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Chiarello D, Cognolato E, Francione S, Nobile G, Bosisio L, Barbagallo G, Pacetti M, Tortora D, Cantalupo G, Nobili L, Consales A. Negative MRI and a seizure onset zone close to eloquent areas in FCD type II: Application of MRg-LiTT after a SEEG re-evaluation in pediatric patients with a previous failed surgery. Epilepsy Behav 2024; 153:109694. [PMID: 38401416 DOI: 10.1016/j.yebeh.2024.109694] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Negative MRI and an epileptogenic zone (EZ) adjacent to eloquent areas are two main issues that can be encountered during pre-surgical evaluation for epilepsy surgery. Focal Cortical Dysplasia type II (FCD type II) is the most common aetiology underlying a negative MRI. The objective of this study is to present three cases of pediatric patients exhibiting negative MRI and a seizure onset zone close to eloquent areas, who previously underwent traditional open surgery or SEEG-guided radiofrequency thermocoagulations (RF-TC). After seizure seizure recrudescence, pre-surgical SEEG was re-evaluated and Magnetic Resonance-guided laser interstitial thermal therapy (MRg-LiTT) was performed. We discuss the SEEG patterns, the planning of laser probes trajectories and the outcomes one year after the procedure. METHODS Pediatric patients who underwent SEEG followed by MRg-LiTT for drug-resistant epilepsy associated with FCD type II at our Centre were included. Pre-surgical videoEEG (vEEG), stereoEEG (sEEG), and MRI were reviewed. Post-procedure clinical outcome (measured by Engel score) and complications rates were evaluated. RESULTS Three patients underwent 3 MRg-LiTT procedures from January 2022 to June 2022. Epileptogenic zone was previously studied via SEEG in all the patients. All the three patients pre-surgical MRI was deemed negative. Mean age at seizure onset was 47 months (21-96 months), mean age at MRg-LiTT was 12 years (10 years 10 months - 12 years 9 months). Engel class Ia outcome was achieved in patients #2 and #3, Engel class Ib in patient #1. Mean follow-up length was of 17 months (13 months - 20 months). Complications occurred in one patient (patient #2, extradural hematoma). CONCLUSIONS The combined use of SEEG and MRg-LiTT in complex cases can lead to good outcomes both as a rescue therapy after failed surgery, but also as an alternative to open surgery after a successful SEEG-guided Radiofrequency Thermocoagulation (RF-TC). Specific SEEG patterns and a previous good outcome from RF-TC can be predictors of a favourable outcome.
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Affiliation(s)
- D Chiarello
- "Claudio Munari" Epilepsy Surgery Center Niguarda Hospital, Milan, Italy; Neurology of Epilepsy and Movement Disorder Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Italy
| | - E Cognolato
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, 16147 Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3).
| | - S Francione
- "Claudio Munari" Epilepsy Surgery Center Niguarda Hospital, Milan, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3)
| | - G Nobile
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3)
| | - L Bosisio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, 16147 Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3)
| | - G Barbagallo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, 16147 Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3)
| | - M Pacetti
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - D Tortora
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - G Cantalupo
- Child Neuropsychiatry Unit, University Hospital of Verona (full member of the European Reference Network EpiCARE), Verona, Italy; Center for Research on Epilepsy in Pediatric age (CREP), University Hospital of Verona, Verona, Italy; Innovation Biomedicine section, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - L Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, 16147 Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy(3).
| | - A Consales
- Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
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Barbagallo G, Caggiula M, Rizzo A, Direnzo V, Lupo A, Fasano A, Greco CA, Pauciulo A, Saponaro A, Paladini A, Barbarini L. Internuclear Ophthalmoplegia as an Isolated Symptom of Brainstem Wake-up Stroke Responsive to Intravenous Thrombolysis: Evidence from MRI. Curr Med Imaging 2022; 19:636-639. [PMID: 36017839 DOI: 10.2174/1573405618666220823122813] [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: 04/12/2022] [Revised: 06/19/2022] [Accepted: 06/29/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Internuclear ophthalmoplegia (INO) is a disorder of eye movements caused by a lesion involving the medial longitudinal fasciculus (MLF) within the brainstem, and it is characterized by adduction impairment combined with contralateral dissociated abduction nystagmus. The frequency of acute ischemic stroke (AIS) presenting with INO as a predominant symptom is very low, and many patients suffering from this brainstem AIS are precluded from intravenous thrombolysis (IVT). OBJECTIVE To provide for the first time a magnetic resonance imaging (MRI) evidence of response to the IVT in brainstem wake-up stroke presenting with INO as an isolated symptom. METHODS Here, we described a rare case of pons AIS presenting with INO as a unique symptom of awakening. In order to differentiate an ischemic stroke from other stroke mimics, and to determine whether the patient was within the therapeutic window for IVT (wake-up stroke), brain MRI including DWI and FLAIR sequences was acquired. RESULTS A left paramedian pontine DWI/FLAIR mismatch was detected and the patient was considered eligible for IVT. After IVT, the patient made a full recovery with complete resolution of INO. Follow-up MRI at 1 month demonstrates the absence of ischemic lesions. CONCLUSION Our case provides neuroradiological evidence of IVT efficacy in brainstem stroke, and it should prompt clinicians to rapidly perform MRI in wake-up onset INO and to just as quickly administer IVT, since INO is a functionally disabling deficit. Finally, this case demonstrates the value of MRI in diagnostic, prognostic, and therapeutic workup of posterior circulation wake-up stroke.
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Affiliation(s)
| | | | - Annalisa Rizzo
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
| | - Vita Direnzo
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
| | - Angela Lupo
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
| | - Antonio Fasano
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Barbagallo G, Caggiula M, Lupo A, Rizzo A, My F, Marulli D, Barbarini L. Recurrent Miller-Fisher syndrome overlapping Guillain-Barrè syndrome and Bickerstaff brainstem encephalitis: A case report. Clin Neurol Neurosurg 2021; 206:106691. [PMID: 34022690 DOI: 10.1016/j.clineuro.2021.106691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
Miller-Fisher syndrome (MFS) together with Guillan-Barré syndrome (GBS) and Bickerstaff brainstem encephalitis (BBE) are considered to form a continuous clinical spectrum of the same disease, possibly affecting the peripheral and/or central nervous systems, with monophasic symptoms. The frequency of overlapping clinical signs and the risk of recurrence are independent and very low, but no cases of GQ1b-seropositive recurrent MFS overlapping with GBS and BBE have been described so far. Here, we describe for the first time an atypical case of recurrent GQ1b-seropositive MFS overlapping GBS and BBE, 12 years after a previous GQ1b-seronegative typical MFS episode. Our case expands the clinical spectrum of recurrent MFS, and it should prompt clinicians to investigate the presence of anti-ganglioside antibodies in recurrent MFS even when these were negative in the previous episode, especially in those presenting with overlapping spectrum symptoms and a critically ill picture during the second episode.
