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Tramontano M, Argento O, Manocchio N, Piacentini C, Orejel Bustos AS, De Angelis S, Bossa M, Nocentini U. Dynamic Cognitive-Motor Training versus Cognitive Computer-Based Training in People with Multiple Sclerosis: A Preliminary Randomized Controlled Trial with 2-Month Follow-Up. J Clin Med 2024; 13:2664. [PMID: 38731193 PMCID: PMC11084403 DOI: 10.3390/jcm13092664] [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: 03/19/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Recent studies underscore the intricate relationship between cognitive and motor impairments in Multiple Sclerosis (MS), often exacerbated by CNS damage compromising neural connections. These cognitive-motor deficits contribute to reduced efficiency in daily activities and heightened risks of falls and accidents. The combination of challenging cognitive-motor training in a more ecological setting could improve cognitive functions in people with MS (PwMS). Objective: This study aims to compare the impact of dynamic cognitive-motor training versus computer-based cognitive training on overall cognitive efficiency in PwMS. Methods: Thirty-eight PwMS were recruited through the neurorehabilitation services of an Institute of research and health. Twenty-four participants were randomly assigned to the Cognitive-Motor group (CMg) and Cognitive Therapy group (CTg). Participants underwent three training sessions per week for four weeks, each lasting 50 min. The primary outcome was a comprehensive cognitive assessment using the Cognitive Impairment Index (CII), and the secondary outcomes were the Multiple Sclerosis Quality of Life Questionnaire MSQOL-54 and the Stroop Color Word Interference Test (SCWT). Results: Significant differences in the CII scores across T0, T1, and T2, as indicated by Friedman's test (χ2(2) = 14.558, p = .001), were found in the CMg. A significant difference in the change in health subscale of the MSQOL-54 was observed when comparing the groups across T0, T1, and T2 (χ2(2) = 6.059, p = .048). There were also statistically significant differences for the emotional well-being (χ2(2) = 7.581, p = .023) and health distress (χ2(2) = 11.902, p = .003) subscales. Post hoc analysis showed a statistically significant improvement in health-related quality of life (HRQOL) for the former at T1 vs. T0 (Z = -2.502, p = .012 and for the latter at T2 vs. T0 (Z = -2.670, p = .008), respectively. Conclusions: Our results support the combination of cognitive-motor training to enhance cognitive functional outcomes and quality of life compared to computer-based cognitive training in PwMS.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Università di Bologna, 40138 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ornella Argento
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
- Research Center CBPT, 00196 Rome, Italy
| | - Nicola Manocchio
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Chiara Piacentini
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
| | - Amaranta Soledad Orejel Bustos
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
| | - Michela Bossa
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
| | - Ugo Nocentini
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (O.A.); (C.P.); (A.S.O.B.); (S.D.A.); (M.B.); (U.N.)
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
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Tramontano M, Argento O, Orejel Bustos AS, DE Angelis S, Montemurro R, Bossa M, Belluscio V, Bergamini E, Vannozzi G, Nocentini U. Cognitive-motor dual-task training improves dynamic stability during straight and curved gait in patients with multiple sclerosis: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:27-36. [PMID: 37997324 DOI: 10.23736/s1973-9087.23.08156-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative disease of the central nervous system and the second most frequent cause of permanent disability in young adults. One of the most common issues concerns the ability to perform postural and gait tasks while simultaneously completing a cognitive task (namely, dual-task DT). AIM Assessing cognitive-motor dual-task training effectiveness in patients with Multiple Sclerosis (PwMS) for dynamic gait quality when walking on straight, curved, and blindfolded paths. DESIGN Two-arm single-blind randomized controlled trial. Follow-up at 8 weeks. SETTING Neurorehabilitation Hospital. POPULATION A sample of 42 PwMS aged 28-71, with a score of 4.00±1.52 on the Expanded Disability Status Scale were recruited. METHODS Participants were randomized in conventional (CTg) neurorehabilitation and dual-task training (DTg) groups and received 12 sessions, 3 days/week/4 weeks. They were assessed at baseline (T0), after the treatment (T1), and 8 weeks after the end of the treatment (T2) through Mini-BESTest, Tinetti Performance Oriented Mobility Assessment, Modified Barthel Index, and a set of spatiotemporal parameters and gait quality indices related to stability, symmetry, and smoothness of gait extracted from initial measurement units (IMUs) data during the execution of the 10-meter Walk Test (10mWT), the Figure-of-8 Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). RESULTS Thirty-one PwMS completed the trial at T2. Significant improvement within subjects was found in Mini-BESTest scores for DTg from T0 to T1. The IMU-based assessment indicated significant differences in stability (P<0.01) and smoothness (P<0.05) measures between CTg and DTg during 10mWT and Fo8WT. Substantial improvements (P<0.017) were also found in the inter-session comparison, primarily for DTg, particularly for stability, symmetry, and smoothness measures. CONCLUSIONS This study supports the effectiveness of DT in promoting dynamic motor abilities in PwMS. CLINICAL REHABILITATION IMPACT Cognitive-motor DT implemented into the neurorehabilitation conventional program could be a useful strategy for gait and balance rehabilitation.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy -
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
| | - Ornella Argento
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Amaranta S Orejel Bustos
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sara DE Angelis
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Rebecca Montemurro
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Michela Bossa
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Valeria Belluscio
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Elena Bergamini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Giuseppe Vannozzi
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ugo Nocentini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Bossa M, Argento O, Piacentini C, Manocchio N, Scipioni L, Oddi S, Maccarrone M, Nocentini U. Effects of Long-Term Oral Administration of N-Palmitoylethanolamine in Subjects with Mild Cognitive Impairment: Study Protocol. Brain Sci 2023; 13:1138. [PMID: 37626494 PMCID: PMC10452679 DOI: 10.3390/brainsci13081138] [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: 06/26/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
N-palmitoylethanolamine (PEA) plays a key role in preventing Aβ-mediated neuroinflammation and neurotoxicity in murine models. It has been demonstrated that PEA provides anti-neuroinflammatory, pain-relieving and neuroprotective actions even in humans. In this project, we aim to evaluate these anti-neuroinflammatory effects via the cognitive evaluation and biochemical analyses of a 12-month oral administration of PEA in subjects with mild cognitive impairment (MCI). Subjects with MCI will be randomized to placebo or PEA groups, and followed for another 6 months. Cognitive abilities and neurological inflammation will be examined at baseline and after treatment. The specific objectives of the project are to ascertain whether: (i) PEA influences the scores of the neuropsychological and behavioral evaluations after one-year treatment, comparing PEA-treated and placebo subjects in both MCI and control groups; (ii) PEA can change the inflammatory and neuronal damage markers of blood and urine in MCI subjects; and (iii) these changes correlate with the clinical scores of participating subjects.
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Affiliation(s)
- Michela Bossa
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Ornella Argento
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Chiara Piacentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Nicola Manocchio
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Lucia Scipioni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio Snc, 67100 L’Aquila, Italy; (L.S.); (M.M.)
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
| | - Sergio Oddi
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
- Faculty of Veterinary Medicine, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio Snc, 67100 L’Aquila, Italy; (L.S.); (M.M.)
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
| | - Ugo Nocentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
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Giordano A, Testa S, Bassi M, Cilia S, Bertolotto A, Quartuccio ME, Pietrolongo E, Falautano M, Grobberio M, Niccolai C, Allegri B, Viterbo RG, Confalonieri P, Giovannetti AM, Cocco E, Grasso MG, Lugaresi A, Ferriani E, Nocentini U, Zaffaroni M, De Livera A, Jelinek G, Solari A, Rosato R. Applying multidimensional computerized adaptive testing to the MSQOL-54: a simulation study. Health Qual Life Outcomes 2023; 21:61. [PMID: 37357308 DOI: 10.1186/s12955-023-02152-8] [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: 09/23/2022] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The Multiple Sclerosis Quality of Life-54 (MSQOL-54) is one of the most commonly-used MS-specific health-related quality of life (HRQOL) measures. It is a multidimensional, MS-specific HRQOL inventory, which includes the generic SF-36 core items, supplemented with 18 MS-targeted items. Availability of an adaptive short version providing immediate item scoring may improve instrument usability and validity. However, multidimensional computerized adaptive testing (MCAT) has not been previously applied to MSQOL-54 items. We thus aimed to apply MCAT to the MSQOL-54 and assess its performance. METHODS Responses from a large international sample of 3669 MS patients were assessed. We calibrated 52 (of the 54) items using bifactor graded response model (10 group factors and one general HRQOL factor). Then, eight simulations were run with different termination criteria: standard errors (SE) for the general factor and group factors set to different values, and change in factor estimates from one item to the next set at < 0.01 for both the general and the group factors. Performance of the MCAT was assessed by the number of administered items, root mean square difference (RMSD), and correlation. RESULTS Eight items were removed due to local dependency. The simulation with SE set to 0.32 (general factor), and no SE thresholds (group factors) provided satisfactory performance: the median number of administered items was 24, RMSD was 0.32, and correlation was 0.94. CONCLUSIONS Compared to the full-length MSQOL-54, the simulated MCAT required fewer items without losing precision for the general HRQOL factor. Further work is needed to add/integrate/revise MSQOL-54 items in order to make the calibration and MCAT performance efficient also on group factors, so that the MCAT version may be used in clinical practice and research.
