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Luca A, Lo Castro T, Mostile G, Donzuso G, Cicero CE, Nicoletti A, Zappia M. Personality and psychopathological characteristics in functional movement disorders. PLoS One 2024; 19:e0303379. [PMID: 38728293 PMCID: PMC11086865 DOI: 10.1371/journal.pone.0303379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Aim of the present study was to assess personality and psychopathological characteristics in patients with functional movement disorders (FMDs) compared to patients with other neurological disorders (OND). METHODS In this cross-sectional study, patients affected by clinically established FMDs and OND who attended the Neurologic Unit of the University-Hospital "Policlinico-San Marco" of Catania from the 1st of December 2021 to the 1st of June 2023 were enrolled. Personality characteristics were assessed with the Rorschach test coded according to Exner's comprehensive system and the Structured Clinical Interview for DSM-5 (SCID-II). RESULTS Thirty-one patients with FMDs (27 women; age 40.2±15.5 years; education 11.7±3.2 years; disease duration 2.3±2.5 years) and 24 patients affected by OND (18 women; age 35.8±16.3 years; education 11.9±2.9 years; disease duration 3.4±2.8 years) were enrolled. At the Rorschach, FMDs presented a significantly higher frequency of Popular (P) and sum of all Human content codes (SumH>5) responses and avoidant coping than OND. CONCLUSION FMDs presented "conformity behaviors", excessive interest in others than usual a maladaptive avoidant style of coping and a difficulty in verbalizing emotional distress. These psychopathological characteristics may favor the occurrence of FMDs.
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Affiliation(s)
- Antonina Luca
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
| | - Tiziana Lo Castro
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS Troina, Troina, Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
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Nicoletti A, Giuliano L, Donzuso G, Cicero CE. Exploring the knowledge, attitudes, and practices on sexual and gender minorities patients: a survey on Italian Neurologists. Neurol Sci 2024; 45:1465-1470. [PMID: 37947982 DOI: 10.1007/s10072-023-07181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Sexual and gender minorities (SGM) encompass individuals identifying as lesbian, gay, bisexual, transgender, and queer (LGBTQ). SGM patients experience difficulties in accessing healthcare and may face discrimination, impacting their overall health outcomes. Enhancing healthcare professionals' knowledge is the initial step in dismantling these barriers. MATERIALS AND METHODS The study has been conducted on the neurologists of the Italian Society of Neurology (SIN). We utilized a survey instrument comprising 24 Likert-type questions to investigate knowledge, attitudes, and practices concerning sexual orientation and gender identity minorities. Likert scales were assessed with scores 1 and 2 as negative response, 3 as neutral, and 4 and 5 as positive responses. RESULTS A total of 177 neurologists (103 women; 58.2%) participated, with a mean age of 44.3 ± 14.6 years answered the survey. Over half recognized sexual and gender orientation as social determinants of health, yet only a minority acknowledged the elevated prevalence of physical and mental health issues in SGM populations. Nearly, all respondents felt confident in examining a sexual minority patient, while only half felt the same regarding transgender patients. The majority of neurologists expressed a need for more comprehensive training and supervision in treating SGM patients. CONCLUSION To enhance healthcare quality for SGM populations, healthcare professionals must receive appropriate training in how to approach, assess, and treat patients within this demographic.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
| | - Loretta Giuliano
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Giulia Donzuso
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
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Nicoletti A, Edoardo Cicero C, Todaro V, Colli C, Cosmi F, Anselmi M, Caicedo C, Vilte E, Mario Camargo W, Bartoloni A, Crespo Gomez EB, Giuliano L. Epilepsy and neurocysticercosis in rural areas of the Bolivian Chaco: What has changed during the last 30 years? Epilepsia Open 2024; 9:513-521. [PMID: 38016915 PMCID: PMC10984303 DOI: 10.1002/epi4.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE Neurocysticercosis (NCC) is considered the major cause of epilepsy in endemic regions. In the rural areas of the Bolivian Chaco prevalence of NCC among people with epilepsy (PWE) was 27.4%, according to a population-based survey carried out in 1994. The aim of the study was to estimate the prevalence of Epilepsy Associated with Tonic-Clonic Seizures (EATCS) and to evaluate the prevalence of NCC among PWE in the rural communities of the Bolivian Chaco after 30 years. METHODS Twenty-two rural communities (total population 12 852) were involved in the study. PWE in the study area were ascertained by multiple sources and the diagnosis was confirmed by a neurologist. All PWE identified were invited to undergo brain CT scan examination and diagnosis of NCC was sought according to the revised Del Brutto criteria. RESULTS Seventy-eight PWE (30 men, 38.4%; mean age at onset was 12.7 ± 13.2 years) with EATCS were identified giving a crude prevalence of 6.1/1000 (95% CI: 4.7-7.3). Due to the COVID-19 lockdown, the study was interrupted in 2020 and only 36 PWE (46%) of the whole sample underwent CT scan examination. Of these, 8 (22.2%) fulfilled the criteria for NCC of whom 6 (75%) presented only single or multiple calcifications. SIGNIFICANCE This is the first study reassessing the prevalence of NCC among PWE after 30 years, in the same rural area and using a population-based design. T. solium is still endemic in the Bolivian Chaco where more than 20% of EATCS may be attributable to NCC. Our findings show a substantially unchanged prevalence of NCC over the past 30 years despite improved knowledge, underlining the need for active intervention programs to control T. solium transmission in this area. PLAIN LANGUAGE SUMMARY Neurocysticercosis is still endemic in the Bolivian Chaco. The proportion of epilepsy attributable to neurocysticercosis is about 22%. Systematic efforts towards elimination of neurocysticercosis in these areas should be implemented.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Valeria Todaro
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Chiara Colli
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases UnitUniversity of FlorenceFlorenceItaly
| | - Francesco Cosmi
- Center of Anthropological Research of the Teko GuaraníGutierrezBolivia
| | - Mariella Anselmi
- Department of Infectious, Tropical Diseases and MicrobiologyIRCCS Sacro Cuore Don Calabria Hospital, NegrarVeronaItaly
| | - Cintia Caicedo
- Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET)EsmeraldasEcuador
| | - Estela Vilte
- Center of Anthropological Research of the Teko GuaraníGutierrezBolivia
| | | | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases UnitUniversity of FlorenceFlorenceItaly
| | | | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of NeurosciencesUniversity of CataniaCataniaItaly
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Terravecchia C, Mostile G, Chisari CG, Rascunà C, Terranova R, Cicero CE, Giuliano L, Donzuso G, Sciacca G, Luca A, Preux PM, Jankovic J, Zappia M, Nicoletti A. Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights: Response. J Neuroophthalmol 2024:00041327-990000000-00590. [PMID: 38466367 DOI: 10.1097/wno.0000000000002123] [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: 03/13/2024]
Affiliation(s)
- Claudio Terravecchia
- Department "G.F. Ingrassia" (CT, GM, CGC, CR, RT, CEC, LG, GD, GS, AL, MZ, AN), Section of Neurosciences, University of Catania, Catania, Italy; Oasi Research Institute-IRCCS (GM), Troina, Italy; INSERM (P-MP), University of Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; and Parkinson's Disease Center and Movement Disorders Clinic (JJ), Department of Neurology, Baylor College of Medicine, Houston, Texas
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Maggio MG, Luca A, Cicero CE, Calabrò RS, Drago F, Zappia M, Nicoletti A. Effectiveness of telerehabilitation plus virtual reality (Tele-RV) in cognitive e social functioning: A randomized clinical study on Parkinson's disease. Parkinsonism Relat Disord 2024; 119:105970. [PMID: 38142630 DOI: 10.1016/j.parkreldis.2023.105970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Telemedicine could represent an emerging and innovative approach to support cognitive and behavioral rehabilitation reducing the overload of healthcare facilities, favoring home care therapy. The present study aimed to assess the potential efficacy of Tele-VR apps in enhancing cognitive performance and improving social skills in patients with Parkinson's disease (PD). METHODS Thirty-four patients with PD were included in the study. Patients were assigned to one of the following treatment groups: Experimental Group 1 (EG1) underwent a Tele-VR program using two cognitive rehabilitation applications (app) on smartphones (Neuronation-Brain Training and Train your Brain); Experimental Group 2 (EG2) received a Tele-VR program through one cognitive rehabilitation app (Neuronation-Brain Training) and one socio-cognitive rehabilitation App (The Sims) on smartphones; Active Control Group (aCG) performed a conventional training using pencil and paper exercises (Not-VR). RESULTS At the end of the study, the aCG and EG1 presented an improvement in the executive, attentional and visuospatial cognitive domains. Mood and subjective memory also improved in the EG1. Moreover, in the EG2 group, a significant improvement was found in all cognitive domains, including social cognition skills (theory of mind). The inter-group comparison showed that both EG1 and EG2 had significantly greater improvements than aCG in MoCA score. Finally, both EG1 and EG2 showed a higher improvement in the FAB score, as compared to the aCG. CONCLUSION Rehabilitation with smartphone apps could be more useful than conventional rehabilitation in improving cognitive and social cognition skills in patients with PD. Combining cognitive and social cognition training could improve the cognitive and affective domains, also aiding in the long-term maintenance of cognitive outcomes.
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Affiliation(s)
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | | | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, Catania, 95123, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
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Donzuso G, Cicero CE, Vinciguerra E, Sergi R, Luca A, Mostile G, Terravecchia C, Zappia M, Nicoletti A. Gender differences in non-motor fluctuations in Parkinson's disease. J Neural Transm (Vienna) 2023; 130:1249-1257. [PMID: 37526768 PMCID: PMC10480257 DOI: 10.1007/s00702-023-02679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
Non-motor symptoms (NMS) and Non-motor fluctuations (NMF) in Parkinson's Disease (PD) are common, involving several domains and affecting quality of life. Aim of the study is to estimate the burden of NMF in PD patients and to evaluate the possible gender effect. PD patients fulfilling the MDS-PD diagnostic criteria attending the "Parkinson's Disease and Movement Disorders Centre" of the University of Catania were evaluated using the Non-Motor Fluctuations Assessment (NoMoFA) Questionnaire. NoMoFA items were also grouped into the following domains: cognitive, mood, sleep/fatigue, dysautonomia, hallucination/perception and miscellaneous domains were identified. One-hundred and twenty-one patients with PD (67 men, 55.4%; mean age 70.2 ± 8.9 years, disease duration 8.3 ± 4.6 years) were evaluated. All PD patients reported at least one NMS, whereas 87 (71.9%) also reported NMF. "Feel sluggish or had low energy levels" (47.2%) along with "Feel excessively sleepy during the day" (40.0%) were the most common NMF reported in the whole sample. The majority of PD patients reported the presence of NMF during the OFF state (79, 65.3%). At multivariate analysis, NMF were positively associated with the female gender (adjusted OR 3.13; 95%CI 1.21-8.11 p-value 0.01). Women with PD had higher NMF scores especially in depression/anxiety, sleep/fatigue and dysautonomia domains. Our study reported the presence of a gender-related pattern in the frequency of NMS and NMF in PD patients, with female gender associated with a higher risk of developing NMF, highlighting the need for personalized treatment strategies when addressing NMF.
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Affiliation(s)
- Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Erica Vinciguerra
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Rosy Sergi
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Luca A, Donzuso G, Mostile G, Terranova R, Cicero CE, Nicoletti A, Zappia M. Brain linear measurements for differentiating normal pressure hydrocephalus from Alzheimer's disease: an exploratory study. Eur J Neurol 2023; 30:2849-2853. [PMID: 37265410 DOI: 10.1111/ene.15904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND PURPOSE Easy and reliable tools for the differential diagnosis between idiopathic normal pressure hydrocephalus (iNPH) and Alzheimer's disease (AD) are needed. MATERIALS AND METHODS In this cross-sectional study iNPH and AD patients referred to the Neurology Unit of the University of Catania from 1 January 2020 to 1 December 2022 were enrolled. The following brain linear measurements (BLMs) were calculated: Evan's index (EI), the parieto-occipital ratio (POR) and the temporal ratio (TR). For each index, sensitivity, specificity and the area under the curve (AUC) were calculated. Moreover, a cumulative index, the BLM index, was also considered. RESULTS Fifty patients (25 iNPH and 25 AD) were enrolled. In differentiating iNPH from AD, EI had the highest AUC (0.956), POR had the highest specificity (100%) whilst TR had the highest sensitivity (92%). The BLM index differentiated iNPH and AD with a sensitivity of 96%, a specificity of 92% and an AUC of 0.963 with an optimal cut-off value of 0.303. CONCLUSION Evan's index, POR and TR may be useful in the differential diagnosis between iNPH and AD. At an individual level, the BLM index represents a valid and reliable tool to achieve an accurate differentiation between these two conditions.
