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Aiello EN, Pucci V, Diana L, Corvaglia A, Niang A, Mattiello S, Preti AN, Durante G, Ravelli A, Consonni L, Guerra C, Ponti AD, Sangalli G, Difonzo T, Scarano S, Perucca L, Zago S, Appollonio I, Mondini S, Bolognini N. The Telephone Language Screener (TLS): standardization of a novel telephone-based screening test for language impairment. Neurol Sci 2024; 45:1989-2001. [PMID: 38010584 PMCID: PMC11021315 DOI: 10.1007/s10072-023-07149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/19/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND This study aimed at developing and standardizing the Telephone Language Screener (TLS), a novel, disease-nonspecific, telephone-based screening test for language disorders. METHODS The TLS was developed in strict pursuance to the current psycholinguistic standards. It comprises nine tasks assessing phonological, lexical-semantic and morpho-syntactic components, as well as an extra Backward Digit Span task. The TLS was administered to 480 healthy participants (HPs), along with the Telephone-based Semantic Verbal Fluency (t-SVF) test and a Telephone-based Composite Language Index (TBCLI), as well as to 37 cerebrovascular/neurodegenerative patients-who also underwent the language subscale of the Telephone Interview for Cognitive Status (TICS-L). An HP subsample was also administered an in-person language battery. Construct validity, factorial structure, internal consistency, test-retest and inter-rater reliability were tested. Norms were derived via Equivalent Scores. The capability of the TLS to discriminate patients from HPs and to identify, among the patient cohort, those with a defective TICS-L, was also examined. RESULTS The TLS was underpinned by a mono-component structure and converged with the t-SVF (p < .001), the TBCLI (p < .001) and the in-person language battery (p = .002). It was internally consistent (McDonald's ω = 0.67) and reliable between raters (ICC = 0.99) and at retest (ICC = 0.83). Age and education, but not sex, were predictors of TLS scores. The TLS optimally discriminated patients from HPs (AUC = 0.80) and successfully identified patients with an impaired TICS-L (AUC = 0.92). In patients, the TLS converged with TICS-L scores (p = 0.016). DISCUSSION The TLS is a valid, reliable, normed and clinically feasible telephone-based screener for language impairment.
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Affiliation(s)
- Edoardo Nicolò Aiello
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
| | - Veronica Pucci
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
- Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy
| | - Lorenzo Diana
- Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Alessia Corvaglia
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Aida Niang
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Silvia Mattiello
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
| | - Alice Naomi Preti
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giorgia Durante
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
| | - Adele Ravelli
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
| | - Lucia Consonni
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
| | - Carolina Guerra
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
| | - Adriana Delli Ponti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
| | - Gaia Sangalli
- Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Perucca
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Sara Mondini
- Dipartimento di Filosofia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, SociologiaPadua, Italy
- Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy
| | - Nadia Bolognini
- Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milan, Italy.
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
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Pezzoni L, Brusa R, Difonzo T, Magri F, Velardo D, Corti S, Comi GP, Saetti MC. Cognitive abnormalities in Becker muscular dystrophy: a mysterious link between dystrophin deficiency and executive functions. Neurol Sci 2024; 45:1691-1698. [PMID: 37968431 PMCID: PMC10943145 DOI: 10.1007/s10072-023-07169-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/28/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Distrophinopathies are a heterogeneous group of neuromuscular disorders due to mutations in the DMD gene. Different isoforms of dystrophin are also expressed in the cerebral cortex and Purkinje cells. Despite cognitive abnormalities in Duchenne muscular dystrophy subjects that have been described in the literature, little is known about a comprehensive cognitive profile in Becker muscular dystrophy patients. AIM The aim of this study was to assess cognitive functioning in Becker muscular dystrophy patients by using an extensive neuropsychological battery. Our hypothesis is that the most impaired functions are the highly intentional and conscious ones, such as working memory functions, which require a prolonged state of cellular activation. METHODS We performed an extensive neuropsychological assessment on 28 Becker muscular dystrophy patients from 18 to 65 years old. As control subjects, we selected 20 patients with limb-girdle muscular dystrophy, whose clinical picture was similar except for cognitive integrity. The evaluation, although extended to all areas, was focused on prefrontal control skills, with a distinction between inhibitory processes of selective attention and activating processes of working memory. RESULTS AND CONCLUSIONS Significant underperformances were found exclusively in the Dual Task and PASAT tests, to demonstrate a selective impairment of working memory that, while not causing intellectual disability, reduces the intellectual potential of patients with Becker muscular dystrophy.