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Affiliation(s)
- Andrea Giordano
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Silvia Testa
- Department of Human and Social Sciences, University of Aosta Valley, Aosta, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Sabina Cilia
- Department of Territorial Activities, Azienda Sanitaria Provinciale, Health District, Catania, Italy
| | - Antonio Bertolotto
- Neurology Unit & Regional Referral Multiple Sclerosis Centre (CReSM), University Hospital San Luigi Gonzaga, Orbassano, Italy
| | | | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Monica Falautano
- Psychological Service - Neurological and Neurological Rehabilitation Units, IRCCS San Raffaele, Milan, Italy
| | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, Psychology Unit, ASST Lariana, Como, Italy
| | | | - Beatrice Allegri
- Multiple Sclerosis Center, Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | | | - Paolo Confalonieri
- Multiple Sclerosis Center, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ambra Mara Giovannetti
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy
- Multiple Sclerosis Center, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleonora Cocco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Multiple Sclerosis Center, ASL Cagliari, ATS Sardegna, Cagliari, Italy
| | | | - Alessandra Lugaresi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Elisa Ferriani
- UOC Psicologia Ospedaliera, AUSL di Bologna, Bologna, Italy
| | - Ugo Nocentini
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
- Behavioral Neuropsychology Laboratory, IRCCS S. Lucia Foundation, Rome, Italy
| | - Mauro Zaffaroni
- Neurologia ad indirizzo Neuroimmunologico - Centro Sclerosi Multipla, Ospedale di Gallarate - ASST della Valle Olona, Gallarate, Italy
| | - Alysha De Livera
- Mathematics and Statistics, La Trobe University, Melbourne, Australia
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - George Jelinek
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy
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Piacentini C, Argento O, Nocentini U. Cognitive impairment in multiple sclerosis: "classic" knowledge and recent acquisitions. Arq Neuropsiquiatr 2023; 81:585-596. [PMID: 37379870 PMCID: PMC10658666 DOI: 10.1055/s-0043-1763485] [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] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/11/2022] [Indexed: 06/30/2023]
Abstract
Multiple sclerosis (MS) is a central nervous system (CNS) disease characterized by inflammation, axonal demyelination, and neurodegeneration, which can have a strong impact on all aspects of the life of the patient. Multiple sclerosis causes motor, sensory, cerebellar, and autonomic dysfunctions, as well as cognitive and psychoemotional impairment. The most frequently compromised cognitive domains are complex attention/information processing, memory, executive and visuospatial functions. Recently, alterations have also been evidenced in complex cognitive functions, such as social cognition, moral judgment, and decision-making. Cognitive impairment is characterized by high variability and can affect work skills, social interactions, coping strategies and more generally the quality of life of patients and their families. With the use of sensitive and easy-to-administer test batteries, an increasingly accurate and early diagnosis is feasible: this allows to determine the effectiveness of possible preventive measures, to predict the future progression of the disease and to improve the quality of life of patients. There is currently limited evidence regarding the efficacy, on cognitive impairment, of disease-modifying therapies. The most promising approach, which has received strong empirical support, is cognitive rehabilitation.
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Affiliation(s)
- Chiara Piacentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ornella Argento
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ugo Nocentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
- University of Rome “Tor Vergata”, Department of Clinical Sciences and
Translational Medicine, Rome, Italy.
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Argento O, Piacentini C, Bossa M, Caltagirone C, Santamato A, Saraceni V, Nocentini U. Correction to: Motor, cognitive, and combined rehabilitation approaches on MS patients' cognitive impairment. Neurol Sci 2023; 44:1835. [PMID: 36658412 DOI: 10.1007/s10072-023-06630-1] [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: 01/21/2023]
Affiliation(s)
- Ornella Argento
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy.
| | - Chiara Piacentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy
| | - Michela Bossa
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy
| | - Carlo Caltagirone
- Scientific Direction, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Andrea Santamato
- Rehabilitation Centre-Physical Medicine and Rehabilitation Section, OORR-Hospital-University of Foggia, Foggia, Italy
| | - Vincenzo Saraceni
- Scientific Direction, "Filippo Turati" Foundation, Rehabilitation Centre, Pistoia, Italy
| | - Ugo Nocentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Sollini ML, Capitanucci ML, Foti C, Nocentini U, Castelli E, Mosiello G. Home pelvic floor exercises in children with non-neurogenic Lower Urinary Tract Symptoms: Is fitball an alternative to classic exercises? Neurourol Urodyn 2023; 42:146-152. [PMID: 36208111 PMCID: PMC10092819 DOI: 10.1002/nau.25060] [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: 07/21/2022] [Revised: 09/09/2022] [Accepted: 09/24/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Biofeedback with home pelvic floor exercises were recommended as non-pharmacologic treatment for non-neurogenic Lower Urinary Tract Symptoms (LUTS) in children. Fitball is recommended to improve all-over flexibility, balance, and coordination, especially for pelvic floor. Aim of the study was to investigate efficacy of standard home pelvic floor exercises versus exercises using fitball. METHODS From April 2021 to February 2022 to all children arrived in our clinic with non-neurogenic LUTS nonresponder at urotherapy, our pelvic floor rehabilitative program was proposed. During the rehabilitation children performed: standard urotherapy, pelvic floor animated biofeedback therapy and pelvic floor exercises in a standard way and using a fitball. After the first session, patients received prescription to repeat at home the same exercises performed at hospital. Children who chose classic exercises were enrolled in group A and they who chose fitball in group B. Continence rate, pelvic floor muscles activity, adherence and satisfaction were evaluated by means of bladder diary, external pubococcygeus test and Likert-type psychometric scale (from 1 = very unsatisfied to 5 = very satisfied) respectively. RESULTS Twenty-six children affected by LUTS were enrolled: 13 in group A and 13 in B. At 4th control urinary incontinence was reduced by 72,5% in A and 71.4% in B. Pubococcygeus test increased in both groups. Adherence at home was 92% in group A and 62% in group B. Satisfaction with the treatment (4 or 5 points) was 95% in both groups. Four patients of group A and all of group B decided to maintain home exercises including fitball. CONCLUSIONS Our preliminary study shows that efficacy of home exercises, with or without fitball, is comparable. Satisfaction with fitball is high, regardless results obtained, because parents and children have learned a new, interesting and stimulating way to manage urinary problems. The opportunity to perform these exercises using fitball, it's an important finding for pediatric population.
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Affiliation(s)
- Maria Laura Sollini
- Clinical Sciences and Translational Medicine, Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy.,Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy.,"Santa Lucia" Foundation, I.R.C.C.S., Rome, Italy
| | | | - Calogero Foti
- Clinical Sciences and Translational Medicine, Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ugo Nocentini
- Clinical Sciences and Translational Medicine, Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy.,"Santa Lucia" Foundation, I.R.C.C.S., Rome, Italy
| | - Enrico Castelli
- Department of Neurorehabilitation, Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Mosiello
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy
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Argento O, Piacentini C, Bossa M, Caltagirone C, Santamato A, Saraceni V, Nocentini U. Motor, cognitive, and combined rehabilitation approaches on MS patients' cognitive impairment. Neurol Sci 2023; 44:1109-1118. [PMID: 36542204 PMCID: PMC9769485 DOI: 10.1007/s10072-022-06552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND At the moment, the possible options for the management of cognitive dysfunctions in patients with MS (pMS) are pharmacological interventions, cognitive rehabilitation (CR), and physical exercise. However, worldwide, multimodal programs are infrequently applied in pMS and CR is not easily accessible through the National Health System as MR. OBJECTIVE The aim of the study is to explore if the combination of motor and cognitive rehabilitation may favor better outcomes on cognitive efficiency compared to separate trainings. METHODS Forty-eight pMS were submitted to detailed neuropsychological and motor assessments, before (T0) and after (T1) having performed one of three rehabilitation conditions (two cognitive trainings/week-Reha1; one cognitive and one motor training/week-Reha2; two motor trainings/week-Reha3, for 12 weeks); they were randomly assigned to one condition or another. The CR was focused on memory functioning and performed with the Rehacom program. RESULTS No significant differences in age, sex, education, and disease course were found between the three groups (sig. > .05). Reha1 patients increased only their cognitive performance, and Reha3 only increased their motor performance, while Reha2 increased both cognitive and motor performances. This benefit was also confirmed by the cognitive efficiency expressed by the Cognitive Impairment Index. CONCLUSIONS These data confirm that to include cognitive training within rehabilitation programs may induce important benefits in pMS. Furthermore, pMS seem to benefit from a combined approach (cognitive and motor) more than from CR and motor rehabilitation separately (ClinicalTrial.gov ID: NCT05462678; 14 July 2022, retrospectively registered).
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Affiliation(s)
- Ornella Argento
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy.
| | - Chiara Piacentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy
| | - Michela Bossa
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy
| | - Carlo Caltagirone
- Scientific Direction, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Andrea Santamato
- Rehabilitation Centre-Physical Medicine and Rehabilitation Section, OORR-Hospital-University of Foggia, Foggia, Italy
| | - Vincenzo Saraceni
- Scientific Direction, “Filippo Turati” Foundation, Rehabilitation Centre, Pistoia, Italy
| | - Ugo Nocentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy ,Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
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Argento O, Piacentini C, Bossa M, Nocentini U. Emotional Recognition and Its Relation to Cognition, Mood and Fatigue in Relapsing-Remitting and Secondary Progressive Multiple Sclerosis. Int J Environ Res Public Health 2022; 19:16408. [PMID: 36554293 PMCID: PMC9778255 DOI: 10.3390/ijerph192416408] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Emotional recognition (ER), the ability to read into others' minds and recognize others' emotional states, is important in social environment adaptation. Recently it has been found that ER difficulties affect patients with multiple sclerosis (pMS) and relate to different gray matter atrophy patterns from secondary progressive (SP-pMS) and relapsing-remitting (RR-pMS). The aim of this study was to compare the performances of the two MS phenotypes on the Reading the Mind in the Eyes test (RMEt) and other cognitive, mood and fatigue measures. We also examined associations between performance on the RMEt and cognitive, mood and fatigue variables. (2) Methods: A total of 43 pMS (27RR-pMS/16SP-pMS) underwent a clinical assessment, the RMEt, the cognitive battery, and completed mood and fatigue questionnaires. Both groups' performances on the RMEt were then correlated with all these measures. (3) Results: the RMEt scores of RR-pMS were significantly correlated with the impairment degree in some cognitive scores. SP-pMS scores correlated mainly with fatigue, anxiety, anger and depression. (4) Conclusions: ER performances relate to cognitive aspects in RR-pMS, whereas mainly to mood outcomes in the SP-pMS group. We can hypothesize that deficits in ER are a further sign of disease progression. Our data support the different roles of cognitive and emotional deficits related to different disease courses and lesional correlates.