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Affiliation(s)
- Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Roberta Terranova
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
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Vallelunga A, Iannitti T, Somma G, Russillo MC, Picillo M, De Micco R, Vacca L, Cilia R, Cicero CE, Zangaglia R, Lazzeri G, Galantucci S, Radicati FG, De Rosa A, Amboni M, Scaglione C, Tessitore A, Stocchi F, Eleopra R, Nicoletti A, Pacchetti C, Di Fonzo A, Volontè MA, Barone P, Pellecchia MT. Correction to: Gender differences in microRNA expression in levodopa‑naive PD patients. J Neurol 2023:10.1007/s00415-023-11750-x. [PMID: 37154896 DOI: 10.1007/s00415-023-11750-x] [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: 05/10/2023]
Affiliation(s)
- A Vallelunga
- Department of Life Sciences and Biotechnologies, Section of Medicines and Health Products, University of Ferrara, Ferrara, Italy
| | - T Iannitti
- Department of Medical Sciences, Section of Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - G Somma
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M C Russillo
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M Picillo
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - R De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - L Vacca
- IRCCS San Raffaele, Rome, Italy
| | - R Cilia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - C E Cicero
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - R Zangaglia
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - G Lazzeri
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - S Galantucci
- IRCCS San Raffaele Scientific Institute, Neurology Unit, Milan, Italy
| | | | - A De Rosa
- IRCCS San Raffaele, Rome, Italy
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - M Amboni
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - C Scaglione
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - A Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Stocchi
- IRCCS San Raffaele, Rome, Italy
- University San Raffaele, Roma, Italy
| | - R Eleopra
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Nicoletti
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - C Pacchetti
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - A Di Fonzo
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - M A Volontè
- IRCCS San Raffaele Scientific Institute, Neurology Unit, Milan, Italy
| | - P Barone
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M T Pellecchia
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy.
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Nicoletti A, Baschi R, Cicero CE, Iacono S, Re VL, Luca A, Schirò G, Monastero R. Sex and gender differences in Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis: a narrative review. Mech Ageing Dev 2023; 212:111821. [PMID: 37127082 DOI: 10.1016/j.mad.2023.111821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 02/14/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023]
Abstract
Neurodegenerative diseases (NDs), including Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS), exhibit high phenotypic variability and they are very common in the general population. These diseases are associated with poor prognosis and a significant burden on patients and their caregivers. Although increasing evidence suggests that biological sex is an important factor for the development and phenotypical expression of some NDs, the role of sex and gender in the diagnosis and prognosis of NDs has been poorly explored. Current knowledge relating to sex- and gender-related differences in the epidemiology, clinical features, biomarkers, and treatment of AD, PD, and ALS will be summarized in this narrative review. The cumulative evidence hitherto collected suggests that sex and gender are factors to be considered in explaining the heterogeneity of these NDs. Clarifying the role of sex and gender in AD, PD, and ALS is a key topic in precision medicine, which will facilitate sex-specific prevention and treatment strategies to be implemented in the near future.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Roberta Baschi
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Salvatore Iacono
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Vincenzina Lo Re
- Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy; Women's Brain Project, Guntershausen, Switzerland
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy.
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Vallelunga A, Iannitti T, Somma G, Russillo MC, Picillo M, De Micco R, Vacca L, Cilia R, Cicero CE, Zangaglia R, Lazzeri G, Galantucci S, Radicati FG, De Rosa A, Amboni M, Scaglione C, Tessitore A, Stocchi F, Eleopra R, Nicoletti A, Pacchetti C, Di Fonzo A, Volontè MA, Barone P, Pellecchia MT. Gender differences in microRNA expression in levodopa-naive PD patients. J Neurol 2023:10.1007/s00415-023-11707-0. [PMID: 37052669 DOI: 10.1007/s00415-023-11707-0] [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: 02/21/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
Gender is an important factor influencing epidemiological and clinical features of Parkinson's disease (PD). We aimed to evaluate gender differences in the expression of a panel of miRNAs (miR-34a-5p, miR-146a, miR-155, miR-29a, miR-106a) possibly involved in the pathophysiology or progression of disease. Serum samples were obtained from 104 PD patients (58 men and 46 women) never treated with levodopa. We measured levels of miRNAs using quantitative PCR. Correlations between miRNA expression and clinical data were assessed using the Spearman's correlation test. We used STRING to evaluate co-expression relationship among target genes. MiR-34a-5p was significantly upregulated in PD male patients compared to PD female patients (fc: 1.62; p < 0.0001). No correlation was found with age, BMI, and disease severity, assessed by UPDRS III scale, in male and female patients. MiR-146a-5p was significantly upregulated in female as compared to male patients (fc: 3.44; p < 0.0001) and a significant correlation was also observed between disease duration and mir-146a-5p. No differences were found in the expression of miR-29a, miR-106a-5p and miR-155 between genders. Predicted target genes for miR-34a-5p and miR-146-5p and protein interactions in biological processes were reported. Our study supports the hypothesis that there are gender-specific differences in serum miRNAs expression in PD patients. Follow-up of this cohort is needed to understand if these differences may affect disease progression and response to treatment.
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Affiliation(s)
- A Vallelunga
- Department of Life Sciences and Biotechnologies, Section of Medicines and Health Products, University of Ferrara, Ferrara, Italy
| | - T Iannitti
- Department of Medical Sciences, Section of Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - G Somma
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M C Russillo
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M Picillo
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - R De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - L Vacca
- IRCCS San Raffaele, Rome, Italy
| | - R Cilia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - C E Cicero
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - R Zangaglia
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - G Lazzeri
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - S Galantucci
- IRCCS San Raffaele Scientific Institute, Neurology Unit, Milan, Italy
| | | | - A De Rosa
- IRCCS San Raffaele, Rome, Italy
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - M Amboni
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - C Scaglione
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - A Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Stocchi
- IRCCS San Raffaele, Rome, Italy
- University San Raffaele, Roma, Italy
| | - R Eleopra
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Nicoletti
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - C Pacchetti
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - A Di Fonzo
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - M A Volontè
- IRCCS San Raffaele Scientific Institute, Neurology Unit, Milan, Italy
| | - P Barone
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy
| | - M T Pellecchia
- Department of Medicine Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Fisciano, Italy.
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11
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Joza S, Hu MT, Jung KY, Kunz D, Stefani A, Dušek P, Terzaghi M, Arnaldi D, Videnovic A, Schiess MC, Hermann W, Lee JY, Ferini-Strambi L, Lewis SJG, Leclair-Visonneau L, Oertel WH, Antelmi E, Sixel-Döring F, Cochen De Cock V, Liguori C, Liu J, Provini F, Puligheddu M, Nicoletti A, Bassetti CLA, Bušková J, Dauvilliers Y, Ferri R, Montplaisir JY, Lawton M, Kim HJ, Bes F, Högl B, Šonka K, Fiamingo G, Pietro M, Lavadia ML, Suescun J, Woo KA, Marelli S, Ehgoetz Martens K, Janzen A, Plazzi G, Mollenhauer B, Fernandes M, Li Y, Cortelli P, Figorilli M, Cicero CE, Schaefer C, Guiraud L, Lanza G, Gagnon JF, Sunwoo JS, Ibrahim A, Girtler N, Trenkwalder C, Baldelli L, Pelletier A, Postuma RB. Progression of clinical markers in prodromal Parkinson's disease and dementia with Lewy bodies: a multicentre study. Brain 2023:7071614. [PMID: 36881989 DOI: 10.1093/brain/awad072] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [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: 10/18/2022] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 03/09/2023] Open
Abstract
The neurodegenerative synucleinopathies, including Parkinson's disease and dementia with Lewy bodies, are characterized by a typically lengthy prodromal period of progressive subclinical motor and non-motor manifestations. Among these, idiopathic REM sleep behavior disorder (iRBD) is a powerful early predictor of eventual phenoconversion, and therefore represents a critical opportunity to intervene with neuroprotective therapy. To inform the design of randomized trials, it is essential to study the natural progression of clinical markers during the prodromal stages of disease in order to establish optimal clinical endpoints. In this study, we combined prospective follow-up data from 28 centers of the International REM Sleep Behavior Disorder Study Group representing 12 countries. Polysomnogram-confirmed REM sleep behavior disorder subjects were assessed for prodromal Parkinson's disease using the Movement Disorder Society criteria and underwent periodic structured sleep, motor, cognitive, autonomic and olfactory testing. We used linear mixed-effect modelling to estimate annual rates of clinical marker progression stratified by disease subtype, including prodromal Parkinson's disease and prodromal dementia with Lewy bodies. In addition, we calculated sample size requirements to demonstrate slowing of progression under different anticipated treatment effects. Overall, 1160 subjects were followed over an average of 3.3 ± 2.2 years. Among clinical variables assessed continuously, motor variables tended to progress faster and required the lowest sample sizes, ranging from 151-560 per group (at 50% drug efficacy and 2-year follow-up). By contrast, cognitive, olfactory, and autonomic variables showed modest progression with higher variability, resulting in high sample sizes. The most efficient design was a time-to-event analysis using combined milestones of motor and cognitive decline, estimating 117 per group at 50% drug efficacy and 2-year trial duration. Finally, while phenoconverters showed overall greater progression than non-converters in motor, olfactory, cognitive, and certain autonomic markers, the only robust difference in progression between Parkinson's disease and dementia with Lewy bodies phenoconverters was in cognitive testing. This large multicenter study demonstrates the evolution of motor and non-motor manifestations in prodromal synucleinopathy. These findings provide optimized clinical endpoints and sample size estimates to inform future neuroprotective trials.
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Affiliation(s)
- Stephen Joza
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, Division of Neurology and Oxford Parkinson's Disease Centre, University of Oxford, UK
| | - Ki-Young Jung
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dieter Kunz
- Clinic for Sleep & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Ambra Stefani
- Medical University Innsbruck, Department of Neurology, Innsbruck, Austria
| | - Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Michele Terzaghi
- Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Aleksandar Videnovic
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mya C Schiess
- Department of Neurology, The University of Texas Health Science Center at Houston, Texas, USA
| | - Wiebke Hermann
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Jee-Young Lee
- Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | | | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Laurène Leclair-Visonneau
- Department of Clinical Neurophysiology, CHU de Nantes, Nantes, France.,Nantes Université, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
| | - Wolfgang H Oertel
- Department of Neurology and Section on Clinical Neuroscience, Philipps University Marburg, Marburg, Germany.,Institute for Neurogenomics, Helmholtz Center for Health and Environment, München-Neuherberg, Germany
| | - Elena Antelmi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Friederike Sixel-Döring
- Department of Neurology and Section on Clinical Neuroscience, Philipps University Marburg, Marburg, Germany.,Paracelsus Elena Klinik, Centre for Movement Disorders, Kassel, Germany
| | - Valérie Cochen De Cock
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, 34090 Montpellier, France.,Department of Neurology and Sleep, Beau Soleil Clinic, Montpellier, France
| | - Claudio Liguori
- Sleep Medicine Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Jun Liu
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Federica Provini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Monica Puligheddu
- Sleep Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Claudio L A Bassetti
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Jitka Bušková
- National Institute of Mental Health, Klecany, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui de Chauliac, Montpellier, INSERM U1061, Montpellier, F-34093 Cedex 5 France
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS. Via Conte Ruggero 73, 94018, Troina, Italy
| | - Jacques Y Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Michael Lawton
- School of Social and Community Medicine, Bristol Medical School, University of Bristol, UK
| | - Han-Joon Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Frederik Bes
- Clinic for Sleep & Chronomedicine, St. Hedwig-Krankenhaus, Berlin, Germany
| | - Birgit Högl
- Medical University Innsbruck, Department of Neurology, Innsbruck, Austria
| | - Karel Šonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Giuseppe Fiamingo
- Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Mattioli Pietro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa
| | - Maria Lorena Lavadia
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessika Suescun
- Department of Neurology, The University of Texas Health Science Center at Houston, Texas, USA
| | - Kyung Ah Woo
- Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sara Marelli
- Sleep Disorders Center, Vita-Salute San Raffaele University, Milan, Italy
| | - Kaylena Ehgoetz Martens
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Annette Janzen
- Department of Neurology and Section on Clinical Neuroscience, Philipps University Marburg, Marburg, Germany
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
| | - Brit Mollenhauer
- Paracelsus Elena Klinik, Centre for Movement Disorders, Kassel, Germany.,Department of Neurosurgery, University Medical Center Goettingen, Göttingen, Germany
| | - Mariana Fernandes
- Sleep Medicine Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Yuanyuan Li
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Michela Figorilli
- Sleep Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Carolin Schaefer
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Lily Guiraud
- Sleep Unit, Department of Neurology, Hôpital Gui de Chauliac, Montpellier, INSERM U1061, Montpellier, F-34093 Cedex 5 France
| | - Giuseppe Lanza
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS. Via Conte Ruggero 73, 94018, Troina, Italy.,Department of Surgery and Medical-Surgical Specialties, University of Catania. Via Santa Sofia 78, 95123, Catania, Italy
| | - Jean-François Gagnon
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Abubaker Ibrahim
- Medical University Innsbruck, Department of Neurology, Innsbruck, Austria
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Claudia Trenkwalder
- Paracelsus Elena Klinik, Centre for Movement Disorders, Kassel, Germany.,Department of Neurosurgery, University Medical Center Goettingen, Göttingen, Germany
| | - Luca Baldelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Amelie Pelletier
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada.,Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
| | - Ronald B Postuma
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada.,Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
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12
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Todaro V, Giuliano L, Cicero CE, Spina L, Colli C, Cuellar S, Cosmi F, Vilte E, Bartoloni A, Crespo Gómez EB, Nicoletti A. Prevalence of epilepsy in the rural area of the Bolivian Gran Chaco: Usefulness of telemedicine and impact of awareness campaigns. Epilepsia Open 2023; 8:125-133. [PMID: 36461651 PMCID: PMC9977747 DOI: 10.1002/epi4.12677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The objective of this study is to estimate the prevalence of epilepsy with Tonic-Clonic (TC) seizures in rural areas of the Bolivian Gran Chaco and to evaluate the usefulness of telemedicine in this context. METHODS The study was carried out in the Isozo Area, southern-eastern Bolivia. Twenty-five rural communities with a population of 8258 inhabitants were included in the survey. Trained community-health workers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II). At stage II subjects were also screened using the smartphone app "Epilepsy Diagnosis Aid". Subjects screened positive at stage II underwent a complete neurological examination to confirm the diagnosis (stage III). Due to the COVID-19 lockdown, some subjects have been evaluated through a digital platform (Zoom®). RESULTS One-thousand two-hundred and thirteen interviews were performed at stage I, corresponding to a total screened population of 6692 inhabitants. Thirty-eight screened positive were identified at stage I and II and of these, 28 people with epilepsy were identified, giving an overall prevalence of 4.2/1000 (95% CI 2.6-5.7). Prevalence rate steeply increased with age reaching a peak of 7.9/1000 in the population aged 20-29 years without significant differences between women and men. For almost 50% of the screened positive subjects, confirmation of epilepsy by a neurologist at stage III was achieved through simple videoconsultation. After a simultaneous awareness campaign, 22 self-reported PWE requested a consultation and, among them, 11 had a diagnosis of epilepsy confirmed. SIGNIFICANCE This study shows a prevalence estimate close to those reported for LMIC. Simple videoconsultation and specific apps may be valuable tools in epidemiological research. Awareness campaigns are important allies for a full case identification, particularly in contexts where higher rates of stigma are recorded.