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Affiliation(s)
| | | | - Angela Lupo
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
| | - Annalisa Rizzo
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
| | - Filomena My
- Division of Neurology, Vito Fazzi Hospital, Lecce, Italy
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Barbagallo G, Altieri R, Cammarata G, Montemagno F, Garozzo M, Certo F. FLAIRectomy: a multimodal approach protocol in the surgical treatment of glioblastomas. Results from a single center study. Brain and Spine 2021; 1:100514. [DOI: 10.1016/j.bas.2021.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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7
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Certo F, Altieri R, Barbagallo G. Glioblastoma treatment in elderly patients: is it different than in younger patients? A single-institution outcome analysis based on a surgical multimodal approach. Brain and Spine 2021; 1:100535. [DOI: 10.1016/j.bas.2021.100535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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8
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Certo F, Altieri R, Barbagallo G. Neuronavigation based on intraoperative CT-scan: imaging protocol to increase navigation accuracy and reliability. Brain and Spine 2021; 1:100534. [DOI: 10.1016/j.bas.2021.100534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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9
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Quattrone A, Sarica A, La Torre D, Morelli M, Vescio B, Nigro S, Barbagallo G, Nisticò R, Salsone M, Arcuri PP, Novellino F, Bianco MG, Arabia G, Cascini G, Quattrone A. Magnetic Resonance Imaging Biomarkers Distinguish Normal Pressure Hydrocephalus From Progressive Supranuclear Palsy. Mov Disord 2020; 35:1406-1415. [PMID: 32396693 DOI: 10.1002/mds.28087] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Idiopathic normal pressure hydrocephalus and PSP share several clinical and radiological features, making differential diagnosis, at times, challenging. OBJECTIVES To differentiate idiopathic normal pressure hydrocephalus from PSP using MR volumetric and linear measurements. METHODS Twenty-seven idiopathic normal pressure hydrocephalus patients, 103 probable PSP patients, and 43 control subjects were consecutively enrolled. Automated ventricular volumetry was performed using Freesurfer 6 on MR T1 -weighted images. Linear measurements, such as callosal angle and a new measure, termed MR Hydrocephalic Index, were calculated on MR T1 -weighted images. Receiver operating characteristic analyses were used for differentiating between patient groups. Generalizability and reproducibility of the results were validated, dividing each participant group in two cohorts used as training and testing subsets. RESULTS Ventricular volumes and linear measurements (callosal angle and Magnetic Resonance Hydrocephalic Index) revealed greater ventricular enlargement in patients with idiopathic normal pressure hydrocephalus than in PSP patients and controls. PSP patients had ventricular volume larger than controls. Automated ventricular volumetry and Magnetic Resonance Hydrocephalic Index were the most accurate measures (98.5%) in differentiating patients with idiopathic normal pressure hydrocephalus from PSP patients, whereas callosal angle misclassified several PSP patients and showed low positive predictive value (70.0%) in differentiating between these two diseases. All measurements accurately differentiated idiopathic normal pressure hydrocephalus patients from controls. Accuracy values obtained in the training set (automated ventricular volumetry, 98.4%; Magnetic Resonance Hydrocephalic Index, 98.4%; callosal angle, 87.5%) were confirmed in the testing set. CONCLUSIONS Our study demonstrates that AVV and Magnetic Resonance Hydrocephalic Index were the most accurate measures for differentiation between idiopathic normal pressure hydrocephalus and PSP patients. Magnetic Resonance Hydrocephalic Index is easy to measure and can be used in clinical practice to prevent misdiagnosis and ineffective shunt procedures in idiopathic normal pressure hydrocephalus mimics. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Andrea Quattrone
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Alessia Sarica
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | - Domenico La Torre
- Institute of Neurosurgery, "University Magna Graecia", Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | | | - Salvatore Nigro
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | | | - Rita Nisticò
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Pier Paolo Arcuri
- Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Fabiana Novellino
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | | | - Gennarina Arabia
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Cascini
- Department of Nuclear Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
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Novellino F, Vasta R, Saccà V, Nisticò R, Morelli M, Arabia G, Chiriaco C, Barbagallo G, Nicoletti G, Salsone M, Quattrone A. Hippocampal impairment in patients with Essential Tremor. Parkinsonism Relat Disord 2020; 72:56-61. [PMID: 32109738 DOI: 10.1016/j.parkreldis.2020.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 01/30/2020] [Accepted: 02/17/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION There is growing evidence that a proportion of patients with Essential Tremor (ET) may develop a memory impairment over time. However, no studies have evaluated whether hippocampal damage really occur in ET. This study investigated the macro and micro-structural integrity of the hippocampus in ET subjects using a multimodal MRI approach. METHODS Neuropsychological and MRI data were acquired from 110 participants (60 patients with ET and 50 age-, sex-, and education-matched healthy controls [HC]). Whole-brain T1-weighted and Diffusion Tensor Imaging (DTI) were performed to assess macro-and microstructural alterations. MRI parameters (volume; mean diffusivity [MD]; fractional anisotropy [FA]) of bilateral hippocampi were obtained. In order to evaluate the relationship between MRI alterations and neurocognitive impairment, hippocampal parameters were also correlated with cognitive test scores. RESULTS Compared to controls, ET patients showed a subclinical memory impairment with significantly lower memory scores, but within the normal ranges. Despite the subclinical damage, however, ET patients showed a significant increase in MD values in the bilateral hippocampi in comparison with HC. A significant correlation was also found between MD and memory scores in ET. CONCLUSION This study improves the knowledge on memory impairment in ET, as our results demonstrate for the first time the hippocampal microstructural damage related to subclinical memory impairment in ET patients. Further studies are needed before these findings can be considered predictive of a distinct ET subtype or suggestive of a co-occurent dementia.
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Affiliation(s)
- Fabiana Novellino
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Roberta Vasta
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Valeria Saccà
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Rita Nisticò
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Gennarina Arabia
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Carmelina Chiriaco
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | | | - Giuseppe Nicoletti
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Aldo Quattrone
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy; Neuroscience Centre, Magna Graecia University, Catanzaro, Italy.
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Ricci M, Chiaravalloti A, Martorana A, Koch G, De Lucia V, Barbagallo G, Schillaci O. The role of epsilon phenotype in brain glucose consumption in Alzheimer's disease. Ann Nucl Med 2020; 34:254-262. [PMID: 32016694 DOI: 10.1007/s12149-020-01441-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of our study was to investigate the impact of the epsilon phenotype in brain glucose consumption in a population with Alzheimer's disease. METHODS Statistical Parametric Mapping (SPM8) was used to investigate differences in brain glucose consumption (as detectable by means of 18F FDG-PET/CT) in the population examined. A total of 129 patients (72 females and 57 males) with a diagnosis of probable AD according to the NINCDS-ADRDA criteria underwent the PET/CT examination. The mean (SD) age of the patients was 70 (± 7) years; the mean Mini-Mental State Examination was 19(± 5.6). 59 expressed epsilon 4 phenotype (E4) and 70 expressed the epsilon 3 phenotype (E3). Cerebral spinal fluid amyloid, tau, and t-tau have been measured resulting equal to 367.4 (± 149.1), 584.7 (± 312.1), and 79.2(± 45.9) pg/ml, respectively. Patients with confirmed amyloid and Tau changes were classified as AD. Patients with amyloid changes but negative Tau, considered as high risk of AD, were classified as IAD. Age, sex, MMSE, scholarship, and CSF parameters were used as a covariate in the SPM analyses. RESULTS We did not find significant differences in age, gender, and MMSE and CSF parameters among groups. In the analysis of the AD group as compared to AD-E3, AD-E4 subjects show a significant reduction of brain glucose consumption in inferior frontal gyrus bilaterally (BA 45, BA 47). In the analysis of the IAD group as compared to IAD-E3, IAD-E4 subjects show a significant reduction of brain glucose consumption in right in medial, middle, and superior frontal gyrus (BA10, BA11), and in left medial and middle frontal gyrus (BA10, BA11). The differences between IAD-E3 and AD-E3 and between IAD-E4 and AD-E4 (and vice versa analysis) resulted not significant. CONCLUSIONS APO-e4 is related to a major involvement of the frontal cortex confirming its role of risk factor in AD, while APO-3 seems not related to a specific pattern, supporting the hypothesis of neutral/protective role in AD.
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Affiliation(s)
- Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Faculty of Medicine and Surgery, La Sapienza University, Rome, Italy.
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, IS, Italy
| | - Alessandro Martorana
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Giacomo Koch
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- Non Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Vincenzo De Lucia
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Magna Græcia University, 88100, Catanzaro, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, IS, Italy
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Nisticò R, Cerasa A, Olivadese G, Dalla Volta R, Crasà M, Vasta R, Gramigna V, Vescio B, Barbagallo G, Chiriaco C, Quattrone A, Salsone M, Novellino F, Arabia G, Nicoletti G, Morelli M, Quattrone A. The embodiment of language in tremor-dominant Parkinson’s disease patients. Brain Cogn 2019; 135:103586. [DOI: 10.1016/j.bandc.2019.103586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
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13
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Nigro S, Bordier C, Cerasa A, Nisticò R, Olivadese G, Vescio B, Bianco MG, Fiorillo A, Barbagallo G, Crasà M, Quattrone A, Morelli M, Arabia G, Augimeri A, Nicolini C, Bifone A, Quattrone A. Apomorphine-induced reorganization of striato-frontal connectivity in patients with tremor-dominant Parkinson's disease. Parkinsonism Relat Disord 2019; 67:14-20. [DOI: 10.1016/j.parkreldis.2019.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/30/2019] [Accepted: 09/07/2019] [Indexed: 01/15/2023]
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Quattrone A, Barbagallo G, Cerasa A, Stoessl AJ. Neurobiology of placebo effect in Parkinson's disease: What we have learned and where we are going. Mov Disord 2019; 33:1213-1227. [PMID: 30230624 DOI: 10.1002/mds.27438] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 01/25/2018] [Revised: 04/19/2018] [Accepted: 04/24/2018] [Indexed: 12/29/2022] Open
Abstract
The placebo effect is a phenomenon produced when an inert substance administered like a regular treatment improves the clinical outcome. Parkinson's disease (PD) is one of the main clinical disorders for which the placebo response rates are high. The first evidence of the neurobiological mechanisms underlying the placebo effect in PD stems from 2001, when de la Fuente-Fernandez and colleagues demonstrated that a placebo injection led to the release of dopamine in the striatal nuclei of PD measured with positron emission tomography technology. Since then, several studies have been conducted to investigate the neurobiological underpinnings of placebo responses. This article presents a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of an initial yield of 143 papers, 19 were included. The lessons learned from these studies are threefold: (i) motor improvement is dependent on the activation of the entire nigrostriatal pathway induced by dopamine release in the dorsal striatum; (ii) the magnitude of placebo-induced effects is modulated by an expectancy of improvement, which is in turn related to the release of dopamine within the ventral striatum; (iii) the functioning of the neural pathways underlying the placebo response can be tuned by prior exposure and learning strategies. In conclusion, although the neural network underlying the placebo effect in PD has been largely confirmed and accepted, what remains to be established is how, when, and where the expectation of reward (mediated by the ventral striatum) interacts with the primary motor system (mediated by the dorsal striatum) to induce clinical improvement in motor symptoms. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Aldo Quattrone
- Neuroscience Research Centre, University Magna Graecia, Catanzaro, Italy
- Neuroimaging Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | | | - Antonio Cerasa
- Neuroimaging Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
- Institute S. Anna-Research in Advanced Neurorehabilitation, Crotone, Italy
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre, Division of Neurology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, Canada
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15
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Chiaravalloti A, Barbagallo G, Martorana A, Castellano AE, Ursini F, Schillaci O. Brain metabolic patterns in patients with suspected non-Alzheimer's pathophysiology (SNAP) and Alzheimer's disease (AD): is [ 18F] FDG a specific biomarker in these patients? Eur J Nucl Med Mol Imaging 2019; 46:1796-1805. [PMID: 31201430 DOI: 10.1007/s00259-019-04379-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 05/28/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE The present study was conducted to compare the pattern of brain [18F] FDG uptake in suspected non-Alzheimer's pathophysiology (SNAP), AD, and healthy controls using 2-deoxy-2-[18F]fluoroglucose ([18F] FDG) positron emission tomography imaging. Cerebrospinal fluid (CSF) biomarkers amyloid-β1-42 peptide (Aβ1-42) and tau were used in order to differentiate AD from SNAP. METHODS The study included 43 newly diagnosed AD patients (female = 23; male = 20) according to the NINCDS-ADRDA criteria, 15 SNAP patients (female = 12; male =3), and a group of 34 healthy subjects that served as the control group (CG), who were found to be normal at neurological evaluation (male = 20; female = 14). A battery of neuropsychological tests was administrated in AD and SNAP subjects; cerebrospinal fluid assay was conducted in both AD and SNAP as well. Brain PET/CT acquisition was started 30 ± 5 min after [18F] FDG injection in all subjects. SPM12 [statistical parametric mapping] implemented in MATLAB 2018a was used for the analysis of PET scans in this study. RESULTS As compared to SNAP, AD subjects showed significant hypometabolism in a wide cortical area involving the right frontal, parietal, and temporal lobes. As compared to CG, AD subjects showed a significant reduction in [18F] FDG uptake in the parietal, limbic, and frontal cortex, while a more limited reduction in [18F] FDG uptake in the same areas was found when comparing SNAP to CG. CONCLUSIONS SNAP subjects show milder impairment of brain [18F] FDG uptake as compared to AD. The partial overlap of the metabolic pattern between SNAP and AD limits the use of [18F] FDG PET/CT in effectively discriminating these clinical entities.