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Affiliation(s)
- Ornella Argento
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy
| | - Chiara Piacentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy
| | - Michela Bossa
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy
| | - Ugo Nocentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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10
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Schwartz CE, Rapkin BD, Bonavita S, Bossa M, Buscarinu MC, Grasso MG, Luca M, Nozzolillo A, Nocentini U. The impact of COVID-19 on people with multiple sclerosis: A comparison of Italian and United States cohorts. Mult Scler Relat Disord 2022; 63:103888. [DOI: 10.1016/j.msard.2022.103888] [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] [Received: 02/14/2022] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 11/26/2022]
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11
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Argento O, Spanò B, Serra L, Incerti CC, Bozzali M, Caltagirone C, Francia A, Fratino M, Nocentini U, Piacentini C, Quartuccio ME, Pisani V. Relapsing-remitting and secondary-progressive multiple sclerosis patients differ in decoding others' emotions by their eyes. Eur J Neurol 2021; 29:505-514. [PMID: 34687120 DOI: 10.1111/ene.15155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/17/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Difficulties in emotion processing and social cognition identified in multiple sclerosis (MS) patients have a potential impact on their adaptation to the social environment. We aimed to explore the neural correlates of emotion recognition in MS and possible differences between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) patients by the Reading the Mind in the Eyes test (RMEt). METHODS A total of 43 MS patients (27 RRMS, 16 SPMS) and 25 matched healthy controls (HC) underwent clinical assessments, RMEt, and a high-resolution T1-weighted 3-T magnetic resonance imaging (MRI) scan. The number of correct answers on the RMEt was compared between groups. T1-weighted volumes were processed according to an optimized voxel-based morphometry (VBM) protocol to obtain gray matter (GM) maps. Voxelwise analyses were run to assess potential associations between RMEt performance and regional GM volumes. RESULTS Taken altogether, MS patients reported significantly lower performance on the RMEt compared to HC. When dividing the patients into those with RRMS and those with SPMS, only the latter group was found to perform significantly worse than HC on the RMEt. VBM analysis revealed significant association between RMEt scores and GM volumes in several cortical (temporoparieto-occipital cortex) and subcortical (hippocampus, parahippocampus, and basal ganglia) brain regions, and in the cerebellum in SPMS patients only. CONCLUSIONS Results suggest that, in addition to other clinical differences between RRMS and SPMS, the ability to recognize others' emotional states may be affected in SPMS more significantly than RRMS patients. This is supported by both behavioral and MRI data.
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Affiliation(s)
- Ornella Argento
- Neurology and Neurorehabilitation Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Barbara Spanò
- Neuroimaging Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Laura Serra
- Neuroimaging Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Chiara Concetta Incerti
- Neurology and Neurorehabilitation Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Marco Bozzali
- Rita Levi Montalcini Department of Neuroscience,, University of Turin, Turin, Italy.,Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Carlo Caltagirone
- Scientific Direction, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Ada Francia
- Department of Neurological Sciences, Sapienza University of Rome, Rome, Italy
| | - Mariangela Fratino
- Department of Neurological Sciences, Sapienza University of Rome, Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy.,Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Chiara Piacentini
- Neurology and Neurorehabilitation Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | | | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
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12
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Argento O, Piacentini C, Santamato A, Caltagirone C, Saraceni V, Nocentini U. Comparison of the effectiveness of motor and cognitive rehabilitation alone compared to the combination of the two in patients with multiple sclerosis. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118566] [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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13
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Giordano A, Testa S, Bassi M, Cilia S, Bertolotto A, Quartuccio ME, Pietrolongo E, Falautano M, Grobberio M, Niccolai C, Allegri B, Viterbo RG, Confalonieri P, Giovannetti AM, Cocco E, Grasso MG, Lugaresi A, Ferriani E, Nocentini U, Zaffaroni M, De Livera A, Jelinek G, Solari A, Rosato R. Viability of a MSQOL-54 general health-related quality of life score using bifactor model. Health Qual Life Outcomes 2021; 19:224. [PMID: 34563229 PMCID: PMC8467164 DOI: 10.1186/s12955-021-01857-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/07/2021] [Indexed: 11/12/2022] Open
Abstract
Background MSQOL-54 is a multidimensional, widely-used, health-related quality of life (HRQOL) instrument specific for multiple sclerosis (MS). Findings from the validation study suggested that the two MSQOL-54 composite scores are correlated. Given this correlation, it could be assumed that a unique total score of HRQOL may be calculated, with the advantage to provide key stakeholders with a single overall HRQOL score. We aimed to assess how well the bifactor model could account for the MSQOL-54 structure, in order to verify whether a total HRQOL score can be calculated. Methods A large international database (3669 MS patients) was used. By means of confirmatory factor analysis, we estimated a bifactor model in which every item loads onto both a general factor and a group factor. Fit of the bifactor model was compared to that of single and two second-order factor models by means of Akaike information and Bayesian information criteria reduction. Reliability of the total and subscale scores was evaluated with Mc Donald’s coefficients (omega, and omega hierarchical). Results The bifactor model outperformed the two second-order factor models in all the statistics. All items loaded satisfactorily (≥ 0.40) on the general HRQOL factor, except the sexual function items. Omega coefficients for total score were very satisfactory (0.98 and 0.87). Omega hierarchical for subscales ranged between 0.22 to 0.57, except for the sexual function (0.70). Conclusions The bifactor model is particularly useful when it is intended to acknowledge multidimensionality and at the same time take account of a single general construct, as the HRQOL related to MS. The total raw score can be used as an estimate of the general HRQOL latent score. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01857-y.
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Affiliation(s)
- Andrea Giordano
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | - Silvia Testa
- Department of Human and Social Sciences, University of Aosta Valley, Aosta, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy
| | - Sabina Cilia
- Distretto Sanitario di Catania, ASP di Catania, Catania, Italy
| | - Antonio Bertolotto
- Neurology Unit & Regional Referral Multiple Sclerosis Centre (CReSM), University Hospital San Luigi Gonzaga, Orbassano, Italy
| | | | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Monica Falautano
- Servizio di Psicologia e Neuropsicologia, UO di Neurologia e Riabilitazione Specialistica Neurologica, San Raffaele Hospital, Milan, Italy
| | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, Psychology Unit, ASST Lariana, Como, Italy
| | | | - Beatrice Allegri
- Multiple Sclerosis Center, Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Paolo Confalonieri
- Multiple Sclerosis Center, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ambra Mara Giovannetti
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy.,Multiple Sclerosis Center, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleonora Cocco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.,Multiple Sclerosis Center, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | | | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Elisa Ferriani
- UOC Psicologia Ospedaliera, AUSL di Bologna, Bologna, Italy
| | - Ugo Nocentini
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.,Neurorehabilitation Unit 3, IRCCS S. Lucia Foundation, Rome, Italy
| | - Mauro Zaffaroni
- Multiple Sclerosis Centre, ASST Valle Olona, Gallarate, Italy
| | - Alysha De Livera
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - George Jelinek
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy. .,Unit of Clinical Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Turin, Italy.
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14
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Argento O, Spanò B, Pisani V, Incerti CC, Bozzali M, Foti C, Caltagirone C, Nocentini U. Dual-Task Performance in Multiple Sclerosis' Patients: Cerebellum Matters? Arch Clin Neuropsychol 2021; 36:517-526. [PMID: 33067615 DOI: 10.1093/arclin/acaa089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Gait, cognitive impairments, and their mutual influence in dual tasking (cognitive-motor dual tasking, CM-DT) are important to address therapeutic approaches in patients with multiple sclerosis (PMS). CM-DT correlates have been widely investigated with variable and dissimilar results, due to differences in methods. However, although the cerebellum has recently shown to be involved in both motor and cognitive functions, few studies have explored its role in the integration of the concurrent execution of gait and cognition. This case-control study aims to explore the effects of adding a cognitive task to walking in PMS and to investigate the role of the cerebellum in the interfering process. METHODS In total, 20 patients and 18 healthy controls (HC) underwent clinical assessments, dual task (DT), and 3 T magnetic resonance imaging (MRI). DT was composed by three 2-min trials requiring fast walking. In 2 of them 2 different cognitive tasks were added. RESULTS Both groups evidenced the presence of cognitive-motor interference (CMI) for both cognitive conditions with a greater effect of word list generation task in PMS. Analysis of variance between HC and patients with high or low performances showed a significantly increased volume in Vermis lobules VIIIa and IX of high performers compared with HC. CONCLUSION Our results show that CMI is also present in healthy individuals but is significantly more disabling in PMS. Furthermore, MRI data point to the existence of an initial mechanism of cerebellar reorganization in PMS with lower interference. Subsequently, the failure of this mechanism due to the progression of disability leads to a more evident expression of symptoms.
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Affiliation(s)
- Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Barbara Spanò
- Neuroimaging Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Chiara C Incerti
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Marco Bozzali
- Neuroimaging Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.,Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Calogero Foti
- Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Caltagirone
- Clinical and Behavioural Neurology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.,Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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15
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Nocentini U. Can we offer more for cognitive impairment in patients with chronic hepatitis C? Arq Neuropsiquiatr 2020; 78:319-320. [PMID: 32609192 DOI: 10.1590/0004-282x20200055] [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] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Ugo Nocentini
- Università di Roma "Tor Vergata", Dipartimento di Scienze Cliniche e Medicina Traslazionale, Roma, Italia.,Fondazione "Santa Lucia" Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italia
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16
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Salvia A, Morone G, Iosa M, Balice MP, Paolucci S, Grasso MG, Traballesi M, Nocentini U, Formisano R, Molinari M, Rossini A, Caltagirone C. An Italian Neurorehabilitation Hospital Facing the SARS-CoV-2 Pandemic: Data From 1207 Patients and Workers. Front Neurol 2020; 11:584317. [PMID: 33162930 PMCID: PMC7581710 DOI: 10.3389/fneur.2020.584317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/07/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of the present observational study is to report on the data from a large sample of inpatients, clinical staff and other workers at an Italian neurorehabilitation hospital dealing with SARS-CoV-2 infections, in order to analyze how it might have affected the management and the effectiveness of neurorehabilitation. Methods: The data on infection monitoring, obtained by 2,192 swabs, were reported and compared among 253 patients, 722 clinical professionals and 232 other hospital workers. The number of admissions and neurorehabilitation sessions performed in the period from March-May 2020 was compared with those of the same period in 2019. Results: Four patients and three clinical professionals were positive for COVID-19 infection. Six out of these seven people were from the same ward. Several measures were taken to handle the infection, putting in place many restrictions, with a significant reduction in new admissions to the hospital (p < 0.001). However, neither the amount of neurorehabilitation for inpatients (p = 0.681) nor the effectiveness of treatments (p = 0.464) were reduced when compared to the data from 2019. Conclusions: Our data show that the number of infections was contained in our hospital, probably thanks to the protocols adopted for reducing contagion and the environmental features of our wards. This allowed inpatients to continue to safely spend more than 3 hours per day in neurorehabilitation, effectively improving their independence in the activities of daily living.
