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Galgani A, Lombardo F, Frijia F, Martini N, Tognoni G, Pavese N, Giorgi FS. The degeneration of locus coeruleus occurring during Alzheimer's disease clinical progression: a neuroimaging follow-up investigation. Brain Struct Funct 2024:10.1007/s00429-024-02797-1. [PMID: 38625557 DOI: 10.1007/s00429-024-02797-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
The noradrenergic nucleus Locus Coeruleus (LC) is precociously involved in Alzheimer's Disease (AD) pathology, and its degeneration progresses during the course of the disease. Using Magnetic Resonance Imaging (MRI), researchers showed also in vivo in patients the disruption of LC, which can be observed both in Mild Cognitively Impaired individuals and AD demented patients. In this study, we report the results of a follow-up neuroradiological assessment, in which we evaluated the LC degeneration overtime in a group of cognitively impaired patients, submitted to MRI both at baseline and at the end of a 2.5-year follow-up. We found that a progressive LC disruption can be observed also in vivo, involving the entire nucleus and associated with clinical diagnosis. Our findings parallel neuropathological ones, which showed a continuous increase of neuronal death and volumetric atrophy within the LC with the progression of Braak's stages for neurofibrillary pathology. This supports the reliability of MRI as a tool for exploring the integrity of the central noradrenergic system in neurodegenerative disorders.
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Affiliation(s)
- Alessandro Galgani
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, Pisa, 56126, Italy
| | | | - Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Nicola Martini
- Bioengineering Unit, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK
- Institute of Clinical Medicine, PET Centre, Aarhus University, Aarhus, Denmark
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, Pisa, 56126, Italy.
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Cintoli S, Favilli L, Morganti R, Siciliano G, Ceravolo R, Tognoni G. Verbal fluency patterns associated with the amnestic conversion from mild cognitive impairment to dementia. Sci Rep 2024; 14:2029. [PMID: 38263387 PMCID: PMC10806051 DOI: 10.1038/s41598-024-52562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/20/2024] [Indexed: 01/25/2024] Open
Abstract
Patients with amnestic mild cognitive impairment (aMCI) are at a higher risk of converting to Alzheimer's disease. The aim of this study was to examine the potential use of Verbal Fluency (VF) measures as markers for predicting the conversion to dementia. At baseline, 61 aMCI, aged 65 to 80 years, underwent a comprehensive neuropsychological assessment, including phonemic (PVF) and semantic verbal fluency (SVF) tasks. After 18 months, 14 individuals with aMCI had progressed to a diagnosis of dementia. The findings revealed that aMCI-converter group had lower Mini Mental State Examination and Rey Auditory Verbal Learning Task scores than aMCI-no converter and produced fewer clusters in both VF tasks and a lower number of switches in PVF at baseline (p < 0.05). According to receiver operating characteristic curve analysis, the number of clusters in PVF had the highest predictive value (AUC = 0.80) with a threshold of 5.510 for identifying aMCI-converter at baseline. Additionally, participants with higher levels of education exhibited more clusters and switches in VF tasks (p < 0.05). These results suggest that qualitative measures of VF could serve as neuropsychological markers for predicting cognitive decline in individuals with aMCI. Furthermore, the study highlights the potential influence of the education level on cognitive performance in neuropsychological tasks.
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Affiliation(s)
- Simona Cintoli
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy.
| | - Laura Favilli
- Department of NEUROFARBA- Section of Psychology, University of Florence, 50135, Florence, Italy
| | - Riccardo Morganti
- Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, 56126, Pisa, Italy
| | - Gabriele Siciliano
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
| | - Roberto Ceravolo
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
| | - Gloria Tognoni
- Department of Medical Specialties - Neurology Unit, AOUP, 56126, Pisa, Italy
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Sale A, Noale M, Cintoli S, Tognoni G, Braschi C, Berardi N, Maggi S, Maffei L. Long-term beneficial impact of the randomised trial 'Train the Brain', a motor/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up. Age Ageing 2023; 52:7160021. [PMID: 37167616 DOI: 10.1093/ageing/afad067] [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: 06/28/2022] [Revised: 01/23/2023] [Indexed: 05/13/2023] Open
Abstract
No treatment options are currently available to counteract cognitive deficits and/or delay progression towards dementia in older people with mild cognitive impairment (MCI). The 'Train the Brain' programme is a combined motor and cognitive intervention previously shown to markedly improve cognitive functions in MCI individuals compared to non-trained MCI controls, as assessed at the end of the 7-month intervention. Here, we extended the previous analyses to include the long-term effects of the intervention and performed a data disaggregation by gender, education and age of the enrolled participants. We report that the beneficial impact on cognitive functions was preserved at the 14-month follow-up, with greater effects in low-educated compared to high-educated individuals, and in women than in men.
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Affiliation(s)
- Alessandro Sale
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
| | - Marianna Noale
- Neuroscience Institute CNR (National Research Council), Via Giustiniani 2, Padua 35128, Italy
| | - Simona Cintoli
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Chiara Braschi
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
| | - Nicoletta Berardi
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, Florence University, Via San Salvi, Florence 50100, Italy
| | - Stefania Maggi
- Neuroscience Institute CNR (National Research Council), Via Giustiniani 2, Padua 35128, Italy
| | - Lamberto Maffei
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
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4
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Aghakhanyan G, Galgani A, Vergallo A, Lombardo F, Martini N, Baldacci F, Tognoni G, Leo A, Guidoccio F, Siciliano G, Fornai F, Pavese N, Volterrani D, Giorgi FS. Brain metabolic correlates of Locus Coeruleus degeneration in Alzheimer's disease: a multimodal neuroimaging study. Neurobiol Aging 2023; 122:12-21. [PMID: 36463849 DOI: 10.1016/j.neurobiolaging.2022.11.002] [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: 11/28/2021] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
Locus Coeruleus (LC) degeneration occurs early in Alzheimer's disease (AD) and this could affect several brain regions innervated by LC noradrenergic axon terminals, as these bear neuroprotective effects and modulate neurovascular coupling/neuronal activity. We used LC-sensitive Magnetic Resonance imaging (MRI) sequences enabling LC integrity quantification, and [18F]Fluorodeoxyglucose (FDG) PET, to investigate the association of LC-MRI changes with brain glucose metabolism in cognitively impaired patients (30 amnesticMCI and 13 demented ones). Fifteen cognitively intact age-matched controls (HCs) were submitted only to LC-MRI for comparison with patients. Voxel-wise regression analyses of [18F]FDG images were conducted using the LC-MRI parameters signal intensity (LCCR) and LC-belonging voxels (LCVOX). Both LCCR and LCVOX were significantly lower in patients compared to HCs, and were directly associated with [18F]FDG uptake in fronto-parietal cortical areas, mainly involving the left hemisphere (p < 0.001, kE > 100). These results suggest a possible association between LC degeneration and cortical hypometabolism in degenerative cognitive impairment with a prevalent left-hemispheric vulnerability, and that LC degeneration might be linked to large-scale functional network alteration in AD pathology.
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Affiliation(s)
- Gayane Aghakhanyan
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alessandro Galgani
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Andrea Vergallo
- Department of Radiology, Fondazione Monasterio/CNR, Pisa, Italy
| | | | | | - Filippo Baldacci
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Leo
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federica Guidoccio
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Aging Research Unit, Newcastle University, Newcastle upon Tyne, UK; Institute of Clinical Medicine, PET Centre, Aarhus University, Aarhus, Denmark
| | - Duccio Volterrani
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Filippo S Giorgi
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
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Cintoli S, Elefante C, Radicchi C, Brancati GE, Bacciardi S, Bonaccorsi J, Siciliano G, Maremmani I, Perugi G, Tognoni G. Could Temperamental Features Modulate Participation in Clinical Trials? J Clin Med 2023; 12:jcm12031121. [PMID: 36769768 PMCID: PMC9917573 DOI: 10.3390/jcm12031121] [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: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
The prodromal stages of Alzheimer's disease (AD) are the primary focus of research aimed at slowing disease progression. This study explores the influence of affective temperament on the motivation of people with mild cognitive impairment (MCI) and subjective cognitive decline (SCD) to participate in clinical trials. One hundred four subjects with MCI and SCD were screened for participation in pharmacological and non-pharmacological trials. Affective temperament was assessed based on the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS) scale. Demographic variables and temperament subscales scores were compared between MCI and SCD patients and among patients participating in the pharmacological trial, the non-pharmacological trial and refusing participation. Twenty-one subjects consented to participate in the pharmacological trial, seventy consented to the non-pharmacological trial and thirteen refused to participate in any trial. Patients with SCD had greater education and more depressive temperamental traits than those with MCI. While older age, higher education and anxious temperament were negatively associated with participation in the pharmacological trial, irritable temperamental positively predicted pharmacological trial participation. In conclusion, temperamental features may affect the willingness of patients with MCI and SCD to take part in clinical trials and, especially, the choice to participate in pharmacological studies.
