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Weidler C, Gramegna C, Müller D, Schrickel M, Habel U. Resting-state functional connectivity and structural differences between smokers and healthy non-smokers. Sci Rep 2024; 14:6878. [PMID: 38519565 PMCID: PMC10960011 DOI: 10.1038/s41598-024-57510-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
Previous studies have shown an association between cigarette use and altered resting-state functional connectivity (rsFC) in many large-scale networks, sometimes complemented by measures of cortical atrophy. In this study, we aimed to further explore the neural differences between smokers and healthy non-smokers through the integration of functional and structural analyses. Imaging data of fifty-two smokers and forty-five non-smokers were analyzed through an independent component analysis for group differences in rsFC. Smokers showed lower rsFC within the dorsal attention network (DAN) in the left superior and middle frontal gyrus and left superior division of the lateral occipital cortex compared to non-smokers; moreover, cigarette use was found to be associated with reduced grey matter volume in the left superior and middle frontal gyrus and right orbitofrontal cortex, partly overlapping with functional findings. Within smokers, daily cigarette consumption was positively associated with increased rsFC within the cerebellar network and the default mode network and decreased rsFC within the visual network and the salience network, while carbon monoxide level showed a positive association with increased rsFC within the sensorimotor network. Our results suggest that smoking negatively impacts rsFC within the DAN and that changes within this network might serve as a circuit-based biomarker for structural deficits.
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Affiliation(s)
- Carmen Weidler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Chiara Gramegna
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
| | - Dario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Maike Schrickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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Aiello EN, Gramegna C, Esposito A, Gazzaniga V, Zago S, Difonzo T, Maddaluno O, Appollonio I, Bolognini N. Correction to: The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy. Aging Clin Exp Res 2023; 35:2857-2859. [PMID: 37552422 PMCID: PMC10627893 DOI: 10.1007/s40520-023-02509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
- PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Ildebrando Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Guidali G, Picardi M, Gramegna C, Bolognini N. Modulating motor resonance with paired associativestimulation: Neurophysiological and behavioral outcomes. Cortex 2023; 163:139-153. [PMID: 37104888 DOI: 10.1016/j.cortex.2023.03.006] [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: 08/09/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
In the human brain, paired associative stimulation (PAS), a non-invasive brain stimulation technique based on Hebbian learning principles, can be used to model motor resonance, the inner activation of an observer's motor system by action observation. Indeed, the newly developed mirror PAS (m-PAS) protocol, through the repeatedly pairing of transcranial magnetic stimulation (TMS) pulses over the primary motor cortex (M1) and visual stimuli depicting index-finger movements, allows the emergence of a new, atypical pattern of cortico-spinal excitability. In the present study, we performed two experiments to explore (a) the debated hemispheric lateralization of the action-observation network and (b) the behavioral after-effects of m-PAS, particularly concerning a core function of the MNS: automatic imitation. In Experiment 1, healthy participants underwent two sessions of m-PAS, delivered over the right and left M1. Before and after each m-PAS session, motor resonance was assessed by recording motor-evoked potentials induced by single-pulse TMS applied to the right M1 while observing contralateral (left) and ipsilateral (right) index-finger movements or static hands. In Experiment 2, participants performed an imitative compatibility task before and after the m-PAS targeting the right M1. Results showed that only m-PAS targeting the right hemisphere, non-dominant in right-handed people, induced the emergence of motor resonance for the conditioned movement, absent before the stimulation. This effect is not present when m-PAS target the M1 of the left hemisphere. Importantly, the protocol also affects behavior, modulating automatic imitation in a strictly somatotopic fashion (i.e., influencing the imitation of the conditioned finger movement). Overall, this evidence shows that the m-PAS can be used to drive new associations between the perception of actions and their corresponding motor programs, measurable both at a neurophysiological and behavioral level. At least for simple, not goal-directed, movements, the induction of motor resonance and automatic imitation effects are governed by mototopic and somatotopic rules.