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Affiliation(s)
| | | | - Marco Iosa
- Fondazione Santa Lucia, IRCCS, Rome, Italy
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17
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Giordano A, Testa S, Bassi M, Cilia S, Bertolotto A, Quartuccio ME, Pietrolongo E, Falautano M, Grobberio M, Niccolai C, Allegri B, Viterbo RG, Confalonieri P, Giovannetti AM, Cocco E, Grasso MG, Lugaresi A, Ferriani E, Nocentini U, Zaffaroni M, De Livera A, Jelinek G, Solari A, Rosato R. Assessing measurement invariance of MSQOL-54 across Italian and English versions. Qual Life Res 2019; 29:783-791. [PMID: 31707695 DOI: 10.1007/s11136-019-02352-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The Multiple Sclerosis Quality of Life-54 (MSQOL-54) is a specific multiple sclerosis (MS) health-related quality of life inventory consisting of 52 items organized into 12 subscales plus two single items. No study was found in literature assessing its measurement invariance across language versions. We investigated whether MSQOL-54 items provide unbiased measurements of underlying constructs across Italian and English versions. METHODS Three constrained levels of measurement invariance were evaluated: configural invariance where equivalent numbers of factors/factor patterns were required; metric invariance where equivalent factor loadings were required; and scalar invariance where equivalent item intercepts between groups were required. Comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR) fit indices and their changes between nested models were used to assess tenability of invariance constraints. RESULTS Overall, the dataset included 3669 MS patients: 1605 (44%) Italian, mean age 41 years, 62% women, 69% with mild level of disability; 2064 (56%) English-speaking (840 [41%] from North America, 797 [39%] from Australasia, 427 [20%] from UK and Ireland), mean age 46 years, 83% women, 54% with mild level of disability. The configural invariance model showed acceptable fit (RMSEA = 0.052, CFI = 0.904, SRMR = 0.046); imposing loadings and intercepts equality constraints produced negligible worsening of fit (ΔRMSEA < 0.001, ΔCFI = - 0.002, ΔSRMR = 0.002 for metric invariance; ΔRMSEA = 0.003, ΔCFI = - 0.013, ΔSRMR = 0.003 for scalar invariance). CONCLUSIONS These findings support measurement invariance of the MSQOL-54 across the two language versions, suggesting that the questionnaire has the same meaning and the same measurement paramaters in the Italian and English versions.
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Affiliation(s)
- Andrea Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Silvia Testa
- Department of Psychology, University of Turin, Turin, Italy
- Department of Human and Social Sciences, University of Aosta Valley , Aosta, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy
| | - Sabina Cilia
- Multiple Sclerosis Center, University Polyclinic Hospital G. Rodolico, Catania, Italy
| | - Antonio Bertolotto
- Neurology & Regional Referral Multiple Sclerosis Centre (CReSM), University Hospital San Luigi Gonzaga, Orbassano, Italy
| | | | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti, Italy
| | - Monica Falautano
- Servizio di Psicologia e Neuropsicologia, UO di Neurologia e Riabilitazione Specialistica, San Raffaele Hospital, Milan, Italy
| | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, Psychology Unit, ASST Lariana, Como, Italy
| | - Claudia Niccolai
- IRCCS Fondazione Carlo Gnocchi, Florence, Italy
- Department of NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy
| | - Beatrice Allegri
- Multiple Sclerosis Center, Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Paolo Confalonieri
- Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ambra Mara Giovannetti
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
- Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleonora Cocco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Multiple Sclerosis Center, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | | | - Alessandra Lugaresi
- UOSI Riabilitazione Sclerosi Multipla, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Elisa Ferriani
- UOC Psicologia Ospedaliera, AUSL di Bologna, Bologna, Italy
| | - Ugo Nocentini
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Neurology and Neurorehabilitation Unit, IRCCS S. Lucia Foundation, Rome, Italy
| | - Mauro Zaffaroni
- Multiple Sclerosis Centre, ASST Valle Olona, Gallarate, Italy
| | - Alysha De Livera
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - George Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy
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Incerti CC, Argento O, Magistrale G, Di Battista G, Ferraro E, Caltagirone C, Pisani V, Nocentini U. Can personality traits influence occupational stress in multiple sclerosis patients? A one-year longitudinal study. Applied Neuropsychology: Adult 2019; 27:390-392. [DOI: 10.1080/23279095.2018.1553045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Giuseppe Magistrale
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | | | | | - Carlo Caltagirone
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
- Department of Neuroscience, University of Rome “Tor Vergata,” Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
- Department of Neuroscience, University of Rome “Tor Vergata,” Rome, Italy
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19
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Spanò B, Giulietti G, Pisani V, Morreale M, Tuzzi E, Nocentini U, Francia A, Caltagirone C, Bozzali M, Cercignani M. Disruption of neurite morphology parallels MS progression. Neurol Neuroimmunol Neuroinflamm 2018; 5:e502. [PMID: 30345330 PMCID: PMC6192688 DOI: 10.1212/nxi.0000000000000502] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/07/2018] [Indexed: 12/31/2022]
Abstract
Objectives To apply advanced diffusion MRI methods to the study of normal-appearing brain tissue in MS and examine their correlation with measures of clinical disability. Methods A multi-compartment model of diffusion MRI called neurite orientation dispersion and density imaging (NODDI) was used to study 20 patients with relapsing-remitting MS (RRMS), 15 with secondary progressive MS (SPMS), and 20 healthy controls. Maps of NODDI were analyzed voxel-wise to assess the presence of abnormalities within the normal-appearing brain tissue and the association with disease severity. Standard diffusion tensor imaging (DTI) parameters were also computed for comparing the 2 techniques. Results Patients with MS showed reduced neurite density index (NDI) and increased orientation dispersion index (ODI) compared with controls in several brain areas (p < 0.05), with patients with SPMS having more widespread abnormalities. DTI indices were also sensitive to some changes. In addition, patients with SPMS showed reduced ODI in the thalamus and caudate nucleus. These abnormalities were associated with scores of disease severity (p < 0.05). The association with the MS functional composite score was higher in patients with SPMS compared with patients with RRMS. Conclusions NODDI and DTI findings are largely overlapping. Nevertheless, NODDI helps interpret previous findings of increased anisotropy in the thalamus of patients with MS and are consistent with the degeneration of selective axon populations.
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Affiliation(s)
- Barbara Spanò
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Giovanni Giulietti
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Valerio Pisani
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Manuela Morreale
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Elisa Tuzzi
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Ugo Nocentini
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Ada Francia
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Carlo Caltagirone
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Marco Bozzali
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
| | - Mara Cercignani
- Neuroimaging Laboratory (B.S., G.G., M.B., M.C.), Santa Lucia Foundation, IRCCS; Department of Clinical and Behavioural Neurology (V.P., U.N., C.C.), Santa Lucia Foundation, IRCCS; Neurovascular Diagnosis Unit (M.M.), Department of Medical and Surgical Sciences and Biotechnology, Section of Neurology, Sapienza, University of Rome; Department of Neurology and Psychiatry (M.M., A.F.), Multiple Sclerosis Center, Sapienza, University of Rome, Italy; High Field Magnetic Resonance (E.T.), Max Planck Institute for Biological Cybernetics, Tuebingen, Germany; Department of System Medicine (U.N., C.C.), University of Rome "Tor Vergata," Italy; and Department of Neuroscience (M.B., M.C.), Brighton & Sussex Medical School, Falmer, United Kingdom
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Argento O, Incerti CC, Quartuccio ME, Magistrale G, Francia A, Caltagirone C, Pisani V, Nocentini U. The Italian validation of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) and the application of the Cognitive Impairment Index scoring procedure in MS patients. Neurol Sci 2018; 39:1237-1244. [DOI: 10.1007/s10072-018-3417-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/20/2018] [Indexed: 11/29/2022]
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21
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Argento O, Incerti CC, Pisani V, Magistrale G, Caltagirone C, Nocentini U. [Domestic accidents in patients with multiple sclerosis: proposal and application of questionnaires for their detection]. G Ital Med Lav Ergon 2017; 38:265-268. [PMID: 29916608] [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] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Domestic accidents are an important topic as for different viewpoints: for the people that could be victim of them, for the health and economic systems. It could be imagined that people affected by neurological diseases, such as Multiple Sclerosis (MS), could incur into domestic accidents more frequently than people in the general population. Aim of the present work is to introduce a survey's questionnaire for registering occurrence and characteristics of domestic accidents in a population with particular features such as MS patients. METHODS In 2011, a first edition of this survey questionnaire was already proposed and then applied with a sample of MS patients (QuID). RESULTS A subsequent newest version of the test (QuID-II) has then been proposed, based on the information collected and on the limits showed by that first edition. CONCLUSIONS With this new version deepen information can be collected on the characteristics, the biological, environmental and behavioural risk factors for the occurrence of domestic accidents, and this could be useful in planning prevention programs.