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Affiliation(s)
- Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. .,IRCCS Neuromed, Pozzilli, Italy.
| | - Gaetano Barbagallo
- Institute of Neurology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Alessandro Martorana
- UOSD Centro Demenze, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Francesco Ursini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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Barbagallo G, Quattrone A. Does levodopa have a disease‐modifying effect in Parkinson's disease? Evidence from a delayed‐start trial. Mov Disord 2019; 34:820. [DOI: 10.1002/mds.27686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Aldo Quattrone
- Neuroscience Research CentreUniversity Magna Græcia Catanzaro Italy
- Neuroimaging UnitIBFM, National Research Council Catanzaro Italy
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Quattrone A, Caligiuri ME, Morelli M, Nigro S, Vescio B, Arabia G, Nicoletti G, Nisticò R, Salsone M, Novellino F, Barbagallo G, Vaccaro MG, Sabatini U, Vescio V, Stanà C, Rocca F, Caracciolo M, Quattrone A. Imaging counterpart of postural instability and vertical ocular dysfunction in patients with PSP: A multimodal MRI study. Parkinsonism Relat Disord 2019; 63:124-130. [PMID: 30803901 DOI: 10.1016/j.parkreldis.2019.02.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/09/2019] [Accepted: 02/16/2019] [Indexed: 01/13/2023]
Abstract
INTRODUCTION We investigated the imaging counterpart of two functional domains (ocular motor dysfunction and postural instability) in progressive supranuclear palsy (PSP) patients classified according to the new clinical diagnostic criteria. METHODS Forty-eight patients with probable PSP-Richardson's syndrome (PSP-RS), 30 with probable PSP-parkinsonism (PSP-P), 37 with Parkinson's disease (PD), and 38 controls were enrolled. For each functional domain, PSP patients were stratified by two certainty levels: vertical supranuclear gaze palsy (O1) and slowness of vertical saccades (O2) for ocular motor dysfunction; early unprovoked falls and tendency to fall on the pull-test for postural instability. Voxel-based morphometry (VBM), whole-brain fractional anisotropy (FA) and MR planimetric measurements were analysed and compared across patient groups. RESULTS O1 was present in 64%, and O2 in 36% of all PSP patients. All PSP-RS patients showed early unprovoked falls. TBSS whole-brain analysis revealed that superior cerebellar peduncles (SCPs) were the only structures with significantly lower FA values in PSP-RS compared with PSP-P patients. PSP/O1 patients had lower FA values in midbrain than PSP/O2 patients. By contrast, VBM revealed no differences in grey matter volume between PSP patient groups. MR Planimetric measurements confirmed atrophy of midbrain and SCPs, in line with DTI findings. CONCLUSIONS Our study demonstrates that SCPs were significantly more damaged in patients with PSP-RS in comparison with PSP-P patients, thus suggesting the role of SCPs in developing postural instability. Midbrain damage was less severe in O2 than in O1 patients, suggesting that the degree of vertical ocular dysfunction reflects the severity of midbrain atrophy.
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Affiliation(s)
- Andrea Quattrone
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Maria Eugenia Caligiuri
- Neuroscience Center, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Salvatore Nigro
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | | | - Gennarina Arabia
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Giuseppe Nicoletti
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Rita Nisticò
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maria Salsone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Maria Grazia Vaccaro
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Umberto Sabatini
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Virginia Vescio
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Carlo Stanà
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Federico Rocca
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Manuela Caracciolo
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Center, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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Quattrone A, Morelli M, Vescio B, Nigro S, Le Piane E, Sabatini U, Caracciolo M, Vescio V, Quattrone A, Barbagallo G, Stanà C, Nicoletti G, Arabia G, Nisticò R, Novellino F, Salsone M. Refining initial diagnosis of Parkinson's disease after follow-up: A 4-year prospective clinical and magnetic resonance imaging study. Mov Disord 2019; 34:487-495. [PMID: 30759325 PMCID: PMC6593994 DOI: 10.1002/mds.27621] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/27/2018] [Accepted: 01/02/2019] [Indexed: 01/05/2023] Open
Abstract
Background No prospective study of patients with Parkinson's disease (PD) has investigated the appearance of vertical gaze abnormalities, a feature suggestive of progressive supranuclear palsy (PSP). Objective To identify, within a cohort of patients with an initial diagnosis of PD, those who developed vertical gaze abnormalities during a 4‐year follow‐up, and to investigate the performance of new imaging biomarkers in predicting vertical gaze abnormalities. Methods A total of 110 patients initially classified as PD and 74 controls were enrolled. All patients underwent clinical assessment at baseline and every year up to the end of the follow‐up. The pons/midbrain area ratio 2.0 and the Magnetic Resonance Parkinsonism Index 2.0 were calculated. Results After 4‐year follow‐up, 100 of 110 patients maintained the diagnosis of PD, whereas 10 PD patients (9.1%) developed vertical gaze abnormalities, suggesting an alternative diagnosis of PSP‐parkinsonism. At baseline, the Magnetic Resonance Parkinsonism Index 2.0 was the most accurate biomarker in differentiating PD patients who developed vertical gaze abnormalities from those who maintained an initial diagnosis of PD. At the end of follow‐up, both of these biomarkers accurately distinguished PSP‐parkinsonism from PD. Conclusions Our results demonstrate that a number of patients with an initial diagnosis of PD developed vertical gaze abnormalities during a 4‐year follow‐up, and the diagnosis was changed from PD to PSP‐parkinsonism. In PD patients, baseline Magnetic Resonance Parkinsonism Index 2.0 showed the best performance in predicting the clinical evolution toward a PSP‐parkinsonism phenotype, enabling PSP‐parkinsonism patients to be identified at the earliest stage of the disease for promising disease‐modifying therapies. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Aldo Quattrone
- Neuroscience Centre, Magna Graecia University, Catanzaro, Italy.,Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Salvatore Nigro
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Emilio Le Piane
- Department of Neurology, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Umberto Sabatini
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Manuela Caracciolo
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Virginia Vescio
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Andrea Quattrone
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Carlo Stanà
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Nicoletti
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Gennarina Arabia
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Rita Nisticò
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maria Salsone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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Barbagallo G, Morelli M, Quattrone A, Chiriaco C, Vaccaro MG, Gullà D, Rocca F, Caracciolo M, Novellino F, Sarica A, Arabia G, Sabatini U, Quattrone A. In vivo evidence for decreased scyllo-inositol levels in the supplementary motor area of patients with Progressive Supranuclear Palsy: A proton MR spectroscopy study. Parkinsonism Relat Disord 2018; 62:185-191. [PMID: 30558837 DOI: 10.1016/j.parkreldis.2018.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Several structural and functional neuroimaging studies have shown that the Supplementary Motor Area (SMA) is affected by tau pathology in patients with Progressive Supranuclear Palsy (PSP). The aim of the study was to investigate the biochemical profile of SMA in PSP patients, using proton magnetic resonance spectroscopy (1H-MRS). METHODS Sixteen PSP patients and 18 healthy controls participated in this study. 1H-MRS was performed by using a Point RESolving Spectroscopy (PRESS) single-voxel sequence implemented on a 3-T scanner. A voxel of 25 × 25 × 15 mm involving the right and left SMA was acquired in all subjects. Peak areas of N-acetyl-aspartate + N-acetyl-aspartyl-glutamate (NAA), creatine with phosphocreatine (Cr), glycerophosphocholine + phosphocholine (Cho), glutamate + glutamine (Glx), glutathione (GSH), myo-Inositol (mI) and Scyllo-Inositol (Scyllo) were calculated using a version 6.3-1K of the fitting program LCModel. Comparative analysis was performed on both absolute concentrations and ratio values relative to Cr. RESULTS PSP patients showed a significant decrease in Scyllo concentration and Scyllo/Cr ratio values in SMA, compared to controls, whereas no difference between groups was found for the other ratio values. Of note, the attention and working memory functions were positively related to Scyllo and Scyllo/Cr values in PSP patients. CONCLUSIONS Our study demonstrates that Scyllo and Scyllo/Cr were significantly reduced in the SMA of PSP patients. Because Scyllo seems to be able to protect against formation of toxic fibrils of amyloid-beta fragments and tau oligomers deposition, these preliminary findings may open new perspectives to investigate Scyllo as a new potential disease-modifying therapy for PSP.