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Affiliation(s)
- Giacomo Guidali
- Department of Psychology & NeuroMI - Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy.
| | - Michela Picardi
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy; PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Chiara Gramegna
- Department of Psychology & NeuroMI - Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy; PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- Department of Psychology & NeuroMI - Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy; Laboratory of Neuropsychology/Dept. Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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Bolognini N, Gramegna C, Esposito A, Aiello EN, Difonzo T, Zago S. Correction to: The Testamentary Capacity Assessment Tool (TCAT): validation and normative data. Neurol Sci 2023; 44:423. [PMID: 35871182 DOI: 10.1007/s10072-022-06292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy. .,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Teresa Difonzo
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. Correction to: The Frontal Assessment Battery (FAB) and its sub‑scales: validation and updated normative data in an Italian population sample. Neurol Sci 2023; 44:425. [PMID: 35871183 PMCID: PMC9816245 DOI: 10.1007/s10072-022-06295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Edoardo Nicolò Aiello
- grid.7563.70000 0001 2174 1754School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy ,grid.7563.70000 0001 2174 1754Clinical Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Antonella Esposito
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Chiara Gramegna
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Valentina Gazzaniga
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Stefano Zago
- grid.4708.b0000 0004 1757 2822Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy ,grid.7563.70000 0001 2174 1754Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- grid.4708.b0000 0004 1757 2822Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Marco Appollonio
- grid.7563.70000 0001 2174 1754School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy ,grid.7563.70000 0001 2174 1754Milan Center for Neuroscience (NeuroMI), Milan, Italy ,grid.7563.70000 0001 2174 1754Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy ,grid.418224.90000 0004 1757 9530Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Lazzeri G, Franco G, Difonzo T, Carandina A, Gramegna C, Vergari M, Arienti F, Naci A, Scatà C, Monfrini E, Dias Rodrigues G, Montano N, Comi GP, Saetti MC, Tobaldini E, Di Fonzo A. Cognitive and Autonomic Dysfunction in Multiple System Atrophy Type P and C: A Comparative Study. Front Neurol 2022; 13:912820. [PMID: 35785342 PMCID: PMC9243310 DOI: 10.3389/fneur.2022.912820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple System Atrophy (MSA) is a rare neurodegenerative disease, clinically defined by a combination of autonomic dysfunction and motor involvement, that may be predominantly extrapyramidal (MSA-P) or cerebellar (MSA-C). Although dementia is generally considered a red flag against the clinical diagnosis of MSA, in the last decade the evidence of cognitive impairment in MSA patients has been growing. Cognitive dysfunction appears to involve mainly, but not exclusively, executive functions, and may have different characteristics and progression in the two subtypes of the disease (i.e., MSA-P and MSA-C). Despite continued efforts, combining in-vivo imaging studies as well as pathological studies, the physiopathological bases of cognitive involvement in MSA are still unclear. In this view, the possible link between cardiovascular autonomic impairment and decreased cognitive performance, extensively investigated in PD, needs to be clarified as well. In the present study, we evaluated a cohort of 20 MSA patients (9 MSA-P, 11 MSA-C) by means of a neuropsychological battery, hemodynamic assessment (heart rate and arterial blood pressure) during rest and active standing and bedside autonomic function tests assessed by heart rate variability (HRV) parameters and sympathetic skin response (SSR) in the same experimental session. Overall, global cognitive functioning, as indicated by the MoCA score, was preserved in most patients. However, short- and long-term memory and attentional and frontal-executive functions were moderately impaired. When comparing MSA-P and MSA-C, the latter obtained lower scores in tests of executive functions and verbal memory. Conversely, no statistically significant difference in cardiovascular autonomic parameters was identified between MSA-P and MSA-C patients. In conclusion, moderate cognitive deficits, involving executive functions and memory, are present in MSA, particularly in MSA-C patients. In addition, our findings do not support the role of dysautonomia as a major driver of cognitive differences between MSA-P and MSA-C.