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Affiliation(s)
| | | | | | | | - Carlo Caltagirone
- IRCCS "Fondazione Santa Lucia", Roma
- Università degli Studi di Roma "Tor Vergata", Roma
| | - Ugo Nocentini
- IRCCS "Fondazione Santa Lucia", Roma
- Università degli Studi di Roma "Tor Vergata", Roma
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Incerti CC, Argento O, Magistrale G, Ferraro E, Caltagirone C, Pisani V, Nocentini U. Adverse working events in patients with multiple sclerosis. Neurol Sci 2016; 38:349-352. [PMID: 27761841 DOI: 10.1007/s10072-016-2737-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
Multiple sclerosis (MS) and working status have recently arisen great interest. Fatigue, physical disability, cognition, and psychological disturbances have been linked to unemployment, as well to accidents during daily activities. The aim of our study was to determine frequency of different types of accidents at workplace (AWE) and possible clinical differences among employed (MSe) and unemployed (MSu) MS patients. Sixty MS patients (31 employed, 29 unemployed) and twenty healthy control subjects were recruited. All employed participants were requested to complete an ad-hoc questionnaire to collect AWE and related risks occurring at workplace in the past 2 months. Physical, cognitive, mood, and fatigue evaluations were also assessed. Illness and bumps along with risk of bumps and near falls resulted the most frequent AWE and risks occurring in MSe. Interestingly, those AWE were mostly observed among subjects with anxiety, depression, and cognitive fatigue rather than depending on severity of physical impairment. Moreover, psychological aspects, like anxiety and anger, seemed to play a crucial role in determining AWE. This study provides data on AWE occurrence and suggests possible mechanisms underlying negative events at workplace in MS. This might be important for planning strategies of AWE prevention in MS patients.
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Affiliation(s)
- Chiara Concetta Incerti
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy.
| | - Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy
| | - Giuseppe Magistrale
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy
| | | | - Carlo Caltagirone
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy.,Department of Neuroscience, University of Rome "Tor Vergata", Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, Rome, Italy.,Department of Neuroscience, University of Rome "Tor Vergata", Rome, Italy
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Incerti CC, Argento O, Pisani V, Magistrale G, Sabatello U, Caltagirone C, Nocentini U. A more in-depth interpretation of MMPI-2 in MS patients by using Harris and Lingoes subscales. Appl Neuropsychol Adult 2016; 24:439-445. [PMID: 27355486 DOI: 10.1080/23279095.2016.1197128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Multiple Sclerosis (MS) is frequently associated with neuropsychiatric abnormalities. The aim of our study was to discriminate between psychosomatic disturbances and MS physically-related symptoms using the Harris-Lingoes subscales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Forty-six MS out-patients (35 females; mean age = 44.5); and 82 healthy volunteers (62 females; mean age = 46.5) were evaluated with MMPI-2 questionnaire. The frequency distribution of MMPI-2 clinical scales with high scores (> = 65) and the related Harris-Lingoes subscales were analyzed for both MS patients and healthy control subjects. Data analysis showed elevated scores in 47.8% of the patients mainly on MMPI-2 clinical scales 1, 2, and 3. The Harris-Lingoes subscales analysis allowed us to isolate and identify physical symptoms contributing to elevation of MMPI-2 clinical scales, reduce the occurrence of false positives (MMPI-2 clinical scales elevations mainly due to MS physical disability) and provide a more detailed description of psycho-emotional symptoms of MS patients. In conclusion, our study shows the utility of Harris-Lingoes subscales analysis when MMPI-2 is used for psychological assessment of MS patients.
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Affiliation(s)
- Chiara C Incerti
- a Neurology and Neurorehabilitation Unit , I.R.C.C.S. "Santa Lucia" Foundation , Rome , Italy
| | - Ornella Argento
- a Neurology and Neurorehabilitation Unit , I.R.C.C.S. "Santa Lucia" Foundation , Rome , Italy
| | - Valerio Pisani
- a Neurology and Neurorehabilitation Unit , I.R.C.C.S. "Santa Lucia" Foundation , Rome , Italy
| | - Giuseppe Magistrale
- a Neurology and Neurorehabilitation Unit , I.R.C.C.S. "Santa Lucia" Foundation , Rome , Italy
| | - Ugo Sabatello
- b Department of Developmental Neurology and Psychiatry , University of Rome "La Sapienza" , Rome , Italy
| | - Carlo Caltagirone
- c Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Ugo Nocentini
- c Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
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Argento O, Smerbeck A, Pisani V, Magistrale G, Incerti CC, Caltagirone C, Benedict RHB, Nocentini U. Regression-Based Norms for the Brief Visuospatial Memory Test-Revised in Italian population and application in MS patients. Clin Neuropsychol 2016; 30:1469-1478. [DOI: 10.1080/13854046.2016.1183713] [Citation(s) in RCA: 8] [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] [Indexed: 10/21/2022]
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Niccolai C, Portaccio E, Goretti B, Hakiki B, Giannini M, Pastò L, Righini I, Falautano M, Minacapelli E, Martinelli V, Incerti C, Nocentini U, Fenu G, Cocco E, Marrosu MG, Garofalo E, Ambra FI, Maddestra M, Consalvo M, Viterbo RG, Trojano M, Losignore NA, Zimatore GB, Pietrolongo E, Lugaresi A, Pippolo L, Roscio M, Ghezzi A, Castellano D, Stecchi S, Amato MP. A comparison of the brief international cognitive assessment for multiple sclerosis and the brief repeatable battery in multiple sclerosis patients. BMC Neurol 2015; 15:204. [PMID: 26472052 PMCID: PMC4608308 DOI: 10.1186/s12883-015-0460-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 03/18/2015] [Accepted: 10/06/2015] [Indexed: 11/25/2022] Open
Abstract
Background Recently, a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been developed as an international and standardized brief cognitive test, which is easily performed in everyday clinical practice for neuropsychological assessment in multiple sclerosis (MS). However, we need to gather more information about this tool compared to other neuropsychological batteries. The aim of our study is to compare the performance of BICAMS and Brief Repeatable Battery (BRB) in MS subjects. Methods Tests of the BRB and BICAMS were administered to MS patients recruited from 11 Italian MS centres. Cognitive impairment (CI) was defined as the failure on at least two tests (scores below the fifth percentile) on the BRB and as the failure on at least one test of the BICAMS. The agreement between the performances on the two batteries was assessed through Cohen’s K statistic. Finally we calculated the effects sizes for each test of the two batteries using Cohen’s d. Results The two batteries were administered to 192 MS patients (142 women, 50 men; mean age 41.4 ± 10.8 years, mean education 12.3 ± 3.5 years). Mean scores of patients were lower compared to those of healthy subjects in all the cognitive measures examined. Forty-six MS patients were identified as impaired and 48 as unimpaired on both of the batteries, when the Symbol Digit Modalities Test (SDMT) was included in the analysis. Cohen’s K statistic was 0.46 which corresponds to a moderate accord. If the SDMT was excluded from the BRB, 37 MS patients were identified as impaired and 57 as unimpaired on both of the batteries. Cohen’s K statistic was 0.3 which corresponds to a poor accord. The SDMT, the Paced Auditory Serial Addition Test (PASAT) 3 and 2 yielded higher d values (SDMT 0.83, PASAT 3 0.65, PASAT 2 0.84). Conclusions This study confirms the feasibility of BICAMS in everyday clinical practice for the identification of CI and highlights the good psychometric properties of the SDMT.
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Affiliation(s)
- Claudia Niccolai
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
| | - Emilio Portaccio
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy. .,Don Gnocchi Foundation, Florence, Italy.
| | - Benedetta Goretti
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
| | - Bahia Hakiki
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy. .,Don Gnocchi Foundation, Florence, Italy.
| | - Marta Giannini
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
| | - Luisa Pastò
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
| | - Isabella Righini
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
| | | | | | | | - Chiara Incerti
- University of Rome "Tor Vergata" c/o I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.
| | - Ugo Nocentini
- University of Rome "Tor Vergata" c/o I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | - Erika Pietrolongo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
| | - Alessandra Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
| | | | - Marco Roscio
- MS Centre, Hospital of Gallarate, Gallarate, Italy.
| | | | | | - Sergio Stecchi
- IRCCS Institute of Neurological Sciences, Bologna, Italy.
| | - Maria Pia Amato
- Department of NEUROFARBA, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
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Macchi B, Marino-Merlo F, Nocentini U, Pisani V, Cuzzocrea S, Grelli S, Mastino A. Role of inflammation and apoptosis in multiple sclerosis: Comparative analysis between the periphery and the central nervous system. J Neuroimmunol 2015; 287:80-7. [PMID: 26439966 DOI: 10.1016/j.jneuroim.2015.08.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 06/12/2015] [Revised: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 01/23/2023]
Abstract
Multiple sclerosis (MS) is a complex, multifactorial disease associated with damage to the axonal myelin sheaths and neuronal degeneration. The pathognomonic event in MS is oligodendrocyte loss accompanied by axonal damage, blood-brain barrier leakage, inflammation and infiltration of immune cells. The etiopathogenesis of MS is far from being elucidated. However, increasing evidence suggests that the inflammatory and apoptotic responses, occurring in patients either at the peripheral level or the central nervous system (CNS), can play a role. In this review, we give a comprehensive picture of general aspects of inflammation and apoptosis in MS, with special emphasis on the until now not well highlighted possible links between phenomena relevant to these aspects occurring in either the periphery or in the CNS during MS.
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Affiliation(s)
- Beatrice Macchi
- Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Francesca Marino-Merlo
- Department of Biological and Environmental Sciences, University of Messina, Via F. Stagno d'Alcontres 31, 98166 Messina, Italy.
| | - Ugo Nocentini
- Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy; I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, 00179 Rome, Italy.
| | - Valerio Pisani
- I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina 306, 00179 Rome, Italy.
| | - Salvatore Cuzzocrea
- Department of Biological and Environmental Sciences, University of Messina, Via F. Stagno d'Alcontres 31, 98166 Messina, Italy.
| | - Sandro Grelli
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Antonio Mastino
- Department of Biological and Environmental Sciences, University of Messina, Via F. Stagno d'Alcontres 31, 98166 Messina, Italy; The Institute of Translational Pharmacology, CNR, Via Fosso del Cavaliere 100, 00133 Rome, Italy.
