD pathology and aging processes. These results indicate that structural and network metrics might yield insight into network reorganization that occurs in PD.
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Affiliation(s)
- Maurizio Bergamino
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States
- *Correspondence: Maurizio Bergamino
| | - Elizabeth G. Keeling
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States
- School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Nicola J. Ray
- Health, Psychology and Communities Research Centre, Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Antonella Macerollo
- Neurology Department, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, School of Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Monty Silverdale
- Manchester Centre for Clinical Neurosciences, University of Manchester, Manchester, United Kingdom
| | - Ashley M. Stokes
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States
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Chen R, Berardelli A, Bhattacharya A, Bologna M, Chen KHS, Fasano A, Helmich RC, Hutchison WD, Kamble N, Kühn AA, Macerollo A, Neumann WJ, Pal PK, Paparella G, Suppa A, Udupa K. Clinical neurophysiology of Parkinson's disease and parkinsonism. Clin Neurophysiol Pract 2022; 7:201-227. [PMID: 35899019 PMCID: PMC9309229 DOI: 10.1016/j.cnp.2022.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/11/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023] Open
Abstract
This review is part of the series on the clinical neurophysiology of movement disorders and focuses on Parkinson’s disease and parkinsonism. The pathophysiology of cardinal parkinsonian motor symptoms and myoclonus are reviewed. The recordings from microelectrode and deep brain stimulation electrodes are reported in detail.
This review is part of the series on the clinical neurophysiology of movement disorders. It focuses on Parkinson’s disease and parkinsonism. The topics covered include the pathophysiology of tremor, rigidity and bradykinesia, balance and gait disturbance and myoclonus in Parkinson’s disease. The use of electroencephalography, electromyography, long latency reflexes, cutaneous silent period, studies of cortical excitability with single and paired transcranial magnetic stimulation, studies of plasticity, intraoperative microelectrode recordings and recording of local field potentials from deep brain stimulation, and electrocorticography are also reviewed. In addition to advancing knowledge of pathophysiology, neurophysiological studies can be useful in refining the diagnosis, localization of surgical targets, and help to develop novel therapies for Parkinson’s disease.
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Affiliation(s)
- Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Alfonso Fasano
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Rick C Helmich
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology and Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - William D Hutchison
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Departments of Surgery and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Andrea A Kühn
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Antonella Macerollo
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom.,The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Wolf-Julian Neumann
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kaviraja Udupa
- Department of Neurophysiology National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
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11
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Healy S, Shepherd H, Mooney N, Da Costa A, Osman-Farah J, Macerollo A. The effect of deep brain stimulation on impulse control related disorders in Parkinson's disease - A 10-year retrospective study of 137 patients. J Neurol Sci 2022; 440:120339. [PMID: 35853293 DOI: 10.1016/j.jns.2022.120339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/14/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Sarah Healy
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Hilary Shepherd
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; University of Liverpool Medical School, Liverpool, UK
| | - Nicole Mooney
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Antonio Da Costa
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Jibril Osman-Farah
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.
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12
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Mulroy E, Macerollo A, Scotton S, Cociasu I, Di Lazzaro G, Bashir S, Doherty J, Hamid S, Mooney N, Batla A, Morgante F, Bhatia KP. Ethnic Differences in Dystonia Prevalence and Phenotype. Mov Disord 2022; 37:1323-1325. [PMID: 35500158 DOI: 10.1002/mds.29034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Eoin Mulroy
- Department of Clinical and MOVEMENT Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom.,Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Sangeeta Scotton
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Ioana Cociasu
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Giulia Di Lazzaro
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Neurology Unit, Roma, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Shaima Bashir
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - John Doherty
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Shahd Hamid
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Nicole Mooney
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Amit Batla
- Department of Clinical and MOVEMENT Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Kailash P Bhatia
- Department of Clinical and MOVEMENT Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
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13
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Rakusa M, Öztürk S, Moro E, Helbok R, Bassetti CL, Beghi E, Bereczki D, Bodini B, Di Liberto G, Jenkins TM, Macerollo A, Maia LF, Martinelli-Boneschi F, Pisani A, Priori A, Sauerbier A, Soffietti R, Taba P, von Oertzen TJ, Zedde M, Crean M, Burlica A, Cavallieri F, Sellner J. COVID-19 vaccination hesitancy among people with chronic neurological disorders: a position paper. Eur J Neurol 2022; 29:2163-2172. [PMID: 35460319 PMCID: PMC9111566 DOI: 10.1111/ene.15368] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Health risks associated with SARS‐CoV‐2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID‐19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID‐19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID‐19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID‐19 course. Methods In this position paper, the NeuroCOVID‐19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID‐19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation. Results The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS‐CoV‐2 vaccination. The prevailing concerns included the chance of worsening the pre‐existing neurological condition, vaccination‐related adverse events, and drug interaction. Conclusions The EAN NeuroCOVID‐19 Task Force reinforces the key role of neurologists as advocates of COVID‐19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID‐19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.
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Affiliation(s)
- Martin Rakusa
- Department of Neurologic Diseases, University Medical Centre Maribor, Maribor, Slovenia
| | - Serefnur Öztürk
- Department of Neurology and Neurointensive Care, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Elena Moro
- Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble, France
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Claudio L Bassetti
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Benedetta Bodini
- Department of Neurology, Saint-Antoine Hospital, APHP, Paris, France.,Paris Brain Institute, Sorbonne University, Paris, France
| | - Giovanni Di Liberto
- Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Thomas M Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK.,Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Luis F Maia
- Department of Neurology, Hospital Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde Universidade do Porto, Porto, Portugal
| | - Filippo Martinelli-Boneschi
- Neurology Unit and MS Centre, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Alberto Priori
- Division of Neurology, Department of Neurology, 'Aldo Ravelli' Research Center, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy
| | - Anna Sauerbier
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Tartu, Estonia.,Tartu University Hospital, Tartu, Estonia
| | - Tim J von Oertzen
- Department of Neurology, Neuromed Campus, Kepler Universitätsklinikum, Linz, Austria.,Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michael Crean
- European Academy of Neurology (EAN) Head Office, Vienna, Austria
| | - Anja Burlica
- European Academy of Neurology (EAN) Head Office, Vienna, Austria
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria
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14
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Sellner J, Jenkins TM, von Oertzen TJ, Bassetti CL, Beghi E, Bereczki D, Bodini B, Cavallieri F, Di Liberto G, Helbok R, Macerollo A, Maia LF, Oreja‐Guevara C, Özturk S, Rakusa M, Pisani A, Priori A, Sauerbier A, Soffietti R, Taba P, Zedde M, Crean M, Burlica A, Twardzik A, Moro E. A plea for equitable global access to COVID-19 diagnostics, vaccination and therapy: The NeuroCOVID-19 Task Force of the European Academy of Neurology. Eur J Neurol 2021; 28:3849-3855. [PMID: 33460486 PMCID: PMC8014664 DOI: 10.1111/ene.14741] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/13/2021] [Indexed: 12/13/2022]
Abstract
Coronavirus disease 2019 (COVID-19), a multi-organ disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to challenge health and care systems around the globe. The pandemic has disrupted acute neurology services and routine patient care and has impacted the clinical course in patients with chronic neurological disease. COVID-19 appears to have exposed inequalities of societies and healthcare systems and had a disproportionate impact on already vulnerable communities. The next challenge will be to set up initiatives to stop disparities in all aspects related to COVID-19. From the medical perspective, there is a need to consider inequalities in prevention, treatment and long-term consequences. Some of the issues of direct relevance to neurologists are summarised. With this appraisal, the European Academy of Neurology NeuroCOVID-19 Task Force intends to raise awareness of the potential impact of COVID-19 on inequalities in healthcare and calls for action to prevent disparity at individual, national and supranational levels.
