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De Luca R, Gangemi A, Bonanno M, Fabio RA, Cardile D, Maggio MG, Rifici C, Vermiglio G, Di Ciuccio D, Messina A, Quartarone A, Calabrò RS. Improving Neuroplasticity through Robotic Verticalization Training in Patients with Minimally Conscious State: A Retrospective Study. Brain Sci 2024; 14:319. [PMID: 38671971 PMCID: PMC11048571 DOI: 10.3390/brainsci14040319] [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: 02/06/2024] [Revised: 03/17/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
In disorders of consciousness, verticalization is considered an effective type of treatment to improve motor and cognitive recovery. Our purpose is to investigate neurophysiological effects of robotic verticalization training (RVT) in patients with minimally conscious state (MCS). Thirty subjects affected by MCS due to traumatic or vascular brain injury, attending the intensive Neurorehabilitation Unit of the IRCCS Neurolesi (Messina, Italy), were included in this retrospective study. They were equally divided into two groups: the control group (CG) received traditional verticalization with a static bed and the experimental group (EG) received advanced robotic verticalization using the Erigo device. Each patient was evaluated using both clinical scales, including Levels of Cognitive Functioning (LCF) and Functional Independence Measure (FIM), and quantitative EEG pre (T0) and post each treatment (T1). The treatment lasted for eight consecutive weeks, and sessions were held three times a week, in addition to standard neurorehabilitation. In addition to a notable improvement in clinical parameters, such as functional (FIM) (p < 0.01) and cognitive (LCF) (p < 0.01) outcomes, our findings showed a significant modification in alpha and beta bands post-intervention, underscoring the promising effect of the Erigo device to influence neural plasticity and indicating a noteworthy difference between pre-post intervention. This was not observed in the CG. The observed changes in alpha and beta bands underscore the potential of the Erigo device to induce neural plasticity. The device's custom features and programming, tailored to individual patient needs, may contribute to its unique impact on brain responses.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Antonio Gangemi
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Rosa Angela Fabio
- Department of Economics, University of Messina, 98100 Messina, Italy;
| | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Carmela Rifici
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Giuliana Vermiglio
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Daniela Di Ciuccio
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Angela Messina
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy; (R.D.L.); (A.G.); (D.C.); (M.G.M.); (C.R.); (G.V.); (D.D.C.); (A.M.); (A.Q.); (R.S.C.)
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Corallo F, Sessa E, Rifici C, De Cola MC, Di Cara M, Cardile D, Venuti G, Bonfiglio N, D’Aleo G, Quartarone A, Lo Buono V. Anxiety and Perception of Disease Control in Multiple Sclerosis Subjects Treated with Natalizumab. J Clin Med 2023; 13:13. [PMID: 38202019 PMCID: PMC10779828 DOI: 10.3390/jcm13010013] [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: 11/01/2023] [Revised: 12/16/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
Multiple sclerosis subjects treated with natalizumab face anxiety about developing progressive multifocal leukoencephalopathy (PML), besides the psychological distress caused by the disease. The aim of this study is to investigate whether increasing the frequency of neurological and nuclear magnetic resonance screening may affect anxiety and the perception of disease control in patients treated with natalizumab. A total of 62 relapsing-remitting multiple sclerosis patients were recruited from 2019 to 2020. All patients received conventional infusion treatments with natalizumab, along with a screening protocol for PML. Three clinical assessments were considered: at the beginning of the study (T0), after 3 months (T1) and after 6 months (T2). Patients were classified into three levels of risk, where level 1 represented a low risk of PML and level 3 a high risk. This classification determined treatment and screening protocol, i.e., the frequency of performing the Stratify test and the brain 3T NMR exam, as well as the frequency of infusion treatments. Anxiety and perception of disease control were assessed at T0, T1, and T2 by a skilled psychologist. The Friedman test and the Wilcoxon signed-rank test were used to compare outcomes at baseline with the two follow-ups. Statistical test results showed that the risk of PML (per 1000 patients) was significantly lower in women than in men (W = 198.5; p = 0.01). Moreover, significant differences between baseline and the two follow-ups were found, both for anxiety (F(2) = 122.6, p < 0.001) and for perception of disease control (F(2) = 123.5, p < 0.001). In both cases, there was significant improvement between baseline (T0) and the end of the study (T2) in any risk level (p < 0.001). An increase in the number of follow-ups, as well as an increase in instrumental investigations, might have a positive effect on both anxiety and the perception of disease control. However, there are many variables involved in the disease process that have an impact on patients' psychological well-being. Therefore, further and more extensive studies are necessary to evaluate how, and how much, each variable impacts the disease course.
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Affiliation(s)
| | | | | | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (F.C.); (C.R.); (M.D.C.); (D.C.); (G.V.); (N.B.); (G.D.); (A.Q.); (V.L.B.)
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Calderone A, Carta D, Cardile D, Quartarone A, Rifici C, Calabrò RS, Corallo F. Use of Virtual Reality in Patients with Acquired Brain Injury: A Systematic Review. J Clin Med 2023; 12:7680. [PMID: 38137752 PMCID: PMC10743630 DOI: 10.3390/jcm12247680] [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: 11/13/2023] [Revised: 11/28/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES ABI is found in all societies as the most severe, disabling neurological disorder. A cognitive rehabilitation program is essential for the clinical recovery of these patients, improving functional outcomes and quality of life. Modern technologies such as virtual reality (VR) offer several advantages over traditional therapies, including the ability to engage people in simulated performance of functional tasks. This review will examine the studies in which virtual reality has been used as an aid, technique, or intervention in patients with acquired brain injury. MATERIALS AND METHODS Studies were identified from an online search of PubMed, Cochrane Library, and Web of Science databases. RESULTS We found that TBI patients responded positively to VR treatment depending on the damaged or impaired cognitive and motor functions they acquired. It is now a tool that is available in the rehabilitation of these patients and supports the recovery of various motor and cognitive functions. CONCLUSIONS This review has shown that VR is an intervention technique that increasingly exists in clinical rehabilitation practice for ABI patients. The device uses advanced technologies that can cause general changes in cognitive, motor, and psychological aspects and create a simulated environment that can partially restore these functions and behaviors, as well as the behaviors of everyday life.
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Affiliation(s)
| | | | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy
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Gangemi A, De Luca R, Fabio RA, Lauria P, Rifici C, Pollicino P, Marra A, Olivo A, Quartarone A, Calabrò RS. Effects of Virtual Reality Cognitive Training on Neuroplasticity: A Quasi-Randomized Clinical Trial in Patients with Stroke. Biomedicines 2023; 11:3225. [PMID: 38137446 PMCID: PMC10740852 DOI: 10.3390/biomedicines11123225] [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: 10/07/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Cognitive Rehabilitation (CR) is a therapeutic approach designed to improve cognitive functioning after a brain injury, including stroke. Two major categories of techniques, namely traditional and advanced (including virtual reality-VR), are widely used in CR for patients with various neurological disorders. More objective outcome measures are needed to better investigate cognitive recovery after a stroke. In the last ten years, the application of electroencephalography (EEG) as a non-invasive and portable neuroimaging method has been explored to extract the hallmarks of neuroplasticity induced by VR rehabilitation approaches, particularly within the chronic stroke population. The aim of this study is to investigate the neurophysiological effects of CR conducted in a virtual environment using the VRRS device. Thirty patients with moderate-to-severe ischemic stroke in the chronic phase (at least 6 months after the event), with a mean age of 58.13 (±8.33) for the experimental group and 57.33 (±11.06) for the control group, were enrolled. They were divided into two groups: an experimental group and a control group, receiving neurocognitive stimulation using VR and the same amount of conventional neurorehabilitation, respectively. To study neuroplasticity changes after the training, we focused on the power band spectra of theta, alpha, and beta EEG rhythms in both groups. We observed that when VR technology was employed to amplify the effects of treatments on cognitive recovery, significant EEG-related neural improvements were detected in the primary motor circuit in terms of power spectral density and time-frequency domains. Indeed, EEG analysis suggested that VR resulted in a significant increase in both the alpha band power in the occipital areas and the beta band power in the frontal areas, while no significant variations were observed in the theta band power. Our data suggest the potential effectiveness of a VR-based rehabilitation approach in promoting neuroplastic changes even in the chronic phase of ischemic stroke.
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Affiliation(s)
- Antonio Gangemi
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rosaria De Luca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rosa Angela Fabio
- Department of Economics, University of Messina, Via Consolare Valeria, 98125 Messina, Italy;
| | - Paola Lauria
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Carmela Rifici
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Patrizia Pollicino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Angela Marra
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Antonella Olivo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
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De Luca R, Lauria P, Bonanno M, Corallo F, Rifici C, Castorina MV, Trifirò S, Gangemi A, Lombardo C, Quartarone A, De Cola MC, Calabrò RS. Neurophysiological and Psychometric Outcomes in Minimal Consciousness State after Advanced Audio-Video Emotional Stimulation: A Retrospective Study. Brain Sci 2023; 13:1619. [PMID: 38137067 PMCID: PMC10741433 DOI: 10.3390/brainsci13121619] [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: 10/21/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
In the last ten years, technological innovations have led to the development of new, advanced sensory stimulation (SS) tools, such as PC-based rehabilitative programs or virtual reality training. These are meant to stimulate residual cognitive abilities and, at the same time, assess cognition and awareness, also in patients with a minimally conscious state (MCS). Our purpose was to evaluate the clinical and neurophysiological effects of multi-sensory and emotional stimulation provided by Neurowave in patients with MCS, as compared to a conventional SS treatment. The psychological status of their caregivers was also monitored. In this retrospective study, we have included forty-two MCS patients and their caregivers. Each MCS subject was included in either the control group (CG), receiving a conventional SS, or the experimental group (EG), who was submitted to the experimental training with the Neurowave. They were assessed before (T0) and after the training (T1) through a specific clinical battery, including both motor and cognitive outcomes. Moreover, in the EG, we also monitored the brain electrophysiological activity (EEG and P300). In both study groups (EG and CG), the psychological caregiver's aspects, including anxiety levels, were measured using the Zung Self-Rating Anxiety Scale (SAS). The intra-group analysis (T0-T1) of the EG showed statistical significances in all patients' outcome measures, while in the CG, we found statistical significances in consciousness and awareness outcomes. The inter-group analysis between the EG and the CG showed no statistical differences, except for global communication skills. In conclusion, the multi-sensory stimulation approach through Neurowave was found to be an innovative rehabilitation treatment, also allowing the registration of brain activity during treatment.