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Affiliation(s)
- Laura Pezzoni
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Roberta Brusa
- ASST Ovest Milanese, Ospedale Di Legnano, Neurology Unit, Legnano, Milan, Italy
| | - Teresa Difonzo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Francesca Magri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Daniele Velardo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Milan, Italy
| | - Stefania Corti
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Milan, Italy
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Giacomo Pietro Comi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Maria Cristina Saetti
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy.
- Department of Pathophysiology and Transplants, Dino Ferrari Center, University of Milan, Milan, Italy.
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Cammisuli DM, Tuena C, Riva G, Repetto C, Axmacher N, Chandreswaran V, Isella V, Pomati S, Zago S, Difonzo T, Pavanello G, Prete LA, Stramba-Badiale M, Mauro A, Cattaldo S, Castelnuovo G. Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study. J Pers Med 2024; 14:192. [PMID: 38392625 PMCID: PMC10890288 DOI: 10.3390/jpm14020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.
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Affiliation(s)
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
- Human Technology Lab, Catholic University, 20145 Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University, 20123 Milan, Italy
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University, 44801 Bochum, Germany
| | - Varnan Chandreswaran
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University, 44801 Bochum, Germany
| | - Valeria Isella
- Department of Neurology, School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
- Milan Center for Neurosciences, 20133 Milan, Italy
| | - Simone Pomati
- Neurology Unit, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Giada Pavanello
- School of Specialization in Clinical Psychology, Catholic University, 20123 Milan, Italy
| | - Lorenzo Augusto Prete
- School of Specialization in Clinical Psychology, Catholic University, 20123 Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, 10126 Turin, Italy
- Neurology and Neurorehabilitation Unit, IRCCS Istituto Auxologico Italiano, "San Giuseppe" Hospital, 33081 Piancavallo, Italy
| | - Stefania Cattaldo
- Clinic Neurobiology Laboratory, IRCCS Istituto Auxologico Italiano, "San Giuseppe" Hospital, 33081 Piancavallo, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
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Aiello EN, Gramegna C, Esposito A, Gazzaniga V, Zago S, Difonzo T, Maddaluno O, Appollonio I, Bolognini N. Correction to: The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy. Aging Clin Exp Res 2023; 35:2857-2859. [PMID: 37552422 PMCID: PMC10627893 DOI: 10.1007/s40520-023-02509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
- PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Ildebrando Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Preti AN, Diana L, Castaldo R, Pischedda F, Difonzo T, Fumagalli G, Arighi A, Sartori G, Zago S, Bolognini N. Does cognitive decline influence signing? Aging Clin Exp Res 2023; 35:2685-2691. [PMID: 37661205 PMCID: PMC10627958 DOI: 10.1007/s40520-023-02523-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE The study explored the change in handwritten signature in neurodegenerative diseases by using of a rater-based approach. METHODS Four independent observers were required to compare a pair of signatures (on average, 5 years elapsed between the two signatures) made by 103 patients (mean age 72 years) with Alzheimer's disease (AD) or frontotemporal dementia (FTD) and by 31 healthy participants (HC; mean age 73 years), judging their change according to a 0-1 rating scale (0 = similar or 1 = different). If a signature change was detected, the rater had also to report which signature features (spatial layout, omitted/added/switched letters or names, shape of letter, pen-flow) changed on the same 0-1 scale. For the AD and FTD groups, one signature was collected prior to the diagnosis of dementia, the other subsequent. RESULTS A signature change was reported by raters in 36% of AD patients, 44% of FTD, and 17% of HC, with significant differences between both clinical groups and HC (vs. AD, p = .01; vs. FTD, p = .001). There was not a distinctive marker of the signature change (i.e., feature change) in patients with dementia. Moreover, the signature changes in neurological patients were unrelated to their clinical and demographic characteristics (age, sex, education, time elapsed between the two signatures, Mini-mental State Examination score). CONCLUSION The findings suggest a resistance of handwritten signature in neurodegenerative diseases and in physiological aging, also suggesting that the signature may be an unreliable indicator of the cognitive status in AD and FTD, at least if subjectively evaluated.
