86 results on '"Houdayer E"'
Search Results
2. Involvement of cortico-subcortical circuits in normoacousic chronic tinnitus: A source localization EEG study
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Houdayer, E., Teggi, R., Velikova, S., Gonzalez-Rosa, J.J., Bussi, M., Comi, G., and Leocani, L.
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- 2015
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- View/download PDF
3. Rehabilitative of COVID-19 patients with acute lower extremity Ischemia and amputation
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Brugliera, L, primary, Spina, A, additional, Castellazzi, P, additional, Cimino, P, additional, Arcuri, P, additional, Deriu, M, additional, Zanetta, C, additional, Angelone, S, additional, Capitanio, J, additional, Alemanno, F, additional, Meloni, C, additional, DAngelo, G, additional, Houdayer, E, additional, Abutalebi, J, additional, Mortini, P, additional, and Iannaccone, S, additional
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- 2020
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4. COVID-19 rehabilitation units are twice as expensive as regular rehabilitation units
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Iannaccone, S, primary, Alemanno, F, additional, Houdayer, E, additional, Brugliera, L, additional, Castellazzi, P, additional, Cianflone, D, additional, Meloni, C, additional, Ambrosio, A, additional, Mortini, P, additional, Spina, A, additional, and Filippi, M, additional
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- 2020
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5. Corticospinal reserve predicts walking impairment but not fatigability in multiple sclerosis
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Nuara, A., Houdayer, E., Chieffo, R., Esposito, F., Martinelli Boneschi, F. , Comola, M. , Comi, LEOCANI , ANNUNZIATA MARIA LETIZIA, Nuara, A., Houdayer, E., Chieffo, R., Esposito, F., Martinelli, Boneschi, F., Comola, M., Comi, and Leocani, ANNUNZIATA MARIA LETIZIA
- Published
- 2015
6. Deep repetitive transcranial magnetic stimulation with H-coil in Alzheimer's disease: a double-blind, placebo-controlled pilot study
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Coppi, E., Ferrari, L., Nuara, A., Chieffo, R., Houdayer, E., Bianco, M., Bernasconi, M.P., Falautano, M., Zangen, A., Comi, G., Magnani, G., LEOCANI , ANNUNZIATA MARIA LETIZIA, Coppi, E., Ferrari, L., Nuara, A., Chieffo, R., Houdayer, E., Bianco, M., Bernasconi, M. P., Falautano, M., Zangen, A., Comi, G., Magnani, G., and Leocani, ANNUNZIATA MARIA LETIZIA
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- 2015
7. Deep repetitive transcranial magnetic stimulation-rTMS with H-coil coupled with cycling in chronic lower limb dysfuncion after stroke: a randomized, placebo-controlled, crossover study
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Chieffo, R., Giatsidis, F., Houdayer, E., Fichera, M., Nuara, A., Coppi, E., Ferrari, L., Di Maggio, G. , Santangelo, R. , Poggi, A. , Sessa, M. , Comola, M. , Zangen, A. , Comi, LEOCANI , ANNUNZIATA MARIA LETIZIA, Chieffo, R., Giatsidis, F., Houdayer, E., Fichera, M., Nuara, A., Coppi, E., Ferrari, L., Di, Maggio, G., Santangelo, R., Poggi, A., Sessa, M., Comola, M., Zangen, A., Comi, and Leocani, ANNUNZIATA MARIA LETIZIA
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- 2015
8. Corticospinal reserve measured with the H-coil predicts walking
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Nuara, A., Houdayer, E., Chieffo, R., Esposito, F., Boneschi, F.M., Comola, M., Comi, G., LEOCANI , ANNUNZIATA MARIA LETIZIA, Nuara, A., Houdayer, E., Chieffo, R., Esposito, F., Boneschi, F. M., Comola, M., Comi, G., and Leocani, ANNUNZIATA MARIA LETIZIA
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- 2015
9. Comparison of motor cortex excitability in progressive supranuclear palsy, Parkinson's disease and healthy controls: a transcranial magnetic stimulation study
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Fichera, M., Houdayer, E., Avantaggiato, F., Chieffo, R., Comi, G., Volonte, M.A., LEOCANI , ANNUNZIATA MARIA LETIZIA, Fichera, M., Houdayer, E., Avantaggiato, F., Chieffo, R., Comi, G., Volonte, M. A., and Leocani, ANNUNZIATA MARIA LETIZIA
- Published
- 2015
10. 101. Functional changes of cortical motor circuits after piano training in adults: TMS and EEG evidence
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Houdayer, E., primary, Cursi, M., additional, Nuara, A., additional, Zanini, S., additional, Gatti, R., additional, Comi, G., additional, and Leocani, L., additional
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- 2016
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11. 61. Patients with progressive supranuclear palsy show abnormal response to conditioned and unconditioned TMS stimuli compared to patients with Parkinson’s disease and healthy subjects
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Fichera, M., primary, Houdayer, E., additional, Avantaggiato, F., additional, Chieffo, R., additional, Comi, G., additional, Volonté, M.A., additional, and Leocani, L., additional
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- 2016
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12. 71. Repetitive Transcranial Magnetic Stimulation (rTMS) applied with H-coil in Alzheimer’s disease: A placebo-controlled, double-blind, pilot study
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Coppi, E., primary, Ferrari, L., additional, Nuara, A., additional, Chieffo, R., additional, Houdayer, E., additional, Ambrosi, A., additional, Bernasconi, M.P., additional, Falautano, M., additional, Zangen, A., additional, Comi, G., additional, Magnani, G., additional, and Leocani, L., additional
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- 2016
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13. ID 295 – Deep repetitive transcranial magnetic stimulation with the H-coil in Alzheimer’s disease: A placebo-controlled, double-blind study
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Coppi, E., primary, Ferrari, L., additional, Nuara, A., additional, Chieffo, R., additional, Houdayer, E., additional, Bernasconi, M.P., additional, Falautano, M., additional, Ambrosi, A., additional, Zangen, A., additional, Comi, G., additional, Magnani, G., additional, and Leocani, L., additional
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- 2016
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14. ID 261 – Motor cortex plasticity after short-term piano training in adults
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Houdayer, E., primary, Cursi, M., additional, Nuara, A., additional, Zanini, S., additional, Gatti, R., additional, Comi, G., additional, and Leocani, L., additional
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- 2016
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15. ID 278 – Motor cortical disinhibition is more pronounced in Progressive Supranuclear Palsy than in Parkinson’s disease: Evidence from TMS
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Fichera, M., primary, Houdayer, E., additional, Avantaggiato, F., additional, Chieffo, R., additional, Comi, G., additional, Volonté, M.A., additional, and Leocani, L., additional
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- 2016
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16. 5. Involvement of different cortico-subcortical circuits in chronic tinnitus: An Sloreta-based EEG study