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Affiliation(s)
- Valeria Todaro
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Ludovica Spina
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Chiara Colli
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Senovia Cuellar
- Center of Anthropological Research of the Teko Guaraní, Gutierrez, Bolivia
| | - Francesco Cosmi
- Center of Anthropological Research of the Teko Guaraní, Gutierrez, Bolivia
| | - Estela Vilte
- Center of Anthropological Research of the Teko Guaraní, Gutierrez, Bolivia
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | | | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
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13
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Gabrielli S, Macchioni F, Spinicci M, Strohmeyer M, Roselli M, Nicoletti A, Cicero CE, Poma V, Rojo D, Lara Y, Gómez EBC, Rojas P, Gamboa H, Villagran AL, Cosmi F, Monasterio J, Cancrini G, Bartoloni A. Long-Standing International Cooperation in Parasitology Research: A Summary of 35 Years of Activities in the Bolivian Chaco. Trop Med Infect Dis 2022; 7:tropicalmed7100275. [PMID: 36288016 PMCID: PMC9611245 DOI: 10.3390/tropicalmed7100275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
The Bolivian Chaco is a semiarid region with a low population density, situated in the southeast part of the Plurinational State of Bolivia. Here, despite the improvements of the last 15 years, poverty remains high in rural areas, where social vulnerability is widespread. The Guaraní ethnic group often lives in isolated communities with a low standard of hygiene and sanitation. This epidemiological scenario favors the spread of transmissible diseases, including several parasitic infections belonging to the neglected tropical diseases (NTDs) group. In this area, a long-standing research activity, built upon the synergism between local and foreign institutions, has been established since the late 1980s and helps to fill in the knowledge gap about the epidemiology dynamics of soil-transmitted helminths, vector-borne parasites, and other parasitic diseases. A 35-year history of cooperation programs in parasitology research has contributed to informing local health authorities of the NTD burden in the Bolivian Chaco and, ultimately, supports local healthcare providers in the management of parasitic diseases.
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Affiliation(s)
- Simona Gabrielli
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, 00185 Rome, Italy
| | - Fabio Macchioni
- Dipartimento di Scienze Veterinarie, Università di Pisa, 56124 Pisa, Italy
| | - Michele Spinicci
- Dipartimento Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Florence, Italy
| | - Marianne Strohmeyer
- Dipartimento Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Florence, Italy
| | - Mimmo Roselli
- Dipartimento Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Florence, Italy
| | - Alessandra Nicoletti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate G.F. Ingrassia, Sez. di Neuroscienze, Università di Catania, 95125 Catania, Italy
| | - Calogero Edoardo Cicero
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate G.F. Ingrassia, Sez. di Neuroscienze, Università di Catania, 95125 Catania, Italy
| | - Veronica Poma
- Escuela de Salud del Chaco Tekove Katu, Gutierrez, Bolivia
| | - David Rojo
- Escuela de Salud del Chaco Tekove Katu, Gutierrez, Bolivia
| | - Yunni Lara
- Hospital San Antonio de los Sauces, Monteagudo, Bolivia
| | | | | | - Herlan Gamboa
- Facultad Integral del Chaco, Universidad Autónoma Gabriel René Moreno, Camiri, Bolivia
| | | | | | - Joaquín Monasterio
- Servicio Departamental de Salud (SEDES) de Santa Cruz, Santa Cruz, Bolivia
| | - Gabriella Cancrini
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, 00185 Rome, Italy
| | - Alessandro Bartoloni
- Dipartimento Medicina Sperimentale e Clinica, Università degli Studi di Firenze, 50121 Florence, Italy
- Correspondence:
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14
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Cicero CE, Donzuso G, Luca A, Davì M, Baschi R, Mostile G, Giuliano L, Palmucci S, Salerno A, Monastero R, Nicoletti A, Zappia M. Morphometric
MRI
Cortico‐subcortical features in Parkinson’s Disease with mild cognitive impairment. Eur J Neurol 2022; 29:3197-3204. [DOI: 10.1111/ene.15489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/30/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Marco Davì
- Department of Biomedicine, Neuroscience and advanced Diagnostics University of Palermo, Via La Loggia 1 Palermo Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and advanced Diagnostics University of Palermo, Via La Loggia 1 Palermo Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
- Oasi Research Institute ‐ IRCCS Troina Italy
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Stefano Palmucci
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Radiodiagnostic and Radiotherapy Unit University of Catania, Via Santa Sofia 78 Catania Italy
| | - Andrea Salerno
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and advanced Diagnostics University of Palermo, Via La Loggia 1 Palermo Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences University of Catania, Via Santa Sofia 78 Catania Italy
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Cicero CE, Monastero R, Terravecchia C, Donzuso G, Luca A, Baschi R, Caccamo M, Mostile G, Giuliano L, Zappia M, Nicoletti A. Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study. Curr Neuropharmacol 2022; 20:998-1003. [PMID: 34951389 PMCID: PMC9881097 DOI: 10.2174/1570159x20666211223122800] [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: 07/13/2021] [Revised: 11/18/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND polytherapy and the anticholinergic activity of several drugs negatively influence cognition in the elderly. However, little is known on the effect on Mild Cognitive Impairment (MCI) in Parkinson's Disease (PD). METHODS patients with PD belonging to the baseline PACOS cohort with full pharmacological data have been included in this study. MCI diagnosis was made according to the MDS level II criteria. Polytherapy was defined as patients assuming ≥6 drugs. The anticholinergic burden has been calculated using the Anticholinergic Drug Scale (ADS). Molecules have been classified according to the ATC classification. Association with MCI has been assessed with a multivariate logistic regression analysis with MCI as the dependent variable. RESULTS pharmacological data were available for 238 patients (mean age 64.7±9.7). One hundred (42.0%) were diagnosed with MCI. No association was found in the full multivariate model (correcting for age, sex, disease duration, education, UPDRS-ME, LEDD-DAs) with either polytherapy or the ADS. Concerning drug classes, anti-hypertensive medications were positively associated with PD-MCI (OR 2.02;95%CI 1.04-3.89; p=0.035) while gastroprotective agents were negatively associated (OR 0.51; 95%CI 0.27-0.99; p=0.047). CONCLUSION the magnitude of polytherapy and anticholinergic drugs burden does not appear to modulate MCI risk in PD, probably due to cautious prescription patterns. The effect of antihypertensive and gastroprotective agents on PD-MCI risk, while needing further confirmations, could be relevant for clinical practice.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy;,Address correspondence to these authors at the Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy; Tel: +390953782783; E-mails: ;
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Maria Caccamo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy;,Address correspondence to these authors at the Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania, Italy; Tel: +390953782783; E-mails: ;
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16
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Luca A, Cicero CE, Giuliano L, Sgroi R, Vancheri E, Terravecchia C, Squillaci R, Rascunà C, Donzuso G, Mostile G, Sciacca G, Zappia M, Nicoletti A. Obsessive–compulsive personality disorder in rapid eye movement sleep behavior disorder. Sci Rep 2022; 12:2401. [PMID: 35165341 PMCID: PMC8844273 DOI: 10.1038/s41598-022-06424-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022] Open
Abstract
Rapid eye movement sleep behavior disorder (RBD) is a common prodromic non-motor symptom of Parkinson’s disease (PD). Only few studies have evaluated the personality of RBD patients with conflicting results. Aim of the study was to evaluate the frequency of Personality Disorders (PeDs)in RBD. RBD patients, PD patients and healthy controls (HC) were enrolled. All the enrolled subjects underwent a full neurological examination. Motor symptoms were evaluated with the UPDRS-Motor Examination. PeDs were assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). Twenty-nine RBD patients [14 men (48.3%); mean age 55.6 ± 11.1], 30 PD patients [17 men (56.7%); mean age 65.7 ± 10.7] and 30 HC [12 men (40%); mean age 65.7 ± 5.4] were enrolled in the study. PD patients had a disease duration of 4.5 ± 4.6 and presented a mean UPDRS-ME score of 26.7 ± 9.4. The most frequent PeDs was the Obsessive–Compulsive one (OCPeD); OCPeD was significantly more frequent in RBD (55.2%) patients than HC (13.3%; p-value < 0.001). No significant differences were found comparing the frequency of OCPeD in RBD patients to that in PD. In the present study, the prevalence of OCPeD in RBD patients was close to that reported in PD patients. Our data could suggest the existence of a common disease-specific RBD-PD personality profile.
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Chebil C, Boumediene F, Cicero CE, Rascunà C, Di Prima A, Maria Torrisi AA, Torrisi A, Sciacca S, Zappia M, Preux PM, Ferrante M, Nicoletti A. Incidence, survival and geoepidemiological analysis of meningiomas and glioblastomas in the province of Catania during the 2003-2016 period. Environ Res 2021; 200:111286. [PMID: 33965389 DOI: 10.1016/j.envres.2021.111286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Meningiomas are the most common primary brain tumors, followed by glioblastomas. Nevertheless, no previous studies have been conducted to evaluate the epidemiology of meningiomas and glioblastomas in the southern region of Italy. Thus, the aim of our study was to evaluate incidence, temporal trend and survival rate of meningiomas and glioblastomas in the province of Catania during the study period. Moreover, a geoepidemiological analysis was performed in order to identify possible geographical and temporal clusters. METHODS All subjects with meningiomas and glioblastomas diagnosed from 2003 to 2016 in the province of Catania were collected, using the local cancer registry. Incidence rate (IR) was calculated by gender, age-groups and tumor behavior. Temporal changes in incidence trend were assessed using a Joinpoint regression analysis while survival analysis was performed using Kaplan-Meier method. Cluster analysis was performed using Kulldorff's spatial scan statistic. RESULTS In the province of Catania, a total of 1488 cases of meningiomas and 443 cases of glioblastomas were identified from 2003 to 2016, with an IR of 9.8/100,000 person-years (95%CI 9.3-10.3) and 2.9/100,000 person-years (95%CI 2.7-3.2), respectively. Meningiomas were more common among women (p-value<0.0001), while glioblastomas among men (p-value<0.0001). IR progressively increased over the ages, reaching a peak in the 75-84 and 65-74 years-old group in, respectively, meningiomas and glioblastomas. Mean survival was higher in subjects diagnosed with meningiomas as compared to those with glioblastomas (10.7 years and 15.8 months, respectively), with age as the strongest risk factor for death. Spatial and space-time cluster of high incidence of meningiomas was detected in a small community on the eastern flank of the Mt. Etna volcano. CONCLUSIONS Epidemiology of meningioma and glioblastoma in the province of Catania is close to that reported worldwide. Spatial and space-time cluster of meningiomas were found in Pedara. Further studies on risks factor are necessary.
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Affiliation(s)
- Chaima Chebil
- INSERM, U1094, Tropical Neuroepidemiology, University of Limoges, France.
| | - Farid Boumediene
- INSERM, U1094, Tropical Neuroepidemiology, University of Limoges, France.
| | - Calogero Edoardo Cicero
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Cristina Rascunà
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Alessia Di Prima
- Catania, Messina, Enna Cancer Registry, Complex Operative Unit Hygiene, Catania University Hospital, Catania, Italy.
| | | | - Antonina Torrisi
- Catania, Messina, Enna Cancer Registry, Complex Operative Unit Hygiene, Catania University Hospital, Catania, Italy.
| | - Salvatore Sciacca
- Mediterranean Oncological Institute (IOM), Via Penninazzo 7, 95029, Viagrande, Catania, Italy.
| | - Mario Zappia
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, University of Limoges, France.
| | - Margherita Ferrante
- Catania, Messina, Enna Cancer Registry, Complex Operative Unit Hygiene, Catania University Hospital, Catania, Italy; Environmental and Food Hygiene (LIAA) of Department of Medical, Surgical and Advanced Technologies G.F. Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Alessandra Nicoletti
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Cicero CE, Allibrio FE, Giuliano L, Luna J, Preux PM, Nicoletti A. Toxoplasma gondii and multiple sclerosis: A systematic review and meta-analysis. Eur J Neurol 2021; 28:4251-4257. [PMID: 34374174 DOI: 10.1111/ene.15055] [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: 05/28/2021] [Revised: 07/09/2021] [Accepted: 08/05/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE According to the hygiene hypothesis, infections by agents such as parasites have a protective role against the risk of developing multiple sclerosis (MS). Among parasites, Toxoplasma gondii, an intracellular parasite, showed evidence of a protective effect. This study was undertaken to summarize the available evidence on the association between T. gondii infection and MS. METHODS A systematic review of all the available articles published up to November 2020 has been conducted independently by two investigators in the following databases: PubMed, Scopus, Lissa, and SciELO. The association between T. gondii infection and MS has been pooled with a random effects model. RESULTS From 562 articles, seven were included in the systematic review and meta-analysis for a global population of 752 MS cases and 1282 controls. T. gondii infection was associated with MS with a pooled odds ratio of 0.68 (95% confidence interval = 0.50-0.93). CONCLUSIONS The available evidence supports the hypothesis that T. gondii infection represents a protective factor against the development of MS.