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Affiliation(s)
- Alice Naomi Preti
- School of Medicine and Surgery, PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Lorenzo Diana
- Neuropsychology Laboratory, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Rita Castaldo
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico, Milan, Italy
| | - Francesca Pischedda
- Neuropsychology Laboratory, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico, Milan, Italy
| | - Giorgio Fumagalli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Andrea Arighi
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico, Milan, Italy
| | - Giuseppe Sartori
- Department of General Psychology, University of Padova, Padua, Italy
| | - Stefano Zago
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico, Milan, Italy.
| | - Nadia Bolognini
- Neuropsychology Laboratory, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Cocuzza A, Difonzo T, Aiello EN, Sbrissa LPE, Zago S, Gendarini C, Sirtori MA, Poletti B, Ticozzi N, Franco G, Di Fonzo A, Comi GP, Saetti MC. Verbal Learning Impairment in Parkinson's Disease: Role of the Frontostriatal System in Working and Strategic Memory. NEURODEGENER DIS 2023; 23:20-24. [PMID: 37757782 DOI: 10.1159/000534307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Learning is a long-term memory process, influenced by working memory control processes, including recognition of semantic properties of items by which subjects generate a semantic structure of engrams. The aim of the study was to investigate the verbal learning strategies of individuals with Parkinson's disease (PD). METHODS Thirty individuals with idiopathic PD and healthy control (HC) subjects were tested with a multi-trial word list learning, under two conditions: without cue and then with an explicit cue suggesting the categories in the list, respectively. RESULTS In comparison to HC subjects, individuals with PD recalled fewer words and achieved a reduced number of categorical clusters; the strategical cue did not improve their performance. CONCLUSION This suggests, besides a difficulty in identifying the correct learning strategy, a deficit in working memory, which undermines the strategy implementation.
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Affiliation(s)
- Alessandro Cocuzza
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luca Pietro Ernesto Sbrissa
- Department of Biomedical Sciences for Health, Institute of Forensic Medicine, University of Milan, Milan, Italy
| | - Stefano Zago
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Gendarini
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicola Ticozzi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giulia Franco
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessio Di Fonzo
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Pietro Comi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Cristina Saetti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy,
- Neurology Unit, Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,
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Zago S, Preti AN, Difonzo T, D'Errico A, Sartori G, Zangrossi A, Bolognini N. Two Cases of Malingered Crime-Related Amnesia. Top Cogn Sci 2023. [PMID: 36855315 DOI: 10.1111/tops.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
Amnesia is a frequent claim in major crimes, and it is estimated that the complete or partial absence of memory following a crime ranges from 25% to 50% of total cases. Although some cases may constitute a genuine form of amnesia, due to organic-neurological defects or psychological causes, and possibly combined with a dissociative or repressive coping style after an extreme experience, malingering is still fairly common in offenders. Therefore, one of the main goals in medico-legal proceedings is to find methods to determine the credibility of crime-related amnesia. At present, a number of lie and memory detection techniques can assist the forensic assessment of the reliability of declarative proof, and have been devised and improved over the past century: for example, modern polygraphs, event-related potentials, thermal imaging, functional magnetic resonance imaging, kinematic, and facial analysis. Other ad hoc psychological tests, such as the so-called Symptom Validity Test (SVT) and Performance Validity Test (PVT), as well as the autobiographical Implicit Association Test (aIAT), can also be used. To date, however, there is little evidence or case reports that document their real usefulness in forensic practice. Here, we report two cases of crime-related amnesia, whereby both defendants, who were found guilty of homicide, appeared to exhibit dissociative amnesia but where the application of SVTs, PVTs, and aIAT detected a malingered amnesia.