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Affiliation(s)
| | - Maurizio Morelli
- Institute of Neurology, Magna Græcia University, Catanzaro, Italy.
| | - Andrea Quattrone
- Institute of Neurology, Magna Græcia University, Catanzaro, Italy.
| | - Carmelina Chiriaco
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Maria Grazia Vaccaro
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Domenico Gullà
- Neuroscience Research Centre, Magna Græcia University, Catanzaro, Italy.
| | - Federico Rocca
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Manuela Caracciolo
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Alessia Sarica
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
| | - Gennarina Arabia
- Institute of Neurology, Magna Græcia University, Catanzaro, Italy.
| | - Umberto Sabatini
- Institute of Radiology, Neuroradiology Unit, Magna Graecia University, Catanzaro, Italy.
| | - Aldo Quattrone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy; Neuroscience Research Centre, Magna Græcia University, Catanzaro, Italy.
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D'Angelo S, Chiaravalloti A, Ursini F, Barbagallo G, Gilio M, Leccese P, De Giorgio R, Di Giorgio E, Schillaci O. Brain glucose consumption abnormalities in neuro-Behçet's disease: a preliminary 18F-FDG PET/CT study. Clin Exp Rheumatol 2018; 36:148-149. [PMID: 30582511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 08/08/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Salvatore D'Angelo
- Rheumatology Institute of Lucania (IReL), Rheumatology Department of Lucania, "San Carlo" Hospital of Potenza and "Madonna delle Grazie" Hospital of Matera, Potenza, and Basilicata Ricerca Biomedica (BRB) Foundation, Potenza, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, and IRCCS Neuromed, Pozzilli, Italy.
| | - Francesco Ursini
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Michele Gilio
- Rheumatology Institute of Lucania (IReL), Rheumatology Department of Lucania, "San Carlo" Hospital of Potenza and "Madonna delle Grazie" Hospital of Matera, Potenza, Italy
| | - Pietro Leccese
- Rheumatology Institute of Lucania (IReL), Rheumatology Department of Lucania, "San Carlo" Hospital of Potenza and "Madonna delle Grazie" Hospital of Matera, Potenza, Italy
| | | | | | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, and IRCCS Neuromed, Pozzilli, Italy
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Fusilli C, Migliore S, Mazza T, Consoli F, De Luca A, Barbagallo G, Ciammola A, Gatto EM, Cesarini M, Etcheverry JL, Parisi V, Al-Oraimi M, Al-Harrasi S, Al-Salmi Q, Marano M, Vonsattel JPG, Sabatini U, Landwehrmeyer GB, Squitieri F. Biological and clinical manifestations of juvenile Huntington's disease: a retrospective analysis. Lancet Neurol 2018; 17:986-993. [PMID: 30243861 DOI: 10.1016/s1474-4422(18)30294-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Huntington's disease is a rare, neurodegenerative disease caused by an expanded CAG repeat mutation in the huntingtin gene. Compared with adult-onset Huntington's disease, juvenile Huntington's disease (onset ≤20 years) is even rarer and has not been studied extensively. We aimed to further characterise juvenile Huntington's disease by examining the effect of CAG repeat size on disease presentation, progression, and survival. METHODS We did a retrospective analysis of patients with juvenile Huntington's disease aged 20 years or younger, according to the length of their CAG repeat and who had disabling psychiatric symptoms (with motor symptoms) or motor symptoms alone, and of patients with adult-onset Huntington's disease manifesting aged 30-60 years with 40 or more CAG repeats, from the REGISTRY and ENROLL-HD platforms and from two institutional databases (Lega Italiana Ricerca Huntington Foundation and the Instituto Neurociencias de Buenos Aires and the Sanatorio de la Trinidad Mitre). Patients with psychiatric but no motor symptoms were excluded. We compared symptoms at onset and longitudinally in patients with juvenile Huntington's disease with highly expanded (HE subgroup) or low expansion (LE subgroup) mutations, grouped by hierarchical clustering analysis. We also compared disease progression (longitudinal change in Unified Huntington's Disease Rating Scale-Total Motor Score) and survival of patients with juvenile and adult-onset Huntington's disease. FINDINGS We extracted medical records from 580 patients entered into the studies or databases between June 23, 2004, and March 31, 2018, of whom 36 patients met our definition of juvenile Huntington's disease and 197 for adult-onset Huntington's disease. According to caregiver reports, gait disturbance was more often a first presenting symptom in the HE subgroup (eight [80%] of 10 patients) than in the LE subgroup (seven [27%] of 26 patients; p=0·0071), whereas loss of hand dexterity was more common in the LE subgroup (11 [42%] of 26 patients) than in the HE subgroup (0 [0%] of 10 patients; p=0·0160). Compared with the LE subgroup, development delay (0 [0%] in the LE subgroup vs nine [90%] in the HE subgroup; p<0·0001), severe gait impairment (nine [35%] in the LE subgroup vs nine [90%] in the HE subgroup; p=0·0072), and seizures (three [11%] in the LE subgroup vs eight [80%] in the HE subgroup; p<0·0001) prevailed over time in the HE subgroup. Disease progression was more rapid in juvenile Huntington's disease (n=14) than in adult-onset Huntington's disease (n=52; generalised estimating equation model, p=0·0003). Of 121 deceased patients, median survival was shorter in the juvenile Huntington's disease (n=17) cohort than in adult-onset Huntington's disease (n=104) cohort (hazard ratio 2·18 [95% CI 1·08-4·40]; p=0·002). INTERPRETATION Patients with HE juvenile Huntington's disease differ clinically from patients with LE juvenile Huntington's disease or adult-onset Huntington's disease, suggesting reclassification of this particularly aggressive form of Huntington's disease might be required. FUNDING Lega Italiana Ricerca Huntington Foundation and IRCCS Ospedale Casa Sollievo della Sofferenza.
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Affiliation(s)
- Caterina Fusilli
- Bioinformatics Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Federica Consoli
- Molecular Genetics Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandro De Luca
- Molecular Genetics Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Andrea Ciammola
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Emilia Mabel Gatto
- Departments of Movement Disorders, Instituto Neurociencias de Buenos Aires, and Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
| | - Martin Cesarini
- Departments of Movement Disorders, Instituto Neurociencias de Buenos Aires, and Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
| | - Jose Luis Etcheverry
- Departments of Movement Disorders, Instituto Neurociencias de Buenos Aires, and Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
| | - Virginia Parisi
- Departments of Movement Disorders, Instituto Neurociencias de Buenos Aires, and Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
| | - Musallam Al-Oraimi
- National Genetic Centre, Royal Hospital, Ministry of Health, Muscat, Sultanate of Oman
| | - Salma Al-Harrasi
- National Genetic Centre, Royal Hospital, Ministry of Health, Muscat, Sultanate of Oman
| | - Qasem Al-Salmi
- National Genetic Centre, Royal Hospital, Ministry of Health, Muscat, Sultanate of Oman
| | - Massimo Marano
- Italian League for Research on Huntington and Related Diseases Foundation, Rome, Italy
| | | | - Umberto Sabatini
- Department of Neuroradiology, University Magna Graecia, Catanzaro, Italy
| | | | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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Mauro D, Barbagallo G, D`Angelo S, Sannino P, Naty S, Bruno C, Olivieri I, Grembiale RD, Ursini F. Role of Positron Emission Tomography for Central Nervous System Involvement in Systemic Autoimmune Diseases: Status and Perspectives. Curr Med Chem 2018; 25:3096-3104. [DOI: 10.2174/0929867324666170523144402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/17/2017] [Accepted: 02/17/2017] [Indexed: 11/22/2022]
Abstract
In the last years, an increasing interest in molecular imaging has been raised by
the extending potential of positron emission tomography [PET]. The role of PET imaging,
originally confined to the oncology setting, is continuously extending thanks to the development
of novel radiopharmaceutical and to the implementation of hybrid imaging techniques,
where PET scans are combined with computed tomography [CT] or magnetic
resonance imaging[MRI] in order to improve spatial resolution.
Early preclinical studies suggested that 18F–FDG PET can detect neuroinflammation;
new developing radiopharmaceuticals targeting more specifically inflammation-related
molecules are moving in this direction. Neurological involvement is a distinct feature of
various systemic autoimmune diseases, i.e. Systemic Lupus Erythematosus [SLE] or
Behcet’s disease [BD]. Although MRI is largely considered the gold-standard imaging
technique for the detection of Central Nervous System [CNS] involvement in these disorders.
Several patients complain of neuropsychiatric symptoms [headache, epilepsy, anxiety
or depression] in the absence of any significant MRI finding; in such patients the diagnosis
relies mainly on clinical examination and often the role of the disease process
versus iatrogenic or reactive forms is doubtful.
The aim of this review is to explore the state-of-the-art for the role of PET imaging in
CNS involvement in systemic rheumatic diseases. In addition, we explore the potential
role of emerging radiopharmaceutical and their possible application in aiding the diagnosis
of CNS involvement in systemic autoimmune diseases.
