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Devigili G, Di Stefano G, Donadio V, Frattale I, Mantovani E, Nolano M, Occhipinti G, Provitera V, Quitadamo S, Tamburin S, Toscano A, Tozza S, Truini A, Valeriani M, de Tommaso M. Clinical criteria and diagnostic assessment of fibromyalgia: position statement of the Italian Society of Neurology-Neuropathic Pain Study Group. Neurol Sci 2023:10.1007/s10072-023-06836-3. [PMID: 37222872 DOI: 10.1007/s10072-023-06836-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/25/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The role of central and/or peripheral nervous system dysfunction is basically fundamental in fibromyalgia. AIM The aim of this position statement on behalf of the Neuropathic Pain Study Group of the Italian Society of Neurology is to give practical guidelines for the clinical and instrumental assessment of fibromyalgia (FM) in the neurological clinical practice, taking into consideration recent studies. METHODS Criteria for study selection and consideration were original studies, case-controls design, use of standardized methodologies for clinical practice, and FM diagnosis with ACR criteria (2010, 2011, 2016). RESULTS ACR criteria were revised. For diagnostic procedure of small-fiber pathology, 47 studies were totally considered. Recent diagnostic criteria should be applied (ACR, 2016). A rheumatologic visit seems mandatory. The involvement of small fibers should request at least 2 among HRV + SSR and/or laser-evoked responses and/or skin biopsy and/or corneal confocal microscopy, eventually followed by monitoring of metabolic and/or immunological/ and or/paraneoplastic basis, to be repeated at 1-year follow-up. CONCLUSIONS The correct diagnostic approach to FM could promote the exclusion of the known causes of small-fiber impairment. The research toward common genetic factors would be useful to promote a more specific therapeutic approach.
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Affiliation(s)
- G Devigili
- UOC Neurologia IIRCCS Carlo Besta, Milan, Italy
| | - G Di Stefano
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - V Donadio
- Clinica Neurologica Bellaria Hospital, Bologna, Italy
| | - I Frattale
- Child Neurology and Psychiatric Unit, Tor Vergata University, Rome, Italy
| | - E Mantovani
- Neurosciences, Biomedicine and Movement Sciences Department, Verona University, Verona, Italy
| | - M Nolano
- Skin Biopsy Laboratory, Department of Neurology, Instituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80100, Naples, Italy
| | - G Occhipinti
- UOC Neurologia E Malattie Neuromuscolari, AUO Martino Messina, Messina, Italy
| | - V Provitera
- Skin Biopsy Laboratory, Department of Neurology, Instituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Italy
| | - S Quitadamo
- Neurophysiopathology Unit, DiBraiN Department, Policlinico General Hospital, Bari Aldo Moro University, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - S Tamburin
- Neurosciences, Biomedicine and Movement Sciences Department, Verona University, Verona, Italy
| | - A Toscano
- EURO-ERN NMD, AOU Martino University of Messina, Messina, Italy
| | - S Tozza
- UOC Neurologia E Malattie Neuromuscolari, AUO Martino Messina, Messina, Italy
| | - A Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - M Valeriani
- Developmental Neurology Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M de Tommaso
- Neurophysiopathology Unit, DiBraiN Department, Policlinico General Hospital, Bari Aldo Moro University, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
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Larcher L, Jauniaux E, Lenzi J, Ragnedda R, Morano D, Valeriani M, Michelli G, Farina A, Contro E. Ultrasound diagnosis of placental and umbilical cord anomalies in singleton pregnancies resulting from in-vitro fertilization. Placenta 2023; 131:58-64. [PMID: 36493624 DOI: 10.1016/j.placenta.2022.11.010] [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: 02/13/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION placental anomalies can affect fetal and maternal outcome due to severe maternal hemorrhage potentially resulting in hysterectomy and cord accident including abruption that can determine fetal damage or death. The aims of our study are to determine if the rate of placental and umbilical cord anomalies are more common in IVF singleton pregnancies compared to spontaneous pregnancies; to evaluate the role of ultrasound in screening for these anomalies and to investigate if oocyte donor fertilization is an additional risk factor for the development of these anomalies. METHODS this was a prospective cohort study involving two tertiary centers. Patients with a singleton pregnancy conceived with IVF and patients presenting with a spontaneous conception were recruited between 1st May 2019 to 31st March 2021. A total of 634 pregnancies were enrolled in the study. All patients underwent similar antenatal care, which included ultrasound examinations at 11-14, 19-22 and 33-35 weeks. Ultrasound findings of placental and/or umbilical cord abnormalities were recorded using the same protocol for both groups and confirmed after birth. RESULTS IVF pregnancies had a significantly higher risk of low-lying placenta, placenta previa, bilobed placenta and velamentous cord insertion (VCI) compared with spontaneous pregnancies. In the heterologous subgroup there was a significant increased incidence of placenta accreta spectrum (PAS) disorders than in spontaneous pregnancies. All these anomalies were identified prenatally on ultrasound imaging and confirmed at birth. DISCUSSION IVF pregnancies in general and those resulting from donor oocyte in particular are at higher risk of placental and umbilical cord abnormalities compared to spontaneous pregnancies. These anomalies can be diagnosed accurately at the mid-trimester detailed fetal anomaly scan and our findings support the need for a targeted ultrasound screening of these anomalies in IVF pregnancies.
