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Giovannini B, Bianchi F, Montano V, Siciliano G, Pasquali L. SARS-CoV-2-related myelitis: two cases from a major neurological clinic in Central Italy. Neurol Sci 2024; 45:1845-1848. [PMID: 38315251 DOI: 10.1007/s10072-024-07370-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/28/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Beatrice Giovannini
- Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy.
| | - Francesca Bianchi
- Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy
| | - Vincenzo Montano
- Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy
| | - Livia Pasquali
- Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy
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2
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Doneddu PE, Gentile L, Cocito D, Fazio R, Luigetti M, Briani C, Filosto M, Siciliano G, Benedetti L, Antonini G, Matà S, Marfia GA, Inghilleri M, Manganelli F, Cosentino G, Brighina F, Carpo M, Carta F, Mazzeo A, Peci E, Strano C, Romano A, Campagnolo M, Cotti-Piccinelli S, Viola DV, Germano F, Leonardi L, Sperti M, Mataluni G, Ceccanti M, Spina E, Vegezzi E, Di Stefano V, Nobile-Orazio E. Assessment of diagnostic criteria for multifocal motor neuropathy in patients included in the Italian database. Eur J Neurol 2024; 31:e16248. [PMID: 38376074 DOI: 10.1111/ene.16248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND AND PURPOSE This study aimed to assess the diagnostic criteria, ancillary investigations and treatment response using real-life data in multifocal motor neuropathy (MMN) patients. METHODS Clinical and laboratory data were collected from 110 patients enrolled in the Italian MMN database through a structured questionnaire. Twenty-six patients were excluded due to the unavailability of nerve conduction studies or the presence of clinical signs and symptoms and electrodiagnostic abnormalities inconsistent with the MMN diagnosis. Analyses were conducted on 73 patients with a confirmed MMN diagnosis and 11 patients who did not meet the diagnostic criteria. RESULTS The European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria were variably applied. AUTHOR When applying the American Association of Electrodiagnostic Medicine criteria, an additional 17% of patients fulfilled the criteria for probable/definite diagnosis whilst a further 9.5% missed the diagnosis. In 17% of the patients only compound muscle action potential amplitude, but not area, was measured and subsequently recorded in the database by the treating physician. Additional investigations, including anti-GM1 immunoglobulin M antibodies, cerebrospinal fluid analysis, nerve ultrasound and magnetic resonance imaging, supported the diagnosis in 46%-83% of the patients. Anti-GM1 immunoglobulin M antibodies and nerve ultrasound demonstrated the highest sensitivity. Additional tests were frequently performed outside the EFNS/PNS guideline recommendations. CONCLUSIONS This study provides insights into the real-world diagnostic and management strategies for MMN, highlighting the challenges in applying diagnostic criteria.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Dario Cocito
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore, Sede di Roma, Roma, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-Brescia Clinical center for Neuromuscular Diseases, Brescia, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giovanni Antonini
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza' University of Rome, Roma, Italy
| | - Sabrina Matà
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Maurizio Inghilleri
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, IRCCS Mondino Foundation, University of Pavia, Pavia, Italy
| | - Filippo Brighina
- Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | | | - Francesca Carta
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Erdita Peci
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Torino, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore, Sede di Roma, Roma, Italy
| | - Marta Campagnolo
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Cotti-Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-Brescia Clinical center for Neuromuscular Diseases, Brescia, Italy
| | - Divina Valeria Viola
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Luca Leonardi
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza' University of Rome, Roma, Italy
| | - Martina Sperti
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Marco Ceccanti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Elisa Vegezzi
- Department of Brain and Behavioral Sciences, IRCCS Mondino Foundation, University of Pavia, Pavia, Italy
| | - Vincenzo Di Stefano
- Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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3
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Lopriore P, Vista M, Tessa A, Giuntini M, Caldarazzo Ienco E, Mancuso M, Siciliano G, Santorelli FM, Orsucci D. Primary Coenzyme Q10 Deficiency-Related Ataxias. J Clin Med 2024; 13:2391. [PMID: 38673663 PMCID: PMC11050807 DOI: 10.3390/jcm13082391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Cerebellar ataxia is a neurological syndrome characterized by the imbalance (e.g., truncal ataxia, gait ataxia) and incoordination of limbs while executing a task (dysmetria), caused by the dysfunction of the cerebellum or its connections. It is frequently associated with other signs of cerebellar dysfunction, including abnormal eye movements, dysmetria, kinetic tremor, dysarthria, and/or dysphagia. Among the so-termed mitochondrial ataxias, variants in genes encoding steps of the coenzyme Q10 biosynthetic pathway represent a common cause of autosomal recessive primary coenzyme Q10 deficiencies (PCoQD)s. PCoQD is a potentially treatable condition; therefore, a correct and timely diagnosis is essential. After a brief presentation of the illustrative case of an Italian woman with this condition (due to a novel homozygous nonsense mutation in COQ8A), this article will review ataxias due to PCoQD.
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Affiliation(s)
- Piervito Lopriore
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, 55100 Lucca, Italy; (P.L.); (M.V.); (M.G.); (E.C.I.)
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (M.M.); (G.S.)
| | - Marco Vista
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, 55100 Lucca, Italy; (P.L.); (M.V.); (M.G.); (E.C.I.)
| | - Alessandra Tessa
- Molecular Medicine, IRCCS Stella Maris Foundation, 56122 Pisa, Italy; (A.T.); (F.M.S.)
| | - Martina Giuntini
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, 55100 Lucca, Italy; (P.L.); (M.V.); (M.G.); (E.C.I.)
| | - Elena Caldarazzo Ienco
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, 55100 Lucca, Italy; (P.L.); (M.V.); (M.G.); (E.C.I.)
| | - Michelangelo Mancuso
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (M.M.); (G.S.)
| | - Gabriele Siciliano
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (M.M.); (G.S.)
| | | | - Daniele Orsucci
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, 55100 Lucca, Italy; (P.L.); (M.V.); (M.G.); (E.C.I.)
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4
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De Lorenzo A, Liberatore G, Doneddu PE, Manganelli F, Cocito D, Briani C, Fazio R, Mazzeo A, Schenone A, Di Stefano V, Cosentino G, Marfia GA, Benedetti L, Carpo M, Filosto M, Antonini G, Clerici AM, Luigetti M, Matà S, Rosso T, Lucchetta M, Siciliano G, Lauria Pinter G, Cavaletti G, Inghilleri M, Cantisani T, Notturno F, Ricciardi D, Habetswallner F, Spina E, Peci E, Salvalaggio A, Falzone Y, Strano C, Gentile L, Vegezzi E, Mataluni G, Cotti Piccinelli S, Leonardi L, Romano A, Nobile-Orazio E. Impact of 2021 European Academy of Neurology/Peripheral Nerve Society diagnostic criteria on diagnosis and therapy of chronic inflammatory demyelinating polyradiculoneuropathy variants. Eur J Neurol 2024; 31:e16190. [PMID: 38165011 DOI: 10.1111/ene.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND PURPOSE There are different criteria for the diagnosis of different variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) guidelines provide specific clinical criteria for each CIDP variant even if their therapeutical impact has not been investigated. METHODS We applied the clinical criteria for CIDP variants of the 2021 EAN/PNS guidelines to 369 patients included in the Italian CIDP database who fulfilled the 2021 EAN/PNS electrodiagnostic criteria for CIDP. RESULTS According to the 2021 EAN/PNS clinical criteria, 245 patients achieved a clinical diagnosis of typical CIDP or CIDP variant (66%). We identified 106 patients with typical CIDP (29%), 62 distal CIDP (17%), 28 multifocal or focal CIDP (7%), four sensory CIDP (1%), 27 sensory-predominant CIDP (7%), 10 motor CIDP (3%), and eight motor-predominant CIDP (2%). Patients with multifocal, distal, and sensory CIDP had milder impairment and symptoms. Patients with multifocal CIDP had less frequently reduced conduction velocity and prolonged F-wave latency and had lower levels of cerebrospinal fluid protein. Patients with distal CIDP more frequently had reduced distal compound muscle action potentials. Patients with motor CIDP did not improve after steroid therapy, whereas those with motor-predominant CIDP did. None of the patients with sensory CIDP responded to steroids, whereas most of those with sensory-predominant CIDP did. CONCLUSIONS The 2021 EAN/PNS criteria for CIDP allow a better characterization of CIDP variants, permitting their distinction from typical CIDP and more appropriate treatment for patients.
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Affiliation(s)
- Alberto De Lorenzo
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Dario Cocito
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Angelo Schenone
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Luana Benedetti
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy
| | - Marinella Carpo
- Department of Neurology, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST "Spedali Civili", University of Brescia, Brescia, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Angelo Maurizio Clerici
- Neurology Unit, Circolo and Macchi Foundation Hospital, University of Insubria, Varese, Italy
| | - Marco Luigetti
- Neurology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sabrina Matà
- Neurology Unit, Dipartimento Neuromuscoloscheletrico e Degli Organi di Senso, University Hospital Careggi, Florence, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassano, Vicenza, Italy
| | - Marta Lucchetta
- UOC Neurologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Lauria Pinter
- Unit of Neuroalgology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Maurizio Inghilleri
- Neurodegenerative Diseases Unit, Department of Human Neuroscience, Sapienza University, Policlinico Universitario Umberto I, Rome, Italy
| | - Teresa Cantisani
- Servizio di Neurofisiopatologia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | | | - Dario Ricciardi
- Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy
| | | | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Erdita Peci
- Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Yuri Falzone
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | | | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST "Spedali Civili", University of Brescia, Brescia, Italy
| | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Angela Romano
- Neurology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
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Strafella C, Colantoni L, Megalizzi D, Trastulli G, Piorgo EP, Primiano G, Sancricca C, Ricci G, Siciliano G, Caltagirone C, Filosto M, Tasca G, Ricci E, Cascella R, Giardina E. Characterization of D4Z4 alleles and assessment of de novo cases in Facioscapulohumeral dystrophy (FSHD) in a cohort of Italian families. Clin Genet 2024; 105:335-339. [PMID: 38041579 DOI: 10.1111/cge.14466] [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: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
Facioscapulohumeral dystrophy (FSHD) is an autosomal dominant disease, although 10%-30% of cases are sporadic. However, this percentage may include truly de novo patients (carrying a reduced D4Z4 allele that is not present in either of the parents) and patients with apparently sporadic disease resulting from mosaicism, non-penetrance, or complex genetic situations in either patients or parents. In this study, we characterized the D4Z4 Reduced Alleles (DRA) and evaluated the frequency of truly de novo cases in FSHD1 in a cohort of DNA samples received consecutively for FSHD-diagnostic from 100 Italian families. The D4Z4 testing revealed that 60 families reported a DRA compatible with FSHD1 (1-10 RU). The DRA co-segregated with the disease in most cases. Five families with truly de novo cases were identified, suggesting that this condition may be slightly lower (8%) than previously reported. In addition, D4Z4 characterization in the investigated families showed 4% of mosaic cases and 2% with translocations. This study further highlighted the importance of performing family studies for clarifying apparently sporadic FSHD cases, with significant implications for genetic counseling, diagnosis, clinical management, and procreative choices for patients and families.
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Affiliation(s)
- Claudia Strafella
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Luca Colantoni
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Domenica Megalizzi
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Giulia Trastulli
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Guido Primiano
- Neurofisiopathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Cristina Sancricca
- Neurofisiopathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trusts, Newcastle Upon Tyne, UK
| | - Enzo Ricci
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaella Cascella
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - Emiliano Giardina
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine and Prevention, Medical Genetics Laboratory, Tor Vergata University, Rome, Italy
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Palermo G, Galgani A, Bellini G, Lombardo F, Martini N, Morganti R, Paoli D, De Cori S, Frijia F, Siciliano G, Ceravolo R, Giorgi FS. Neurogenic orthostatic hypotension in Parkinson's disease: is there a role for locus coeruleus magnetic resonance imaging? J Neural Transm (Vienna) 2024; 131:157-164. [PMID: 38032367 PMCID: PMC10791951 DOI: 10.1007/s00702-023-02721-7] [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: 07/17/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
Locus coeruleus (LC) is the main noradrenergic nucleus of the brain, and degenerates early in Parkinson's disease (PD). The objective of this study is to test whether degeneration of the LC is associated with orthostatic hypotension (OH) in PD. A total of 22 cognitively intact PD patients and 52 age-matched healthy volunteers underwent 3 T magnetic resonance (MRI) with neuromelanin-sensitive T1-weighted sequences (LC-MRI). For each subject, a template space-based LC-MRI was used to calculate LC signal intensity (LC contrast ratio-LCCR) and the estimated number of voxels (LCVOX) belonging to LC. Then, we compared the LC-MRI parameters in PD patients with OH (PDOH+) versus without OH (PDOH-) (matched for sex, age, and disease duration) using one-way analysis of variance followed by multiple comparison tests. We also tested for correlations between subject's LC-MRI features and orthostatic drop in systolic blood pressure (SBP). PDOH- and PDOH+ did not differ significantly (p > 0.05) based on demographics and clinical characteristics, except for blood pressure measurements and SCOPA-AUT cardiovascular domain (p < 0.05). LCCR and LCVOX measures were significantly lower in PD compared to HC, while no differences were observed between PDOH- and PDOH+. Additionally, no correlation was found between the LC-MRI parameters and the orthostatic drop in SBP or the clinical severity of autonomic symptoms (p > 0.05). Conversely, RBD symptom severity negatively correlated with several LC-MRI parameters. Our results failed to indicate a link between the LC-MRI features and the presence of OH in PD but confirmed a marked alteration of LC signal in PD patients.
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Affiliation(s)
- Giovanni Palermo
- Center for Neurodegenerative diseases-Parkinson's disease and Movement disorders, Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Galgani
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Gabriele Bellini
- Center for Neurodegenerative diseases-Parkinson's disease and Movement disorders, Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Nicola Martini
- Deep Health Unit, Fondazione Monasterio/CNR, Pisa, Italy
| | | | - Davide Paoli
- Center for Neurodegenerative diseases-Parkinson's disease and Movement disorders, Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara De Cori
- Department of Radiology, Fondazione Monasterio/CNR, Pisa, Italy
| | - Francesca Frijia
- Deep Health Unit, Fondazione Monasterio/CNR, Pisa, Italy
- Bioengineering Unit, Fondazione Monasterio/CNR, Pisa, Italy
| | - Gabriele Siciliano
- Center for Neurodegenerative diseases-Parkinson's disease and Movement disorders, Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Center for Neurodegenerative diseases-Parkinson's disease and Movement disorders, Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
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Fontanelli L, Vadi G, Schirinzi E, Di Rauso G, Bellini G, Ricci G, Siciliano G. Intravenous immunoglobulin in the treatment of sporadic inclusion body myositis: time for new evidence? Clin Exp Rheumatol 2024; 42:462-463. [PMID: 38372729 DOI: 10.55563/clinexprheumatol/7x5o3q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Lorenzo Fontanelli
- Health Science Interdisciplinary Centre, Sant'Anna School of Advanced Studies, Pisa, and Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Gabriele Vadi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Erika Schirinzi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giulia Di Rauso
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Gabriele Bellini
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giulia Ricci
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
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8
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Cintoli S, Favilli L, Morganti R, Siciliano G, Ceravolo R, Tognoni G. Verbal fluency patterns associated with the amnestic conversion from mild cognitive impairment to dementia. Sci Rep 2024; 14:2029. [PMID: 38263387 PMCID: PMC10806051 DOI: 10.1038/s41598-024-52562-x] [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: 10/28/2023] [Accepted: 01/20/2024] [Indexed: 01/25/2024] Open
Abstract
Patients with amnestic mild cognitive impairment (aMCI) are at a higher risk of converting to Alzheimer's disease. The aim of this study was to examine the potential use of Verbal Fluency (VF) measures as markers for predicting the conversion to dementia. At baseline, 61 aMCI, aged 65 to 80 years, underwent a comprehensive neuropsychological assessment, including phonemic (PVF) and semantic verbal fluency (SVF) tasks. After 18 months, 14 individuals with aMCI had progressed to a diagnosis of dementia. The findings revealed that aMCI-converter group had lower Mini Mental State Examination and Rey Auditory Verbal Learning Task scores than aMCI-no converter and produced fewer clusters in both VF tasks and a lower number of switches in PVF at baseline (p < 0.05). According to receiver operating characteristic curve analysis, the number of clusters in PVF had the highest predictive value (AUC = 0.80) with a threshold of 5.510 for identifying aMCI-converter at baseline. Additionally, participants with higher levels of education exhibited more clusters and switches in VF tasks (p < 0.05). These results suggest that qualitative measures of VF could serve as neuropsychological markers for predicting cognitive decline in individuals with aMCI. Furthermore, the study highlights the potential influence of the education level on cognitive performance in neuropsychological tasks.