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Affiliation(s)
- Daniele Mauro
- William Harvey Research Institute and Barts and The London, School of Medicine and Dentistry Queen Mary University of London, London, United Kingdom
| | | | - Salvatore D`Angelo
- Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
| | - Pasqualina Sannino
- Department of Nuclear Medicine and Neuroradiology, IRCCS Neuromed, Pozzilli, Italy
| | - Saverio Naty
- Department of Health Sciences, University of Catanzaro , Italy
| | - Caterina Bruno
- Department of Health Sciences, University of Catanzaro , Italy
| | - Ignazio Olivieri
- Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
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Quattrone A, Morelli M, Nigro S, Quattrone A, Vescio B, Arabia G, Nicoletti G, Nisticò R, Salsone M, Novellino F, Barbagallo G, Le Piane E, Pugliese P, Bosco D, Vaccaro MG, Chiriaco C, Sabatini U, Vescio V, Stanà C, Rocca F, Gullà D, Caracciolo M. A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson's disease. Parkinsonism Relat Disord 2018; 54:3-8. [DOI: 10.1016/j.parkreldis.2018.07.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 12/22/2022]
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Arabia G, Lupo A, Manfredini LI, Vescio B, Nisticò R, Barbagallo G, Salsone M, Morelli M, Novellino F, Nicoletti G, Quattrone A, Cascini GL, Louis ED, Quattrone A. Clinical, electrophysiological, and imaging study in essential tremor-Parkinson's disease syndrome. Parkinsonism Relat Disord 2018; 56:20-26. [PMID: 29885986 DOI: 10.1016/j.parkreldis.2018.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/17/2018] [Accepted: 06/03/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Essential tremor-Parkinson's disease (ET-PD) syndrome is a clinical condition in which individuals with a long-lasting history of Essential tremor (ET) eventually develop Parkinson's disease (PD). The aim of the study was to investigate the accuracy performances of clinical, neurophysiological, and imaging biomarkers in differentiating patients affected by ET-PD syndrome from patients with ET or PD. METHODS Nineteen patients affected by ET-PD syndrome, 48 ET patients, and 37 tremor-dominant PD (t-PD) patients were included. Electrophysiological studies, including blink-reflex recovery cycle and tremor parameters analyses, were performed in all groups. Nigro-striatal and cardiac sympathetic denervation were also investigated. Sensitivity, specificity and accuracy of clinical, electrophysiological, and radiological features in differentiating ET-PD syndrome from ET and PD were calculated. RESULTS ET-PD patients had significantly lower rigidity (p = 0.007) and higher postural/kinetic tremor (p = 0.007) scores, in comparison to t-PD patients. ET-PD patients, differently from PD patients, had a synchronous pattern of resting tremor and, differently from ET patients, had abnormal blink-reflex recovery cycle. ET-PD patients also showed reduced nigro-striatal and cardiac sympathetic uptakes, albeit to a lesser extent than in PD patients. The highest accuracy values were found for the synchronous pattern of resting tremor (97.1%) in distinguishing ET-PD from PD, and for presence of abnormal blink-recovery cycle (100%) in distinguishing ET-PD syndrome from ET. CONCLUSION Our study demonstrates that some electrophysiological parameters, such as a synchronous resting tremor pattern and the abnormal blink-recovery cycle were the most accurate biomarkers in distinguishing patient with ET-PD syndrome from those with ET or those with PD.
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Affiliation(s)
- Gennarina Arabia
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Angela Lupo
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Lucia Ilaria Manfredini
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | | | - Rita Nisticò
- Neuroimaging Research Unit, IBFM, National Research Council, Catanzaro, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Maria Salsone
- Neuroimaging Research Unit, IBFM, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, IBFM, National Research Council, Catanzaro, Italy
| | - Giuseppe Nicoletti
- Neuroimaging Research Unit, IBFM, National Research Council, Catanzaro, Italy
| | - Andrea Quattrone
- Institute of Neurology, Department of Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | | | - Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Aldo Quattrone
- Neuroimaging Research Unit, IBFM, National Research Council, Catanzaro, Italy; Neuroscience Center, University "Magna Graecia" of Catanzaro, Italy.
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Barbagallo G, Nisticò R, Vescio B, Cerasa A, Olivadese G, Nigro S, Crasà M, Quattrone A, Bianco MG, Morelli M, Augimeri A, Salsone M, Novellino F, Nicoletti G, Arabia G, Quattrone A. The placebo effect on resting tremor in Parkinson's disease: an electrophysiological study. Parkinsonism Relat Disord 2018; 52:17-23. [PMID: 29551396 DOI: 10.1016/j.parkreldis.2018.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/07/2018] [Revised: 02/26/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The aim of our study was to investigate the effect of apomorphine and placebo on resting tremor in tremor-dominant Parkinson's disease (tPD) patients. METHODS Fifteen tPD patients were enrolled. Each patient underwent two treatments on two consecutive days: on day one the patients received a subcutaneous injection of placebo, while on day two they received apomorphine. On each day, the patients underwent three electrophysiological recording sessions: T0, T1, and T2: before, 30 min, and 60 min after the treatment respectively. Electrophysiological changes in tremor amplitude were evaluated using a triaxial accelerometer. RESULTS Placebo was effective in improving resting tremor in all tPD patients (p = 0.009) at T1, but not at T2. Eight out of 15 tPD patients (53.3%) responded to placebo with an at least 70% reduction in tremor amplitude compared to the basal condition (responders). By contrast, seven out of 15 tPD patients (46.7%) did not show any variation in tremor amplitude after placebo administration (non-responders). Apomorphine induced a marked reduction in tremor amplitude at 30 min and 60 min in all investigated tPD patients. Of note, the decrease in tremor amplitude in placebo responders was similar to that achieved with dopaminergic stimulation induced by apomorphine. CONCLUSIONS Our study demonstrates that placebo was very effective in reducing resting tremor in about half of patients with tPD. The decrease in tremor amplitude in placebo responders was similar to that induced by apomorphine. The cerebral mechanisms underlying the placebo effect on resting tremor need further investigations.
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Affiliation(s)
| | - Rita Nisticò
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | | | - Antonio Cerasa
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy; S. Anna Institute and Research in Advanced Neurorehabilitation (RAN) Crotone, Italy.
| | | | - Salvatore Nigro
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Marianna Crasà
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Andrea Quattrone
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
| | | | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
| | | | - Maria Salsone
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Fabiana Novellino
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | | | - Gennarina Arabia
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
| | - Aldo Quattrone
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy; Neuroscience Research Centre, University "Magna Graecia", Catanzaro, Italy.
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Péran P, Barbagallo G, Nemmi F, Sierra M, Galitzky M, Traon APL, Payoux P, Meissner WG, Rascol O. MRI supervised and unsupervised classification of Parkinson's disease and multiple system atrophy. Mov Disord 2018; 33:600-608. [PMID: 29473662 DOI: 10.1002/mds.27307] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/15/2017] [Accepted: 12/22/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multimodal MRI approach is based on a combination of MRI parameters sensitive to different tissue characteristics (eg, volume atrophy, iron deposition, and microstructural damage). The main objective of the present study was to use a multimodal MRI approach to identify brain differences that could discriminate between matched groups of patients with multiple system atrophy, Parkinson's disease, and healthy controls. We assessed the 2 different MSA variants, namely, MSA-P, with predominant parkinsonism, and MSA-C, with more prominent cerebellar symptoms. METHODS Twenty-six PD patients, 29 MSA patients (16 MSA-P, 13 MSA-C), and 26 controls underwent 3-T MRI comprising T2*-weighted, T1-weighted, and diffusion tensor imaging scans. Using whole-brain voxel-based MRI, we combined gray-matter density, T2* relaxation rates, and diffusion tensor imaging scalars to compare and discriminate PD, MSA-P, MSA-C, and healthy controls. RESULTS Our main results showed that this approach reveals multiparametric modifications within the cerebellum and putamen in both MSA-C and MSA-P patients, compared with PD patients. Furthermore, our findings revealed that specific single multimodal MRI markers were sufficient to discriminate MSA-P and MSA-C patients from PD patients. Moreover, the unsupervised analysis based on multimodal MRI data could regroup individuals according to their clinical diagnosis, in most cases. CONCLUSIONS This study demonstrates that multimodal MRI is able to discriminate patients with PD from those with MSA with high accuracy. The combination of different MR biomarkers could be a great tool in early stage of disease to help diagnosis. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | | | - Federico Nemmi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Maria Sierra
- Neurology Service, University Hospital Marqués de Valdecilla and Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Santander, Spain
| | - Monique Galitzky
- Centre d'Investigation Clinique (CIC), CHU de Toulouse, Toulouse, France
| | - Anne Pavy-Le Traon
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France.,Department of Neurology and Institute for Neurosciences, University Hospital of Toulouse, Toulouse, France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Wassilios G Meissner
- Service de Neurologie, CHU Bordeaux, Bordeaux, France.,Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Olivier Rascol
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.,Université de Toulouse 3, CHU de Toulouse, INSERM, Centre de Reference AMS, Service de Neurologie et de Pharmacologie Clinique, Centre d'Investigation Clinique CIC1436, Réseau NS-Park/FCRIN et Centre of excellence for neurodegenerative disorders (COEN) de Toulouse, Toulouse, France
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Chiaravalloti A, Castellano AE, Ricci M, Barbagallo G, Sannino P, Ursini F, Karalis G, Schillaci O. Coupled Imaging with [18F]FBB and [18F]FDG in AD Subjects Show a Selective Association Between Amyloid Burden and Cortical Dysfunction in the Brain. Mol Imaging Biol 2018; 20:659-666. [DOI: 10.1007/s11307-018-1167-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Barbagallo G, Arabia G, Novellino F, Nisticò R, Salsone M, Morelli M, Rocca F, Quattrone A, Caracciolo M, Sabatini U, Cherubini A, Quattrone A. Increased glutamate + glutamine levels in the thalamus of patients with essential tremor: A preliminary proton MR spectroscopic study. Parkinsonism Relat Disord 2018; 47:57-63. [DOI: 10.1016/j.parkreldis.2017.11.345] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/12/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
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Péran P, Nemmi F, Barbagallo G. Brain Morphometry: Parkinson’s Disease. Neuromethods 2018:267-277. [DOI: 10.1007/978-1-4939-7647-8_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Barbagallo G, Arabia G, Morelli M, Nisticò R, Novellino F, Salsone M, Rocca F, Quattrone A, Caracciolo M, Sabatini U, Cherubini A, Quattrone A. Thalamic neurometabolic alterations in tremulous Parkinson's disease: A preliminary proton MR spectroscopy study. Parkinsonism Relat Disord 2017; 43:78-84. [PMID: 28774469 DOI: 10.1016/j.parkreldis.2017.07.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 03/24/2017] [Revised: 07/20/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the thalamic biochemical changes in tremor-dominant Parkinson's disease (tPD) patients in comparison with essential tremor with resting tremor (rET) patients, by using proton MR spectroscopy (1H-MRS). METHODS Fourteen tPD patients, 12 rET patients and 10 controls participated in this study. All patients underwent dopamine transporter single-photon emission computed tomography (DAT-SPECT) with 123I-ioflupane, and a short-echo single-voxel 1H-MRS on a 3T scanner. A voxel of 10 × 15 × 10 mm involving the Vim nucleus was acquired in both thalami of all subjects. Peak areas of N-acetyl-aspartate (NAA), creatine (Cr), glycerophosphocholine (Cho), and glutamate (Glu) were measured for each voxel using LCModel. The NAA/Cr, Cho/Cr, and Glu/Cr ratios were then calculated. RESULTS DAT-SPECT was abnormal in tPD patients, whereas it was normal in rET patients. Patients with tPD showed a significant reduction of NAA/Cr and Cho/Cr in the thalami compared to rET and healthy controls; whereas there were no significant differences between rET patients and controls. The combination of thalamic NAA/Cr and Cho/Cr ratios showed a 100% accuracy in distinguishing tPD patients from rET patients and controls. CONCLUSIONS This study provides preliminary evidence that thalamic neurometabolic abnormalities occur in tremor-dominant phenotype of PD, and suggests that 1H-MRS can help differentiate patients with tPD from those with rET.