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Affiliation(s)
- Johann Sellner
- Department of NeurologyLandesklinikum Mistelbach‐GänserndorfMistelbachAustria
- Department of NeurologyChristian Doppler Medical CenterParacelsus Medical UniversitySalzburgAustria
- Department of NeurologyKlinikum rechts der IsarTechnische Universität MünchenMünchenGermany
| | - Thomas M. Jenkins
- Sheffield Institute for Translational NeuroscienceUniversity of SheffieldSheffieldUK
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Tim J. von Oertzen
- Faculty of MedicineJohannes‐Kepler UniversitätLinzAustria
- Department of Neurology 1Kepler UniversitätsklinikumLinzAustria
| | | | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario NegriIRCCSMilanItaly
| | | | - Benedetta Bodini
- Department of NeurologySaint‐Antoine HospitalAPHPSorbonne UniversityParisFrance
| | - Francesco Cavallieri
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
- Clinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaModenaItaly
| | - Giovanni Di Liberto
- Department of Clinical NeurosciencesCentre Hospitalier Universitaire Vaudois and University of LausanneLausanneSwitzerland
| | - Raimund Helbok
- Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - Antonella Macerollo
- Walton Centre NHS Foundation TrustLiverpoolUK
- School of PsychologyFaculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - Luis F. Maia
- Department of NeurologyHospital Santo AntónioCentro Hospitalar Universitário do PortoPortoPortugal
- i3S ‐ Instituto de Investigação e Inovação em Saúde Universidade do PortoPortoPortugal
| | - Celia Oreja‐Guevara
- Department of NeurologyHospital Clinico San CarlosMadridSpain
- Departamento de MedicinaFacultad de MedicinaUniversidad Complutense de Madrid (UCMMadridSpain
- IdISSCMadridSpain
| | - Serefnur Özturk
- Department of NeurologyFaculty of MedicineSelcuk UniversityKonyaTurkey
| | - Martin Rakusa
- Department of NeurologyUniversity Medical Centre MariborMariborSlovenia
| | - Antonio Pisani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- IRCCS Mondino FoundationPaviaItaly
| | - Alberto Priori
- Division of NeurologyDepartment of Neurology‘Aldo Ravelli’ Research CenterUniversity of Milan and ASST Santi Paolo e CarloMilanItaly
| | - Anna Sauerbier
- Department of NeurologyUniversity Hospital CologneCologneGermany
- King's College HospitalNational Parkinson Foundation International Centre of ExcellenceLondonUK
| | - Riccardo Soffietti
- Division of Neuro‐OncologyDepartment of NeuroscienceUniversity of TurinTurinItaly
| | - Pille Taba
- Department of Neurology and NeurosurgeryInstitute of Clinical MedicineUniversity of TartuTartuEstonia
| | - Marialuisa Zedde
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
- Clinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaModenaItaly
| | - Michael Crean
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Anja Burlica
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Alex Twardzik
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Elena Moro
- Division of NeurologyCHU of GrenobleGrenoble Institute of NeurosciencesGrenoble Alpes UniversityGrenobleFrance
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15
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Vijiaratnam N, Girges C, Wirth T, Grover T, Preda F, Tripoliti E, Foley J, Scelzo E, Macerollo A, Akram H, Hyam J, Zrinzo L, Limousin P, Foltynie T. Long-term success of low-frequency subthalamic nucleus stimulation for Parkinson's disease depends on tremor severity and symptom duration. Brain Commun 2021; 3:fcab165. [PMID: 34396114 PMCID: PMC8361419 DOI: 10.1093/braincomms/fcab165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/15/2022] Open
Abstract
Patients with Parkinson’s disease can develop axial symptoms, including speech, gait and balance difficulties. Chronic high-frequency (>100 Hz) deep brain stimulation can contribute to these impairments while low-frequency stimulation (<100 Hz) may improve symptoms but only in some individuals. Factors predicting which patients benefit from low-frequency stimulation in the long term remain unclear. This study aims to confirm that low-frequency stimulation improves axial symptoms, and to go further to also explore which factors predict the durability of its effects. We recruited patients who developed axial motor symptoms while using high-frequency stimulation and objectively assessed the short-term impact of low-frequency stimulation on axial symptoms, other aspects of motor function and quality of life. A retrospective chart review was then conducted on a larger cohort to identify which patient characteristics were associated with not only the need to trial low-frequency stimulation, but also those which predicted its sustained use. Among 20 prospective patients, low-frequency stimulation objectively improved mean motor and axial symptom severity and quality of life in the short term. Among a retrospective cohort of 168 patients, those with less severe tremor and those in whom axial symptoms had emerged sooner after subthalamic nucleus deep brain stimulation were more likely to be switched to and remain on long-term low-frequency stimulation. These data suggest that low-frequency stimulation results in objective mean improvements in overall motor function and axial symptoms among a group of patients, while individual patient characteristics can predict sustained long-term benefits. Longer follow-up in the context of a larger, controlled, double-blinded study would be required to provide definitive evidence of the role of low-frequency deep brain stimulation.
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Affiliation(s)
- Nirosen Vijiaratnam
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Christine Girges
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Thomas Wirth
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Timothy Grover
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Francesca Preda
- Unit of Neurology of Ospedale "M. Bufalini" of Cesena, Cesena, Italy
| | - Elina Tripoliti
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Jennifer Foley
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Emma Scelzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Antonella Macerollo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology, the Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Jonathan Hyam
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Patricia Limousin
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
| | - Thomas Foltynie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Unit of Functional Neurosurgery, the National Hospital for Neurology and Neurosurgery, London, UK
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16
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Symonds AL, Macerollo A, Foy K, Alusi SH, Davies R. Genetic and Environmental Contributors to Neurodegeneration: An Exploration of the Effects of Alcohol on Clinical Features of Huntington's Disease Using the Enroll-HD Global Platform. Int J Environ Res Public Health 2021; 18:ijerph18105113. [PMID: 34065918 PMCID: PMC8151139 DOI: 10.3390/ijerph18105113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 11/29/2022]
Abstract
Huntington’s disease (HD) is a neurodegenerative dementia with a well recognised genetic cause. Alcohol misuse is a major environmental factor relevant to numerous neurological presentations, including HD. We explored the effects of alcohol intake on clinical features of HD by means of data from the Enroll-HD, which is a global registry study. A retrospective observational study making use of the Enroll-HD periodic dataset up to 2020 (in accordance with the Enroll-HD guidelines, encompassing 16,120 subjects with the HD gene (CAG expansion > 36), was carried out. This included 180 sites in 21 countries. The study looked at the association of alcohol use with the clinical presentation of HD, specifically looking into the age of first symptoms and HD severity. We also describe a specific case with manifest HD, a participant in the Enroll-HD study, whereby the patient’s obsessionality was central to her pattern of high alcohol intake and to her successful avoidance of alcohol thereafter. A record of past problems with high alcohol intake was more common in the group with manifest HD (9.0%, n = 1121) when compared with the pre-manifest carriers of the HD genetic abnormality (2.3%, n = 339). Age at onset of symptoms was not significantly influenced by current alcohol misuse, or past misuse. The severity of clinical impairments in HD was influenced by alcohol. Patients who reported high alcohol intake in the past had a statistically significant increase in motor impairments, by the Unified Huntington’s Disease Rating Scale total motor score (Kruskal–Wallis, post hoc Dunn’s, p < 0.001), and a significantly higher burden of psychiatric symptoms by the Problem Behaviours Assessment score (Kruskal–Wallis, post hoc Dunn’s, p < 0.01) compared with those not reporting high alcohol use. However, the past alcohol group did not have a lower Mini Mental State Examination score (Kruskal–Wallis, post hoc Dunn’s, p > 0.05) The first symptom of HD, as determined by the assessing clinician, was more likely to be psychiatric disturbance in patients currently misusing alcohol or those with prior history of alcohol misuse (55% and 31% respectively) when compared with controls (5%). Individual case experience, such as that presented in this study, shows that HD and alcohol, two major genetic and environmental contributors to neurodegeneration, interact in producing clinical problems. However, the complexities of these interactions are difficult to define, and may require larger studies dedicated to exploring the various factors in this interaction.