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Affiliation(s)
- Giulia Lazzeri
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Franco
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelica Carandina
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Chiara Gramegna
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maurizio Vergari
- Neurophysiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Arienti
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Anisa Naci
- Neurophysiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Costanza Scatà
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of General Psychology, University of Padua, Padua, Italy
| | - Edoardo Monfrini
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giacomo P. Comi
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Cristina Saetti
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessio Di Fonzo
- Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- *Correspondence: Alessio Di Fonzo
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. Correction to: The Frontal Assessment Battery (FAB) and its sub‑scales: validation and updated normative data in an Italian population sample. Neurol Sci 2022; 43:6621. [PMID: 35451665 PMCID: PMC9616748 DOI: 10.1007/s10072-022-06087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pasotti F, De Luca G, Aiello EN, Gramegna C, Di Gangi M, Foderaro G, Gallucci M, Biglia E, Bottini G. A multi-component, adaptive Working Memory Assessment Battery (WoMAB): validation and norms in an Italian population sample. Neurol Sci 2022; 43:985-992. [PMID: 34185185 PMCID: PMC8789625 DOI: 10.1007/s10072-021-05416-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Working memory (WM) abilities are frequently impaired in neurological disorders affecting fronto-parietal cortical/sub-cortical structures. WM deficits negatively influence interventional outcomes and everyday functioning. This study thus aimed at the following: (a) developing and standardizing an ecologically valid task for WM assessment ( Ice Cream Test, ICT); (b) validating and norming a novel WM test (Digit Ordering Test, DOT), as well as providing updated norms for digit span (DS) tasks, in an Italian population sample; (c) introducing a novel scoring procedure for measuring WM. METHODS One-hundred and sixty-eight Italian healthy participants-73 male, 95 females; age: 48.4 ± 19.1 (18-86); education: 12.1 ± 4.8 (4-21)-underwent a thorough WM assessment-DOT, ICT, and both forward and backward DS tasks (FDS, BDS). The ICT requires participants to act as waiters who have to keep track of customers' orders. For each task, WM and total (T) outcomes were computed, i.e., the number of elements in the longest sequence and that of recalled sequences, respectively. Norms were derived via the equivalent score (ES) method. RESULTS DS ratios (DSRs) were computed for both WM/S and T outcomes on raw DS measures (BDS divided by FDS). Age and education significantly predicted all WM tasks; sex affected FDS and DSR-T scores (males > females). WM measures were highly internally related. DISCUSSION The present work provides Italian practitioners with a normatively updated, multi-component, adaptive battery for WM assessment (WoMAB) as well as with novel outcomes which capture different WM facets-WM capacity and attentive monitoring abilities.
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Affiliation(s)
- Fabrizio Pasotti
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Giulia De Luca
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- PhD in Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Marco Di Gangi
- Studio Di Gangi & Vicini Psicologia Psicoterapia e Neuropsicologia, Minusio, Switzerland
| | - Giuseppe Foderaro
- Neurocentro Della Svizzera Italiana, Ente Ospedaliero Cantonale Ospedale Regionale Di Lugano, Lugano, Switzerland
| | - Marcello Gallucci
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
- Milan Center for Neuroscience (NeuroMI), Milano, Italy
| | - Elena Biglia
- Neurocentro Della Svizzera Italiana, Ente Ospedaliero Cantonale Ospedale Regionale Di Lugano, Lugano, Switzerland
| | - Gabriella Bottini
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Milan Center for Neuroscience (NeuroMI), Milano, Italy
- Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Aiello EN, Gramegna C, Esposito A, Gazzaniga V, Zago S, Difonzo T, Maddaluno O, Appollonio I, Bolognini N. The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy. Aging Clin Exp Res 2022; 34:375-382. [PMID: 34313961 PMCID: PMC8847194 DOI: 10.1007/s40520-021-01943-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Background The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage; (iii) information on sensitivity and discriminative capability at the item level. Methods Five hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females; age: 63.4 ± 15, 21–96; education: 11.3 ± 4.6, 1–25) were administered the MoCA. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Average ESs were also computed. Agreement with previous ESs classification was assessed via Cohen’s k. Results Age and education significantly predicted all MoCA measures except for Orientation, which was related to age only. No sex differences were detected when tested along with age and education. Substantial disagreements with previous ESs classifications were detected. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. Discussion Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA.