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Affiliation(s)
| | | | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (R.D.L.); (P.L.); (F.C.); (C.R.); (M.V.C.); (S.T.); (A.G.); (C.L.); (A.Q.); (M.C.D.C.); (R.S.C.)
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Lo Buono V, Corallo F, Bonanno L, Pria D, Di Cara M, Palmeri R, D'Aleo G, Rifici C, Sessa E, Marino S, De Cola MC. Psychological symptoms in Multiple Sclerosis and the role of marital status: results from a retrospective single-center study. Mult Scler Relat Disord 2023; 79:105051. [PMID: 37820445 DOI: 10.1016/j.msard.2023.105051] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 07/18/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Married people have, on average, better mental health than no married people. Psychological symptoms as anxiety and depression occur frequently in patients with multiple sclerosis (MS), increasing the severity of neurologic disability. The aim of this retrospective study was to investigate the relationship between functional disability and psychological symptoms differentiating by marital status. METHODS In this study 150 MS outpatients without a history of psychological disorders were selected from the hospital database. The outpatient procedure for all patients includes the administration of the Expanded Disability Status Scale and the questionnaire Symptoms Checklist-90-Revised (SCL-90-R) a multidimensional self-report inventory, consisting of 90 items covering nine clinical dimensions: somatization (SOM), obsessive-compulsive (OC), interpersonal sensitivity (IS), depression (DEP), anxiety (ANX), hostility (HOS), phobic anxiety (PHOB), paranoid ideation (PAR), psychoticism (PSY), and three global indices of distress: global severity index (GSI), positive symptoms total (PST) and positive symptom distress index (PSDI). According to marital status, subjects were subdivided in single, married (including cohabitants), and divorced (including separated). A nonparametric group comparisons analysis was performed, as well as multivariate analysis which included generalized linear regression models. RESULTS Regression results showed that functional disability was a significant predictor for all SCL- 90-R subscales. Moreover, it would seem that the single condition might be a protective factor for the development of psychological symptoms in SM patients. Notably, findings showed that younger subjects were predominantly single and had less psychological symptoms, whereas patients with greater psychological alterations were older in a stable affective couple relationship, presenting an elevation in depression, anxiety, somatization and compulsive, and obsessive scales. CONCLUSION Numerous factors contribute to the onset of psychological disorders in multiple sclerosis. Marriage does not represent a protective factor for the development of psychological symptoms in SM patients. Future investigation is needed to ascertain the prevalence and underlying causes of psychological symptoms.
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Affiliation(s)
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - Deborah Pria
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | | | | | | | | | - Edoardo Sessa
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
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Calabrò RS, Bonanno M, Torregrossa W, Cacciante L, Celesti A, Rifici C, Tonin P, De Luca R, Quartarone A. Benefits of Telerehabilitation for Patients With Severe Acquired Brain Injury: Promising Results From a Multicenter Randomized Controlled Trial Using Nonimmersive Virtual Reality. J Med Internet Res 2023; 25:e45458. [PMID: 37490017 PMCID: PMC10477931 DOI: 10.2196/45458] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/02/2023] [Revised: 04/26/2023] [Accepted: 06/09/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND In neurorehabilitation, the use of innovative technologies offers many opportunities to monitor and improve the health status of patients with severe acquired brain injury (SABI). Telerehabilitation allows for continuity of service through the entire rehabilitation cycle, including assessment, intervention, consultation, and education, affording early reintegration and positively enhancing the quality of life (QoL). OBJECTIVE The main purpose of this multicenter randomized controlled trial was to test the effectiveness of advanced training provided using a nonimmersive virtual reality rehabilitation system (ie, the VRRS HomeKit device) in improving functional outcomes in patients with SABI. METHODS In total, 40 patients with SABI and their 40 caregivers visiting 2 Italian rehabilitation centers were enrolled in the study protocol and randomized into 2 groups. Of the 40 patients, 20 (50%) underwent the experimental training using the VRRS HomeKit (teleneuro-VRRS group), whereas the other 20 (50%) were administered usual territorial rehabilitative treatments (UTRTs; control group). To investigate motor and neuropsychological functioning, patients with SABI were evaluated before (T0) and at the end of (T1) each training session by a multispecialist team through a complete clinical and psychometric battery: the Barthel Index (BI), the Tinetti Scale (TS), the Modified Ashworth Scale (MAS), the Montreal Cognitive Assessment (MoCa), the Frontal Assessment Battery (FAB), the Beck Depression Inventory II (BDI-II), the Short Form Health Survey 36 (SF-36), and the Psychological General Well-Being Index (PGWBI). In addition, the Caregiver Burden Inventory (CBI) was administered to each caregiver to investigate the emotional burden status. RESULTS The teleneuro-VRRS group achieved a statistically significant improvement in both general and motor outcomes, as well as psychological well-being and QoL, compared to the control group. In particular, the BI (P<.001), FAB (P<.001), and BDI-II (P<.001) were the outcome scales with the best improvement. The burden of caregivers also significantly improved in the teleneuro-VRRS group (CBI; P<.004). Between-group analysis showed statistical differences in the anxiety (effect size [ES]=0.85, P<.02) and self-control (ES=0.40, P<.03) subtests of the PGWBI and in the social role functioning (ES=0.85, P<.02) subtest of the SF-36, confirmed by quite medium and large ESs. CONCLUSIONS Our results suggest that the VRRS is a suitable alternative tool or complementary tool or both to improve motor (level of functional independence) and cognitive (frontal/executive abilities) outcomes, reducing behavioral alterations (anxiety and depression symptoms) in patients with SABI, with a beneficial impact also on the caregivers' burden distress management, mitigating distress and promoting positive aspects of caring. TRIAL REGISTRATION ClinicalTrials.gov NCT03709875; https://classic.clinicaltrials.gov/ct2/show/NCT03709875.
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Affiliation(s)
- Rocco Salvatore Calabrò
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Mirjam Bonanno
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - William Torregrossa
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Luisa Cacciante
- Laboratory of Healthcare Innovation Technology, Istituto di Ricovero e Cura a Carattere Scientifico San Camillo Hospital, Venezia, Italy
| | - Antonio Celesti
- Department of Mathematics, Computer Science, Physics and Earth Science, University of Messina, Messina, Italy
| | - Carmela Rifici
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | - Rosaria De Luca
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Angelo Quartarone
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino Pulejo, Messina, Italy
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Torregrossa W, Torrisi M, De Luca R, Casella C, Rifici C, Bonanno M, Calabrò RS. Neuropsychological Assessment in Patients with Traumatic Brain Injury: A Comprehensive Review with Clinical Recommendations. Biomedicines 2023; 11:1991. [PMID: 37509630 PMCID: PMC10376996 DOI: 10.3390/biomedicines11071991] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Traumatic brain injury is damage to the brain occurring after birth, often resulting in the deterioration of cognitive, behavioural, and emotional functions. Neuropsychological evaluation can assist clinicians to better assess the patient's clinical condition, reach differential diagnoses, and develop interventional strategies. However, considering the multiple rating scales available, it is not easy to establish which tool is most suitable for the different brain injury conditions. The aim of this review is to investigate and describe the most used neurocognitive assessment tools in patients with traumatic brain injury to provide clinicians with clear indications on their use in clinical practice. Indeed, during the acute phase, after the head trauma, alertness and wakefulness of the patients affected by a disorder of consciousness can be assessed using different scales, such as the Coma Recovery Scale-Revised. In both postacute and chronic phases after traumatic brain injury, general cognitive assessment tools (such as the Mini Mental State Examination) or more specific cognitive tests (e.g., Wisconsin Card Sorting Test and Trail Making Test) could be administered according to the patient's functional status. In this way, clinicians may be aware of the patient's neuropsychological and cognitive level, so they can guarantee a personalized and tailored rehabilitation approach in this frail patient population.
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Affiliation(s)
- William Torregrossa
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Michele Torrisi
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Carmela Casella
- Department of Clinical and Experimental Medicine "AOU Policlinico G. Martino", University Hospital "G. Martino", 98124 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
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De Luca R, Bonanno M, Rifici C, Quartarone A, Calabrò RS. Post-traumatic olfactory dysfunction: a scoping review of assessment and rehabilitation approaches. Front Neurol 2023; 14:1193406. [PMID: 37521284 PMCID: PMC10374209 DOI: 10.3389/fneur.2023.1193406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Post-traumatic Olfactory Dysfunction (PTOD) consists of a complete or partial loss of olfactory function that may occur after a traumatic brain injury (TBI). PTOD may be linked to some neuropsychiatric features, such as social, cognitive and executive dysfunction, as well as behavioral symptoms, especially when TBI involves the orbito-frontal cortex. The diagnosis of PTOD is based on medical history and clinical data and it is supported by psychometric tests (i.e., subjective tools) as well as electrophysiological and neuroimaging measures (i.e., objective methods). The assessment methods allow monitoring the changes in olfactory function over time and help to establish the right therapeutic and rehabilitative approach. In this context, the use of the olfactory training (OT), which is a non-pharmacological and non-invasive treatment option, could promote olfactory function through top-down (central) and bottom-up (peripheral) processes. To better manage patients with TBI, PTOD should be detected early and properly treated using the various therapeutic rehabilitative possibilities, both conventional and advanced, also taking into consideration the emerging neuromodulation approach.