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17
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Nsengiyumva N, Barakat A, Macerollo A, Pullicino R, Bleakley A, Bonello M, Ellis RJB, Alusi SH. Thalamic versus midbrain tremor; two distinct types of Holmes' Tremor: a review of 17 cases. J Neurol 2021; 268:4152-4162. [PMID: 33973107 DOI: 10.1007/s00415-021-10491-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/11/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Holmes Tremor (HT) is a unique and debilitating movement disorder. It usually results from lesions of the midbrain and its connection but can also result from posterior thalamic injury. Clinical examination can help lesion localization between these two areas. We studied the clinical features and their radiological correlations to distinguish midbrain HT (HT-m) from thalamic HT (HT-t). METHODS Retrospective review of 17 patients with a HT-type presentation was conducted. Tremor characteristics, associated clinical signs and radiological findings were studied. RESULTS Eleven patients had a myorythmic rest tremor, large amplitude proximal tremor with goal-directed worsening, with or without mild distal dystonic posturing, representing HT-m. Six patients had slow, large amplitude proximal tremors and distal choreathetoid movements, significant proximal/distal dystonic posturing, associated with proprioceptive sensory loss, representing HT-t. Haemorrhagic lesions were the predominant cause of HT-m; whereas, ischaemia was more commonly associated with HT-t. CONCLUSION When assessing patients with HT, attentiveness to the presence of associated signs in the affected limb, such as a proprioceptive sensory deficits and additional movement disorders, can aid lesion localisation, which can have implications for management.
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Affiliation(s)
- N Nsengiyumva
- Department of Neurology, People's Friendship University of Russia, Moscow, Russia.,Department of Medicine, Hope Africa University, Bujumbura, Burundi
| | - A Barakat
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - A Macerollo
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - R Pullicino
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - A Bleakley
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - M Bonello
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - R J B Ellis
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - S H Alusi
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
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18
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Sellner J, M Jenkins T, J von Oertzen T, Bassetti CL, Beghi E, Bereczki D, Bodini B, Cavallieri F, Di Liberto G, Helbok R, Macerollo A, Maia LF, Oreja-Guevara C, Özturk S, Rakusa M, Sauerbier A, Soffietti R, Taba P, Pisani A, Priori A, Zedde M, Crean M, Burlica A, Twardzik A, Moro E. Primary prevention of COVID-19: Advocacy for vaccination from a neurological perspective. Eur J Neurol 2021; 28:3226-3229. [PMID: 33386655 DOI: 10.1111/ene.14713] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.,Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Thomas M Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tim J von Oertzen
- Faculty of Medicine, Johannes-Kepler Universität, Linz, Austria.,Department of Neurology 1, Kepler Universitätsklinikum, Linz, Austria
| | - Claudio L Bassetti
- Department of Neurology, University of Bern, Inselspital, Bern, Switzerland
| | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Benedetta Bodini
- Department of Neurology, Sorbonne University, Saint-Antoine Hospital, APHP, Paris, France
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Di Liberto
- Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Antonella Macerollo
- Walton Centre NHS Foundation Trust, Liverpool, UK.,School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Luis F Maia
- Department of Neurology, Hospital Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde Universidade do Porto, Porto, Portugal
| | - Celia Oreja-Guevara
- Department of Neurology, Hospital Clinico San Carlos, Madrid, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.,IdISSC, Madrid, Spain
| | - Serefnur Özturk
- Department of Neurology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Martin Rakusa
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Anna Sauerbier
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Riccardo Soffietti
- Department of Neuroscience, Division of Neuro-Oncology, University of Turin, Turin, Italy
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Alberto Priori
- Department of Neurology, Division of Neurology, 'Aldo Ravelli' Research Center, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michael Crean
- European Academy of Neurology (EAN) Headoffice, Vienna, Austria
| | - Anja Burlica
- European Academy of Neurology (EAN) Headoffice, Vienna, Austria
| | - Alex Twardzik
- European Academy of Neurology (EAN) Headoffice, Vienna, Austria
| | - Elena Moro
- Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France
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von Oertzen TJ, Macerollo A, Leone MA, Beghi E, Crean M, Oztuk S, Bassetti C, Twardzik A, Bereczki D, Di Liberto G, Helbok R, Oreja‐ Guevara C, Pisani A, Sauerbier A, Sellner J, Soffietti R, Zedde M, Bianchi E, Bodini B, Cavallieri F, Campiglio L, Maia LF, Priori A, Rakusa M, Taba P, Moro E, Jenkins TM. EAN consensus statement for management of patients with neurological diseases during the COVID-19 pandemic. Eur J Neurol 2021; 28:7-14. [PMID: 33058321 PMCID: PMC7675361 DOI: 10.1111/ene.14521] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/20/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE The recent SARS-CoV-2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fast-evolving pandemic, evidence-based studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID-19. METHODS A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP co-chairs rated importance on a five-point Likert scale. Results were graded by importance and reported as consensus statements. RESULTS In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fifty-nine statements obtained >70% agreement and were retained. In round three, responses were received from 55 co-chairs of 29 SPs. Whilst general recommendations related to prevention of COVID-19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. CONCLUSION This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID-19 pandemic that provides immediate guidance for neurologists. In this fast-evolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges.
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Affiliation(s)
- T. J. von Oertzen
- Faculty of MedicineJohannes‐Kepler UniversitätLinzAustria
- Department of Neurology 1Kepler UniversitätsklinikumLinzAustria
| | - A. Macerollo
- Walton Centre NHS Foundation TrustLiverpoolUK
- Faculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - M. A. Leone
- UO NeurologiaFondazione IRCCS 'Casa Sollievo della Sofferenza'San Giovanni RotondoItaly
| | - E. Beghi
- Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - M. Crean
- European Academy of NeurologyHead OfficeViennaAustria
| | - S. Oztuk
- Department of NeurologyFaculty of MedicineSelcuk UniversityKonyaTurkey
| | - C. Bassetti
- Department of NeurologyInselspitalUniversity of BernBernSwitzerland
| | - A. Twardzik
- European Academy of NeurologyHead OfficeViennaAustria
| | - D. Bereczki
- Department of NeurologySemmelweis UniversityBudapestHungary
| | - G. Di Liberto
- Department of Pathology and ImmunologyGeneva Faculty of MedicineGenevaSwitzerland
| | - R. Helbok
- Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - C. Oreja‐ Guevara
- Department of NeurologyHospital Clínico San CarlosMadridSpain
- Departamento de MedicinaFacultad de MedicinaUniversidad Complutense de Madrid (UCM)MadridSpain
- IdISSCMadridSpain
| | - A. Pisani
- NeurologyDepartment of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - A. Sauerbier
- Department of NeurologyUniversity Hospital CologneCologneGermany
| | - J. Sellner
- Department of NeurologyLandesklinikum Mistelbach‐GänserndorfMistelbachAustria
- Department of NeurologyChristian Doppler Medical CenterParacelsus Medical UniversitySalzburgAustria
- Department of NeurologyKlinikum rechts der IsarTechnische Universität MünchenMünchenGermany
| | - R. Soffietti
- Division of Neuro‐OncologyDepartment of NeuroscienceUniversity of TurinTurinItaly
| | - M. Zedde
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - E. Bianchi
- Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - B. Bodini
- Department of NeurologySaint‐Antoine HospitalAPHPSorbonne UniversityParisFrance
| | - F. Cavallieri
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
- Clinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaReggio EmiliaItaly
| | - L. Campiglio
- Division of Neurology'Aldo Ravelli' Research CenterDepartment of NeurologyUniversity of Milan and ASST Santi Paolo e CarloMilanItaly
| | - L. F. Maia
- Department of NeurologyCentro Hospitalar Universitário do PortoPortoPortugal
| | - A. Priori
- Division of Neurology'Aldo Ravelli' Research CenterDepartment of NeurologyUniversity of Milan and ASST Santi Paolo e CarloMilanItaly
| | - M. Rakusa
- Department of NeurologyUniversity Medical Centre MariborMariborSlovenia
| | - P. Taba
- Department of Neurology and NeurosurgeryInstitute of Clinical MedicineUniversity of TartuTartuEstonia
| | - E. Moro
- Division of NeurologyCHU of GrenobleGrenoble Alpes UniversityGrenoble Institute of NeurosciencesGrenobleFrance
| | - T. M. Jenkins
- Sheffield Institute for Translational NeuroscienceUniversity of SheffieldSheffieldUK
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
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20
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Pontillo G, Castagna A, Vola EA, Macerollo A, Peluso S, Russo C, Baglio F, Manganelli F, Brunetti A, Cocozza S, Esposito M. The cerebellum in idiopathic cervical dystonia: A specific pattern of structural abnormalities? Parkinsonism Relat Disord 2020; 80:152-157. [DOI: 10.1016/j.parkreldis.2020.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/17/2020] [Accepted: 09/20/2020] [Indexed: 12/21/2022]
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21