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Affiliation(s)
- L Larcher
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy.
| | - E Jauniaux
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, UK
| | - J Lenzi
- Section of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - R Ragnedda
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy
| | - D Morano
- Department of Obstetrics and Gynecology S. Anna University Hospital, Cona, Ferrara, Italy
| | - M Valeriani
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy
| | - G Michelli
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy
| | - A Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy
| | - E Contro
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, IRCCS University Hospital of Bologna, Italy
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Voci A, Bruni O, Ferilli M, Papetti L, Tarantino S, Ursitti F, Sforza G, Vigevano F, Mazzone L, Valeriani M, Moavero R. Sleep Disorders in Pediatric Migraine: a questionnaire-based study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Moavero R, Voci A, Romigi A, Bisulli F, Luisi C, Vigevano F, Mazzone L, Valeriani M, Curatolo P, Bruni O. Sleep disorders in adults with tuberous sclerosis complex: a questionnaire-based study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caivano D, Sigillo R, Rotondi M, Angelicone I, Valeriani M, Osti M. SBRT for Nodal Metastasis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Caivano D, Rotondi M, Sigillo R, Angelicone I, Bonome P, Valeriani M, Osti M. Mediastinal and Hilar Lymphadenopathy Treated by SABR. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sigillo R, Facondo G, Vullo G, Bertozzi A, Osti M, Valeriani M. PO-1369 Salvage SBRT re-irradiation for local recurrence of prostate cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03333-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Angelicone I, Priore A, Perrone Congedi F, de Giacomo F, Campanella B, Osti M, Valeriani M. PO-1404 Adjuvant, Early Salvage and Salvage Radiotherapy after surgery in prostate cancer: survival outcomes. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vullo G, Facondo G, Sigillo R, Priore A, Rotondi M, Valeriani M, De Sanctis V, Osti M. PO-1458 The impact of post-operative radiotherapy (PORT) in patients with thymomas and thymic carcinomas. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03422-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Di Lionardo A, Di Stefano G, Leone C, Di Pietro G, Sgro E, Malara E, Cosentino C, Mollica C, Blockeel AJ, Caspani O, Garcia-Larrea L, Mouraux A, Treede RD, Phillips KG, Valeriani M, Truini A. Modulation of the N13 component of the somatosensory evoked potentials in an experimental model of central sensitization in humans. Sci Rep 2021; 11:20838. [PMID: 34675309 PMCID: PMC8531029 DOI: 10.1038/s41598-021-00313-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022] Open
Abstract
The N13 component of somatosensory evoked potential (N13 SEP) represents the segmental response of dorsal horn neurons. In this neurophysiological study, we aimed to verify whether N13 SEP might reflect excitability changes of dorsal horn neurons during central sensitization. In 22 healthy participants, we investigated how central sensitization induced by application of topical capsaicin to the ulnar nerve territory of the hand dorsum modulated N13 SEP elicited by ulnar nerve stimulation. Using a double-blind placebo-controlled crossover design, we also tested whether pregabalin, an analgesic drug with proven efficacy on the dorsal horn, influenced capsaicin-induced N13 SEP modulation. Topical application of capsaicin produced an area of secondary mechanical hyperalgesia, a sign of central sensitization, and increased the N13 SEP amplitude but not the peripheral N9 nor the cortical N20-P25 amplitude. This increase in N13 SEP amplitude paralleled the mechanical hyperalgesia and persisted for 120 min. Pregabalin prevented the N13 SEP modulation associated with capsaicin-induced central sensitization, whereas capsaicin application still increased N13 SEP amplitude in the placebo treatment session. Our neurophysiological study showed that capsaicin application specifically modulates N13 SEP and that this modulation is prevented by pregabalin, thus suggesting that N13 SEP may reflect changes in dorsal horn excitability and represent a useful biomarker of central sensitization in human studies.
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Affiliation(s)
- A Di Lionardo
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - G Di Stefano
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Leone
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - G Di Pietro
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - E Sgro
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - E Malara
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Cosentino
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - C Mollica
- Department of Statistical Sciences, Sapienza University, Rome, Italy
| | - A J Blockeel
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - O Caspani
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L Garcia-Larrea
- Lyon Neurosciences Center Research Unit Inserm U 1028, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France.,Pain Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - A Mouraux
- UCLouvain, Institute of Neuroscience (IoNS), Brussels, Belgium
| | - R D Treede
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - K G Phillips
- Neuroscience Next Generation Therapeutics, Eli Lilly and Company, Lilly Innovation Center, Cambridge, MA, 02142, USA
| | - M Valeriani
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Andrea Truini
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy.