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Magistrale G, Medori R, Cadavid D, Argento O, Incerti C, Pisani V, Caltagirone C, Bozzali M, DeLuca J, Nocentini U. Assessing clinical correlates of self-rated disability in patients with multiple sclerosis. Mult Scler J Exp Transl Clin 2015; 1:2055217315592425. [PMID: 28607696 PMCID: PMC5433396 DOI: 10.1177/2055217315592425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/27/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is associated with significant impairment. OBJECTIVE The objective of this article is to identify and compare clinical measures that can predict self-rated disability in patients with MS using the World Health Organization Disability Assessment Schedule II (WHODAS-II). METHODS Patients with MS and healthy controls were consecutively recruited at one center. Patients were evaluated for cognitive function assessment, neurological status, perceived disability, mood, fatigue and disease duration. Controls underwent neuropsychological evaluation only. Data were analyzed using multivariate regression. RESULTS WHODAS-II total score was predicted by fatigue (p < 0.001) and neurological status (p < 0.05). Student's t test comparisons between published WHODAS-II normative data and the enrolled cohort of patients with MS showed significantly worse (p < 0.05) scores for patients on mobility, self-care, life activities, participation and total score domains, but not in cognition. Group differences between patients with MS (n = 61) and controls (n = 61) were significant in all cognitive measures except one verbal memory test subscale. Memory function correlated best with the social participation domain of the WHODAS-II. CONCLUSIONS Self-reported disability in patients with MS was most strongly influenced by fatigue and to a lesser extent by physical disability. Although cognitive function does affect self-assessment of disability, this is not captured by patients on the WHODAS-II cognitive domain.
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Affiliation(s)
| | | | | | - Ornella Argento
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
| | - Chiara Incerti
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
| | - Valerio Pisani
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
| | - Carlo Caltagirone
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
| | - Marco Bozzali
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
| | - John DeLuca
- Kessler Foundation, West Orange, NJ, USA; New Jersey Medical School, Rutgers University, USA
| | - Ugo Nocentini
- Neurology and NeuroRehabilitation Unit, IRCCS Santa Lucia Foundation, Italy
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Concetta Incerti C, Magistrale G, Argento O, Pisani V, Di Battista G, Ferraro E, Caltagirone C, Benedict RHB, Nocentini U. Occupational stress and personality traits in multiple sclerosis: A preliminary study. Mult Scler Relat Disord 2015. [DOI: 10.1016/j.msard.2015.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Incerti CC, Argento O, Pisani V, Mannu R, Magistrale G, Battista GD, Caltagirone C, Nocentini U. A Preliminary Investigation of Abnormal Personality Traits in MS Using the MCMI-III. Applied Neuropsychology: Adult 2015; 22:452-8. [DOI: 10.1080/23279095.2014.979489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Chiara C. Incerti
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Rosalba Mannu
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Giuseppe Magistrale
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | | | - Carlo Caltagirone
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, and Department of Systems Medicine, University of Rome “Tor Vergata,” Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. “Santa Lucia” Foundation, and Department of Systems Medicine, University of Rome “Tor Vergata,” Rome, Italy
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Argento O, Pisani V, Incerti CC, Magistrale G, Caltagirone C, Nocentini U. The California Verbal Learning Test- II: Normative Data for Two Italian Alternative Forms. Clin Neuropsychol 2014; 28 Suppl 1:S42-54. [DOI: 10.1080/13854046.2014.978381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ornella Argento
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
| | - Chiara C. Incerti
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
| | - Giuseppe Magistrale
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
| | - Carlo Caltagirone
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata” , Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, IRCCS “Santa Lucia” Foundation , Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata” , Rome, Italy
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Magistrale G, Pisani V, Argento O, Incerti CC, Bozzali M, Cadavid D, Caltagirone C, Medori R, DeLuca J, Nocentini U. Validation of the World Health Organization Disability Assessment Schedule II (WHODAS-II) in patients with multiple sclerosis. Mult Scler 2014; 21:448-56. [DOI: 10.1177/1352458514543732] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The World Health Organization Disability Assessment Schedule (WHODAS-II) is a widely used generic assessment instrument for health and disability. However, a specific psychometric evaluation for this scale in multiple sclerosis (MS) is lacking. This study is aimed at the assessment of the psychometric properties of the WHODAS-II in MS with Cronbach’s α and modern Rasch-model analyses. Methods: The WHODAS-II was administered to 136 consecutively recruited MS patients. Several indexes of fit to the Rasch model were evaluated in order to assess internal construct validity. Internal consistency was assessed with Cronbach’s α and the Person Separation Index (PSI). External validity was evaluated by analyzing correlations between the WHODAS-II and the Multiple Sclerosis Quality of Life-54 (MSQoL-54). Results: Classical reliability indexes (Cronbach’s α and intraclass correlation) showed good to excellent reliability for most of the subscales and for the total scale (α = 0.93). The total scale both with (36 items) or without (32 items) work items reached good fit to the Rasch model (PSI = 0.83). However, analysis of the subscales could resolve only four subscales out of seven. Conclusions: The WHODAS-II is a reliable and valid instrument for the assessment of patient-reported disability in MS, with some limitations including some item redundancy and questionable reliability of some subscales.
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Affiliation(s)
| | - Valerio Pisani
- Neurology and NeuroRehabilitation Unit, Fondazione IRCCS Santa Lucia, Italy
| | - Ornella Argento
- Neurology and NeuroRehabilitation Unit, Fondazione IRCCS Santa Lucia, Italy
| | - Chiara C Incerti
- Neurology and NeuroRehabilitation Unit, Fondazione IRCCS Santa Lucia, Italy
| | - Marco Bozzali
- Neuroimaging Laboratory, Fondazione IRCCS Santa Lucia, Italy
| | - Diego Cadavid
- Neurology Clinical Development Group, Biogen Idec, USA
| | - Carlo Caltagirone
- Neurology and NeuroRehabilitation Unit, Fondazione IRCCS Santa Lucia, Italy/University of Rome “Tor Vergata”, Italy
| | | | - John DeLuca
- Kessler Foundation, USA/Rutgers, New Jersey Medical School, USA
| | - Ugo Nocentini
- Neurology and NeuroRehabilitation Unit, Fondazione IRCCS Santa Lucia, Italy/University of Rome “Tor Vergata”, Italy
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Argento O, Incerti CC, Pisani V, Magistrale G, Di Battista G, Romano S, Ferraro E, Caltagirone C, Nocentini U. Domestic accidents and multiple sclerosis: an exploratory study of occurrence and possible causes. Disabil Rehabil 2014; 36:2205-9. [PMID: 24588071 DOI: 10.3109/09638288.2014.895429] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Domestic accidents are widespread, but no data are available on their occurrence in pathological populations such as patients with multiple sclerosis (MS). Aim was to investigate domestic habits and occurrence of different types of domestic accidents and near falls in a sample of MS patients compared with healthy controls and to determine whether patients' domestic accidents are linked to any disease characteristics. METHOD Descriptive survey of 50 patients and 50 healthy controls. Participants were administered an ad-hoc questionnaire to collect data on domestic habits and accidents they had in the past 2 months. Their physical and neuropsychological functioning, mood and fatigue were also assessed. RESULTS Results showed that patients spend most of their time at home with caregivers. No differences emerged for total number of domestic accident types, but there were differences in bumps and near falls. The latter seem to be linked to patients' walking ability and to bowel/bladder functioning and the former to reasoning ability and fatigue. CONCLUSIONS This study provides the first data on the occurrence of domestic accidents and possible causes in MS patients. It encourages further studies on the topic, with the final goal of designing preventive and rehabilitation strategies.
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Affiliation(s)
- Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation , Rome , Italy
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Basile B, Castelli M, Monteleone F, Nocentini U, Caltagirone C, Centonze D, Cercignani M, Bozzali M. Functional connectivity changes within specific networks parallel the clinical evolution of multiple sclerosis. Mult Scler 2013; 20:1050-7. [DOI: 10.1177/1352458513515082] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 11/02/2013] [Indexed: 11/15/2022]
Abstract
Background: In multiple sclerosis (MS), the location of focal lesions does not always correlate with clinical symptoms, suggesting disconnection as a major pathophysiological mechanism. Resting-state (RS) functional magnetic resonance imaging (fMRI) is believed to reflect brain functional connectivity (FC) within specific neuronal networks. Objective: RS-fMRI was used to investigate changes in FC within two critical networks for the understanding of MS disabilities, namely, the sensory-motor network (SMN) and the default-mode network (DMN), respectively, implicated in sensory-motor and cognitive functions. Methods: Thirty-four relapsing–remitting (RR), 14 secondary progressive (SP) MS patients and 25 healthy controls underwent MRI at 3T, including conventional images, T1-weighted volumes, and RS-fMRI sequences. Independent component analysis (ICA) was employed to extract maps of the relevant RS networks for every participant. Group analyses were performed to assess changes in FC within the SMN and DMN in the two MS phenotypes. Results: Increased FC was found in both networks of MS patients. Interestingly, specific changes in either direction were observed also between RR and SP MS groups. Conclusions: FC changes seem to parallel patients’ clinical state and capability of compensating for the severity of clinical/cognitive disabilities.