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Affiliation(s)
- Stefano Zago
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | - Alice N Preti
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano
- School of Medicine, University of Milano-Bicocca
| | - Teresa Difonzo
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | - Annalisa D'Errico
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | | | - Andrea Zangrossi
- Department of General Psychology, University of Padova
- Padova Neuroscience Center (PNC), University of Padova
| | - Nadia Bolognini
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano
- Department of Psychology and NeuroMI, University of Milano-Bicocca
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Bolognini N, Gramegna C, Esposito A, Aiello EN, Difonzo T, Zago S. Correction to: The Testamentary Capacity Assessment Tool (TCAT): validation and normative data. Neurol Sci 2023; 44:423. [PMID: 35871182 DOI: 10.1007/s10072-022-06292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy. .,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Teresa Difonzo
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. Correction to: The Frontal Assessment Battery (FAB) and its sub‑scales: validation and updated normative data in an Italian population sample. Neurol Sci 2023; 44:425. [PMID: 35871183 PMCID: PMC9816245 DOI: 10.1007/s10072-022-06295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Edoardo Nicolò Aiello
- grid.7563.70000 0001 2174 1754School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy ,grid.7563.70000 0001 2174 1754Clinical Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Antonella Esposito
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Chiara Gramegna
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Valentina Gazzaniga
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Stefano Zago
- grid.4708.b0000 0004 1757 2822Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy ,grid.7563.70000 0001 2174 1754Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- grid.4708.b0000 0004 1757 2822Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Marco Appollonio
- grid.7563.70000 0001 2174 1754School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy ,grid.7563.70000 0001 2174 1754Milan Center for Neuroscience (NeuroMI), Milan, Italy ,grid.7563.70000 0001 2174 1754Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy ,grid.418224.90000 0004 1757 9530Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Aiello EN, Preti AN, Pucci V, Diana L, Corvaglia A, Barattieri di San Pietro C, Difonzo T, Zago S, Appollonio I, Mondini S, Bolognini N. The Italian telephone-based Verbal Fluency Battery (t-VFB): standardization and preliminary clinical usability evidence. Front Psychol 2022; 13:963164. [PMID: 35992426 PMCID: PMC9384842 DOI: 10.3389/fpsyg.2022.963164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed at standardizing and providing preliminary evidence on the clinical usability of the Italian telephone-based Verbal Fluency Battery (t-VFB), which includes phonemic (t-PVF), semantic (t-SVF) and alternate (t-AVF) verbal fluency tasks. Methods Three-hundred and thirty-five Italian healthy participants (HPs; 140 males; age range = 18-96 years; education range = 4-23 years) and 27 individuals with neurodegenerative or cerebrovascular diseases were administered the t-VFB. Switch number and cluster size were computed via latent semantic analyses. HPs underwent the telephone-based Mental State Examination (MMSE) and Backward Digit Span (BDS). Construct validity, factorial structure, internal consistency, test-retest and inter-rater reliability and equivalence with the in-person Verbal Fluency tasks were assessed. Norms were derived via Equivalent Scores. Diagnostic accuracy against clinical populations was assessed. Results The majority of t-VFB scores correlated among each other and with the BDS, but not with the MMSE. Switch number correlated with t-PVF, t-SVF, t-AVF scores, whilst cluster size with the t-SVF and t-AVF scores only. The t-VFB was underpinned by a mono-component structure and was internally consistent (Cronbach's α = 0.91). Test-retest (ICC = 0.69-0.95) and inter-rater reliability (ICC = 0.98-1) were optimal. Each t-VFB test was statistically equivalent to its in-person version (equivalence bounds yielding a p < 0.05). Education predicted all t-VFB scores, whereas age t-SVF and t-AVF scores and sex only some t-SVF scores. Diagnostic accuracy against clinical samples was optimal (AUC = 0.81-0.86). Discussion The t-VFB is a valid, reliable and normed telephone-based assessment tool for language and executive functioning, equivalent to the in-person version; results show promising evidence of its diagnostic accuracy in neurological populations.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alice Naomi Preti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Veronica Pucci
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy
- Human Inspired Technology Research Centre, University of Padova, Padua, Italy
| | - Lorenzo Diana
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Alessia Corvaglia
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Chiara Barattieri di San Pietro
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy
- Human Inspired Technology Research Centre, University of Padova, Padua, Italy
| | - Nadia Bolognini
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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11