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Affiliation(s)
- Calogero Edoardo Cicero
- Section of Neurosciences, Department of Medical, Surgical, and Advanced Technologies G. F. Ingrassia, University of Catania, Catania, Italy
| | - Francesca Elsa Allibrio
- Section of Neurosciences, Department of Medical, Surgical, and Advanced Technologies G. F. Ingrassia, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Section of Neurosciences, Department of Medical, Surgical, and Advanced Technologies G. F. Ingrassia, University of Catania, Catania, Italy
| | - Jaime Luna
- IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, INSERM, University of Limoges, Limoges University Hospital Center, Limoges, France
| | - Pierre-Marie Preux
- IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, INSERM, University of Limoges, Limoges University Hospital Center, Limoges, France
| | - Alessandra Nicoletti
- Section of Neurosciences, Department of Medical, Surgical, and Advanced Technologies G. F. Ingrassia, University of Catania, Catania, Italy
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Cicero CE, Scondotto S, Allotta AV, De Luca G, Murolo G, Nicoletti A, Zappia M. Burden of Parkinson's disease in Sicily: a health administrative database study. Neurol Sci 2021; 43:1043-1046. [PMID: 34259973 DOI: 10.1007/s10072-021-05460-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Prevalence of Parkinson's disease (PD) increases with the advanced ages, representing a relevant health burden. Accurate prevalence estimates are of fundamental need in order to adjust the supply of health services for these patients. The availability of administrative health data from the National Health System provides a useful resource to assess the burden of diseases. Our aim was to evaluate the prevalence of PD through the use of administrative data in the Sicily region. METHODS We have identified all the subjects affected by PD in Sicily in 2017 by gathering data from three regional health administrative databases: the hospital discharge records, the medical exemption databases, and the pharmacological prescription database. Prevalence rates and 95% confidence intervals (CI) have been calculated across 5-year age classes. RESULTS PD patients identified through database searching were 24,674, giving a prevalence of 488/100,000 (95%CI 481.9-494.1) inhabitants. Prevalence was higher among men (514.5/100,000; 95%CI 505.6-523.6) and reached a peak in the 85-89 age class (3203.8/100,000; 95%CI 3095.2-3315.1). DISCUSSION Our prevalence estimates of PD were higher when compared to previous epidemiological surveys conducted in Sicily. These findings are, however, comparable to other studies conducted in Italy that identified cases through administrative databases. Using health databases is a feasible strategy to assess the burden of PD.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Salvatore Scondotto
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | | | - Giovanni De Luca
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | - Giuseppe Murolo
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
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Cicero CE, Giuliano L, Luna J, Zappia M, Preux PM, Nicoletti A. Prevalence of idiopathic REM behavior disorder: a systematic review and meta-analysis. Sleep 2021; 44:6060057. [PMID: 33388771 DOI: 10.1093/sleep/zsaa294] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To provide an overall estimate of the prevalence of idiopathic REM Sleep Behavior Disorder (iRBD). METHODS Two investigators have independently searched the PubMed and Scopus databases for population-based studies assessing the prevalence of iRBD. Data about type of diagnosis (polysomnographic diagnosis, defined iRBD [dRBD]; clinical diagnosis, probable RBD [pRBD]), continent, age range of the screened population, quality of the studies, sample size, screening questionnaires, and strategies have been gathered. A random-effect model was used to estimate the pooled prevalence. Heterogeneity was investigated with subgroup analysis and meta-regression. RESULTS From 857 articles found in the databases, 19 articles were selected for the systematic review and meta-analysis. According to the type of diagnosis, five studies identified dRBD cases given a pooled prevalence of 0.68% (95% confidence interval [CI] 0.38-1.05) without significant heterogeneity (Cochran's Q p = 0.11; I2 = 46.43%). Fourteen studies assessed the prevalence of pRBD with a pooled estimate of 5.65% (95% CI 4.29-7.18) and a significant heterogeneity among the studies (Cochran's Q p < 0.001; I2 = 98.21%). At the subgroup analysis, significant differences in terms of prevalence were present according to the quality of the studies and, after removing two outlaying studies, according to the continents and the screening questionnaire used. Meta-regression did not identify any significant effect of the covariates on the pooled estimates. CONCLUSION Prevalence estimates of iRBD are significantly impacted by diagnostic level of certainty. Variations in pRBD prevalence are due to methodological differences in study design and screening questionnaires employed.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Jaime Luna
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Mario Zappia
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Alessandra Nicoletti
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
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Rascunà C, Cicero CE, Chisari CG, Russo A, Giuliano L, Castellino N, Terravecchia C, Grillo M, Longo A, Avitabile T, Zappia M, Reibaldi M, Nicoletti A. Retinal thickness and microvascular pathway in Idiopathic Rapid eye movement sleep behaviour disorder and Parkinson's disease. Parkinsonism Relat Disord 2021; 88:40-45. [PMID: 34118642 DOI: 10.1016/j.parkreldis.2021.05.031] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Retinal impairment has previously been described in Parkinson's Disease (PD), also in early stage of disease. Idiopathic Rapid-eye-movement sleep Behavior Disorder (iRBD) is considered the strongest marker in the diagnosis of "Prodromal PD". Thus, we evaluated the thickness of retinal layers and the microvascular retinal pattern in a group of iRBD patients compared to PD and healthy subjects (HCs). METHODS retinal layer's thickness and microvascular pattern among PD, iRBD and HCs were assessed using Spectral-Density Optical Coherence Tomography (SD-OCT) and OCT-Angiography (OCT-A), respectively. RESULTS Forty-one eyes from 21 PD, 37 eyes from 19 iRBD and 33 eyes from 17 HCs were analysed. Peripapillary Retinal Nerve Fiber Layer (RNFL) was thinner in PD and RBD compared to HCs. All macular retinal layers, except for retinal pigment epithelium, resulted to be significantly thinner in iRBD and in PD compared to HCs, also adjusting by age, sex and hypertension. Macular RNFL and ganglionic cell layer were thinner in PD compared to iRBD. Moreover, in iRBD, a peculiar microvascular pattern was found, characterized by a higher vascularization of the deep capillary plexus with respect both PD patients and HCs. CONCLUSION in PD and iRBD patients retina was thinner than HCs, and values of iRBD were between PD and HCs. Moreover, in iRBD, a peculiar microvascular pattern has been found, characterized by a higher vascularization of the deep capillary plexus. Our findings suggest that retina might be considered a biomarker of neurodegeneration in iRBD, easily estimable using non-invasive tool such as OCT and OCT-A.
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Affiliation(s)
- Cristina Rascunà
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Clara Grazia Chisari
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | | | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Marco Grillo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
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Cicero CE, Giuliano L, Sgroi R, Squillaci R, Terravecchia C, Vancheri E, Todaro V, Reitano P, Rizzo S, Luca A, Mostile G, Paradisi V, Zappia M, Nicoletti A. Prevalence of isolated RBD in the city of Catania, Italy: a population-based study. J Clin Sleep Med 2021; 17:2241-2248. [PMID: 34027887 DOI: 10.5664/jcsm.9416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Few studies have analyzed the prevalence of isolated REM sleep behavior disorder (RBD) giving different estimates. Aim of the study was to estimate the prevalence of isolated RBD in the city of Catania. METHODS A three-stage design was adopted. Participants attending the cabinets of General Practitioners in the city of Catania were screened with the RBD1Q questionnaire (Stage I). Positive participants were interviewed by phone and if suspected of RBD, were invited for clinical examination by a movement disorders specialist and a sleep specialist (Stage II). After the clinical examination, patients diagnosed as probable isolated RBD (pRBD) were invited to undergo a video polysomnography (VPSG) (Stage III) to confirm the diagnosis of definite RBD (dRBD). RESULTS A total of 1,524 participants have been screened. Of these, 220 (14.4%) screened positive. One-hundred-forty-three of them were further screened by phone, of whom 75 were suspected RBD. Thirty-six patients were diagnosed as pRBD giving a prevalence of 2.36% (95%CI 1.71-3.25). Twelve pRBD agreed to a VPSG and, of these, four were diagnosed as dRBD giving a prevalence of 0.26% (95%CI 0.07-0.67). Prevalence adjusted by non-participants was 3.48% (95%CI 2.67-4.52) and 1.18% (95%CI 0.45-1.37) for pRBD and dRBD respectively. CONCLUSIONS Prevalence of both pRBD and dRBD in Italy is comparable to the estimates reported in literature, confirming that isolated RBD has a low prevalence in the general population.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Loretta Giuliano
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Riccardo Sgroi
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Raffaele Squillaci
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Claudio Terravecchia
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Edoardo Vancheri
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Valeria Todaro
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Paola Reitano
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Sofia Rizzo
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy.,Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
| | | | - Mario Zappia
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy
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Mostile G, Terranova R, Rascunà C, Terravecchia C, Cicero CE, Giuliano L, Davì M, Chisari C, Luca A, Preux PM, Jankovic J, Zappia M, Nicoletti A. Clinical-Instrumental patterns of neurodegeneration in Essential Tremor: A data-driven approach. Parkinsonism Relat Disord 2021; 87:124-129. [PMID: 34030068 DOI: 10.1016/j.parkreldis.2021.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Essential Tremor (ET) is increasingly recognized as a complex disorder with additional clinical signs other than tremor. It is still unknown whether a unique pathophysiologic or neurodegenerative process underlies progression and prognosis of the disease. The aim of the study was to identify ET phenotypes through a clinical-instrumental data-driven approach and to characterize possible patterns of neurodegeneration. METHODS ET patients were categorized using spatio-temporal and kinematic variables related to mobility and dynamic stability processed by motion transducers. Differences between the identified groups in clinical-demographic variables, neuropsychological performances and retinal parameters by Optical Coherence Tomography (OCT) segmentation analysis were tested. RESULTS Twenty-five ET patients were studied. Based on clustering of kinematic and spatio-temporal gait parameters, two independent groups were identified: cluster "A" (N = 15) and cluster "B" (N = 10). Compared to group A, group B had overall worse performance in mobility, especially on turning tasks. Identified clusters did not differ in terms of age, age at onset and disease duration. Patients in group B had more head tremor and more severe action tremor in the upper limbs as compared to group A, demonstrating also worse performances on cognitive assessments. Based on OCT analysis, group B presented a reduced thickness of the retinal inner layer as compared to group A, suggesting underlying neurodegenerative processes. CONCLUSIONS The presence of gait and mobility impairment, associated with midline tremor, cognitive decline and retinal degeneration suggests a subtype of ET associated with neurodegeneration.
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Affiliation(s)
- Giovanni Mostile
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy; Oasi Research Institute - IRCCS, Troina, Italy
| | - Roberta Terranova
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Cristina Rascunà
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Claudio Terravecchia
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Calogero Edoardo Cicero
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Loretta Giuliano
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Marco Davì
- University of Palermo, Department of Biomedicine, Neuroscience and Advanced Diagnostic, Palermo, Italy
| | - Clara Chisari
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Antonina Luca
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Pierre-Marie Preux
- INSERM, University of Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Mario Zappia
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy
| | - Alessandra Nicoletti
- University of Catania, Department "G.F. Ingrassia", Section of Neurosciences, Catania, Italy.