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Affiliation(s)
- Simona Cintoli
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy.
| | - Laura Favilli
- Department of NEUROFARBA- Section of Psychology, University of Florence, 50135, Florence, Italy
| | - Riccardo Morganti
- Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, 56126, Pisa, Italy
| | - Gabriele Siciliano
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
| | - Roberto Ceravolo
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
| | - Gloria Tognoni
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
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9
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Milano C, Montali M, Barachini S, Burzi IS, Pratesi F, Petrozzi L, Chico L, Morganti R, Gambino G, Rossi L, Ceravolo R, Siciliano G, Migliorini P, Petrini I, Pizzanelli C. Increased production of inflammatory cytokines by circulating monocytes in mesial temporal lobe epilepsy: A possible role in drug resistance. J Neuroimmunol 2024; 386:578272. [PMID: 38160122 DOI: 10.1016/j.jneuroim.2023.578272] [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: 09/09/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
We analyzed peripheral blood mononuclear cells (PBMCs) and serum inflammatory biomarkers in patients with mesial temporal lobe epilepsy (drug-resistant - DR, vs. drug-sensitive - DS). Patients with epilepsy showed higher levels of serum CCL2, CCL3, IL-8 and AOPP, and lower levels of FRAP and thiols compared to healthy controls (HC). Although none of the serum biomarkers distinguished DR from DS patients, when analysing intracellular cytokines after in vitro stimulation, DR patients presented higher percentages of IL-1β and IL-6 positive monocytes compared to DS patients and HC. Circulating innate immune cells might be implicated in DR epilepsy and constitute potential new targets for treatments.
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Affiliation(s)
- C Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
| | - M Montali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Barachini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I S Burzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Pratesi
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - L Petrozzi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - L Chico
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - R Morganti
- Section of Statistics, University of Pisa, Pisa, Italy
| | - G Gambino
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Ceravolo
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - P Migliorini
- Department of Clinical and Experimental Medicine, Clinical Immunology and Allergy Unit, University of Pisa, Pisa, Italy
| | - I Petrini
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
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10
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Saad FA, Saad JF, Siciliano G, Merlini L, Angelini C. Duchenne Muscular Dystrophy Gene Therapy. Curr Gene Ther 2024; 24:17-28. [PMID: 36411557 DOI: 10.2174/1566523223666221118160932] [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: 05/05/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022]
Abstract
Duchenne and Becker muscular dystrophies are allelic X-linked recessive neuromuscular diseases affecting both skeletal and cardiac muscles. Therefore, owing to their single X chromosome, the affected boys receive pathogenic gene mutations from their unknowing carrier mothers. Current pharmacological drugs are palliative that address the symptoms of the disease rather than the genetic cause imbedded in the Dystrophin gene DNA sequence. Therefore, alternative therapies like gene drugs that could address the genetic cause of the disease at its root are crucial, which include gene transfer/implantation, exon skipping, and gene editing. Presently, it is possible through genetic reprogramming to engineer AAV vectors to deliver certain therapeutic cargos specifically to muscle or other organs regardless of their serotype. Similarly, it is possible to direct the biogenesis of exosomes to carry gene editing constituents or certain therapeutic cargos to specific tissue or cell type like brain and muscle. While autologous exosomes are immunologically inert, it is possible to camouflage AAV capsids, and lipid nanoparticles to evade the immune system recognition. In this review, we highlight current opportunities for Duchenne muscular dystrophy gene therapy, which has been known thus far as an incurable genetic disease. This article is a part of Gene Therapy of Rare Genetic Diseases thematic issue.
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Affiliation(s)
- Fawzy A Saad
- Department of Biology, Padua University School of Medicine, Via Trieste 75, Padova 35121, Italy
- Department of Gene Therapy, Saad Pharmaceuticals, Tornimäe 7-26, Tallinn, 10145, Estonia
| | - Jasen F Saad
- Department of Gene Therapy, Saad Pharmaceuticals, Tornimäe 7-26, Tallinn, 10145, Estonia
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Pisa University School of Medicine, Pisa, Italy
| | - Luciano Merlini
- Department of Biomedical and Neuromotor Sciences, Bologna University School of Medicine, 40126 Bologna, Italy
| | - Corrado Angelini
- Department Neurosciences, Padova University School of Medicine, Padova, Italy
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11
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Ricci G, Govoni A, Torri F, Astrea G, Buchignani B, Marinella G, Battini R, Manca ML, Castiglione V, Giannoni A, Emdin M, Siciliano G. Characterization of Phenotypic Variability in Becker Muscular Dystrophy for Clinical Practice and Towards Trial Readiness: A Two-Years Follow up Study. J Neuromuscul Dis 2024; 11:375-387. [PMID: 38189759 DOI: 10.3233/jnd-221513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Becker muscular dystrophy (BMD) is a dystrophinopathy due to in-frame mutations in the dystrophin gene (DMD) which determines a reduction of dystrophin at muscle level. BMD has a wide spectrum of clinical variability with different degrees of disability. Studies of natural history are needed also in view of up-coming clinical trials. Objectives From an initial cohort of 32 BMD adult subjects, we present a detailed phenotypic characterization of 28 patients, then providing a description of their clinical natural history over the course of 12 months for 18 and 24 months for 13 of them. Methods Each patient has been genetically characterized. Baseline, and 1-year and 2 years assessments included North Star Ambulatory Assessment (NSAA), timed function tests (time to climb and descend four stairs), 6-minute walk test (6MWT), Walton and Gardner-Medwin Scale and Medical Research Council (MRC) scale. Muscle magnetic resonance imaging (MRI) was acquired at baseline and in a subgroup of 9 patients after 24 months. Data on cardiac function (electrocardiogram, echocardiogram, and cardiac MRI) were also collected. Results and conclusions Among the clinical heterogeneity, a more severe involvement is often observed in patients with 45-X del, with a disease progression over two years. The 6MWT appears sensitive to detect modification from baseline during follow up while no variation was observed by MRC testing. Muscle MRI of the lower limbs correlates with clinical parameters.Our study further highlights how the phenotypic variability of BMD adult patients makes it difficult to describe an uniform course and substantiates the need to identify predictive parameters and biomarkers to stratify patients.
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Affiliation(s)
- Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Alessandra Govoni
- Neuromuscular and Rare Disease Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy
| | - Francesca Torri
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Guja Astrea
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Bianca Buchignani
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
- Department of Translational Research and of New Surgical and Medical Technologies Pisa University, Pisa, Italy
| | - Gemma Marinella
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa, Italy
| | - Maria Laura Manca
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
- Department of Mathematics, University of Pisa, Pisa, Italy
| | - Vincenzo Castiglione
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Alberto Giannoni
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Michele Emdin
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
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12
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Schirinzi E, Ricci G, Torri F, Mancuso M, Siciliano G. Biomolecules of Muscle Fatigue in Metabolic Myopathies. Biomolecules 2023; 14:50. [PMID: 38254650 PMCID: PMC10812926 DOI: 10.3390/biom14010050] [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: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Metabolic myopathies are a group of genetic disorders that affect the normal functioning of muscles due to abnormalities in metabolic pathways. These conditions result in impaired energy production and utilization within muscle cells, leading to limitations in muscle function with concomitant occurrence of related signs and symptoms, among which fatigue is one of the most frequently reported. Understanding the underlying molecular mechanisms of muscle fatigue in these conditions is challenging for the development of an effective diagnostic and prognostic approach to test targeted therapeutic interventions. This paper outlines the key biomolecules involved in muscle fatigue in metabolic myopathies, including energy substrates, enzymes, ion channels, and signaling molecules. Potential future research directions in this field are also discussed.
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13
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Ricci M, Cicala G, Capasso A, Coratti G, Fiori S, Cutrona C, D'Amico A, Sansone VA, Bruno C, Messina S, Mongini T, Coccia M, Siciliano G, Pegoraro E, Masson R, Filosto M, Comi GP, Corti S, Ronchi D, Maggi L, D'Angelo MG, Vacchiano V, Ticci C, Ruggiero L, Verriello L, Ricci FS, Berardinelli AL, Maioli MA, Garibaldi M, Nigro V, Previtali SC, Pera MC, Tizzano E, Pane M, Tiziano FD, Mercuri E. Clinical Phenotype of Pediatric and Adult Patients With Spinal Muscular Atrophy With Four SMN2 Copies: Are They Really All Stable? Ann Neurol 2023; 94:1126-1135. [PMID: 37695206 DOI: 10.1002/ana.26788] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE The aim of this study was to provide an overview of the clinical phenotypes associated with 4 SMN2 copies. METHODS Clinical phenotypes were analyzed in all the patients with 4 SMN2 copies as part of a nationwide effort including all the Italian pediatric and adult reference centers for spinal muscular atrophy (SMA). RESULTS The cohort includes 169 patients (102 men and 67 women) with confirmed 4 SMN2 copies (mean age at last follow-up = 36.9 ± 19 years). Six of the 169 patients were presymptomatic, 8 were classified as type II, 145 as type III (38 type IIIA and 107 type IIIB), and 8 as type IV. The remaining 2 patients were asymptomatic adults identified because of a familial case. The cross-sectional functional data showed a reduction of scores with increasing age. Over 35% of the type III and 25% of the type IV lost ambulation (mean age = 26.8 years ± 16.3 SD). The risk of loss of ambulation was significantly associated with SMA type (p < 0.0001), with patients with IIIB and IV less likely to lose ambulation compared to type IIIA. There was an overall gender effect with a smaller number of women and a lower risk for women to lose ambulation. This was significant in the adult (p = 0.009) but not in the pediatric cohort (p = 0.43). INTERPRETATION Our results expand the existing literature on natural history of 4 SMN2 copies confirming the variability of phenotypes in untreated patients, ranging from type II to type IV and an overall reduction of functional scores with increasing age. ANN NEUROL 2023;94:1126-1135.
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Affiliation(s)
- Martina Ricci
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Gianpaolo Cicala
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Anna Capasso
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Giorgia Coratti
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Stefania Fiori
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Costanza Cutrona
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Adele D'Amico
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Valeria A Sansone
- The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy
| | - Claudio Bruno
- Center of Translational and Experimental Myology, and Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Sonia Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Tiziana Mongini
- AOU Città della Salute e della Scienza di Torino, presidio Molinette e OIRM (SS Malattie neuromuscolari e SC Neuropsichiatria Infantile), Turin, Italy
| | - Michela Coccia
- Department of Neurological Sciences, AOU Ospedali Riuniti di Ancona, Torrette, Ancona, Italy
| | - Gabriele Siciliano
- AOU Pisana (Department of Clinical and Experimental Medicine), Neurology Unit, Pisa, Italy
| | | | - Riccardo Masson
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia (Italy), NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Giacomo P Comi
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefania Corti
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Dario Ronchi
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lorenzo Maggi
- Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit, Milan, Italy
| | - Maria G D'Angelo
- NeuroMuscular Unit, Scientific Institute IRCCS E. Medea, Lecco, Italy
| | - Veria Vacchiano
- UOC Clinica Neurologica, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Chiara Ticci
- Metabolic Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Lucia Ruggiero
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lorenzo Verriello
- Neurology Unit, Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Federica S Ricci
- AOU Città della Salute e della Scienza di Torino, presidio Molinette e OIRM (SS Malattie neuromuscolari e SC Neuropsichiatria Infantile), Turin, Italy
| | | | | | - Matteo Garibaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Vincenzo Nigro
- Medical Genetics and Cardiomyology Unit, Department of Precision Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
- TIGEM, Pozzuoli, Italy
| | - Stefano C Previtali
- Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Carmela Pera
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Eduardo Tizzano
- Department of Clinical and Molecular Genetics, Medicine Genetics Group, VHIR, Hospital Vall Hebron Barcelona, Barcelona, Spain
| | - Marika Pane
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Danilo Tiziano
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Agostino Gemelli IRCCS, Rome, Italy
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14
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Vicino A, Bello L, Bonanno S, Govoni A, Cerri F, Ferraro M, Capece G, Gadaleta G, Meneri M, Vacchiano V, Ricci G, D'Errico E, Tramacere I, Banfi P, Bortolani S, Zanin R, Maioli MA, Silvestrini M, Previtali SC, Berardinelli A, Turri M, Coccia M, Mantegazza R, Liguori R, Filosto M, Siciliano G, Simone IL, Mongini T, Comi G, Pegoraro E, Maggi L. Respiratory function in a large cohort of treatment-naïve adult spinal muscular atrophy patients: a cross-sectional study. Neuromuscul Disord 2023; 33:911-916. [PMID: 37945485 DOI: 10.1016/j.nmd.2023.10.002] [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: 09/03/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
Due to poor data in literature, we aimed to investigate the respiratory function in a large cohort of naïve Italian adult (≥18 years) SMA patients in a multi-centric cross-sectional study. The following respiratory parameters were considered: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and need for non-invasive ventilation (NIV). We included 145 treatment-naïve adult patients (SMA2=18, SMA3=125; SMA4=2), 58 females (40 %), with median age at evaluation of 37 years (range 18-72). Fifty-six (37 %) and 41 (31 %) patients had abnormal (<80 %) values of FVC and FEV1, respectively. Fourteen (14 %) patients needed NIV, started at median age of 21 (range 4-68). Motor function, measured by Hammersmith Functional Motor Scale Expanded and Revised Upper Limb Module as well as SMA2, loss of walking ability, surgery for scoliosis, use of NIV, and cough assisting device (CAD) were all significantly associated to lower FVC and FEV1 values, while no association with age at baseline, disease duration, gender or 6 min walking test was observed, except for a correlation between FVC and age in SMA3 walkers (p < 0.05). In conclusion, respiratory function in adult SMA patients is relatively frequently impaired, substantially stable, and significantly correlated with motor function and disease severity.
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Affiliation(s)
- Alex Vicino
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta Neurological Institute, Via Celoria 11, Milano 20133, Italy; Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Luca Bello
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Silvia Bonanno
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta Neurological Institute, Via Celoria 11, Milano 20133, Italy
| | - Alessandra Govoni
- Neuromuscular and Rare Disease Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federica Cerri
- Division of Neuroscience, Department of Neurology & INSPE, San Raffaele Hospital, Milano, Italy
| | - Manfredi Ferraro
- Department of Neuroscience Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Giuliana Capece
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Giulio Gadaleta
- Department of Neuroscience Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Megi Meneri
- Neuromuscular and Rare Disease Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy
| | - Veria Vacchiano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eustachio D'Errico
- Neurology Unit, Azienda Ospedaliero-Universitaria, Policlinico of Bari, Bari, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Paolo Banfi
- Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Sara Bortolani
- Department of Neuroscience Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Riccardo Zanin
- Developmental Neurology, Foundation IRCCS Carlo Besta Neurological Institute, Milano, Italy
| | | | - Mauro Silvestrini
- Department of Experimental and Clinical Medicine, Universita Politecnica delle Marche Facolta di Medicina e Chirurgia, Ancona, Italy; Department of Neurological Sciences, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Stefano Carlo Previtali
- Division of Neuroscience, Department of Neurology & INSPE, San Raffaele Hospital, Milano, Italy
| | - Angela Berardinelli
- Department of Child Neuropsychiatry, Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy
| | - Mara Turri
- Department of Neurology/Stroke Unit, Bolzano Hospital, Bolzano, Italy
| | - Michela Coccia
- Department of Neurological Sciences, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Renato Mantegazza
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta Neurological Institute, Via Celoria 11, Milano 20133, Italy
| | - Rocco Liguori
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy; Dipartimento di Scienze Biomediche e Neuromotorie, Universita degli Studi di Bologna, Bologna, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Isabella Laura Simone
- Neurology Unit, Azienda Ospedaliero-Universitaria, Policlinico of Bari, Bari, Italy; School of Medicine, University of Bari "Aldo Moro" Bari, Bari, Italy
| | - Tiziana Mongini
- Department of Neuroscience Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Giacomo Comi
- Neuromuscular and Rare Disease Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milano, Italy
| | - Elena Pegoraro
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta Neurological Institute, Via Celoria 11, Milano 20133, Italy.
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Conti F, Di Martino S, Drago F, Bucolo C, Micale V, Montano V, Siciliano G, Mancuso M, Lopriore P. Red Flags in Primary Mitochondrial Diseases: What Should We Recognize? Int J Mol Sci 2023; 24:16746. [PMID: 38069070 PMCID: PMC10706469 DOI: 10.3390/ijms242316746] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Primary mitochondrial diseases (PMDs) are complex group of metabolic disorders caused by genetically determined impairment of the mitochondrial oxidative phosphorylation (OXPHOS). The unique features of mitochondrial genetics and the pivotal role of mitochondria in cell biology explain the phenotypical heterogeneity of primary mitochondrial diseases and the resulting diagnostic challenges that follow. Some peculiar features ("red flags") may indicate a primary mitochondrial disease, helping the physician to orient in this diagnostic maze. In this narrative review, we aimed to outline the features of the most common mitochondrial red flags offering a general overview on the topic that could help physicians to untangle mitochondrial medicine complexity.
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Affiliation(s)
- Federica Conti
- Department of Biomedical and Biotechnological Science, School of Medicine, University of Catania, 95123 Catania, Italy; (F.C.); (S.D.M.); (C.B.); (V.M.)
| | - Serena Di Martino
- Department of Biomedical and Biotechnological Science, School of Medicine, University of Catania, 95123 Catania, Italy; (F.C.); (S.D.M.); (C.B.); (V.M.)
| | - Filippo Drago
- Department of Biomedical and Biotechnological Science, School of Medicine, University of Catania, 95123 Catania, Italy; (F.C.); (S.D.M.); (C.B.); (V.M.)
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Science, School of Medicine, University of Catania, 95123 Catania, Italy; (F.C.); (S.D.M.); (C.B.); (V.M.)
- Center for Research in Ocular Pharmacology-CERFO, University of Catania, 95213 Catania, Italy
| | - Vincenzo Micale
- Department of Biomedical and Biotechnological Science, School of Medicine, University of Catania, 95123 Catania, Italy; (F.C.); (S.D.M.); (C.B.); (V.M.)
| | - Vincenzo Montano
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy (P.L.)
| | - Gabriele Siciliano
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy (P.L.)
| | - Michelangelo Mancuso
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy (P.L.)
| | - Piervito Lopriore
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy (P.L.)