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Lazzeri G, Franco G, Difonzo T, Carandina A, Gramegna C, Vergari M, Arienti F, Naci A, Scatà C, Monfrini E, Dias Rodrigues G, Montano N, Comi GP, Saetti MC, Tobaldini E, Di Fonzo A. Cognitive and Autonomic Dysfunction in Multiple System Atrophy Type P and C: A Comparative Study. Front Neurol 2022; 13:912820. [PMID: 35785342 PMCID: PMC9243310 DOI: 10.3389/fneur.2022.912820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple System Atrophy (MSA) is a rare neurodegenerative disease, clinically defined by a combination of autonomic dysfunction and motor involvement, that may be predominantly extrapyramidal (MSA-P) or cerebellar (MSA-C). Although dementia is generally considered a red flag against the clinical diagnosis of MSA, in the last decade the evidence of cognitive impairment in MSA patients has been growing. Cognitive dysfunction appears to involve mainly, but not exclusively, executive functions, and may have different characteristics and progression in the two subtypes of the disease (i.e., MSA-P and MSA-C). Despite continued efforts, combining in-vivo imaging studies as well as pathological studies, the physiopathological bases of cognitive involvement in MSA are still unclear. In this view, the possible link between cardiovascular autonomic impairment and decreased cognitive performance, extensively investigated in PD, needs to be clarified as well. In the present study, we evaluated a cohort of 20 MSA patients (9 MSA-P, 11 MSA-C) by means of a neuropsychological battery, hemodynamic assessment (heart rate and arterial blood pressure) during rest and active standing and bedside autonomic function tests assessed by heart rate variability (HRV) parameters and sympathetic skin response (SSR) in the same experimental session. Overall, global cognitive functioning, as indicated by the MoCA score, was preserved in most patients. However, short- and long-term memory and attentional and frontal-executive functions were moderately impaired. When comparing MSA-P and MSA-C, the latter obtained lower scores in tests of executive functions and verbal memory. Conversely, no statistically significant difference in cardiovascular autonomic parameters was identified between MSA-P and MSA-C patients. In conclusion, moderate cognitive deficits, involving executive functions and memory, are present in MSA, particularly in MSA-C patients. In addition, our findings do not support the role of dysautonomia as a major driver of cognitive differences between MSA-P and MSA-C.
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Affiliation(s)
- Giulia Lazzeri
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Franco
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelica Carandina
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Chiara Gramegna
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maurizio Vergari
- Neurophysiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Arienti
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Anisa Naci
- Neurophysiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Costanza Scatà
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of General Psychology, University of Padua, Padua, Italy
| | - Edoardo Monfrini
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giacomo P. Comi
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Cristina Saetti
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessio Di Fonzo
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- *Correspondence: Alessio Di Fonzo
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12
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Aiello EN, Pucci V, Diana L, Niang A, Preti AN, Delli Ponti A, Sangalli G, Scarano S, Tesio L, Zago S, Difonzo T, Appollonio I, Mondini S, Bolognini N. Telephone-based Frontal Assessment Battery (t-FAB): standardization for the Italian population and clinical usability in neurological diseases. Aging Clin Exp Res 2022; 34:1635-1644. [PMID: 35699839 PMCID: PMC9194888 DOI: 10.1007/s40520-022-02155-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/23/2022] [Accepted: 05/13/2022] [Indexed: 12/18/2022]
Abstract
Background Despite the relevance of telephone-based cognitive screening tests in clinical practice and research, no specific test assessing executive functioning is available. The present study aimed at standardizing and providing evidence of clinical usability for the Italian telephone-based Frontal Assessment Battery (t-FAB). Methods The t-FAB (ranging 0–12), comprising two subtests, has two versions: one requiring motor responses (t-FAB-M) and the other verbal responses (t-FAB-V). Three hundred and forty-six Italian healthy adults (HPs; 143 males; age range = 18–96 years; education range = 4–23 years) and 40 participants with neurological diseases were recruited. To HPs, the t-FAB was administered along with a set of telephone-based tests: MMSE, verbal fluency (VF), backward digit span (BDS). The in-person version of the FAB was administered to both HPs and clinical groups. Factorial structure, construct validity, inter-rater and test–retest reliability, t-FAB-M vs. t-FAB-V equivalence and diagnostic accuracy were assessed. Norms were derived via Equivalent Scores. Results In HPs, t-FAB measures yielded high inter-rater/test–retest reliability (ICC = .78–.94), were internally related (p ≤ .005) and underpinned by a single component, converging with the telephone-based MMSE, VF, BDS (p ≤ .0013). The two t-FAB versions were statistically equivalent in clinical groups (ps of both equivalence bounds < .001). Education predicted all t-FAB scores (p < .001), whereas age only the t-FAB-M score (p ≤ .004). t-FAB scores converge with the in-person FAB in HPs and clinical groups (rs = .43–.78). Both t-FAB versions were accurate in discriminating HPs from the clinical cohort (AUC = .73-.76). Discussion The t-FAB is a normed, valid, reliable and clinically usable telephone-based cognitive screening test to adopt in both clinical and research practice. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-022-02155-3.