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Sharpe G, Macerollo A, Fabbri M, Tripoliti E. Non-pharmacological Treatment Challenges in Early Parkinson's Disease for Axial and Cognitive Symptoms: A Mini Review. Front Neurol 2020; 11:576569. [PMID: 33101185 PMCID: PMC7546346 DOI: 10.3389/fneur.2020.576569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/17/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Parkinson's disease (PD) is now known to be a multisystemic heterogeneous neurodegenerative disease, including a wide spectrum of both motor and non-motor symptoms. PD patients' management must encompass a multidisciplinary approach to effectively address its complex nature. There are still challenges in terms of treating axial (gait, balance, posture, speech, and swallowing) and cognitive symptoms that typically arise with disease progression becoming poorly responsive to dopaminergic or surgical treatments. Objective: The objectives of the study are to further establish the presentation of axial and cognitive symptoms in early PD [Hoehn and Yahr (H&Y) scale ≤ 2] and to discuss the evidence for non-pharmacological approaches in early PD. Results: Mild and subtle changes in the investigated domains can be present even in early PD. Over the last 15 years, a few randomized clinical trials have been focused on these areas. Due to the low number of studies and the heterogeneity of the results, no definitive recommendations are possible. However, positive results have been obtained, with effective treatments being high-intensity treadmill and cueing for gait disturbances, high-intensity voice treatment, video-assisted swallowing therapy for dysphagia, and warm-up exercises and Wii FitTM training for cognition. Conclusions: Considering the association of motor, speech, and cognitive function, future trials should focus on multidisciplinary approaches to combined non-pharmacological management. We highlight the need for a more unified approach in managing these “orphan” symptoms, from the very beginning of the disease. The concept “the sooner the better” should be applied to multidisciplinary non-pharmacological management in PD.
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Affiliation(s)
- Gabriella Sharpe
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Antonella Macerollo
- Department of Neurology, The Walton Center for Neurology and Neurosurgery, Liverpool, United Kingdom.,Department of Neurosciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Margherita Fabbri
- Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network, NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Elina Tripoliti
- Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, United Kingdom
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22
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Macerollo A, Holz C, Cletheror D, Vega J, Moody J, Saul G, Paleyes N, Villar N, Korlipara P, Foltynie T, Limousin P, Zhang H, Kilner J. Non-invasive intervention for motor signs of Parkinson's disease: the effect of vibratory stimuli. J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2020-323427. [PMID: 32917824 PMCID: PMC7611709 DOI: 10.1136/jnnp-2020-323427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/20/2020] [Accepted: 08/05/2020] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | - Julio Vega
- Innovation Microsoft Research, Cambridge, UK
| | | | - Greg Saul
- Innovation Microsoft Research, Cambridge, UK
| | | | | | - Prasad Korlipara
- University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
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23
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Moro E, Priori A, Beghi E, Helbok R, Campiglio L, Bassetti CL, Bianchi E, Maia LF, Ozturk S, Cavallieri F, Zedde M, Sellner J, Bereczki D, Rakusa M, Di Liberto G, Sauerbier A, Pisani A, Macerollo A, Soffietti R, Taba P, Crean M, Twardzik A, Oreja-Guevara C, Bodini B, Jenkins TM, von Oertzen TJ. The international European Academy of Neurology survey on neurological symptoms in patients with COVID-19 infection. Eur J Neurol 2020; 27:1727-1737. [PMID: 32558002 PMCID: PMC7323212 DOI: 10.1111/ene.14407] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
Background and purpose Although the main clinical features of COVID‐19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. The incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID‐19 Task Force initiated a survey on neurological symptoms observed in patients with COVID‐19 infection. Methods A 17‐question online survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on 9 April 2020. Results By 27 April 2020, proper data were collected from 2343 responders (out of 4199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID‐19 mainly in emergency rooms and in COVID‐19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID‐19 (neuro COVID‐19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%) and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID‐19; they were most commonly recognized in patients with multiple general symptoms and occurred at any time during infection. Conclusion Neurologists are currently and actively involved in the management of neurological issues related to the COVID‐19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID‐19, neurological disease characteristics and the contribution of neurological manifestations to outcome.
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Affiliation(s)
- E Moro
- Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France
| | - A Priori
- Department of Neurology, Division of Neurology, 'Aldo Ravelli' Research Center, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy
| | - E Beghi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - R Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - L Campiglio
- Department of Neurology, Division of Neurology, 'Aldo Ravelli' Research Center, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy
| | - C L Bassetti
- Department of Neurology, University of Bern, Inselspital, Bern, Switzerland
| | - E Bianchi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - L F Maia
- Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - S Ozturk
- Department of Neurology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - F Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - M Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - J Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.,Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - D Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - M Rakusa
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - G Di Liberto
- Department of Pathology and Immunology, Geneva Faculty of Medicine, Geneva, Switzerland
| | - A Sauerbier
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - A Pisani
- Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - A Macerollo
- Walton Centre NHS Foundation Trust, Liverpool, UK.,School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - R Soffietti
- Department of Neuroscience, Division of Neuro-Oncology, University of Turin, Turin, Italy
| | - P Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Estonia
| | - M Crean
- European Academy of Neurology, Head Office, Vienna, Austria
| | - A Twardzik
- European Academy of Neurology, Head Office, Vienna, Austria
| | - C Oreja-Guevara
- Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.,IdISSC, Madrid, Spain
| | - B Bodini
- Department of Neurology, Sorbonne University, Saint-Antoine Hospital, APHP, Paris, France
| | - T M Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - T J von Oertzen
- Department of Neurology 1, Kepler Universitätklinikum, Linz, Austria
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24
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Macerollo A, Hammersley B, Bonello M, Somerset J, Bhargava D, Das K, Osman-Farah J, Eldridge PR, Alusi SH. Deep brain stimulation for post-thalamic stroke complex movement disorders. Neurol Sci 2020; 42:337-342. [PMID: 32654009 DOI: 10.1007/s10072-020-04572-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- A Macerollo
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. .,Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
| | - B Hammersley
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - M Bonello
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - J Somerset
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - D Bhargava
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - K Das
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - J Osman-Farah
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - P R Eldridge
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - S H Alusi
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
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25
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Macerollo A, Sajin V, Bonello M, Barghava D, Alusi SH, Eldridge PR, Osman-Farah J. Deep brain stimulation in dystonia: State of art and future directions. J Neurosci Methods 2020; 340:108750. [DOI: 10.1016/j.jneumeth.2020.108750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 01/03/2023]
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26
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De Marco R, Bhargava D, Macerollo A, Osman-Farah J. Could ZI have a role in DBS for Parkinson's Disease? An observational study to optimize DBS target localization. J Clin Neurosci 2020; 77:89-93. [PMID: 32402608 DOI: 10.1016/j.jocn.2020.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) is a well-recognized intervention for Parkinson's Disease (PD). We used LEAD-DBS, a toolbox facilitating DBS electrode reconstructions and computer simulations based on postoperative MRI and CT imaging, to investigate the interaction and followed benefits of electrical field generated by STN-DBS and surrounding areas, such as caudal Zona Incerta (cZI). Thirty-two PD patients, treated with directional STN-DBS in the period 2016-2018 at the Walton Center NHS Foundation Trust, were retrospectively recruited. Their MRI and CT imaging were analyzed with LEAD-DBS to measure the volume of tissue activated (VTA). Considering the clinical outcome based on the UPDRS III score improvement of 62.65% at 6 months follow up, we found a VTA intersection of 21.5% with motor STN and 61.7% with cZI. These observations may support the contribution of cZI deep stimulation to improve clinical outcome of PD patients treated with DBS, promoting the intriguing path of dual targeting.