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Anzellini D, Scalabrino G, Campanella B, Perrone F, Ascolese A, Valeriani M, Osti M. PO-1169 30 Gy single dose stereotactic radiation therapy in a series of patients with lung oligometastasis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07620-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Anzellini D, De Sanctis V, Valeriani M, Vullo G, Facondo G, Massaro M, Sigillo R, Osti M. PO-1497 Stereotactic and hypofractionated radiotherapy associated with immune checkpoints inhibitors. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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De Sanctis V, Alfò M, Vitiello C, Vullo G, Facondo G, Marinelli L, Burocchi S, Gallo G, Valeriani M, Campanella B, Scalabrino G, Russo I, Salerno G, Cardelli P, Osti M, De Biase L. Markers of Cardiotoxicity in Early Breast Cancer Patients Treated With a Hypofractionated Schedule: A Prospective Study. Clin Breast Cancer 2021; 21:e141-e149. [DOI: 10.1016/j.clbc.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 12/25/2022]
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Osti MF, Agolli L, Valeriani M, Reverberi C, Braccia S, Marinelli L, De Sanctis V, Cortesi E, Martelli M, De Dominicis C, Minniti G, Nicosia L. Erratum to "30 Gy single dose stereotactic body radiation therapy (SBRT): Report on outcome in a large series of patients with lung oligometastatic disease" [Lung Cancer 122 (2018) 165-170]. Lung Cancer 2021; 157:168. [PMID: 34030912 DOI: 10.1016/j.lungcan.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - S Braccia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - E Cortesi
- Department of Radiology, Oncology and Human Pathology, Policlinico Umberto I "Sapienza" University of Rome, Italy
| | - M Martelli
- Thoracic Surgery Unit, Carlo Forlanini Hospital, Rome, Italy
| | - C De Dominicis
- Department of Radiology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - G Minniti
- Department of Neurological Sciences, IRCCS Neuromed, Via Atinense, Pozzilli, IS, Italy; UPMC San Pietro FBF, Radiotherapy Center, Rome, Italy.
| | - L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy.
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Alongi F, Nicosia L, Figlia V, De Sanctis V, Mazzola R, Giaj-Levra N, Reverberi C, Valeriani M, Osti MF. A multi-institutional analysis of fractionated versus single-fraction stereotactic body radiotherapy (SBRT) in the treatment of primary lung tumors: a comparison between two antipodal fractionations. Clin Transl Oncol 2021; 23:2133-2140. [PMID: 33840047 DOI: 10.1007/s12094-021-02619-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/01/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Stereotactic body radiotherapy (SBRT) is a consolidate treatment for inoperable early-stage lung tumors, usually delivered in single or multi-fraction regimens. We aimed to compare these two approaches in terms of local effectiveness, safety and survival. MATERIALS AND METHODS Patients affected by medically inoperable early-stage lung tumor were treated at two Institutions with two different schedules: 70 Gy in ten fractions (TF) (BED10: 119 Gy) or 30 Gy in single fraction (SF) (BED10: 120 Gy). RESULTS 73 patients were treated with SBRT delivered with two biological equivalent schedules: SF (44) and TF (29). The median follow-up was 34 months (range 3-81 months). Three-year Overall survival (OS) was 57.9%, 3-year cancer-specific survival (CSS) was 77.2%, with no difference between treatment groups. Three-year progression-free survival (LPFS) was 88.9% and did not differs between SF and TF. Overall, four cases (5.4%) of acute grade ≥ 3 pneumonitis occurred. No differences in acute and late toxicity between the two groups were detected. CONCLUSION SF and TF seems to be equally safe and effective in the treatment of primary inoperable lung tumors especially for smaller lesion. The SF may be preferentially offered to reduce patient access to hospital with no negative impact on tumor control and survival.
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Affiliation(s)
- F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
- University of Brescia, Brescia, Italy
| | - L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy.
| | - V Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - N Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
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Ursitti F, Roberto D, Papetti L, Moavero R, Ferilli MAN, Fusco L, Vigevano F, Curatolo P, Valeriani M. Diagnosis of pediatric anti-NMDAR encephalitis at the onset: A clinical challenge. Eur J Paediatr Neurol 2021; 30:9-16. [PMID: 33321446 DOI: 10.1016/j.ejpn.2020.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUNDS To investigate the clinical and instrumental features at the onset addressing to the diagnosis of anti-NMDAR encephalitis. METHODS Twenty children (age: 15 months-17 years; 7 males, 13 females) with initial suspected diagnosis of autoimmune encephalitis, observed between January 2008 and March 2018, were included. The final diagnosis was anti-NMDAR encephalitis in 7 children, other/probable autoimmune encephalitis in 7 children, and primary psychosis in the remaining 6 children. RESULTS At the clinical onset, anxiety disorder was the main symptom that helped in distinguishing the group of psychotic children from children with non-infectious encephalitis (P = 0.05 OR = 0.001), while epileptic seizures strongly predicted anti-NMDAR encephalitis (P = 0.04 OR = 28.6). At the onset, anti-NMDAR encephalitis could be distinguished from other/probable autoimmune encephalitis for the presence of sleep/wake rhythm alteration (P = 0.05 OR = 15). Among the symptoms occurring during the hospitalization, movement disorders (P = 0.031 OR = 12) were predictive of non-infectious encephalitis rather than primary psychosis. More specifically, the occurrence of language impairment (P = 0.03 OR = 33), epileptic seizures (P = 0.04 OR = 28.6) and catatonia (P = 0.03, OR = 33), were predictive of anti-NMDAR encephalitis. Also at this stage, anxiety disorder (P = 0.03 OR = 0.033) was predictive of primary psychosis. CONCLUSION Our findings suggest that at the clinical onset epileptic seizures and sleep/wake rhythm alteration represent the main features addressing to the diagnosis of anti-NMDAR encephalitis rather than primary psychosis and other/probable autoimmune encephalitis, while anxiety disorder could be a solid predictor of primary psychosis.