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Nicoletti A, Todaro V, Cicero CE, Giuliano L, Zappia M, Cosmi F, Vilte E, Bartoloni A, Crespo Gómez EB. The impact of COVID-19 pandemic on frail health systems of low- and middle-income countries: The case of epilepsy in the rural areas of the Bolivian Chaco. Epilepsy Behav 2021; 118:107917. [PMID: 33735816 PMCID: PMC9760068 DOI: 10.1016/j.yebeh.2021.107917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/28/2021] [Accepted: 02/28/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The Coronavirus disease 2019 (COVID-19) has put some health systems under pressure, especially in low- and middle-income countries. We aimed at evaluating the impact of COVID-19 emergency on the management of people with epilepsy (PWE) living in the rural communities of the Gran Chaco area of the Plurinational State of Bolivia. MATERIALS AND METHODS We selected a sample of PWE living in the rural communities of the Bolivian Chaco. A standardized questionnaire was developed, consisting of six questions addressing drug availability, drug discontinuation, personnel responsible for drug retrieval during the lockdown, and the presence of seizures in the two months preceding the interview. Questionnaires were administered by community health workers of the rural health centers in September 2020. RESULTS Seventy PWE (38 men, 54.3%; mean age 26.9 ± 16.7) were interviewed. During the lockdown the large majority of them (n = 51, 73.9%) reported an irregular medication intake mainly due to the lack of antiseizure medications in the local health posts, leading to an increase in seizure frequency. CONCLUSION The COVID-19 pandemic has unmasked the frailty of the Bolivian health system, especially for the management of chronic diseases such as epilepsy in the rural communities.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Catania, Italy.
| | - Valeria Todaro
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Neuroscience Section, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Neuroscience Section, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Neuroscience Section, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Neuroscience Section, University of Catania, Catania, Italy
| | | | - Estela Vilte
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
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Luca A, Nicoletti A, Donzuso G, Terravecchia C, Cicero CE, D'Agate C, Rascuná C, Manna R, Mostile G, Zappia M. Phonemic Verbal Fluency and Midbrain Atrophy in Progressive Supranuclear Palsy. J Alzheimers Dis 2021; 80:1669-1674. [PMID: 33720901 DOI: 10.3233/jad-210023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The neuropsychological profile of progressive supranuclear palsy (PSP) patients is mainly characterized by executive dysfunction, but the relationship between the latter and midbrain atrophy is still unclear. OBJECTIVE The aims of the study were to investigate which test evaluating executive functioning is more frequently impaired in PSP patients and to evaluate the relationship between midbrain-based MRI morphometric measures and executive dysfunction. METHODS PSP patients who had undergone a neuropsychological battery assessing executive functioning with the Frontal Assessment Battery (FAB), the phonemic verbal fluency F-A-S, the Raven's Progressive Colored Matrix, and the Stroop word colors test (time and errors) were enrolled in the study. A group of Parkinson's disease (PD) patients matched by age, sex, education, and global cognitive status was selected. All the enrolled patients also underwent a volumetric T1-3D brain MRI. RESULTS Thirty-five PSP patients and 35 PD patients were enrolled. Patients with PSP as compared to patients with PD showed a significant greater impairment in verbal fluency (16.0±7.9 and 23.4±8.7 words/180 s; p < 0.001) and a significant lower score at the FAB total score (11.5±3.8 and 13.7±3.4; p = 0.013). Midbrain area was significantly smaller in PSP patients than in PD patients (83.9±20.1 and 134.5±19.9 mm2; p < 0.001). In PSP patients, a significant positive correlation between verbal fluency and the midbrain area (r = 0.421; p = 0.028) was observed. CONCLUSION Our findings suggest that the phonemic verbal fluency is among the most frequently impaired executive functions in PSP patients and is strongly correlated to midbrain atrophy.
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Affiliation(s)
- Antonina Luca
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Giulia Donzuso
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Claudio Terravecchia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Concetta D'Agate
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Cristina Rascuná
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Roberta Manna
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Giovanni Mostile
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Mario Zappia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
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Luca A, Monastero R, Baschi R, Cicero CE, Mostile G, Davì M, Restivo V, Zappia M, Nicoletti A. Cognitive impairment and levodopa induced dyskinesia in Parkinson's disease: a longitudinal study from the PACOS cohort. Sci Rep 2021; 11:867. [PMID: 33441571 PMCID: PMC7806828 DOI: 10.1038/s41598-020-79110-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/11/2020] [Accepted: 11/02/2020] [Indexed: 11/09/2022] Open
Abstract
Aim of the study was to evaluate possible associations between cognitive dysfunctions and development of Levodopa Induced Dyskinesia (LID). PD patients from the Parkinson’s disease Cognitive impairment Study cohort who underwent a baseline and follow-up neuropsychological evaluations were enrolled. Mild Cognitive Impairment (PD-MCI) was diagnosed according to MDS level II criteria. The following cognitive domains were evaluated: episodic memory, attention, executive function, visuo-spatial function and language. A domain was considered as impaired when the subject scored 2 standard deviation below normality cut-off values in at least one test for each domain. Levodopa equivalent dose, UPDRS-ME and LID were recorded at baseline and follow-up. To identify possible neuropsychological predictors associated with the probability of LID development at follow-up, Cox proportional-hazards regression model was used. Out of 139 PD patients enrolled (87 men, mean age 65.7 ± 9.4), 18 (12.9%) were dyskinetic at baseline. Out of 121 patients non-dyskinetic at baseline, 22 (18.1%) developed LID at follow-up. The impairment of the attention and executive domains strongly predicted the development of LID (HR 4.45;95%CI 1.49–13.23 and HR 3.46; 95%CI 1.26–9.48 respectively). Impairment of the attention and executive domains increased the risk of dyskinesia reflecting the alteration of common cortical network.
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Affiliation(s)
- Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, Neurologic Unit, AOU "Policlinico-Vittorio Emanuele", University of Catania, Via Santa Sofia n.78, 95100, Catania, Sicily, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via G. La Loggia n.1, Palermo, Sicily, Italy.
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via G. La Loggia n.1, Palermo, Sicily, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, Neurologic Unit, AOU "Policlinico-Vittorio Emanuele", University of Catania, Via Santa Sofia n.78, 95100, Catania, Sicily, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, Neurologic Unit, AOU "Policlinico-Vittorio Emanuele", University of Catania, Via Santa Sofia n.78, 95100, Catania, Sicily, Italy
| | - Marco Davì
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via G. La Loggia n.1, Palermo, Sicily, Italy
| | - Vincenzo Restivo
- Department of Sciences for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, Neurologic Unit, AOU "Policlinico-Vittorio Emanuele", University of Catania, Via Santa Sofia n.78, 95100, Catania, Sicily, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, Neurologic Unit, AOU "Policlinico-Vittorio Emanuele", University of Catania, Via Santa Sofia n.78, 95100, Catania, Sicily, Italy.
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Rascunà C, Russo A, Terravecchia C, Castellino N, Avitabile T, Bonfiglio V, Fallico M, Chisari CG, Cicero CE, Grillo M, Longo A, Luca A, Mostile G, Zappia M, Reibaldi M, Nicoletti A. Retinal Thickness and Microvascular Pattern in Early Parkinson's Disease. Front Neurol 2020; 11:533375. [PMID: 33117254 PMCID: PMC7575742 DOI: 10.3389/fneur.2020.533375] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 02/07/2020] [Accepted: 08/24/2020] [Indexed: 01/09/2023] Open
Abstract
A thinning of intraretinal layers has been previously described in Parkinson's disease (PD) patients compared to healthy controls (HCs). Few studies evaluated the possible correlation between retinal thickness and retinal microvascularization. Thus, here we assessed the thickness of retinal layers and microvascular pattern in early PD patients and HCs, using, respectively, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT-angiography (SD-OCT-A), and more interestingly, we evaluated a possible correlation between retinal thickness and microvascular pattern. Patients fulfilling criteria for clinically established/clinically probable PD and HCs were enrolled. Exclusion criteria were any ocular, retinal, and systemic disease impairing the visual system. Retinal vascularization was analyzed using SD-OCT-A, and retinal layer thickness was assessed using SD-OCT. Forty-one eyes from 21 PD patients and 33 eyes from 17 HCs were evaluated. Peripapillary retinal nerve fiber layer (RNFL) and macular RNFL, ganglionic cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL), resulted to be thinner in PD compared to HCs. Among PD patients, a positive correlation between RNFL, GCL, and IPL thickness and microvascular density was found in the foveal region, also adjusting by age, sex, and, especially, hypertension. Such findings were already present in the early stage of disease and were irrespective of dopaminergic treatment. Thus, the retina might be considered a biomarker of PD and could be a useful instrument for onset and disease progression.
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Affiliation(s)
- Cristina Rascunà
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Claudio Terravecchia
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | | | | | | | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Clara Grazia Chisari
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Marco Grillo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Antonina Luca
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Mario Zappia
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
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Monastero R, Baschi R, Nicoletti A, Pilati L, Pagano L, Cicero CE, Zappia M, Brighina F. Transcranial random noise stimulation over the primary motor cortex in PD-MCI patients: a crossover, randomized, sham-controlled study. J Neural Transm (Vienna) 2020; 127:1589-1597. [PMID: 32965593 PMCID: PMC7666273 DOI: 10.1007/s00702-020-02255-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/14/2020] [Indexed: 02/04/2023]
Abstract
Mild cognitive impairment (MCI) is a very common non-motor feature of Parkinson’s disease (PD) and the non-amnestic single-domain is the most frequent subtype. Transcranial random noise stimulation (tRNS) is a non-invasive technique, which is capable of enhancing cortical excitability. As the main contributor to voluntary movement control, the primary motor cortex (M1) has been recently reported to be involved in higher cognitive functioning. The aim of this study is to evaluate the effects of tRNS applied over M1 in PD-MCI patients in cognitive and motor tasks. Ten PD-MCI patients, diagnosed according to the Movement Disorder Society, Level II criteria for MCI, underwent active (real) and placebo (sham) tRNS single sessions, at least 1 week apart. Patients underwent cognitive (Digit Span Forward and Backward, Digit Symbol, Visual Search, Letter Fluency, Stroop Test) and motor assessments (Unified Parkinson’s Disease Rating Scale [UPDRS-ME], specific timed trials for bradykinesia, 10-m walk and Timed up and go tests) before and after each session. A significant improvement in motor ability (UPDRS-ME and lateralized scores, ps from 0.049 to 0.003) was observed after real versus sham tRNS. On the contrary, no significant differences were found in other motor tasks and cognitive assessment both after real and sham stimulations. These results confirm that tRNS is a safe and effective tool for improving motor functioning in PD-MCI. Future studies using a multisession tRNS applied over multitargeted brain areas (i.e., dorsolateral prefrontal cortex and M1) are required to clarify the role of tRNS regarding rehabilitative intervention in PD.
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Affiliation(s)
- Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy.
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Laura Pilati
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Lorenzo Pagano
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
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Baschi R, Restivo V, Nicoletti A, Cicero CE, Luca A, Recca D, Zappia M, Monastero R. Mild Behavioral Impairment in Parkinson's Disease: Data from the Parkinson's Disease Cognitive Impairment Study (PACOS). J Alzheimers Dis 2020; 68:1603-1610. [PMID: 30909234 DOI: 10.3233/jad-181117] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neuropsychiatric symptoms (NPS) have been frequently described in Parkinson's disease (PD), even in the earliest stages of the disease. Recently the construct of mild behavioral impairment (MBI) has been proposed as an at-risk state for incident cognitive decline and dementia. The aim of the present study is to evaluate the prevalence and associated factors of MBI in PD. Cross-sectional data from 429 consecutive PD patients enrolled in the PArkinson's disease COgnitive impairment Study (PACOS) were included in the study. All subjects underwent neuropsychological assessment, according to the MDS Level II criteria. NPS were evaluated with the Neuropsychiatric Inventory. Multivariate logistic regression models were used to evaluate clinical and behavioral characteristics, which are associated with PD-MBI. The latter was ascertained in 361 (84.1%) subjects of whom 155 (36.1%) were newly diagnosed patients (disease duration ≤1 year) and 206 (48.0%) had a disease duration >1 year. Furthermore, 68 (15.9%) out of 429 subjects were PDw (without MBI). Across the MBI domains, Impulse Dyscontrol was significantly more prevalent among PD-MBI with disease duration >1 year than newly diagnosed patients. The frequency of Social Inappropriateness and Abnormal Perception significantly increased throughout the entire PD-MBI sample with increasing Hoehn and Yahr (H&Y) stages. PD-MBI in newly diagnosed PD was significantly associated with H&Y stage (OR 2.35, 95% CI 1.05-5.24) and marginally with antidepressant drug use (OR 2.94, 95% CI 0.91-9.47), while in patients with a disease duration >1 year was associated with UPDRS-ME (OR 3.37, 95% CI 1.41-8.00). The overall MBI frequency in the PACOS sample was 84% and 36% among newly diagnosed patients. The presence of MBI mainly related to motor impairment and disability.
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Affiliation(s)
- Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | | | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Italy
| | | | - Antonina Luca
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Italy
| | - Deborah Recca
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
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Giuliano L, Mainieri G, Cicero CE, Battaglia G, Guccione A, Salomone S, Drago F, Nicoletti A, Sofia V, Zappia M. Parasomnias, sleep-related movement disorders and physiological sleep variants in focal epilepsy: A polysomnographic study. Seizure 2020; 81:84-90. [PMID: 32771823 DOI: 10.1016/j.seizure.2020.07.026] [Citation(s) in RCA: 5] [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: 06/12/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The link existing between epilepsy and sleep is widely recognized. However, little is known about the prevalence and the clinical consequences of the comorbidity between focal epilepsy and sleep disorders, especially those sleep phenomena classified as isolated symptoms or normal variants. Objective of the study was to evaluate the frequency of sleep disorders and physiological sleep variants in a group of adult patients with focal epilepsy as compared to healthy controls by means of nocturnal polysomnography. METHODS We performed a retrospective observational study in the Neurological Clinic of the University of Catania in adult patients with a diagnosis of focal epilepsy and in a group of control subjects. All subjects underwent an overnight polysomnography. The following sleep disorders were considered: NREM-related parasomnias; REM-related parasomnias; sleep-related movement disorders; isolated symptoms or normal variants. RESULTS 100 patients [mean age 30.3 ± 14.7 years, 40 men] and 62 controls [mean age 36.4 ± 15.9, 20 men] were studied. A significant higher percentage of sleep disorders was recorded in patients as compared to controls (73 % vs 48.4 %; p = 0.002). In particular, we found a higher frequency of periodic limb movements (PLM) (20 % vs 4.8 %; p = 0.007), bruxism (20 % vs 4.8 %; p = 0.007) and neck myoclonus (22 % vs 4.8 %; p = 0.003). Moreover, alternating limb muscle activation was associated with sleep-related hypermotor epilepsy (OR = 7.9; p = 0.01). CONCLUSION Sleep disorders and physiological sleep variants are common in adult patients with focal epilepsy.