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Affiliation(s)
| | - Gennarina Arabia
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy.
| | - Maurizio Morelli
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy.
| | - Rita Nisticò
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Fabiana Novellino
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Maria Salsone
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Federico Rocca
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Andrea Quattrone
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy.
| | | | - Umberto Sabatini
- Institute of Neuroradiology, University Magna Graecia, Catanzaro, Italy.
| | - Andrea Cherubini
- Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
| | - Aldo Quattrone
- Institute of Neurology, University Magna Græcia, Catanzaro, Italy; Neuroimaging Unit, IBFM, National Research Council, Catanzaro, Italy.
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Chiaravalloti A, Ursini F, Fiorentini A, Barbagallo G, Martorana A, Koch G, Tavolozza M, Schillaci O. Functional correlates of TSH, fT3 and fT4 in Alzheimer disease: a F-18 FDG PET/CT study. Sci Rep 2017; 7:6220. [PMID: 28740088 PMCID: PMC5524843 DOI: 10.1038/s41598-017-06138-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/08/2017] [Indexed: 11/24/2022] Open
Abstract
The present study was aimed to investigate the relationships between thyroid stimulating hormone (TSH), freeT3 (fT3) and freeT4 (fT4) and brain glucose consumption as detectable by means of 2-deoxy-2-(F-18) fluoro-D-glucose (F-18 FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in a selected population with Alzheimer disease (AD). We evaluated 87 subjects (37 males and 50 females, mean age 70 (±6) years old) with AD. All of them were subjected to TSH, fT3 and fT4 assay and to cerebrospinal fluid amyloid (Aβ1-42) and tau [phosphorylated-tau (p-tau) and total-tau (t-tau)] assay prior PET/CT examination. Values for TSH, fT3 and fT4 were in the normal range. The relationships were evaluated by means of statistical parametric mapping (SPM8) using age, sex, MMSE, scholarship and CSF values of amyloid and tau as covariates. We found a significant positive correlation between TSH values and cortical glucose consumption in a wide portion of the anterior cingulate cortex bilaterally (BA32) and left frontal lobe (BA25) (p FWE-corr <0.001; p FDRcorr <0.000; cluster extent 66950). No significant relationships were found between cortical F-18 FDG uptake and T3 and T4 serum levels. The results of our study suggest that a cortical dysfunction in anterior cingulate and frontal lobes may affect serum values of TSH in AD patients.
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Affiliation(s)
- Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. .,IRCCS Neuromed, Pozzilli (IS), Italy.
| | - Francesco Ursini
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | | | - Alessandro Martorana
- Department of Neurosciences, University Tor Vergata, Rome, Italy.,IRCCS Santa Lucia, Rome, Italy
| | - Giacomo Koch
- Department of Neurosciences, University Tor Vergata, Rome, Italy.,IRCCS Santa Lucia, Rome, Italy
| | - Mario Tavolozza
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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Caligiuri ME, Arabia G, Barbagallo G, Lupo A, Morelli M, Nisticò R, Novellino F, Quattrone A, Salsone M, Vescio B, Cherubini A, Quattrone A. Structural connectivity differences in essential tremor with and without resting tremor. J Neurol 2017; 264:1865-1874. [DOI: 10.1007/s00415-017-8553-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
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Barbagallo G, Caligiuri ME, Arabia G, Cherubini A, Lupo A, Nisticò R, Salsone M, Novellino F, Morelli M, Cascini GL, Galea D, Quattrone A. Structural connectivity differences in motor network between tremor-dominant and nontremor Parkinson's disease. Hum Brain Mapp 2017. [PMID: 28631404 DOI: 10.1002/hbm.23697] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Motor phenotypes of Parkinson's disease (PD) are recognized to have different prognosis and therapeutic response, but the neural basis for this clinical heterogeneity remains largely unknown. The main aim of this study was to compare differences in structural connectivity metrics of the main motor network between tremor-dominant and nontremor PD phenotypes (TD-PD and NT-PD, respectively) using probabilistic tractography-based network analysis. A total of 63 PD patients (35 TD-PD patients and 28 NT-PD patients) and 30 healthy controls underwent a 3 T MRI. Next, probabilistic tractography-based network analysis was performed to assess structural connectivity in cerebello-thalamo-basal ganglia-cortical circuits, by measuring the connectivity indices of each tract and the efficiency of each node. Furthermore, dopamine transporter single-photon emission computed tomography (DAT-SPECT) with 123 I-ioflupane was used to assess dopaminergic striatal depletion in all PD patients. Both PD phenotypes showed nodal abnormalities in the substantia nigra, in agreement with DAT-SPECT evaluation. In addition, NT-PD patients displayed connectivity alterations in nigro-pallidal and fronto-striatal pathways, compared with both controls and TD-PD patients, in which the same motor connections seemed to be relatively spared. Of note, in NT-PD group, rigidity-bradykinesia score correlated with fronto-striatal connectivity abnormalities. These findings demonstrate that structural connectivity alterations occur in the cortico-basal ganglia circuit of NT-PD patients, but not in TD-PD patients, suggesting that these anatomical differences may underlie different motor phenotypes of PD. Hum Brain Mapp 38:4716-4729, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Maria Eugenia Caligiuri
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Gennarina Arabia
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Andrea Cherubini
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Angela Lupo
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Rita Nisticò
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maria Salsone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Lucio Cascini
- Institute of Radiology, Nuclear Medicine Unit, University "Magna Graecia", Catanzaro, Italy
| | - Domenico Galea
- Institute of Radiology, Nuclear Medicine Unit, University "Magna Graecia", Catanzaro, Italy
| | - Aldo Quattrone
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.,Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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Visocchi M, Signorelli F, Iacopino G, Barbagallo G. Nuances of Microsurgical and Endoscope Assisted Surgical Techniques to the Cranio-Vertebral Junction: Review of the Literature. Open J Orthop Rheumatol 2017; 2:001-008. [DOI: 10.17352/ojor.000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Barbagallo G, Arabia G, Lupo A, Sabatini U, Quattrone A. Midbrain hemiatrophy and nigral rarefaction in a patient with hemiparkinsonism-hemiatrophy syndrome. Mov Disord 2016; 31:1756-1757. [PMID: 27664073 DOI: 10.1002/mds.26811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Gennarina Arabia
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Angela Lupo
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Umberto Sabatini
- Institute of Neuroradiology, University Magna Graecia, Catanzaro, Italy
| | - Aldo Quattrone
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy.,Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council, Catanzaro, Italy
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Nigro S, Riccelli R, Passamonti L, Arabia G, Morelli M, Nisticò R, Novellino F, Salsone M, Barbagallo G, Quattrone A. Characterizing structural neural networks in de novo Parkinson disease patients using diffusion tensor imaging. Hum Brain Mapp 2016; 37:4500-4510. [PMID: 27466157 DOI: 10.1002/hbm.23324] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 06/16/2016] [Accepted: 07/14/2016] [Indexed: 01/17/2023] Open
Abstract
Parkinson disease (PD) can be considered as a brain multisystemic disease arising from dysfunction in several neural networks. The principal aim of this study was to assess whether large-scale structural topological network changes are detectable in PD patients who have not been exposed yet to dopaminergic therapy (de novo patients). Twenty-one drug-naïve PD patients and thirty healthy controls underwent a 3T structural MRI. Next, Diffusion Tensor Imaging (DTI) and graph theoretic analyses to compute individual structural white-matter (WM) networks were combined. Centrality (degree, eigenvector centrality), segregation (clustering coefficient), and integration measures (efficiency, path length) were assessed in subject-specific structural networks. Moreover, Network-based statistic (NBS) was used to identify whether and which subnetworks were significantly different between PD and control participants. De novo PD patients showed decreased clustering coefficient and strength in specific brain regions such as putamen, pallidum, amygdala, and olfactory cortex compared with healthy controls. Moreover, NBS analyses demonstrated that two specific subnetworks of reduced connectivity characterized the WM structural organization of PD patients. In particular, several key pathways in the limbic system, basal ganglia, and sensorimotor circuits showed reduced patterns of communications when comparing PD patients to controls. This study shows that PD is characterized by a disruption in the structural connectivity of several motor and non-motor regions. These findings provide support to the presence of disconnectivity mechanisms in motor (basal ganglia) as well as in non-motor (e.g., limbic, olfactory) circuits at an early disease stage of PD. Hum Brain Mapp 37:4500-4510, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- S Nigro
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy
| | - R Riccelli
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Graecia,", Catanzaro, 88100, Italy
| | - L Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - G Arabia
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Graecia,", Catanzaro, 88100, Italy
| | - M Morelli
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Graecia,", Catanzaro, 88100, Italy
| | - R Nisticò
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy
| | - F Novellino
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy
| | - M Salsone
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy
| | - G Barbagallo
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Graecia,", Catanzaro, 88100, Italy
| | - A Quattrone
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, 88100, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Graecia,", Catanzaro, 88100, Italy