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Luca RD, Rifici C, Terranova A, Orecchio L, Castorina MV, Torrisi M, Cannavò A, Bramanti A, Bonanno M, Calabrò RS, Cola MCD. Healthcare worker burnout during the first COVID-19 lockdown in Italy: experiences from an intensive neurological rehabilitation unit. J Int Med Res 2023; 51:3000605231182664. [PMID: 37486238 PMCID: PMC10369104 DOI: 10.1177/03000605231182664] [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] [Indexed: 07/25/2023] Open
Abstract
OBJECTIVE The study aim was to investigate the prevalence of behavioral symptoms and burnout in healthcare workers in an intensive neurological rehabilitation unit in Messina, Italy, during the first COVID-19 lockdown in Italy. METHODS Forty-seven healthcare workers (including neurologists, physiatrists, nurses and rehabilitation therapists) were enrolled in this cross-sectional study from February 2020 to June 2020. Participants were administered the following psychometric tests to investigate burnout and related symptoms: the Maslach Burnout Inventory, which measures emotional exhaustion, depersonalization and reduced personal accomplishment; the Zung Self-Rating Depression Scale (SDS); the Pre-Sleep Arousal Scale (PSAS); the Dyadic Adjustment Scale; and the Buss-Perry Aggression Questionnaire (BPAQ). RESULTS We found several correlations between test scores and burnout subdimensions. Emotional exhaustion was correlated with SDS (r = 0.67), PSAS-Cognitive (r = 0.67) and PSAS-Somatic (r = 0.70) scores, and moderately correlated with all BPAQ dimensions (r = 0.42). Depersonalization was moderately correlated with SDS (r = 0.54), PSAS-Cognitive (r = 0.53) and PSAS-Somatic (r = 0.50) scores. CONCLUSION During the first COVID-19 lockdown in Italy, healthcare workers were more exposed to physical and mental exhaustion and burnout. Research evaluating organizational and system-level interventions to promote psychological well-being at work for healthcare workers are needed.
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Lo Buono V, Bonanno L, Corallo F, Cardile D, D'Aleo G, Rifici C, Sessa E, Quartarone A, De Cola MC. The Relationship between Body Image, Disability and Mental Health in Patients with Multiple Sclerosis. J Clin Med 2023; 12:jcm12103606. [PMID: 37240712 DOI: 10.3390/jcm12103606] [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: 04/13/2023] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Multiple sclerosis is a progressive degenerative disorder that frequently involves the development of physical and emotional changes, including loss of limb function or sensitivity, sexual dysfunction, and cognitive and mood alterations. It is likely that these alterations lead to changes in body aspects. However, knowledge about body image perception in multiple sclerosis is lacking. PURPOSE The present study investigated the relationship between body image perception and its correlation with a disability, neuropsychiatric symptoms, and self-esteem. METHODS A total of 100 outpatients with relapsing-remitting multiple sclerosis underwent neurological assessment using the Expanded Disability Status Scale. Participants also completed the Body Image Scale (BIS), Rosenberg Self-Esteem Scale (RSES), and Symptom Checklist-90-Revised (SCL-90-R). RESULTS We found a significant positive correlation between body image and disability (r = 0.21; p = 0.03), body image and self-esteem (r = -0.52; p < 0.001), body image and somatization (r = 0.44; p < 0.001), body image and depression (r = 0.57; p < 0.001), and body image and anxiety (r = 0.5; p < 0.001). CONCLUSIONS The body is considered one of the main parts of a person's identity. Dissatisfaction with one's own body changes the general evaluation of the "self". The body image construct has important health outcomes and should be studied more in patients with multiple sclerosis.
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Affiliation(s)
- Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Davide Cardile
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Giangaetano D'Aleo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Edoardo Sessa
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C/da Casazza, 98124 Messina, Italy
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Torregrossa W, Raciti L, Rifici C, Rizzo G, Raciti G, Casella C, Naro A, Calabrò RS. Behavioral and Psychiatric Symptoms in Patients with Severe Traumatic Brain Injury: A Comprehensive Overview. Biomedicines 2023; 11:biomedicines11051449. [PMID: 37239120 DOI: 10.3390/biomedicines11051449] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Traumatic brain injury (TBI) is defined as an altered brain structure or function produced by an external force. Adults surviving moderate and severe TBI often experience long-lasting neuropsychological and neuropsychiatric disorders (NPS). NPS can occur as primary psychiatric complications or could be an exacerbation of pre-existing compensated conditions. It has been shown that changes in behavior following moderate to severe TBI have a prevalence rate of 25-88%, depending on the methodology used by the different studies. Most of current literature has found that cognitive behavioral and emotional deficit following TBI occurs within the first six months whereas after 1-2 years the condition becomes stable. Identifying the risk factors for poor outcome is the first step to reduce the sequelae. Patients with TBI have an adjusted relative risk of developing any NPS several-fold higher than in the general population after six months of moderate-severe TBI. All NPS features of an individual's life, including social, working, and familiar relationships, may be affected by the injury, with negative consequences on quality of life. This overview aims to investigate the most frequent psychiatric, behavioral, and emotional symptoms in patients suffering from TBI as to improve the clinical practice and tailor a more specific rehabilitation training.
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Affiliation(s)
- William Torregrossa
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Loredana Raciti
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Carmela Rifici
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Giuseppina Rizzo
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Gianfranco Raciti
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Carmela Casella
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Antonino Naro
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
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De Luca R, Bonanno M, Marra A, Rifici C, Pollicino P, Caminiti A, Castorina MV, Santamato A, Quartarone A, Calabrò RS. Can Virtual Reality Cognitive Rehabilitation Improve Executive Functioning and Coping Strategies in Traumatic Brain Injury? A Pilot Study. Brain Sci 2023; 13:brainsci13040578. [PMID: 37190543 DOI: 10.3390/brainsci13040578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Executive dysfunction is among the most common and disabling facets of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, mental flexibility, some aspects of attention and orientation, awareness and behavior. Rehabilitation programs based on cognitive-behavioral approaches to retrain planning and problem-solving and other executive deficits may improve such cognitive dysfunction. The purpose of this study is to investigate the effects of non-immersive virtual reality-based training to improve executive abilities and to reduce anxiety and depression symptoms in patients with TBI. Twenty patients with moderate to severe TBI were enrolled at our Neurorehabilitation Unit and divided to receive either the standard cognitive training or the virtual reality (VR) based cognitive training using the virtual reality rehabilitation system (VRRS-Evo). Each group received the same amount of rehabilitative training, including ROT (Reality Orientation Therapy) and Executive Training (ET), but using a different approach, i.e., a paper and pencil and an advanced approach. All patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. Comparing pre- and post- treatment scores, in the VR-CT group, we found statistically significant differences in all administered outcome measures for cognitive and executive functioning, i.e., MoCA (p < 0.005), FAB (p < 0.005), TMT-A (p < 0.005), TMT-B (p < 0.005), TMT-BA (p < 0.001), and mood, i.e., HRS-D (p < 0.008). In the Conventional cognitive training (C-CT) group, we found a significant improvement only in MoCA (p < 0.03), FAB (p < 0.02) and in TMT-BA (p < 0.01). Coping strategies also improved, with better results in the VR-CT group. Our results suggest that VR rehabilitation, using the VRRS system, may be a valuable and motivational approach to improve visuo-executive abilities and coping strategies as well as mood in chronic TBI patients.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Angela Marra
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Angelo Caminiti
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Andrea Santamato
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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De Luca R, Pollicino P, Rifici C, Mondo N, Iorio S, Cassaniti A, Ferrara D, Caminiti A, Famà F, Bonanno M, Calabrò RS. Psycho-Emotional Well-Being in Caregivers of People with Acquired Brain Injury: An Exploratory Study on the Human Immersion Model during the Omicron Wave. Clin Pract 2023; 13:487-496. [PMID: 37530721 PMCID: PMC10137299 DOI: 10.3390/clinpract13020044] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 08/03/2023] Open
Abstract
The purpose of this study was to investigate the effects of a "human immersion model" (HIM) in improving psychological well-being in caregivers of patients with acquired brain injury (ABI) during the Omicron wave in Italy. Fifteen subjects affected by ABI, who attended our intensive neurorehabilitation unit from January to March 2022 and their caregivers were submitted to the HIM. This novel approach consisted of "real" long-lasting meetings between the patients and their careers in a hospital setting (1-72 h meeting per week for 8 weeks). Each ABI caregiver was assessed through the administration of a short psychometric battery before starting the first immersion session with their family member and at the end of the HIM. We found significant changes in the caregivers' scores analyzed for anxiety, as per SAS (p < 0.0007, d = 1.02), burden and stress (ZBI-22; p < 0.001, d = 0.65), and emotive intelligence (TEIQue-SF; p < 0.0007, d = 0.82). Our data suggest that the HIM may be useful to promote ABI caregivers' psycho-emotional well-being in the context of critical periods such as the COVID-19 pandemic.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
| | | | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
| | - Natale Mondo
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
| | - Stefania Iorio
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
| | | | | | - Angelo Caminiti
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital "G. Martino", 98125 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", 98123 Messina, Italy
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Rifici C, Sfacteria A, Di Giorgio S, Giambrone G, Marino G, Mazzullo G. Mast Cell Tumour and Mammary Gland Carcinoma Collision Tumour. Case report and literature review. J HELL VET MED SOC 2022. [DOI: 10.12681/jhvms.27639] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Collision tumours are the coexistence, at the same venue, of distinct tumours not macroscopically distinguishable and consisting of two independent cell populations without histological admixture. In human medicine, collision tumours in different anatomical sites have been described. In the veterinary literature, few cases exist so far. A 12-year-old female Labrador with a mammary gland nodular lesion was presented for clinical examination. The nodule was surgically removed and underwent histological and immunohistochemical analysis. Histopathological examination revealed two distinct malignant tumours: a mammary gland carcinoma and a cutaneous mast cells tumour. To the author's knowledge, the paper reports the first case of a collision tumour composed of mammary gland neoplasia and mast cell tumour. The rising interest in collision tumours suggests widening their knowledge and setting up a multimodal approach that includes surgery and targeted therapy.