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16
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Pascazio A, Maestri M, Pasquali L, Hoxhaj D, Fabbrini M, Furfori G, Ulivi M, Bianchi F, Morganti R, Siciliano G, Bonanni E. Restless Legs Syndrome and fatigue in multiple sclerosis: A cross-sectional clinical study. Mult Scler Relat Disord 2023; 79:104946. [PMID: 37639779 DOI: 10.1016/j.msard.2023.104946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/05/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Restless Legs Syndrome is a sleep-related sensorimotor disorder with a higher prevalence in Multiple Sclerosis (MS) patients than in the general population. Our aim was to determine the prevalence of RLS in a group of relapsing-remittent multiple sclerosis (RRMS) patients, and to investigate whether RLS is associated with MS-related disability, sleep quality, mood disorders and fatigue. METHODS In this retrospective, mono-centric, observational study, 92 RRMS patients were recruited (median age 46.5 years, 68.5% female patients). Data on MS clinical and radiological variables were collected. Patients underwent a subjective evaluation with standardized questionnaires on sleep fatigue and mood, which were evaluated by an expert neurologists specialized in sleep disorders about the occurrence of RLS. RESULTS Prevalence of RLS in our sample was of 47.8%. Patients with RLS had a significantly higher rate of worse sleep quality and fatigue, compared to non RLS subjects (respectively 56.8% vs. 35.4%, p=0.04 and 54.4% vs 22.7%, p=0.002). Univariate analysis showed that RLS was significantly more frequent in fatigued patients (66.7% vs 38.5% RLS- patients, p=0.009). Multivariate analysis showed that fatigue correlated with MS-related disability (OR 1.556, p=0.011), poor sleep quality (OR 1.192, p 0.036), and mood disorders (OR 1.096, p 0.046). RLS appears to independently increase the risk of fatigue of 50%, without reaching clear statistical significance (OR 1.572, p 0,0079). CONCLUSION Our study confirms the high prevalence of RLS in patients with multiple sclerosis and highlights the potential impact of RLS on fatigue and its strict interaction with sleep quality.
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Affiliation(s)
- Alessia Pascazio
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy.
| | - Livia Pasquali
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Domeniko Hoxhaj
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Monica Fabbrini
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Giulia Furfori
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Martina Ulivi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Francesca Bianchi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, via Roma 67, Pisa 56126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, via Roma 67, Pisa 56126, Italy
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17
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Toscano A, Musumeci O, Sacchini M, Ravaglia S, Siciliano G, Fiumara A, Verrecchia E, Maione M, Gentile J, Fischetto R, Crescimanno G, Taurisano R, Sechi A, Gasperini S, Cianci V, Maggi L, Parini R, Lupica A, Scarpa M. Safety outcomes and patients' preferences for home-based intravenous enzyme replacement therapy (ERT) in pompe disease and mucopolysaccharidosis type I (MPS I) disorder: COVID-19 and beyond. Orphanet J Rare Dis 2023; 18:338. [PMID: 37891668 PMCID: PMC10604412 DOI: 10.1186/s13023-023-02919-8] [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: 06/28/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The Italian Medicines Agency (AIFA) demands precise information on benefit/risk profile of home-based enzyme replacement therapy (ERT) for the treatment of patients with Pompe disease and Mucopolysaccharidosis type I (MPS I). This passage is necessary to obtain the authorization for ERT home therapy, even after the coronavirus disease-19 (COVID-19) pandemic period. This research intends to evaluate the safety, treatment satisfaction, and compliance of MPS I patients treated with laronidase (Aldurazyme®) and Pompe Disease patients treated with alglucosidase alfa (Myozyme®) in a homecare setting. RESULTS We report herein an early interim analysis of the HomERT (Home infusions of ERT) study, a multicenter, non-interventional, double-cohort study that retrospectively analyzed 38 patients from 14 sites in Italy: cohort A (Pompe disease - 32 patients) and cohort B (MPS I - 6 patients). Among the selected patients who started home therapy before enrollment, the average number of missed home-based infusions was 0.7 (1.3) in cohort A and 3.8 (6.4) in cohort B with no return to the hospital setting. Irrespective of the treatment location, 3 prior ADRs per cohort were reported. The majority of patients preferred home-based infusions (cohort A: 96.9%; cohort B: 100%): the main reason was attributed to treatment convenience (cohort A: 81.3%; cohort B: 83.3%). Despite the underlying conditions, most patients self-evaluated their health as "good" (cohort A: 50%; cohort B: 83.3%). CONCLUSIONS Evidence of favorable safety profile, improved treatment compliance and personal satisfaction validates the use of ERT with laronidase and alglucosidase alfa as a strong candidate for home therapy.
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Affiliation(s)
- Antonio Toscano
- Full Professor of Neurology, ERN-NMD Center of Messina for Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria, 1, Messina, 98125, Italy.
| | - Olimpia Musumeci
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, 98125, ME, Italy
| | - Michele Sacchini
- DH Hereditary metabolic-muscular diseases Meyer Hospital, Ground floor - DH Viale Pieraccini, 24, Florence, 50139, Italy
| | - Sabrina Ravaglia
- IRCCS Fondazione Istituto Neurologico Nazionale C.Mondino, Via Mondino, 2, Pavia, 27100, PV, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, S. Chiara Hospital - University of Pisa, Via Roma, 67, Pisa, 56126, Italy
| | - Agata Fiumara
- A.O.U. Policlinico - Pediatric Clinic and Regional Referral Center for Inherited Metabolic Diseases, Via Santa Sofia, 78, Catania, 95122, CT, Italy
| | - Elena Verrecchia
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Agostino Gemelli University Hospital Foundation, Via Giuseppe Moscati, 31, Rome, 00168, RM, Italy
| | - Melania Maione
- Medical Manager Pompe Disease - Rare Diseases Specialty Care, Sanofi S.r.l., Viale Luigi Bodio 37/b, Milano, 20158, MI, Italy
| | - Jennifer Gentile
- Medical Manager Gaucher, MPS & ASMD, Sanofi S.r.l., Viale Luigi Bodio 37/b, Milano, 20158, MI, Italy
| | - Rita Fischetto
- Policlinico di Bari Stabilimento Pediatrico Giovanni XXIII, Metabolic and Genetic Diseases, Piazza Giulio Cesare, 11, Bari, 70120, BA, Italy
| | - Grazia Crescimanno
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Via La Malfa 153, Palermo, Italy
| | - Roberta Taurisano
- Bambin Gesù Pediatric Hospital Piazza Sant'Onofrio, Rome (RM), 4 00165, Italy
| | - Annalisa Sechi
- Regional Coordination Center for Rare Diseases, Udine University Hospital, Udine, 33100, UD, Italy
| | - Serena Gasperini
- Unit of Inherited Metabolic Disorders, Pediatric Department, IRCCS San Gerardo Foundation dei Tintori, Via Pergolesi, 33 - Monza (MB), Tintori, Italy
| | - Vittoria Cianci
- Great Metropolitan Hospital "Bianchi Melacrino Morelli" - Neurology, Reggio Calabria (RC), Via Melacrino, Calabria, 89100, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, IRCCS Istituto Neurologico Besta, Via Celoria, 11, Milan, 20133, MI, Italy
| | - Rossella Parini
- ASST Monza - Rare Disease Center, San Gerardo hospital in Monza, Via Pergolesi, Monza, 33 - 20900, MB, Italy
| | - Antonino Lupica
- AOU Policlinico P. Giaccone of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Maurizio Scarpa
- Regional Coordinating Center for Rare Diseases, Udine University Hospital, Udine, 33100, Italy
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18
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Merico E, Schirinzi E, Baldinotti F, Govoni A, Siciliano G. Phenotypic characterization of c.379A > G GJB1 mutation in a Charcot-Marie-Tooth female patient. Acta Neurol Belg 2023; 123:2031-2033. [PMID: 36175785 DOI: 10.1007/s13760-022-02093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/05/2022] [Indexed: 11/01/2022]
Affiliation(s)
- E Merico
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, via Roma 67, 56126, Pisa, Italy.
| | - E Schirinzi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - F Baldinotti
- Laboratory of Molecular Genetics, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Govoni
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, via Roma 67, 56126, Pisa, Italy
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19
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Ricci G, Torri F, Govoni A, Chiappini R, Manca L, Vadi G, Roccella S, Magri F, Meneri M, Fassini F, Vacchiano V, Tomassini S, Gironella N, Coccia M, Comi G, Liguori R, Siciliano G. Proposal of a new clinical protocol for evaluating fatigability in adult SMA patients. Acta Myol 2023; 42:65-70. [PMID: 38090548 PMCID: PMC10712654 DOI: 10.36185/2532-1900-330] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/28/2023] [Indexed: 12/18/2023]
Abstract
Objective Spinal Muscular Atrophy (SMA) is a genetic neuromuscular disease affecting the lower motor neuron, carrying a significant burden on patients' general motor skills and quality of life, characterized by a great variability in phenotypic expression. As new therapeutic options make their appearance on the scene, sensitive clinical tools and outcome measures are needed, especially in adult patients undergoing treatment, in which the expected clinical response is a mild improvement or stabilization of disease progression. Methods Here, we describe a new functional motor scale specifically designed for evaluating the endurance dimension for the upper and lower limbs in adult SMA patients. Results The scale was first tested in eight control healthy subjects and then validated in ten adult SMA patients, proving intra- and inter-observer reliability. We also set up an evaluation protocol by using wearable devices including surface EMG and accelerometer. Conclusions The endurance evaluation should integrate the standard clinical monitoring in the management and follow-up of SMA adult patients.
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Affiliation(s)
- Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Torri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Govoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Chiappini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Manca
- Department of Mathematics, University of Pisa, Pisa, Italy
| | - Gabriele Vadi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Roccella
- The Biorobotics Institute, Sant’Anna Superior Studies School, Pisa, Italy
| | - Francesca Magri
- Ospedale Maggiore Policlinico; University of Milan, Dpt Neurological Sciences, Milano, Italy
| | - Megi Meneri
- Ospedale Maggiore Policlinico; University of Milan, Dpt Neurological Sciences, Milano, Italy
| | - Federica Fassini
- Ospedale Maggiore Policlinico; University of Milan, Dpt Neurological Sciences, Milano, Italy
| | - Veria Vacchiano
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | | | - Giacomo Comi
- Ospedale Maggiore Policlinico; University of Milan, Dpt Neurological Sciences, Milano, Italy
| | - Rocco Liguori
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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20
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Fontanelli L, Pizzanelli C, Milano C, Cassano Cassano R, Galimberti S, Rossini MI, Santo I, Turco F, Bonanni E, Siciliano G, Orciuolo E, Baldacci F. Pre-existing frontal lobe dysfunction signs as predictors of subsequent neurotoxicity in CAR T cell therapy: insights from a case series. Neurol Sci 2023; 44:3291-3297. [PMID: 37160803 PMCID: PMC10170036 DOI: 10.1007/s10072-023-06841-6] [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: 03/04/2023] [Accepted: 05/02/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Chimeric Antigen Receptor (CAR) T cell therapies are innovative treatments against hematological malignancies, with increasing therapeutic indications. Despite their great efficacy, these therapies are hampered by high rates of neurotoxicity (immune effector cell-associated neurotoxicity (ICANS)). In the past few years, several risk factors have been associated with ICANS and grouped together in the attempt to build validated models able to predict neurologic complications. However, little is known about pre-existing neurologic conditions possibly related to the development of neurotoxicity. METHODS AND RESULTS In our case series, including sixteen consecutive patients treated with CAR T cells, we observed that (i) neurotoxicity only occurred in the two patients who presented subtle clinical signs of frontal lobe impairment at baseline and (ii) neurologic manifestations of ICANS consisted of language disturbances and cortical frontal myoclonus, which were both manifestations of a frontal predominant dysfunction. DISCUSSION Based on our experience, we suggest that a pre-existing frontal lobe impairment, even if at a subclinical level, may eventually drive to ICANS, which in turn shows symptoms compatible with a frontal encephalopathy. It is remarkable that this focal neurotoxicity involved the same CNS regions that were responsible of subtle neurological signs at baseline. Future studies on larger numbers of patients are needed to confirm the possible role of baseline frontal lobe dysfunction as a predictor of ICANS, in order to enhance efforts to safely deliver CAR T cell therapy.
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Affiliation(s)
- Lorenzo Fontanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
| | - Chiara Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | | | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Haematology Unit, University of Pisa, Pisa, Italy
| | - Maria Ida Rossini
- Department of Clinical and Experimental Medicine, Haematology Unit, University of Pisa, Pisa, Italy
| | - Ignazio Santo
- Department of Clinical and Experimental Medicine, Haematology Unit, University of Pisa, Pisa, Italy
| | - Francesco Turco
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Enrico Orciuolo
- Department of Clinical and Experimental Medicine, Haematology Unit, University of Pisa, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
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21
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Beretta S, Cristillo V, Camera G, Morotti Colleoni C, Pellitteri G, Viti B, Bianchi E, Gipponi S, Grimoldi M, Valente M, Guttmann S, Cotelli MS, Palumbo P, Gelosa G, Meletti S, Schenone C, Ottaviani D, Filippi M, Zini A, Basilico P, Tancredi L, Cortelli P, Braga M, De Giuli V, Servidei S, Paolicelli D, Verde F, Caproni S, Pisani A, Lo Re V, Massacesi L, Roccatagliata DV, Manganotti P, Spitaleri D, Formenti A, Piccioli M, Marino S, Polverino P, Aguglia U, Ornello R, Perego E, Siciliano G, Merlo P, Capobianco M, Pantoni L, Lugaresi A, Angelocola S, De Rosa A, Sessa M, Beghi E, Agostoni EC, Monaco S, Padovani A, Priori A, Silani V, Tedeschi G, Ferrarese C. Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants. Neurology 2023; 101:e892-e903. [PMID: 37414564 PMCID: PMC10501088 DOI: 10.1212/wnl.0000000000207534] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 05/04/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A variety of neurologic disorders have been reported as presentations or complications of coronavirus disease 2019 (COVID-19) infection. The objective of this study was to determine their incidence dynamics and long-term functional outcome. METHODS The Neuro-COVID Italy study was a multicenter, observational, cohort study with ambispective recruitment and prospective follow-up. Consecutive hospitalized patients presenting new neurologic disorders associated with COVID-19 infection (neuro-COVID), independently from respiratory severity, were systematically screened and actively recruited by neurology specialists in 38 centers in Italy and the Republic of San Marino. The primary outcomes were incidence of neuro-COVID cases during the first 70 weeks of the pandemic (March 2020-June 2021) and long-term functional outcome at 6 months, categorized as full recovery, mild symptoms, disabling symptoms, or death. RESULTS Among 52,759 hospitalized patients with COVID-19, 1,865 patients presenting 2,881 new neurologic disorders associated with COVID-19 infection (neuro-COVID) were recruited. The incidence of neuro-COVID cases significantly declined over time, comparing the first 3 pandemic waves (8.4%, 95% CI 7.9-8.9; 5.0%, 95% CI 4.7-5.3; 3.3%, 95% CI 3.0-3.6, respectively; p = 0.027). The most frequent neurologic disorders were acute encephalopathy (25.2%), hyposmia-hypogeusia (20.2%), acute ischemic stroke (18.4%), and cognitive impairment (13.7%). The onset of neurologic disorders was more common in the prodromic phase (44.3%) or during the acute respiratory illness (40.9%), except for cognitive impairment whose onset prevailed during recovery (48.4%). A good functional outcome was achieved by most patients with neuro-COVID (64.6%) during follow-up (median 6.7 months), and the proportion of good outcome increased throughout the study period (r = 0.29, 95% CI 0.05-0.50; p = 0.019). Mild residual symptoms were frequently reported (28.1%) while disabling symptoms were common only in stroke survivors (47.6%). DISCUSSION Incidence of COVID-associated neurologic disorders decreased during the prevaccination phase of the pandemic. Long-term functional outcome was favorable in most neuro-COVID disorders, although mild symptoms commonly lasted more than 6 months after infection.