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Affiliation(s)
- Edoardo Nicolò Aiello
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Veronica Pucci
- Dipartimento di Filosofia, Sociologia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, Padua, Italy.,Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy
| | - Lorenzo Diana
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Aida Niang
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Alice Naomi Preti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Neurology Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Adriana Delli Ponti
- Neurology Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Gaia Sangalli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefano Zago
- Neurology Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Sara Mondini
- Dipartimento di Filosofia, Sociologia, Pedagogia e Psicologia Applicata (FISPPA), University of Padova, Padua, Italy.,Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. Correction to: The Frontal Assessment Battery (FAB) and its sub‑scales: validation and updated normative data in an Italian population sample. Neurol Sci 2022; 43:6621. [PMID: 35451665 PMCID: PMC9616748 DOI: 10.1007/s10072-022-06087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Aiello EN, Gramegna C, Esposito A, Gazzaniga V, Zago S, Difonzo T, Maddaluno O, Appollonio I, Bolognini N. The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy. Aging Clin Exp Res 2022; 34:375-382. [PMID: 34313961 PMCID: PMC8847194 DOI: 10.1007/s40520-021-01943-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Background The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage; (iii) information on sensitivity and discriminative capability at the item level. Methods Five hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females; age: 63.4 ± 15, 21–96; education: 11.3 ± 4.6, 1–25) were administered the MoCA. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Average ESs were also computed. Agreement with previous ESs classification was assessed via Cohen’s k. Results Age and education significantly predicted all MoCA measures except for Orientation, which was related to age only. No sex differences were detected when tested along with age and education. Substantial disagreements with previous ESs classifications were detected. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. Discussion Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA.
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample. Neurol Sci 2022; 43:979-984. [PMID: 34184168 PMCID: PMC8789707 DOI: 10.1007/s10072-021-05392-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Deficits of executive functioning (EF) are frequently found in neurological disorders. The Frontal Assessment Battery (FAB) is one of the most widespread and psychometrically robust EF screeners in clinical settings. However, in Italy, FAB norms date back to 15 years ago; moreover, its validity against "EF-loaded" global cognitive screeners (e.g., the Montreal Cognitive Assessment, MoCA) has yet to be tested. This study thus aimed at (a) providing updated normative data for the Italian FAB and (b) assessing its convergent validity with the MoCA. METHODS Four-hundred and seventy-five healthy Italian native speakers (306 females, 169 males; mean age: 61.08 ± 15.1; mean education: 11.67 ± 4.57) were administered by the MoCA and the FAB. FAB items were divided into three subscales: FAB-1 (linguistically mediated EF), FAB-2 (planning), and FAB-3 (inhibition). Regression-based norms were derived (equivalent scores) for all FAB measures. RESULTS Age and education were predictive of all FAB measures, whereas no gender differences were detected. The FAB and its sub-scales were related to MoCA measures-the strongest associations being found with MoCA total and MoCA-EF scores. FAB sub-scales were both internally related and associated with FAB total scores. DISCUSSION The FAB proved to have convergent validity with both global cognitive and EF measures in healthy individuals. The present study provides updated normative data for the FAB and its sub-scales in an Italian population sample, and thus supports an adaptive usage of this EF screener.