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Affiliation(s)
- Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Greta Mainieri
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Giulia Battaglia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Antonella Guccione
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Salvatore Salomone
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Vito Sofia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neuroscience Section, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
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Cicero CE, Giuliano L, Todaro V, Colli C, Padilla S, Vilte E, Crespo Gómez EB, Camargo Villarreal WM, Bartoloni A, Zappia M, Nicoletti A. Comic book-based educational program on epilepsy for high-school students: Results from a pilot study in the Gran Chaco region, Bolivia. Epilepsy Behav 2020; 107:107076. [PMID: 32315969 DOI: 10.1016/j.yebeh.2020.107076] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/29/2020] [Accepted: 03/29/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION In low- and middle-income countries (LMIC), epilepsy still represents a significant health challenge. In the Bolivian Chaco, we have previously found high levels of stigma towards people with epilepsy (PWE) especially expressed by high school students. In order to increase the knowledge about epilepsy, we have tested a comic book-based intervention on a sample of high school students. METHODS The study has been conducted in the Bolivian Chaco region where two urban and two rural classrooms have been randomly selected. Students have been administered a knowledge, attitudes, and practices (KAP) questionnaire, and then they underwent a comic book-based educational program where they were randomly assigned either to an autonomous reading or a character interpretation methodology. The same KAP questionnaire has been administered after the teaching session and at a three months follow-up. Mean KAP scores at the baseline were compared with the after teaching and the three-month assessment. RESULTS Eighty-three students with a mean age of 15.5 ± 0.9 years, of whom 38 (45.8%) males, were recruited. After the comic book session, students improved in the global score (p < 0.001) and in the knowledge (p < 0.001), attitudes (p = 0.004), and practices (p < 0.001) subscores. Both the autonomous reading and the character interpretation groups significantly improved in the global score, but only the latter improved in all the subscores. At the three months follow-up, there were no differences in the global, knowledge, and attitudes subscores, compared with scores immediately after the intervention. CONCLUSION Using a comic book to teach about epilepsy led to a significant improvement in the knowledge, attitudes, and practices about the disease in high school students of LMIC. This teaching strategy can be easily implemented in LMIC.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Valeria Todaro
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Chiara Colli
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Sandra Padilla
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | - Estela Vilte
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | | | | | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Nicoletti A, Rascunà C, Boumediene F, Vasta R, Cicero CE, Lo Fermo S, Ferrante M, Marziolo R, Maimone D, Grimaldi LM, Preux PM, Patti F, Zappia M. Incidence of multiple sclerosis in the province of Catania. A geo-epidemiological study. Environ Res 2020; 182:109022. [PMID: 31883496 DOI: 10.1016/j.envres.2019.109022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/03/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND An increasing incidence of MS in the city of Catania was reported during 1975-2004, with a higher incidence along the south-eastern flank of the Mt.Etna. We evaluated the incidence of MS in the entire province of Catania during 2005-2015 and the spatial distribution of MS-cases using a cluster analysis. METHODS Patients were considered as incident MS-cases if they fulfilled the revised McDonald criteria for MS during 2005-2015 and were residents in the province of Catania at the time of disease onset. Cluster analysis was performed using both LISA and Kulldorff's spatial scan statistic. Residence address at disease onset was considered for each case. Communalities were assessed considering the centroid of their inhabited area. RESULTS A total of 973 MS-cases were identified. Mean annual incidence risk was 8.2/100,000 person-years (95%CI 7.7-8.7), significantly higher among women (10.5/100,000 versus 5.7/100,000). LISA identified a spatial aggregation of MS-cases in the eastern side of the province of Catania and Kulldorff's statistics confirmed the existence of a statistically significant spatial cluster in this area (SIR 1.23,95%CI 1.08-1.23, p-value 0.04). CONCLUSIONS Our study confirms a high incidence of MS in the province of Catania and the presence of a spatial cluster along the eastern side of the province. This area is considered the most exposed to volcanogenic ashes due to the prevailing westerly to north-westerly trade winds. Even if such distribution could be related with a greater exposure to volcanogenic metals, further studies are needed to explore possible alternative hypotheses.
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Affiliation(s)
- Alessandra Nicoletti
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
| | - Cristina Rascunà
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
| | - Farid Boumediene
- INSERM, U1094, Tropical Neuroepidemiology, University of Limoges, France.
| | - Rosario Vasta
- ALS Center, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.
| | | | - Salvatore Lo Fermo
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratory LIAA, Department GF Ingrassia, University of Catania, Catania, Italy.
| | | | | | | | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, University of Limoges, France.
| | - Francesco Patti
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
| | - Mario Zappia
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
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Baschi R, Luca A, Nicoletti A, Caccamo M, Cicero CE, D'Agate C, Di Giorgi L, La Bianca G, Lo Castro T, Zappia M, Monastero R. Changes in Motor, Cognitive, and Behavioral Symptoms in Parkinson's Disease and Mild Cognitive Impairment During the COVID-19 Lockdown. Front Psychiatry 2020; 11:590134. [PMID: 33381057 PMCID: PMC7768013 DOI: 10.3389/fpsyt.2020.590134] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/04/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: The effects of the COVID-19 lockdown on subjects with prodromal phases of dementia are unknown. The aim of this study was to evaluate the motor, cognitive, and behavioral changes during the COVID-19 lockdown in Italy in patients with Parkinson's disease (PD) with and without mild cognitive impairment (PD-MCI and PD-NC) and in patients with MCI not associated with PD (MCInoPD). Methods: A total of 34 patients with PD-NC, 31 PD-MCI, and 31 MCInoPD and their caregivers were interviewed 10 weeks after the COVID-19 lockdown in Italy, and changes in cognitive, behavioral, and motor symptoms were examined. Modified standardized scales, including the Neuropsychiatric Inventory (NPI) and the Movement Disorder Society, Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts I and II, were administered. Multivariate logistic regression was used to evaluate associated covariates by comparing PD-NC vs. PD-MCI and MCInoPD vs. PD-MCI. Results: All groups showed a worsening of cognitive (39.6%), pre-existing (37.5%), and new (26%) behavioral symptoms, and motor symptoms (35.4%) during the COVID-19 lockdown, resulting in an increased caregiver burden in 26% of cases. After multivariate analysis, PD-MCI was significantly and positively associated with the IADL lost during quarantine (OR 3.9, CI 1.61-9.58), when compared to PD-NC. In the analysis of MCInoPD vs. PD-MCI, the latter showed a statistically significant worsening of motor symptoms than MCInoPD (OR 7.4, CI 1.09-45.44). Regarding NPI items, nighttime behaviors statistically differed in MCInoPD vs. PD-MCI (16.1% vs. 48.4%, p = 0.007). MDS-UPDRS parts I and II revealed that PD-MCI showed a significantly higher frequency of cognitive impairment (p = 0.034), fatigue (p = 0.036), and speech (p = 0.013) than PD-NC. On the contrary, PD-MCI showed significantly higher frequencies in several MDS-UPDRS items compared to MCInoPD, particularly regarding pain (p = 0.001), turning in bed (p = 0.006), getting out of bed (p = 0.001), and walking and balance (p = 0.003). Conclusion: The COVID-19 quarantine is associated with the worsening of cognitive, behavioral, and motor symptoms in subjects with PD and MCI, particularly in PD-MCI. There is a need to implement specific strategies to contain the effects of quarantine in patients with PD and cognitive impairment and their caregivers.
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Affiliation(s)
- Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Antonina Luca
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Maria Caccamo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Calogero Edoardo Cicero
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Concetta D'Agate
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Lucia Di Giorgi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giuseppe La Bianca
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Tiziana Lo Castro
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Mario Zappia
- Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia," University of Catania, Catania, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
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Nicoletti A, García HH, Cicero CE, Portaro G, Giuliano L, Patti F, Sofia V, Noh J, Handali S, Zappia M. Lack of evidence for Toxocara infection in Italian myelitis patients. Neurol Sci 2020; 41:239-241. [PMID: 31332580 DOI: 10.1007/s10072-019-04017-9] [Citation(s) in RCA: 2] [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] [Received: 04/12/2019] [Accepted: 07/17/2019] [Indexed: 02/07/2023]
Abstract
Acute myelitis is a common neurological manifestation due to different causes, but in about 15-30% of cases its etiology remains unknown (idiopathic myelitis). Myelitis represents the most common manifestation of neurotoxocariasis, the infection of the human nervous system by larvae of the nematode Toxocara spp.; however, despite the high seroprevalence worldwide, its contribution to the burden of disease has not been assessed. We evaluated the presence of antibodies against Toxocara spp. in cerebrospinal fluid (CSF) from a sample of 28 patients with a diagnosis of idiopathic myelitis (N = 20) or encephalomyelitis (N = 8) who attended the Neurological Unit of the University Hospital of Catania, Sicily. Antibodies against Toxocara spp. were measured using a multiplex bead-based assay and Toxocara immunoblot using Toxocara canis excretory secretory antigens. All samples tested negative for the presence of anti-T. canis IgG antibodies. In this series, we found no evidence of a contribution of neurotoxocariasis to the burden of myelitis.
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Affiliation(s)
- Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Hector H García
- Department of Microbiology, School of Sciences, and Center for Global Health - Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Calogero Edoardo Cicero
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giacomo Portaro
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Francesco Patti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Vito Sofia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
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Cicero CE, Raciti L, Monastero R, Mostile G, Donzuso G, Sciacca G, Luca A, Terravecchia C, Giuliano L, Baschi R, Davì M, Zappia M, Nicoletti A. Cardiovascular autonomic function and MCI in Parkinson's disease. Parkinsonism Relat Disord 2019; 69:55-58. [PMID: 31677456 DOI: 10.1016/j.parkreldis.2019.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION dysautonomic dysfunction and cognitive impairment represent the most disabling non-motor features of Parkinson's Disease (PD). Recent evidences suggest the association between Orthostatic Hypotension (OH) and PD-Dementia. However, little is known on the interactions between cardiovascular dysautonomia and Mild Cognitive Impairment (MCI). We aimed to evaluate the association between cardiovascular dysautonomia and MCI in patients with PD. METHODS non-demented PD patients belonging to the PACOS cohort underwent a comprehensive instrumental neurovegetative assessment including the study of both parasympathetic and sympathetic function (30:15 ratio, Expiratory-Inspiratory ratio [E-I] and presence of Orthostatic Hypotension [OH]). Diagnosis of MCI was made according to the MDS criteria level II. RESULTS we enrolled 185 PD patients of whom 102 (55.1%) were men, mean age was 64.6 ± 9.7 years, mean disease duration of 5.6 ± 5.5 years with a mean UPDRS-ME score of 31.7 ± 10.9. MCI was diagnosed in 79 (42.7%) patients. OH was recorded in 52 (28.1%) patients, altered 30:15 ratio was recorded in 39 (24.1%) patients and an altered E-I ratio was found in 24 (19.1%) patients. Presence of MCI was associated with an altered 30:15 ratio (adjOR 2.83; 95%CI 1.25-6.40) but not with an altered E-I ratio, while OH was associated only with the amnestic MCI subgroup (OR 2.43; 95% CI 1.05-5.06). CONCLUSION in our study sample, MCI was mainly associated with parasympathetic dysfunction in PD.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loredana Raciti
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Giovanni Mostile
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giulia Donzuso
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giorgia Sciacca
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Claudio Terravecchia
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Marco Davì
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Neuroscience Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Nicoletti A, Cicero CE, Mostile G, Giuliano L, Luca A, Zappia M. Comment to: Trace elements in ALS patients and their relationships with clinical severity, by Oggiano R. et al. Chemosphere 2019; 233:986-987. [PMID: 30824159 DOI: 10.1016/j.chemosphere.2019.02.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/07/2019] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Alessandra Nicoletti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy.
| | - Calogero Edoardo Cicero
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Giovanni Mostile
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Loretta Giuliano
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Antonina Luca
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Mario Zappia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
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Raciti L, Nicoletti A, Mostile G, Bonomo R, Dibilio V, Donzuso G, Sciacca G, Cicero CE, Luca A, Zappia M. Accuracy of MDS-UPDRS section IV for detecting motor fluctuations in Parkinson’s disease. Neurol Sci 2019; 40:1271-1273. [DOI: 10.1007/s10072-019-03745-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
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Giuliano L, Cicero CE, Crespo Gómez EB, Sofia V, Zappia M, Nicoletti A. A screening questionnaire for generalized tonic-clonic seizures: Hospital-based validation vs field-validation method. Epilepsia Open 2019; 4:339-343. [PMID: 31168502 PMCID: PMC6546018 DOI: 10.1002/epi4.12315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/28/2019] [Indexed: 11/15/2022] Open
Abstract
The majority of the screening questionnaires for epilepsy have been validated in hospital settings. We previously developed and used for field validation a screening tool to detect generalized tonic-clonic seizures (GTCS) in the rural communities of the Chaco region of Bolivia. The objective of the present study was to perform a hospital-based validation of the same questionnaire and to compare the levels of accuracy obtained when validated in the field or in a hospital-based context. We carried out a hospital-based validation in the Hospital Hernandez Vera of Santa Cruz, Bolivia, where we enrolled patients affected by epilepsy with GTCS and controls. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated. One hundred twenty questionnaires were administered to 59 patients (27 men [45.8%]; mean age ± SD = 32.4 ± 14.2 years) and 61 controls (27 men [44.3%]; mean age ± SD = 32.6 ± 14.3 years). We obtained levels of accuracy of 100%. Sensitivity and PPV were significantly higher than the estimates obtained in the field-validation study (sensitivity 100% vs 76.3%; PPV 100% vs 69.0%). Our screening questionnaire showed a significantly lower level of sensitivity when validated in the field, confirming that hospital-based validation can lead to an overestimation of sensitivity.