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Houdayer, E., primary, Teggi, R., additional, Velikova, S., additional, Gonzalez-Rosa, J.J., additional, Bianco, M., additional, Trimarchi, M., additional, Bussi, M., additional, Comi, G., additional, and Leocani, L., additional
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- 2015
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17. 31. Retinal nerve fiber layer thinning as a mirror of neurodegeneration in Alzheimer’s disease
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Ferrari, L., primary, Vitali, F., additional, Di Maggio, G., additional, Santangelo, R., additional, Houdayer, E., additional, Coppi, E., additional, Magnani, G., additional, Comi, G., additional, and Leocani, L., additional
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- 2015
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18. 106. Deep repetitive transcranial magnetic stimulation (rTMS) with H-coil coupled with cycling in chronic lower limb dysfuncion after stroke: A randomized, placebo-controlled, crossover study
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Chieffo, R., primary, Giatsidis, F., additional, Houdayer, E., additional, Fichera, M., additional, Nuara, A., additional, Coppi, E., additional, Ferrari, L., additional, Di Maggio, G., additional, Santangelo, R., additional, Poggi, A., additional, Sessa, M., additional, Comola, M., additional, Zangen, A., additional, Comi, G., additional, and Leocani, L., additional
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- 2015
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19. 85. Deep repetitive transcranial magnetic stimulation with H-coil for motor symptoms in Parkinson’s disease: A randomized, double blind, placebo-controlled study
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Fichera, M., primary, Spagnolo, F., additional, Chieffo, R., additional, Houdayer, E., additional, Coppi, E., additional, Nuara, A., additional, Di Maggio, G., additional, Ferrari, L., additional, Libera, D. Dalla, additional, Velikova, S., additional, Bianco, M., additional, Straffi, L., additional, Zangen, A., additional, Comi, G., additional, Volontè, M.A., additional, and Leocani, L., additional
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- 2015
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20. 114. Physiological aging is associated with reorganization of map motor cortical representation and interhemispheric interactions: A TMS mapping study
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Coppi, E., primary, Houdayer, E., additional, Chieffo, R., additional, Spagnolo, F., additional, Straffi, L., additional, Comi, G., additional, and Leocani, L., additional
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- 2015
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21. 108. Corticospinal reserve predicts walking improvement after intensive rehabilitation and deep rTMS with H-coil in progressive multiple sclerosis
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Nuara, A., primary, Saraceno, L., additional, Houdayer, E., additional, Chieffo, R., additional, Di Maggio, G., additional, Coppi, E., additional, Fichera, M., additional, Martinelli-Boneschi, F., additional, Esposito, F., additional, Zangen, A., additional, Comola, M., additional, Comi, G., additional, and Leocani, L., additional
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- 2015
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22. Nutritional management of COVID-19 patients in a rehabilitation unit
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Elise Houdayer, Alessandra Negro, Paola Castellazzi, Pietro Arcuri, Pietro Mortini, Federica Alemanno, Alfio Spina, Paolo Cimino, Sandro Iannaccone, Luigia Brugliera, Alessandra Giordani, Brugliera, L., Spina, A., Castellazzi, P., Cimino, P., Arcuri, P., Negro, A., Houdayer, E., Alemanno, F., Giordani, A., Mortini, P., and Iannaccone, S.
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,MEDLINE ,Medicine (miscellaneous) ,Betacoronavirus ,Pandemic ,Medicine ,Humans ,Pandemics ,Nutrition ,Nutrition and Dietetics ,biology ,business.industry ,SARS-CoV-2 ,Malnutrition ,COVID-19 ,Rehabilitation unit ,medicine.disease ,biology.organism_classification ,Pneumonia ,Treatment Outcome ,Risk factors ,Emergency medicine ,Dietary Supplements ,Perspective ,Nutrition Therapy ,business ,Coronavirus Infections - Published
- 2020
23. Uncertain Effectiveness of Prophylactic Anticonvulsive Medication in Predicting Cognitive Outcome of Neurosurgical Patients
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Sandro Iannaccone, Luigia Brugliera, Elise Houdayer, Pietro Mortini, Federica Alemanno, Alfio Spina, Alberto Raggi, Lucia Riccio, Pasquale Anthony Della Rosa, Iannaccone, S., Spina, A., Alemanno, F., Della Rosa, P. A., Houdayer, E., Raggi, A., Riccio, L., Brugliera, L., and Mortini, P.
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Male ,medicine.medical_specialty ,Levetiracetam ,medicine.medical_treatment ,Antiepileptic drugs ,Neurosurgery ,Cognitive outcome ,Neurosurgical Procedures ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,medicine ,Humans ,Side effects ,Neurorehabilitation ,Aged ,Retrospective Studies ,Aged, 80 and over ,Intracerebral hemorrhage ,Rehabilitation ,business.industry ,Uncertainty ,Middle Aged ,Prognosis ,medicine.disease ,Functional Independence Measure ,Treatment Outcome ,Italy ,030220 oncology & carcinogenesis ,Emergency medicine ,Cohort ,Anticonvulsants ,Female ,Pre-Exposure Prophylaxis ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Objectives To evaluate the influence of prophylactic anticonvulsive medication, above all levetiracetam monotherapy, in predicting the cognitive outcome of neurosurgical patients with post-traumatic brain injury, intracerebral hemorrhage, and encephalic tumors. Methods We examined data concerning 232 of 327 adult patients admitted to the Neurorehabilitation Department of the San Raffaele Hospital (Milan, Italy) after discharge from the Neurosurgery Department. Cognitive status was evaluated by means of the “Mini-Mental State” examination and the Functional Independence Measure at baseline and at the end of a rehabilitation care with an average duration of about four weeks. Results The vast majority of the patients were treated with levetiracetam. Our data showed a negative role of antiepileptic drugs on cognitive recovery in a cohort of neurosurgical patients. Conclusions Knowing thoroughly the effects of antiepileptic drugs in rehabilitation outcome is of fundamental importance. This study represents the only large series analyzing these aspects in the rehabilitation of neurosurgical patients. Antiepileptic drugs should be managed to ensure patients the best possible cognitive outcome. Further evidence from good-quality trials is required to assess the clinical effectiveness of prophylactic anticonvulsive medication in predicting the cognitive outcome of neurosurgical patients who are treated with rehabilitation.
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- 2019
24. COVID-19 COGNITIVE DEFICITS AFTER RESPIRATORY ASSISTANCE IN THE SUBACUTE PHASE: A COVID-REHABILITATION UNIT EXPERIENCE
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Luigi Beretta, Alfio Spina, Alessandra Scatolini, Elise Houdayer, Federica Alemanno, Andrea Tettamanti, Sara M. Angelone, Sandro Iannaccone, Anna Parma, Luigia Brugliera, Alessandra Del Forno, Alemanno, F., Houdayer, E., Parma, A., Spina, A., Del Forno, A., Scatolini, A., Angelone, S., Brugliera, L., Tettamanti, A., Beretta, Luigi, and Iannaccone, S.