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Affiliation(s)
- Raffaele De Marco
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK; Department of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Italy.
| | - Deepti Bhargava
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - Antonella Macerollo
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK; Faculty of Brain Sciences, University of Liverpool, UK
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27
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Teodoro T, Koreki A, Meppelink AM, Little S, Nielsen G, Macerollo A, Ferreira JJ, Pareés I, Lang A, Edwards MJ. Contingent negative variation: a biomarker of abnormal attention in functional movement disorders. Eur J Neurol 2020; 27:985-994. [PMID: 32096289 PMCID: PMC7982797 DOI: 10.1111/ene.14189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Contingent negative variation (CNV) is a negative cortical wave that precedes a pre-cued imperative stimulus requiring a quick motor response. It has been related to motor preparation and anticipatory attention. The aim was to ascertain whether the clinical improvement of functional movement disorders after physiotherapy would be associated with faster reaction times and modulation of CNV. METHODS Motor performance and CNV were analysed during a pre-cued choice reaction time task with varying cue validity. Twenty-one patients with functional movement disorders and 13 healthy controls at baseline were compared. Patients then underwent physiotherapy. At follow-up after physiotherapy, patients were categorized as clinically improved (responders) or not improved (non-responders) and retested. RESULTS At baseline, patients did not generate CNV, contrary to controls [mean amplitude (µV) at the end of preparation to move: patients -0.47 (95% CI -1.94, 1.00) versus controls -2.59 (95% CI -4.46, -0.72)]. Responders performed faster after physiotherapy [mean natural logarithm (ln) reaction time (RT) (ms): follow-up 6.112 (95% CI 5.923, 6.301) versus baseline 6.206 (95% CI 6.019, 6.394), P = 0.010], contrary to non-responders. Simultaneously, responders showed a recovery of CNV after physiotherapy [follow-up -1.95 (95% CI -3.49, -0.41) versus baseline -0.19 (95% CI -1.73, 1.35), P < 0.001], contrary to non-responders [follow-up -0.32 (95% CI -1.79, 1.14) versus baseline -0.72 (95% CI -2.19, 0.75), P = 0.381]. CONCLUSIONS Clinical improvement of functional movement disorders after physiotherapy was associated with faster reaction times and normalization of CNV, which was absent at baseline. These findings suggest that CNV may constitute a useful neurophysiological biomarker related to abnormal attention in functional movement disorders.
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Affiliation(s)
- T Teodoro
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK.,Ashford and St Peter's Hospital NHS Foundation Trust, Chertsey, UK.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - A Koreki
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Department of Neuropsychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - A M Meppelink
- Stichting Epilepsie Instellingen Nederland, Zwolle, The Netherlands
| | - S Little
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK
| | - G Nielsen
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | | | - J J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - I Pareés
- Neurology Department, Hospital Ruber Internacional, Madrid, Spain.,Neurology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - A Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Brain Institute, Toronto, Ontario, Canada
| | - M J Edwards
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK.,Ashford and St Peter's Hospital NHS Foundation Trust, Chertsey, UK
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Macerollo A, Zrinzo L, Akram H, Foltynie T, Limousin P. Subthalamic nucleus deep brain stimulation for Parkinson’s disease: current trends and future directions. Expert Rev Med Devices 2020; 17:1063-1074. [DOI: 10.1080/17434440.2020.1747433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Antonella Macerollo
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Harith Akram
- Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Thomas Foltynie
- Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Patricia Limousin
- Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
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Capiluppi E, Romano L, Rebora P, Nanetti L, Castaldo A, Gellera C, Mariotti C, Macerollo A, Cislaghi MG. Late-onset Huntington's disease with 40-42 CAG expansion. Neurol Sci 2020; 41:869-876. [PMID: 31820322 PMCID: PMC7160095 DOI: 10.1007/s10072-019-04177-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/25/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Huntington's disease (HD) is a rare autosomal dominant neurodegenerative disorder caused by a CAG expansion greater than 35 in the IT-15 gene. There is an inverse correlation between the number of pathological CAG and the age of onset. However, CAG repeats between 40 and 42 showed a wider onset variation. We aimed to investigate potential clinical differences between patients with age at onset ≥ 60 years (late onset-HD) and patients with age at onset between 30 and 59 years (common-onset HD) in a cohort of patients with the same CAG expansions (40-42). METHODS A retrospective analysis of 66 HD patients with 40-41-42 CAG expansion was performed. Patients were investigated with the Unified Huntington's Disease Rating Scale (subitems I-II-III and Total Functional Capacity, Functional Assessment and Stage of Disease). Data were analysed using χ2, Fisher's test, t test and Pearson's correlation coefficient. GENMOD analysis and Kaplan-Meier analysis were used to study the disease progression. RESULTS The age of onset ranged from 39 to 59 years in the CO subgroup, whereas the LO subgroup showed an age of onset from 60 to 73 years. No family history was reported in 31% of the late-onset in comparison with 20% in common-onset HD (p = 0.04). No difference emerged in symptoms of onset, in clinical manifestations and in progression of disease between the two groups. CONCLUSION There were no clinical differences between CO and LO subgroups with 40-42 CAG expansion. There is a need of further studies on environmental as well genetic variables modifying the age at onset.
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Affiliation(s)
| | - Luca Romano
- Department of Clinical Sciences "Luigi Sacco"- L. Sacco Hospital, University of Milan, Milan, Italy
| | - Paola Rebora
- Medical Statistics School, University of Milano-Bicocca, Milan, Italy
| | - Lorenzo Nanetti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Castaldo
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cinzia Gellera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Caterina Mariotti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonella Macerollo
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
- School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
| | - M Giuliana Cislaghi
- Department of Clinical Sciences "Luigi Sacco"- L. Sacco Hospital, University of Milan, Milan, Italy
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Beudel M, Macerollo A, Brown MJN, Chen R. Editorial: The Role of the Basal Ganglia in Somatosensory-Motor Interactions: Evidence From Neurophysiology and Behavior. Front Hum Neurosci 2020; 13:451. [PMID: 31969811 PMCID: PMC6960399 DOI: 10.3389/fnhum.2019.00451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/06/2019] [Indexed: 12/02/2022] Open
Affiliation(s)
- Martijn Beudel
- Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | | | - Matt J N Brown
- Department of Kinesiology, California State University Sacramento, Sacramento, CA, United States
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Macerollo A, Palmer C, Foltynie T, Korlipara P, Limousin P, Edwards M, Kilner JM. High-frequency peripheral vibration decreases completion time on a number of motor tasks. Eur J Neurosci 2019; 48:1789-1802. [PMID: 29923362 PMCID: PMC6175240 DOI: 10.1111/ejn.14050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/18/2018] [Indexed: 02/01/2023]
Abstract
A recent theoretical account of motor control proposes that modulation of afferent information plays a role in affecting how readily we can move. Increasing the estimate of uncertainty surrounding the afferent input is a necessary step in being able to move. It has been proposed that an inability to modulate the gain of this sensory information underlies the cardinal symptoms of Parkinson's disease (PD). We aimed to test this theory by modulating the uncertainty of the proprioceptive signal using high‐frequency peripheral vibration, to determine the subsequent effect on motor performance. We investigated if this peripheral stimulus might modulate oscillatory activity over the sensorimotor cortex in order to understand the mechanism by which peripheral vibration can change motor performance. We found that 80 Hz peripheral vibration applied to the right wrist of a total of 54 healthy human participants reproducibly improved performance across four separate randomised experiments on a number of motor control tasks (nine‐hole peg task, box and block test, reaction time task and finger tapping). Improved performance on all motor tasks (except the amplitude of finger tapping) was also seen for a sample of 18PD patients ON medication. EEG data investigating the effect of vibration on oscillatory activity revealed a significant decrease in beta power (15–30 Hz) over the contralateral sensorimotor cortex at the onset and offset of 80 Hz vibration. This finding is consistent with a novel theoretical account of motor initiation, namely that modulating uncertainty of the proprioceptive afferent signal improves motor performance potentially by gating the incoming sensory signal and allowing for top‐down proprioceptive predictions.