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Affiliation(s)
- Simone Beretta
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy.
| | - Viviana Cristillo
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Giorgia Camera
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Carlo Morotti Colleoni
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Gaia Pellitteri
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Beatrice Viti
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Elisa Bianchi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Stefano Gipponi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Maria Grimoldi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Mariarosaria Valente
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Susanna Guttmann
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Maria Sofia Cotelli
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Pasquale Palumbo
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Giorgio Gelosa
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Stefano Meletti
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Cristina Schenone
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Donatella Ottaviani
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Massimo Filippi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Andrea Zini
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Paola Basilico
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Lucia Tancredi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Pietro Cortelli
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Massimiliano Braga
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Valeria De Giuli
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Serenella Servidei
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Damiano Paolicelli
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Federico Verde
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Stefano Caproni
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Antonio Pisani
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Vincenzina Lo Re
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Luca Massacesi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Daria Valeria Roccatagliata
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Paolo Manganotti
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Daniele Spitaleri
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Anna Formenti
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Marta Piccioli
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Silvia Marino
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Paola Polverino
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Umberto Aguglia
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Raffaele Ornello
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Elisabetta Perego
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Gabriele Siciliano
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Paola Merlo
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Marco Capobianco
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Leonardo Pantoni
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Alessandra Lugaresi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Stefania Angelocola
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Anna De Rosa
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Maria Sessa
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Ettore Beghi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Elio Clemente Agostoni
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Salvatore Monaco
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Alessandro Padovani
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Alberto Priori
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Vincenzo Silani
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Gioacchino Tedeschi
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
| | - Carlo Ferrarese
- From the Department of Neurology (S.B., C.M.C., C.F.), Fondazione IRCCS San Gerardo dei Tintori, Monza; Department of Medicine and Surgery (S.B., C.M.C., C.F.), University of Milano Bicocca; The Milan Center for Neuroscience (NeuroMI) (S.B., G.G., C.F.); Neurology Unit and Department of Clinical and Experimental Sciences (V.C., S. Gipponi, A. Padovani), University of Brescia; Unit of Neurology and Neurophysiology (G.C., M.G., M.S.), ASST PG23, Bergamo; Santa Maria della Misericordia University Hospital (G.P., M.V.), Udine, Italy; San Marino Neurological Unit (B.V., S. Guttmann), San Marino Hospital; The Mario Negri Institute for Pharmacological Research IRCCS (E. Bianchi, E. Beghi), Milan; Department of Medical Area (DAME) (M.V.), University of Udine; Neurology Unit (M.S.C.), ASST Valcamonica, Esine, Brescia; USL Centro Toscana (P. Palumbo), Neurology Unit, Nuovo Ospedale Santo Stefano, Prato; Department of Neurology and Stroke Unit (G.G., E.C.A.), Niguarda, Milan; Department of Neurology and Department of Clinical Neurophysiology AOU Modena (S. Meletti), University of Modena and Reggio Emilia; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health (C.S.), University of Genoa; Ospedale Santa Maria del Carmine di Rovereto (D.O.), Trento; Neurology Unit (M.F.), IRCCS San Raffaele Scientific Institute, Milan; Department of Neurology (A.Z.), Metropolitan Stroke Network, Ospedale Maggiore, Bologna; Department of Neurology (P.B.), Ospedale A. Manzoni ASST Lecco; University of Milan (L.T., L.P., A. Priori); Neurology Unit (L.T., A. Priori), ASST Santi Paolo e Carlo; Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics (L.T.), Milan; IRCCS Institute of Neurological Science of Bologna (P.C.); DIBINEM (P.C.), University of Bologna; UOC Neurology (M.B.), ASST Vimercate; Department of Neurology (V.D.G.), ASST Cremona; Neurophysiopathology Unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs (D.P.), University of Bari; Department of Neurology and Laboratory of Neuroscience (F.V., V.S.), IRCCS Istituto Auxologico Italiano; "Dino Ferrari" Center (F.V., V.S.), Department of Pathophysiology and Transplantation, Università degli Studi di Milano; Neurology Division (S.C.), "S. Maria" University Hospital, Terni; IRCCS Mondino Foundation (A. Pisani), Department of Brain and Behavioral Sciences, University of Pavia; Department of Diagnostic and Therapeutic Services (V.L.R.), IRCCS ISMETT, Palermo; Department of Neurology 2 (L.M.), Careggi University Hospital, Florence; Department of Neurology and Neurosurgery (D.V.R.), ASST di Mantova; Clinical Neurology Unit (P. Manganotti), Cattinara University Hospital, University of Trieste; Department of Neurology (D.L.A.S.), AORN S.Giovanni Moscati, Avellino; Neurology and Stroke Unit (A.F.), Neuroscience Department, ASST-Lecco, Merate; Department of Neurology (M.P.), Ospedale San Filippo Neri, Rome; IRCCS Centro Neurolesi Bonino-Pulejo (S. Marino), Messina; Department of Neurology (P. Polverino), IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Medical and Surgical Sciences (U.A.), Magna Graecia University of Catanzaro; Department of Biotechnological and Clinical Sciences (R.O.), University of L'Aquila; Department of Neurology (E.P.), Ospedale Valduce, Como; Neurological Clinic (G.S.), University of Pisa; Department of Neurology (P. Merlo), Humanitas Gavazzeni, Bergamo; Department of Neurology (M.C.), S. Luigi Gonzaga Hospital, Orbassano; Ospedale Luigi Sacco (L.P.), Milan; IRCCS Institute of Neurological Science of Bologna (A.L.), UOSI Multiple Sclerosis Rehabilitation; Department of Biomedical Science and Neuromotricity (A.L.), University of Bologna; Department of Neurology (S.A.), Fermo; Department of Neurosciences (A.D.R.), Federico II University, Naples; Neurology Unit and Department of Neurosciences (S. Monaco), University of Verona; IRCCS Fondazione Ospedale Maggiore Policlinico (A. Priori), Milan; and Department of Advanced Medical and Surgical Sciences (G.T.), University of Campania, Naples, Italy
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22
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Saad FA, Siciliano G, Angelini C. Advances in Dystrophinopathy Diagnosis and Therapy. Biomolecules 2023; 13:1319. [PMID: 37759719 PMCID: PMC10526396 DOI: 10.3390/biom13091319] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 07/13/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Dystrophinopathies are x-linked muscular disorders which emerge from mutations in the Dystrophin gene, including Duchenne and Becker muscular dystrophy, and dilated cardiomyopathy. However, Duchenne muscular dystrophy interconnects with bone loss and osteoporosis, which are exacerbated by glucocorticoids therapy. Procedures for diagnosing dystrophinopathies include creatine kinase assay, haplotype analysis, Southern blot analysis, immunological analysis, multiplex PCR, multiplex ligation-dependent probe amplification, Sanger DNA sequencing, and next generation DNA sequencing. Pharmacological therapy for dystrophinopathies comprises glucocorticoids (prednisone, prednisolone, and deflazacort), vamorolone, and ataluren. However, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and β-blockers are the first-line to prevent dilated cardiomyopathy in dystrophinopathy patients. Duchenne muscular dystrophy gene therapy strategies involve gene transfer, exon skipping, exon reframing, and CRISPR gene editing. Eteplirsen, an antisense-oligonucleotide drug for skipping exon 51 from the Dystrophin gene, is available on the market, which may help up to 14% of Duchenne muscular dystrophy patients. There are various FDA-approved exon skipping drugs including ExonDys-51 for exon 51, VyonDys-53 and Viltolarsen for exon 53 and AmonDys-45 for exon 45 skipping. Other antisense oligonucleotide drugs in the pipeline include casimersen for exon 45, suvodirsen for exon 51, and golodirsen for exon 53 skipping. Advances in the diagnosis and therapy of dystrophinopathies offer new perspectives for their early discovery and care.
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Affiliation(s)
- Fawzy A. Saad
- Department of Gene Therapy, Saad Pharmaceuticals, Juhkentali 8, 10132 Tallinn, Estonia
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Pisa University School of Medicine, Via Paradisa 2, 56100 Pisa, Italy;
| | - Corrado Angelini
- Department of Neurosciences, Padova University School of Medicine, Via Giustiniani 5, 35128 Padova, Italy;
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23
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Faravelli I, Gagliardi D, Abati E, Meneri M, Ongaro J, Magri F, Parente V, Petrozzi L, Ricci G, Farè F, Garrone G, Fontana M, Caruso D, Siciliano G, Comi GP, Govoni A, Corti S, Ottoboni L. Multi-omics profiling of CSF from spinal muscular atrophy type 3 patients after nusinersen treatment: a 2-year follow-up multicenter retrospective study. Cell Mol Life Sci 2023; 80:241. [PMID: 37543540 PMCID: PMC10404194 DOI: 10.1007/s00018-023-04885-7] [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: 04/02/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/07/2023]
Abstract
Spinal muscular atrophy (SMA) is a neurodegenerative disorder caused by mutations in the SMN1 gene resulting in reduced levels of the SMN protein. Nusinersen, the first antisense oligonucleotide (ASO) approved for SMA treatment, binds to the SMN2 gene, paralogue to SMN1, and mediates the translation of a functional SMN protein. Here, we used longitudinal high-resolution mass spectrometry (MS) to assess both global proteome and metabolome in cerebrospinal fluid (CSF) from ten SMA type 3 patients, with the aim of identifying novel readouts of pharmacodynamic/response to treatment and predictive markers of treatment response. Patients had a median age of 33.5 [29.5; 38.25] years, and 80% of them were ambulant at time of the enrolment, with a median HFMSE score of 37.5 [25.75; 50.75]. Untargeted CSF proteome and metabolome were measured using high-resolution MS (nLC-HRMS) on CSF samples obtained before treatment (T0) and after 2 years of follow-up (T22). A total of 26 proteins were found to be differentially expressed between T0 and T22 upon VSN normalization and LIMMA differential analysis, accounting for paired replica. Notably, key markers of the insulin-growth factor signaling pathway were upregulated after treatment together with selective modulation of key transcription regulators. Using CombiROC multimarker signature analysis, we suggest that detecting a reduction of SEMA6A and an increase of COL1A2 and GRIA4 might reflect therapeutic efficacy of nusinersen. Longitudinal metabolome profiling, analyzed with paired t-Test, showed a significant shift for some aminoacid utilization induced by treatment, whereas other metabolites were largely unchanged. Together, these data suggest perturbation upon nusinersen treatment still sustained after 22 months of follow-up and confirm the utility of CSF multi-omic profiling as pharmacodynamic biomarker for SMA type 3. Nonetheless, validation studies are needed to confirm this evidence in a larger sample size and to further dissect combined markers of response to treatment.
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Affiliation(s)
- Irene Faravelli
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy.
| | - Delia Gagliardi
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Abati
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Megi Meneri
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica Ongaro
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Magri
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Parente
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucia Petrozzi
- Department of Clinical and Experimental Medicine, Neurological Clinics, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinics, University of Pisa, Pisa, Italy
| | | | | | | | - Donatella Caruso
- Unitech OMICs, University of Milan, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinics, University of Pisa, Pisa, Italy
| | - Giacomo Pietro Comi
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Govoni
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Stefania Corti
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy.
- Neurology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Linda Ottoboni
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy.
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24
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Doneddu PE, Akyil H, Manganelli F, Briani C, Cocito D, Benedetti L, Mazzeo A, Fazio R, Filosto M, Cosentino G, Di Stefano V, Antonini G, Marfia GA, Inghilleri M, Siciliano G, Clerici AM, Carpo M, Schenone A, Luigetti M, Lauria G, Matà S, Rosso T, Minicuci GM, Lucchetta M, Cavaletti G, Liberatore G, Spina E, Campagnolo M, Peci E, Germano F, Gentile L, Strano C, Cotti Piccinelli S, Vegezzi E, Leonardi L, Mataluni G, Ceccanti M, Schirinzi E, Romozzi M, Nobile-Orazio E. Unclassified clinical presentations of chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2023; 94:614-621. [PMID: 37015771 DOI: 10.1136/jnnp-2022-331011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/15/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND To assess the ability of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) clinical criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) to include within their classification the whole spectrum of clinical heterogeneity of the disease and to define the clinical characteristics of the unclassifiable clinical forms. METHODS The 2021 EAN/PNS clinical criteria for CIDP were applied to 329 patients fulfilling the electrodiagnostic (and in some cases also the supportive) criteria for the diagnosis of CIDP. Clinical characteristics were reviewed for each patient not strictly fulfilling the clinical criteria ('unclassifiable'). RESULTS At study inclusion, 124 (37.5%) patients had an unclassifiable clinical presentation, including 110 (89%) with a typical CIDP-like clinical phenotype in whom some segments of the four limbs were unaffected by weakness ('incomplete typical CIDP'), 10 (8%) with a mild distal, symmetric, sensory or sensorimotor polyneuropathy confined to the lower limbs with cranial nerve involvement ('cranial nerve predominant CIDP') and 4 (1%) with a symmetric sensorimotor polyneuropathy limited to the proximal and distal areas of the lower limbs ('paraparetic CIDP'). Eighty-one (65%) patients maintained an unclassifiable presentation during the entire disease follow-up while 13 patients progressed to typical CIDP. Patients with the unclassifiable clinical forms compared with patients with typical CIDP had a milder form of CIDP, while there was no difference in the distribution patterns of demyelination. CONCLUSIONS A proportion of patients with CIDP do not strictly fulfil the 2021 EAN/PNS clinical criteria for diagnosis. These unclassifiable clinical phenotypes may pose diagnostic challenges and thus deserve more attention in clinical practice and research.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Houseyin Akyil
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | - Chiara Briani
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Cocito
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | | | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience, and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Maurizio Inghilleri
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Angelo Schenone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Marco Luigetti
- UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Giuseppe Lauria
- Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milano, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
| | - Sabrina Matà
- Dipartimento Neuromuscoloscheletrico e degli organi di Senso, Neurology Unit, University Hospital Careggi, Firenze, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassiano, Vicenza, Italy
| | | | - Marta Lucchetta
- UOC Neurologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | - Guido Cavaletti
- School of Medicine and surgery and experimental Neurology Unit, University of Milan-Bicocca, Milano, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Emanuele Spina
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | | | - Erdita Peci
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | | | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | | | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Marco Ceccanti
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy
| | - Erika Schirinzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marina Romozzi
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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25
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Karazi W, Scalco RS, Stemmerik MG, Løkken N, Lucia A, Santalla A, Martinuzzi A, Vavla M, Reni G, Toscano A, Musumeci O, Kouwenberg CV, Laforêt P, Millán BS, Vieitez I, Siciliano G, Kühnle E, Trost R, Sacconi S, Durmus H, Kierdaszuk B, Wakelin A, Andreu AL, Pinós T, Marti R, Quinlivan R, Vissing J, Voermans NC. Data from the European registry for patients with McArdle disease (EUROMAC): functional status and social participation. Orphanet J Rare Dis 2023; 18:210. [PMID: 37488619 PMCID: PMC10367320 DOI: 10.1186/s13023-023-02825-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The European registry for individuals with GSD5 and other muscle glycogenosis (EUROMAC) was launched to register rare muscle glycogenosis in Europe, to facilitate recruitment for research trials and to learn about the phenotypes and disseminate knowledge about the diseases. A network of twenty collaborating partners from eight European countries and the US contributed data on rare muscle glycogenosis in the EUROMAC registry. METHODS Following the initial report on demographics, neuromuscular features and comorbidity (2020), we here present the data on social participation, previous and current treatments (medication, supplements, diet and rehabilitation) and limitations. Furthermore, the following questionnaires were used: Fatigue severity scale (FSS), WHO Disability Assessment Scale (DAS 2.0), health related quality of life (SF36) and International Physical Activity Questionnaire (IPAQ). RESULTS Of 282 participants with confirmed diagnoses of muscle glycogenosis, 269 had GSD5. Of them 196 (73%) completed all questionnaires; for the others, the data were incomplete. The majority, 180 (67%) were currently working. Previous medical treatments included pain medication (23%) and rehabilitation treatment (60%). The carbohydrate-rich diet was reported to be beneficial for 68%, the low sucrose diet for 76% and the ketogenic diet for 88%. Almost all participants (93%) reported difficulties climbing stairs. The median FSS score was 5.22, indicating severe fatigue. The data from the WHODAS and IPAQ was not of sufficient quality to be interpreted. CONCLUSIONS The EUROMAC registry have provided insight into the functional and social status of participants with GSD5: most participants are socially active despite limitations in physical and daily life activities. Regular physical activity and different dietary approaches may alleviate fatigue and pain.
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Affiliation(s)
- Walaa Karazi
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Renata S Scalco
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, National Hospital, London, UK
| | - Mads G Stemmerik
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Instituto de Investigación Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Alfredo Santalla
- Instituto de Investigación Hospital, 12 de Octubre (imas12), Madrid, Spain
- Universidad Pablo de Olavide, Seville, Spain
| | - Andrea Martinuzzi
- Departments of Neurorehabilitation, IRCCS Medea Scientifc Insitute, Conegliano-Pieve Di Soligo, Italy
| | - Marinela Vavla
- Departments of Neurorehabilitation, IRCCS Medea Scientifc Insitute, Conegliano-Pieve Di Soligo, Italy
| | - Gianluigi Reni
- Department of Information Technology, Autonomous Province of Bolzano, Bolzano, Italy
| | - Antonio Toscano
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Olimpia Musumeci
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Carlyn V Kouwenberg
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
| | - Beatriz San Millán
- Pathology Department, Alvaro Cunqueiro Hospital, Vigo, Spain
- Rare Diseases and Pediatric Medicine Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGASUVIGO, Vigo, Spain
| | - Irene Vieitez
- Rare Diseases and Pediatric Medicine Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGASUVIGO, Vigo, Spain
| | - Gabriele Siciliano
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Kühnle
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bochum, Bochum, Germany
| | - Rebecca Trost
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bochum, Bochum, Germany
| | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, CHU Nice, Université Côte D'Azur, Institute for Research On Cancer and Aging of Nice (IRCAN), INSERM U1081, CNRS UMR 7284, Faculty of Medicine, Université Côte D'Azur (UCA), Nice, France
| | - Hacer Durmus
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Andrew Wakelin
- Association for Glycogen Storage Disease (UK), Bristol, UK
| | - Antoni L Andreu
- EATRIS, European Infrastructure for Translational Medicine, 1081 HZ, Amsterdam, The Netherlands
| | - Tomàs Pinós
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, and Research Group on Neuromuscular and Mitochondrial Diseases, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Ramon Marti
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, and Research Group on Neuromuscular and Mitochondrial Diseases, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, National Hospital, London, UK
| | - John Vissing
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Nicol C Voermans
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Fortunato F, Bianchi F, Ricci G, Torri F, Gualandi F, Neri M, Farnè M, Giannini F, Malandrini A, Volpi N, Lopergolo D, Silani V, Ticozzi N, Verde F, Pareyson D, Fenu S, Bonanno S, Nigro V, Peduto C, D'Ambrosio P, Zeuli R, Zanobio M, Picillo E, Servidei S, Primiano G, Sancricca C, Sciacco M, Brusa R, Filosto M, Cotti Piccinelli S, Pegoraro E, Mongini T, Solero L, Gadaleta G, Brusa C, Minetti C, Bruno C, Panicucci C, Sansone VA, Lunetta C, Zanolini A, Toscano A, Pugliese A, Nicocia G, Bertini E, Catteruccia M, Diodato D, Atalaia A, Evangelista T, Siciliano G, Ferlini A. Digital health and Clinical Patient Management System (CPMS) platform utility for data sharing of neuromuscular patients: the Italian EURO-NMD experience. Orphanet J Rare Dis 2023; 18:196. [PMID: 37480080 PMCID: PMC10360326 DOI: 10.1186/s13023-023-02776-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/18/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND The development of e-health technologies for teleconsultation and exchange of knowledge is one of the core purposes of European Reference Networks (ERNs), including the ERN EURO-NMD for rare neuromuscular diseases. Within ERNs, the Clinical Patient Management System (CPMS) is a web-based platform that seeks to boost active collaboration within and across the network, implementing data sharing. Through CPMS, it is possible to both discuss patient cases and to make patients' data available for registries and databases in a secure way. In this view, CPMS may be considered a sort of a temporary storage for patients' data and an effective tool for data sharing; it facilitates specialists' consultation since rare diseases (RDs) require multidisciplinary skills, specific, and outstanding clinical experience. Following European Union (EU) recommendation, and to promote the use of CPMS platform among EURO-NMD members, a twelve-month pilot project was set up to train the 15 Italian Health Care Providers (HCPs). In this paper, we report the structure, methods, and results of the teaching course, showing that tailored, ERN-oriented, training can significantly enhance the profitable use of the CPMS. RESULTS Throughout the training course, 45 professionals learned how to use the many features of the CPMS, eventually opening 98 panels of discussion-amounting to 82% of the total panels included in the EURO-NMD. Since clinical, genetic, diagnostic, and therapeutic data of patients can be securely stored within the platform, we also highlight the importance of this platform as an effective tool to discuss and share clinical cases, in order to ease both case solving and data storing. CONCLUSIONS In this paper, we discuss how similar course could help implementing the use of the platform, highlighting strengths and weaknesses of e-health for ERNs. The expected result is the creation of a "map" of neuromuscular patients across Europe that might be improved by a wider use of CPMS.