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Male ,Viral Diseases ,Pulmonology ,Social Sciences ,Disease ,Neuropsychological Tests ,Medical Conditions ,0302 clinical medicine ,Medicine and Health Sciences ,Psychology ,030212 general & internal medicine ,Depression (differential diagnoses) ,Cognitive Impairment ,Multidisciplinary ,Cognitive Neurology ,Depression ,Neuropsychology ,Montreal Cognitive Assessment ,Cognition ,Middle Aged ,Mental Status and Dementia Tests ,Executive functions ,Functional Independence Measure ,Chemistry ,Infectious Diseases ,Neurology ,Physical Sciences ,Medicine ,Female ,Psychosocial ,Research Article ,Chemical Elements ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Cognitive Neuroscience ,Science ,Cognitive neuroscience ,Respiratory Disorders ,03 medical and health sciences ,Mental Health and Psychiatry ,medicine ,Humans ,Neuropsychological Testing ,Aged ,Mood Disorders ,SARS-CoV-2 ,business.industry ,Biology and Life Sciences ,COVID-19 ,Hamilton Rating Scale for Depression ,Covid 19 ,Rehabilitation unit ,Respiration, Artificial ,Oxygen ,Respiratory Infections ,Physical therapy ,Cognitive Science ,Cognition Disorders ,business ,030217 neurology & neurosurgery ,Neuroscience ,Follow-Up Studies - Abstract
Introduction COVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy). Material and methods 87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge. Results Out of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p = 0.016), naming (p = 0.024), short- and long-term memory (p = 0.010, p = 0.005), abstraction (p = 0.024), and orientation (p = 0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients’ age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM ( Conclusion Patients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for correct neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term psychological support and treatment of post-COVID-19 patients.
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- 2020
25. COVID-19 rehabilitation units are twice as expensive as regular rehabilitation units
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Domenico Cianflone, Carlo Meloni, Sandro Iannaccone, Alberto Ambrosio, Luigia Brugliera, Massimo Filippi, Elise Houdayer, Pietro Mortini, Paola Castellazzi, Federica Alemanno, Alfio Spina, Iannaccone, S., Alemanno, F., Houdayer, E., Brugliera, L., Castellazzi, P., Cianflone, D., Meloni, C., Ambrosio, A., Mortini, P., Spina, A., and Filippi, M.
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030506 rehabilitation ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Pneumonia, Viral ,Physical Therapy, Sports Therapy and Rehabilitation ,RM1-950 ,World health ,Unit (housing) ,rehabilitation ,Betacoronavirus ,03 medical and health sciences ,Multidisciplinary approach ,Intensive care ,Acute care ,Pandemic ,medicine ,Humans ,Pandemics ,Health Services Needs and Demand ,Rehabilitation ,SARS-CoV-2 ,business.industry ,clinical organization ,pandemic ,COVID-19 ,General Medicine ,medicine.disease ,Italy ,covid-19 ,Medical emergency ,Therapeutics. Pharmacology ,Coronavirus Infections ,0305 other medical science ,business ,Hospital Units - Abstract
Objective: The COVID-19 pandemic has caused significant motor, cognitive, psychological, neurological and cardiological disabilities in many infected patients. Functional rehabilitation of infectious COVID-19 patients has been implemented in the acute care wards and in appropriate, ad hoc, multidisciplinary COVID-19 rehabilitation units. However, because COVID-19 rehabilitation units are a clinical novelty, clinical and organizational benchmarks are not yet available. The aim of this study is to describe the organizational needs and operational costs of such a unit, by comparing its activity, organization, and costs with 2 other functional rehabilitation units, in San Raffaele Hospital, Milan, Italy. Methods: The 2-month activity of the COVID-19 Rehabilitation Unit at San Raffaele Hospital, Milan, Italy, which was created in response to the emergency need for rehabilitation of COVID-19 patients, was compared with the previous year’s activity of the Cardiac Rehabilitation and Motor Rehabilitation Units of the same institute. Results: The COVID-19 Rehabilitation Unit had the same number of care beds as the other units, but required twice the amount of staff and instrumental equipment, leading to a deficit in costs. Discussion: The COVID-19 Rehabilitation Unit was twice as expensive as the 2 other units studied. World health systems are organizing to respond to the pandemic by expanding capacity in acute intensive care and sub-intensive care units. This study shows that COVID-19 rehabilitation units must be organized and equiped according to the clinical and rehabilitative needs of patients, following specific measures to prevent the spread of infection amongs patients and workers.
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- 2020
26. Rehabilitation of covid-19 patients with acute lower extremity ischaemia and amputation
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Giuseppe D'Angelo, Sandro Iannaccone, Luigia Brugliera, Pietro Mortini, Jubin Abutalebi, Sara M. Angelone, Alfio Spina, Jody Filippo Capitanio, Pietro Arcuri, Federica Alemanno, Maria Grazia Deriu, Chiara Zanetta, Elise Houdayer, Carlo Meloni, Paola Castellazzi, Paolo Cimino, Brugliera, L., Spina, A., Castellazzi, P., Cimino, P., Arcuri, P., Deriu, M. G., Zanetta, C., Angelone, S. M., Capitanio, J. F., Alemanno, F., Meloni, C., D'Angelo, G., Houdayer, E., Abutalebi, J., Mortini, P., and Iannaccone, S.
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Pneumonia, Viral ,Ischemia ,Physical Therapy, Sports Therapy and Rehabilitation ,Disease ,Ischaemia ,Amputation, Surgical ,rehabilitation ,Betacoronavirus ,Quality of life ,amputation ,COVID-19 coagulopathy ,medicine ,Coagulopathy ,Humans ,Amputation ,Pandemics ,Aged ,Rehabilitation ,business.industry ,SARS-CoV-2 ,Medical record ,lcsh:RM1-950 ,Neuropsychology ,covid-19 coagulopathy ,COVID-19 ,General Medicine ,Blood Coagulation Disorders ,Middle Aged ,medicine.disease ,sars-cov-2 ,lcsh:Therapeutics. Pharmacology ,covid-19 ,Italy ,Lower Extremity ,Physical therapy ,Quality of Life ,ischaemia ,business ,Coronavirus Infections - Abstract
Objective: To evaluate the clinical characteristics and rehabilitation management of patients who undergo amputation for COVID-19-associated coagulopathy. Methods: Clinical and laboratory data for 3 patients were analysed and their rehabilitative management discussed. Results: The medical records of 3 patients who had undergone amputation due to acute lower extremity ischaemia and who were provided with rehabilitation in the COVID-19 unit at San Raffaele Scientific Insitute, Milan Italy were reviewed. Conclusion: Coagulation changes related to SARSCoV- 2 may complicate recovery from this devastating disease. The rehabilitation management of amputated patients for COVID-19 acute lower extremity ischaemia is based on a multilevel approach for clinical, functional, nutritional and neuropsychological needs. Based on this limited experience, a dedicated programme for this specific group of patients seems advantageous to warrant the best functional outcome and quality of life.