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De Luca R, Bonanno M, Vermiglio G, Trombetta G, Andidero E, Caminiti A, Pollicino P, Rifici C, Calabrò RS. Robotic Verticalization plus Music Therapy in Chronic Disorders of Consciousness: Promising Results from a Pilot Study. Brain Sci 2022; 12:brainsci12081045. [PMID: 36009107 PMCID: PMC9405818 DOI: 10.3390/brainsci12081045] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Music stimulation is considered a valuable form of intervention in disorders of consciousness (DoC); for instance, verticalization may improve motor and cognitive recovery. Our purpose is to investigate the effects of a novel rehabilitative approach combining robotic verticalization training (RVT) with personalized music stimulation in people with DoC. Methods: Sixteen subjects affected by minimally conscious state due to traumatic brain lesions who attended our Intensive Neuro-Rehabilitation Unit were enrolled in this randomized trial. They received either music robotic verticalization (MRV) using the Erigo device plus a personalized music playlist or only RVT without music stimuli. Each treatment was performed 2 times a week for 8 consecutive weeks in addition to standard neurorehabilitation. Results: We found significant improvements in all patients’ outcomes in the experimental group (who received MRV): Coma Recovery Scale-Revised (CRS-R) (p < 0.01), Level of Cognitive Functioning (LCF) (p < 0.02), Functional Independence Measure (FIM) (p < 0.03), Functional Communication Scale (FCS) (p < 0.007), Trunk Control Test (TCT) (p = 0.05). Significant differences between the two groups were also found in the main outcome measure CRS-R (p < 0.01) but not for TCT and FIM. Conclusions: Our study supports the safety and effectiveness of RVT with the Erigo device in chronic MCS, and the achievement of better outcomes when RVT is combined with music stimulation.
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Corallo F, Rifici C, Lo Buono V. Rehabilitation in atypical neurological disease: a case report. J Int Med Res 2022; 50:3000605221102083. [PMID: 35766015 PMCID: PMC9247376 DOI: 10.1177/03000605221102083] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The rehabilitative management of neurological diseases such as Parkinson's disease (PD) and multiple sclerosis (MS) is complex; drug treatment alone is generally insufficient. Multidisciplinary rehabilitation programs can fundamentally contribute to the management of neurological patients and have important positive repercussions on their quality of life. We describe the unusual case of a 70-year-old man with a diagnosis of both MS and PD, who presented with motor and cognitive impairments. He was admitted to our institute for a rehabilitation program. Motor, cognitive, and linguistic abilities were evaluated at admission and 60 days after the multidisciplinary rehabilitation, which included motor exercises, speech therapy, and cognitive interventions. The multidisciplinary rehabilitation improved the patient's functional status and exerted positive effects on his mood, autonomy in activities of daily life, perception of quality of life, cognitive performance, and speech skills. It is important to find new methods for treating neurological patients to better manage the social and economic implications of neurological disease, and to ensure a long course of treatment and rehabilitation.
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De Luca R, Marra A, Pollicino P, Buda M, Mucari M, Bonanno M, Torregrossa W, Caminiti A, Rifici C, Calabrò RS. Advances in neuroRehabilitation of TREM2-related dementia: A case report on a novel multimodal approach using virtual reality. Medicine (Baltimore) 2022; 101:e29470. [PMID: 35623081 PMCID: PMC9276317 DOI: 10.1097/md.0000000000029470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 04/27/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONABLE The aim of this study is to investigate the effects of an advanced neuroRehabilitation protocol using virtual reality in the treatment of a patient with fronto- temporal dementia due to TREM2 mutation. PATIENTS CONCERN A 41-year-old caucasian male, affected by Nasu-Hakola Disease (NHD), presented a 1-year history of change in behavioral and cognitive functioning, before our observation. The onset of the disease was characterized by severe pain in the lower limbs and knees with limitations in the performance of daily life activities. DIAGNOSIS Motor and cognitive deficits in NHD. INTERVENTIONS As the patient was in a chronic phase, to manage his cognitive and motor status, we decided to treat him by using a specific rehabilitation protocol, including 2 different types of training: conventional cognitive and motor treatment and a combined advanced approach using the virtual reality rehabilitation system (VRRS). The two protocols were separated by 4 weeks of rest, to avoid/reduce a cumulative effect. The patient's cognitive and motor profile was assessed three times: that is before (at T0) and after (at T1) the conventional training as well as at the beginning (T2) and at the end of the combined experimental approach (T3). OUTCOMES After the combined therapeutic approach with the virtual reality rehabilitation system, we observed a significant reduction in anxiety, apathy, indifference and depressive symptoms with a more evident motor improvement involving the head and the trunk control. LESSONS Virtual reality can be considered a promising tool for the motor and cognitive rehabilitation of rare neurodegenerative disorders, including patients with NHD.
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Lo Buono V, D’Aleo G, Cammaroto S, De Cola MC, Palmese F, Smorto C, Marino S, Venuti G, Sessa E, Rifici C, Corallo F. Neuropsychological Disability in the Case of Natalizumab-Related Progressive Multifocal Leukoencephalopathy. Medicina (Kaunas) 2022; 58:medicina58040551. [PMID: 35454389 PMCID: PMC9025511 DOI: 10.3390/medicina58040551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Progressive multifocal leukoencephalopathy (PML) is a viral disease characterized by progressive damage or inflammation of the cerebral white matter that can be encountered in patients with multiple sclerosis (MS). There are cases of PML caused by pharmacological agents including natalizumab. Therefore, in patients treated with this drug, early identification of PML allows changes in the treatment plan, reducing the risks of morbidity and mortality. CASE PRESENTATION We reported the case of a 57-year-old female diagnosed with relapsing-remitting MS, who presented with PML related to natalizumab. The patient presented with change in behavioral, radiological abnormalities in the left parieto-temporal lobes. We described the longitudinal course of PML, from the diagnosis until the patient's death, documenting the progressive deterioration of her cognitive functioning, supported by changes on sequential brain scans and neurophysiological data. CONCLUSION The neuropsychological impairment documented in this case study expands the range of treatment-related complications associated with natalizumab, and provides evidence that occurrence of "atypical" cognitive deficits in MS may support the early diagnosis of PML.
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Affiliation(s)
- Viviana Lo Buono
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Giangaetano D’Aleo
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Simona Cammaroto
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
- Correspondence:
| | - Francesca Palmese
- Azienda ULSS Marca Trevigiana, Ospedale Cà Foncello, 31100 Treviso, Italy;
| | - Chiara Smorto
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Silvia Marino
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Giuseppe Venuti
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Edoardo Sessa
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Carmela Rifici
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino Pulejo, 98100 Messina, Italy; (V.L.B.); (G.D.); (S.C.); (C.S.); (S.M.); (G.V.); (E.S.); (C.R.); (F.C.)
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Di Cara M, Grezzo D, Palmeri R, Lo Buono V, Cartella E, Micchia K, Formica C, Rifici C, Sessa E, D'Aleo G, Maresca G, Bramanti P, Corallo F. Correction to: Psychological well‑being in people with multiple sclerosis: a descriptive review of the effects obtained with mindfulness interventions. Neurol Sci 2021; 43:2167. [PMID: 34913096 DOI: 10.1007/s10072-021-05812-z] [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: 11/24/2022]
Affiliation(s)
- Marcella Di Cara
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Denise Grezzo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Rosanna Palmeri
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy.
| | - Emanuele Cartella
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Katia Micchia
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Caterina Formica
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Edoardo Sessa
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Giangaetano D'Aleo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Giuseppa Maresca
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S, 113 Via, Palermo, C.da Casazza, 98124, Messina, Italy
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De Luca R, Pollicino P, Rifici C, de Cola C, Billeri L, Marino S, Trifirò S, Fiumara E, Randazzo M, Bramanti P, Torrisi M. Improving motor and cognitive recovery following severe traumatic brain injury using advanced emotional audio-video stimulation: Lessons from a case report. Medicine (Baltimore) 2021; 100:e26685. [PMID: 34397801 PMCID: PMC8341226 DOI: 10.1097/md.0000000000026685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/07/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE It is estimated that about 6 million people suffer from severe traumatic brain injury (TBI) each year (73 cases per 100,000 people). TBI may affect emotional, sensory-motor, cognitive, and psychological functions with a consequent worsening of both patient and his/her caregiver's quality of life. In recent years, technological innovations allowed the development of new, advanced sensory stimulation systems, such as Neurowave, to further stimulate residual cognitive abilities and, at the same time, evaluate residual cognition. PATIENT CONCERN An 69-year-old Italian man entered our neurorehabilitation unit with a diagnosis of minimally conscious state following severe TBI. He breathed spontaneously via tracheostomy and was fed via percutaneous gastrostomy. At the neurological examination, the patient showed severe tetraparesis as he showed fluctuating alertness and responsiveness to external stimuli and opened the eyes without stimulation. DIAGNOSIS Patient was affected by subarachnoid hemorrhage and frontotemporal bilateral hematoma, which were surgically treated with decompressive craniotomy and subsequent cranioplasty about 6 months before. INTERVENTIONS The patient underwent a neuropsychological and clinical evaluation before (T0) and after a conventional rehabilitation cycle (T1), and after a Neurowave emotional stimulation-supported rehabilitative cycle (T2). OUTCOMES Following conventional rehabilitation (T1), the patient achieved a partial improvement in behavioral responsiveness; there was also a mild improvement in the caregiver's distress. Conversely, Neurowave emotional stimulation session determined (at T2) a significant improvement of the patient's behavioral responsiveness, cognition, and in the caregiver's distress. The P300 recording in response to the NES showed a significant change of P300 magnitude and latency. DISCUSSION Our data suggest that emotional-integrated sensory stimulation using adequate visual stimuli represents a beneficial, complementary rehabilitative treatment for patients in minimally conscious state following a severe TBI. This may occur because stimuli with emotional salience can provide a reliable motivational resource to stimulate motor and cognitive recovery following severe TBI.