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Affiliation(s)
- Simona Cintoli
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
| | - Camilla Elefante
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Claudia Radicchi
- Institute of Neuroscience, National Research Council, 56124 Pisa, Italy
| | - Giulio Emilio Brancati
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Silvia Bacciardi
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy
- PISA-School of Clinical and Experimental Psychiatry, 56100 Pisa, Italy
| | - Joyce Bonaccorsi
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Icro Maremmani
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56127 Pisa, Italy
- Saint Camillus International University of Health and Medical Sciences (UniCamillus), 00131 Rome, Italy
- Correspondence: ; Tel.: +39-050-992965; Fax: +39-050-993267
| | - Giulio Perugi
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56127 Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit, Santa Chiara University Hospital, 56126 Pisa, Italy
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Galgani A, Lombardo F, Martini N, Vergallo A, Bastiani L, Hampel H, Hlavata H, Baldacci F, Tognoni G, De Marchi D, Ghicopulos I, De Cori S, Biagioni F, Busceti CL, Ceravolo R, Bonuccelli U, Chiappino D, Siciliano G, Fornai F, Pavese N, Giorgi FS. Magnetic resonance imaging Locus Coeruleus abnormality in amnestic Mild Cognitive Impairment is associated with future progression to dementia. Eur J Neurol 2023; 30:32-46. [PMID: 36086917 PMCID: PMC10092028 DOI: 10.1111/ene.15556] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 06/22/2022] [Revised: 08/17/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Human neuropathological studies indicate that the pontine nucleus Locus Coeruleus (LC) undergoes significant and early degeneration in Alzheimer's disease. This line of evidence alongside experimental data suggests that the LC functional/structural decay may represent a critical factor for Alzheimer's disease pathophysiological and clinical progression. In the present prospective study, we used Magnetic Resonance Imaging (MRI) with LC-sensitive sequence (LC-MRI) to investigate in vivo the LC involvement in Alzheimer's disease progression, and whether specific LC-MRI features at baseline are associated with prognosis and cognitive performance in amnestic Mild Cognitive Impairment. METHODS LC-MRI parameters were measured at baseline by a template-based method on 3.0-T magnetic resonance images in 34 patients with Alzheimer's disease dementia, 73 patients with amnestic Mild Cognitive Impairment, and 53 cognitively intact individuals. A thorough neurological and neuropsychological assessment was performed at baseline and 2.5-year follow-up. RESULTS In subjects with Mild Cognitive Impairment who converted to dementia (n = 32), the LC intensity and number of LC-related voxels were significantly lower than in cognitively intact individuals, resembling those observed in demented patients. Such a reduction was not detected in Mild Cognitive Impairment individuals, who remained stable at follow-up. In Mild Cognitive Impairment subjects converting to dementia, LC-MRI parameter reduction was maximal in the rostral part of the left nucleus. Structural equation modeling analysis showed that LC-MRI parameters positively correlate with cognitive performance. CONCLUSIONS Our findings highlight a potential role of LC-MRI for predicting clinical progression in Mild Cognitive Impairment and support the key role of LC degeneration in the Alzheimer clinical continuum.
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Affiliation(s)
- Alessandro Galgani
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Lombardo
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Nicola Martini
- Deep Health Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Andrea Vergallo
- GRC No. 21, Alzheimer Precision Medicine, Public Hospital Network of Paris, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Luca Bastiani
- Institute of Clinical Physiology of National Research Council, Pisa, Italy
| | - Harald Hampel
- GRC No. 21, Alzheimer Precision Medicine, Public Hospital Network of Paris, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Hana Hlavata
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniele De Marchi
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Irene Ghicopulos
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara De Cori
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Francesca Biagioni
- Scientific Institute for Research and Health Care Neuromed, Pozzilli, Italy
| | | | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dante Chiappino
- Cardiovascular and Neuroradiological Multimodal Imaging Unit, G. Monasterio Foundation-National Research Council/Tuscany Region, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Scientific Institute for Research and Health Care Neuromed, Pozzilli, Italy.,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Institute of Clinical Medicine, Positron Emission Tomography Center, Aarhus University, Aarhus, Denmark
| | - Filippo Sean Giorgi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Milano C, Hoxhaj D, Del Chicca M, Pascazio A, Paoli D, Tommasini L, Vergallo A, Pizzanelli C, Tognoni G, Nuti A, Ceravolo R, Siciliano G, Hampel H, Baldacci F. Alzheimer's Disease and Neurosyphilis: Meaningful Commonalities and Differences of Clinical Phenotype and Pathophysiological Biomarkers. J Alzheimers Dis 2023; 94:611-625. [PMID: 37334599 DOI: 10.3233/jad-230170] [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] [Indexed: 06/20/2023]
Abstract
BACKGROUND Neurosyphilis-associated cognitive and behavioral impairment- historically coined as "general paralysis of the insane"- share clinical and neuroradiological features with the neurodegenerative disease spectrum, in particular Alzheimer's disease (AD). Anatomopathological similarities have been extensively documented, i.e., neuronal loss, fibrillary alterations, and local amyloid-β deposition. Consequently, accurate classification and timely differential diagnosis may be challenging. OBJECTIVE To describe clinical, bio-humoral, brain MRI, FDG-PET, and amyloid-PET features in cases of neurosyphilis with an AD-like phenotypical presentation, as well as clinical outcome in terms of response to antibiotic therapy. METHODS We selected the studies comparing patients with AD and with neurosyphilis associated cognitive impairment, to investigate candidate biomarkers classifying the two neurological diseases. RESULTS The neuropsychological phenotype of general paralysis, characterized by episodic memory impairment and executive disfunction, substantially mimics clinical AD features. Neuroimaging often shows diffuse or medial temporal cortical atrophy, thus contributing to a high rate of misdiagnosis. Cerebrospinal fluid (CSF)-based analysis may provide supportive diagnostic value, since increased proteins or cells are often found in neurosyphilis, while published data on pathophysiological AD candidate biomarkers are controversial. Finally, psychometric testing using cross-domain cognitive tests, may highlight a wider range of compromised functions in neurosyphilis, involving language, attention, executive function, and spatial ability, which are atypical for AD. CONCLUSION Neurosyphilis should be considered a potential etiological differential diagnosis of cognitive impairment whenever imaging, neuropsychological or CSF features are atypical for AD, in order to promptly start antibiotic therapy and delay or halt cognitive decline and disease progression.
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Affiliation(s)
- Chiara Milano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Domeniko Hoxhaj
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marta Del Chicca
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessia Pascazio
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Davide Paoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angelo Nuti
- Division of Neurology, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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8
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Galgani A, Palermo G, Lombardo F, Martini N, Bastiani L, Vergallo A, Tommasini L, Bellini G, Baldacci F, Frosini D, Tognoni G, Gesi M, Cademartiri F, Fornai F, Pavese N, Ceravolo R, Giorgi FS. Different Patterns of Locus Coeruleus MRI Alteration in Alzheimer's and Dementia with Lewy Bodies. Curr Alzheimer Res 2023; 20:277-288. [PMID: 37488756 DOI: 10.2174/1567205020666230721144603] [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: 01/25/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The integrity of Locus Coeruleus can be evaluated in vivo using specific Magnetic Resonance Imaging sequences. While this nucleus has been shown to be degenerated both in post-mortem and in vivo studies in Alzheimer's Disease, for other neurodegenerative dementias such as Dementia with Lewy Bodies this has only been shown ex-vivo. OBJECTIVE To evaluate the integrity of the Locus Coeruleus through Magnetic Resonance Imaging in patients suffering from Dementia with Lewy Bodies and explore the possible differences with the Locus Coeruleus alterations occurring in Alzheimer's Dementia. METHODS Eleven patients with Dementia with Lewy Bodies and 35 with Alzheimer's Dementia were recruited and underwent Locus Coeruleus Magnetic Resonance Imaging, along with 52 cognitively intact, age-matched controls. Images were analyzed applying an already developed template-based approach; Locus Coeruleus signal was expressed through the Locus Coeruleus Contrast Ratio parameter, and a locoregional analysis was performed. RESULTS Both groups of patients showed significantly lower values of Locus Coeruleus Contrast Ratio when compared to controls. A different pattern of spatial involvement was found; patients affected by Dementia with Lewy bodies showed global and bilateral involvement of the Locus Coeruleus, whereas the alterations in Alzheimer's Dementia patients were more likely to be localized in the rostral part of the left nucleus. CONCLUSIONS Magnetic Resonance Imaging successfully detects widespread Locus Coeruleus degeneration in patients suffering from Dementia with Lewy Bodies. Further studies, in larger cohorts and in earlier stages of the disease, are needed to better disclose the potential diagnostic and prognostic role of this neuroradiological tool.
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Affiliation(s)
- Alessandro Galgani
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Nicola Martini
- Deep Health Unit, Fondazione Monasterio/CNR, Pisa, Italy
| | - Luca Bastiani
- Institute of Clinical Physiology of National Research Council, Pisa, Italy
| | - Andrea Vergallo
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Bellini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniela Frosini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Gesi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | | | - Francesco Fornai
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK
- Institute of Clinical Medicine, PET Centre, Aarhus University, Nordre Ringgade 1, 8000 Aarhus C, Denmark
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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9
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Tommasini L, Bonaccorsi J, Del Prete E, Cintoli S, Pagni C, Mazzucchi S, Palermo G, Morganti R, Frosini D, Siciliano G, Tognoni G, Ceravolo R. Qualitative evaluation of the Rey-Osterrieth Complex Figure Test in patients with progressive supranuclear palsy. Clin Neuropsychol 2022:1-14. [PMID: 35997036 DOI: 10.1080/13854046.2022.2112296] [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: 11/03/2022]
Abstract
Objective: In early stages of disease, the differential diagnosis between Parkinson's Disease (PD) and atypical parkinsonism, such as Progressive Supranuclear Palsy (PSP), could be challenging. Growing attention has recently been dedicated to investigating neuropsychological markers of degenerative parkinsonism. The Rey-Osterrieth Complex Figure Test (ROCFT) copy score was hypothesized able to differentiate PSP from PD. However, ROCFT is a drawing test requiring multiple cognitive abilities and it is still unknown which of them assumes an important role in PSP performance. Using a qualitative scoring system, we investigated which cognitive abilities underpin the PSP performance at the ROCFT copy trial. Moreover, we evaluated usefulness of the BQSS scores in discriminating PSP from PD. Methods: Thirty PSP-Richardson's Syndrome (PSP-RS) patients, 30 PD patients, and 30 healthy control (HC) comparable for age, education, and gender were enrolled. All subjects underwent a neuropsychological evaluation; ROCFT copy were evaluated with the 36-Point Score and with the Boston Qualitative Scoring System (BQSS). Results: PSP-RS patients performed worse in ROCFT 36-Point Score and in several BQSS scores compared to other groups. Most suitable scores discriminating PSP-RS from PD were "Perseveration" and "Vertical Expansion" of BQSS. A logistic regression model considering "Perseveration" and "Vertical Expansion" showed a diagnostic accuracy of 83,3% for PSP-RS condition. Conclusion: our findings showed that "Perseveration" and "Vertical Expansion" BQSS scores were useful in discriminating PSP-RS from PD. "Perseveration" and "Vertical Expansion" BQSS scores might be included in the cognitive evaluation along with quantitative scores when PSP diagnosis is considered.