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Affiliation(s)
- Fernanda Fortunato
- Medical Genetics Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Medical Genetics Unit, Department of Mother and Child, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Francesca Bianchi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Francesca Torri
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Francesca Gualandi
- Medical Genetics Unit, Department of Mother and Child, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Marcella Neri
- Medical Genetics Unit, Department of Mother and Child, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Marianna Farnè
- Medical Genetics Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Medical Genetics Unit, Department of Mother and Child, Sant'Anna University Hospital of Ferrara, Ferrara, Italy
| | - Fabio Giannini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Alessandro Malandrini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Nila Volpi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Diego Lopergolo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università Degli Studi Di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università Degli Studi Di Milano, Milan, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università Degli Studi Di Milano, Milan, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Fenu
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Bonanno
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Vincenzo Nigro
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Naples, Italy
| | - Cristina Peduto
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Paola D'Ambrosio
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Roberta Zeuli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mariateresa Zanobio
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Esther Picillo
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Serenella Servidei
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Cristina Sancricca
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Monica Sciacco
- Neuromuscular and Rare Disease Unit, Department of Neuroscience, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Brusa
- Neuromuscular and Rare Disease Unit, Department of Neuroscience, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- ASST Spedali Civili Di Brescia, Brescia, Italy
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- ASST Spedali Civili Di Brescia, Brescia, Italy
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Elena Pegoraro
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Tiziana Mongini
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Luca Solero
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giulio Gadaleta
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Chiara Brusa
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Carlo Minetti
- Pediatric Neurology Unit and Muscle Unit, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Claudio Bruno
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Chiara Panicucci
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Valeria A Sansone
- The NEMO (NEuroMuscular Omniservice) Clinical Center, Milan, Italy
- Neurorehabilitation Unit, University of Milan, Milan, Italy
| | | | - Alice Zanolini
- The NEMO (NEuroMuscular Omniservice) Clinical Center, Milan, Italy
| | - Antonio Toscano
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- ERN-NMD Center of Messina, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessia Pugliese
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giulia Nicocia
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Michela Catteruccia
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Daria Diodato
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Antonio Atalaia
- Service of Neuromyology, APHP-GH Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Teresinha Evangelista
- Neuromuscular Morphology Unit, Institute of Myology, GHU Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Alessandra Ferlini
- Medical Genetics Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
- Medical Genetics Unit, Department of Mother and Child, Sant'Anna University Hospital of Ferrara, Ferrara, Italy.
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Castellani F, Visentin A, Schirinzi E, Salvalaggio A, Cacciavillani M, Candiotto C, Baratè C, Cellini A, Bertorelle R, Siciliano G, Trentin L, Briani C. Mutational Profile in 75 Patients With Anti-Myelin-Associated Glycoprotein Neuropathy: Clinical and Hematologic Therapy Response and Hints on New Therapeutic Targets. Neurol Neuroimmunol Neuroinflamm 2023; 10:10/4/e200122. [PMID: 37137530 PMCID: PMC10155778 DOI: 10.1212/nxi.0000000000200122] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Neuropathy with antibodies to myelin-associated glycoprotein (MAG) is the most common paraproteinemic IgM neuropathy. Recently, the mutational profile of the MYD88 and CXCR4 genes has been included in the diagnostic workup of IgM monoclonal gammopathies. The objective of our study was to assess the prevalence of MYD88 L265P and CXCR4 S338X gene variants in patients with anti-MAG antibody neuropathy. Secondary aims were to evaluate possible correlations between the mutational profile and neuropathy severity, antibody titers, and treatment response. METHODS Seventy-five patients (47 men, mean age at molecular analysis 70.8 ± 10.2 years; mean disease duration 5.1 ± 4.9 years) with anti-MAG antibody neuropathy were recruited. Among them, 38 (50.7%) had IgM monoclonal gammopathy of undetermined significance, 29 (38.7%) Waldenstrom macroglobulinemia (WM), and 8 (10.6%) chronic lymphocytic leukemia/marginal zone lymphoma/hairy cell leukemia variant. Molecular analysis was performed on DNA from the bone marrow mononuclear cells in 55 of 75 patients and from peripheral mononuclear cells in 18 of 75 patients. Forty-five patients were treated with rituximab, 6 with ibrutinib, 2 with obinutuzumab-chlorambucil, and 3 with venetoclax-based therapy. All the patients were assessed with the Inflammatory Neuropathy Cause and Treatment (INCAT) Disability Scale, INCAT Sensory Sum Score, and MRC Sum Score at baseline and follow-up. We considered as responders, patients who improved by at least 1 point in 2 clinical scales. RESULTS Fifty patients (66.7%) carried the MYD88L265P variant, with a higher frequency in WM and naive patients (77.2% vs 33.3%, p = 0.0012). No patients harbored the CXCR4S338X variant. There were no significant differences in hematologic data (IgM levels, M protein, and anti-MAG antibody titers), neuropathy severity, or response to rituximab in MYD88-altered and MYD88 wild-type patients. Nine of 11 (81.8%) patients treated with novel targeted drug, according to the MYD88 status, responded to treatments. DISCUSSION MYD88L265P variant has a high prevalence (66.7%) in anti-MAG antibody neuropathy representing a potential effective mutational target for Bruton tyrosine kinase inhibitors. MYD88L265P variant, however, does not seem to be a prognostic factor of neuropathy severity or response to rituximab. In patients not responding or becoming refractory to rituximab, a tailored therapy with new effective target therapies should be considered.
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Affiliation(s)
- Francesca Castellani
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Andrea Visentin
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Erika Schirinzi
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Alessandro Salvalaggio
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Mario Cacciavillani
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Cinzia Candiotto
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Claudia Baratè
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Alessandro Cellini
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Roberta Bertorelle
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Gabriele Siciliano
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Livio Trentin
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy
| | - Chiara Briani
- From the Department of Neurosciences (F.C., A.S., Chiara Briani), Neurology Unit, University of Padova; Hematology and Clinical Immunology Unit (A.V., A.C., L.T.), Department of Medicine, University of Padova; Department of Clinical and Experimental Medicine (E.S., G.S.), Neurological Clinic, University of Pisa; EMG Lab (M.C.), CEMES, Synlab Group, Padova; Immunology and Molecular Oncology (C.C., R.B.), Veneto Institute of Oncology IOV-IRCCS, Padova; and Department of Clinical and Experimental Medicine (Claudia Baratè), Section of Hematology, University of Pisa, Italy.
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Angelini CI, Ansevin C, Siciliano G. The role of sleep in neuromuscular disorders. Front Neurol 2023; 14:1195302. [PMID: 37456652 PMCID: PMC10339827 DOI: 10.3389/fneur.2023.1195302] [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: 03/28/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
Sleep represents a major frontier both in clinical myology and as a new possibility for delivering treatment to neuromuscular patients since various neuromuscular cases present a variable degree of disordered sleep and such conditions should be diagnosed and prevented, i.e., sleep apnea and hypoxemia. These sleep disorders are present in dystrophinopathies and in various types of limb-girdle muscular dystrophies (LGMD). Excessive daytime sleepiness (EDS) is found in patients affected by spastic paraparesis or cerebellar ataxia but is rather common in both myotonic dystrophy type 1 and 2, and the correction of sleep disorders is therefore important to improve their daily quality of life (QoL) and consequent daily functioning. Other types of sleep dysfunction such as insomnia, a reduction in rapid eye movement (REM) sleep, loss of normal REM, or sleep-disordered breathing are found in other disorders including myasthenia, ataxias, spastic paraparesis, Charcot-Marie-Tooth disease, and neurogenic disorders, including polyneuropathies, and need appropriate treatment. Research done on this topic aims to incorporate a variety of nuances in metabolic disorders such as those in late-onset Pompe disease and are such as those in late-onset Pompe disease who are susceptible to enzyme replacement therapy (ERT). The overarching goal is to explore both the diagnosis and methodology of sleep-related problems in both genetic and acquired neuromuscular disorders. We also review the type of available treatment opportunities utilized to improve neuromuscular patients' QoL.
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Affiliation(s)
| | - Carl Ansevin
- Department of Neurosciences, Sleep Center of the Ohio Neurologic Institute, Youngstown, OH, United States
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Leali M, Aimo A, Ricci G, Torri F, Todiere G, Vergaro G, Grigoratos C, Giannoni A, Aquaro GD, Siciliano G, Emdin M, Passino C, Barison A. Cardiac magnetic resonance findings and prognosis in type 1 myotonic dystrophy. J Cardiovasc Med (Hagerstown) 2023; 24:340-347. [PMID: 37129928 DOI: 10.2459/jcm.0000000000001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Cardiac involvement is a major determinant of prognosis in type 1 myotonic dystrophy (DM1), but limited information is available about myocardial remodeling and tissue changes. The aim of the study was to investigate cardiac magnetic resonance (CMR) findings and their prognostic significance in DM1. METHODS We retrospectively identified all DM1 patients referred from a neurology unit to our CMR laboratory from 2009 to 2020. RESULTS Thirty-four patients were included (aged 45 ± 12, 62% male individuals) and compared with 68 age-matched and gender-matched healthy volunteers (43 male individuals, age 48 ± 15 years). At CMR, biventricular and biatrial volumes were significantly smaller (all P < 0.05), as was left ventricular mass (P < 0.001); left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) were significantly lower (all P < 0.01). Five (15%) patients had a LVEF less than 50% and four (12%) a RVEF less than 50%. Nine patients (26%) showed mid-wall late gadolinium enhancement (LGE; 5 ± 2% of LVM), and 14 (41%) fatty infiltration. Native T1 in the interventricular septum (1041 ± 53 ms) was higher than for healthy controls (1017 ± 28 ms) and approached the upper reference limit (1089 ms); the extracellular volume was slightly increased (33 ± 2%, reference <30%). Over 3.7 years (2.0-5.0), 6 (18%) patients died of extracardiac causes, 5 (15%) underwent device implantation; 5 of 21 (24%) developed repetitive ventricular ectopic beats (VEBs) on Holter monitoring. LGE mass was associated with the occurrence of repetitive VEBs (P = 0.002). Lower LV stroke volume (P = 0.017), lower RVEF (P = 0.016), a higher LVMi/LVEDVI ratio (P = 0.016), fatty infiltration (P = 0.04), and LGE extent (P < 0.001) were associated with death. CONCLUSION DM1 patients display structural and functional cardiac abnormalities, with variable degrees of cardiac muscle hypotrophy, fibrosis, and fatty infiltration. Such changes, as evaluated by CMR, seem to be associated with the development of ventricular arrhythmias and a worse outcome.
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Affiliation(s)
- Marco Leali
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Torri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giancarlo Todiere
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | | | - Alberto Giannoni
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | | | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Andrea Barison
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
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De Filippi P, Errichiello E, Toscano A, Mongini T, Moggio M, Ravaglia S, Filosto M, Servidei S, Musumeci O, Giannini F, Piperno A, Siciliano G, Ricci G, Di Muzio A, Rigoldi M, Tonin P, Croce MG, Pegoraro E, Politano L, Maggi L, Telese R, Lerario A, Sancricca C, Vercelli L, Semplicini C, Pasanisi B, Bembi B, Dardis A, Palmieri I, Cereda C, Valente EM, Danesino C. Distribution of Exonic Variants in Glycogen Synthesis and Catabolism Genes in Late Onset Pompe Disease (LOPD). Curr Issues Mol Biol 2023; 45:2847-2860. [PMID: 37185710 PMCID: PMC10136686 DOI: 10.3390/cimb45040186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Pompe disease (PD) is a monogenic autosomal recessive disorder caused by biallelic pathogenic variants of the GAA gene encoding lysosomal alpha-glucosidase; its loss causes glycogen storage in lysosomes, mainly in the muscular tissue. The genotype–phenotype correlation has been extensively discussed, and caution is recommended when interpreting the clinical significance of any mutation in a single patient. As there is no evidence that environmental factors can modulate the phenotype, the observed clinical variability in PD suggests that genetic variants other than pathogenic GAA mutations influence the mechanisms of muscle damage/repair and the overall clinical picture. Genes encoding proteins involved in glycogen synthesis and catabolism may represent excellent candidates as phenotypic modifiers of PD. The genes analyzed for glycogen synthesis included UGP2, glycogenin (GYG1-muscle, GYG2, and other tissues), glycogen synthase (GYS1-muscle and GYS2-liver), GBE1, EPM2A, NHLRC1, GSK3A, and GSK3B. The only enzyme involved in glycogen catabolism in lysosomes is α-glucosidase, which is encoded by GAA, while two cytoplasmic enzymes, phosphorylase (PYGB-brain, PGL-liver, and PYGM-muscle) and glycogen debranching (AGL) are needed to obtain glucose 1-phosphate or free glucose. Here, we report the potentially relevant variants in genes related to glycogen synthesis and catabolism, identified by whole exome sequencing in a group of 30 patients with late-onset Pompe disease (LOPD). In our exploratory analysis, we observed a reduced number of variants in the genes expressed in muscles versus the genes expressed in other tissues, but we did not find a single variant that strongly affected the phenotype. From our work, it also appears that the current clinical scores used in LOPD do not describe muscle impairment with enough qualitative/quantitative details to correlate it with genes that, even with a slightly reduced function due to genetic variants, impact the phenotype.