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Andaloro A, Caliri S, Corallo F, Bramanti P, Rifici C, De Cola MC. Is the natural feed the better nutritional therapy in patients with severe acquired brain injury? A retrospective study. Clinical Nutrition Open Science 2021. [DOI: 10.1016/j.nutos.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Corallo F, Pria D, Di Blasi A, Bonanno L, De Cola MC, Di Cara M, Rifici C, De Salvo S, Bramanti P, Marino S, Buono VL. The effects of caregiver's burden on dynamic structure in disorder of consciousness families: An observational study. Brain Behav 2021; 11:e2305. [PMID: 34350729 PMCID: PMC8413804 DOI: 10.1002/brb3.2305] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/22/2021] [Accepted: 07/12/2021] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Disorder of consciousness is a clinical condition due to severe brain damage. The impact of consciousness disorder on the family is characterized by a combination of biopsychosocial factors. The burden and suffering perceived by caregivers can cause psychological distress characterized by anxiety, depression, and physical illness. The aim of the study was to investigate the interaction between family dynamics and caregiver burden. METHODS We enlisted 35 caregivers of subjects in a minimally conscious state. Two skilled psychologists administered the Olson's Adaptability and Family Cohesion Assessment Scale and the Novak's Burden Inventory Caregiver Scale to assess family function and family burden, respectively. RESULTS We found that the caregiver burden correlates with the family adaptability and cohesion, as well as with enmeshment, rigidity, and disengagement. CONCLUSION Findings suggest that the traumatic event does not affect the family structure. Families are able to maintain a balanced functioning and control distress.
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Affiliation(s)
| | - Deborah Pria
- IRCCS Centro Neurolesi “Bonino‐Pulejo”MessinaItaly
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Marino S, Ciurleo R, Todaro A, Alagna A, Logiudice AL, Corallo F, Formica C, Rifici C, Pollicino P, Caminiti F, Morini E, Bramanti P. The impact of the SARS-COV2 infection on the disorder of consciousness rehabilitation unit. PLoS One 2021; 16:e0253958. [PMID: 34191844 PMCID: PMC8244854 DOI: 10.1371/journal.pone.0253958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 06/16/2021] [Indexed: 01/16/2023] Open
Abstract
Background and objective Disorders of consciousness include coma (cannot be aroused, eye remain closed), vegetative state—VS (can appear to be awake, but unable to purposefully interact) and minimally conscious state—MCS (minimal but definite awareness). The objective of this study is to assess the impact of the SARS-CoV-2 infection on the Disorder of Consciousness (DOC) Rehabilitation Unit. Methods This is a retrospective, longitudinal, descriptive, observational, pilot study. We consecutively enrolled 18 patients (age range: 40–72 years, 9 females and 9 males), from three to five months after a brain injury. They were grouped into VS (n = 8) and MCS (n = 10). A confirmed case of COVID-19 was defined as a positive result on high-throughput sequencing or real-time reverse-transcription polymerase chain reaction analysis of throat swab specimens. We collected data of lung Computed Tomography (CT) and laboratory exams. DOC patients who were positive for SARS-CoV-2 were classified into severe and no severe infected group, according to the American Thoracic Society guidelines. Results A total of 18 hospitalized patients with (16) and without confirmed (2) SARS-CoV-2 infection were included in the analysis. After one month, a follow-up clinical evaluation reported that one patient died, one patient was transferred from Covid Unit to Emergency Unit and 3 patients were resulted negative to double swab and they returned to Rehabilitative Unit. Significant differences were reported about hypertension, cardiac disease and respiratory problems between the patients with severe infection and patients without severe infection (P< 0.001). The laboratory findings, such as blood cell counts (P < 0.001), C-reactive protein, D-dimer, potassium and vitamin D levels, seemed to be considered as useful prognostic predictors. Conclusions To our knowledge, this is the first longitudinal study on a sample of chronic DOC patients affected by SARS-CoV-2. This study may offer important new clinical information on COVID-19 for management of DOC patients. Our findings showed that for the subjects with severe infection due to COVID-19, rapid clinical deterioration or worsening could be associated with clinical and laboratory findings, which could contribute to high mortality rate. During the COVID-19 epidemic period, the clinicians should consider all the reported risk factors to avoid delayed diagnosis or misdiagnosis and to prevent the infection transmission in DOC Rehabilitation Unit.
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Affiliation(s)
- Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
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Corallo F, Rifici C, Bonanno L, Di Cara M, Lo Buono V, Venuti G, Marino S, Ciurleo R, Torre V, D'Aleo G, Bramanti P, Sessa E. The role of teriflunamide in multiple sclerosis patient: an observational study. PSYCHOL HEALTH MED 2021; 27:2204-2211. [PMID: 34044680 DOI: 10.1080/13548506.2021.1931371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Teriflunomide is a drug with immunosuppressive and selective immunomodulatory action, characterized by anti-inflammatory and antiproliferative properties. Several clinical studies have demonstrated the efficacy and safety of this drug in Multiple Sclerosis, estimating a significant improvement in cognitive performance.The aim of our study is to evaluate the effects of teriflunomide by analysing the correlation between brain atrophy and the general cognitive profile and evaluating long-term changes. The effect of teriflunomide was studied in 30 patients with multiple sclerosis and 30 control subjects. Patients underwent a full cognitive profile assessment using the Brief Repeatable Battery of Neuropsychological Tests and a neuroimaging examination with a 3.0 T working scanner.Our results suggested that treatment with teriflunomide could potentially not only slow down the accumulation of microstructural tissue damage in Grey Matter and With Matter, but also better preserve the cognitive profile, particularly by highlighting the benefits in the memory domain. Thanks to drug therapy, brain volume in our patients has remained constant, leading to improvements in memory, indicating teriflunomide as a neuroprotective potential and further strengthening the evidence of a link between loss of brain volume and cognitive impairment.
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Affiliation(s)
- Francesco Corallo
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Carmela Rifici
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Lilla Bonanno
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Marcella Di Cara
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Viviana Lo Buono
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Giuseppe Venuti
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Silvia Marino
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Rosella Ciurleo
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Viviana Torre
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Giangaetano D'Aleo
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Placido Bramanti
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Edoardo Sessa
- Neuroimaging Laboratory - IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
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Corallo F, Anselmo A, Palmeri R, Di Cara M, Formica C, De Salvo S, Todaro A, Rifici C, Marino S, Bramanti P, Lo Buono V. The psychometric measures to assess aggressive dimension following traumatic brain injury: A review. Medicine (Baltimore) 2021; 100:e24648. [PMID: 33787573 PMCID: PMC8021345 DOI: 10.1097/md.0000000000024648] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/11/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND higher level of aggression and antisocial behavior are frequent following head trauma, due to specific brain alterations. Many tests are used to assess this aspect. A descriptive review was conducted on the main tests used to detect the appearance of aggressive dimensions following traumatic brain injury. REVIEW SUMMARY we searched on PubMed and Web of Science databases and screening references of included studies and review articles for additional citations. From initial 723 publications, only 7 met our search criteria. Findings showed that various psychometric tools are used to assess aggressiveness and its subdomains, following head trauma. CONCLUSIONS further investigation are necessary to clarify whether these tools ensure a reliable diagnosis in order to make an early intervention and reduce violent behavior and its development.
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Affiliation(s)
| | | | | | | | - Caterina Formica
- IRCCS Centro Neurolesi “Bonino-Pulejo,” Messina
- Biomedical Department of Internal Medicine and Medical Specialties - University of Palermo
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Lo Gullo A, Rifici C, Caliri S, Donato A, De Cola MC, Di Cara M, Corallo F, Bramanti P, Giuffrida C. Refeeding syndrome in a woman with pancreatitis: a case report. J Int Med Res 2021; 49:300060520986675. [PMID: 33535848 PMCID: PMC7871053 DOI: 10.1177/0300060520986675] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Refeeding syndrome can occur in malnourished patients with acute pancreatitis who have electrolyte imbalances. Refeeding syndrome is characterized by severe electrolyte imbalances (mainly hypophosphatemia, hypomagnesemia, and hypokalemia), vitamin deficiency (mainly thiamine deficiency), fluid overload, and salt retention resulting in organ dysfunction and cardiac arrhythmias. We herein report a case involving a patient with severe pancreatitis and gallbladder stones who developed refeeding syndrome with shock and loss of consciousness. The patient was treated by opportune vitamin and electrolyte supplementation therapy and showed substantial improvement after 2 weeks of hospitalization, gaining the ability to eat small bites of solid food orally. Early diagnosis and treatment of refeeding syndrome may reduce morbidity and mortality in patients with acute pancreatitis. Patients should be fasted only if alimentation is contraindicated, and electrolyte values must be closely monitored.