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Affiliation(s)
- Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”Section of NeurosciencesUniversity of CataniaCataniaItaly
| | | | - Vito Sofia
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”Section of NeurosciencesUniversity of CataniaCataniaItaly
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”Section of NeurosciencesUniversity of CataniaCataniaItaly
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Mostile G, Giuliano L, Monastero R, Luca A, Cicero CE, Donzuso G, Dibilio V, Baschi R, Terranova R, Restivo V, Sofia V, Zappia M, Nicoletti A. Electrocortical networks in Parkinson's disease patients with Mild Cognitive Impairment. The PaCoS study. Parkinsonism Relat Disord 2019; 64:156-162. [PMID: 30981665 DOI: 10.1016/j.parkreldis.2019.03.027] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 03/27/2019] [Accepted: 03/30/2019] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Parkinson's Disease (PD) is frequently associated with cognitive dysfunction ranging from Mild Cognitive Impairment (PD-MCI) to dementia. Few electrophysiological studies are available evaluating potential pathogenetic mechanisms linked to cognitive impairment in PD since its initial phases. The objective of the study is to analyze electrocortical networks related with cognitive decline in PD-MCI for identifying possible early electrophysiological markers of cognitive impairment in PD. METHODS From the PaCoS (Parkinson's disease Cognitive impairment Study) cohort, a sample of 102 subjects including 46 PD-MCI and 56 PD with normal cognition (PD-NC) was selected based on the presence of a neuropsychological assessment and at least one EEG recording. EEG signal epochs were analysed using Independent Component Analysis LORETA and spectral analysis by computing the Power Spectral Density (PSD) of site-specific signal epochs. RESULTS LORETA analysis revealed significant differences in PD-MCI patients compared to PD-NC, with a decreased network involving alpha activity over the occipital lobe, an increased network involving beta activity over the frontal lobe associated with a reduction over the parietal lobe, an increased network involving theta and delta activity over the frontal lobe and a reduction of networks involving theta and delta activity in the parietal lobe. Quantitative EEG analysis showed a significant decrease of alpha PSD over the occipital regions and an increase of delta PSD over the left temporal region in PD-MCI as compared to PD-NC. CONCLUSION Electrocortical abnormalities detected in PD-MCI patients may represent the instrumental counterpart of early cognitive decline in PD.
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Affiliation(s)
- Giovanni Mostile
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Antonina Luca
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Giulia Donzuso
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Valeria Dibilio
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Roberta Terranova
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Vincenzo Restivo
- Department of Sciences for Health Promotion and Mother-Child Care, University of Palermo, Via Del Vespro 133, 90127, Palermo, Italy
| | - Vito Sofia
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Mario Zappia
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
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Giuliano L, Cicero CE, Padilla S, Rojo Mayaregua D, Camargo Villarreal WM, Sofia V, Zappia M, Bartoloni A, Crespo Gómez EB, Nicoletti A. Knowledge, stigma, and quality of life in epilepsy: Results before and after a community-based epilepsy awareness program in rural Bolivia. Epilepsy Behav 2019; 92:90-97. [PMID: 30634158 DOI: 10.1016/j.yebeh.2018.11.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Epilepsy represents around 0.7% of the overall global burden of diseases and is particularly prevalent and associated with significant disability in low- and middle-income countries (LMIC) in Latin American Countries (LAC). A community-based epilepsy awareness program was carried out by our group in the rural areas of the Chaco region, Plurinational state of Bolivia, to improve the knowledge about epilepsy, with a first part directed toward general practitioners and a second part toward nurses and community health workers (CHWs) of the rural communities with a positive outcome. The objective of the study was to assess the level of knowledge, attitudes, and practices toward epilepsy, the stigma related to epilepsy and the quality of life in people with epilepsy (PWE) before and after the interventional campaign directed toward representative members of the rural communities in the Chaco region in Bolivia. METHODS The study was conducted in three areas of Bolivia. Key subjects from each community were randomly selected. Before and after the courses they answered a questionnaire to assess their knowledge, attitudes, beliefs, and practices about epilepsy, a validated Stigma Scale of Epilepsy (SSE) and Quality of Life in Epilepsy Inventory-10 (QOLIE-10). RESULTS Two hundred sixteen subjects were involved in the program. Only 133 (61.6%) subjects completed the questionnaires a month after the educational program. A significant improvement was recorded in knowledge, attitudes, and practices toward epilepsy, and a significant reduction was found in the mean SSE total score (38.3 ± 14.7 vs. 28.5 ± 12.3; p < 0.01), reflecting a reduction of stigma levels. Regarding the quality of life, after the training, PWE stated to experience less depression, memory difficulties, work or social issues, and seizure worry. CONCLUSION Our study confirms that continuous educational campaigns can lead to a significant change in the social perception and attitudes toward epilepsy.
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Affiliation(s)
- Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Sandra Padilla
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | | | | | - Vito Sofia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | | | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Cicero CE, Patti F, Lo Fermo S, Giuliano L, Rascunà C, Chisari CG, D'Amico E, Paradisi V, Marin B, Preux PM, Mantella A, Bartoloni A, Zappia M, Nicoletti A. Lack of association between Toxocara canis and multiple sclerosis: A population-based case-control study. Mult Scler 2019; 26:258-259. [PMID: 30741090 DOI: 10.1177/1352458518825394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Salvatore Lo Fermo
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Cristina Rascunà
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Clara Grazia Chisari
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Emanuele D'Amico
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | | | - Benoît Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, Centre d'Epidemiologie de Biostatistique et de Methodologie de la Recherche, Limoges, France
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; CHU Limoges, Centre d'Epidemiologie de Biostatistique et de Methodologie de la Recherche, Limoges, France
| | - Antonia Mantella
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
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Nicoletti A, Luca A, Baschi R, Cicero CE, Mostile G, Davì M, Pilati L, Restivo V, Zappia M, Monastero R. Incidence of Mild Cognitive Impairment and Dementia in Parkinson's Disease: The Parkinson's Disease Cognitive Impairment Study. Front Aging Neurosci 2019; 11:21. [PMID: 30800065 PMCID: PMC6376919 DOI: 10.3389/fnagi.2019.00021] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/24/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Cognitive impairment in Parkinson’s disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients. Methods: PD patients from a large hospital-based cohort who underwent at least two comprehensive neuropsychological evaluations were retrospectively enrolled in the study. PD-MCI and PDD were diagnosed according to the Movement Disorder Society criteria. Incidence rates of PD-MCI and PDD were estimated. Clinical and demographic factors predicting PD-MCI and dementia were evaluated using Cox proportional hazard model. Results: Out of 139 enrolled PD patients, 84 were classified with normal cognition (PD-NC), while 55 (39.6%) fulfilled the diagnosis of PD-MCI at baseline. At follow-up (mean follow-up 23.5 ± 10.3 months) 28 (33.3%) of the 84 PD-NC at baseline developed MCI and 4 (4.8%) converted to PDD. The incidence rate of PD-MCI was 184.0/1000 pyar (95% CI 124.7–262.3). At multivariate analysis a negative association between education and MCI development at follow-up was observed (HR 0.37, 95% CI 0.15–0.89; p = 0.03). The incidence rate of dementia was 24.3/1000 pyar (95% CI 7.7–58.5). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD, giving an incidence rate of 123.5/1000 pyar (95% CI 70.3–202.2). A five time increased risk of PDD was found in PD patients with MCI at baseline (RR 5.09, 95% CI 1.60–21.4). Conclusion: Our study supports the relevant role of PD-MCI in predicting PDD and underlines the importance of education in reducing the risk of cognitive impairment.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Antonina Luca
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Roberta Baschi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Marco Davì
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Laura Pilati
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Vincenzo Restivo
- Department of Sciences for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
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Mostile G, Giuliano L, Dibilio V, Luca A, Cicero CE, Sofia V, Nicoletti A, Zappia M. Complexity of electrocortical activity as potential biomarker in untreated Parkinson's disease. J Neural Transm (Vienna) 2018; 126:167-172. [PMID: 30506462 DOI: 10.1007/s00702-018-1961-6] [Citation(s) in RCA: 3] [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] [Received: 10/23/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Abstract
In Parkinson's disease (PD), the identification of instrumental biomarkers is crucial to evaluate disease susceptibility and motor stage. We evaluated self-similarity of electrocortical activity as expression of brain signal complexity in untreated PD, to investigate its possible role as a neurophysiological biomarker. We analyzed the data of 34 untreated PD subjects and 18 group-matched controls who underwent standardized electroencephalography. A Welch's periodogram was applied to site-specific electroencephalographic signal epochs. To investigate self-similarity of electrocortical activity, the power law exponent β was computed for each selected coordinate. In both PD subjects and controls, β values at each coordinate increased with an antero-posterior gradient, changing from values around one in fronto-temporal sites to values around two among parieto-occipital sites. PD subjects presented overall lower β values among different sites compared to controls, with significant differences for the left fronto-temporal sites. Our findings suggest an increased level of fronto-temporal neuronal organization in untreated PD. We hypothesize a possible role of β as a neurophysiological biomarker for early untreated PD.
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Affiliation(s)
- Giovanni Mostile
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Valeria Dibilio
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Vito Sofia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Mario Zappia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Nicoletti A, Giuliano L, Colli C, Cicero CE, Padilla S, Vilte E, Rojo Mayaregua D, Martinez MDC, Camargo M, Zappia M, Bartoloni A, Crespo Gómez EB. Treating People With Epilepsy in Rural Low-Income Countries Is Feasible. Observations and Reflections From a "Real Life Experience" After a Long Lasting Intervention in the Rural Chaco. Front Neurol 2018; 9:855. [PMID: 30364141 PMCID: PMC6191465 DOI: 10.3389/fneur.2018.00855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/21/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction: Epilepsy represents an important public health issue, in particular in low and middle-income countries where significant disparities are present in the care available for patients with epilepsy. Treatment cost and unavailability of drugs represent important barriers in treating people with epilepsy especially in rural setting. Aim of the study was to evaluate, by means of routine data, the current real-life clinical practice in epilepsy in the rural communities of the Plurinational State of Bolivia. Treatment activity followed educational campaigns and an anthropological fieldwork over more than 20 years. Material and Methods: Medical records of people with epilepsy (PWE) living in the rural communities of the Bolivian Chaco who received antiepileptic drugs (AEDs), from 2012 to 2016, and were followed-up for at least 1 year were analyzed. Treatment delivery and follow up visits were managed by a neurologist with the support of rural health care workers. Results: From 2012 to 2016, 157 PWE (76 men with a mean age of 24.2 ± 15.7) have been included in the study. Structural epilepsy was the most common type, recorded in 54 cases (34.4%) and the most common reported causes were perinatal factors, present in 11 subjects (20.0%). Almost all patients presented epilepsy with generalized tonic-clonic seizures (91.4%). The most common AED prescribed was phenobarbital followed by carbamazepine. During the follow-up, a dramatic seizures reduction was observed, with 31 subjects (19.7%) being seizures-free at the last follow-up. However, 48 subjects (30.6%) did not assume the medication regularly and 10 interrupted the drug intake. More than 20% of PWE did not receive any financial supports for AEDs. During the follow-up period 10 patients died but only in one case the death was probably caused by epilepsy. Conclusion: Our study demonstrated that PWE in rural areas of the Bolivian Chaco are willing to seek medical attention and to receive antiepileptic treatment. However, improvement in care is needed to assure compliance to AED treatment, including activity to increase awareness toward epilepsy among community members and health staff of the rural communities and to guarantee the coverage of treatment costs and drug supply.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia, " Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia, " Section of Neurosciences, University of Catania, Catania, Italy
| | - Chiara Colli
- Department of Experimental and Clinical Medicine, Infectious Diseases Unit, University of Florence, Florence, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia, " Section of Neurosciences, University of Catania, Catania, Italy
| | - Sandra Padilla
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | - Estela Vilte
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | | | - Maria Del Carmen Martinez
- Department of Experimental and Clinical Medicine, Infectious Diseases Unit, University of Florence, Florence, Italy
| | - Mario Camargo
- Bolivian League Against Epilepsy, Santa Cruz, Bolivia
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia, " Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious Diseases Unit, University of Florence, Florence, Italy
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Giuliano L, Cicero CE, Padilla S, Camargo M, Sofia V, Zappia M, Bartoloni A, Crespo Gómez EB, Nicoletti A. Knowledge and attitudes towards epilepsy among nonmedical health workers in rural Bolivia: Results after a long-term activity in the Chaco region. Epilepsy Behav 2018; 85:58-63. [PMID: 29908385 DOI: 10.1016/j.yebeh.2018.05.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/11/2018] [Accepted: 05/12/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Epilepsy represents a major global healthcare issue, particularly in low- and middle-income countries (LMIC), where nonmedical health workers play a key role in providing care to people with epilepsy (PWE). Over the last 20 years, many projects have been carried out by our group in the Chaco region, Plurinational State of Bolivia, with the aim of enhancing knowledge about epilepsy. However, the level of knowledge of epilepsy that nonmedical health workers have reached has never been assessed until now. The main objective of our study was to assess the level of knowledge, attitudes, and practices (KAP) towards epilepsy among nonmedical health staff of the rural communities of the Chaco region in Bolivia. METHODS The study was conducted in three departments of Bolivia. The nonmedical health personnel were invited to participate in a training program. They answered a validated questionnaire to evaluate their knowledge and attitudes towards epilepsy before and after the courses. RESULTS One hundred nineteen subjects [42 men (36.2%); mean age 29.3 ± 1.1 years] were interviewed among community health workers and nurses before the courses, demonstrating a very good level of knowledge regarding epilepsy and its causes. Only 55 health workers participated in the second training module, and their answer did not significantly differ from the baseline. CONCLUSION Our study confirms the usefulness of continuous educational campaigns, especially directed to nonspecialist healthcare providers of rural communities of LMIC, as they may be the only persons responsible for providing healthcare to PWE in that setting. Moreover, the importance of the baseline assessment of KAP was highlighted in order to adapt the educational campaigns to the baseline level of knowledge found.