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Affiliation(s)
- Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - Clare Palmer
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - Prasad Korlipara
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - Patricia Limousin
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - Mark Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
| | - James M Kilner
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL, London, UK
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Macerollo A, Limousin P, Korlipara P, Foltynie T, Edwards MJ, Kilner J. Dopaminergic Modulation of Sensory Attenuation in Parkinson's Disease: Is There an Underlying Modulation of Beta Power? Front Neurol 2019; 10:1001. [PMID: 31620072 PMCID: PMC6759719 DOI: 10.3389/fneur.2019.01001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/02/2019] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Pathological high amplitude of beta oscillations is thought as the underlying mechanism of motor symptoms in Parkinson's disease (PD), in particular with regard to bradykinesia. In addition, abnormality in a neurophysiological phenomenon labeled sensory attenuation has been found in patients with PD. The current study explored the hypothesis that the abnormal sensory attenuation has a causal link with the typical abnormality in beta oscillations in PD. Methods: The study tested sixteen right-handed patients with a diagnosis of PD and 22 healthy participants, which were matched by age and gender. Somatosensory evoked potentials were elicited through electrical stimulation of the median nerve at the wrist. Electrical activity was recorded at the scalp using a 128 channels EEG. Somatosensory evoked potentials were recorded in 2 conditions: at rest and at the onset of a voluntary movement, which was a self-paced abduction movement of the right thumb. Results: Healthy participants showed a reduction of the N20-P25 amplitude at the onset of the right thumb abduction compared to the rest condition (P < 0.05). When patients were OFF medication, they showed mild reduction of the N20-P25 component at movement onset (P < 0.05). On the contrary, they did show greater attenuation of the N20-P25 component at the onset of movement compared to the rest condition when ON medication (P < 0.05). There was no significant evidence of a link between the degree of sensory attenuation and the change in beta oscillations in our cohort of patients. Conclusion: These results confirmed a significant link between dopaminergic modulation and sensory attenuation. However, the sensory attenuation and beta oscillations were found as two independent phenomena.
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Affiliation(s)
- Antonella Macerollo
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.,School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom.,National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Institute of Neurology, University College of London, London, United Kingdom
| | - Patricia Limousin
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Institute of Neurology, University College of London, London, United Kingdom
| | - Prasad Korlipara
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Tom Foltynie
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Institute of Neurology, University College of London, London, United Kingdom
| | - Mark J Edwards
- Department of Neurology, St George's University of London, London, United Kingdom
| | - James Kilner
- Institute of Neurology, University College of London, London, United Kingdom
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Zapparoli L, Macerollo A, Joyce EM, Martino D, Kilner JM. Voluntary tic suppression and the normalization of motor cortical beta power in Gilles de la Tourette syndrome: an
EEG
study. Eur J Neurosci 2019; 50:3944-3957. [DOI: 10.1111/ejn.14548] [Citation(s) in RCA: 13] [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] [Received: 04/05/2019] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 12/16/2022]
Affiliation(s)
| | - Antonella Macerollo
- School of Psychology Faculty of Health and Life Sciences University of Liverpool Liverpool UK
- The Walton Centre NHS Foundation Trust Fazakerley UK
| | - Eileen M. Joyce
- Department of Clinical and Movement Neurosciences UCL Institute of Neurology London UK
| | - Davide Martino
- Department of Clinical Neurosciences University of Calgary Calgary Canada
- Hotchkiss Brain Institute University of Calgary Calgary Canada
| | - James M. Kilner
- Department of Clinical and Movement Neurosciences UCL Institute of Neurology London UK
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Aoh Y, Hsiao HJ, Lu MK, Macerollo A, Huang HC, Hamada M, Tsai CH, Chen JC. Event-Related Desynchronization/Synchronization in Spinocerebellar Ataxia Type 3. Front Neurol 2019; 10:822. [PMID: 31417491 PMCID: PMC6684955 DOI: 10.3389/fneur.2019.00822] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/16/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction: Spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant, cerebellar degeneration predominant disease caused by excessive CAG repeats. We examined event-related dysynchronization/synchronization (ERD/ERS) in patients with SCA3. Methods: We assessed ERD/ERS of self-paced voluntary hand movements in 15 patients with genetically proven SCA3 in comparison with healthy controls. Results: In ERS, a significant interaction effect between group, frequency, and period (F = 1.591; p = 0.005; ρI = 0.86) was observed. The post-hoc two-tailed independent t-test showed significant differences in high beta and low beta ERS. By contrast, in ERD, no apparent differences were observed in the pattern of patients with SCA3 in comparison with healthy controls (F = 1.01; p = 0.442). Conclusion: The study revealed a decreased ERS in patients with SCA3, especially at the frequency of 20–30 Hz. This study elucidates the significant role of cerebellum in motor control.
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Affiliation(s)
- Yu Aoh
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
| | - Han-Jun Hsiao
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
| | - Ming-Kuei Lu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung City, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Hui-Chun Huang
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung City, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
| | - Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung City, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan.,Department of Neurology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
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Macerollo A, Edwards MJ, Huang HC, Lu MK, Chen HJ, Tsai CH, Chen JC. Peripheral trauma and risk of dystonia: What are the evidences and potential co-risk factors from a population insurance database? PLoS One 2019; 14:e0216772. [PMID: 31075156 PMCID: PMC6510449 DOI: 10.1371/journal.pone.0216772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 04/30/2019] [Indexed: 11/19/2022] Open
Abstract
Background Dystonia is a neurological syndrome typically resulting in abnormal postures. Objectives We tested the role of physical injury as potential risk factor for development of dystonia using The National Health Insurance Research Database of Taiwan. Methods We identified 65704 people who were coded in the database as having had peripheral traumatic injuries (ICD-9-CM 807–848 and 860–959) in the year 2000. Patients with traumatic brain or spine injuries were excluded from analysis. We matched them using purposive sampling with 65704 people in the database who had not suffered peripheral trauma. We looked then at the incidence of dystonia occurring at least 1 year from the date of the peripheral trauma until 2011. Psychiatric symptoms (depression and anxiety) and sleeps difficulties have been investigated as potential covariates. Results We found 189 patients with dystonia (0.28%) in the trauma group, and 52 patients with dystonia (0.08%) in the non-trauma group. Trauma was independently associated with dystonia (adjusted HR = 3.12, 95% CI = 2.30–4.24). The incidence density of dystonia in the trauma group was 2.27 per 10000 person-years, while it was 0.71 per 10000 person-years in the non-trauma group Beyond the peripheral trauma, other variables associated to the incidence of dystonia included female sex, aged 40 years and above, depression and sleep disorders. Conclusion These data from a large population dataset support traumatic injury as a risk factor for the development of dystonia.