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De Luca R, Rifici C, Pollicino P, Di Cara M, Miceli S, Sergi G, Sorrenti L, Romano M, Naro A, Billeri L, Lauria P, Caminiti A, Bramanti P, Torrisi M. 'Online therapy' to reduce caregiver's distress and to stimulate post-severe acquired brain injury motor and cognitive recovery: A Sicilian hospital experience in the COVID era. J Telemed Telecare 2021:1357633X21990195. [PMID: 33535914 DOI: 10.1177/1357633x21990195] [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
INTRODUCTION Severe acquired brain injury(SABI) often results in the deterioration of physical, cognitive and emotional functions in the patient and a significant caregiver's distress syndrome, which is now amplified by the social isolation, depression and financial difficulties related to the COVID-19 pandemic. The use of web-based online-therapy has been shown to be useful to overcome caregiver's distress syndrome and further stimulate cognitive-motor recovery of SABI-patients. Our study aimed to investigate whether a systematic online Skype-therapy(OLST) may be of support in favoring global cognitive and sensory-motor recovery in SABI-patients and reducing caregiver distress. METHODS Twenty-five SABI-subjects in inpatient regimen were provided with intensive OLST with the caregiver for 12 weeks in addition to standard neurorehabilitation. Each subject and caregiver was evaluated before and after the treatment by administering an ad hoc battery. Furthermore, 18 of 27 patients were provided with EEG recording in resting state. RESULTS We found a significant reduction in caregiver's anxiety (p<0.0001) and burden(p<0.0001). Patients showed significant improvement in trunk control (p<0.0001), functional independence (p = 0.005), functional (p = 0.01) and global communication (p = 0.004), cognitive functioning (p = 0.001), and behavioral responsiveness (p = 0.0004). The training yielded a significant connectivity change within the fronto-centro-parietal areas in the delta frequency band (p<0.0001) and the centro-parieto-occipital areas in the alpha range (p = 0.004). DISCUSSION OLST may be a useful and complementary treatment to optimize global cognitive and functional recovery in SABI-subjects and reduce caregivers' concerns in the Covid-era. OLST can foster cognitive-motor recovery potentially by favoring the plasticity-dependent functional recovery. Therefore, OLST could be proposed as a tool allowing social conversations also in the hospital setting.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Paola Lauria
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
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Bonanno L, Mammone N, De Salvo S, Bramanti A, Rifici C, Sessa E, Bramanti P, Marino S, Ciurleo R. Multiple Sclerosis lesions detection by a hybrid Watershed-Clustering algorithm. Clin Imaging 2020; 72:162-167. [PMID: 33278790 DOI: 10.1016/j.clinimag.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 03/24/2020] [Revised: 09/21/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Computer Aided Diagnosis (CAD) systems have been developing in the last years with the aim of helping the diagnosis and monitoring of several diseases. We present a novel CAD system based on a hybrid Watershed-Clustering algorithm for the detection of lesions in Multiple Sclerosis. METHODS Magnetic Resonance Imaging scans (FLAIR sequences without gadolinium) of 20 patients affected by Multiple Sclerosis with hyperintense lesions were studied. The CAD system consisted of the following automated processing steps: images recording, automated segmentation based on the Watershed algorithm, detection of lesions, extraction of both dynamic and morphological features, and classification of lesions by Cluster Analysis. RESULTS The investigation was performed on 316 suspect regions including 255 lesion and 61 non-lesion cases. The Receiver Operating Characteristic analysis revealed a highly significant difference between lesions and non-lesions; the diagnostic accuracy was 87% (95% CI: 0.83-0.90), with an appropriate cut-off of 192.8; the sensitivity was 77% and the specificity was 87%. CONCLUSIONS In conclusion, we developed a CAD system by using a modified algorithm for automated image segmentation which may discriminate MS lesions from non-lesions. The proposed method generates a detection out-put that may be support the clinical evaluation.
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Affiliation(s)
- Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Nadia Mammone
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | | | - Edoardo Sessa
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Di Cara M, Palmeri R, Formica C, Lo Buono V, Andaloro A, Bonanno L, Romeo L, Rifici C, Bramanti P, Marino S, Corallo F. Assessment of insight in hospitalized neurological patient: Cognitive profile and mood disorder. J Clin Neurosci 2020; 79:104-107. [DOI: 10.1016/j.jocn.2020.07.050] [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: 05/27/2020] [Accepted: 07/19/2020] [Indexed: 11/27/2022]
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Di Cara M, Bonanno L, Rifici C, Sessa E, D'Aleo G, Corallo F, Lo Buono V, Venuti G, Bramanti P, Marino S. Quality of life in patients with multiple sclerosis and caregivers. Predictive factors: An observational study. J Clin Neurosci 2020; 78:242-245. [DOI: 10.1016/j.jocn.2020.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/04/2020] [Indexed: 01/22/2023]
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D’Aleo G, Rifici C, Donato A, Corallo F, Di Cara M, Bramanti P, Sessa E. Twin pregnancy outcome following teriflunomide treatment in a relapsing-remitting multiple sclerosis patient: A case report. Medicine (Baltimore) 2020; 99:e21212. [PMID: 32664171 PMCID: PMC7360296 DOI: 10.1097/md.0000000000021212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Teriflunomide is a disease-modifying drug that has been approved for treatment of relapsing-remitting multiple sclerosis. Due to its teratogenic effect in animals, however, it is not recommended during pregnancy. For this reason, effective contraception must be used during its administration. When an unscheduled pregnancy occurs during therapy, patients must undergo a cholestyramine procedure for rapid flushing of the drug. PATIENT CONCERNS We describe the case of a 35-year-old female patient suffering diagnosed with relapsing-remitting multiple sclerosis at the age of 20. The patient as a result of side effects of previous therapies started taking teriflunomide. DIAGNOSIS Despite recommendations for the use of contraceptives, the patient became pregnant during drug therapy. Pregnancy occurred 12 months after initiating teriflunomide treatment. INTERVENTIONS Therapy with teriflunomide was immediately suspended and cholestyramine was prescribed (8 g 3 times a day, for 11 days) to flush out any residual drug from the body. OUTCOMES Despite an 8-week exposure to teriflumomide during gestation, the patient gave birth to healthy twin girls at 35 week. Controls carried out after birth did not reveal any malformation or genetic and chromosomal abnormality. At a 5-month pediatric specialist check both babies were healthy and growing regularly. CONCLUSION This shows that even if there is evidence of teratogenic effects in animals, an 8-week exposure to teraflunomide >0.02 mg/L did not have effects on the newborn.
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Calabrò RS, Russo M, Naro A, Ciurleo R, D'Aleo G, Rifici C, Balletta T, La Via C, Destro M, Bramanti P, Sessa E. Nabiximols plus robotic assisted gait training in improving motor performances in people with Multiple Sclerosis. Mult Scler Relat Disord 2020; 43:102177. [PMID: 32447249 DOI: 10.1016/j.msard.2020.102177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/21/2019] [Revised: 03/03/2020] [Accepted: 05/02/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system, affecting ambulation even in people with only mild neurological signs. Patients with MS frequently experience spasticity, which contributes significantly to impair their motor functions, including ambulation, owing to muscle stiffness, spasms, and pain. OBJECTIVES To clarify the role of delta-9-tetrahydrocannabinol(THC):cannabidiol(CBD) oromucosal spray, coupled to robot-aided gait training (RAGT) using the Lokomat©Pro to improve functional ambulation in patients with MS. METHODS We compared 20 patients with MS, who were treated with THC:CBD oromucosal spray in add-on to the ongoing oral antispastic therapy (OAT) (group A), with 20 individuals with MS (matched for clinical-demographic characteristics) who were treated only with OAT (group B). Both the groups underwent RAGT using the Lokomat-Pro (three 45-minute sessions per week). Our primary outcome measures were the Functional Independence Measure (FIM) and the 10 meters walking test (10MWT). As secondary outcome measures we evaluated the brain cortical excitability by using Transcranial Magnetic Stimulation. Both parameters were taken before and after the end of the RAGT. RESULTS FIM improved in group A more than in group B (p<0.001). Moreover, 10MWT decreased in group A more than in group B (p<0.001). These clinical findings were paralleled by a more evident reshape of intracortical excitability in both upper and lower limbs, as suggested by motor evoked potential amplitude increase (p<0.001), intracortical inhibition strengthening (p<0.001), and intracortical facilitation decrease (p=0.01) in group A as compared to group B. CONCLUSIONS Our results suggest that the combined THC:CBD-RAGT approach could be useful in improving gait performance in patients with MS.
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Affiliation(s)
- Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy.
| | - Margherita Russo
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Rossella Ciurleo
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Giangaetano D'Aleo
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Tina Balletta
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Cristian La Via
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Massimo Destro
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
| | - Edoardo Sessa
- IRCCS Centro Neurolesi Bonino Pulejo, Via Palermo, SS 113, Ctr. Casazza; 98124, Messina, Italy
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D’Angelo M, Boretti I, Quattrocchi S, Alongi G, Rifici C, Corallo F, Magazù A, Milardi D, Cannavà G, Bramanti P, Duca A. Lethal infective endocarditis due to Streptococcus agalactiae in a man with a history of alcohol abuse: A case report. Medicine (Baltimore) 2019; 98:e18270. [PMID: 31860973 PMCID: PMC6940177 DOI: 10.1097/md.0000000000018270] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONAL Infective endocarditis (IE) is defined as an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium. PATIENT CONCERNS A 53-years-old man with a history of alcohol abuse was admitted in hospital for fever, paroxysmal atrial fibrillation cardioverted by Amiodarone and pulmonary infection. DIAGNOSIS A case of recurrent severe endocarditis, with neurological complications both ischemic and hemorrhagic and heart failure caused by Streptococcus agalactiae in healthy man we reported. INTERVENTIONS Surgery was performed 2 weeks after admission. OUTCOMES The onset of intracranial hemorrhage delayed second cardiac surgery and the patient died because of end-stage heart failure. CONCLUSIONS Infective endocarditis caused by S. agalactiae is very rare, particularly in patients without underlying structural heart disease. This study showed that IE due to S. Agalactiae is a disease with high mortality when associated with neurological complication, heart failure but especially when it is recurrent and hits valve prosthesis.
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Affiliation(s)
- Myriam D’Angelo
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Ilaria Boretti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Salvina Quattrocchi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Giovanni Alongi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Carmela Rifici
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Francesco Corallo
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Angela Magazù
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Demetrio Milardi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Italy
| | - Gaetano Cannavà
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Placido Bramanti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
| | - Antonio Duca
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino Pulejo”, Messina
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Caliri S, Andaloro A, Corallo F, Donato A, Marino S, Mantarro C, Terranova A, Bramanti P, Caminiti F, Rifici C. Recovery of malnutrition in a patient with severe brain injury outcomes: A case report. Medicine (Baltimore) 2019; 98:e16755. [PMID: 31577695 PMCID: PMC6783252 DOI: 10.1097/md.0000000000016755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Severe brain injury often induces a state of malnutrition due to insufficient caloric and protein input. If left untreated, it will have a negative impact on rehabilitation. Nutritional therapy provides caloric and the nutritional support necessary to cover the daily needs and help contrast hospital infections. Our hypothesis is that integration of natural foods in the daily diet can enhance the recovery of the state of malnutrition and increase rehabilitation outcomes. PATIENT CONCERNS We present the case of a young man with traumatic brain injury caused by a car accident. Who underwent tracheostomy and percutaneous endoscopic gastrostomy (PEG) procedures, had severe consciousness disorder, was severely malnourished and therefore underweight. DIAGNOSIS He was severely underweight, malnourished, with a severe consciousness disorder that necessitated the tracheostomy and the PEG. INTERVENTIONS Our approach included caloric implementation of artificial nutrition and the gradual introduction of semi-liquid natural foods administered through PEG. OUTCOMES The patient was followed for a year during which the metabolic/nutritional pattern and the blood tests improved, normal weight restored, and consciousness regained. CONCLUSION Nutritional intervention integrated with natural foods, has allowed a gradual increase in weight, a better recovery of the lean mass and the stabilization of the metabolic-nutritional framework.Nutritional approach used has contributed to the reduction of recovery times, making the therapeutic path more effective.