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Affiliation(s)
| | - Edoardo Errichiello
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonio Toscano
- ERN-NMD Center of Messina for Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Tiziana Mongini
- Neuromuscular Unit, Department of Neuroscience RLM, University of Torino, 10126 Torino, Italy
| | - Maurizio Moggio
- Neuromuscular and Rare Diseases Unit, BioBank of Skeletal Muscle, Peripheral Nerve, DNA and Dino Ferrari Center, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | | | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, 25121 Brescia, Italy
| | | | - Olimpia Musumeci
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Fabio Giannini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, “Le Scotte” Hospital, 53100 Siena, Italy
| | - Alberto Piperno
- Fondazione IRCCS San Gerardo, Centro Ricerca Testamenti, Monza-European Reference Network–MetabERN, 20900 Monza, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinics, University of Pisa, 56100 Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinics, University of Pisa, 56100 Pisa, Italy
| | - Antonio Di Muzio
- Centre for Neuromuscular Disease, CeSI, University “G. d’Annunzio”, 66100 Chieti, Italy
| | - Miriam Rigoldi
- Dipartimento di Ricerca Malattie Rare, Istituto Mario Negri IRCCS, 24020 Ranica, Italy
| | - Paola Tonin
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, 37100 Verona, Italy
| | | | - Elena Pegoraro
- Department of Neurosciences, University of Padova, 35100 Padova, Italy
| | - Luisa Politano
- Cardiomiologia e Genetica Medica, Dipartimento di Medicina Sperimentale, Seconda Università di Napoli, 80100 Napoli, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20100 Milano, Italy
| | - Roberta Telese
- Centre for Neuromuscular Disease, CeSI, University “G. d’Annunzio”, 66100 Chieti, Italy
| | - Alberto Lerario
- Neuromuscular and Rare Diseases Unit, BioBank of Skeletal Muscle, Peripheral Nerve, DNA and Dino Ferrari Center, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | | | - Liliana Vercelli
- Neuromuscular Unit, Department of Neuroscience RLM, University of Torino, 10126 Torino, Italy
| | | | - Barbara Pasanisi
- Cardiomiologia e Genetica Medica, Dipartimento di Medicina Sperimentale, Seconda Università di Napoli, 80100 Napoli, Italy
| | - Bruno Bembi
- Regional Coordinator Centre for Rare Diseases, University Hospital “Santa Maria della Misericordia”, 33100 Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Centre for Rare Diseases, University Hospital “Santa Maria della Misericordia”, 33100 Udine, Italy
| | - Ilaria Palmieri
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Cristina Cereda
- Center of Functional Genomic and Rare Diseases-Buzzi Children’s Hospital, 20100 Milano, Italy
| | - Enza Maria Valente
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Cesare Danesino
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
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31
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Doneddu PE, Briani C, Cocito D, Manganelli F, Fabrizi GM, Matà S, Mazzeo A, Fazio R, Benedetti L, Luigetti M, Inghilleri M, Ruiu E, Siciliano G, Cosentino G, Marfia GA, Carpo M, Filosto M, Antonini G, Notturno F, Sotgiu S, Cucurachi L, Dell'Aquila C, Bianchi E, Rosso T, Giordano A, Fernandes M, Campagnolo M, Peci E, Spina E, Tagliapietra M, Sperti M, Gentile L, Strano C, Germano F, Romozzi M, Moret F, Zarbo IR, Viola DV, Vegezzi E, Mataluni G, Piccinelli SC, Leonardi L, Carta A, Nobile-Orazio E. Risk of disease relapse, safety and tolerability of SARS-CoV-2 vaccination in patients with chronic inflammatory neuropathies. Eur J Neurol 2023. [PMID: 37000158 DOI: 10.1111/ene.15811] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND To evaluate the risk of relapse after SARS-CoV-2 vaccination, and its safety and tolerability, in patients with chronic inflammatory neuropathies. METHODS In this multicenter, cohort, and case-crossover study, the risk of relapse associated with SARS-CoV-2 vaccination was assessed by comparing frequency of relapse in CIDP and MMN patients who underwent or did not undergo vaccination. Frequency of relapse in the three months prior and after vaccination, and safety and tolerability of SARS-CoV-2 vaccination were also assessed. RESULTS 336 patients were included (278 CIDP; 58 MMN). 307 (91%) patients underwent SARS-CoV-2 vaccination. Twenty-nine patients (9%) did not undergo vaccination. Mild and transient relapses were observed in 16 (5%) patients (13 CIDP; 3 MMN) after SARS-CoV-2 vaccination and in none of the patients who did not undergo vaccination (RR= 3.21, 95% CI, 0.19-52.25). There was no increase in the specific risk of relapse associated with type of vaccine or diagnosis. Comparison with the 3-month control period preceding vaccination revealed an increased risk of relapse after vaccination (RR= 4.00; 95% CI, 1.35-11.82), which was restricted to CIDP patients (RR= 3.25, 95% CI, 1.07-9.84). The safety profile of SARS-CoV-2 vaccination was characterized by short-term, mild-to-moderate local and systemic adverse events. CONCLUSIONS SARS-CoV-2 vaccination in CIDP and MMN patients does not seem to be associated with an increased risk of relapse at primary endpoint, although a slightly increased risk in CIDP patients was found compared to the 3 months before vaccination.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele -, Milan, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Cocito
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Gian Maria Fabrizi
- UOC Neurology B, Department of Neuroscience, University Hospital GB Rossi, AOUI and University of Verona, Verona, Italy
| | - Sabrina Matà
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | | | - Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS. UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | | | - Elisa Ruiu
- Neurology Unit, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | | | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-, Brescia, Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Giovanni Antonini
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Roma, Italy
| | | | - Stefano Sotgiu
- Child Neuropsychiatry Division, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | | | - Elisa Bianchi
- Laboratorio di Malattie Neurologiche, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassiano, Bassano del Grappa, Vicenza, Italy
| | - Andrea Giordano
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
| | - Marco Fernandes
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
| | - Marta Campagnolo
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Erdita Peci
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Matteo Tagliapietra
- UOC Neurology B, Department of Neuroscience, University Hospital GB Rossi, AOUI and University of Verona, Verona, Italy
| | - Martina Sperti
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | | | - Marina Romozzi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS. UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Federica Moret
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Ignazio Roberto Zarbo
- Neurology Unit, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Divina Valeria Viola
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-, Brescia, Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Luca Leonardi
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Roma, Italy
| | - Alessandra Carta
- Child Neuropsychiatry Division, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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32
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Merico E, Montano V, Viola D, Schirinzi E, Siciliano G. Ophthalmopathy in chronic inflammatory demyelinating polyradiculoneuropathy: a case report. Acta Neurol Belg 2023:10.1007/s13760-023-02255-5. [PMID: 36995653 DOI: 10.1007/s13760-023-02255-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Affiliation(s)
- E Merico
- Department of Clinical and Experimental Medicine, Neurological Clinic-University of Pisa, Via Roma 67, 56126, Pisa, Italy.
| | - V Montano
- Department of Clinical and Experimental Medicine, Neurological Clinic-University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - D Viola
- Department of Clinical and Experimental Medicine, Neurological Clinic-University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - E Schirinzi
- Department of Clinical and Experimental Medicine, Neurological Clinic-University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic-University of Pisa, Via Roma 67, 56126, Pisa, Italy
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33
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Coratti G, Ricci M, Capasso A, D'amico A, Sansone V, Bruno C, Messina S, Ricci F, Mongini T, Coccia M, Siciliano G, Pegoraro E, Turri M, Filosto M, Comi G, Masson R, Maggi L, Bruno I, D'Angelo MG, Trabacca A, Vacchiano V, Donati M, Simone I, Ruggiero L, Varone A, Verriello L, Berardinelli A, Agosto C, Pini A, Maioli MA, Passamano L, Brighina F, Carboni N, Garibaldi M, Zuccarino R, Gagliardi D, Siliquini S, Previtali S, Taruscio D, Boccia S, Pera MC, Pane M, Mercuri E. Prevalence of Spinal Muscular Atrophy in the Era of Disease-Modifying Therapies: An Italian Nationwide Survey. Neurology 2023; 100:522-528. [PMID: 36460469 PMCID: PMC10074458 DOI: 10.1212/wnl.0000000000201654] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Spinal muscular atrophy (SMA) is a neurodegenerative disorder caused by mutations in the SMN1 gene. The aim of this study was to assess the prevalence of SMA and treatment prescription in Italy. METHODS An online survey was distributed to 36 centers identified by the Italian government as referral centers for SMA. Data on the number of patients with SMA subdivided according to age, type, SMN2 copy number, and treatment were collected. RESULTS One thousand two hundred fifty-five patients with SMA are currently followed in the Italian centers with an estimated prevalence of 2.12/100,000. Of the 1,255, 284 were type I, 470 type II, 467 type III, and 15 type IV with estimated prevalence of 0.48, 0.79, 0.79 and 0.02/100,000, respectively. Three patients with SMA 0 and 16 presymptomatic patients were also included. Approximately 85% were receiving one of the available treatments. The percentage of treated patients decreased with decreasing severity (SMA I: 95.77%, SMA II: 85.11%, SMA III: 79.01%). DISCUSSION The results provide for the first time an estimate of the prevalence of SMA at the national level and the current distribution of patients treated with the available therapeutical options. These data provide a baseline to assess future changes in relation to the evolving therapeutical scenario.
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Affiliation(s)
- Giorgia Coratti
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Ricci
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Capasso
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Adele D'amico
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valeria Sansone
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio Bruno
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sonia Messina
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Ricci
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tiziana Mongini
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michela Coccia
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Siciliano
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elena Pegoraro
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mara Turri
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Filosto
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Comi
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Masson
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Maggi
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Irene Bruno
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Grazia D'Angelo
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Trabacca
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Veria Vacchiano
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Donati
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Isabella Simone
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lucia Ruggiero
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Varone
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Verriello
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angela Berardinelli
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Caterina Agosto
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonella Pini
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Maioli
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigia Passamano
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Brighina
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Carboni
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Garibaldi
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Zuccarino
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Delio Gagliardi
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sabrina Siliquini
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Previtali
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenica Taruscio
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Carmela Pera
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marika Pane
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio Mercuri
- From the Pediatric Neurology (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Università Cattolica del Sacro Cuore, Rome; Centro Clinico Nemo (Giorgia Coratti, M.R., A.C., M.C.P., M.D.P., E.M.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Department of Neurosciences (A.D.), Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome; The NEMO Center in Milan (V.S.), Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Italy; Center of Translational and Experimental Myology (C.B.), and Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Istituto Giannina Gaslini; Department of Clinical and Experimental Medicine (S.M.), University of Messina; AOU Città della Salute e della Scienza di Torino (F.R., T.M.), presidio Molinette e OIRM (SS Malattie Neuromuscolari e SC Neuropsichiatria Infantile), Turin; Department of Neurological Sciences (M.C.), AOU Ospedali Riuniti di Ancona; AOU Pisana (Department of Clinical and Experimental Medicine) (G.S.), Neurology Unit, Pisa; Neurology Unit (E.P.), Azienda Ospedale Padova, Padua; Department of Neurology/Stroke Unit (M.T.), Bolzano Hospital, Trentino-Alto Adige; Department of Clinical and Experimental Sciences (M.F.), University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases (M.F.), Brescia; Neurology Unit (Giacomo Comi), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; Dino Ferrari Center (Giacomo Comi), Department of Pathophysiology and Transplantation, University of Milan; Fondazione IRCCS Istituto Neurologico Carlo Besta Developmental Neurology Unit (R.M.), Milan; Neuroimmunology and Neuromuscular Disorders Unit (L.M.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Institute for Maternal and Child Health (I.B.), IRCCS, Burlo Garofolo, Trieste; NeuroMuscular Unit (M.G.D.A.), Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco; Scientific Institute IRCCS "E. Medea" (A.T.), Unit for Severe disabilities in developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi; UOC Clinica Neurologica (V.V.), IRCCS Institute of Neurological Sciences of Bologna, Emilia-Romagna; Metabolic Unit (M.D.), A. Meyer Children's Hospital, Florence; Neurology Unit (I.S.), Azienda Ospedaliero-Universitaria, Policlinico Bari "Amaducci", Bari; Department of Neurosciences (L.R.), Reproductive Sciences and Odontostomatology, University of Naples Federico II; Department of Neurosciences (A.V.), Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples; Neurology Unit (L.V.), Department of Neurosciences, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia; Department of Child Neuropsychiatry (A.B.), Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia; Dipartimento di Salute della Donna e del Bambino (C.A.), Università di Padova, Padua; IRCCS Istituto delleScienze Neurologiche di Bologna-UOC Neuropsichiatria Infantile (A.P.); Centro Sclerosi Multipla (M.A.M.), P.O. Binaghi, ASSL Cagliari; Cardiomyology and Medical Genetics Unit (L.P.), Università degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli; Section of Neurology (F.B.), Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo; Neurology Department (N.C.), Hospital San Francesco of Nuoro; Department of Neuroscience (M.G.), Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital; Neuromuscular Omnicentre (NeMO) Trento-Fondazione Serena Onlus (R.Z.), Pergine Valsugana; Pediatric Neurology Unit (D.G.), Pediatric Hospital "Giovanni XXIII", Bari; Child Neuropsychiatry Unit (S.S.), Paediatric Hospital G Salesi, Ancona; Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; National Centre for Rare Diseases (D.T.), Istituto Superiore di Sanità, Rome; and Sezione di Igiene (S.B.), Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
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Barsotti S, Aringhieri G, Mugellini B, Torri F, Minichilli F, Tripoli A, Cardelli C, Cioffi E, Zampa V, Siciliano G, Caramella D, Ricci G, Mosca M. The role of magnetic resonance imaging in the diagnostic work-out of myopathies: differential diagnosis between inflammatory myopathies and muscular dystrophies. Clin Exp Rheumatol 2023; 41:301-308. [PMID: 36826782 DOI: 10.55563/clinexprheumatol/dkmz6o] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES The differential diagnosis between idiopathic inflammatory myopathies (IIM) and muscular dystrophies (MD) may be challenging. We analysed the potential role of muscular magnetic resonance imaging (MRI) in the differential diagnosis between IIM and MD. METHODS MRI of patients (91 IIM and 43 MD), studied with a standardised protocol, have been collected. The presence of oedema, muscular atrophy and intramuscular adipose changes were evaluated. Moreover, we computed a composite score for each MRI item to better discriminate between the two diseases. RESULTS Oedema was significantly more prevalent in IIM compared with MD in pelvis muscles (p<0.001), anterior lodge and medial lodges (p=0.044) of the thighs. Adipose infiltration/substitution and muscular atrophy were more prevalent in MD, in particular adipose tissue was prevalent in all the compartments of the thighs (p<0.05), atrophy was prevalent at the thighs and pelvis muscles (p<0.001). The probability of IIM increased with higher oedema score and decreased with higher atrophy and intramuscular adipose infiltration/substitution scores. CONCLUSIONS A different distribution of muscular involvement between IIM and MD has been identified. Muscular MRI may be useful in the differential diagnosis, potentially reducing the number of muscular biopsies that may be reserved only for doubtful cases.
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Affiliation(s)
- Simone Barsotti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Giacomo Aringhieri
- Radiology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Barbara Mugellini
- Radiology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Francesca Torri
- Neurological Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Fabrizio Minichilli
- Unit of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Alessandra Tripoli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Chiara Cardelli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, and Department of Medical Biotechnology, University of Siena, Italy
| | - Elisa Cioffi
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Virna Zampa
- Radiology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Gabriele Siciliano
- Neurological Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Davide Caramella
- Radiology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Giulia Ricci
- Neurological Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Aghakhanyan G, Galgani A, Vergallo A, Lombardo F, Martini N, Baldacci F, Tognoni G, Leo A, Guidoccio F, Siciliano G, Fornai F, Pavese N, Volterrani D, Giorgi FS. Brain metabolic correlates of Locus Coeruleus degeneration in Alzheimer's disease: a multimodal neuroimaging study. Neurobiol Aging 2023; 122:12-21. [PMID: 36463849 DOI: 10.1016/j.neurobiolaging.2022.11.002] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
Locus Coeruleus (LC) degeneration occurs early in Alzheimer's disease (AD) and this could affect several brain regions innervated by LC noradrenergic axon terminals, as these bear neuroprotective effects and modulate neurovascular coupling/neuronal activity. We used LC-sensitive Magnetic Resonance imaging (MRI) sequences enabling LC integrity quantification, and [18F]Fluorodeoxyglucose (FDG) PET, to investigate the association of LC-MRI changes with brain glucose metabolism in cognitively impaired patients (30 amnesticMCI and 13 demented ones). Fifteen cognitively intact age-matched controls (HCs) were submitted only to LC-MRI for comparison with patients. Voxel-wise regression analyses of [18F]FDG images were conducted using the LC-MRI parameters signal intensity (LCCR) and LC-belonging voxels (LCVOX). Both LCCR and LCVOX were significantly lower in patients compared to HCs, and were directly associated with [18F]FDG uptake in fronto-parietal cortical areas, mainly involving the left hemisphere (p < 0.001, kE > 100). These results suggest a possible association between LC degeneration and cortical hypometabolism in degenerative cognitive impairment with a prevalent left-hemispheric vulnerability, and that LC degeneration might be linked to large-scale functional network alteration in AD pathology.
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Affiliation(s)
- Gayane Aghakhanyan
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alessandro Galgani
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Andrea Vergallo
- Department of Radiology, Fondazione Monasterio/CNR, Pisa, Italy
| | | | | | - Filippo Baldacci
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Leo
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federica Guidoccio
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Aging Research Unit, Newcastle University, Newcastle upon Tyne, UK; Institute of Clinical Medicine, PET Centre, Aarhus University, Aarhus, Denmark
| | - Duccio Volterrani
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Filippo S Giorgi
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
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Cintoli S, Elefante C, Radicchi C, Brancati GE, Bacciardi S, Bonaccorsi J, Siciliano G, Maremmani I, Perugi G, Tognoni G. Could Temperamental Features Modulate Participation in Clinical Trials? J Clin Med 2023; 12:jcm12031121. [PMID: 36769768 PMCID: PMC9917573 DOI: 10.3390/jcm12031121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
The prodromal stages of Alzheimer's disease (AD) are the primary focus of research aimed at slowing disease progression. This study explores the influence of affective temperament on the motivation of people with mild cognitive impairment (MCI) and subjective cognitive decline (SCD) to participate in clinical trials. One hundred four subjects with MCI and SCD were screened for participation in pharmacological and non-pharmacological trials. Affective temperament was assessed based on the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS) scale. Demographic variables and temperament subscales scores were compared between MCI and SCD patients and among patients participating in the pharmacological trial, the non-pharmacological trial and refusing participation. Twenty-one subjects consented to participate in the pharmacological trial, seventy consented to the non-pharmacological trial and thirteen refused to participate in any trial. Patients with SCD had greater education and more depressive temperamental traits than those with MCI. While older age, higher education and anxious temperament were negatively associated with participation in the pharmacological trial, irritable temperamental positively predicted pharmacological trial participation. In conclusion, temperamental features may affect the willingness of patients with MCI and SCD to take part in clinical trials and, especially, the choice to participate in pharmacological studies.