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- 2020
27. Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan
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Sandro Iannaccone, Francesco de Blasio, Luigia Brugliera, Paolo Scarpellini, Marco Ripa, Paolo Cimino, Elise Houdayer, Federica Alemanno, Andrea Tettamanti, Carlo Meloni, Paola Castellazzi, Iannaccone, S., Castellazzi, P., Tettamanti, A., Houdayer, E., Brugliera, L., de Blasio, F., Cimino, P., Ripa, M., Meloni, C., Alemanno, F., and Scarpellini, P.
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Adult ,Male ,030506 rehabilitation ,medicine.medical_specialty ,Telemedicine ,medicine.medical_treatment ,Pneumonia, Viral ,Physical Therapy, Sports Therapy and Rehabilitation ,law.invention ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,law ,Neuropsychology ,Intensive care ,Acute care ,medicine ,Humans ,Pandemics ,Pulmonologists ,Aged ,Rehabilitation ,business.industry ,Physical therapy modalities ,SARS-CoV-2 ,COVID-19 ,Emergency department ,Middle Aged ,Physiatrists ,Physical and Rehabilitation Medicine ,Intensive care unit ,Hospitals ,Coronavirus ,Italy ,Emergency medicine ,Critical Pathways ,Female ,0305 other medical science ,business ,Coronavirus Infections ,030217 neurology & neurosurgery ,Subacute Care - Abstract
The rapid evolution of the health emergency linked to the spread of severe acute respiratory syndrome coronavirus 2 requires specifications for the rehabilitative management of patients with coronavirus disease 2019 (COVID-19). The symptomatic evolution of patients with COVID-19 is characterized by 2 phases: an acute phase in which respiratory symptoms prevail and a postacute phase in which patients can show symptoms related to prolonged immobilization, to previous and current respiratory dysfunctions, and to cognitive and emotional disorders. Thus, there is the need for specialized rehabilitative care for these patients. This communication reports the experience of the San Raffaele Hospital of Milan and recommends the setup of specialized clinical pathways for the rehabilitation of patients with COVID-19. In this hospital, between February 1 and March 2, 2020, about 50 patients were admitted every day with COVID-19 symptoms. In those days, about 400 acute care beds were created (intensive care/infectious diseases). In the following 30 days, from March 2 to mid-April, despite the presence of 60 daily arrivals to the emergency department, the organization of patient flow between different wards was modified, and several different units were created based on a more accurate integration of patients' needs. According to this new organization, patients were admitted first to acute care COVID-19 units and then to COVID-19 rehabilitation units, post-COVID-19 rehabilitation units, and/or quarantine/observation units. After hospital discharge, telemedicine was used to follow-up with patients at home. Such clinical pathways should each involve dedicated multidisciplinary teams composed of pulmonologists, physiatrists, neurologists, cardiologists, physiotherapists, neuropsychologists, occupational therapists, speech therapists, and nutritionists.
- Published
- 2020
28. Involvement of cortico-subcortical circuits in normoacousic chronic tinnitus: A source localization EEG study
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Mario Bussi, Letizia Leocani, G. Comi, S. Velikova, Roberto Teggi, Elise Houdayer, Javier J. Gonzalez-Rosa, Houdayer, E, Teggi, R, Velikova, S, Gonzalez Rosa, Jj, Bussi, Mario, Comi, Giancarlo, and Leocani, ANNUNZIATA MARIA LETIZIA
- Subjects
Adult ,Male ,medicine.medical_specialty ,Auditory Pathways ,Medicina ,Alpha (ethology) ,Electroencephalography ,Audiology ,Tinnitus ,Thalamus ,Inferior temporal gyrus ,Event-related potential ,Physiology (medical) ,Neuroplasticity ,Reaction Time ,otorhinolaryngologic diseases ,medicine ,Humans ,Auditory Cortex ,Informática ,Resting state fMRI ,medicine.diagnostic_test ,Middle Aged ,Sensory Systems ,Acoustic Stimulation ,Neurology ,Evoked Potentials, Auditory ,Female ,Electrónica ,Memory consolidation ,Neurology (clinical) ,medicine.symptom ,Psychology ,Neuroscience - Abstract
Objective To better characterize brain circuits dysfunctions in normoacousic tinnitus sufferers. Methods 17 normoacousic chronic, unilateral high-pitched tinnitus sufferers (6 females, 43.6 ± 9.8 y.o, disease duration 22 ± 35 months) underwent a 29-channel resting-state electroencephalography (EEG – 5 min opened-eyes, 5 min closed-eyes) and auditory oddball paradigm for event-related potentials analyses (ERPs – N1, P2 and P300). Cortical 3D distribution of current source density was computed with sLORETA. Results were compared with 17 controls (9 females, 45.7 ± 15.1 y.o). Results Eyes opened, tinnitus sufferers had lower alpha and beta sources in the left inferior parietal lobule. Eyes closed, tinnitus sufferers had decreased alpha sources in the left inferior temporal and post-central gyri, and low gamma sources in the left middle temporal gyrus. EEG data did not correlate with tinnitus sufferers’ clinical features. Subjects with tinnitus had shorter N1 and P2 latencies. P300 did not differ between groups. sLORETA solutions showed decreased sources of these ERPs in the left inferior temporal gyrus in the tinnitus group. Conclusions We showed cortico-thalamo-cortical involvements in normoacousic tinnitus with hyperexcitability of the left auditory cortex and inferior temporal gyrus. Significance This might reflect processes of maladaptive cortical plasticity and memory consolidation. Further validation is needed to establish the value of this tool in customizing therapeutic approach.
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- 2015
29. Rehabilitation of COVID-19 patients
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Pietro Arcuri, Federica Alemanno, Andrea Tettamanti, Sandro Iannaccone, Luigia Brugliera, Pietro Mortini, Paolo Cimino, Elise Houdayer, Alfio Spina, Paola Castellazzi, Brugliera, L., Spina, A., Castellazzi, P., Cimino, P., Tettamanti, A., Houdayer, E., Arcuri, P., Alemanno, F., Mortini, P., and Iannaccone, S.