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Corallo F, Bonanno L, Formica C, Corallo F, De Salvo S, Lo Buono V, Di Cara M, Alagna A, Rifici C, Bramanti P, Marino S. Religious Coping in Caregiver of Patients with Acquired Brain Injuries. J Relig Health 2019; 58:1444-1452. [PMID: 31098828 DOI: 10.1007/s10943-019-00840-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Caregivers play a crucial role in physical and psychological management in terms of assistance. For this reason, it is important for caregivers to find better coping strategies to minimize a possible physical and emotional burden. The aim of our study is to demonstrate how the religious coping can influence the burden of caregivers about health care of patients with severe brain injuries. Caregivers were, respectively, divided into two groups: 31 religious believers and 20 unbelievers. We submitted the questionnaires to participants, which investigate the caregiver burden, presence of depressive symptoms and kind of coping strategies adopted. Our results demonstrated that participants with religious belief used avoidance strategies more frequently compared to non-believers' group. We want to improve adaptive coping strategies to upgrade the awareness of caregiver, supporting burden and distress. A problem-solving training might improve quality of life in terms of social and psychological wellness.
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Affiliation(s)
- Francesco Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy.
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Caterina Formica
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Federica Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Simona De Salvo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Marcella Di Cara
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Antonella Alagna
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria, Messina, Italy
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Corallo F, Bonanno L, Di Cara M, Rifici C, Sessa E, D’Aleo G, Lo Buono V, Venuti G, Bramanti P, Marino S. Therapeutic adherence and coping strategies in patients with multiple sclerosis: An observational study. Medicine (Baltimore) 2019; 98:e16532. [PMID: 31335734 PMCID: PMC6709257 DOI: 10.1097/md.0000000000016532] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder affecting the central nervous system and targets the myelin sheaths around nerves. Local problem: Medical advances have enabled patients to lead a better quality of life (QoL) than before. However, because of its chronicity and unpredictability, it remains a very challenging disease for both patients and their families, as it involves the continued use of medication to slow down progression. The aim of this study is to assess drug adherence in patients with MS. In particular, we will examine how the way drugs are administered (oral or injective) affects compliance with therapy, including the correlation with coping strategies and the QoL of each patient.We enrolled 88 patients with MS, divided into 2 groups according to therapy (injective or oral). The Morisky Medication Adherence scale was administered to evaluate adherence to treatment, the MS QoL 54 to estimate mental and physical health, and Brief coping orientation to problems experienced Inventory for coping strategies.The results showed that in both groups the patients showed a good therapeutic alliance and trust in treatment. In particular, a correlation has been found between therapeutic adherence, adaptive coping strategies, and mental health when drug therapy is administered by injection. In conclusion, this result suggests that for patients receiving injection treatment to have greater adherence to therapy, appropriate coping strategies and good mental health must be developed in order for patients receiving injection therapy to have greater adherence to therapy; they need to develop appropriate coping strategies and good mental health to address this mode of administration successfully.
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Corallo F, Lo Buono V, Genovese R, Palmeri R, Di Cara M, Rifici C, Sessa E, D'Aleo G, Galletti F, Bonanno L, Marino S. A complex relation between depression and multiple sclerosis: a descriptive review. Neurol Sci 2019; 40:1551-1558. [PMID: 31001715 DOI: 10.1007/s10072-019-03889-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a demyelinating neurodegenerative disease that affects central nervous system (CNS). MS patients are more likely to develop depressive symptoms than patients with other chronic diseases. OBJECTIVE In this review, we have analysed if there is a correlation between brain lesions (BL), structural damage (SD) and depressive symptoms (DS). METHODS We Searched on PubMed and Web of Science databases and screening references of included studied and some review article for additional citations. From initial 745 studies, only 9 met the inclusion criteria. All studies conducted research on 389 patients with MS associated with DS and 120 HC (healthy controls). RESULTS The selected researches highlighted the involvement of limbic system, the role of hippocampus and the impact of brain lesions on the emotional status of MS patients. DISCUSSION In the genesis of depression are implicated many mechanisms including genetic, biochemical, immunological and psychosocial factors, even if a prominent role in the onset of DS seem to be associated with structural and functional brain alterations.
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Affiliation(s)
- Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Roberto Genovese
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Rosanna Palmeri
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Marcella Di Cara
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Edoardo Sessa
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Giangaetano D'Aleo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy.
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Ciurleo R, Sessa E, Marino S, D’Aleo G, Bramanti P, Rifici C. Acute exacerbation of Hashimoto's thyroiditis in a patient treated with dimethyl fumarate for multiple sclerosis: A case report. Medicine (Baltimore) 2019; 98:e15185. [PMID: 31027063 PMCID: PMC6831155 DOI: 10.1097/md.0000000000015185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Dimethyl fumarate (DMF) has been recently approved for first-line monotherapy of Multiple Sclerosis (MS). Its effects are due to mechanism modulating the immune system and activating antioxidative and neuroprotective pathways. PATIENT CONCERNS A 59-year-old female patient affected by chronic Hashimoto's thyroiditis (HT) from 10 years was diagnosed with relapsing remitting MS in 2013. She started therapy with DMF in November 2016. DIAGNOSIS After 2 months of therapy with DMF, the results of thyroid function test were abnormal. Thyroid ultrasonography confirmed the diagnosis of acute exacerbation of HT. INTERVENTIONS This condition led to discontinuation of DMF therapy. OUTCOME Two months after the interruption of DMF therapy, the findings of thyroid function test were within normal limits. CONCLUSION The association of MS with autoimmune thyroid diseases supports a common immune-mediated pathogenic mechanism. We assume that the acute exacerbation of HT in our MS patient is associated not with the immunomodulatory effect of DMF but rather with its antioxidative mechanism.Constant monitoring of thyroid hormone levels should be recommended especially if the MS patients in treatment with DMF are affected by concomitant autoimmune thyroid diseases.
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Corallo F, Lo Buono V, Di Cara M, De Salvo S, Formica C, Morabito R, Floridia D, Pastura C, Rifici C, D’Aleo G, Sessa E, Bramanti P, Marino S. The role of cognitive rehabilitation in limbic encephalitis: A case report. Medicine (Baltimore) 2018; 97:e13223. [PMID: 30508904 PMCID: PMC6283188 DOI: 10.1097/md.0000000000013223] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Limbic encephalitis is a parenchymal inflammation caused by viral, bacterial, or other microbial and postinfectious agents, which is usually expressed by multifocal neurological signs and cognitive impairment. PATIENT CONCERNS A 50-year-old female was admitted in postacute phase, at our rehabilitative Center, to undertake neuro-motor treatment for a period of 4 months. DIAGNOSES The patient was affected by limbic encephalitis. Clinical presentation revealed attention, memory and executive dysfunctions, as well as behavioral changes, emotional dysregulation and reduction of self-awareness. INTERVENTIONS The patients received an intensive cognitive and motor rehabilitation training. OUTCOMES Neuropsychological assessment and magnetic resonance imaging were performed before and after rehabilitative training to evaluate the cognitive and cerebral changes induced by treatment. The patient showed an improvement in cognitive performances and behavioral aspects. LESSONS The reducing cognitive deficits, especially memory deficits, could improve quality of life by using available cognitive resources.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo,” Messina
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Corallo F, Lo Buono V, Di Cara M, De Salvo S, Vermiglio G, Pollicino P, Bramanti P, Marino S, Rifici C. Effects of cognitive and motor rehabilitation in non-convulsive status epilepticus: A case report. J Clin Neurosci 2018; 54:137-139. [DOI: 10.1016/j.jocn.2018.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/03/2018] [Accepted: 06/06/2018] [Indexed: 10/14/2022]
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Corallo F, Bonanno L, Lo Buono V, De Salvo S, Rifici C, Bramanti A, Marino S. Coping strategies in caregivers of disorders of consciousness patients. Neurol Sci 2018; 39:1375-1381. [PMID: 29728939 DOI: 10.1007/s10072-018-3431-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/26/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The management of patients with disorders of consciousness (DOC) has raised several important ethical, social, and medical issues. It is also known that families and caregivers are subjected to physical and emotional load due to their assistance activity. The aim of this observational study was to compare distress and coping strategies used among caregivers of two kinds of DOC: vegetative state (VS) and minimally conscious state (MCS). METHODS We have enrolled 80 caregivers (mean age 47.87 ± 11-28 years) that were tested with self-administered measures of distress and coping to individuate which coping strategies were adopted by caregivers of DOC patients and to analyze how these have influenced the degree of distress. RESULTS Data showed that the reaction to stress was different between two groups of caregivers (VS and MCS); moreover, it may vary according to the coping strategies used. CONCLUSION Results showed the importance to develop effective coping strategies aimed to reduce psychological distress and improving caregiver's well-being.
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Affiliation(s)
- Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy.