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Affiliation(s)
- L Tommasini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - J Bonaccorsi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - E Del Prete
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - S Cintoli
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - C Pagni
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - S Mazzucchi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Palermo
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - R Morganti
- Section of Statistics, AOUP, Pisa, Italy
| | - D Frosini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Siciliano
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - G Tognoni
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - R Ceravolo
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
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10
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Galgani A, Vergallo A, Campese N, Lombardo F, Pavese N, Petrozzi L, LoGerfo A, Franzini M, Cecchetti D, Puglisi-Allegra S, Busceti CL, Siciliano G, Tognoni G, Baldacci F, Lista S, Hampel H, Fornai F, Giorgi FS. Biological determinants of blood-based cytokines in the Alzheimer's Disease clinical continuum. J Neurochem 2022; 163:40-52. [PMID: 35950445 DOI: 10.1111/jnc.15686] [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: 01/11/2022] [Revised: 05/31/2022] [Accepted: 08/06/2022] [Indexed: 11/29/2022]
Abstract
Converging translational and clinical research strongly indicates that altered immune and inflammatory homeostasis (neuroinflammation) plays a critical pathophysiological role in Alzheimer's disease (AD), across the clinical continuum. A dualistic role of neuroinflammation may account for a complex biological phenomenon, representing a potential pharmacological target. Emerging blood-based pathophysiological biomarkers, such as cytokines (Cyt) and interleukins (ILs) have been studied as indicators of neuroinflammation in AD. However, inconsistent results have been reported, probably due to lack of standardization of assays with methodological and analytical differences. We used machine-learning and a cross-validation-based statical workflow to explore and analyze the potential impact of key biological factors, such as age, sex, apolipoproteinE (APOE) genotype (the major genetic risk factor for late-onset AD) on Cyt. A set of Cyt was selected based on previous literature, and we investigated any potential association in a pooled cohort of cognitively healthy, mild cognitive impairment (MCI), and AD-like dementia patients. We also performed explorative analyses to extrapolate preliminary clinical insights. We found a robust sex effect on IL12 and an APOE-related difference in IL10, with the latter being also related to the presence of advanced cognitive decline. IL1β was the variable most significantly associated with MCI-to-dementia conversion over a 2.5 year-clinical follow-up. Albeit preliminary, our data support further clinical research to understand whether plasma Cyt may represent reliable and non-invasive tools serving the investigation of neuroimmune and inflammatory dynamics in AD and to foster biomarker-guided pathway-based therapeutic approaches, within the precision medicine development framework.
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Affiliation(s)
- A Galgani
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - A Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - N Campese
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - F Lombardo
- U.O.C. "Risonanza Magnetica Specialistica e Neuroradiologia", Fondazione "G. Monasterio"- National Research Council/Tuscany Region, Pisa, Italy
| | - N Pavese
- Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK.,Institute of clinical Medicine, PET Centre, Aarhus University
| | - L Petrozzi
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - A LoGerfo
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - M Franzini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - D Cecchetti
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | | | - G Siciliano
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - G Tognoni
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - F Baldacci
- Neurology Unit, Pisa University Hospital, Pisa, Italy
| | - S Lista
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France
| | - H Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - F Fornai
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - F S Giorgi
- Neurology Unit, Pisa University Hospital, Pisa, Italy.,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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11
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Stoccoro A, Baldacci F, Ceravolo R, Giampietri L, Tognoni G, Siciliano G, Migliore L, Coppedè F. Increase in Mitochondrial D-Loop Region Methylation Levels in Mild Cognitive Impairment Individuals. Int J Mol Sci 2022; 23:ijms23105393. [PMID: 35628202 PMCID: PMC9142993 DOI: 10.3390/ijms23105393] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 12/25/2022] Open
Abstract
Methylation levels of the mitochondrial displacement loop (D-loop) region have been reported to be altered in the brain and blood of Alzheimer’s disease (AD) patients. Moreover, a dynamic D-loop methylation pattern was observed in the brain of transgenic AD mice along with disease progression. However, investigations on the blood cells of AD patients in the prodromal phases of the disease have not been performed so far. The aim of this study was to analyze D-loop methylation levels by means of the MS-HRM technique in the peripheral blood cells of 14 mild cognitive impairment (MCI) patients, 18 early stage AD patients, 70 advanced stage AD patients, and 105 healthy control subjects. We found higher D-loop methylation levels in MCI patients than in control subjects and AD patients. Moreover, higher D-loop methylation levels were observed in control subjects than in AD patients in advanced stages of the disease, but not in those at early stages. The present pilot study shows that peripheral D-loop methylation levels differ in patients at different stages of AD pathology, suggesting that further studies deserve to be performed in order to validate the usefulness of D-loop methylation analysis as a peripheral biomarker for the early detection of AD.
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Affiliation(s)
- Andrea Stoccoro
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, 56126 Pisa, Italy;
- Correspondence: (A.S.); (F.C.); Tel.: +39-0502-218549 (A.S.); +39-0502-218544 (F.C.)
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (R.C.); (L.G.); (G.T.); (G.S.)
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (R.C.); (L.G.); (G.T.); (G.S.)
| | - Linda Giampietri
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (R.C.); (L.G.); (G.T.); (G.S.)
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (R.C.); (L.G.); (G.T.); (G.S.)
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (R.C.); (L.G.); (G.T.); (G.S.)
| | - Lucia Migliore
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, 56126 Pisa, Italy;
| | - Fabio Coppedè
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, 56126 Pisa, Italy;
- Correspondence: (A.S.); (F.C.); Tel.: +39-0502-218549 (A.S.); +39-0502-218544 (F.C.)
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12
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Palermo G, Belli E, Tommasini L, Morganti R, Frosini D, Nicoletti V, Tognoni G, Siciliano G, Bonuccelli U, Baldacci F, Ceravolo R. Dissecting the Interplay Between Time of Dementia and Cognitive Profiles in Lewy Body Dementias. J Alzheimers Dis 2021; 84:757-766. [PMID: 34602466 DOI: 10.3233/jad-210006] [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: 11/15/2022]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are differentiated by the time of onset of cognitive and motor symptoms ('1-year rule'). We explored the neuropsychological continuum of DLB and PDD subjects with different timing of dementia onset. OBJECTIVE Our aim was to compare the neuropsychological profile of DLB and PDD patients with different timing of dementia onset. METHODS Neuropsychological findings at the diagnosis of dementia of 66 PDD and 42 DLB patients were retrospectively compared. Patients with PDD were divided into three tertile subgroups according to the time interval between the onset of parkinsonism and dementia (N = 24, 2-4 years; N = 17, 5-7 years; N = 25 ≥8 years, respectively). RESULTS DLB patients performed worse on the Stroop and semantic fluency tests than PDD, even in comparison to PD with early dementia onset. No significant differences among PDD subgroups were reported. CONCLUSION Executive and semantic language tests could differentiate DLB and PD patients with earlier development of dementia relative to parkinsonism.
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Affiliation(s)
- Giovanni Palermo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Elisabetta Belli
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | | | - Daniela Frosini
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Valentina Nicoletti
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
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13
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Galgani A, Aghakhanyan G, Lombardo F, Martini N, Baldacci F, Tognoni G, Ceravolo R, Vergallo A, Hampel H, Fornai F, Siciliano G, Pavese N, Volterrani D, Giorgi F. Locus coeruleus magnetic resonance imaging correlates with [18F]Fluoro deoxyglucose uptake in Alzheimer’s disease patients. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117850] [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: 10/20/2022]
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14
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Galgani A, Campese N, Logerfo A, Petrozzi L, Baldacci F, Tognoni G, Ceravolo R, Lombardo F, Pavese N, Fornai F, Paolicchi A, Vergallo A, Hampel H, Siciliano G, Giorgi F. Comparison of plasmatic interleukins patterns among cognitively unimpaired subjects, patients affected by mild cognitive impairment and subjects with Alzheimer's disease dementia. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Cintoli S, Radicchi C, Noale M, Maggi S, Meucci G, Tognoni G, Bonuccelli U, Sale A, Berardi N, Maffei L. Effects of combined training on neuropsychiatric symptoms and quality of life in patients with cognitive decline. Aging Clin Exp Res 2021; 33:1249-1257. [PMID: 31385203 DOI: 10.1007/s40520-019-01280-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI. METHODS Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7 months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer's Disease (QOL-AD) scale. RESULTS After 7 months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL. CONCLUSIONS Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can 'live well' with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline.
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Affiliation(s)
- Simona Cintoli
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - Claudia Radicchi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Marianna Noale
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Stefania Maggi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Giuseppe Meucci
- Department of Clinical Medicine, U.O.C. Neurology, Livorno, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Alessandro Sale
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Nicoletta Berardi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy.
| | - Lamberto Maffei
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
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16
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Cammisuli DM, Pagni C, Palermo G, Frosini D, Bonaccorsi J, Radicchi C, Cintoli S, Tommasini L, Tognoni G, Ceravolo R, Bonuccelli U. Mild Cognitive Impairment in de novo Parkinson's Disease: Selective Attention Deficit as Early Sign of Neurocognitive Decay. Front Psychol 2021; 12:546476. [PMID: 33859587 PMCID: PMC8042228 DOI: 10.3389/fpsyg.2021.546476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/26/2021] [Indexed: 12/31/2022] Open
Abstract
Background: In the present study, we aimed to better investigate attention system profile of Parkinson's disease-Mild Cognitive Impairment (PD-MCI) patients and to determine if specific attentional deficits are associated with 123I-FP-CIT SPECT. Methods: A total of 44 de novo drug-naïve PD patients [(27) with normal cognition (PD-NC) and 17 with MCI (PD-MCI)], 23 MCI patients and 23 individuals with subjective cognitive impairment (SCI) were recruited at the Clinical Neurology Unit of Santa Chiara hospital (Pisa University Medical School, Italy). They were assessed by a wide neuropsychological battery, including Visual Search Test (VST) measuring selective attention. Performances among groups were compared by non-parametric tests (i.e., Kruskal-Wallis and Mann-Whitney, Bonferroni corrected). Further, Spearman's rank correlations were performed to explore the association between neuropsychological variables and 123I-FP-CIT SPECT data in PD subgroup. Results: PD-MCI patients performed worse on VST than patients with PD-NC (p = 0.002), patients with MCI and individuals with SCI (p < 0.001). The performance of PD-MCI patients on VST significantly correlated with caudate nucleus 123I-FP-CIT SPECT uptake (rho = 0.582, p < 0.05), whereas a negative correlation between such test and 123I-FP-CIT SPECT uptake in the left putamen (rho = -0.529, p < 0.05) was found in PD-NC patients. Conclusions: We suggest that selective attention deficit might be a trigger of cognitive decay in de novo PD-MCI patients. The VST should be routinely used to detect attentional deficits in hospital clinical practice, in the light of its closely association with dopamine depletion of basal ganglia in mildly impaired PD patients.