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Rehabilitation ,Coronavirus disease 2019 (COVID-19) ,business.industry ,medicine.medical_treatment ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Physical Therapy, Sports Therapy and Rehabilitation ,RM1-950 ,General Medicine ,Emergency medicine ,medicine ,Therapeutics. Pharmacology ,Covid-19 ,business - Published
- 2020
30. Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players
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E. Coppi, Giancarlo Comi, Alberto Inuggi, Letizia Leocani, Laura Straffi, Francesca Spagnolo, Elise Houdayer, Javier J. Gonzalez-Rosa, Arturo Nuara, Raffaella Chieffo, Chieffo, R, Straffi, L, Inuggi, A, Gonzalez Rosa, Jj, Spagnolo, F, Coppi, E, Nuara, A, Houdayer, E, Comi, Giancarlo, and Leocani, ANNUNZIATA MARIA LETIZIA
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Male ,0301 basic medicine ,Physiology ,medicine.medical_treatment ,lcsh:Medicine ,Hands ,Electromyography ,Nervous System ,Brain mapping ,0302 clinical medicine ,Medicine and Health Sciences ,Right Hemisphere ,Child ,lcsh:Science ,Musculoskeletal System ,Brain Mapping ,Neuronal Plasticity ,Multidisciplinary ,medicine.diagnostic_test ,Age Factors ,Motor Cortex ,Brain ,Transcranial Magnetic Stimulation ,Electrophysiology ,Arms ,Bioassays and Physiological Analysis ,medicine.anatomical_structure ,Brain Electrophysiology ,Child, Preschool ,Female ,Anatomy ,Psychology ,Algorithms ,Muscle Electrophysiology ,Research Article ,Motor cortex ,Adult ,Movement ,Neurophysiology ,Research and Analysis Methods ,Lateralization of brain function ,Young Adult ,03 medical and health sciences ,Neuroplasticity ,Motor system ,medicine ,Humans ,Left Hemisphere ,Transcranial Stimulation ,Analysis of Variance ,Limbs (Anatomy) ,Electrophysiological Techniques ,lcsh:R ,Biology and Life Sciences ,Models, Theoretical ,Evoked Potentials, Motor ,Hand ,Motor System ,Transcranial magnetic stimulation ,030104 developmental biology ,Silent period ,lcsh:Q ,Cerebral Hemispheres ,Neuroscience ,Psychomotor Performance ,030217 neurology & neurosurgery - Abstract
Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere.
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- 2016
31. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence
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Giancarlo Comi, Elise Houdayer, Arturo Nuara, Marco Cursi, Letizia Leocani, Roberto Cazzolla Gatti, Sonia Zanini, Houdayer, E, Cursi, M, Nuara, A, Zanini, S, Gatti, R, Comi, Giancarlo, and Leocani, ANNUNZIATA MARIA LETIZIA
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Male ,0301 basic medicine ,genetic structures ,Physiology ,medicine.medical_treatment ,Social Sciences ,lcsh:Medicine ,Hands ,Electromyography ,Audiology ,Electroencephalography ,Functional Laterality ,Learning and Memory ,0302 clinical medicine ,Medicine and Health Sciences ,Psychology ,Right Hemisphere ,lcsh:Science ,Musculoskeletal System ,Clinical Neurophysiology ,Brain Mapping ,Neuronal Plasticity ,Multidisciplinary ,medicine.diagnostic_test ,Physics ,Motor Cortex ,Brain ,Transcranial Magnetic Stimulation ,Electrophysiology ,Arms ,Bioassays and Physiological Analysis ,medicine.anatomical_structure ,Brain Electrophysiology ,Physical Sciences ,Female ,Anatomy ,Motor learning ,Muscle Electrophysiology ,Research Article ,Adult ,medicine.medical_specialty ,Imaging Techniques ,Neurophysiology ,Neuroimaging ,Research and Analysis Methods ,Premotor cortex ,03 medical and health sciences ,Rhythm ,Diagnostic Medicine ,Neuroplasticity ,medicine ,Humans ,Learning ,Music Cognition ,business.industry ,Electrophysiological Techniques ,Limbs (Anatomy) ,lcsh:R ,Cognitive Psychology ,Biology and Life Sciences ,Neural Inhibition ,Acoustics ,Evoked Potentials, Motor ,Electric Stimulation ,Transcranial magnetic stimulation ,030104 developmental biology ,Cognitive Science ,Silent period ,lcsh:Q ,Nerve Net ,business ,Bioacoustics ,Cerebral Hemispheres ,Music ,030217 neurology & neurosurgery ,Neuroscience - Abstract
The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits.
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- 2016
32. The Neurophysiologist Perspective into MS Plasticity
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Elise eHoudayer, Giancarlo eComi, Letizia eLeocani, Houdayer, E, Comi, Giancarlo, and Leocani, ANNUNZIATA MARIA LETIZIA
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non-invasive brain stimulation ,Mini Review ,medicine.medical_treatment ,Electroencephalography ,multiple sclerosis ,lcsh:RC346-429 ,transcranial magnetic stimulation ,Neuroplasticity ,medicine ,Spasticity ,lcsh:Neurology. Diseases of the nervous system ,medicine.diagnostic_test ,Transcranial direct-current stimulation ,Multiple sclerosis ,Neurophysiology ,medicine.disease ,Transcranial magnetic stimulation ,Neurology ,plasticity ,Brain stimulation ,Neurology (clinical) ,medicine.symptom ,Psychology ,Neuroscience ,electroencephalography - Abstract
Multiple sclerosis (MS) is a frequent, highly debilitating inflammatory demyelinating disease, starting to manifest in early adulthood and presenting a wide variety of symptoms which are often resistant to pharmacological treatments. Cortical dysfunctions have been demonstrated to be key components of MS condition, and plasticity of the corticospinal motor system is highly involved in major MS symptoms, such as fatigue, spasticity or pain. Cortical dysfunction in MS can be studied with neurophysiological tools such as electroencephalography (EEG) and related techniques (evoked potentials – EPs) or transcranial magnetic stimulation (TMS). These techniques are now widely used to provide essential elements of MS diagnosis and can also be used to modulate plasticity. Indeed the recent development of non-invasive brain stimulation (NIBS) techniques able to induce cortical plasticity, such as repetitive TMS or transcranial direct current stimulation (tDCS), has brought promising results as add-on treatments.In this review we will focus on the use of these tools (EEG, TMS) to study plasticity in MS and on the major techniques used to modulate plasticity in MS.