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy
| | - Simona De Salvo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy
| | - Alessia Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, Cda. Casazza, 98124, Messina, Italy.,Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Ciurleo R, Bonanno L, De Salvo S, Romeo L, Rifici C, Sessa E, D’Aleo G, Russo M, Bramanti P, Marino S, Caminiti F. Olfactory dysfunction as a prognostic marker for disability progression in Multiple Sclerosis: An olfactory event related potential study. PLoS One 2018; 13:e0196006. [PMID: 29664936 PMCID: PMC5903665 DOI: 10.1371/journal.pone.0196006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/04/2018] [Indexed: 11/18/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease and one of the leading causes of disability in young adults. Functional markers able to predict MS progression are still lacking. It is recognized that olfactory dysfunction may be an early symptom in MS. The aim of this study was to investigate whether alterations in olfactory event-related potentials could play a prognostic role in MS. Thirty patients affected by MS relapsing-remitting underwent an olfactory potential examination (T0). Three years after baseline (T1), 28 of 30 patients were clinically evaluated by expanded disability status scale. In addition, the number of Disease Modifying Therapies (DMTs) and the total number of relapses occurred in the last 3 years were collected. At T1, we observed a negative correlation between presence/absence of olfactory potentials and expanded disability status scale scores (rpb = -0.48; p = 0.009). A significant trend for a negative correlation between presence/absence of olfactory potentials and disease duration (rpb = -0.36; p = 0.06) and total number of relapses (rpb = -0.34; p = 0.08) was found. Only patients with olfactory potential absence showed a significant trend in the difference of the disability status scale (p = 0.06) between T0 and T1. In the sub-group of patients with reduced olfactory potential amplitude, we detected a trend for a negative correlation between the disability status scale and the amplitude of N1-P2 components more marked at T1 (r = -0.52; p = 0.06) than T0 (r = -0.47; p = 0.09). This is the first study that evaluated the prognostic role of olfactory event-related potentials in MS. Our results highlighted that olfactory alterations of MS patients were related to disability progression and, to a lesser extent, disease activity. The analysis of olfactory potential parameters confirmed the involvement in olfactory network damage of inflammatory and/or neurodegeneration processes which could predict the progressive course of the disease.
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Affiliation(s)
- Rosella Ciurleo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- * E-mail:
| | - Lilla Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | - Laura Romeo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | - Edoardo Sessa
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Corallo F, Bonanno L, Lo Buono V, De Salvo S, Rifici C, Pollicino P, Allone C, Palmeri R, Todaro A, Alagna A, Bramanti A, Bramanti P, Marino S. Augmentative and Alternative Communication Effects on Quality of Life in Patients with Locked-in Syndrome and Their Caregivers. J Stroke Cerebrovasc Dis 2017; 26:1929-1933. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 06/12/2017] [Accepted: 06/18/2017] [Indexed: 12/13/2022] Open
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Gugliandolo A, Caio C, Mezzatesta ML, Rifici C, Bramanti P, Stefani S, Mazzon E. Successful ceftazidime-avibactam treatment of MDR-KPC-positive Klebsiella pneumoniae infection in a patient with traumatic brain injury: A case report. Medicine (Baltimore) 2017; 96:e7664. [PMID: 28767588 PMCID: PMC5626142 DOI: 10.1097/md.0000000000007664] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Carbapenem-resistant Enterobacteriaceae infections are a serious health care problem, because of the high mortality. Carbapenem resistance is mainly caused by carbapenemases production, including Klebsiella pneumoniae carbapenemase (KPC). Ceftazidime-avibactam is a new cephalosporin/β-lactamase inhibitor combination for the treatment of complicated urinary, intra-abdominal infections, and nosocomial pneumonia caused by gram negative, or other serious gram-negative infections. PATIENT CONCERNS We showed the case of a 27-year-old patient, hospitalized for traumatic brain injury and chest trauma, with KPC-producing Klebsiella pneumoniae infection. DIAGNOSES Blood and bronchial aspirate culture analysis detected an infection caused by MDR Klebsiella pneumoniae, resistant to meropenem, ertapenem, piperacillin/tazobactam, amoxicillin/clavulanic acid, aztreonam, ceftazidime, cefotaxime, cefepime, amikacin, ciprofloxacin, trimethoprim/sulfamethoxazole, colistin while it showed an intermediate sensitivity to gentamicin and was sensitive to ceftazidime-avibactam. Molecular analyses revealed that the isolate belonged to the epidemic clone sequence type 258 (ST258) carrying blaKPC-3, blaTEM-1, and blaSHV-11genes. INTERVENTIONS After various combined antibiotic therapies without improvements, he was treated with ceftazidime-avibactam, on a compassionate-use basis. OUTCOMES With ceftazidime-avibactam monotherapy clinical and microbiological clearance was obtained. A week after the end of the therapy microbiological analysis was repeated and a positive rectal swab for KPC-Klebsiella pneumoniae was found, becoming negative after 1 month. Moreover, the patient did not show any relapses for up to 18 weeks. LESSONS This case indicates that ceftazidime-avibactam monotherapy could be efficacious against KPC positive Klebsiella pneumoniae infections.
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Affiliation(s)
- Agnese Gugliandolo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Messina
| | - Carla Caio
- Section of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maria Lina Mezzatesta
- Section of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Messina
| | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Messina
| | - Stefania Stefani
- Section of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Emanuela Mazzon
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Messina
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Marino S, Bonanno L, Ciurleo R, Baglieri A, Morabito R, Guerrera S, Rifici C, Giorgio A, Bramanti P, De Stefano N. Functional Evaluation of Awareness in Vegetative and Minimally Conscious State. Open Neuroimag J 2017; 11:17-25. [PMID: 28553427 PMCID: PMC5427708 DOI: 10.2174/1874440001711010017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/31/2017] [Accepted: 03/21/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI). Methods: We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale and the Clinical Unawareness Assessment Scale, the patients were grouped into VS (n=23) and MCS (n=27). All patients underwent to fMRI examination. After 6 months, the patients were reassessed using Glasgow Outcome Scale and Revised Coma Recovery Scale. Results: fMRI showed significant (p<0.01, cluster-corrected) brain activation in the primary auditory cortex bilaterally during the acoustic stimuli in patients with both VS and MCS. However, ten patients clinically classified as VS, showed a pattern of brain activation very similar to that of MCS patients. Six months later, these ten VS patients had significant clinical improvement, evolving into MCS, whereas the other VS patients and patients with MCS remained clinically stable. Conclusion: Brain activity could help in discerning whether the status of wakefulness in VS is also accompanied by partial awareness, as occurs in MCS. This may have very important prognostic implications.
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Affiliation(s)
- Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | | - Rosa Morabito
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | | - Antonio Giorgio
- UOSA Experimental Neurology, Dept. of Medicine, Surgery & Neuroscience, University of Siena, Italy
| | | | - Nicola De Stefano
- UOSA Experimental Neurology, Dept. of Medicine, Surgery & Neuroscience, University of Siena, Italy
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Corallo F, Bonanno L, Lo Buono V, De Salvo S, Allone C, Palmeri R, La Gattuta E, Rifici C, Alagna A, Todaro A, Bramanti P, Marino S. Evolution of psychological condition in caregivers of patients with disorders of consciousness: a longitudinal study. Neurol Sci 2017; 38:1249-1253. [DOI: 10.1007/s10072-017-2941-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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De Salvo S, Caminiti F, Bonanno L, De Cola MC, Corallo F, Caizzone A, Rifici C, Bramanti P, Marino S. Neurophysiological assessment for evaluating residual cognition in vegetative and minimally conscious state patients: a pilot study. Funct Neurol 2016; 30:237-44. [PMID: 26727702 DOI: 10.11138/fneur/2015.30.4.237] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess residual cognitive function and perform outcome evaluation in vegetative state (VS) and minimally conscious state (MCS) patients, using Neurowave, a system able to monitor event-related potentials (ERPs) induced by neurosensory stimulation. Eleven VS and five MCS patients underwent neurological examination and clinical evaluation performed using validated clinical and behavioral scales; they also underwent neurosensory stimulation, which consisted of administration of target images (rare stimuli), relevant to the patient's personal history and having emotional significance, alternated with nontarget images ("standard" stimuli), which had no emotional significance. All simultaneous ERP responses at baseline (T0) and at three months from T0 (T1) were recorded. At T0 we found significant differences between the VS and MCS patients for the N200 (p=0.02) and P300 (p=0.04) waves. The neurophysiological analysis at T1 showed a significant difference only for P300 (p=0.02), probably due to the improvements observed in the VS subjects for the N100 (p=0.009) and N200 (p=0.02) sensory components. Neurophysiological assessment for evaluating residual cognition in vegetative and minimally conscious state patients: a pilot study Our findings seem to show the value of ERP monitoring in VS and MCS patients as a means of investigating residual cognitive function. This approach could guide early therapeutic and rehabilitation interventions, and contribute to identifying better diagnostic and prognostic markers for use in unresponsive or low-responsive patients.
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Nunnari D, De Cola MC, Costa A, Rifici C, Bramanti P, Marino S. Exploring cognitive reserve in multiple sclerosis: New findings from a cross-sectional study. J Clin Exp Neuropsychol 2016; 38:1158-67. [DOI: 10.1080/13803395.2016.1200538] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Russo M, De Luca R, Torrisi M, Rifici C, Sessa E, Bramanti P, Naro A, Calabrò RS. Should we care about sativex-induced neurobehavioral effects? A 6-month follow-up study. Eur Rev Med Pharmacol Sci 2016; 20:3127-3133. [PMID: 27460745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Sativex® is an exclusive cannabinoid-based drug approved for the treatment of spasticity due to Multiple Sclerosis (MS). The most common side effects include dizziness, nausea, and somnolence. However, it is still under debate whether the drug could cause negative cognitive effects. The aim of our study was to investigate the effect of Sativex® on functional and psychological status in cannabis-naïve MS patients. PATIENTS AND METHODS All the study participants (i.e. 40 patients affected by MS) underwent a specific clinical and neuropsychological assessment to investigate spasticity and associated symptoms, besides the cognitive and psychiatric domains commonly impaired in MS, before and after 1 and 6 months of Sativex® administration. RESULTS After the treatment, we did not observe any significant neurobehavioral impairment in all the patients, but one. CONCLUSIONS Our findings suggest that Sativex® treatment does not significantly affect the cognitive and neurobehavioral functions. However, the study supports the relevance of an extensive neuropsychological evaluation in MS patients selected for the drug administration, in an attempt to early detect the uncommon but important neurobehavioral side effects.
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Affiliation(s)
- M Russo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
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