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Affiliation(s)
| | - Cristina Pagni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniela Frosini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Joyce Bonaccorsi
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Claudia Radicchi
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy
| | - Simona Cintoli
- Department of Neurosciences, Psychology, Drugs and Child Health Area, School of Psychology, University of Florence, Florence, Italy
| | - Luca Tommasini
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
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17
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Liguori C, Cremascoli R, Maestri M, Fernandes M, Izzi F, Tognoni G, Scarpina F, Siciliano G, Mercuri NB, Priano L, Bonanni E, Placidi F. Obstructive sleep apnea syndrome and Alzheimer's disease pathology: may continuous positive airway pressure treatment delay cognitive deterioration? Sleep Breath 2021; 25:2135-2139. [PMID: 33619666 DOI: 10.1007/s11325-021-02320-4] [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] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD). METHODS This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included. Both Mini-Mental State Examination (MMSE) and clinical dementia rating scale (CDR) were conducted during the baseline and the follow-up visits. RESULTS Twenty-four patients were included in the study and were distributed according to the diagnosis in MCI (n = 8) or ADD (n = 16). There were no significant differences in the variables analysed at baseline between the CPAP non-adherent and CPAP adherent patients. In the whole group, a significant decrease was found in MMSE scores, and a significant increase was found in CDR scores between baseline and follow-up. No longitudinal changes in ESS scores were statistically significant from baseline to follow-up. A significant difference was found for the mean score change of the CDR since CPAP non-adherent patients showed a higher mean change of CDR compared to CPAP adherent patients. No significant differences were found for the mean change of MMSE. CONCLUSION These findings highlight the clinical potential of treating OSAS with CPAP to delay cognitive deterioration in patients with MCI or ADD.
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Affiliation(s)
- Claudio Liguori
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy. .,Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.
| | - Riccardo Cremascoli
- Department of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Mariana Fernandes
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Federica Scarpina
- Department of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Lorenzo Priano
- Department of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Fabio Placidi
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
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18
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Daniele S, Baldacci F, Piccarducci R, Palermo G, Giampietri L, Manca ML, Pietrobono D, Frosini D, Nicoletti V, Tognoni G, Giorgi FS, Lo Gerfo A, Petrozzi L, Cavallini C, Franzoni F, Ceravolo R, Siciliano G, Trincavelli ML, Martini C, Bonuccelli U. α-Synuclein Heteromers in Red Blood Cells of Alzheimer's Disease and Lewy Body Dementia Patients. J Alzheimers Dis 2021; 80:885-893. [PMID: 33579836 DOI: 10.3233/jad-201038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Red blood cells (RBCs) contain the majority of α-synuclein (α-syn) in blood, representing an interesting model for studying the peripheral pathological alterations proved in neurodegeneration. OBJECTIVE The current study aimed to investigate the diagnostic value of total α-syn, amyloid-β (Aβ1-42), tau, and their heteroaggregates in RBCs of Lewy body dementia (LBD) and Alzheimer's disease (AD) patients compared to healthy controls (HC). METHODS By the use of enzyme-linked immunosorbent assays, RBCs concentrations of total α-syn, Aβ1-42, tau, and their heteroaggregates (α-syn/Aβ1-42 and α-syn/tau) were measured in 27 individuals with LBD (Parkinson's disease dementia, n = 17; dementia with Lewy bodies, n = 10), 51 individuals with AD (AD dementia, n = 37; prodromal AD, n = 14), and HC (n = 60). RESULTS The total α-syn and tau concentrations as well as α-syn/tau heterodimers were significantly lower in the LBD group and the AD group compared with HC, whereas α-syn/Aβ1-42 concentrations were significantly lower in the AD dementia group only. RBC α-syn/tau heterodimers had a higher diagnostic accuracy for differentiating patients with LBD versus HC (AUROC = 0.80). CONCLUSION RBC α-syn heteromers may be useful for differentiating between neurodegenerative dementias (LBD and AD) and HC. In particular, RBC α-syn/tau heterodimers have demonstrated good diagnostic accuracy for differentiating LBD from HC. However, they are not consistently different between LBD and AD. Our findings also suggest that α-syn, Aβ1-42, and tau interact in vivo to promote the aggregation and accumulation of each other.
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Affiliation(s)
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Linda Giampietri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Laura Manca
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Mathematics, University of Pisa, Pisa, Italy
| | | | - Daniela Frosini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valentina Nicoletti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lucia Petrozzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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19
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Guarnieri B, Maestri M, Cucchiara F, Lo Gerfo A, Schirru A, Arnaldi D, Mattioli P, Nobili F, Lombardi G, Cerroni G, Bartoli A, Manni R, Sinforiani E, Terzaghi M, Arena MG, Silvestri R, La Morgia C, Di Perri MC, Franzoni F, Tognoni G, Mancuso M, Sorbi S, Bonuccelli U, Siciliano G, Faraguna U, Bonanni E. Multicenter Study on Sleep and Circadian Alterations as Objective Markers of Mild Cognitive Impairment and Alzheimer’s Disease Reveals Sex Differences. J Alzheimers Dis 2020; 78:1707-1719. [DOI: 10.3233/jad-200632] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Circadian and sleep disturbances are associated with increased risk of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Wearable activity trackers could provide a new approach in diagnosis and prevention. Objective: To evaluate sleep and circadian rhythm parameters, through wearable activity trackers, in MCI and AD patients as compared to controls, focusing on sex dissimilarities. Methods: Based on minute level data from consumer wearable devices, we analyzed actigraphic sleep parameters by applying an electromedical type I registered algorithm, and the corresponding circadian variables in 158 subjects: 86 females and 72 males (42 AD, 28 MCI, and 88 controls). Moreover, we used a confusion-matrix chart method to assess accuracy, precision, sensitivity, and specificity of two decision-tree models based on actigraphic data in predicting disease or health status. Results: Wake after sleep onset (WASO) was higher (p < 0.001) and sleep efficiency (SE) lower (p = 0.003) in MCI, and Sleep Regularity Index (SRI) was lower in AD patients compared to controls (p = 0.004). SE was lower in male AD compared to female AD (p = 0.038) and SRI lower in male AD compared to male controls (p = 0.008), male MCI (p = 0.047), but also female AD subjects (p = 0.046). Mesor was significantly lower in males in the overall population. Age reduced the dissimilarities for WASO and SE but demonstrated sex differences for amplitude (p = 0.009) in the overall population, controls (p = 0.005), and AD subjects (p = 0.034). The confusion-matrices showed good predictive power of actigraphic data. Conclusion: Actigraphic data could help identify disease or health status. Sex (possibly gender) differences could impact on neurodegeneration and disease trajectory with potential clinical applications.
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Affiliation(s)
- Biancamaria Guarnieri
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Michelangelo Maestri
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Cucchiara
- SONNOLab, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Lo Gerfo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Schirru
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | - Pietro Mattioli
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | | | - Gianluigi Cerroni
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Antonella Bartoli
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Raffaele Manni
- Sleep and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Sinforiani
- Neuropsychology/Alzheimer's Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Michele Terzaghi
- Sleep and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Maria Grazia Arena
- Center for Cognitive Disorders and Dementias, Alzheimer's Disease Assessment Unit, UOC of Neurology and Neuromuscular Disorders, AOU Policlinico, ``G. Martino'', University of Messina, Messina, Italy
| | - Rosalia Silvestri
- Sleep Medicine Center, UOSD of Neurophysiopathology and Movement Disorders, AOU Policlinico ``G.~Martino'', Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy
| | - Maria Caterina Di Perri
- Sleep Medicine Center, UOSD of Neurophysiopathology and Movement Disorders, AOU Policlinico ``G.~Martino'', Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Ubaldo Bonuccelli
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- SONNOLab, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Enrica Bonanni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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20
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Prete ED, Daniele S, Giampietri L, Galgani A, Piccarducci R, Gerfo AL, Petrozzi L, Cavallini C, Pietrobono D, Trincavelli ML, Frosini D, Siciliano G, Bonuccelli U, Ceravolo R, Tognoni G, Martini C, Baldacci F. Sex differences in red blood cell α ‐synuclein protein and its heteroaggregates with amyloid‐β and tau in early Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.042079] [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: 11/12/2022]
Affiliation(s)
- Eleonora Del Prete
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | - Linda Giampietri
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Alessandro Galgani
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Lucia Petrozzi
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | | | | | - Daniela Frosini
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | - Filippo Baldacci
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
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21
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Galgani A, Lombardo F, Hana H, Daniele DL, Ghicopulos I, Coi A, Martini N, Marchi D, Keilberg P, Tognoni G, Siciliano G, Ceravolo R, Pavese N, Fornai F, Bonuccelli U, Giorgi FS. Assessment of the integrity of the noradrenergic nucleus locus coeruleus during normal ageing by neuromelanin‐3T MRI. Alzheimers Dement 2020. [DOI: 10.1002/alz.043332] [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: 11/11/2022]
Affiliation(s)
- Alessandro Galgani
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Francesco Lombardo
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Hlavata Hana
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | | | - Irene Ghicopulos
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
| | - Alessio Coi
- National Research Council Institute of Clinical Physiology, Unit of Environmental Epidemiology and Disease Registries Pisa Italy
| | - Nicola Martini
- Deep Health Unit, Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Daniele Marchi
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Petra Keilberg
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Gloria Tognoni
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit ‐ Newcastle University Newcastle upon Tyne United Kingdom
| | - Francesco Fornai
- Department of Translational Research and of New Surgical and Medical Technologies Pisa Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Filippo Sean Giorgi
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
- Department of Translational Research and of New Surgical and Medical Technologies Pisa Italy
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22
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Giorgi FS, Galgani A, Lombardo F, Palermo G, Hana H, Daniele DL, Ghicopulos I, Martini N, Baldacci F, Coi A, Tognoni G, Siciliano G, Ceravolo R, Pavese N, Fornai F, Bonuccelli U. In vivo assessment of the noradrenergic nucleus locus coeruleus in Alzheimer’s disease and other types of dementia. Alzheimers Dement 2020. [DOI: 10.1002/alz.043616] [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: 11/09/2022]
Affiliation(s)
- Filippo Sean Giorgi
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
- Department of Translational Research and of New Surgical and Medical Technologies Pisa Italy
| | - Alessandro Galgani
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Francesco Lombardo
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Hlavata Hana