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Affiliation(s)
- B Basile
- Neuroimaging Laboratory, Santa Lucia Foundation, Italy
- School of Cognitive Psychotherapy, Italy
| | - M Castelli
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Italy
| | - F Monteleone
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Italy
| | - U Nocentini
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Italy
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Italy
| | - C Caltagirone
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Italy
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Italy
| | - D Centonze
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Italy
| | - M Cercignani
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, UK
| | - M Bozzali
- Neuroimaging Laboratory, Santa Lucia Foundation, Italy
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Incerti C, Argento O, Magistral G, Caltagirone C, Nocentini U, Pisani V. A global survey on risk and occurrence of both domestic and work accidents in patients with multiple sclerosis. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1343] [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: 10/26/2022]
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Bozzali M, Spanò B, Parker GJM, Giulietti G, Castelli M, Basile B, Rossi S, Serra L, Magnani G, Nocentini U, Caltagirone C, Centonze D, Cercignani M. Anatomical brain connectivity can assess cognitive dysfunction in multiple sclerosis. Mult Scler 2013; 19:1161-8. [PMID: 23325589 DOI: 10.1177/1352458512474088] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Brain disconnection plays a major role in determining cognitive disabilities in multiple sclerosis (MS). We recently developed a novel diffusion-weighted magnetic resonance imaging (DW-MRI) tractography approach, namely anatomical connectivitity mapping (ACM), that quantifies structural brain connectivity. OBJECTIVE Use of ACM to assess structural connectivity modifications in MS brains and ascertain their relationship with the patients' Paced-Auditory-Serial-Addition-Test (PASAT) scores. METHODS Relapsing-remitting MS (RRMS) patients (n = 25) and controls (n = 25) underwent MRI at 3T, including conventional images, T1-weighted volumes and DW-MRI. Volumetric scans were coregistered to fractional anisotropy (FA) images, to obtain parenchymal FA maps for both white and grey matter. We initiated probabilistic tractography from all parenchymal voxels, obtaining ACM maps by counting the number of streamlines passing through each voxel, then normalizing by the total number of streamlines initiated. The ACM maps were transformed into standard space, for statistical use. RESULTS RRMS patients had reduced grey matter volume and FA, consistent with previous literature. Also, we showed reduced ACM in the thalamus and in the head of the caudate nucleus, bilaterally. In our RRMS patients, ACM was associated with PASAT scores in the corpus callosum, right hippocampus and cerebellum. CONCLUSIONS ACM opens a new perspective, clarifying the contribution of anatomical brain disconnection to clinical disabilities in MS.
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Affiliation(s)
- M Bozzali
- Santa Lucia Foundation, Rome, Italy.
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Abstract
Multiple sclerosis (MS) is a chronic and disabling disease that attacks the central nervous system (CNS). The symptoms, progression, and severity of the disease are unpredictable and vary from one person to another. Major symptoms include fatigue, sensory-motor (e.g., visual disturbance, spasticity, locomotion), cognitive (e.g., decreased information processing speed, impaired memory), and psychiatric problems (e.g., depression). Although the etiology is unknown, MS is thought to be an autoimmune disease triggered by a viral or other infectious agent in genetically susceptible individuals. The CNS target of the disease is myelin, although it is now known that other aspects of the CNS such as axonal and gray matter regions are also involved.
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Affiliation(s)
- John DeLuca
- Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA.
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Paolucci S, Bureca I, Multari M, Nocentini U, Matano A. An open-label pilot study of the use of rivastigmine to promote functional recovery in patients with unilateral spatial neglect due to first ischemic stroke. Funct Neurol 2010; 25:195-200. [PMID: 21388579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of this study was to evaluate the efficacy and safety of rivastigmine as add-on treatment to specific cognitive rehabilitation for unilateral spatial neglect (USN). Twenty patients were randomly assigned either to rehabilitation treatment only (No-RIV) or to rivastigmine (3 mg twice a day, for 8 weeks) add-on treatment (RIV+,). USN and functional status were evaluated by means of specific and validated instruments at baseline, at discharge and at one-month follow up. Compared with the untreated patients, the RIV+ subjects, at discharge, recorded significantly better discharge scores and higher effectiveness on two of the scales. However, subsequent further improvement of the No-RIV patients meant that at follow up there was no significant difference between the two groups. No other statistically significant difference was found. Rivastigmine as add-on treatment to specific cognitive training for USN may improve and accelerate recovery on some specific impairment tests as compared with cognitive training alone.
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Quattrocchi CC, Cherubini A, Luccichenti G, Grasso MG, Nocentini U, Beomonte Zobel B, Sabatini U. Infratentorial lesion volume correlates with sensory functional system in multiple sclerosis patients: a 3.0-Tesla MRI study. Radiol Med 2009; 115:115-24. [PMID: 20017006 DOI: 10.1007/s11547-009-0477-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Accepted: 11/05/2008] [Indexed: 12/20/2022]
Abstract
PURPOSE This study sought to correlate lesion volume in infratentorial areas using 3.0-T proton-density (PD)-weighted images with disability scales and appropriate functional system scores in patients with multiple sclerosis (MS). MATERIALS AND METHODS We examined 20 consecutive patients (13 women and 7 men) with a median age of 47 years (range 26-70). Neurological examination included the Expanded Disability Status Scale and its functional systems, the Barthel Index (BI) and the Rivermead Mobility Index (RMI). MRI scans were performed on a system operating at 3.0 T using a quadrature birdcage head coil. Acquired images imported as Digital Imaging and Communication in Medicine (DICOM) files, and the region of interest (ROI) files were converted to Neuroimaging Informatics Technology Initiative (NIfTI) format and normalised to the Montreal Neurological Institute (MNI) standard template. An automated segmentation algorithm was used to distinguish between supratentorial and infratentorial areas. Normalisation to the magnetisation-prepared rapid acquisition with gradient echo (MPRAGE) T1-weighted sequence allowed lesion volume estimation in the different anatomical areas. RESULTS A significant correlation was found between infratentorial lesion volume and the sensory functional system score (rho=0.76, p=0.002). No significant correlation was found between supratentorial lesion volume and Expanded Disability Status Scale (EDSS), RMI and BI scores. CONCLUSIONS The described method, by means of anatomical assignment of MS lesions, allows detection of significant correlation coefficients between clinical and MRI lesion burden in MS patients at the infratentorial level.
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Affiliation(s)
- C C Quattrocchi
- Department of Radiology, IRCCS Fondazione Santa Lucia, Rome, Italy.
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Spanò B, Cercignani M, Basile B, Romano S, Mannu R, Centonze D, Caltagirone C, Bramanti P, Nocentini U, Bozzali M. Multiparametric MR investigation of the motor pyramidal system in patients with 'truly benign' multiple sclerosis. Mult Scler 2009; 16:178-88. [PMID: 20007429 DOI: 10.1177/1352458509356010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 11/15/2022]
Abstract
One possible explanation for the mismatch between tissue damage and preservation of neurological functions in patients with benign multiple sclerosis (BMS) is that the pathophysiology differs from that occurring in other multiple sclerosis (MS) phenotypes. The objective of this study was to identify pathologically specific patterns of tissue integrity/damage characteristics of patients with BMS, and markers of potential prognostic value. The pyramidal system was investigated in 10 BMS patients and 20 controls using voxel-based morphometry to assess grey matter (GM) atrophy, and diffusion tractography and quantitative magnetization transfer to quantify the microstructural damage in the corticospinal tracts (CSTs). Widespread reductions in GM volume were found in patients compared with controls, including the primary motor cortex. A significant decrease was observed in the mean macromolecular pool ratio (F) of both CSTs, with no fractional anisotropy (FA) change. GM volume of the primary motor areas was associated with clinical scores but not with the CST parameters. The mismatch between F and FA suggests the presence of extensive demyelination in the CSTs of patients with BMS, in the absence of axonal damage. The lack of correlation with GM volume indicates a complex interaction between disruptive and reparative mechanisms in BMS.
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Affiliation(s)
- Barbara Spanò
- Neuroimaging Laboratory, Santa Lucia Foundation, IRCCS, Rome, Italy
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Maini M, Nocentini U, Prevedini A, Giardini A, Muscolo E. An Italian experience in the ICF implementation in rehabilitation: Preliminary theoretical and practical considerations. Disabil Rehabil 2009; 30:1146-52. [DOI: 10.1080/09638280701478397] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cercignani M, Basile B, Spanò B, Comanducci G, Fasano F, Caltagirone C, Nocentini U, Bozzali M. Investigation of quantitative magnetisation transfer parameters of lesions and normal appearing white matter in multiple sclerosis. NMR Biomed 2009; 22:646-53. [PMID: 19322806 DOI: 10.1002/nbm.1379] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The aim of this study was to use quantitative magnetisation transfer (MT) imaging to assess the different pathological substrates of tissue damage in multiple sclerosis (MS) and examine whether the MT parameters may be used to explain the disability in relapsing remitting (RR) MS. Thirteen patients with RRMS and 14 healthy controls were prescribed conventional MRI and quantitative MT imaging at 3.0 T. A two-pool model of MT (where A refers to the free pool and B to the macromolecular pool) was fitted to the data yielding a longitudinal relaxation rate R(A), a relative size F of macromolecular pool, transverse relaxation times T(2) (A) and T(2) (B) for the two pools and a forward exchange rate RM(0) (B). The MT ratio (MTR) was also computed. The mean MT parameters of the normal appearing white matter (NAWM) and of lesions in patients, and of white matter in controls were estimated. MT parameters were significantly different between lesions and NAWM in patients, and between the NAWM and the white matter of controls (with the exception of T(2) (B) and the MTR). Two models were investigated using ordered logistic regression, with the expanded disability status scale (EDSS) as the dependent variable. In the first one, mean NAWM MT parameters and lesion load were entered as explanatory variables; in the second one, mean MT variables within lesions and lesion load were entered as explanatory variables. Unexpectedly, T(2) (B) was the parameter most significantly associated with EDSS in NAWM. This parameter might represent a weighted average of the relaxation times of spins with different molecular environments, and therefore its variation could indicate a change in the balance between subpopulations of macromolecular spins. Conversely, in lesions, RM(0) (B), T(2) (B), F, R(A), and lesion load significantly predicted disability only when combined together. This might reflect the complex interaction between demyelination, remyelination, gliosis, inflammation and axonal loss taking place within lesions.
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Affiliation(s)
- M Cercignani
- Neuroimaging Laboratory, Fondazione Santa Lucia, Via Ardeatina 306, Rome, Italy.