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Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio IM, Bolognini N. The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample. Neurol Sci 2022; 43:979-984. [PMID: 34184168 PMCID: PMC8789707 DOI: 10.1007/s10072-021-05392-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Deficits of executive functioning (EF) are frequently found in neurological disorders. The Frontal Assessment Battery (FAB) is one of the most widespread and psychometrically robust EF screeners in clinical settings. However, in Italy, FAB norms date back to 15 years ago; moreover, its validity against "EF-loaded" global cognitive screeners (e.g., the Montreal Cognitive Assessment, MoCA) has yet to be tested. This study thus aimed at (a) providing updated normative data for the Italian FAB and (b) assessing its convergent validity with the MoCA. METHODS Four-hundred and seventy-five healthy Italian native speakers (306 females, 169 males; mean age: 61.08 ± 15.1; mean education: 11.67 ± 4.57) were administered by the MoCA and the FAB. FAB items were divided into three subscales: FAB-1 (linguistically mediated EF), FAB-2 (planning), and FAB-3 (inhibition). Regression-based norms were derived (equivalent scores) for all FAB measures. RESULTS Age and education were predictive of all FAB measures, whereas no gender differences were detected. The FAB and its sub-scales were related to MoCA measures-the strongest associations being found with MoCA total and MoCA-EF scores. FAB sub-scales were both internally related and associated with FAB total scores. DISCUSSION The FAB proved to have convergent validity with both global cognitive and EF measures in healthy individuals. The present study provides updated normative data for the FAB and its sub-scales in an Italian population sample, and thus supports an adaptive usage of this EF screener.
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Affiliation(s)
- Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Clinical Neuroscience, University of Milano-Bicocca, Monza, Italy
| | | | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Stefano Zago
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Ildebrando Marco Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Faggiano A, Difonzo T, Avallone C, Forgione A, Gazzaniga V, Gramegna C, Locatelli G, Mallardi G, Nicotra A, Zago S, Carugo S. 208 Association between cardiovascular data and the development and progression of mild cognitive impairment: results from the retrospective cohort study. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab145.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Mild cognitive impairment (MCI) is characterized by objective evidence of cognitive impairment in one or more cognitive domains in the absence of significant interference in daily-life activities. Anyway, people with MCI are considered to be at heightened risk of further cognitive decline and progression to dementia. To date, few evidence regarding the association between cardiovascular data and MCI are present in the literature. To investigate the association between various cardiovascular data (traditional risk factors and outcomes) and the development and progression of MCI.
Methods and results
The study included 127 patients referred to the Neurological Unit of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan for subjective memory complaints and/or clinical suspect of cognitive impairment. Neuropsychological tests evaluating executive functions and cardiovascular data were collected at baseline and 2-year follow-up. Visit reports and medical records were reviewed to extrapolate the data. The study was conducted between 2012 and 2020. The 51 (40.2%) patients on antiplatelet therapy (94% on aspirin) had a worse baseline degree of cognitive impairment on neuropsychological tests of executive functions and had greater worsening of MCI at 2 years (Table 1). Patients on antiplatelet therapy were significantly older (75.85 vs. 71.7; P = 0.009), more ischaemic (21.6% vs. 1.3%; P < 0.001), hypertensive (90.2% vs. 60.5%; P < 0.001), and dyslipidaemic (62.7% vs. 19.7%; P < 0.001) than patients without antiplatelet therapy. No other single cardiovascular data analysed (presence of hypertension, dyslipidaemia, ischaemic heart disease, diabetes, atrial fibrillation, and anticoagulation therapy) showed a statistical significant association with MCI presence or progression.
Conclusions
The present study suggests that the prevalence and progression of MCI is significantly higher among patients on antiplatelet therapy, who carry a greater cardiovascular burden. Although patients on antiplatelet therapy were older, more ischaemic, hypertensive, and dyslipidaemic than patients without antiplatelet therapy, none of these parameters were associated with MCI presence and/or progression and can therefore be considered a confounding factor.