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Affiliation(s)
- Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Clinical Neuroscience, University of Milano-Bicocca, Monza, Italy
| | | | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Stefano Zago
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Marco Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Faggiano A, Difonzo T, Avallone C, Forgione A, Gazzaniga V, Gramegna C, Locatelli G, Mallardi G, Nicotra A, Zago S, Carugo S. 208 Association between cardiovascular data and the development and progression of mild cognitive impairment: results from the retrospective cohort study. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab145.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Mild cognitive impairment (MCI) is characterized by objective evidence of cognitive impairment in one or more cognitive domains in the absence of significant interference in daily-life activities. Anyway, people with MCI are considered to be at heightened risk of further cognitive decline and progression to dementia. To date, few evidence regarding the association between cardiovascular data and MCI are present in the literature. To investigate the association between various cardiovascular data (traditional risk factors and outcomes) and the development and progression of MCI.
Methods and results
The study included 127 patients referred to the Neurological Unit of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan for subjective memory complaints and/or clinical suspect of cognitive impairment. Neuropsychological tests evaluating executive functions and cardiovascular data were collected at baseline and 2-year follow-up. Visit reports and medical records were reviewed to extrapolate the data. The study was conducted between 2012 and 2020. The 51 (40.2%) patients on antiplatelet therapy (94% on aspirin) had a worse baseline degree of cognitive impairment on neuropsychological tests of executive functions and had greater worsening of MCI at 2 years (Table 1). Patients on antiplatelet therapy were significantly older (75.85 vs. 71.7; P = 0.009), more ischaemic (21.6% vs. 1.3%; P < 0.001), hypertensive (90.2% vs. 60.5%; P < 0.001), and dyslipidaemic (62.7% vs. 19.7%; P < 0.001) than patients without antiplatelet therapy. No other single cardiovascular data analysed (presence of hypertension, dyslipidaemia, ischaemic heart disease, diabetes, atrial fibrillation, and anticoagulation therapy) showed a statistical significant association with MCI presence or progression.
Conclusions
The present study suggests that the prevalence and progression of MCI is significantly higher among patients on antiplatelet therapy, who carry a greater cardiovascular burden. Although patients on antiplatelet therapy were older, more ischaemic, hypertensive, and dyslipidaemic than patients without antiplatelet therapy, none of these parameters were associated with MCI presence and/or progression and can therefore be considered a confounding factor.
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Affiliation(s)
- Andrea Faggiano
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Carlo Avallone
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Arianna Forgione
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Valentina Gazzaniga
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Chiara Gramegna
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Giuseppe Locatelli
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Giulio Mallardi
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Alessia Nicotra
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Stefano Zago
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Stefano Carugo
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
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Bolognini N, Gramegna C, Esposito A, Aiello EN, Difonzo T, Zago S. The Testamentary Capacity Assessment Tool (TCAT): validation and normative data. Neurol Sci 2021; 43:2831-2838. [PMID: 34787752 DOI: 10.1007/s10072-021-05736-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is an increasing need for objective and standardized assessment of testamentary capacity (TC) in dementia. A new instrument, the Testamentary Capacity Assessment Tool (TCAT), has been recently developed; however, the lack of validation and normative data regarding this cognitive screening test has limited its adoption in forensic and clinical settings. The present study collects normative data for the TCAT and assesses its convergent validity with standardized cognitive tests and the capacity to define what a 'testament' is. METHODS The study involved 323 neurologically healthy adults (123 males, 200 females) of different ages (31-93 years) and different educational levels (4-25 years). The TCAT was administered along with the Beck Depression Inventory-II (BDI-II), the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Testament Definition Scale (TDS). RESULTS Multiple regression analyses revealed a significant effect for gender, age and education on TCAT scores. Correlation analyses showed significant associations between the TCAT and the MMSE, MoCA, FAB and BDI-II. A positive correlation between the TCAT and TDS was also found, proving good convergent validity of the TCAT with respect to TC. Finally, cut-off scores and Equivalent Scores (ES) were computed. DISCUSSION The present study provides normative data for using the TCAT as an adjuvant cognitive screening test in the neuropsychological evaluation of TC. Our findings shall be of interest for the adoption of the TCAT also in clinical practice, since it evaluates cognitive functions (e.g., autobiographic memory, Theory of Mind) not measured by traditional screening tests.