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Affiliation(s)
- F Ursitti
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - D Roberto
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - L Papetti
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - R Moavero
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy; Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - M A N Ferilli
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - L Fusco
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - F Vigevano
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - P Curatolo
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - M Valeriani
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy; Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
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Buglione M, Bruni A, Bardoscia L, Borghesi S, Mazzeo E, Cozzaglio C, Mortellaro G, Triggiani L, Santini R, Lisi R, Valeriani M, Amara L, Cagna E, Fondelli S, Alitto A, Franzese C, Muto P, Corsini A, Livi L, Garibaldi E, Tartarelli M, Deatoni C, Baiguini A, Bertoni F, Magrini S. PO-1192: Elective Pelvic Nodes Irradiation in Patients with Prostate Cancer (PRO-EPI Study). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reverberi C, Massaro M, Osti MF, Anzellini D, Marinelli L, Montalto A, De Sanctis V, Valeriani M. Local and metastatic curative radiotherapy in patients with de novo oligometastatic prostate cancer. Sci Rep 2020; 10:17471. [PMID: 33060732 PMCID: PMC7563994 DOI: 10.1038/s41598-020-74562-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/10/2020] [Indexed: 11/24/2022] Open
Abstract
The aim of this observational study is to investigate whether local consolidative treatment delivered to the primary site and metastatic tumour burden may add survival benefit to de novo oligometastatic prostate cancer (Oligo-PCa) patients. We retrospectively reviewed all Oligo-PCa patients treated with radiotherapy to the primary tumor sites and metastatic tumor burden at our institution between March 2010 and June 2019. All patients having ≤ 5 metastases involving nodes and/or bones, loco-regional and/or extra-pelvic sites, were included. Most of the patients had started androgen deprivation therapy with or without docetaxel as standard of care before radiotherapy. The Kaplan Meier analysis was performed to estimate survival outcomes. The univariate analysis tested possible prognostic factors increasing the rate of biochemical relapse. We analysed 37 Oligo-PCa patients. Twenty-eight (75.7%) had loco-regional metastases, in 9 patients (24.3%) the metastatic tumour burden was extra-pelvic. Nineteen (51.4%) had bone metastases, 21 (56.8%) nodal involvement and 7 (18.9%) both. Twenty (54.1%) had a single metastasis. The median follow-up was 55.5 months. The median overall survival (OS) was 68.8 months, the 2- and 5-year OS rates were 96.9% and 65.4%. The median biochemical relapse free survival (b-RFS) was 58 months and the 2- and 5-year b-RFS rates were 73.3% and 39.3%. The 2- and 5-year local relapse free survival rates were 93.9% and 83.7%. On the univariate analysis post-treatment PSA level ≤ 1 ng/ml was significantly related with the b-RFS (p = 0.004). Curative approach in Oligo-PCa patients involving both the primary tumor and metastatic sites may be feasible and well tolerate. Many patients presented longer survival and PSA at first follow-up was the most important prognostic factor. Further trials are needed to confirm our results and to evaluate if patients with PSA at first follow-up > 1 ng/ml may benefit from further treatments.
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Affiliation(s)
- C Reverberi
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - M Massaro
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy.
| | - M F Osti
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - D Anzellini
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - L Marinelli
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - A Montalto
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - V De Sanctis
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
| | - M Valeriani
- Radiotherapy Department, Sant'Andrea Hospital, La Sapienza II, University of Rome, Rome, Italy
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19
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Gastaldi M, Mariotto S, Giannoccaro MP, Iorio R, Zoccarato M, Nosadini M, Benedetti L, Casagrande S, Di Filippo M, Valeriani M, Ricci S, Bova S, Arbasino C, Mauri M, Versino M, Vigevano F, Papetti L, Romoli M, Lapucci C, Massa F, Sartori S, Zuliani L, Barilaro A, De Gaspari P, Spagni G, Evoli A, Liguori R, Ferrari S, Marchioni E, Giometto B, Massacesi L, Franciotta D. Subgroup comparison according to clinical phenotype and serostatus in autoimmune encephalitis: a multicenter retrospective study. Eur J Neurol 2020; 27:633-643. [PMID: 31814224 DOI: 10.1111/ene.14139] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 07/31/2019] [Accepted: 12/03/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Autoimmune encephalitides (AE) include a spectrum of neurological disorders whose diagnosis revolves around the detection of neuronal antibodies (Abs). Consensus-based diagnostic criteria (AE-DC) allow clinic-serological subgrouping of AE, with unclear prognostic implications. The impact of AE-DC on patients' management was studied, focusing on the subgroup of Ab-negative-AE. METHODS This was a retrospective multicenter study on patients fulfilling AE-DC. All patients underwent Ab testing with commercial cell-based assays (CBAs) and, when available, in-house assays (immunohistochemistry, live/fixed CBAs, neuronal cultures) that contributed to defining final categories. Patients were classified as Ab-positive-AE [N-methyl-d-aspartate-receptor encephalitis (NMDAR-E), Ab-positive limbic encephalitis (LE), definite-AE] or Ab-negative-AE (Ab-negative-LE, probable-AE, possible-AE). RESULTS Commercial CBAs detected neuronal Abs in 70/118 (59.3%) patients. Testing 37/48 Ab-negative cases, in-house assays identified Abs in 11 patients (29.7%). A hundred and eighteen patients fulfilled the AE-DC, 81 (68.6%) with Ab-positive-AE (Ab-positive-LE, 40; NMDAR-E, 32; definite-AE, nine) and 37 (31.4%) with Ab-negative-AE (Ab-negative-LE, 17; probable/possible-AE, 20). Clinical phenotypes were similar in Ab-positive-LE versus Ab-negative-LE. Twenty-four/118 (20.3%) patients had tumors, and 19/118 (16.1%) relapsed, regardless of being Ab-positive or Ab-negative. Ab-positive-AE patients were treated earlier than Ab-negative-AE patients (P = 0.045), responded more frequently to treatments (92.3% vs. 65.6%, P < 0.001) and received second-line therapies more often (33.3% vs. 10.8%, P = 0.01). Delays in first-line therapy initiation were associated with poor response (P = 0.022; odds ratio 1.02; confidence interval 1.00-1.04). CONCLUSIONS In-house diagnostics improved Ab detection allowing better patient management but was available in a patient subgroup only, implying possible Ab-positive-AE underestimation. Notwithstanding this limitation, our findings suggest that Ab-negative-AE and Ab-positive-AE patients share similar oncological profiles, warranting appropriate tumor screening. Ab-negative-AE patients risk worse responses due to delayed and less aggressive treatments.