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Affiliation(s)
- Antonella Macerollo
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Mark J. Edwards
- Department of Molecular and Clinical Sciences, St George’s University of London, London, United Kingdom
| | - Hui-Chun Huang
- Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
| | - Ming-Kuei Lu
- Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Hsuan-Ju Chen
- School of Medicine, China Medical University, Taichung City, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan
| | - Chon-Haw Tsai
- Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Jui Cheng Chen
- Department of Neurology, China Medical University Hospital, Taichung City, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
- * E-mail:
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Chen JC, Macerollo A, Sadnicka A, Lu MK, Tsai CH, Korlipara P, Bhatia K, Rothwell JC, Edwards MJ. Cervical dystonia: Normal auditory mismatch negativity and abnormal somatosensory mismatch negativity. Clin Neurophysiol 2018; 129:1947-1954. [PMID: 30015084 DOI: 10.1016/j.clinph.2018.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/16/2017] [Revised: 05/16/2018] [Accepted: 05/28/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Previous electrophysiological and psychophysical tests have suggested that somatosensory integration is abnormal in dystonia. Here, we hypothesised that this abnormality could relate to a more general deficit in pre-attentive error/deviant detection in patients with dystonia. We therefore tested patients with dystonia and healthy subjects using a mismatch negativity paradigm (MMN), where evoked potentials generated in response to a standard repeated stimulus are subtracted from the responses to a rare "odd ball" stimulus. METHODS We assessed MMN for somatosensory and auditory stimuli in patients with cervical dystonia and healthy age matched controls. RESULTS We found a significant group ∗ oddball type interaction effect (F (1, 34) = 4.5, p = 0.04, ρI = 0.63). A follow up independent t-test for sMMN data, showed a smaller sMMN amplitude in dystonic patients compared to controls (mean difference control-dystonia: -1.0 µV ± 0.3, p < 0.00, t = -3.1). However the amplitude of aMMN did not differ between groups (mean difference control-dystonia: -0.2 µV ± 0.2, p = 0.24, t = -1.2). We found a positive correlation between somatosensory MMN and somatosensory temporal discrimination threshold. CONCLUSION These results suggest that pre-attentive error/deviant detection, specifically in the somatosensory domain, is abnormal in dystonia. This could underlie some previously reported electrophysiological and psychophysical abnormalities of somatosensory integration in dystonia. SIGNIFICANCE One could hypothesize a deficit in pre-conscious orientation towards potentially salient signals might lead to a more conservative threshold for decision-making in dystonia.
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Affiliation(s)
- Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Anna Sadnicka
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Min-Kuei Lu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Prasad Korlipara
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Kailash Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Mark J Edwards
- Department of Molecular and Clinical Sciences, St George's University of London, London
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Macerollo A, Deuschl G. Deep brain stimulation for tardive syndromes: Systematic review and meta-analysis. J Neurol Sci 2018; 389:55-60. [DOI: 10.1016/j.jns.2018.02.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
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Stucci LS, D'Oronzo S, Tucci M, Macerollo A, Ribero S, Spagnolo F, Marra E, Picasso V, Orgiano L, Marconcini R, De Rosa F, Di Guardo L, Galli G, Gandini S, Palmirotta R, Palmieri G, Queirolo P, Silvestris F. Vitamin D in melanoma: Controversies and potential role in combination with immune check-point inhibitors. Cancer Treat Rev 2018; 69:21-28. [PMID: 29864718 DOI: 10.1016/j.ctrv.2018.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
The role of vitamin D in melanoma is still controversial. Although several Authors described a correlation between vitamin D deficiency and poor survival in metastatic melanoma patients, clinical trials exploring the effects of vitamin D supplementation in this clinical setting were mostly inconclusive. However, recent evidence suggests that vitamin D exerts both anti-proliferative effects on tumor cells and immune-modulating activities, that have been widely explored in auto-immune disorders. On the one hand, vitamin D has been shown to inhibit T-helper17 lymphocytes, notoriously involved in the pathogenesis of immune-related adverse events (iAEs) which complicate immune-checkpoint inhibitor (ICI) treatment. On the other hand, vitamin D up-regulates PDL-1 expression on both epithelial and immune cells, suggesting a synergic effect in combination with ICIs, for which further investigation is needed.
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Affiliation(s)
- Luigia Stefania Stucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Stella D'Oronzo
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy.
| | - Marco Tucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, United Kingdom
| | - Simone Ribero
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Francesco Spagnolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Elena Marra
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Virginia Picasso
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Laura Orgiano
- Department of Medical Oncology, University of Cagliari, Cagliari, Italy
| | - Riccardo Marconcini
- Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Istituto Toscano Tumori, Santa Chiara Hospital, Pisa, Italy
| | - Francesco De Rosa
- Immunotherapy-Cell Therapy and Biobank Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorenza Di Guardo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulia Galli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Raffaele Palmirotta
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | | | - Paola Queirolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Silvestris
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
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Macerollo A, Brown MJ, Kilner JM, Chen R. Neurophysiological Changes Measured Using Somatosensory Evoked Potentials. Trends Neurosci 2018; 41:294-310. [DOI: 10.1016/j.tins.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 01/05/2023]
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40
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Chen JC, Macerollo A, Edwards M. T52. Mismatch negativity in the diagnosis of Alzheimer disease. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Macerollo A, Brown MJN. Beta Oscillations and Indirect Pathway Spiny Projecting Neurons: A Selective Neuronal Mechanism Linked to Parkinsonian Pathophysiology? Mov Disord 2018; 33:760. [PMID: 29603411 DOI: 10.1002/mds.27388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/21/2018] [Accepted: 02/25/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Matt J N Brown
- Department of Kinesiology and Health Science, California State University Sacramento, Sacramento, California, USA
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Ling H, Macerollo A. Is it Useful to Classify PSP and CBD as Different Disorders? Yes. Mov Disord Clin Pract 2018; 5:145-148. [PMID: 30363457 DOI: 10.1002/mdc3.12581] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 12/10/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Helen Ling
- Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology University College London London UK
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders University College London London UK
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Teodoro T, Meppelink AM, Little S, Grant R, Nielsen G, Macerollo A, Pareés I, Edwards MJ. Abnormal beta power is a hallmark of explicit movement control in functional movement disorders. Neurology 2017; 90:e247-e253. [PMID: 29273688 PMCID: PMC5772156 DOI: 10.1212/wnl.0000000000004830] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/09/2017] [Indexed: 12/05/2022] Open
Abstract
Objective To determine whether sensorimotor beta-frequency oscillatory power is raised during motor preparation in patients with functional movement disorders (FMD) and could therefore be a marker of abnormal “body-focused” attention. Methods We analyzed motor performance and beta-frequency cortical oscillations during a precued choice reaction time (RT) task with varying cue validity (50% or 95% congruence between preparation and go cues). We compared 21 patients with FMD with 13 healthy controls (HCs). Results In HCs, highly predictive cues were associated with faster RT and beta desynchronization in the contralateral hemisphere (contralateral slope −0.045 [95% confidence interval (CI) −0.057 to −0.033] vs ipsilateral −0.033 [95% CI −0.046 to −0.021], p < 0.001) and with a tendency for reaching lower contralateral end-of-preparation beta power (contralateral −0.482 [95% CI −0.827 to −0.137] vs ipsilateral −0.328 [95% CI −0.673 to 0.016], p = 0.069). In contrast, patients with FMD had no improvement in RTs with highly predictive cues and showed an impairment of beta desynchronization and lateralization before movement. Conclusions Persistent beta synchronization during motor preparation could reflect abnormal explicit control of movement in FMD. Excessive attention to movement itself rather than the goal might maintain beta synchronization and impair performance.
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Affiliation(s)
- Tiago Teodoro
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Anne Marthe Meppelink
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Simon Little
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Robert Grant
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Glenn Nielsen
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Antonella Macerollo
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Isabel Pareés
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain
| | - Mark J Edwards
- From St. George's (T.T., G.N., M.J.E.), University of London, and St. George's University Hospitals NHS Foundation Trust, London, UK; Instituto de Medicina Molecular (T.T.), Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia, Hospital de Santa Maria, Portugal; Department of Neurology (A.M.M.), University Medical Center Groningen and University of Groningen, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (S.L., A.M.), University College of London, Institute of Neurology; Faculty of Health, Social Care and Education (R.G.), Kingston University and St. George's, University of London, UK; and Neurology Department (I.P.), Hospital Ruber Internacional, Madrid, Spain.