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Affiliation(s)
- Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy. .,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Teresa Difonzo
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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18
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Zago S, Scarpazza C, Difonzo T, Arighi A, Hajhajate D, Torrente Y, Sartori G. Behavioral Variant of Frontotemporal Dementia and Homicide in a Historical Case. J Am Acad Psychiatry Law 2021; 49:219-227. [PMID: 33731422 DOI: 10.29158/jaapl.200081-20] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Criminal behavior is a clinical feature of the behavioral variant of frontotemporal dementia (bvFTD), ranging from socially inappropriate behavior and minor offenses (such as shoplifting, driving-related violations, housebreaking, trespassing) to the more extreme acts of sex crimes and violence. To our knowledge, no homicide case involving bvFTD is well illustrated in the scientific literature, and only a few anecdotal annotations are available about bvFTD and homicide. This is surprising considering the inclination of individuals with bvFTD to lack impulse control, to manifest disinhibition, to display diminished emotional awareness and loss of empathy, and to show behavior indicative of disordered moral reasoning. Here, we describe the 19th-century homicide case of Benjamin Reynaud, a man whose clinical characteristics suggest the bvFTD diagnosis. Reynaud's case may represent a rare instance of homicide committed by an individual with bvFTD and provide a basis for some reflections regarding the relationship between homicidal behavior and bvFTD.
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Affiliation(s)
- Stefano Zago
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cristina Scarpazza
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Teresa Difonzo
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Arighi
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Dounia Hajhajate
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Yvan Torrente
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Sartori
- Dr. Zago and Dr. Difonzo are Clinical Neuropsychologists, Neurology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Dr. Scarpazza is Assistant Professor and Dr. Sartori is Professor, Department of General Psychology, University of Padua, Padua, Italy. Dr. Arighi is a neurologist, Neurodegenerative Disease Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, and Centro Dino Ferrari, University of Milan, Milan, Italy. Dr. Hajhajate is Clinical Research Assistant, Sorbonne Université, Paris, France. Dr. Torrente is Associate Professor, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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19
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Zago S, Piacquadio E, Monaro M, Orrù G, Sampaolo E, Difonzo T, Toncini A, Heinzl E. The Detection of Malingered Amnesia: An Approach Involving Multiple Strategies in a Mock Crime. Front Psychiatry 2019; 10:424. [PMID: 31263432 PMCID: PMC6589901 DOI: 10.3389/fpsyt.2019.00424] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/29/2019] [Indexed: 12/23/2022] Open
Abstract
The nature of amnesia in the context of crime has been the subject of a prolonged debate. It is not uncommon that after committing a violent crime, the offender either does not have any memory of the event or recalls it with some gaps in its recollection. A number of studies have been conducted in order to differentiate between simulated and genuine amnesia. The recognition of probable malingering requires several inferential methods. For instance, it typically involves the defendant's medical records, self-reports, the observed behavior, and the results of a comprehensive neuropsychological examination. In addition, a variety of procedures that may detect very specific malingered amnesia in crime have been developed. In this paper, we investigated the efficacy of three techniques, facial thermography, kinematic analysis, and symptom validity testing in detecting malingering of amnesia in crime. Participants were randomly assigned to two different experimental conditions: a group was instructed to simulate amnesia after a mock homicide, and a second group was simply asked to behave honestly after committing the mock homicide. The outcomes show that kinematic analysis and symptom validity testing achieve significant accuracy in detecting feigned amnesia, while thermal imaging does not provide converging evidence. Results are encouraging and may provide a first step towards the application of these procedures in a multimethod approach on crime-specific cases of amnesia.
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Affiliation(s)
- Stefano Zago
- U.O.C. Neurologia, IRCSS Fondazione Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Emanuela Piacquadio
- U.O.C. Neurologia, IRCSS Fondazione Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Merylin Monaro
- Department of General Psychology, University of Padova, Padova, Italy
| | - Graziella Orrù
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Erika Sampaolo
- U.O.C. Neurologia, IRCSS Fondazione Ospedale Maggiore Policlinico di Milano, Milano, Italy
- IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Teresa Difonzo
- U.O.C. Neurologia, IRCSS Fondazione Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Andrea Toncini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Eugenio Heinzl
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milano, Italy
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