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Caligiuri ME, Nisticò R, Arabia G, Morelli M, Novellino F, Salsone M, Barbagallo G, Lupo A, Cascini GL, Galea D, Cherubini A, Quattrone A. Alterations of putaminal shape in de novo Parkinson's disease. Mov Disord 2016; 31:676-83. [DOI: 10.1002/mds.26550] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maria Eugenia Caligiuri
- Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council; Catanzaro Italy
| | - Rita Nisticò
- Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council; Catanzaro Italy
| | - Gennarina Arabia
- Institute of Neurology; University “Magna Graecia”; Catanzaro Italy
| | - Maurizio Morelli
- Institute of Neurology; University “Magna Graecia”; Catanzaro Italy
| | - Fabiana Novellino
- Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council; Catanzaro Italy
| | - Maria Salsone
- Institute of Neurology; University “Magna Graecia”; Catanzaro Italy
| | | | - Angela Lupo
- Institute of Neurology; University “Magna Graecia”; Catanzaro Italy
| | - Giuseppe Lucio Cascini
- Institute of Radiology, Nuclear Medicine Unit; University “Magna Graecia”; Catanzaro Italy
| | - Domenico Galea
- Institute of Radiology, Nuclear Medicine Unit; University “Magna Graecia”; Catanzaro Italy
| | - Andrea Cherubini
- Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council; Catanzaro Italy
| | - Aldo Quattrone
- Neuroimaging Unit, Institute of Bioimaging and Molecular Physiology (CNR-IBFM), National Research Council; Catanzaro Italy
- Institute of Neurology; University “Magna Graecia”; Catanzaro Italy
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Augimeri A, Cherubini A, Cascini GL, Galea D, Caligiuri ME, Barbagallo G, Arabia G, Quattrone A. CADA-computer-aided DaTSCAN analysis. EJNMMI Phys 2016; 3:4. [PMID: 26879864 PMCID: PMC4754234 DOI: 10.1186/s40658-016-0140-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/04/2016] [Indexed: 11/17/2022] Open
Abstract
Background Dopamine transporter (DaT) imaging (DaTSCAN) is useful for the differential diagnosis of parkinsonian syndromes. Visual evaluation of DaTSCAN images represents the generally accepted diagnostic method, but it is strongly dependent on the observer’s experience and shows inter- and intra-observer variability. A reliable and automatic method for DaTSCAN evaluation can provide objective quantification; it is desirable for longitudinal studies, and it allows for a better follow-up control. Moreover, it is crucial for an automated method to produce coherent measures related to the severity of motor symptoms. Methods In this work, we propose a novel fully automated technique for DaTSCAN analysis that generates quantitative measures based on striatal intensity, shape, symmetry and extent. We tested these measures using a support vector machine (SVM) classifier. Results The proposed measures reached 100 % accuracy in distinguishing between patients with Parkinson’s disease (PD) and control subjects. We also demonstrate the existence of a linear relationship and an exponential trend between pooled structural and functional striatal characteristics and the Unified Parkinson’s disease Rating Scale (UPDRS) motor score. Conclusions We present a novel, highly reproducible, user-independent technique for DaTSCAN analysis producing quantitative measures directly connected to striatum uptake and shape. In our method, no a priori assumption is required on the spatial conformation and localization of striatum, and both uptake and symmetry contribute to the index quantification. These measures can reliably support a computer-assisted decision system. Electronic supplementary material The online version of this article (doi:10.1186/s40658-016-0140-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antonio Augimeri
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
| | - Andrea Cherubini
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
| | - Giuseppe Lucio Cascini
- Institute of Radiology, Nuclear Medicine Unit, University Magna Graecia, Catanzaro, Italy.
| | - Domenico Galea
- Institute of Radiology, Nuclear Medicine Unit, University Magna Graecia, Catanzaro, Italy.
| | - Maria Eugenia Caligiuri
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
| | | | - Gennarina Arabia
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy.
| | - Aldo Quattrone
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy. .,Institute of Neurology, University Magna Graecia, Catanzaro, Italy.
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Barbagallo G, Sierra-Peña M, Nemmi F, Traon APL, Meissner WG, Rascol O, Péran P. Multimodal MRI assessment of nigro-striatal pathway in multiple system atrophy and Parkinson disease. Mov Disord 2015; 31:325-34. [PMID: 26676922 DOI: 10.1002/mds.26471] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/02/2015] [Accepted: 10/05/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) and multiple system atrophy (MSA) are two neurodegenerative alpha-synucleinopathies characterized by severe impairment of the nigro-striatal pathway. Based on T1-, T2*-, and diffusion-weighted magnetic resonance imaging (MRI), macro-structural and micro-structural abnormalities in these diseases can be detected. OBJECTIVE This study was undertaken to compare the nigro-striatal changes that occur in patients with PD with those in patients with both variants of MSA (the parkinsonian variant, MSA-P, and the cerebellar variant, MSA-C), and to explore correlations between different MRI parameters and clinical data. METHODS We simultaneously measured volume, T2* relaxation rates, and mean diffusivity in nigro-striatal structures (substantia nigra, caudate nucleus, and putamen) of 26 patients with PD and 29 patients with MSA (16 with MSA-P and 13 with MSA-C). RESULTS Significant changes in the putamina in patients with MSA were observed compared with patients with PD. Patients with MSA-P had higher mean diffusivity values in their putamina than did patients with PD or MSA-C. The putamina of both subgroups of MSA had higher T2* relaxation rates values than PD. Remarkably, discriminant analysis showed that using two measurements of microstructural damage (T2* relaxation rates and mean diffusivity in the putamen) allowed 96% accuracy to distinguish patients with PD from those with MSA-P. Correlation analyses between MRI findings and clinical variables revealed that patients with PD showed significant correlations only at the nigra. In patients with MSA, clinical variables correlated with MRI findings in both the nigra and striatum. CONCLUSIONS Multimodal MRI reveals different pattern of nigro-striatal involvement in patients with PD and patients with MSA.
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Affiliation(s)
- Gaetano Barbagallo
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France.,Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Maria Sierra-Peña
- Service of Neurology, University Hospital "Marqués de Valdecilla (IFIMAV)," University of Cantabria and "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED),", Santander, Spain
| | - Federico Nemmi
- Neuroscience Department, Retzius vag 8, Karolinska Institutet, Stockholm, Sweden
| | - Anne Pavy-Le Traon
- Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Wassilios G Meissner
- Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,Service de Neurologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Olivier Rascol
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France.,Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Département de Pharmacologie Clinique, INSERM CIC1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Patrice Péran
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France
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Barbagallo G, Certo F, Albanese V, Visocchi M. The impact of complications following cervical spine surgery: a systematic review. J Neurosurg Sci 2014; 58:55-64. [PMID: 25371950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Barbagallo G, Certo F, Princiotto S, Piccini M, Albanese V, Visocchi M. Early postoperative extramedullary MRI signal changes after ACDF: misinterpretations can be dangerous and misleading. Case report and review of the literature. J Neurosurg Sci 2014; 58:123-128. [PMID: 25371962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Visocchi M, Della Pepa GM, Roselli R, La Rocca G, Conforti G, Spallone A, Barbagallo G. Laminoplasty and laminectomy in cervical stenotic myelopathy: allies not enemies. J Neurosurg Sci 2014; 58:101-105. [PMID: 25371958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Visocchi M, Conforti G, La Rocca G, Roselli R, Spallone A, Barbagallo G. Invasive and mini-invasive lumbar fusions. Does exist a state of art? An enigma in search of solutions. J Neurosurg Sci 2014; 58:113-117. [PMID: 25371960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Johnson RD, Liebenberg WA, Maartens N, Barbagallo G, Balsano M. Spinal surgery. Landmark Papers in Neurosurgery 2014:191-236. [DOI: 10.1093/med/9780199674022.003.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Morelli M, Arabia G, Messina D, Vescio B, Salsone M, Chiriaco C, Perrotta P, Rocca F, Cascini GL, Barbagallo G, Nigro S, Quattrone A. Effect of aging on magnetic resonance measures differentiating progressive supranuclear palsy from Parkinson's disease. Mov Disord 2014; 29:488-95. [PMID: 24573655 DOI: 10.1002/mds.25821] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 11/18/2013] [Accepted: 12/30/2013] [Indexed: 11/08/2022] Open
Abstract
Imaging measurements, such as the ratio of the midsagittal areas of the midbrain and pons (midbrain/pons) and the Magnetic Resonance Parkinsonism Index (MRPI), have been proposed to differentiate progressive supranuclear palsy (PSP) from Parkinson's disease (PD). However, abnormal midbrain/pons values suggestive of PSP have also been reported in elderly individuals and in patients with PD. We investigated the effect of aging on single or combined imaging measurements of the brainstem. We calculated the midbrain/pons and the MRPI (the ratio of the midsagittal areas of the pons and the midbrain multiplied by the ratio of the middle cerebellar peduncle and superior cerebellar peduncle widths) in 152 patients affected by PD, 25 patients with PSP, and a group of 81 age-matched and sex-matched healthy controls using a 3-Tesla magnetic resonance imaging scanner. In healthy controls, aging was negatively correlated with midsagittal area of the midbrain and midbrain/pons values. In patients with PD, in addition to the effect of aging, the disease status further influenced the midbrain/pons values (R(2) = 0.23; P < 0.001). In both groups, MRPI values were not influenced either by aging or by disease status. No effect of aging on either midbrain/pons or MRPI values was shown in the patients with PSP. Our findings indicated that the MRPI was not significantly influenced by aging or disease-related changes occurring in PD; whereas, in contrast, the midbrain/pons was influenced. Therefore, the MRPI appears to be a more reliable imaging measurement compared with midbrain/pons values for differentiating PSP from PD and controls in an elderly population.