- Unit “Risonanza Magnetica Specialistica e Neuroradiologia” Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | | | - Irene Ghicopulos
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
| | - Nicola Martini
- Deep Health Unit Fondazione “G. Monasterio” CNR/Regione Toscana Pisa Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Alessio Coi
- National Research Council Institute of Clinical Physiology Unit of Environmental Epidemiology and Disease Registries Pisa Italy
| | - Gloria Tognoni
- Neurology Unit Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit ‐ Newcastle University Newcastle upon Tyne United Kingdom
| | - Francesco Fornai
- Department of Translational Research and of New Surgical and Medical Technologies Pisa Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
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23
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Giampietri L, Daniele S, Piccarducci R, Palermo G, Manca ML, Nicoletti V, Giorgi FS, Frosini D, Petrozzi L, Gerfo AL, Pietrobono D, Cavallini C, Franzoni F, Trincavelli ML, Bonuccelli U, Siciliano G, Tognoni G, Ceravolo R, Baldacci F, Martini C. Red blood cell α‐synuclein heteroaggregates can discriminate healthy controls from cognitively impaired subjects of the AD‐LBD spectrum. Alzheimers Dement 2020. [DOI: 10.1002/alz.040618] [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: 11/11/2022]
Affiliation(s)
- Linda Giampietri
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | | | - Giovanni Palermo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Maria Laura Manca
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
- Department of Mathematics University of Pisa Pisa Italy
| | - Valentina Nicoletti
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Filippo Sean Giorgi
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Daniela Frosini
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Lucia Petrozzi
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | | | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | | | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
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Belli E, Nicoletti V, Radicchi C, Bonaccorsi J, Cintoli S, Ceravolo R, Tognoni G. Confabulations in Cases of Dementia: Atypical Early Sign of Alzheimer’s Disease or Misleading Feature in Dementia Diagnosis? Front Psychol 2020; 11:553886. [PMID: 33117224 PMCID: PMC7550794 DOI: 10.3389/fpsyg.2020.553886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/07/2020] [Indexed: 11/21/2022] Open
Abstract
Confabulations, also known as false memories, have been associated with various diseases involving mainly the frontal areas, such as Wernicke–Korsakoff syndrome or frontal epilepsy. The neuropsychological dysfunctions underlying mechanisms of confabulation are not well known. We describe two patients with memory impairment and confabulations at the onset speculating about neuropsychological correlates of confabulations and self-awareness. Both patients, a 77-year-old woman and a 57-years-old man, exhibited confabulations as first symptom of cognitive decline. She later developed memory impairment without awareness of her memory deficits and her cognitive and imaging profile suggested an amnesic mild cognitive impairment due to Alzheimer’s disease (AD). Unlike her, he developed a prevalent involvement of frontal functions despite a clear consciousness of his cognitive deficits. However, the clinical diagnostic hypothesis of behavioral variant of frontotemporal dementia was not supported by imaging findings, which suggested AD. Both patients underwent neuropsychological evaluation including the Confabulation Battery. Despite that the exact anatomical correlation of confabulations is still not defined, imaging data shown by our patients is consistent with recent theories according to which at the origin of confabulatory tendency in AD there is an impairment of the connections between crucial hubs in frontal and mediotemporal areas, mainly involving the right hemisphere. Besides, it would be reasonable to hypothesize that self-awareness and confabulations should not be considered as necessarily associated dimensions.
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Palermo G, Tommasini L, Aghakhanyan G, Frosini D, Giuntini M, Tognoni G, Bonuccelli U, Volterrani D, Ceravolo R. Clinical Correlates of Cerebral Amyloid Deposition in Parkinson’s Disease Dementia: Evidence from a PET Study. J Alzheimers Dis 2019; 70:597-609. [DOI: 10.3233/jad-190323] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gayanè Aghakhanyan
- Regional Center of Nuclear Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniela Frosini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martina Giuntini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Duccio Volterrani
- Regional Center of Nuclear Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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26
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Vergallo A, Giampietri L, Pagni C, Giorgi FS, Nicoletti V, Miccoli M, Libertini P, Petrozzi L, Bonuccelli U, Tognoni G. Association Between CSF Beta-Amyloid and Apathy in Early-Stage Alzheimer Disease. J Geriatr Psychiatry Neurol 2019; 32:164-169. [PMID: 30913958 DOI: 10.1177/0891988719838627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The apathetic syndrome is a common clinical feature in patients with Alzheimer diseases (AD), from preclinical phases to late stages of dementia, and it is strongly related to major disease outcomes. Unfortunately, no specific pharmacological treatments for apathy have been accomplished so far. Translational evidences have previously shown that a link between apathy and hallmarks of AD-related pathophysiology, that is, β-amyloid (Aβ) plaques and neurofibrillary tangles, exists. However, only few studies investigated the association between core biomarkers of AD and apathy scores, finding conflicting results. METHODS Thirty-seven patients were identified as having AD dementia according to National Institute on Aging-Alzheimer Association 2011 criteria. All participants underwent an extensive diagnostic workup including cerebrospinal fluid (CSF) assessment to measure the concentrations of Aβ42, t-tau, and pTau181. To follow, they were stratified as: apathy absence, apathy mild, and apathy severe according to the Neuro Psychiatric Inventory-apathy item scores. We investigated for potential associations between apathy scores and CSF biomarkers concentrations as well as for differences in terms of clinical and CSF biomarkers data across the 3 apathy groups. RESULTS The CSF Aβ42 concentrations were negatively correlated with apathy scores. In addition, patients with severe apathy had significantly lower Aβ42 levels compared to nonapathetic ones. CONCLUSION Based on our results, we encourage further studies to untangle the potential association between the complex pathophysiological dynamics of AD and apathy which may represent an innovative reliable clinical outcome measure to use in clinical trials, investigating treatments with either a symptomatic or a disease-modifying effect.
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Affiliation(s)
- A Vergallo
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Giampietri
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Pagni
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - F S Giorgi
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - V Nicoletti
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Miccoli
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Libertini
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Petrozzi
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - U Bonuccelli
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Tognoni
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
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27
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Aghakhanyan G, Vergallo A, Gennaro M, Mazzarri S, Guidoccio F, Radicchi C, Ceravolo R, Tognoni G, Bonuccelli U, Volterrani D. The Precuneus – A Witness for Excessive Aβ Gathering in Alzheimer’s Disease Pathology. NEURODEGENER DIS 2019; 18:302-309. [DOI: 10.1159/000492945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
Evidence of cortical beta-amyloid (Aβ) load, assessed by Aβ positron emission tomography (Aβ-PET), is an established in vivo biomarker of Alzheimer’s disease (AD)-related pathophysiology. Qualitative assessment of Aβ-PET provides binary information; meanwhile semiquantitative approaches require a parcellation of PET image either manually or by placement of atlas-based volumes of interest. We supposed that a whole-brain approach with voxel-by-voxel standardized uptake value ratio (SUVr) parametric images may better elucidate the spatial trajectories of Aβ burden along the continuum of AD. Methods: We recruited 32 subjects with a diagnosis of probable AD dementia (ADD, n = 20) and mild cognitive impairment due to AD (MCI-AD, n = 12) according to the NIA-AA 2011 criteria. We also enrolled a control group of 6 cognitively healthy individuals (HCs) with preserved cognitive functions and negative Aβ-PET scan. The PET images were spatially normalized using the AV45 PET template in the MNI brain space. Subsequently, parametric SUVr images were calculated using the whole cerebellum as a reference region. A voxel-wise analysis of covariance was used to compare (between groups) the Αβ distribution pattern considering age as a nuisance covariate. Results: Both ADD and MCI-AD subjects showed a widespread increase in radiotracer uptake when compared with HC participants (p < 0.001, uncorrected). After applying a multiple comparison correction (p < 0.05, corrected), a relative large cluster of increased [18F]-florbetapir uptake was observed in the precuneus in the ADD and MCI-AD groups compared to HCs. Voxel-wise regression analysis showed a significant positive linear association between the voxel-wise SUVr values and the disease duration. Conclusions: The voxel-wise semiquantitative analysis shows that the precuneus is a region with higher vulnerability to Aβ depositions when compared to other cortical regions in both MCI-AD and ADD subjects. We think that the precuneus is a promising PET-based outcome measure for clinical trials of drugs targeting brain Aβ. We found a positive association between the overall Aβ-PET SUVr and the disease duration suggesting that the region-specific slow saturation of Aβ deposition continuously takes place as the disease progresses.
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Carnicelli L, Maestri M, Di Coscio E, Tognoni G, Fabbrini M, Schirru A, Giorgi FS, Siciliano G, Bonuccelli U, Bonanni E. A longitudinal study of polysomnographic variables in patients with mild cognitive impairment converting to Alzheimer's disease. J Sleep Res 2019; 28:e12821. [DOI: 10.1111/jsr.12821] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Luca Carnicelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Michelangelo Maestri
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Elisa Di Coscio
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gloria Tognoni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Monica Fabbrini
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Alessandro Schirru
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Filippo S. Giorgi
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gabriele Siciliano
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Ubaldo Bonuccelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Enrica Bonanni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
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29
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Chiti A, Cecchi P, Pesaresi I, Orlandi G, Giannini N, Gialdini G, Terni E, Tognoni G, Volpi L, Pagni C, Ghicopulos I, Siciliano G, Dotti MT, Federico A, Poggesi A, Salvadori E, Pantoni L, Inzitari D, Cosottini M, Bonuccelli U. Functional magnetic resonance imaging with encoding task in patients with mild cognitive impairment and different severity of leukoaraiosis. Psychiatry Res Neuroimaging 2018; 282:126-131. [PMID: 30539733 DOI: 10.1016/j.pscychresns.2018.06.012] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/15/2018] [Accepted: 06/28/2018] [Indexed: 11/20/2022]
Abstract
Leukoaraiosis is one of the main contributors to mild cognitive impairment due to vascular damage (vascular MCI, VMCI), whose pathophysiology has not been fully elucidated yet. We aimed to shed light on such issue using functional MRI (fMRI). Sixteen patients with VMCI were enrolled and compared with twenty-five patients with MCI but without significant vascular damage (non-vascular MCI, NVMCI) and with fifteen healthy controls (HC). They all underwent fMRI with incidental verbal learning paradigm, using a 3T scanner. Differently from cases with NVMCI (versus HC), VMCI patients presented a higher BOLD activation in the right parieto-occipital cortex and a lower activation in the left superior and middle frontal gyri, anterior cingulum and in left fronto-opercular area when compared to HC. Cortical activation evaluated by fMRI may reflect specific patterns of damage and attempt of compensation in patients with MCI and different severity of leukoaraiosis.