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Affiliation(s)
- M Gastaldi
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - S Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - M P Giannoccaro
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,UOC Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - R Iorio
- Istituto di Neurologia, Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.,Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - M Zoccarato
- Ospedale S. Antonio, AULSS Euganea, Padua, Italy.,Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padua, Italy
| | - M Nosadini
- Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padua, Italy.,Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - L Benedetti
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - S Casagrande
- Neurosciences Department, Florence University, Italy.,Careggi University Hospital, Florence, Italy
| | - M Di Filippo
- Neurology Clinic, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
| | - M Valeriani
- Neurology Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - S Ricci
- Ospedale 'Città-di-Castello-e-Branca', Italy
| | - S Bova
- Pediatric Neurology Unit, ASST Fatebenefratelli Sacco, Children Hospital Vittore Buzzi, Milan, Italy
| | | | - M Mauri
- Neurology and Stroke Unit, Insubria University, Varese, Italy
| | - M Versino
- Neurology and Stroke Unit, Insubria University, Varese, Italy
| | - F Vigevano
- Neurology Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - L Papetti
- Neurology Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - M Romoli
- Neurology Clinic, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy.,Neurology Unit, Rimini "Infermi" Hospital - AUSL Romagna, Rimini, Italy
| | - C Lapucci
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - F Massa
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - S Sartori
- Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padua, Italy.,Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - L Zuliani
- Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padua, Italy.,Neurology Department, Ospedale S. Bortolo, Vicenza, Italy
| | - A Barilaro
- Careggi University Hospital, Florence, Italy
| | - P De Gaspari
- Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padua, Italy
| | - G Spagni
- Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - A Evoli
- Istituto di Neurologia, Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.,Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - R Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,UOC Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - S Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - E Marchioni
- Neuroncology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | | | - L Massacesi
- Neurosciences Department, Florence University, Italy.,Careggi University Hospital, Florence, Italy
| | - D Franciotta
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
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20
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Osti M, Figlia V, Rigo M, Mazzola R, Ricchetti F, Giaj-Levra N, Valeriani M, Reverberi C, Nicosia L, Alongi F. Fractionated Stereotactic Body Radiotherapy (SBRT) Versus Single Dose Stereotactic Body Radiotherapy in the Treatment of Primary Lung Tumors: Early Results from a Multi-Institutional Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Ciaramitaro P, Cruccu G, de Tommaso M, Devigili G, Fornasari D, Geppetti P, Lacerenza M, Lauria G, Mameli S, Marchettini P, Nolano M, Polati E, Provitera V, Romano M, Solaro C, Tamburin S, Tugnoli V, Valeriani M, Truini A. A Delphi consensus statement of the Neuropathic Pain Special Interest Group of the Italian Neurological Society on pharmacoresistant neuropathic pain. Neurol Sci 2019; 40:1425-1431. [PMID: 30941628 DOI: 10.1007/s10072-019-03870-y] [Citation(s) in RCA: 5] [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: 12/18/2018] [Accepted: 03/23/2019] [Indexed: 12/25/2022]
Abstract
To improve patient care and help clinical research, the Neuropathic Pain Special Interest Group of the Italian Neurological Society appointed a task force to elaborate a consensus statement on pharmacoresistant neuropathic pain. The task force included 19 experts in neuropathic pain. These experts participated in a Delphi survey consisting of three consecutive rounds of questions and a face-to-face meeting, designed to achieve a consensus definition of pharmacoresistant neuropathic pain. In the three rounds of questions, the participants identified and described the main distinguishing features of pharmacoresistance. In the face-to-face meeting the participants discussed the clinical features determining pharmacoresistance. They finally agreed that neuropathic pain is pharmacoresistant when "the patient does not reach the 50% reduction of pain or an improvement of at least 2 points in the Patient Global Impression of Change, having used all drug classes indicated as first, second, or third line in the most recent and widely agreed international guidelines, for at least 1 month after titration to the highest tolerable dose." Our consensus statement might be useful for identifying eligible patients for invasive treatments, and selecting patients in pharmacological trials, thus improving patient care and helping clinical research.