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- 2015
33. Sativex® and clinical–neurophysiological measures of spasticity in progressive multiple sclerosis
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Ubaldo Del Carro, Laura Straffi, Maria Pia Sormani, Irene Schiavetti, Carlos Vila, Vittorio Martinelli, Giancarlo Comi, Stefano Amadio, Arturo Nuara, Elise Houdayer, Paolo Rossi, Letizia Leocani, Leocani, ANNUNZIATA MARIA LETIZIA, Nuara, A, Houdayer, E, Schiavetti, I, Del Carro, U, Amadio, S, Straffi, L, Rossi, P, Martinelli, V, Vila, C, Sormani, Mp, and Comi, Giancarlo
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Adult ,Male ,medicine.medical_specialty ,Modified Ashworth scale ,H-reflex ,Multiple sclerosis ,Sativex ,Spasticity ,Transcranial magnetic stimulation ,Neurology (clinical) ,Neurology ,Placebo ,Severity of Illness Index ,McNemar's test ,Physical medicine and rehabilitation ,Double-Blind Method ,Outcome Assessment, Health Care ,medicine ,Cannabidiol ,Humans ,Stretch reflex ,Dronabinol ,Cerebral Cortex ,Cross-Over Studies ,Electromyography ,Plant Extracts ,Middle Aged ,Multiple Sclerosis, Chronic Progressive ,medicine.disease ,Evoked Potentials, Motor ,Crossover study ,Electric Stimulation ,Drug Combinations ,medicine.anatomical_structure ,Muscle Spasticity ,Female ,medicine.symptom ,Psychology ,medicine.drug - Abstract
Despite the proven efficacy of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol) oromucosal spray in reducing spasticity symptoms in multiple sclerosis (MS), little is known about the neurophysiological correlates of such effects. The aim of the study was to investigate the effects of Sativex on neurophysiological measures of spasticity (H/M ratio) and corticospinal excitability in patients with progressive MS. This was a randomized, double-blind, placebo-controlled, crossover study. Consecutive subjects with progressive MS and lower limb spasticity referred to our center were randomized to 4 weeks' treatment (including 2 weeks' titration) with Sativex or placebo, with crossover after a 2-week washout. Clinical and neurophysiological measures (H/M ratio and cortical excitability) of spasticity were assessed. The H/M ratio was the primary outcome, with sample size calculation of 40 patients. Of 44 recruited patients, 34 were analyzed due to 6 drop-outs and 4 exclusions, which lowered the power of the study to show differences between treatments. Neurophysiological measures did not differ significantly according to treatment and did not correlate significantly with clinical response. Response on the modified Ashworth scale (at least 20 % improvement) was significantly more frequent after Sativex than placebo (50 vs 23.5 %; p = 0.041; McNemar). Side effects did not differ significantly according to treatment. Our findings confirm the clinical benefit of Sativex on MS spasticity. The lack of corresponding changes in corticospinal excitability and on the monosynaptic component, of the stretch reflex, although in a limited sample size, points to the involvement of other spinal and supraspinal mechanisms in the physiopathology of spasticity in progressive MS.
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- 2015
34. Sensory-motor training with virtual reality as a complementary intervention to manual therapy for persistent non-specific neck pain: a randomized controlled trial.
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Emedoli D, Alemanno F, Iannaccone S, Houdayer E, Castellazzi P, Zangrillo F, Gasperotti F, Locatelli M, and Tettamanti A
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- Humans, Male, Female, Single-Blind Method, Adult, Middle Aged, Virtual Reality, Range of Motion, Articular, Virtual Reality Exposure Therapy methods, Disability Evaluation, Treatment Outcome, Neck Pain rehabilitation, Musculoskeletal Manipulations methods, Pain Measurement
- Abstract
Background: Persistent non-specific neck pain (NP) is a widespread condition described as a complex biopsychosocial disorder, characterized by physical and psychological symptoms. Virtual reality (VR) shows promise in NP treatment, potentially reducing pain, kinesiophobia, and improving range of motion (ROM) and motor control., Aim: The primary aim of the study was to assess the effectiveness of VR sensorimotor training, combined with manual therapy, in reducing the level of disability in persistent non-specific NP individuals. The secondary aim was to determine if this VR-enhanced approach also contributes to improvement in overall function, pain perception and kinesiophobia., Design: Monocentric, single-blind, randomized controlled trial., Setting: We conducted this trial at San Raffaele Scientific Institute, Department of Rehabilitation and Functional Recovery, Milan, Italy., Population: Forty NP participants were enrolled in the study and randomly allocated into two groups., Methods: The study involved a 6-week rehabilitation program, comprising 12 sessions of 45 minutes each, twice weekly. Both intervention groups underwent manual therapy as a consistent component of their treatment. The Experimental Group (VRT) was additionally engaged in sensorimotor rehabilitation exercises using Virtual Reality, whereas the Control Group (CT) performed the same exercises without VR. We assessed subjects at baseline (T0) and after six weeks of rehabilitation (T1). The primary outcome was the disability (Neck Disability Index) while the secondary outcomes were: pain perception (Numeric Rating Scale, NP and Disability Scale, Central Sensitization Inventory) function (Cervical Kinematics) and kinesiophobia (Tampa Scale of Kinesiophobia)., Results: Both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia. Significant advancements in kinematics were observed: VRT group showed enhanced ROM during craniocervical rotation (P=0.039), lateral bending (P=0.001), flexion-extension (P=0.009), and mean velocity across movements (P<0.001), whereas CT group improved in maximal ROM during lateral bending rotation (P=0.001). Between-group analysis, after Bonferroni's correction for multiple comparisons, revealed that VRT group had significantly better outcomes in ROM during rotation (P=0.040), ratio of the primary over the secondary movement while performing rotation (P=0.021), and mean velocity during lateral bending (P=0.031)., Conclusions: Sensorimotor training, combined with manual therapy, could enhance kinematic outcomes for NP patients, supporting the potential of VR in rehabilitation., Clinical Rehabilitation Impact: This study highlighted that both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia after sensorimotor training combined with manual therapy. It is important to underscore that in terms of reducing the level of neck disability, both interventions proved to be equally effective. This parity in efficacy is a critical finding, reaffirming the robustness of our therapeutic approaches for this specific outcome.
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- 2024
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35. Increased interhemispheric functional connectivity after right anodal tDCS in chronic non-fluent aphasia: preliminary findings.
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Alemanno F, Fedeli D, Monti A, Houdayer E, Della Rosa PA, Zangrillo F, Emedoli D, Pelagallo E, Corbo M, Iannaccone S, and Abutalebi J
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Introduction: Anodal transcranial Direct Current Stimulation (tDCS) is a non-invasive, low-cost and environment-friendly brain neuromodulation technique that increases cortical excitability. In post-stroke aphasia, the role of the right hemisphere in language recovery remains debated. In this preliminary study, we aimed to investigate the efficacy of excitatory tDCS on the right hemisphere in chronic aphasic patients., Methods: We applied anodal tDCS to the right homologous region of Broca's area in four chronic aphasic patients while performing a one-month naming rehabilitation treatment. Longitudinal data on language assessment and naming performance were collected. Resting-state fMRI images were acquired before and after treatment to measure changes in functional connectivity., Results: Results showed enhanced positive functional connectivity of the right Broca homologous with the left middle frontal and middle temporal gyri. Every patient showed improvements in language functions, but no major changes in naming performance., Conclusion: These preliminary findings suggest that tDCS applied over the unaffected hemisphere may result in longitudinal inter-hemispheric functional neuroplastic changes that could specifically improve language recovery and could potentially be included in therapeutic neurorehabilitative plans., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Alemanno, Fedeli, Monti, Houdayer, Della Rosa, Zangrillo, Emedoli, Pelagallo, Corbo, Iannaccone and Abutalebi.)