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Affiliation(s)
- Alberto Chiti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy; Unit of Neurology, Ospedale Apuane, Via Mattei 21, Massa 54100, Italy.
| | - Paolo Cecchi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Ilaria Pesaresi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Giovanni Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy; Unit of Neurology, Ospedale Apuane, Via Mattei 21, Massa 54100, Italy
| | - Nicola Giannini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gino Gialdini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Eva Terni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Leda Volpi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristina Pagni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Irene Ghicopulos
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Maria Teresa Dotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, Siena 53100, Italy
| | - Antonio Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, Siena 53100, Italy
| | - Anna Poggesi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Emilia Salvadori
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Leonardo Pantoni
- "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via G.B Grassi, 74, Milan 20157, Italy
| | - Domenico Inzitari
- NEUROFARBA Department, Neuroscience Section, University of Florence, Largo Brambilla 3, Florence 50134, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, Pisa 56126, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56126, Italy
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30
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Unti E, Mazzucchi S, Frosini D, Pagni C, Tognoni G, Palego L, Betti L, Miraglia F, Giannaccini G, Ceravolo R. Social Cognition and Oxytocin in Huntington's Disease: New Insights. Brain Sci 2018; 8:brainsci8090161. [PMID: 30149684 PMCID: PMC6162368 DOI: 10.3390/brainsci8090161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/20/2018] [Accepted: 08/23/2018] [Indexed: 11/16/2022] Open
Abstract
This study is aimed at relating social cognition in Huntington's Disease (HD) to plasma levels of the social hormone oxytocin (OT). Indeed, HD patients commonly display reduced social skills and OT is involved in bonding behavior and improved recognition of facial emotions. Twelve mild-symptomatic HD patients (stage II Shoulson & Fahn) and 11 gender/age matched controls (healthy controls, HC), without concurrent psychiatric disorders, were investigated at baseline (T₀) for OT plasma levels and social cognition through an extensive battery of neuropsychological tests. Social cognition was also re-examined after two years (T1) in 8 of the 12 patients. Results showed a trend for reduced T₀-OT levels in HD vs. HC, mean ± stardard deviation: 6.5 ± 2.4 vs. 9.9 ± 7.2 pg/mL, without reaching statistical significance. At T₀, patients showed significantly lower performances than controls at the "Faux-Pas" and "Strange Stories" tests (p < 0.05; p < 0.01); a reduced perception of visual emotions (p < 0.01) and verbal stimuli (p < 0.01) was also reported, involving anger, fear, and sadness (p < 0.05; p < 0.01). Additionally, in the HD population, OT concentrations positively correlated with T1-performances at Neutral\Faux-Pas test (p < 0.05), whereas the cognitive Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) scores positively correlated with psychosocial perception at the "Strange Stories" and Karolinska Directed Emotional Faces (KDEF) tests (p < 0.05). This study, despite its limitations, supports correlations between OT and HD social cognition, suggesting a possible therapeutic use of this hormone. More subjects and additional body tissues/fluids, such as cerebrospinal fluid, should be investigated to confirm this hypothesis.
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Affiliation(s)
- Elisa Unti
- Neurology Unit, Apuane Hospital, 54100 Massa-Carrara, Italy.
| | - Sonia Mazzucchi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Daniela Frosini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Cristina Pagni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Lionella Palego
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Laura Betti
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy.
| | | | | | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
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31
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Cosmi D, Shen L, Magnoli M, Abrahm WT, Anand IS, Cleland JG, Cohn JN, De Berardis G, Maggioni AP, Masson S, Nicolucci A, Staszewsky L, Tognoni G, Cosmi F, Latini R. 3381Treatment with insulin is associated with worse outcome in patients with chronic heart failure and diabetes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3381] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Cosmi
- Gubbio/Gualdo Tadino Hospital, Cardiology, Gubbio, Italy
| | - L Shen
- University of Glasgow, Glasgow, United Kingdom
| | - M Magnoli
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - W T Abrahm
- Davis Heart & Lung Research Institute, Columbus, United States of America
| | - I S Anand
- University of Minnesota, Minneapolis, United States of America
| | - J G Cleland
- University of Glasgow, Glasgow, United Kingdom
| | - J N Cohn
- University of Minnesota, Minneapolis, United States of America
| | - G De Berardis
- Center for Outcomes Research and clinical Epidemiology srl, Pescara, Italy
| | - A P Maggioni
- ANMCO Foundation For Your Heart, Florence, Italy
| | - S Masson
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - A Nicolucci
- Center for Outcomes Research and clinical Epidemiology srl, Pescara, Italy
| | - L Staszewsky
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - G Tognoni
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - F Cosmi
- Santa Margherita La Fratta Hospital, Cortona, Italy
| | - R Latini
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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32
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Bruno RM, Stea F, Sicari R, Ghiadoni L, Taddei S, Ungar A, Bonuccelli U, Tognoni G, Cintoli S, Del Turco S, Sbrana S, Gargani L, D’Angelo G, Pratali L, Berardi N, Maffei L, Picano E, Andreassi M, Angelucci A, Baldacci F, Baroncelli L, Begenisic T, Bellinvia P, Biagi L, Bonaccorsi J, Bonanni E, Borghini A, Braschi C, Broccardi M, Caleo M, Carlesi C, Carnicelli L, Cartoni G, Cecchetti L, Cenni M, Ceravolo R, Chico L, Cioni G, Costa M, D’Ascanio P, De Nes M, Di Coscio E, Di Galante M, di Lascio N, Faita F, Falorni I, Faraguna U, Fenu A, Fortunato L, Franco R, Gargiulo R, Giorgi F, Iannarella R, Iofrida C, Kusmic C, Limongi F, Maestri M, Maffei M, Maggi S, Mainardi M, Mammana L, Marabotti A, Mariotti V, Melissari E, Mercuri A, Molinaro S, Narducci R, Navarra T, Noale M, Pagni C, Palumbo S, Pasquariello R, Pellegrini S, Pietrini P, Pizzorusso T, Poli A, Retico A, Ricciardi E, Rota G, Sale A, Scabia G, Scali M, Scelfo D, Siciliano G, Tonacci A, Tosetti M, Turchi S, Volpi L. Vascular Function Is Improved After an Environmental Enrichment Program. Hypertension 2018; 71:1218-1225. [DOI: 10.1161/hypertensionaha.117.10066] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/09/2017] [Accepted: 03/15/2018] [Indexed: 11/16/2022]
Abstract
Environmental enrichment may slow cognitive decay possibly acting through an improvement in vascular function. Aim of the study was to assess the effects of a 7-month cognitive, social, and physical training program on cognitive and vascular function in patients with mild cognitive impairment. In a single-center, randomized, parallel-group study, 113 patients (age, 65–89 years) were randomized to multidomain training (n=55) or usual care (n=58). All participants underwent neuropsychological tests and vascular evaluation, including brachial artery flow-mediated dilation, carotid–femoral pulse wave velocity, carotid distensibility, and assessment of circulating hematopoietic CD34+ and endothelial progenitor cells. At study entry, an age-matched control group (n=45) was also studied. Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97±2.14% versus 3.73±2.06%;
P
=0.03) and hyperemic stimulus (shear rate area under the curve, 19.1±15.7 versus 25.7±15.1×10
−3
;
P
=0.009); only the latter remained significant after adjustment for confounders (
P
=0.03). Training improved Alzheimer disease assessment scale cognitive (training, 14.0±4.8 to 13.1±5.5; nontraining, 12.1±3.9 to 13.2±4.8;
P
for interaction visit×training=0.02), flow-mediated dilation (2.82±2.19% to 3.40±1.81%, 3.05±2.08% to 2.24±1.59%;
P
=0.006;
P
=0.023 after adjustment for diameter and shear rate area under the curve), and circulating hematopoietic CD34
+
cells and prevented the decline in carotid distensibility (18.4±5.3 to 20.0±6.6, 23.9±11.0 to 19.5±7.1 Pa
−1
;
P
=0.005). The only clinical predictor of improvement of cognitive function after training was established hypertension. There was no correlation between changes in measures of cognitive and vascular function. In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals. This effect is accompanied by improved systemic endothelial function, mobilization of progenitor CD34
+
cells, and preserved carotid distensibility.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01725178.
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Affiliation(s)
- Rosa Maria Bruno
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., F.S., L.G., S.T., U.B.)
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Francesco Stea
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., F.S., L.G., S.T., U.B.)
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Rosa Sicari
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Lorenzo Ghiadoni
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., F.S., L.G., S.T., U.B.)
| | - Stefano Taddei
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., F.S., L.G., S.T., U.B.)
| | | | - Ubaldo Bonuccelli
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., F.S., L.G., S.T., U.B.)
| | - Gloria Tognoni
- Azienda Ospedaliero Universitaria Careggi, University of Florence, Italy (A.U.); Azienda Ospedaliero Universitaria Pisana, Italy (G.T., S.C.)
| | - Simona Cintoli
- Azienda Ospedaliero Universitaria Careggi, University of Florence, Italy (A.U.); Azienda Ospedaliero Universitaria Pisana, Italy (G.T., S.C.)
| | - Serena Del Turco
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Silverio Sbrana
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Luna Gargani
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Gennaro D’Angelo
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | - Lorenza Pratali
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
| | | | | | - Eugenio Picano
- Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy (R.M.B., F.S., R.S., S.D.T., S.S., L.G., G.D., L.P., E.P.)
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Abstract
Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978–79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without « ad hoc » organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.
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Liberati A, Confalonieri C, Martino G, Talamini R, Tamburini M, Viola P, Tognoni G. Patients’ Assessment of Quality of Care: A Survey of a Group of Breast Cancer Patients in Italy. Tumori 2018; 71:491-7. [PMID: 4060250 DOI: 10.1177/030089168507100513] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients’ assessment of quality of care was investigated in 825 women with breast cancer treated in a group of specialized and non-specialized institutions in Italy. A 10-page mail questionnaire explored patients’ adjustment to the disease, satisfaction with care, and quality of the information on diagnosis and treatment. Most of the 428 (52 %) responders reported good or acceptable adjustment to the disease (as reflected by acceptable performance in some daily living activities), and favorable judgment about care providers, but many women complained of hospital organizational deficiencies. A contradictory picture emerged regarding the quality of information. Completeness and thoroughness appeared seriously deficient when examined objectively using a series of explicit predefined criteria, but patients’ assessments showed in most cases moderate or high satisfaction. The paper presents these results and discusses pros and cons in the use of patients’ opinions for evaluation of quality of care.