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Affiliation(s)
- P Ciaramitaro
- Clinical Neurophysiology, Neuroscience Department, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - G Cruccu
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy
| | - M de Tommaso
- Applied Neurophysiology and Pain Unit, Basic Medical Science, Neuroscience and Sensory System-SMBNOS-Department, Aldo Moro University, Bari, Italy
| | - G Devigili
- Neurological Unit 1, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - D Fornasari
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - P Geppetti
- Department of Health Sciences, Section of Clinical Pharmacology and Headache Center, University of Florence, Florence, Italy
| | - M Lacerenza
- Neurology and Pain Medicine Center, Humanitas, San Pio X Clinic, Milan, Italy
| | - G Lauria
- Neuroalgology Unit, IRCCS Foundation, "Carlo Besta" Neurological Institute, Milan, Italy
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - S Mameli
- Pain Therapy Unit, "A. Businco" Hospital, ASL 8, 09134, Cagliari, Italy
| | - P Marchettini
- Department of Health Sciences, Section of Clinical Pharmacology and Headache Center, University of Florence, Florence, Italy
- Pain Medicine Centre, Ospedale San Raffaele, Milan, Italy
- University of Applied Science of Southern Switzerland, Pain Pathophysiology and Therapy Programme, Manno, Switzerland
| | - M Nolano
- Neurology Department, Skin Biopsy Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri, 4, 27100, Pavia, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - E Polati
- Department of Surgery, Dentistry, Maternal and Infant Sciences, Pain Therapy Centre, Verona University Hospital, Verona, Italy
| | - V Provitera
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Telese Terme (BN), Telese Terme, Italy
| | - M Romano
- Neurology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - C Solaro
- CRRF Mons L Novarese Moncrivello (VC), Moncrivello, Italy
| | - S Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - V Tugnoli
- Neurology Unit, Azienda Ospedaliero-Universitaria, Ferrara, Italy
| | - M Valeriani
- Division of Neurology, Ospedale Pediatrico Bambino Gesú, IRCCS, Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Andrea Truini
- Department of Human Neuroscience, University Sapienza, Viale Università 30, 00185, Rome, Italy.
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22
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Nicosia L, Agolli L, Valeriani M, Reverberi C, Bracci S, Marinelli L, De Sanctis V, Cortesi E, Martelli M, De Dominicis C, Osti M. PO-0781 30 Gy single dose SBRT: Outcome in a large series of patients with lung oligometastatic disease. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Bocci T, De Carolis G, Mansani F, De Rosa A, Ferrucci R, Priori A, Valeriani M, Sartucci F. Cerebellar Direct Current Stimulation (ctDCS) for the treatment of Phantom Limb Pain (PLP). Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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24
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Vollono C, Pazzaglia C, Di Sipio E, Giordano R, Padua L, Arendt-Nielsen L, Santoro M, Valeriani M. RP11-819C21.1 and ZNRD1-AS long non-coding RNA changes following painful laser stimulation correlate with pain habituation in healthy subjects: A laser evoked potential (LEP) study. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Insola A, Mazzone P, Valeriani M. Transitory impairment of the somatosensory postsynaptic fibres after electrode implantation in the thalamus. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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26
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Pro S, Moavero R, Marciano S, Vigevano F, Curatolo P, Valeriani M. ERP recording shows subclinical differences in ADHD patients with and without Tuberous Sclerosis. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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27
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Nicosia L, Agolli L, Reverberi C, De Sanctis V, Marinelli L, Minniti G, Di Muzio J, Valeriani M, Osti MF. Salvage radiotherapy with simultaneous integrated boost in non small-cell lung cancer patients with mediastinal relapse after surgery: a pilot study. Radiat Oncol 2018; 13:207. [PMID: 30352607 PMCID: PMC6199747 DOI: 10.1186/s13014-018-1155-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/11/2018] [Indexed: 12/25/2022] Open
Abstract
Background The aim of our study was to evaluate feasibility, toxicity profile and local control of salvage intensity modulated radiotherapy (IMRT) delivered with simultaneous integrated boost (SIB) associated or not to concomitant weekly cisplatin in patients affected by NSCLC with mediastinal nodal recurrence after surgery. Patterns of recurrence, outcomes and prognostic factors were assessed. Methods Fourteen consecutive patients received 25 fractions of 50Gy/2Gy to the elective nodal stations and boost up to 62.5Gy/2.5Gy to the macroscopic lymph node metastases. Concomitant weekly cisplatin (40 mg/m2) was administered to 8 (57.1%) patients. Results Five (35.7%) patients experienced grade 2 pneumonitis and 5 (35.7%) patients had grade 2 esophagitis. One case of grade 3 pneumonitis occurred and was successfully treated with antibiotics and steroids with no sequelae. No patient recurred locally in the boost volume (local control 100%). Loco-regional control was 79% with 3 patients that developed nodal recurrence principally marginal to the elective volume. Seven patients developed distant metastases. Median PFS was 7 months. The nodal involvement of station 7 was associated to a significantly lower median metastasis-free survival (4 months vs. not reached, p = 0.036). Conclusions Salvage radiotherapy with IMRT-SIB is a feasible and a well-tolerated treatment option for mediastinal recurrent NSCLC after surgery. The role of more intensified radiation regimens and association to systemic therapy remain to be evaluated in larger cohorts.