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- 2024
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36. On the brain struggles to recognize basic facial emotions with face masks: an fMRI study.
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Abutalebi J, Gallo F, Fedeli D, Houdayer E, Zangrillo F, Emedoli D, Spina A, Bellini C, Del Maschio N, Iannaccone S, and Alemanno F
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Introduction: The COVID-19 pandemic impacted public health and our lifestyles, leading to new social adaptations such as quarantine, social distancing, and facial masks. Face masks, covering extended facial zones, hamper our ability to extract relevant socio-emotional information from others' faces. In this fMRI study, we investigated how face masks interfere with facial emotion recognition, focusing on brain responses and connectivity patterns as a function of the presence of a face mask., Methods: A total of 25 healthy participants (13F; mean age: 32.64 ± 7.24y; mean education: 18.28 ± 1.31y) were included. Participants underwent task-related fMRI during the presentation of images of faces expressing basic emotions (joy or fear versus neutral expression). Half of the faces were covered by a face mask. Subjects had to recognize the facial emotion (masked or unmasked). FMRI whole-brain and regions-of-interest analyses were performed, as well as psychophysiological interaction analysis (PPI)., Results: Subjects recognized better and faster emotions on unmasked faces. FMRI analyses showed that masked faces induced a stronger activation of a right occipito-temporal cluster, including the fusiform gyrus and the occipital face area bilaterally. The same activation pattern was found for the neutral masked > neutral unmasked contrast. PPI analyses of the masked > unmasked contrast showed, in the right occipital face area, a stronger correlation with the left superior frontal gyrus, left precentral gyrus, left superior parietal lobe, and the right supramarginal gyrus., Discussion: Our study showed how our brain differentially struggles to recognize face-masked basic emotions, implementing more neural resources to correctly categorize those incomplete facial expressions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Abutalebi, Gallo, Fedeli, Houdayer, Zangrillo, Emedoli, Spina, Bellini, Del Maschio, Iannaccone and Alemanno.)
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- 2024
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37. Continuity of care for patients with dementia during COVID-19 pandemic: flexibility and integration between in-person and remote visits.
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Emedoli D, Houdayer E, Della Rosa PA, Zito A, Brugliera L, Cimino P, Padul JD, Tettamanti A, Iannaccone S, and Alemanno F
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- Humans, Pandemics, Outpatients, Continuity of Patient Care, COVID-19 epidemiology, Dementia therapy
- Abstract
Introduction: During the pandemic, the Cognitive Disorders Unit of San Raffaele Hospital (Milan, Italy) offered patients the opportunity to undergo neuropsychological evaluations and cognitive training through telemedicine., Method: We conducted an investigation to assess how patients responded to this option and to determine if telemedicine could ensure continuity of care., Results: Between October 2019 and May 2022, a total of 5,768 telemedicine appointments and 8,190 in-person outpatient appointments were conducted, resulting in an increase in the rate of telemedicine activity from 16.81% in January 2020 to 23.21% in May 2022. Peaks in telemedicine activity reached 85.64% in May 2020 and 83.65% in February 2021, both representing a significant portion of the total activity. Interestingly, there was a notable positive correlation between telemedicine activity and the worsening of the Italian pandemic ( r = 0.433, p = 0.027)., Discussion: During the peaks of contagion, the total number of visits remained stable, highlighting that telemedicine effectively served as a valuable and efficient tool to ensure continuity of care for vulnerable patients. This was evident from the integration of remote visits with in-person appointments., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Emedoli, Houdayer, Della Rosa, Zito, Brugliera, Cimino, Padul, Tettamanti, Iannaccone and Alemanno.)
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- 2024
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38. Quantitative EEG for early differential diagnosis of dementia with Lewy bodies.
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Iannaccone S, Houdayer E, Spina A, Nocera G, and Alemanno F
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Introduction: Differentiating between the two most common forms of dementia, Alzheimer's dementia and dementia with Lewy bodies (DLB) remains difficult and requires the use of invasive, expensive, and resource-intensive techniques. We aimed to investigate the sensitivity and specificity of electroencephalography quantified using the statistical pattern recognition method (qEEG-SPR) for identifying dementia and DLB., Methods: Thirty-two outpatients and 16 controls underwent clinical assessment (by two blinded neurologists), EEG recording, and a 6-month follow-up clinical assessment. EEG data were processed using a qEEG-SPR protocol to derive a Dementia Index (positive or negative) and DLB index (positive or negative) for each participant which was compared against the diagnosis given at clinical assessment. Confusion matrices were used to calculate sensitivity, specificity, and predictive values for identifying dementia and DLB specifically., Results: Clinical assessment identified 30 cases of dementia, 2 of which were diagnosed clinically with possible DLB, 14 with probable DLB and DLB was excluded in 14 patients. qEEG-SPR confirmed the dementia diagnosis in 26 out of the 32 patients and led to 6.3% of false positives (FP) and 9.4% of false negatives (FN). qEEG-SPR was used to provide a DLB diagnosis among patients who received a positive or inconclusive result of Dementia index and led to 13.6% of FP and 13.6% of FN. Confusion matrices indicated a sensitivity of 80%, a specificity of 89%, a positive predictive value of 92%, a negative predictive value of 72%, and an accuracy of 83% to diagnose dementia. The DLB index showed a sensitivity of 60%, a specificity of 90%, a positive predictive value of 75%, a negative predictive value of 81%, and an accuracy of 75%. Neuropsychological scores did not differ significantly between DLB and non- DLB patients. Head trauma or story of stroke were identified as possible causes of FP results for DLB diagnosis., Conclusion: qEEG-SPR is a sensitive and specific tool for diagnosing dementia and differentiating DLB from other forms of dementia in the initial state. This non-invasive, low-cost, and environmentally friendly method is a promising diagnostic tool for dementia diagnosis which could be implemented in local care settings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Iannaccone, Houdayer, Spina, Nocera and Alemanno.)
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- 2023
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39. SARCOPENIA IS A FREQUENT DISEASE IN SARS-COV-2 INFECTION.