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Affiliation(s)
- Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Germaneto, Catanzaro, Italy
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Della Pepa GM, Roselli R, La Rocca G, Spallone A, Barbagallo G, Visocchi M. Laminoplasty is better of laminectomy in cervical stenotic myelopathy: myth or truth? Eur Rev Med Pharmacol Sci 2014; 18:50-54. [PMID: 24825042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Laminoplasty has been proposed as a treatment for cervical stenotic myelopathy (CSM) as an alternative to standard laminectomy as this has been considered directly associated with an increased risk of postoperative deformity. METHODS We retrospective reviewed postoperative results of open door laminoplasty (unilateral approach technique) compared with laminectomy in terms of clinical/electophysiological results (somatosensory evoked potentials - SSEP, and motor evoked potentials - MEP); in addition the rate of subsequent spinal deformities was analyzed in both techniques. RESULTS Postoperative results in terms of late follow up neurological assessment and neurophysiological improvement was substantially comparable in both groups. Postoperative dynamic cervical X-rays showed a kyphotic deformity in (12.5%) in patients undergoing laminectomy; none was unstable. No case of kypothic deformity occurred in patients undergoing open door laminoplasty. Complication rate was similar in both groups. DISCUSSION AND CONCLUSIONS Standard laminectomy seems to be associated to late cervical spine deformities in a more relevant percentage of patients, possibly leading to severe forms of kyphosis and segmental instability over time compared with open-door expansive laminoplasty. The unilateral approach represents an evolution to standard open door technique that further spares posterior elements, may decrease the incidence of progressive spinal deformity and prevent the need for subsequent spinal stabilization.
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Affiliation(s)
- G M Della Pepa
- Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
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Della Pepa GM, La Rocca G, Barbagallo G, Spallone A, Visocchi M. Transient breathing disorders after posterior cervical surgery for degenerative diseases: pathophysiological interpretation. Eur Rev Med Pharmacol Sci 2014; 18:89-92. [PMID: 24825050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Central sleep apnea is a breathing disorder that manifests as repetitive cessation of the breath during the sleep. The occurrence of breathing disorders after cervical laminectomy has been exceptionally described as a complication after cervical decompressive laminectomy for cervical stenotic myelopathy. In 1994, Naim-ur-Rahman reported the first case of postoperative central sleep apnea following C3-C6 laminectomy, occurring right after surgery and associated with spyncterial incontinence, that spontaneously recovered three weeks after onset. Recently we described a rare complication of cervical laminectomy for cervical stenotic myelopathy: the onset was delayed from surgery (nearly two weeks later) and cervical stenotic myelopathy was not associated to any other neurological sign of spinal cord damage as demonstrated by the neurophysiological assessment. Possible familiar predisposition can be matter of discussion. No definite interpretation of pathophysiological mechanisms can ultimately explain the occurrence of delayed and isolated central sleep apnea after laminectomy for the treatment of cervical stenotic myelopathy. Such a reversible and benign complication remain unpredictable in the best surgical hands.
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Affiliation(s)
- G M Della Pepa
- Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
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Nisticò R, Salsone M, Vescio B, Morelli M, Trotta M, Barbagallo G, Arabia G, Quattrone A. Blink reflex recovery cycle distinguishes essential tremor with resting tremor from de novo Parkinson's disease: an exploratory study. Parkinsonism Relat Disord 2013; 20:153-6. [PMID: 24572624 DOI: 10.1016/j.parkreldis.2013.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 09/30/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022]
Abstract
An increased R2 recovery component of the blink reflex (R2-BRrc) has been observed in Parkinson's disease (PD), cranio-cervical dystonia, dystonic tremor and essential tremor with associated resting tremor (rET), while the BRrc was reported normal in patients with essential tremor (ET). Distinguishing rET from tremor dominant PD (tPD) may be challenging especially in the first stages of the diseases, in the absence of DAT-SPECT investigation. We evaluated the possible usefulness of BRrc for differentiating subjects with de novo tPD from those with rET. We investigated R2-BRrc at interstimulus intervals (ISI) of 100, 150, 200, 300, 400, 500 and 750 ms in 11 participants with tPD, 10 with rET and 20 healthy controls. All participants underwent DAT-SPECT and cardiac MIBG scintigraphy. R2 recovery was significantly enhanced in tPD compared to controls at all investigated ISIs (p < 0.001), while in subjects with rET patients BRrc was significantly increased compared to controls at ISI 150, 200, 300, 400, 500 and 750 ms (p < 0.001). At ISI 100 R2-BRrc distinguished patients participants with de novo tPD from those with rET with a sensitivity, specificity and accuracy of 100%. Our findings demonstrate the usefulness of BRrc for differentiating de novo tPD from rET.
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Affiliation(s)
- R Nisticò
- Neuroimaging Research Unit, Catanzaro, Italy
| | - M Salsone
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy
| | - B Vescio
- Neuroimaging Research Unit, Catanzaro, Italy
| | - M Morelli
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy
| | - M Trotta
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy
| | - G Barbagallo
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy
| | - G Arabia
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy
| | - A Quattrone
- The Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Campus Universitario Germaneto, Viale Europa, Catanzaro 88100, Italy; Neuroimaging Research Unit, Catanzaro, Italy.
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Nicoletti G, Rizzo G, Barbagallo G, Tonon C, Condino F, Manners D, Messina D, Testa C, Arabia G, Gambardella A, Lodi R, Quattrone A. Diffusivity of cerebellar hemispheres enables discrimination of cerebellar or parkinsonian multiple system atrophy from progressive supranuclear palsy-Richardson syndrome and Parkinson disease. Radiology 2013; 267:843-50. [PMID: 23329659 DOI: 10.1148/radiol.12120364] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE To explore the usefulness of histogram analysis of mean diffusivity (MD) derived from diffusion-weighted imaging of large infratentorial structures to distinguish parkinsonian syndromes. MATERIALS AND METHODS Local research ethics committee approval and informed consent were obtained. Ten patients with Parkinson disease (PD), nine with the parkinsonian variant of multiple system atrophy (MSA-P), seven with the cerebellar variant of MSA (MSA-C), 17 with progressive supranuclear palsy-Richardson syndrome (PSP-RS), and 10 healthy subjects were recruited. Histograms of MD values were generated for all pixels in the whole infratentorial compartment and separately for the whole brainstem, vermis, and cerebellar hemispheres. To assess the differences in MD values among groups, the Kruskal-Wallis test was used, followed by the Mann-Whitney U test for pairwise comparisons. All P values resulting from pairwise comparisons were corrected with the Bonferroni method. RESULTS MSA-P and MSA-C groups had higher median MD values (P < .01) in the brainstem and cerebellum when compared with other groups; this finding was in line with the known consistent neurodegenerative damage in posterior cranial fossa structures in these diseases. Median MD values from cerebellar hemispheres were used to discriminate patients with MSA-C and those with MSA-P from patients with PD and those with PSP-RS (P < .01; sensitivity, specificity, and positive predictive value equaled 100%). Furthermore, patients with PSP-RS had significantly higher MD values in the vermis than did healthy subjects (P < .05) and patients with PD (P < .001). CONCLUSION These findings support the clinical usefulness of diffusion imaging in the differential diagnosis of parkinsonism, suggesting that the minimally operator-dependent histogram analysis of the infratentorial structures and particularly of the whole cerebellar hemispheres can be used to distinguish patients with MSA-P and those with MSA-C from patients with PSP-RS and those with PD.
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Affiliation(s)
- Giuseppe Nicoletti
- Institute of Neurologic Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
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van Middendorp JJ, Barbagallo G, Schuetz M, Hosman AJF. Design and rationale of a Prospective, Observational European Multicenter study on the efficacy of acute surgical decompression after traumatic Spinal Cord Injury: the SCI-POEM study. Spinal Cord 2012; 50:686-94. [DOI: 10.1038/sc.2012.34] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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