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Affiliation(s)
- L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - G Minniti
- Radiation Oncology Unit, UPMC Hillman Cancer Center, San Pietro Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - J Di Muzio
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
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28
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Valeriani M. Laser Evoked potentials: a pain related signal beyond the stimulus salience. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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29
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Osti MF, Agolli L, Valeriani M, Reverberi C, Bracci S, Marinelli L, De Sanctis V, Cortesi E, Martelli M, De Dominicis C, Minniti G, Nicosia L. 30 Gy single dose stereotactic body radiation therapy (SBRT): Report on outcome in a large series of patients with lung oligometastatic disease. Lung Cancer 2018; 122:165-170. [PMID: 30032826 DOI: 10.1016/j.lungcan.2018.06.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the local control (LC) and long term adverse effects in a series of patients with lung metastases who received 30 Gy in single dose with stereotactic technique. MATERIALS AND METHODS Between December 2008 and April 2016, a total of 166 lung metastases in 129 patients affected by oligometastatic disease were treated at our Institution with stereotactic body radiotherapy (SBRT). Mainly, the primary tumors were non small-cell lung cancer and colorectal cancer (45.2% and 28.8%, respectively). Prognostic factors were also assessed. RESULTS The median follow-up was 38 months. Local progression occurred in 24 (14.4%) lesions in 21 patients. Intra-thoracic progression (new lung lesions or thoracic lymph node metastases) occurred in 59 (45.7%) patients. Forty-five (34.8%) patients had distant progression after a median time of 14 months. The 3- and 5-years local relapse-free survival (LPFS) were 80.1% and 79.2% (median not reached), respectively. One-hundred forty-eight patients were evaluated for late toxicity (follow-up >6 months): 51 (34.4%) patients had grade ≤2 fibrosis, 11 (7.4%) patients experienced grade 3 fibrosis. Two (1.3%) cases of rib fracture occurred. One case of toxic death (grade 5) has been reported. Median OS was 39 months. At the univariate analysis, lesion diameter ≤18 mm correlated significantly with a longer LPFS (p = 0.001). At the multivariate analysis, lesion diameter <18 mm was predictive for longer LPFS (p = 0.006). Also, oligometastases from primary colorectal cancer was a significant predictive factor for worse LPFS (p = 0.041) and progression-free survival (p = 0.04). CONCLUSIONS To our knowledge, the current study represents the largest series on the use of SBRT 30 Gy single dose for lung metastases. Our results confirm the effectiveness and safety of this schedule administered in selected oligometastatic patients. Further prospective series could better validate these results.
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Affiliation(s)
- M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - S Bracci
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - E Cortesi
- Department of Radiology, Oncology and Human Pathology, Policlinico Umberto I "Sapienza" University of Rome, Italy
| | - M Martelli
- Thoracic Surgery Unit, Carlo Forlanini Hospital, Rome, Italy
| | - C De Dominicis
- Department of Radiology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - G Minniti
- Department of Neurological Sciences, IRCCS Neuromed, Via Atinense, Pozzilli, IS, Italy; UPMC San Pietro FBF, Radiotherapy Center, Rome, Italy.
| | - L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy.
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30
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Tombolini V, Bonanni A, Valeriani M, Zurlo A, Vitturini A. Brachytherapy for Squamous Cell Carcinoma of the LIP. The Experience of the Institute of Radiology of the University of Rome “La Sapienza”. Tumori 2018; 84:478-82. [PMID: 9825000 DOI: 10.1177/030089169808400408] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aims and background Cancer of the lip is the most common malignancy occurring in the oral cavity. The aim of our retrospective study was to review the results of patients with lower lip squamous cell carcinoma who were treated with radiotherapy. Methods & study design From 1970 to 1992, 57 patients with squamous cell carcinoma of the lower lip were treated at the Institute of Radiology of the University of Rome “La Sapienza” with low-dose rate interstitial brachytherapy. According to the UICC 1992 TNM classification, the disease stage was T1 in 27 (47%) cases, T2 in 20 (35%) and T3 in 10 (18%); 8 patients (14%) were cN+. The median tumor dose was 62 Gy (range, 44-96): 10 patients (18%) received a total dose < 50 Gy, 28 (49%) between 50 and 70 Gy, and 19 (33%) > 70 Gy. The cN+ cases were irradiated to total doses of 65-70 Gy on the involved station. Ail patients obtained complete remission. Results The actuarial overall survival rates at 3, 5 and 10 years were 95%, 76% and 53%; actuarial disease-free survival at 3, 5 and 10 years was 84%, 81%, and 81%, respectively. Actuarial cause-specific survival was 98%, 88% and 84% at 3, 5 and 10 years, respectively. Actuarial local control rate was 90% at 3 and 5 years, rising to 94% with salvage surgery. Local-regional control was obtained in 90% and 86% of patients at 3 and 5 years, and in 93% and 89% of cases, respectively, following surgery. Five of 11 deaths were due to local-regional or distant disease recurrence. Conclusions Tumor stage and positivity of regional nodes were the only predictive factors of survival and disease control. Radiation-induced morbidity was very low, and all patients considered their cosmetic outcome at least satisfactory.