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Affiliation(s)
- Loretta Giuliano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Sandra Padilla
- Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia
| | - Mario Camargo
- The Bolivian League Against Epilepsy, Santa Cruz, Bolivia
| | - Vito Sofia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy
| | | | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Luca A, Nicoletti A, Mostile G, Sciacca G, Dibilio V, Cicero CE, Raciti L, Donzuso G, Zappia M. Temperament traits and executive functions in Parkinson's disease. Neurosci Lett 2018; 684:25-28. [PMID: 29940327 DOI: 10.1016/j.neulet.2018.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/27/2018] [Revised: 06/11/2018] [Accepted: 06/21/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Aim of the study was to evaluate the possible relationship between Temperament traits and executive dysfunction in patients with Parkinson's disease (PD). METHODS Patients affected by PD diagnosed according to the UK Parkinson's disease Society Brain Bank criteria were enrolled in the study. Patients with a Mini Mental State Examination <24 were excluded from the study. The Temperament and Character Inventory (TCI), a self-report questionnaire assessing the Harm Avoidance (HA), Novelty Seeking (NS) and Reward Dependence (RD) temperamental traits, has been performed. The executive functions were assessed with the Frontal Assessment Battery (FAB). RESULTS Fifty PD patients (28 men and 22 women; mean age 59.1 ± 10.1 years) were enrolled. High HA (mean score 73.3 ± 24.7) and a low NS score (24.2 ± 18.7) were recorded. Fifteen (30%) patients presented a pathological FAB score (≤13.5). Patients with a pathological FAB score presented an HA score significantly higher than patients with normal FAB score (respectively 84.9 ± 13.7 versus 69.8 ± 26.9; p = 0.045). At the univariate analysis an association between high HA score and pathological FAB score was found (OR 3.85, 95%CI 1.06-13.9; p-value 0.040). CONCLUSION Our study confirmed an association between executive disturbances and HA in PD patients, possibly related to a common impairment of the frontostriatal circuits.
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Affiliation(s)
- Antonina Luca
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Giovanni Mostile
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Giorgia Sciacca
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Valeria Dibilio
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Loredana Raciti
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Giulia Donzuso
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Mario Zappia
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Via Santa Sofia 79, 95123, Catania, Italy.
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Monastero R, Cicero CE, Baschi R, Davì M, Luca A, Restivo V, Zangara C, Fierro B, Zappia M, Nicoletti A. Mild cognitive impairment in Parkinson's disease: the Parkinson's disease cognitive study (PACOS). J Neurol 2018; 265:1050-1058. [PMID: 29478221 DOI: 10.1007/s00415-018-8800-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [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: 12/17/2017] [Revised: 02/13/2018] [Accepted: 02/14/2018] [Indexed: 11/25/2022]
Abstract
Approximately 30% of Parkinson's disease (PD) patients show impaired cognitive performance, which is suggestive of Mild Cognitive Impairment (MCI), representing a predictor of dementia, especially when present at diagnosis. The objective of the study was to evaluate the frequency and clinical predictors of MCI in a large hospital-based cohort of PD patients. We collected cross-sectional data from the Parkinson's disease cognitive impairment study (PACOS), a multicenter study involving two Movement Disorder centers, which are located in south Italy. The PD subjects were diagnosed according to the UK Brain Bank criteria and they underwent an extensive neuropsychological assessment. PD-MCI was diagnosed according to the Movement Disorder Society task force criteria for MCI. PD severity was evaluated in accordance with the Unified PD Rating Scale-Motor Examination (UPDRS-ME) and the Hoehn and Yahr scales. The study included 659 PD patients (57.5% men; mean age 67.0 ± 9.7 years), with a mean disease duration of 3.8 ± 4.6 years and a mean UPRDS-ME score of 25.8 ± 12.3. PD-MCI was diagnosed in 261 (39.6%) subjects and in 82 (31.7%) of 259 newly diagnosed patients (disease duration ≤ 1 year). An amnestic MCI multidomain phenotype was the most frequent MCI subtype (39.1% of the overall sample and 43.9% in newly diagnosed PD). A positive significant association between MCI, age and motor scores was found at multivariate logistic regression analysis, while a negative association was observed between educational level and MCI. In conclusion and in agreement with the literature data, the prevalence of MCI recorded in the PACOS sample was approximately 40 and 32% amongst newly diagnosed patients.
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Affiliation(s)
- Roberto Monastero
- Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy.
| | - Calogero Edoardo Cicero
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Roberta Baschi
- Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Marco Davì
- Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Antonina Luca
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Vincenzo Restivo
- Department of Sciences for Health Promotion and Mother-Child Care, University of Palermo, Via Del Vespro 133, 90127, Palermo, Italy
| | - Chiara Zangara
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Brigida Fierro
- Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy
| | - Mario Zappia
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy.
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Cicero CE, Mostile G, Vasta R, Rapisarda V, Signorelli SS, Ferrante M, Zappia M, Nicoletti A. Metals and neurodegenerative diseases. A systematic review. Environ Res 2017; 159:82-94. [PMID: 28777965 DOI: 10.1016/j.envres.2017.07.048] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [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: 07/04/2017] [Revised: 07/26/2017] [Accepted: 07/28/2017] [Indexed: 05/28/2023]
Abstract
Neurodegenerative processes encompass a large variety of diseases with different pathological patterns and clinical presentation such as Amyotrophic Lateral Sclerosis (ALS), Alzheimer Disease (AD) and Parkinson's disease (PD). Genetic mutations have a known causative role, but the majority of cases are likely to be probably caused by a complex gene-environment interaction. Exposure to metals has been hypothesized to increase oxidative stress in brain cells leading to cell death and neurodegeneration. Neurotoxicity of metals has been demonstrated by several in vitro and in vivo experimental studies and it is likely that each metal could be toxic through specific pathways. The possible pathogenic role of different metals has been supported by some epidemiological evidences coming from occupational and ecological studies. In order to assess the possible association between metals and neurodegenerative disorders, several case-control studies have also been carried out evaluating the metals concentration in different biological specimens such as blood/serum/plasma, cerebrospinal fluid (CSF), nail and hair, often reporting conflicting results. This review provides an overview of our current knowledge on the possible association between metals and ALS, AD and PD as main neurodegenerative disorders.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Rosario Vasta
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy.
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Bonomo R, Mostile G, Raciti L, Contrafatto D, Dibilio V, Luca A, Sciacca G, Cicero CE, Vasta R, Nicoletti A, Zappia M. Quantitative estimation of motor fluctuations in Parkinson's disease. Parkinsonism Relat Disord 2017. [PMID: 28624431 DOI: 10.1016/j.parkreldis.2017.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To provide a quantitative estimation of motor fluctuations in PD through a 12-h Waking-day Motor Assessment (WDMA) and to develop new WDMA-based tools, the Motor Fluctuation Indices. METHODS Two independent samples of PD patients (exploratory population N = 51, testing population N = 109) were examined. Patients underwent a WDMA using the Unified Parkinson's Disease Rating Scale (UPDRS) and were classified as either having or not having motor fluctuations. To quantify motor fluctuations, the Worsening Index (WI), the Mean Fluctuation Index (MFI) and the Coefficient of Variation (CV) were computed. The optimal cut-off for each index distinguishing patients with or without fluctuations was calculated on the exploratory population. Cut-offs' accuracy was then verified in the testing population. RESULTS Optimal cut-off scores to differentiate stable patients from fluctuating ones were 8.3 for WI, 5 for MFI and 12.9 for CV. Sensitivity and a specificity were 91.2% (95%CI: 85.9 to 96.5) and 87.8% (95%CI: 81.7 to 93.9) for WI; 75% (95%CI: 66.9 to 83.1) and 90.2% (95%CI: 84.7 to 95.8) for MFI; 69.1% (95%CI: 60.4 to 77.8) and 95.1% (95%CI: 91.1 to 99.2) for CV. Patients with a larger magnitude of fluctuation had higher values for all three indices, whereas patients with multiple daily fluctuations presented only higher WI values. CONCLUSIONS WDMA-derived Motor Fluctuation Indices may represent reliable tools for evaluating and quantifying the severity of motor fluctuations in PD patients. Even if WDMA is a time-consuming procedure, the detection of Motor Fluctuation Indices could be helpful in assessing therapeutic efficacy on motor fluctuations.
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Affiliation(s)
- Roberta Bonomo
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Loredana Raciti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Donatella Contrafatto
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Valeria Dibilio
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Antonina Luca
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Giorgia Sciacca
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Rosario Vasta
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Nigro S, Arabia G, Antonini A, Weis L, Marcante A, Tessitore A, Cirillo M, Tedeschi G, Zanigni S, Calandra-Buonaura G, Tonon C, Pezzoli G, Cilia R, Zappia M, Nicoletti A, Cicero CE, Tinazzi M, Tocco P, Cardobi N, Quattrone A. Magnetic Resonance Parkinsonism Index: diagnostic accuracy of a fully automated algorithm in comparison with the manual measurement in a large Italian multicentre study in patients with progressive supranuclear palsy. Eur Radiol 2017; 27:2665-2675. [PMID: 27761709 DOI: 10.1007/s00330-016-4622-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 06/18/2016] [Revised: 08/26/2016] [Accepted: 09/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate the reliability of a new in-house automatic algorithm for calculating the Magnetic Resonance Parkinsonism Index (MRPI), in a large multicentre study population of patients affected by progressive supranuclear palsy (PSP) or Parkinson's disease (PD), and healthy controls (HC), and to compare the diagnostic accuracy of the automatic and manual MRPI values. METHODS The study included 88 PSP patients, 234 PD patients and 117 controls. MRI was performed using both 3T and 1.5T scanners. Automatic and manual MRPI values were evaluated, and accuracy of both methods in distinguishing PSP from PD and controls was calculated. RESULTS No statistical differences were found between automated and manual MRPI values in all groups. The automatic MRPI values differentiated PSP from PD with an accuracy of 95 % (manual MRPI accuracy 96 %) and 97 % (manual MRPI accuracy 100 %) for 1.5T and 3T scanners, respectively. CONCLUSION Our study showed that the new in-house automated method for MRPI calculation was highly accurate in distinguishing PSP from PD. Our automatic approach allows a widespread use of MRPI in clinical practice and in longitudinal research studies. KEY POINTS • A new automatic method for calculating the MRPI is presented. • Automatic MRPI values are in good agreement with manual values. • Automatic MRPI can distinguish patients with PSP from patients with PD. • The automatic method overcomes MRPI application limitations in routine practice. • The automatic method may allow a more widespread use of MRPI.
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Affiliation(s)
- Salvatore Nigro
- Institute of Bioimaging and Molecular Physiology, National Research Council, 88100, Catanzaro, Italy
| | - Gennarina Arabia
- Institute of Neurology, Department of Medical and Surgical Sciences, University 'Magna Graecia', 88100, Catanzaro, Italy
| | - Angelo Antonini
- Parkinson's Disease and Movement Disorders Unit, 'Fondazione Ospedale San Camillo' - I.R.C.C.S, Venice-Lido, Italy
| | - Luca Weis
- Parkinson's Disease and Movement Disorders Unit, 'Fondazione Ospedale San Camillo' - I.R.C.C.S, Venice-Lido, Italy
| | - Andrea Marcante
- Parkinson's Disease and Movement Disorders Unit, 'Fondazione Ospedale San Camillo' - I.R.C.C.S, Venice-Lido, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Mario Cirillo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Gioacchino Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Stefano Zanigni
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Caterina Tonon
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gianni Pezzoli
- Parkinson Institute, ASST G.Pini - CTO, ex ICP, Milano, Italy
| | - Roberto Cilia
- Parkinson Institute, ASST G.Pini - CTO, ex ICP, Milano, Italy
| | - Mario Zappia
- Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - Michele Tinazzi
- Department of Neurological and Movement Sciences, University Hospital of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Pierluigi Tocco
- Department of Neurological and Movement Sciences, University Hospital of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Nicolò Cardobi
- Institute of Radiology, University Hospital of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Aldo Quattrone
- Institute of Bioimaging and Molecular Physiology, National Research Council, 88100, Catanzaro, Italy.
- Institute of Neurology, Department of Medical and Surgical Sciences, University 'Magna Graecia', 88100, Catanzaro, Italy.
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