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Affiliation(s)
- Simona Cintoli
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
| | - Camilla Elefante
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Claudia Radicchi
- Institute of Neuroscience, National Research Council, 56124 Pisa, Italy
| | - Giulio Emilio Brancati
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Silvia Bacciardi
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy
- PISA-School of Clinical and Experimental Psychiatry, 56100 Pisa, Italy
| | - Joyce Bonaccorsi
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Icro Maremmani
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56127 Pisa, Italy
- Saint Camillus International University of Health and Medical Sciences (UniCamillus), 00131 Rome, Italy
- Correspondence: ; Tel.: +39-050-992965; Fax: +39-050-993267
| | - Giulio Perugi
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56127 Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Giannese D, Montano V, Lopriore P, Nesti C, LoGerfo A, Caligo MA, Dal Canto F, Pasquinelli G, Bonadio AG, Moriconi D, Siciliano G, Mancuso M. A Multisystem Mitochondrial Disease Caused by a Novel MT-TL1 mtDNA Variant: A Case Report. J Neuromuscul Dis 2023; 10:119-123. [PMID: 36404555 PMCID: PMC9881017 DOI: 10.3233/jnd-221526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mitochondrial tRNA (MTT) genes are hotspot for mitochondrial DNA mutation and are responsible of half mitochondrial disease. MTT mutations are associated with a broad spectrum of phenotype often with complex multisystem involvement and complex genotype-phenotype correlations. MT-TL1 mutations, among which the m.3243A>G mutation is the most frequent, are associated with myopathy, maternal inherited diabetes and deafness, MELAS, cardiomyopathy, and focal segmental glomerulosclerosis. CASE STUDY Here we report the case of an Italian 49-years old female presenting with encephalomyopathy, chronic proteinuric kidney disease and a new heteroplasmic m.3274_3275delAC MT-TL1 gene mutation. CONCLUSIONS Our case demonstrates a systemic mitochondrial disease caused by the heteroplasmic m.3274_3275delAC MT-TL1 gene mutation, not yet described in the literature. A mitochondrial disease should be suspected in case of complex multisystem phenotypes, including steroid-resistant nephrotic syndrome with multisystemic involvement.
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Affiliation(s)
- Domenico Giannese
- Department of Clinical and Experimental Medicine, Nephrology, Transplant and Dialysis Division, University Hospital of Pisa, Pisa, Italy
| | - Vincenzo Montano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Piervito Lopriore
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Claudia Nesti
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Annalisa LoGerfo
- Laboratory of Molecular Genetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Adelaide Caligo
- Laboratory of Molecular Genetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Gianandrea Pasquinelli
- Department of Experimental, Biotechnology and Methods in Laboratory Medicine, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy,Subcellular Nephro-Vascular Diagnostic Program, Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Angelo Giovanni Bonadio
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Diego Moriconi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy,Correspondence to: Michelangelo Mancuso, MD, PhD, Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy. E-mail:
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Milano C, Canovetti S, Cosottini M, Siciliano G, Pizzanelli C. Bilateral hippocampal toxic damage: an "unforgettable" cause of acute global amnesia. Neurol Sci 2023; 44:1805-1807. [PMID: 36598617 DOI: 10.1007/s10072-022-06565-z] [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: 09/19/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Chiara Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Silvia Canovetti
- Department of Translational Research and New Technology in Medicine and Surgery, Neuroradiologic Unit, University of Pisa, Pisa, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technology in Medicine and Surgery, Neuroradiologic Unit, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
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Galgani A, Lombardo F, Martini N, Vergallo A, Bastiani L, Hampel H, Hlavata H, Baldacci F, Tognoni G, De Marchi D, Ghicopulos I, De Cori S, Biagioni F, Busceti CL, Ceravolo R, Bonuccelli U, Chiappino D, Siciliano G, Fornai F, Pavese N, Giorgi FS. Magnetic resonance imaging Locus Coeruleus abnormality in amnestic Mild Cognitive Impairment is associated with future progression to dementia. Eur J Neurol 2023; 30:32-46. [PMID: 36086917 PMCID: PMC10092028 DOI: 10.1111/ene.15556] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/17/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Human neuropathological studies indicate that the pontine nucleus Locus Coeruleus (LC) undergoes significant and early degeneration in Alzheimer's disease. This line of evidence alongside experimental data suggests that the LC functional/structural decay may represent a critical factor for Alzheimer's disease pathophysiological and clinical progression. In the present prospective study, we used Magnetic Resonance Imaging (MRI) with LC-sensitive sequence (LC-MRI) to investigate in vivo the LC involvement in Alzheimer's disease progression, and whether specific LC-MRI features at baseline are associated with prognosis and cognitive performance in amnestic Mild Cognitive Impairment. METHODS LC-MRI parameters were measured at baseline by a template-based method on 3.0-T magnetic resonance images in 34 patients with Alzheimer's disease dementia, 73 patients with amnestic Mild Cognitive Impairment, and 53 cognitively intact individuals. A thorough neurological and neuropsychological assessment was performed at baseline and 2.5-year follow-up. RESULTS In subjects with Mild Cognitive Impairment who converted to dementia (n = 32), the LC intensity and number of LC-related voxels were significantly lower than in cognitively intact individuals, resembling those observed in demented patients. Such a reduction was not detected in Mild Cognitive Impairment individuals, who remained stable at follow-up. In Mild Cognitive Impairment subjects converting to dementia, LC-MRI parameter reduction was maximal in the rostral part of the left nucleus. Structural equation modeling analysis showed that LC-MRI parameters positively correlate with cognitive performance. CONCLUSIONS Our findings highlight a potential role of LC-MRI for predicting clinical progression in Mild Cognitive Impairment and support the key role of LC degeneration in the Alzheimer clinical continuum.
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Affiliation(s)
- Alessandro Galgani
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Lombardo
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Nicola Martini
- Deep Health Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Andrea Vergallo
- GRC No. 21, Alzheimer Precision Medicine, Public Hospital Network of Paris, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Luca Bastiani
- Institute of Clinical Physiology of National Research Council, Pisa, Italy
| | - Harald Hampel
- GRC No. 21, Alzheimer Precision Medicine, Public Hospital Network of Paris, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Hana Hlavata
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniele De Marchi
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Irene Ghicopulos
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara De Cori
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Francesca Biagioni
- Scientific Institute for Research and Health Care Neuromed, Pozzilli, Italy
| | | | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dante Chiappino
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Scientific Institute for Research and Health Care Neuromed, Pozzilli, Italy.,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Institute of Clinical Medicine, Positron Emission Tomography Center, Aarhus University, Aarhus, Denmark
| | - Filippo Sean Giorgi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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El-Hassar L, Amara A, Sanson B, Lacatus O, Amir Belhouchet A, Kroneman M, Claeys K, Plançon JP, Rodolico C, Primiano G, Trojsi F, Filosto M, Mongini TE, Bortolani S, Monforte M, Carraro E, Maggi L, Ricci F, Silani V, Orsucci D, Créange A, Péréon Y, Stojkovic T, van der Beek NAME, Toscano A, Pareyson D, Attarian S, Van den Bergh PYK, Remiche G, Hoeijmakers JGJ, Badrising U, Voermans NC, Kaindl AM, Schara-Schmidt U, Schoser B, Gazzerro E, Haberlová J, Voháňka S, Pál E, Molnar MJ, Leonardis L, Tournev IL, Osorio AN, Olivé M, Muelas N, Alonso-Perez J, Plá F, de Visser M, Siciliano G, Sacconi S. Telemedicine in Neuromuscular Diseases During Covid-19 Pandemic: ERN-NMD European Survey. J Neuromuscul Dis 2023; 10:173-184. [PMID: 36373291 DOI: 10.3233/jnd-221525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Telemedicine (TM) contributes to bridge the gap between healthcare facilities and patients' homes with neuromuscular disease (NMD) because of mobility issues. However, its deployment is limited due to difficulties evaluating subtle neurological signs such as mild weakness or sensory deficits. The COVID-19 pandemic has disrupted healthcare delivery worldwide, necessitating rapid measures implementation by health care providers (HCPs) to protect patients from acquiring SARS-CoV-2 while maintaining the best care and treatment. OBJECTIVES Given the challenges faced by remote healthcare assistance of NMD patients, we aim to evaluate the use of TM in NMD during the COVID-19 pandemic. METHODS Based on the Model for Assessment-of-Telemedicine-Applications (MAST), we conducted a survey amongst clinicians of the ERN EURO NMD (European-Reference-Network-for-Rare-Neuromuscular-Diseases). RESULTS Based on 42 responses over 76 expected ones, our results show that the COVID-19 pandemic significantly increased the number of HCPs using TM (from 60% to 100%). The TM types most used during the COVID-19 period are teleconsultation and consultation by phone, particularly in the context of symptoms worsening in NMD patients with COVID-19 infection. Most European HCPs were satisfied when using TM but as a complementary option to physical consultations. Many responses addressed the issue of technical aspects needing improvement, particularly for elderly patients who need caregivers' assistance for accessing the TM platform. CONCLUSIONS TM has been essential during COVID-19, but its use still presents some limitations for NMD patients with cognitive deficits or for first-time diagnosis. Thus, TM should be used as complement to, rather than substitute, for face-to-face consultations.
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Affiliation(s)
- Lynda El-Hassar
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Ahmed Amara
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Benoit Sanson
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Oana Lacatus
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France.,Neurology Department, Bucharest University and Emergency Hospital, Bucharest, Romania
| | - Ahmed Amir Belhouchet
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
| | - Madelon Kroneman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Kristl Claeys
- Department of Neurology, University Hospitals Leuven, and Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jean Philippe Plançon
- European Patient Organisation for Dysimmune and Inflammatory Neuropathies (EPODIN) and EURO-NMD Educational board, Paris, France
| | - Carmelo Rodolico
- Centro di Riferimento Regionale perla Ricerca, Neurology and Neuromuscular Diseases Unit, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesca Trojsi
- First Division of Neurology, Department of Advanced Medical and Surgical Sciences, Università degli Studidella Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Massimiliano Filosto
- ASST 'Spedali Civili', Clinical Center NEMO-Brescia for neuromuscular diseases and University of Brescia, Brescia, Italy
| | - Tiziana Enrica Mongini
- Neuromuscular Center, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Sara Bortolani
- Department of Neurosciences Rita Levi Montalcini, Neuromuscular Center, University of Torino, Turin, Italy
| | - Mauro Monforte
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
| | - Elena Carraro
- Neuromuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Disease Unit, Foundation IRCCS Carlo Besta, Neurological Institute, Milan, Italy
| | - Federica Ricci
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Daniele Orsucci
- Unit of Neurology, San Luca Hospital, Via Lippi-Francesconi, Lucca, Italy
| | - Alain Créange
- Neurology Department, CHU Henri Mondor, APHP, UPEC, Créteil, France
| | - Yann Péréon
- Centre de Référence Maladies Neuromusculaires Atlantique-Occitanie-Caraïbes, Hôpital Hôtel-Dieu, Nantes, France
| | - Tanya Stojkovic
- Institut de Myologie, Centre de Référence de Pathologie Neuromusculaire Paris-Est, AP-HP, Pitié Salpêtrière University Hospital, Sorbonne University, Paris, France
| | | | - Antonio Toscano
- Department of Clinical and Experimental Medicine, Reference Centre for Rare Neuromuscular Disorders, University of Messina, Messina, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Shahram Attarian
- Centre de Référence des Maladies Neuromusculaires et de la SLA, APHM, CHU Timone, Marseille, France
| | - Peter Y K Van den Bergh
- Department of Neurology, Neuromuscular Reference Centre, University Hospital Saint-Luc, Brussels, Belgium
| | - Gauthier Remiche
- Department of Neurology, Centre de Référence Neuromusculaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Umesh Badrising
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Radboud University Medical Centre, GA Nijmegen, The Netherlands
| | - Angela M Kaindl
- Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Schara-Schmidt
- Clinic for Pediatrics I, Pediatric Neurology, University Hospital Essen, Essen, Germany
| | - Benedikt Schoser
- Department of Neurology Klinikum München, Friedrich-Baur-Institut, München, Germany
| | - Elisabetta Gazzerro
- Muscle Research Unit, Experimental and Clinical Research Center, Charit, Germany
| | - Jana Haberlová
- Department of Pediatric Neurology, Motol University Hospital, Prague, Czech Republic
| | - Stanislav Voháňka
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Endre Pál
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Lea Leonardis
- Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ivailo L Tournev
- Department of Neurology, Clinic of Nervous Diseases, University Hospital Aleksandrovska, Medical University, Sofia, Bulgaria
| | - Andrés Nascimento Osorio
- Neuromuscular Unit, Neuropaediatrics Department, Institut de Recerca Hospital Universitari Sant Joan de Déu, ISCIII, CIBERER, Barcelona, Spain
| | - Montse Olivé
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Nuria Muelas
- Department of Neurology, Neuromuscular Diseases Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jorge Alonso-Perez
- Neuromuscular Unit, Neurology Department, Hospital de Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Francesc Plá
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Marianne de Visser
- Amsterdam University Medical Centres, Academic Medical Centre, Amsterdam, The Netherlands
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, Rare Neuromuscular Disease Reference Center, University Hospital Center of Nice, Nice, France
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Milano C, Hoxhaj D, Del Chicca M, Pascazio A, Paoli D, Tommasini L, Vergallo A, Pizzanelli C, Tognoni G, Nuti A, Ceravolo R, Siciliano G, Hampel H, Baldacci F. Alzheimer's Disease and Neurosyphilis: Meaningful Commonalities and Differences of Clinical Phenotype and Pathophysiological Biomarkers. J Alzheimers Dis 2023; 94:611-625. [PMID: 37334599 DOI: 10.3233/jad-230170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 06/20/2023]
Abstract
BACKGROUND Neurosyphilis-associated cognitive and behavioral impairment- historically coined as "general paralysis of the insane"- share clinical and neuroradiological features with the neurodegenerative disease spectrum, in particular Alzheimer's disease (AD). Anatomopathological similarities have been extensively documented, i.e., neuronal loss, fibrillary alterations, and local amyloid-β deposition. Consequently, accurate classification and timely differential diagnosis may be challenging. OBJECTIVE To describe clinical, bio-humoral, brain MRI, FDG-PET, and amyloid-PET features in cases of neurosyphilis with an AD-like phenotypical presentation, as well as clinical outcome in terms of response to antibiotic therapy. METHODS We selected the studies comparing patients with AD and with neurosyphilis associated cognitive impairment, to investigate candidate biomarkers classifying the two neurological diseases. RESULTS The neuropsychological phenotype of general paralysis, characterized by episodic memory impairment and executive disfunction, substantially mimics clinical AD features. Neuroimaging often shows diffuse or medial temporal cortical atrophy, thus contributing to a high rate of misdiagnosis. Cerebrospinal fluid (CSF)-based analysis may provide supportive diagnostic value, since increased proteins or cells are often found in neurosyphilis, while published data on pathophysiological AD candidate biomarkers are controversial. Finally, psychometric testing using cross-domain cognitive tests, may highlight a wider range of compromised functions in neurosyphilis, involving language, attention, executive function, and spatial ability, which are atypical for AD. CONCLUSION Neurosyphilis should be considered a potential etiological differential diagnosis of cognitive impairment whenever imaging, neuropsychological or CSF features are atypical for AD, in order to promptly start antibiotic therapy and delay or halt cognitive decline and disease progression.
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Affiliation(s)
- Chiara Milano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Domeniko Hoxhaj
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marta Del Chicca
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessia Pascazio
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Davide Paoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angelo Nuti
- Division of Neurology, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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42
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Beghi E, Pupillo E, Bianchi E, Bonetto V, Luotti S, Pasetto L, Bendotti C, Tortarolo M, Sironi F, Camporeale L, Sherman AV, Paganoni S, Scognamiglio A, De Marchi F, Bongioanni P, Del Carratore R, Caponnetto C, Diamanti L, Martinelli D, Calvo A, Filosto M, Padovani A, Piccinelli SC, Ricci C, Dalla Giacoma S, De Angelis N, Inghilleri M, Spataro R, La Bella V, Logroscino G, Lunetta C, Tarlarini C, Mandrioli J, Martinelli I, Simonini C, Zucchi E, Monsurrò MR, Ricciardi D, Trojsi F, Riva N, Filippi M, Simone IL, Sorarù G, Spera C, Florio L, Messina S, Russo M, Siciliano G, Conte A, Saddi MV, Carboni N, Mazzini L. Effect of RNS60 in amyotrophic lateral sclerosis: a phase II multicentre, randomized, double-blind, placebo-controlled trial. Eur J Neurol 2023; 30:69-86. [PMID: 36148821 PMCID: PMC10092300 DOI: 10.1111/ene.15573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with limited treatment options. RNS60 is an immunomodulatory and neuroprotective investigational product that has shown efficacy in animal models of ALS and other neurodegenerative diseases. Its administration has been safe and well tolerated in ALS subjects in previous early phase trials. METHODS This was a phase II, multicentre, randomized, double-blind, placebo-controlled, parallel-group trial. Participants diagnosed with definite, probable or probable laboratory-supported ALS were assigned to receive RNS60 or placebo administered for 24 weeks intravenously (375 ml) once a week and via nebulization (4 ml/day) on non-infusion days, followed by an additional 24 weeks off-treatment. The primary objective was to measure the effects of RNS60 treatment on selected biomarkers of inflammation and neurodegeneration in peripheral blood. Secondary objectives were to measure the effect of RNS60 on functional impairment (ALS Functional Rating Scale-Revised), a measure of self-sufficiency, respiratory function (forced vital capacity, FVC), quality of life (ALS Assessment Questionnaire-40, ALSAQ-40) and survival. Tolerability and safety were assessed. RESULTS Seventy-four participants were assigned to RNS60 and 73 to placebo. Assessed biomarkers did not differ between arms. The mean rate of decline in FVC and the eating and drinking domain of ALSAQ-40 was slower in the RNS60 arm (FVC, difference 0.41 per week, standard error 0.16, p = 0.0101; ALSAQ-40, difference -0.19 per week, standard error 0.10, p = 0.0319). Adverse events were similar in the two arms. In a post hoc analysis, neurofilament light chain increased over time in bulbar onset placebo participants whilst remaining stable in those treated with RNS60. CONCLUSIONS The positive effects of RNS60 on selected measures of respiratory and bulbar function warrant further investigation.