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Zis P, Macerollo A, Sauerbier A, Papp V, Klingelhoefer L, Cock HR. Subspecialty preferences among neurologists of the future. Eur J Neurol 2017; 25:597-601. [DOI: 10.1111/ene.13526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- P. Zis
- Academic Department of Neurosciences Sheffield Teaching Hospitals NHS Foundation Trust Sheffield
| | - A. Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders University College London London
| | - A. Sauerbier
- Department of Neurology King's College Hospital London
- Institute of Psychiatry, Psychology and Neuroscience King's College London UK
| | - V. Papp
- Department of Neurology Aarhus University Hospital Aarhus Denmark
| | - L. Klingelhoefer
- Department of Neurology Technical University Dresden Dresden Germany
| | - H. R. Cock
- Atkinson Morley Regional Neuroscience Centre St George's Hospital NHS Trust London UK
- Institute of Medical & Biomedical Education St George's University of London London UK
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Saifee TA, Macerollo A. Jaw clonus in motor neuron disease: an interesting case and review of literature. Neurol Sci 2017; 39:949-950. [DOI: 10.1007/s10072-017-3216-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/05/2017] [Indexed: 11/24/2022]
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Macerollo A, Brown MJN. EEG oscillations: how are they modulated during different phases of repetitive movements? J Neurophysiol 2017; 118:4-6. [PMID: 28275058 DOI: 10.1152/jn.00105.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 11/22/2022] Open
Abstract
Voluntary movements are planned through the relative timing between submovements of movement sequences as part of the motor program. Different movement phases are characterized by specific amplitude modulation of cortical oscillations. The latter represent neurophysiological correlates of specific synchronization or desynchronization of different neuronal groups. In this Neuro Forum, we review recent evidence regarding the temporal relation between neurophysiological correlates of different phases of a repetitive motor task using electroencephalography and source localization using individualized MRI.
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Affiliation(s)
- Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK; and
| | - Matt J N Brown
- Division of Brain, Imaging and Behavior-Systems Neuroscience, Krembil Research Institute, Toronto, Ontario, Canada
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Papp V, Klingelhoefer L, Zis P, Melis M, Tábuas-Pereira M, Macerollo A, Sauerbier A. European Academy of Neurology - Resident and Research Fellow Section: innovations and future direction in 2017. Eur J Neurol 2017. [PMID: 28636145 DOI: 10.1111/ene.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- V Papp
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - L Klingelhoefer
- Department of Neurology, Technical University of Dresden, Dresden, Germany
| | - P Zis
- Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - M Melis
- Neurology Service, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - M Tábuas-Pereira
- Neurology Service, University Hospital of Coimbra, Coimbra, Portugal
| | - A Macerollo
- Neurology, UCL Institute of Neurology, London
| | - A Sauerbier
- Department of Neurology, King's College London and King's College Hospital, London, UK
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Macerollo A, Lu MK, Huang HC, Chen HJ, Lin CC, Kao CH, Tsai CH, Chen JC. Colonic diverticular disease: A new risk factor for Parkinson's disease? Parkinsonism Relat Disord 2017; 42:61-65. [PMID: 28651752 DOI: 10.1016/j.parkreldis.2017.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 05/15/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Colonic diverticular disease is a chronic gastrointestinal disorder. Previous studies have suggested that chronic gastrointestinal tract is involved in the pathophysiology of Parkinson's disease. OBJECT This study investigated the potential link between colonic diverticular disease and risk of Parkinson's disease. METHODS Data in this nationwide population-based cohort study were obtained from the National Health Insurance Research Database. Patients with colonic diverticular disease were identified from among 23.22 million insured Taiwanese residents who had been diagnosed between 2000 and 2005 and were aged ≥20 years (n = 23367). The comparison cohort included patients without colonic diverticular disease, matched by sex, age, and all comorbidities with the colonic diverticular disease patients cohort (n = 23367). Using univariable and multivariable Cox proportional hazard regression models, we estimated the adjusted hazard ratio (aHR) for PD with a 95% confidence interval (CI) after adjusting for age, sex, and all of comorbidities. RESULTS The risk of Parkinson's disease was higher in the CDD cohort than in the comparison cohort (HR = 1.27, 95%CI = 1.10-1.47). Compared with patients aged ≥65 years without CDD, the CDD patients in the equal age group had a 1.25-fold increased risk of PD (95% CI = 1.07-1.46). CONCLUSION Colonic diverticular disease may be associated with an increased risk of Parkinson's disease. Thus, the risk of this neurodegenerative disease should be considered in patients with colonic diverticular disease.
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Affiliation(s)
| | - Ming-Kuei Lu
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Hui-Chun Huang
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Che-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chon-Haw Tsai
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Brain Disease Research Centre, China Medical University Hospital, Taichung, Taiwan.
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Affiliation(s)
- Antonella Macerollo
- Sobell Department, Institute of Neurology, University College of London, London, England
| | - Jui-Cheng Chen
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan3Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan
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Peterson DA, Littlewort GC, Bartlett MS, Macerollo A, Perlmutter JS, Jinnah HA, Hallett M, Sejnowski TJ. Objective, computerized video-based rating of blepharospasm severity. Neurology 2016; 87:2146-2153. [PMID: 27770067 PMCID: PMC5109937 DOI: 10.1212/wnl.0000000000003336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 05/02/2016] [Accepted: 08/02/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare clinical rating scales of blepharospasm severity with involuntary eye closures measured automatically from patient videos with contemporary facial expression software. METHODS We evaluated video recordings of a standardized clinical examination from 50 patients with blepharospasm in the Dystonia Coalition's Natural History and Biorepository study. Eye closures were measured on a frame-by-frame basis with software known as the Computer Expression Recognition Toolbox (CERT). The proportion of eye closure time was compared with 3 commonly used clinical rating scales: the Burke-Fahn-Marsden Dystonia Rating Scale, Global Dystonia Rating Scale, and Jankovic Rating Scale. RESULTS CERT was reliably able to find the face, and its eye closure measure was correlated with all of the clinical severity ratings (Spearman ρ = 0.56, 0.52, and 0.56 for the Burke-Fahn-Marsden Dystonia Rating Scale, Global Dystonia Rating Scale, and Jankovic Rating Scale, respectively, all p < 0.0001). CONCLUSIONS The results demonstrate that CERT has convergent validity with conventional clinical rating scales and can be used with video recordings to measure blepharospasm symptom severity automatically and objectively. Unlike EMG and kinematics, CERT requires only conventional video recordings and can therefore be more easily adopted for use in the clinic.
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Affiliation(s)
- David A Peterson
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD.
| | - Gwen C Littlewort
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - Marian S Bartlett
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - Antonella Macerollo
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - Joel S Perlmutter
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - H A Jinnah
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - Mark Hallett
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
| | - Terrence J Sejnowski
- From the Computational Neurobiology Laboratory (D.A.P., T.J.S.) and Howard Hughes Medical Institute (T.J.S.), Salk Institute for Biological Studies; Institute for Neural Computation (D.A.P., G.C.L., M.S.B., T.J.S.), Kavli Institute for Brain and Mind (D.A.P., T.J.S.), Machine Perception Laboratory (G.C.L., M.S.B.), and Division of Biological Sciences (T.J.S.), University of California, San Diego, La Jolla; Sobell Department of Motor Neuroscience and Movement Disorders (A.M.), National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, UK; Departments of Neurology, Radiology, and Anatomy and Neurobiology, and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology, Human Genetics, and Pediatrics (H.A.J.), Emory University, Atlanta, GA; and Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD
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