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35
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Vergallo A, Giampietri L, Baldacci F, Volpi L, Chico L, Pagni C, Giorgi FS, Ceravolo R, Tognoni G, Siciliano G, Bonuccelli U. Oxidative Stress Assessment in Alzheimer's Disease: A Clinic Setting Study. Am J Alzheimers Dis Other Demen 2018; 33:35-41. [PMID: 28931301 PMCID: PMC10852477 DOI: 10.1177/1533317517728352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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] [Indexed: 12/25/2022]
Abstract
BACKGROUND Oxidative stress (OS) is a physiological age-related brain process, dramatically overexpressed in neurodegenerative disorders like Alzheimer's disease (AD). Nevertheless, the pathophysiological role of OS in AD pathology has not been clarified yet. OS as a biomarker for AD is a controversial issue. A comparison of previous data is difficult due to a remarkable methodological variability. Most of the previous studies have shown higher levels of OS markers and lower antioxidant power in patients with dementia when compared to mild cognitive impairment (MCI) and healthy controls. METHODS We followed a strict protocol in order to limit intrasite variability of OS assessment. In addition, we have taken into account possible confounding factors. RESULTS In agreement with previous reports, we found both lower plasmatic OS and higher plasmatic antioxidant defenses when comparing patients with AD having dementia that is stably treated to patients with MCI-AD. DISCUSSION A speculative hypothesis based on correlative data is provided.
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Affiliation(s)
- Andrea Vergallo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Linda Giampietri
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Baldacci
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leda Volpi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lucia Chico
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Cristina Pagni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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36
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Bruno R, Pratali L, Sicari R, Stea F, Berardi N, Tognoni G, Bonuccelli U, Ghiadoni L, Taddei S, Scelfo D, Biagi L, Tosetti M, Maffei L, Picano E. P3443Hippocampal cerebral blood flow depends on systemic endothelial function in individuals with mild cognitive impairment: the Train the Brain-Mind the vessel study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3443] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - L. Pratali
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - R. Sicari
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - F. Stea
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - N. Berardi
- Institute of Neuroscience of CNR, Pisa, Italy
| | - G. Tognoni
- Azienda Ospedaliero - Universitaria Pisana, Pisa, Italy
| | | | | | | | | | | | | | - L. Maffei
- Institute of Neuroscience of CNR, Pisa, Italy
| | - E. Picano
- Institute of Clinical Physiology of CNR, Pisa, Italy
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Vergallo A, Carlesi C, Pagni C, Giorgi FS, Baldacci F, Petrozzi L, Ceravolo R, Tognoni G, Siciliano G, Bonuccelli U. A single center study: Aβ42/p-Tau181 CSF ratio to discriminate AD from FTD in clinical setting. Neurol Sci 2017; 38:1791-1797. [DOI: 10.1007/s10072-017-3053-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 06/30/2017] [Indexed: 12/20/2022]
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38
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Tonacci A, Bruno RM, Ghiadoni L, Pratali L, Berardi N, Tognoni G, Cintoli S, Volpi L, Bonuccelli U, Sicari R, Taddei S, Maffei L, Picano E. Olfactory evaluation in Mild Cognitive Impairment: correlation with neurocognitive performance and endothelial function. Eur J Neurosci 2017; 45:1279-1288. [PMID: 28370677 DOI: 10.1111/ejn.13565] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 01/05/2023]
Abstract
Mild Cognitive Impairment (MCI) is an intermediate condition between normal aging and dementia, associated with an increased risk of progression into the latter within months or years. Olfactory impairment, a well-known biomarker for neurodegeneration, might be present in the condition early, possibly representing a signal for future pathological onset. Our study aimed at evaluating olfactory function in MCI and healthy controls in relation to neurocognitive performance and endothelial function. A total of 85 individuals with MCI and 41 healthy controls, matched for age and gender, were recruited. Olfactory function was assessed by Sniffin' Sticks Extended Test (Burghart, Medizintechnik, GmbH, Wedel, Germany). A comprehensive neurocognitive assessment was performed. Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery by ultrasound. MCI individuals showed an impaired olfactory function compared to controls. The overall olfactory score is able to predict MCI with a good sensitivity and specificity (70.3 and 77.4% respectively). In MCI, olfactory identification score is correlated with a number of neurocognitive abilities, including overall cognitive status, dementia rating, immediate and delayed memory, visuospatial ability and verbal fluency. FMD was reduced in MCI (2.90 ± 2.15 vs. 3.66 ± 1.96%, P = 0.016) and was positively associated with olfactory identification score (ρs =0.219, P = 0.025). The association remained significant after controlling for age, gender, and smoking. In conclusion, olfactory evaluation is able to discriminate between MCI and healthy individuals. Systemic vascular dysfunction might be involved, at least indirectly, in olfactory dysfunction in MCI.
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Affiliation(s)
- Alessandro Tonacci
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Rosa M Bruno
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenza Pratali
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Nicoletta Berardi
- Neuroscience Institute, National Research Council (IN-CNR), Pisa, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, Florence, Italy
| | - Gloria Tognoni
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simona Cintoli
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leda Volpi
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rosa Sicari
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lamberto Maffei
- Neuroscience Institute, National Research Council (IN-CNR), Pisa, Italy.,Laboratory of Neurobiology, Scuola Normale Superiore, Pisa, Italy
| | - Eugenio Picano
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
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Volpi L, Pagni C, Radicchi C, Cintoli S, Miccoli M, Bonuccelli U, Tognoni G. Detecting cognitive impairment at the early stages: The challenge of first line assessment. J Neurol Sci 2017; 377:12-18. [PMID: 28477679 DOI: 10.1016/j.jns.2017.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 02/16/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Leda Volpi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Cristina Pagni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Claudia Radicchi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Simona Cintoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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40
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Simoncini C, Siciliano G, Tognoni G, Mancuso M. Mitochondrial ANT-1 related adPEO leading to cognitive impairment: is there a link? Acta Myol 2017; 36:25-27. [PMID: 28690391 PMCID: PMC5479106] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ANT1 is one of the nuclear genes responsible of autosomal dominant progressive external ophthalmoplegia (adPEO) with mitochondrial DNA multiple deletions. The course of ANT1- related adPEO is relatively benign, symptoms being generally restricted to skeletal muscle. Here we report the case of an Italian 74 years old woman with ANT1-related adPEO and dementia. Further studies are needed to assess the prevalence of central neurological manifestations in ANT1 mitochondrial disease.
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Affiliation(s)
| | | | | | - Michelangelo Mancuso
- Address for correspondence: Michelangelo Mancuso, Department of Experimental and Clinical Medicine, Neurological Clinic, University of Pisa, via Roma 67, 56126 Pisa, Italy. Tel. +39 050 992440. Fax +39 050 554808. E-mail:
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41
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Accorroni A, Giorgi FS, Donzelli R, Lorenzini L, Prontera C, Saba A, Vergallo A, Tognoni G, Siciliano G, Baldacci F, Bonuccelli U, Clerico A, Zucchi R. Thyroid hormone levels in the cerebrospinal fluid correlate with disease severity in euthyroid patients with Alzheimer's disease. Endocrine 2017; 55:981-984. [PMID: 26902870 DOI: 10.1007/s12020-016-0897-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/08/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Alice Accorroni
- Scuola Superiore di Studi Universitari e di Perfezionamento Sant'Anna, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Riccardo Donzelli
- Department of Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy
| | - Leonardo Lorenzini
- Department of Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy
| | - Concetta Prontera
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Alessandro Saba
- Department of Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy
| | - Andrea Vergallo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Aldo Clerico
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Riccardo Zucchi
- Department of Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy.
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42
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Bruno RM, Pratali L, Sicari R, Stea F, Berardi N, Tognoni G, Bonuccelli U, Ghiadoni L, Taddei S, Scelfo D, Biagi L, Tosetti M, Maffei L, Picano E. 4.6 HIPPOCAMPAL CEREBRAL BLOOD FLOW DEPENDS ON SYSTEMIC ENDOTHELIAL FUNCTION IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT: THE TRAIN THE BRAIN-MIND THE VESSEL STUDY. Artery Res 2017. [DOI: 10.1016/j.artres.2017.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Maestri M, Carnicelli L, Economou NT, Bonakis A, Paparrigopoulos T, Papageorgiou ST, Giorgi FS, Di Coscio E, Tognoni G, Ferri R, Bonuccelli U, Bonanni E. NREM sleep transient events in fronto-temporal dementia: beyond sleep stage architecture. Arch Ital Biol 2016; 153:214-24. [PMID: 26742675 DOI: 10.12871/0003982920152346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Frontotemporal dementia (FTD) is increasingly becoming recognized as a major cause of early onset (<65 years) neurodegenerative dementia. Although sleep disorders significantly impair patients' and caregivers' quality of life in neurodegenerative diseases, polysomnographic data in FTD patients are scarce in literature. Aim of our study was to investigate sleep microstructure in FTD, by means of Cyclic Alternating Pattern (CAP), in a group of ten behavioral variant FTD patients (6 M, 4 F; mean age 61.2±7.3 years; disease duration: 1.4±0.7 years) and to compare them with cognitively intact healthy elderly. Sleep in FTD patients was altered at different levels, involving not only the conventional sleep stage architecture parameters (total sleep time, single stage percentage, NREM/REM cycle organization), but also microstructure. FTD subjects showed CAP disruption with decreased slow wave activity related phases (A1 index, n/h:14.5±6.8 vs 38.8±6.6; p<.001) and increased arousal-related fast CAP components (A2 index 22.9±8.2 vs 11.6±3.7; p=.006; A3 index 41.9±20.7 vs 13.0±6.5; p=.002). Several correlations between sleep variables and neuropsychological tests were found. Sleep impairment in FTD may be specifically related to the specific frontal lobe involvement in the neurodegenerative process. The pattern of alterations seems somewhat peculiar, probably due to the anatomical distribution of the neurodegenerative process with a major impact on frontal lobe generated sleep transients, and a substantial sparing of phenomena related to the posterior cortex.
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Affiliation(s)
- Michelangelo Maestri
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy.