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Affiliation(s)
- V Tombolini
- Cattedra di Radioterapia Oncologica, Istituto di Radiologia Università La Sapienza, Rome, Italy
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Marinelli L, Reverberi C, Nicosia L, Magrini S, Giacinti S, Poti G, Arrivi G, Osti M, De Sanctis V, Proietti C, Aschelter A, Marchetti P, Valeriani M. EP-1610: Oligoprogression during Abiraterone therapy treated with radiotherapy in mCRPC patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31919-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Pro S, Specchio N, De Palma L, Marras C, Fusco L, Vigevano F, Valeriani M. 40. Event related potentials recorded by intracerebral electrodes. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Valeriani M, Pazzaglia C, Rizzo V, Quartarone A, Vollono C. 68. Painful laser evoked potential inhibition during high-frequency non-noxious somatosensory stimulation. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bonome P, Osti M, Giuliani M, De Sanctis V, Caivano D, Valeriani M. Intermediate Risk Prostate Cancer Patients Treated With Image Guided Hypofractionated Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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La Cesa S, Di Stefano G, Leone C, Pepe A, Galosi E, Alu F, Fasolino A, Cruccu G, Valeriani M, Truini A. Skin denervation does not alter cortical potentials to surface concentric electrode stimulation: A comparison with laser evoked potentials and contact heat evoked potentials. Eur J Pain 2017; 22:161-169. [DOI: 10.1002/ejp.1112] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/20/2023]
Affiliation(s)
- S. La Cesa
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Di Stefano
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Leone
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Pepe
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - E. Galosi
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - F. Alu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - A. Fasolino
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - G. Cruccu
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - M. Valeriani
- Ospedale Bambino Gesù; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Denmark
| | - A. Truini
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
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Bocci T, Barloscio D, Parenti L, Ferrucci R, Priori A, Valeriani M, Sartucci F. O208 Evidence by direct current stimulation (tDCS) of cerebellum involvement in pain perception and modulation in humans. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.07.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Trivisano M, Bellusci M, Terracciano A, De Palma L, Pietrafusa N, Valeriani M, Vigevano F, Specchio. TBC1D24 gene mutations are associated with high risk of sudden unexpected death. Epilepsy Behav 2017; 72:208-209. [PMID: 28606688 DOI: 10.1016/j.yebeh.2017.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Affiliation(s)
- M Trivisano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - M Bellusci
- Pediatric Neurology, "12th of October" University Hospital, Avenida de Córdoba s/n, 28041 Madrid, Spain
| | - A Terracciano
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Viale Di San Paolo, 15, 00146 Rome, Italy
| | - L De Palma
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - N Pietrafusa
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - M Valeriani
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - F Vigevano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Specchio
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
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Nicosia L, Reverberi C, Agolli L, Valeriani M, De Sanctis V, De Dominicis C, Minniti G, Cortesi E, Martelli M, Osti M. PO-0666: 30 Gy single-dose SBRT to lung lesions: outcome in a large series of patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bocci T, Ferrucci R, Parenti L, Barloscio D, Vergari M, Cortese F, Priori A, Valeriani M, Sartucci F. P190 Cerebellar direct current stimulation modulates pain perception in humans. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Valeriani M, Insola A, Mazzone P. 24. Dorsal column nuclei evoked activity recorded from the human Pedunculopontine nucleus. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bocci T, Santarcangelo E, Parenti L, Barloscio D, Carli G, Ferrucci R, Priori A, Valeriani M, Sartucci F. 5. Cerebellar direct current stimulation modulates pain perception and its neural correlates in humans. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Testani E, Granata G, Pazzaglia C, Padua L, Valeriani M. 69. Prolonged inhibitory effect of 1 Hz rTMS of the motor cortex on the nociceptive evoked potentials to contralateral hand stimulation. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bracci S, Osti M, Agolli L, Bertaccini L, De Sanctis V, Valeriani M. EP-1373: Hypofractionated radiotherapy and androgen deprivation in intermediate risk prostate cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pro S, Specchio N, De Palma L, Marras C, Fusco L, Vigevano F, Valeriani M. 97. Event related potentials recorded by intracerebral electrodes. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bocci T, Carli G, Santarcangelo E, Hesgens M, Di Rollo A, Barloscio D, Parenti L, Priori A, Valeriani M, Sartucci F. 74. Cerebellum and pain: A transcranial direct current stimulation (tDCS) study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Insola A, Mazzone P, Valeriani M. 15. Scalp somatosensory evoked potentials recordings after human subthalamic and pedunculopontine tegmental nucleus stimulation. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Valeriani M, Juel J, Liguori S, Graversen C, Olesen S, Drewes A. 56. A new method for sham-controlled acupuncture in experimental visceral pain. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Valeriani M, Lelic D, Olesen S, Hansen T, Drewes A. ID 95 – Functional reorganization of brain networks in patients with painful chronic pancreatitis. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pro S, Specchio N, Rebessi E, Marras C, Fusco L, Vigevano F, Valeriani M. ID 119 – Short-latency somatosensory evoked potentials to median and tibial stimulation recorded by intracerebral electrodes. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Testani E, Pazzaglia C, Valeriani M. ID 155 – CO2 versus Nd–YAP lasers: Are they really the same? Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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