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Affiliation(s)
- Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Elisa Bianchi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Valentina Bonetto
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Silvia Luotti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Laura Pasetto
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Caterina Bendotti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Massimo Tortarolo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Francesca Sironi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Laura Camporeale
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alexander V Sherman
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sabrina Paganoni
- Sean M. Healey and AMG Center for ALS at Mass General Hospital, Department of Neurology, Boston, Massachusetts, USA.,Spaulding Rehabilitation Hospital, Department of PM&R, Harvard Medical School, Boston, Massachusetts, USA
| | - Ada Scognamiglio
- ALS Expert Center 'Maggiore della Carità' Hospital and University of Piemonte Orientale, Novara, Italy
| | - Fabiola De Marchi
- ALS Expert Center 'Maggiore della Carità' Hospital and University of Piemonte Orientale, Novara, Italy
| | - Paolo Bongioanni
- Spinal Cord Injuries Section, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | | | | | | | - Andrea Calvo
- Centro Regionale Esperto per la Sclerosi Laterale Amiotrofica, Dipartimento di Neuroscienze 'Rita Levi Montalcini', Università degli Studi di Torino, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Gussago Brescia, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Gussago Brescia, Italy
| | | | - Claudia Ricci
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Stefania Dalla Giacoma
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Nicoletta De Angelis
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Maurizio Inghilleri
- Università di Roma 'Sapienza' UOSD Malattie Neurodegenerative, Centro Malattie Rare Neuromuscolari Policlinico Universitario Umberto I, Roma, Italy
| | - Rossella Spataro
- ALS Clinical Research Center, AOUP 'P Giaccone' - University of Palermo, Palermo, Italy
| | - Vincenzo La Bella
- ALS Clinical Research Center, AOUP 'P Giaccone' - University of Palermo, Palermo, Italy
| | - Giancarlo Logroscino
- Center for neurodegenerative diseases and the Aging Brain, Department of Clinical Research in Neurology of the University of Bari at 'Pia Fondazione Card G. Panico 'Hospital Tricase, Tricase, Italy.,Department of Basic Medicine Neuroscience and Sense Organs, University Aldo Moro Bari, Bari, Italy
| | | | | | - Jessica Mandrioli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Neurosciences, Azienda Ospedaliero-Universitaria Di Modena, Modena, Italy
| | - Ilaria Martinelli
- Department of Neurosciences, Azienda Ospedaliero-Universitaria Di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Cecilia Simonini
- Department of Neurosciences, Azienda Ospedaliero-Universitaria Di Modena, Modena, Italy
| | - Elisabetta Zucchi
- Department of Neurosciences, Azienda Ospedaliero-Universitaria Di Modena, Modena, Italy.,Neuroscience PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Rosaria Monsurrò
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Dario Ricciardi
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Nilo Riva
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Unit, Vita-Salute San Raffaele University and San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Unit, Vita-Salute San Raffaele University and San Raffaele Scientific Institute, Milan, Italy
| | - Isabella Laura Simone
- Neurology Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Gianni Sorarù
- Motor Neuton Disease Center, Department of Neurosciences, Azienda Ospedale Università di Padova, Padova, Italy
| | | | - Lucia Florio
- Neurology Department, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Sonia Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gabriele Siciliano
- Department of clinical and experimental medicine, University of Pisa, Pisa, Italy
| | - Amelia Conte
- Centro Clinico NEMO-Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Nicola Carboni
- Neurology Department, San Francesco Hospital, Nuoro, Italy
| | - Letizia Mazzini
- ALS Expert Center 'Maggiore della Carità' Hospital and University of Piemonte Orientale, Novara, Italy
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Castiglione V, Sciarrone P, Torri F, Borrelli C, Barison A, Todiere G, Grigoratos C, Siciliano G, Passino C, Emdin M, Ricci G, Giannoni A. 1099 ERGOREFLEX SENSITIVITY IS ASSOCIATED WITH CARDIAC INVOLVEMENT IN BECKER MUSCULAR DYSTROPHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background and aims
Becker muscular dystrophy (BMD) is a X-linked recessive inherited skeletal myopathy due to dystrophin deficiency ensuing in a variable phenotype characterized by slowly progressing muscle weakness and, often, the development of dilated cardiomyopathy. The relationship between muscle and cardiac involvement in BMD is yet to be clarified. We aimed to assess the association between ergoreflex sensitivity, a marker of skeletal muscle work regulating ventilatory and autonomic responses to exercise, and cardio-muscular involvement in BMD.
Methods
Fifteen male BMD patients (median age 37 years [25-42]) underwent a comprehensive evaluation including ECG, biohumoral assessment (high sensitivity troponin T/I [hs-TnT/I], natriuretic peptides, soluble suppression of tumorigenesis 2 [sST2], catecholamines, creatine phosphokinase [CPK], myoglobin), cardiac magnetic resonance (CMR), and ergoreflex determination. Muscular phenotype was distinguished into “classic” (proximal weakness affecting the shoulders and pelvis with waddling gait) or “mild”. Cardiac involvement was defined based on the presence of late gadolinium enhancement (LGE) at CMR. Ergoreflex sensitivity was calculated as the percentage of the ventilatory response to a handgrip exercise maintained by circulatory occlusion through the inflation of a forearm tourniquet (clamp) during the third minute of recovery compared with the third minute of recovery without clamp: [(Rec∕Ex) clamp − (Rec∕Ex) no clamp]∗100, where Ex is the mean ventilation during the last 30 s of exercise, Rec the mean ventilation during the last 30 s of the third minute of recovery.
Results
Ten patients (67%) had a “classic” muscular phenotype. Nine patients (60%) had LGE at CMR (median number of segments 9 [6-12]). The percentage of patients with cardiac involvement was not different between those with “classic” or mild muscular phenotype. Patients with cardiac involvement had higher ergoreflex sensitivity (24% [8-38] vs. 4% [0-24], p=0.036), hs-TnI (9.8 ng/L [5.9-14.5] vs. 2.1 ng/L [1.7-4.5], p=0.018), and hs-TnT (24 ng/L [20-35] vs. 11 ng/L [5-20], p=0.012), but did not show significant differences in terms of cardiac chamber size or systolic function compared to those without LGE. Ergoreflex sensitivity correlated with biomarkers of both cardiac (hs-TnI, rho=0.654, p=0.008; hs-TnT, rho=0.529, p=0.043; sST2, rho=0.654, p=0.009) and muscular damage (CPK, rho=0.645, p=0.009), as well as with the number of LGE segments (rho=0.583, p=0.022). No difference in ergoreflex sensitivity was detected in patients with “classic” versus mild muscular phenotype.
Conclusions
In BMD, there is no relationship between cardiac involvement and the muscular phenotype. Nonetheless, cardiac involvement in BMD is characterized by enhanced ergoreflex sensitivity, which is associated with biomarkers of both cardiac and muscular damage.
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Affiliation(s)
- Vincenzo Castiglione
- Health Science Interdisciplinary Research Center , Scuola Superiore Sant’anna - Pisa - Italy
- Cardiology Division, University Of Pisa - Pisa - Italy
| | | | - Francesca Torri
- Department Of Clinical And Experimental Medicine, University Of Pisa - Pisa - Italy
| | | | | | | | | | - Gabriele Siciliano
- Department Of Clinical And Experimental Medicine, University Of Pisa - Pisa - Italy
| | - Claudio Passino
- Health Science Interdisciplinary Research Center , Scuola Superiore Sant’anna - Pisa - Italy
- Fondazione Toscana Gabriele Monasterio- Pisa - Italy
| | - Michele Emdin
- Health Science Interdisciplinary Research Center , Scuola Superiore Sant’anna - Pisa - Italy
- Fondazione Toscana Gabriele Monasterio- Pisa - Italy
| | - Giulia Ricci
- Department Of Clinical And Experimental Medicine, University Of Pisa - Pisa - Italy
| | - Alberto Giannoni
- Health Science Interdisciplinary Research Center , Scuola Superiore Sant’anna - Pisa - Italy
- Fondazione Toscana Gabriele Monasterio- Pisa - Italy
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Pascazio A, Maestri Tassoni M, Ulivi M, Furfori G, Fabbrini M, Hoxhaj D, Annuzzi E, Siciliano G, Bonanni E, Pasquali L. RLS prevalence and impact on sleep quality in a group of relapsing-remittent multiple sclerosis patients. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.623] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maggi L, Bello L, Bonanno S, Govoni A, Caponnetto C, Passamano L, Grandis M, Trojsi F, Cerri F, Gardani A, Ferraro M, Gadaleta G, Zangaro V, Caumo L, Maioli M, Tanel R, Saccani E, Meneri M, Vacchiano V, Ricci G, Sorarù G, D'Errico E, Bortolani S, Pavesi G, Gellera C, Zanin R, Corti S, Silvestrini M, Politano L, Schenone A, Previtali SC, Berardinelli A, Turri M, Verriello L, Coccia M, Mantegazza R, Liguori R, Filosto M, Marrosu G, Tiziano FD, Siciliano G, Simone IL, Mongini T, Comi G, Pegoraro E. Adults with spinal muscular atrophy: a large-scale natural history study shows gender effect on disease. J Neurol Neurosurg Psychiatry 2022; 93:1253-1261. [PMID: 36220341 DOI: 10.1136/jnnp-2022-329320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Natural history of spinal muscular atrophy (SMA) in adult age has not been fully elucidated yet, including factors predicting disease progression and response to treatments. Aim of this retrospective, cross-sectional study, is to investigate motor function across different ages, disease patterns and gender in adult SMA untreated patients. METHODS Inclusion criteria were as follows: (1) clinical and molecular diagnosis of SMA2, SMA3 or SMA4 and (2) clinical assessments performed in adult age (>18 years). RESULTS We included 64 (38.8%) females and 101 (61.2%) males (p=0.0025), among which 21 (12.7%) SMA2, 141 (85.5%) SMA3 and 3 (1.8%) SMA4. Ratio of sitters/walkers within the SMA3 subgroup was significantly (p=0.016) higher in males (46/38) than in females (19/38). Median age at onset was significantly (p=0.0071) earlier in females (3 years; range 0-16) than in males (4 years; range 0.3-28), especially in patients carrying 4 SMN2 copies. Median Hammersmith Functional Rating Scale Expanded scores were significantly (p=0.0040) lower in males (16, range 0-64) than in females (40, range 0-62); median revised upper limb module scores were not significantly (p=0.059) different between males (24, 0-38) and females (33, range 0-38), although a trend towards worse performance in males was observed. In SMA3 patients carrying three or four SMN2 copies, an effect of female sex in prolonging ambulation was statistically significant (p=0.034). CONCLUSIONS Our data showed a relevant gender effect on SMA motor function with higher disease severity in males especially in the young adult age and in SMA3 patients.
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Affiliation(s)
- Lorenzo Maggi
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Luca Bello
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Silvia Bonanno
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alessandra Govoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Luigia Passamano
- Cardiomyology and Medical Genetics Unit, University Hospital "L Vanvitelli", Napoli, Italy
| | - Marina Grandis
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), Università di Genova, Genova, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Federica Cerri
- Department of Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | | | - Manfredi Ferraro
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giulio Gadaleta
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Vittoria Zangaro
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Luca Caumo
- Department of Neurosciences, University of Padova, Padova, Italy
| | | | | | - Elena Saccani
- Specialistic Medicine Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Megi Meneri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Veria Vacchiano
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, Universita degli Studi di Bologna, Bologna, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianni Sorarù
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Eustachio D'Errico
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Sara Bortolani
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giovanni Pavesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cinzia Gellera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Riccardo Zanin
- Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Stefania Corti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Silvestrini
- Department of Neurological Sciences, Ospedali Riuniti di Ancona, Ancona, Italy.,Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Luisa Politano
- Cardiomyology and Medical Genetics Unit, University Hospital "L Vanvitelli", Napoli, Italy
| | - Angelo Schenone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), Università di Genova, Genova, Italy
| | | | | | - Mara Turri
- Department of Neurology/Stroke Unit, San Maurizio Hospital, Bolzano, Italy
| | - Lorenzo Verriello
- Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Michela Coccia
- Department of Neurological Sciences, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Renato Mantegazza
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Rocco Liguori
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, Universita degli Studi di Bologna, Bologna, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | | | - Francesco Danilo Tiziano
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italy.,Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Isabella Laura Simone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Tiziana Mongini
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Giacomo Comi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milano, Italy
| | - Elena Pegoraro
- Department of Neurosciences, University of Padova, Padova, Italy
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Benedetti D, Olcese U, Bruno S, Barsotti M, Maestri Tassoni M, Bonanni E, Siciliano G, Faraguna U. Consumer wrist-worn smartbands and OSAS screening: performance of supervised machine-learning algorithms. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.653] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lopriore P, Gomes F, Montano V, Siciliano G, Mancuso M. Mitochondrial Epilepsy, a Challenge for Neurologists. Int J Mol Sci 2022; 23:ijms232113216. [PMID: 36362003 PMCID: PMC9656379 DOI: 10.3390/ijms232113216] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 01/29/2023] Open
Abstract
Primary mitochondrial diseases are relatively common inborn errors of energy metabolism, with a combined prevalence of 1 in 4300. These disorders typically affect tissues with high energy requirements, including the brain. Epilepsy affects >1% of the worldwide population, making it one of the most common neurological illnesses; it may be the presenting feature of a mitochondrial disease, but is often part of a multisystem clinical presentation. The major genetic causes of mitochondrial epilepsy are mutations in mitochondrial DNA and in the nuclear-encoded gene POLG. Treatment of mitochondrial epilepsy may be challenging, often representing a poor prognostic feature. This narrative review will cover the most recent advances in the field of mitochondrial epilepsy, from pathophysiology and genetic etiologies to phenotype and treatment options.
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Affiliation(s)
- Piervito Lopriore
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Fábio Gomes
- Neurology Department, Coimbra University Hospital Centre, 3004-561 Coimbra, Portugal
| | - Vincenzo Montano
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Gabriele Siciliano
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Michelangelo Mancuso
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Correspondence:
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Siciliano G, Ricci G, Torri F, Govoni A, Trabacca A. P.224 Non-5q spinal muscular atrophy in twin sisters with SPG11/CMT2X associated spatacsin gene mutation. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ricci G, Maggi L, D'Amico A, Fiorillo C, Schirinzi E, Pini A, Pegoraro E, Bertini E, Bernascono P, Lattanzi G, Gerfo AL, Siciliano G. P.147 Deflazacort treatment in LMNA-related congenital muscular dystrophy: an ongoing Italian cohort pilot study. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Tommasini L, Bonaccorsi J, Del Prete E, Cintoli S, Pagni C, Mazzucchi S, Palermo G, Morganti R, Frosini D, Siciliano G, Tognoni G, Ceravolo R. Qualitative evaluation of the Rey-Osterrieth Complex Figure Test in patients with progressive supranuclear palsy. Clin Neuropsychol 2022:1-14. [PMID: 35997036 DOI: 10.1080/13854046.2022.2112296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: In early stages of disease, the differential diagnosis between Parkinson's Disease (PD) and atypical parkinsonism, such as Progressive Supranuclear Palsy (PSP), could be challenging. Growing attention has recently been dedicated to investigating neuropsychological markers of degenerative parkinsonism. The Rey-Osterrieth Complex Figure Test (ROCFT) copy score was hypothesized able to differentiate PSP from PD. However, ROCFT is a drawing test requiring multiple cognitive abilities and it is still unknown which of them assumes an important role in PSP performance. Using a qualitative scoring system, we investigated which cognitive abilities underpin the PSP performance at the ROCFT copy trial. Moreover, we evaluated usefulness of the BQSS scores in discriminating PSP from PD. Methods: Thirty PSP-Richardson's Syndrome (PSP-RS) patients, 30 PD patients, and 30 healthy control (HC) comparable for age, education, and gender were enrolled. All subjects underwent a neuropsychological evaluation; ROCFT copy were evaluated with the 36-Point Score and with the Boston Qualitative Scoring System (BQSS). Results: PSP-RS patients performed worse in ROCFT 36-Point Score and in several BQSS scores compared to other groups. Most suitable scores discriminating PSP-RS from PD were "Perseveration" and "Vertical Expansion" of BQSS. A logistic regression model considering "Perseveration" and "Vertical Expansion" showed a diagnostic accuracy of 83,3% for PSP-RS condition. Conclusion: our findings showed that "Perseveration" and "Vertical Expansion" BQSS scores were useful in discriminating PSP-RS from PD. "Perseveration" and "Vertical Expansion" BQSS scores might be included in the cognitive evaluation along with quantitative scores when PSP diagnosis is considered.
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Affiliation(s)
- L Tommasini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - J Bonaccorsi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - E Del Prete
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - S Cintoli
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - C Pagni
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - S Mazzucchi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Palermo
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - R Morganti
- Section of Statistics, AOUP, Pisa, Italy
| | - D Frosini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Siciliano
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - G Tognoni
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - R Ceravolo
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
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