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Affiliation(s)
- Andrea Faggiano
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Teresa Difonzo
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Carlo Avallone
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Arianna Forgione
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Valentina Gazzaniga
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Chiara Gramegna
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Giuseppe Locatelli
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Giulio Mallardi
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Alessia Nicotra
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Stefano Zago
- Neurology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Stefano Carugo
- Cardiology Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
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Bolognini N, Gramegna C, Esposito A, Aiello EN, Difonzo T, Zago S. The Testamentary Capacity Assessment Tool (TCAT): validation and normative data. Neurol Sci 2021; 43:2831-2838. [PMID: 34787752 DOI: 10.1007/s10072-021-05736-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is an increasing need for objective and standardized assessment of testamentary capacity (TC) in dementia. A new instrument, the Testamentary Capacity Assessment Tool (TCAT), has been recently developed; however, the lack of validation and normative data regarding this cognitive screening test has limited its adoption in forensic and clinical settings. The present study collects normative data for the TCAT and assesses its convergent validity with standardized cognitive tests and the capacity to define what a 'testament' is. METHODS The study involved 323 neurologically healthy adults (123 males, 200 females) of different ages (31-93 years) and different educational levels (4-25 years). The TCAT was administered along with the Beck Depression Inventory-II (BDI-II), the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Testament Definition Scale (TDS). RESULTS Multiple regression analyses revealed a significant effect for gender, age and education on TCAT scores. Correlation analyses showed significant associations between the TCAT and the MMSE, MoCA, FAB and BDI-II. A positive correlation between the TCAT and TDS was also found, proving good convergent validity of the TCAT with respect to TC. Finally, cut-off scores and Equivalent Scores (ES) were computed. DISCUSSION The present study provides normative data for using the TCAT as an adjuvant cognitive screening test in the neuropsychological evaluation of TC. Our findings shall be of interest for the adoption of the TCAT also in clinical practice, since it evaluates cognitive functions (e.g., autobiographic memory, Theory of Mind) not measured by traditional screening tests.
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Affiliation(s)
- Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy. .,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Edoardo Nicolò Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Teresa Difonzo
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Pasotti F, Serranò S, Aiello EN, Gramegna C, Querzola M, Gallucci M, Micieli G, Bollani A, Agostoni EC, Bottini G. Assessing mood and cognitive functioning in acute stroke: clinical usability of a Visual Analogue Mood Scale (VAMS). Neurol Sci 2021; 43:1741-1745. [PMID: 34365548 PMCID: PMC8860784 DOI: 10.1007/s10072-021-05440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/25/2021] [Indexed: 12/05/2022]
Abstract
Background Patients suffering from stroke in the acute/post-acute phases often present with depressive mood — which negatively impacts on patients’ prognosis. However, psychometric evaluation of mood in acute stroke patients may be challenging due to cognitive deficits. Tools investigating emotional states via a vertical analogue line may overcome language/visuo-spatial disorders. This study thus aimed at (a) investigating the clinical usability of a Visual Analogue Mood Scale (VAMS) in acute stroke patients and (b) investigating the interplay between mood and cognition in this population. Methods Forty-one acute stroke patients were compared to 41 age-, education- and sex-matched healthy participants (HPs) on the VAMS and on cognitive measures (mental performance in acute stroke, MEPS). A control line bisection (LB) task was administered to control for potential visuo-spatial deficits in patients. Results Patients reported higher depression levels than HPs (lower VAMS scores); this between-group difference stayed significant when covarying for LB scores. MEPS scores discriminated patients from HPs; among cognitive measures, only the Clock drawing test (CDT) was positively associated with VAMS scores. Lesion side did not affect patients’ mood state; however, disease duration was inversely related to VAMS scores. Discussion The VAMS proved to be a suitable tool for assessing mood in acute stroke patients, as being independent from post-stroke cognitive sequelae. The CDT might represent an adequate measure of depression-induced, post-stroke cognitive efficiency decrease. Mood disorders might occur and thus should be adequately addressed also in post-acute phases — likely due to longer hospitalization times and regression of anosognosic features.
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Affiliation(s)
- Fabrizio Pasotti
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Sabrina Serranò
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Chiara Gramegna
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Matteo Querzola
- Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marcello Gallucci
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Giuseppe Micieli
- Neurology Department, Fondazione Istituto Neurologico Casimiro Mondino, Pavia, Italy
| | - Allesandra Bollani
- Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Gabriella Bottini
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy. .,Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. .,Milan Center for Neuroscience (NeuroMI), Milan, Italy.
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