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Nocentini U, Tedeschi G, Migliaccio R, Dinacci D, Lavorgna L, Bonavita S, Bresciamorra V, Comanducci G, Coniglio G, Livrea P, Mannu R, Orefice G, Paciello M, Patti F, Quattrone A, Salemi G, Savettieri G, Simone I, Valentino P, Zappia M, Bonavita V, Musicco M, Caltagirone C. An exploration of anger phenomenology in multiple sclerosis. Eur J Neurol 2009; 16:1312-7. [DOI: 10.1111/j.1468-1331.2009.02727.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [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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Nocentini U, Pasqualetti P, Bonavita S, Buccafusca M, De Caro MF, Farina D, Girlanda P, Le Pira F, Lugaresi A, Quattrone A, Reggio A, Salemi G, Savettieri G, Tedeschi G, Trojano M, Valentino P, Caltagirone C. Cognitive dysfunction in patients with relapsing-remitting multiple sclerosis. Mult Scler 2006; 12:77-87. [PMID: 16459723 DOI: 10.1191/135248506ms1227oa] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cognitive dysfunction is considered one of the clinical markers of multiple sclerosis (MS). However, in the literature there are inconsistent reports on the prevalence of cognitive dysfunction, and separate data for the relapsing-remitting (RR) type of the disease are not always presented. In this study, we submitted 461 RRMS patients to a battery of neuropsychological tests to investigate their impairment in various cognitive domains. As a consequence of the exclusion criteria, the sample is not fully representative of the entire population of RRMS patients. In this selected sample, when only the eight scores of a core battery (Mental Deterioration Battery) were considered (with respective cutoffs), it emerged that 31% of the patients were affected by some degree of cognitive deficit. In particular, 15% had mild, 11.2% moderate and 4.8% had severe impairment. Information processing speed was the most frequently impaired area, followed by memory. When two other tests (SDMT and MCST) were added and cognitive domains were considered, it emerged that 39.3% of the patients were impaired in two or more domains. When four subgroups were obtained by means of cluster analysis and then compared, it emerged that information processing speed and memory deficits differentiated the still cognitively unimpaired from the mildly impaired MS patients. Significant associations were found between cognitive and clinical characteristics. However, due to the large sample size, clinically irrelevant relationships may also have emerged. Even with the limitations imposed by the sample selection and the possible underestimation of the prevalence and severity of cognitive dysfunction, these results seem to provide further evidence that information processing speed deficit may be an early and important marker of cognitive impairment in MS patients.
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Affiliation(s)
- U Nocentini
- Department of Neurology, University of Rome 'Tor Vergata' and IRCCS 'S. Lucia' Foundation, Rome, 00179 Italy.
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Nocentini U, Giordano A, Di Vincenzo S, Panella M, Pasqualetti P. The Symbol Digit Modalities Test - Oral version: Italian normative data. Funct Neurol 2006; 21:93-6. [PMID: 16796824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In neuropsychological practice, the availability of effective and reliable tests is crucial. The Symbol Digit Modalities Test (SDMT) is widely used because it is easy to administer, reliable and also evaluates information processing speed. We set out to obtain normative data (currently unavailable for the Italian population) for the oral version of this test. Both age and education influenced performance on the SDMT; therefore, correction scores were obtained on the basis of these factors. The cut-off for normality was 34.2. The availability of Italian normative data for the SDMT will allow wider application of this test in clinical practice.
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Leonardi M, Bickenbach J, Raggi A, Sala M, Guzzon P, Valsecchi MR, Fusaro G, Russo E, Francescutti C, Nocentini U, Martinuzzi A. Training on the International Classification of Functioning, Disability and Health (ICF): the ICF-DIN Basic and the ICF-DIN Advanced Course developed by the Disability Italian Network. J Headache Pain 2006; 6:159-64. [PMID: 16355299 PMCID: PMC3451633 DOI: 10.1007/s10194-005-0173-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The objective is to present
training on the International
Classification of Functioning,
Disability and Health (ICF) prepared
by the Disability Italian
Network (DIN) and to present
strategies of ICF dissemination in
Italy. A description of DIN’s training
methodology, prepared in collaboration
with World Health
Organization (WHO) experts, is
provided within its practical applications
in health, labour, rehabilitation
and statistical sectors. The
ICF–DIN Basic Course is eight
hours long and focuses on ICF
basic principles, structure and
application in different settings.
The ICF–DIN Advanced Course,
three days long followed by three
months of distance learning,
assumes Basic Course completion,
and focuses also on ICF–checklist’s
coding and WHO–DAS II administration.
The first training courses’
outcomes, held in Italy and
addressed to health, social and
labour professionals, are provided.
The feedback received by participants
at the end of the courses
showed that the main mistake they
made was to consider ICF as an
assessment instrument. The ICF–DIN
training course was crucial in
explaining the correct use of the
ICF as a classification and to show
its impact and usefulness on daily
practice, particularly in multidisciplinary
teams. The ICF–DIN courses
already carried out in Italy show
that this teaching methodology
teaches how to avoid incomplete
applications, simplification and
misunderstanding of ICF’s complexity.
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Affiliation(s)
- Matilde Leonardi
- C. Besta Italian National Neurological Institute, Via Celoria 11, I-20133 Milan, Italy.
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Marini A, Carlomagno S, Caltagirone C, Nocentini U. The role played by the right hemisphere in the organization of complex textual structures. Brain Lang 2005; 93:46-54. [PMID: 15766767 DOI: 10.1016/j.bandl.2004.08.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2004] [Indexed: 05/24/2023]
Abstract
Eleven patients with right hemisphere damage (RHD), 11 left hemisphere damaged (LHD) nonaphasic subjects, and 11 neurologically intact controls were given three story description tasks. The two brain-damaged groups had no language, visuospatial, memory, or conceptual deficits on standardized neuropsychological testing. In the first experiment, the subjects were asked to retell previously read stories. In the second they had to tell stories which were depicted in cartoon-like fashion. In the third experiment, the story content was also depicted but pictures were given unordered so that the participants had first to arrange them in a plausible sequence. The elicited narratives were analyzed with a method which allowed examining within-sentence (lexical selection and syntactic complexity) and between-sentence (cohesion and coherence) processing abilities of the three groups. In the first experiment all groups performed quite well on both within- and between-sentence measures. In the two picture description tasks, however, the performances of the right hemisphere damaged subjects were poorer than those of normal controls when examined in terms of information content or coherent and cohesive aspects of narrative production. These findings agree with the hypothesis that RHD subjects are impaired in deriving from visual information the mental model of a story. They also indicate that clinical methods for analyzing structural aspects of discourse are suitable to identify these symptoms.
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Affiliation(s)
- Andrea Marini
- Fondazione IRCCS Santa Lucia, Laboratorio di Neurologia Clinica e Comportamentale, Via Ardeatina 306, 00179 Rome, Italy.
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Savettieri G, Messina D, Andreoli V, Bonavita S, Caltagirone C, Cittadella R, Farina D, Fazio MC, Girlanda P, Le Pira F, Liguori M, Lugaresi A, Nocentini U, Reggio A, Salemi G, Tedeschi G, Trojano M, Valentino P, Quattrone A. Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis. J Neurol 2005; 251:1208-14. [PMID: 15503099 DOI: 10.1007/s00415-004-0508-y] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Revised: 03/29/2004] [Accepted: 04/01/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cognitive impairment may occur at any time during the course of multiple sclerosis (MS), and it is often a major cause of disability in patients with the disease. The APOE-epsilon4 allele is the major known genetic risk factor for late onset familial and sporadic Alzheimer's Disease (AD), and it seems to be implicated in cognitive decline in normal elderly persons. OBJECTIVE To investigate the clinical and genetic variables that can be associated with the cognitive decline in patients with MS. METHODS Five-hundred and three patients with clinically definite MS underwent a battery of neuropsychological tests and, according to the number of failed tests, were divided into cognitively normal and impaired. All patients were genotyped for APOE gene polymorphisms. RESULTS Fifty-six percent of MS patients showed, to different extents, cognitive impairment. Cognitive decline was predominant in men and was associated with disease duration, Kurtzke Expanded Disability Status Scale (EDSS) score, a low level of education, and, interestingly, the epsilon4 allele of the APOE gene. By contrast, cognitive impairment in women was independent of any investigated variable. CONCLUSION The findings demonstrate that clinical and genetic factors play a role in men affected by MS developing cognitive impairment.
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Affiliation(s)
- U Nocentini
- Neurology Chair, University of Rome Tor Vergata, c/o IRCCS Fondazione Santa Lucia, Via Ardeatina 306, IT-00179 Rome, Italy.
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Savettieri G, Andreoli V, Bonavita S, Cittadella R, Caltagirone C, Fazio MC, Girlanda P, Le Pira F, Liguori M, Logroscino G, Lugaresi A, Nocentini U, Reggio A, Salemi G, Serra P, Tedeschi G, Toma L, Trojano M, Valentino P, Quattrone A. Apolipoprotein E genotype does not influence the progression of multiple sclerosis. J Neurol 2003; 250:1094-8. [PMID: 14504972 DOI: 10.1007/s00415-003-0163-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2002] [Revised: 03/07/2003] [Accepted: 05/08/2003] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the association between apolipoprotein E (APOE) polymorphisms and the progression of MS. METHODS We investigated 428 subjects affected by clinically defined MS, with a disease duration of at least three years. We collected data concerning the age at onset of MS, clinical type, disease duration and disability according to the expanded disability status scale (EDSS). We also calculated the progression index (PI) to evaluate disease progression. APOE genotyping and the -491 A/T polymorphism of the APOE promoter were determined. RESULTS No association was observed between the APOE epsilon4 allele and clinical characteristics of our study population. We also investigated the -491 A/T APOE promoter polymorphism in 236 MS subjects and did not find any association between the -491 A/T polymorphism and the selected clinical variables. CONCLUSIONS In our population the APOE epsilon4 allele and the -491 A/T APOE promoter polymorphism are not associated with a more rapid course of MS.
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