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Unti E, Mazzucchi S, Palermo G, Kiferle L, Pagni C, Tognoni G, Bonuccelli U, Ceravolo R. F5 Social cognition in huntington’s disease: evidence from a prospective study. J Neurol Psychiatry 2016. [DOI: 10.1136/jnnp-2016-314597.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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45
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Baldanzi S, Bevilacqua F, Lorio R, Volpi L, Simoncini C, Petrucci A, Cosottini M, Massimetti G, Tognoni G, Ricci G, Angelini C, Siciliano G. Disease awareness in myotonic dystrophy type 1: an observational cross-sectional study. Orphanet J Rare Dis 2016; 11:34. [PMID: 27044540 PMCID: PMC4820880 DOI: 10.1186/s13023-016-0417-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 03/30/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Myotonic dystrophy type 1 (Steinert's disease or DM1), the most common form of autosomal dominant muscular dystrophy in adults, is a multisystem disorder, affecting skeletal muscle as well as eyes, heart, gastrointestinal tract, endocrine system, and central nervous system, finally responsible of increasing disabilities and secondary social consequences. To date, DM1-related brain involvement represents a challenging field of research. It is well known that DM1 patients frequently present neuropsychological disturbances and psychiatric comorbidities among which reduced awareness of disease burden and its progression, also defined as anosognosia, is common in clinical practice, this leading to secondary misattribution of symptoms, delay in timely diagnostic procedures and low compliance to treatment. METHODS Here we present an observational cross sectional study in which disease-related cognitive dysfunctions and quality of life were assessed by a protocol finally designed to estimate the prevalence of disease awareness in a sample of 65 adult-onset DM1 patients. RESULTS Our analysis showed that in DM1 patients several cognitive functions, including executive and mnesic domains with visuo-spatial involvement, were affected. The assessment of anosognosia revealed that a high percentage (51.6%) of DM1 subjects was disease unaware. The reduced illness awareness occurs across different physical and life domains, and it appears more prominent in Activities and Independence domains investigated by the Individualized Neuromuscular Quality Of Life (INQoL) questionnaire. Moreover, the unawareness resulted significantly related (at p <0.05 and p < 0.01) to the performance failure in cognitive tests, specifically in the domains of visuo-spatial memory, cognitive flexibility and conceptualization. CONCLUSIONS The obtained data confirm, by a systematic analysis, what's the common clinical perceiving of disease unawareness in Steinert's disease, this related to the already known cognitive-behavioural impairment of frontal type in affected patients. We believe that a deep knowledge of this aspect will be useful for medical practice in the management of patients with DM1, also for guidance in occupational and social interventions, definition of outcome measures and in preparation of trial readiness.
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Affiliation(s)
- Sigrid Baldanzi
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | | | - Rita Lorio
- IRCCS San Camillo Venezia, Via Alberoni 70, Venezia, 30126, Italy
| | - Leda Volpi
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Costanza Simoncini
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Antonio Petrucci
- Neurology and Neurophysiopathology Unit, San Camillo Forlanini Hospital, Piazza Carlo Forlanini 1, 00151, Rome, Italy
| | - Mirco Cosottini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Paradisa 2, 56126, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Corrado Angelini
- IRCCS San Camillo Venezia, Via Alberoni 70, Venezia, 30126, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Unit, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
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46
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Tannorella P, Stoccoro A, Tognoni G, Bonuccelli U, Migliore L, Coppedè F. Association study between the DNMT3A -448A>G polymorphism and risk of Alzheimer's disease in Caucasians of Italian origin. Am J Neurodegener Dis 2016; 5:85-93. [PMID: 27073746 PMCID: PMC4788735] [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] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/02/2016] [Indexed: 06/05/2023]
Abstract
Increasing evidence points to an epigenetic contribution in Alzheimer's disease (AD) pathogenesis. In this regard, variants and polymorphisms of DNA methyltransferase genes (DNMTs) are being investigated for their contribution to cognitive decline and dementia, but results are still scarce or controversial. In the present study we genotyped 710 Caucasian subjects of Italian descent, including 320 late-onset AD (LOAD) patients, 70 individuals with amnestic Mild Cognitive Impairment (MCI), and 320 matched healthy controls, for the presence of a functional DNMT3A -448A>G (rs1550117) polymorphism, searching for association with disease risk. In addition, we searched for correlation between the studied polymorphism and circulating levels of folate, homocysteine (hcy) and vitamin B12, all involved in DNA methylation reactions and available from 189 LOAD patients and 186 matched controls. Both allele and genotype frequencies of rs1550117 were closely similar between MCI, LOAD and control subjects, and no association with dementia or pre-dementia conditions was observed. Plasma hcy levels were significantly higher (p = 0.04) and serum folate levels significantly lower (p = 0.01) in LOAD than in controls, but no difference in circulating folate, hcy or vitamin B12 levels was seen between carriers and non-carriers of the minor DNMT3A -448A allele. Collectively, present results confirmed previous associations of increased hcy and decreased folate with LOAD risk, but do not support an association between the DNMT3A -448A>G polymorphism and AD in our population.
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Affiliation(s)
- Pierpaola Tannorella
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of PisaVia Roma 55, 56126 Pisa, Italy
| | - Andrea Stoccoro
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of PisaVia Roma 55, 56126 Pisa, Italy
- Doctoral School in Genetics Oncology and Clinical Medicine, University of SienaSiena, Italy
| | - Gloria Tognoni
- Unit of Neurology, Department of Neuroscience, Pisa University HospitalVia Roma 67, 56126 Pisa, Italy
| | - Ubaldo Bonuccelli
- Unit of Neurology, Department of Neuroscience, Pisa University HospitalVia Roma 67, 56126 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Neurological ClinicVia Roma 67, 56126 Pisa, Italy
| | - Lucia Migliore
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of PisaVia Roma 55, 56126 Pisa, Italy
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of PisaVia del Borghetto 80, 56124 Pisa, Italy
| | - Fabio Coppedè
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of PisaVia Roma 55, 56126 Pisa, Italy
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of PisaVia del Borghetto 80, 56124 Pisa, Italy
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47
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Giorgi FS, Baldacci F, Dini E, Tognoni G, Bonuccelli U. Epilepsy occurrence in patients with Alzheimer’s disease: clinical experience in a tertiary dementia center. Neurol Sci 2015; 37:645-7. [DOI: 10.1007/s10072-015-2442-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
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48
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Maestri M, Carnicelli L, Tognoni G, Di Coscio E, Giorgi FS, Volpi L, Economou NT, Ktonas P, Ferri R, Bonuccelli U, Bonanni E. Non-rapid eye movement sleep instability in mild cognitive impairment: a pilot study. Sleep Med 2015; 16:1139-45. [DOI: 10.1016/j.sleep.2015.04.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/01/2015] [Accepted: 04/27/2015] [Indexed: 01/29/2023]
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49
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Tannorella P, Stoccoro A, Tognoni G, Petrozzi L, Salluzzo MG, Ragalmuto A, Siciliano G, Haslberger A, Bosco P, Bonuccelli U, Migliore L, Coppedè F. Methylation analysis of multiple genes in blood DNA of Alzheimer's disease and healthy individuals. Neurosci Lett 2015; 600:143-7. [PMID: 26079324 DOI: 10.1016/j.neulet.2015.06.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 03/19/2015] [Revised: 05/19/2015] [Accepted: 06/02/2015] [Indexed: 11/16/2022]
Abstract
We collected blood DNA from 120 late-onset Alzheimer's disease (AD) patients and 115 healthy matched controls and analysed the methylation levels of genes involved in amyloid-beta peptide production (PSEN1 and BACE1), in DNA methylation (DNMT1, DNMT3A and DNMT3B), and in one-carbon metabolism (MTHFR), searching for correlation with age and gender, with biomarkers of one-carbon metabolism (plasma homocysteine, and serum folate and vitamin B12 levels), and with disease status (being healthy or having AD). We also evaluated the contribution of the APOE ϵ4 allele, the major late-onset AD genetic risk factor, to the studied gene methylation levels. All the genes showed low mean methylation levels (<5%) in both AD and control DNA, no difference between groups, and no correlation with the studied biomarkers, except for MTHFR that showed methylation levels ranging from 5% to 75%, and correlation with circulating biomarkers of one-carbon metabolism. However, mean MTHFR methylation levels were similar between groups (31.1% in AD and 30.7% in controls, P=0.58). Overall, present data suggest that none of the studied regions is differently methylated in blood DNA between AD and control subjects.
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Affiliation(s)
- Pierpaola Tannorella
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of Pisa, Via Roma 55, Pisa 56126, Italy; Department of Biology, University of Pisa, Via Luca Ghini 13, Pisa 56126, Italy
| | - Andrea Stoccoro
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of Pisa, Via Roma 55, Pisa 56126, Italy
| | - Gloria Tognoni
- Unit of Neurology, Department of Neuroscience, Pisa University Hospital, Via Roma 67, Pisa 56126, Italy
| | - Lucia Petrozzi
- Unit of Neurology, Department of Neuroscience, Pisa University Hospital, Via Roma 67, Pisa 56126, Italy
| | - Maria Grazia Salluzzo
- IRCCS, Oasi Maria SS Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Alda Ragalmuto
- IRCCS, Oasi Maria SS Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Gabriele Siciliano
- Unit of Neurology, Department of Neuroscience, Pisa University Hospital, Via Roma 67, Pisa 56126, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Neurological Clinic, Via Roma 67, Pisa 56126, Italy
| | | | - Paolo Bosco
- IRCCS, Oasi Maria SS Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Ubaldo Bonuccelli
- Unit of Neurology, Department of Neuroscience, Pisa University Hospital, Via Roma 67, Pisa 56126, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Neurological Clinic, Via Roma 67, Pisa 56126, Italy
| | - Lucia Migliore
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of Pisa, Via Roma 55, Pisa 56126, Italy; Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Via del Borghetto 80, Pisa 56124, Italy
| | - Fabio Coppedè
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Medical Genetics, University of Pisa, Via Roma 55, Pisa 56126, Italy; Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Via del Borghetto 80, Pisa 56124, Italy.
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50
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Unti E, Mazzucchi S, Frosini D, Pagni C, Tognoni G, Palego L, Giannaccini G, Bonuccelli U, Ceravolo R. B41 Social Cognition And Oxytocin In Huntington's Disease: Evidences From A Preliminary Study. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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