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Iannaccone S, Brugliera L, Spina A, Nocera G, Tettamanti A, Giordani A, Angelone S, Castellazzi P, Cimino P, Padul JD, Houdayer E, and Alemanno F
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Objective: We aimed to investigate the clinical symptoms and specific care requirements of SARS-CoV-2 patients who were admitted to a COVID-19 Rehabilitation Unit while still infectious for SARS-CoV-2 and in the subacute phase of the disease., Methods: Patients admitted to our COVID-19 Rehabilitation Unit from March 2020 to December 2020 were evaluated for sarcopenia, and they also completed the following assessments: functional independence measure, short physical performance battery and Hamilton Rating Scale for Depression. Age and body mass index and symptoms of dysosmia or dysgeusia were also recorded., Results: A total of 126 patients were enrolled (50 women, median age 72 years, 18.7 years), of whom 82% of patients presented with low grip strength. Sarcopenia was diagnosed in 52 patients. Sarcopenic patients were older than non-sarcopenic ones (median age 73.4 years, IQR 13.2 vs 63.9 years, IQR 14.5, respectively, p = 0.014). Sarcopenia was associated with the presence of depression ( p = 0.008), was more common in women ( p = 0.023) and was associated with greater functional deficits (functional independence measure and short physical performance battery analyses, p < 0.05). Sarcopenic patients also had a lower body mass index than other patients ( p < 0.01)., Conclusion: More than 40% of our patients suffered from sarcopenia, which was associated with ageing, depression, low body mass index, reduction in functional autonomy and being a woman. Such data provide evidence for the need to assist hospitalized COVID-19 patients by means of a multidisciplinary specialist team., Competing Interests: The authors have no conflicts of interest to declare., (© Published by Medical Journals Sweden, on behalf of the Foundation for Rehabilitation Information.)
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- 2023
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40. Mobile application tool for remote rehabilitation after discharge from coronavirus disease-19 rehabilitation unit.
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Emedoli D, Alemanno F, Houdayer E, Brugliera L, Iannaccone S, and Tettamanti A
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A smartphone application (Medico-Amico) has been developed by the collaboration of San Raffaele Scientific Institute and Khymeia Group S.R.L. with the aim of providing physical exercises and communicating with patients after their hospitalization in a coronavirus disease (COVID)-rehabilitation unit. Thirty patients used the application for remote rehabilitation for 4 weeks. They were prescribed personalized motor exercises to perform three times a week. Clinicians could interact with each patient by an encrypted video call in order to give encouragement, mental support, modify intensity during training sessions, or to prescribe new exercises. Patients were asked to perform motor exercises and also to monitor their vital signs, such as temperature, blood pressure, and oxygen saturation, inserting scores in a specific section of the application. After 4 weeks of remote rehabilitation patients showed improvements in independence during activity of daily living and strength. Also, satisfaction and mobile application usability scores reached patients' appreciation and enjoyment., Competing Interests: D. Emedoli received compensation for consulting services, speaking activities and clinical development from Khymeia Group S.R.L. The other authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© 2022 The Authors. Healthcare Technology Letters published by John Wiley & Sons Ltd on behalf of The Institution of Engineering and Technology.)
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- 2022
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41. Cognitive and Emotional Disturbances Due to COVID-19: An Exploratory Study in the Rehabilitation Setting.
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Pistarini C, Fiabane E, Houdayer E, Vassallo C, Manera MR, and Alemanno F
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The coronavirus disease 19 (COVID-19) can cause neurological, psychiatric, psychological, and psychosocial impairments. Literature regarding cognitive impact of COVID-19 is still limited. The aim of this study was to evaluate cognitive deficits and emotional distress among COVID-19 and post-COVID-19 patients who required functional rehabilitation. Specifically, this study explored and compared cognitive and psychological status of patients in the subacute phase of the disease (COVID-19 group) and patients in the postillness period (post-COVID-19 group). Forty patients admitted to rehabilitation units were enrolled in the study and divided into two groups according to the phase of the disease: (a) COVID-19 group ( n = 20) and (b) post-COVID-19 group ( n = 20). All patients underwent a neuropsychological assessment including Mini-Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Impact of Event Scale-Revised (IES-R). A larger part of the COVID group showed neuropsychological deficits in the total MMSE (35%) compared to the post-COVID group (5%), whereas the majority of both groups (75-70%) reported cognitive impairments in the total MoCA. The post-COVID group reported significantly higher score in MMSE subtests of language ( p = 0.02) and in MoCA subtests of executive functions ( p = 0.05), language ( p = 0.01), and abstraction ( p = 0.02) compared to the COVID group. Regarding emotional disturbances, ~40% of patients presented with mild to moderate depression (57.9-60%). The post-COVID-19 group reported significantly higher levels of distress at the IES-R compared to the COVID group ( p = 0.02). These findings highlight the gravity of neuropsychological and psychological symptoms that can be induced by COVID-19 infection and the need for tailored rehabilitation, including cognitive training and psychological support., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pistarini, Fiabane, Houdayer, Vassallo, Manera and Alemanno.)
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- 2021
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42. COVID-19 cognitive deficits after respiratory assistance in the subacute phase: A COVID-rehabilitation unit experience.
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Alemanno F, Houdayer E, Parma A, Spina A, Del Forno A, Scatolini A, Angelone S, Brugliera L, Tettamanti A, Beretta L, and Iannaccone S
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- Aged, COVID-19 psychology, COVID-19 virology, Cognition Disorders psychology, Female, Follow-Up Studies, Humans, Male, Mental Status and Dementia Tests, Middle Aged, Neuropsychological Tests, SARS-CoV-2 physiology, COVID-19 complications, COVID-19 rehabilitation, Cognition Disorders virology, Respiration, Artificial
- Abstract
Introduction: COVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy)., Material and Methods: 87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge., Results: Out of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p = 0.016), naming (p = 0.024), short- and long-term memory (p = 0.010, p = 0.005), abstraction (p = 0.024), and orientation (p = 0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients' age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder., Conclusion: Patients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for correct neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term psychological support and treatment of post-COVID-19 patients., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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43. Cerebral preparation of spontaneous movements: An EEG study.
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Houdayer E, Lee SJ, and Hallett M
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- Adult, Attention physiology, Electroencephalography, Electromyography, Evoked Potentials, Motor physiology, Female, Humans, Male, Volition physiology, Brain physiology, Contingent Negative Variation physiology, Functional Laterality physiology, Movement physiology
- Abstract
Objective: The current study sought to determine whether there is a Bereitschaftspotential (BP) before uninstructed, spontaneous movements., Methods: 14 participants were seated on a comfortable armchair for one hour without any instruction except not to fall asleep and to keep their eyes open. Electroencephalography (EEG) and electromyography (EMG) activity were recorded during the whole session. EEG activity was analyzed before spontaneous movements and compared with EEG activity before repetitive, instructed movements in a separate session., Results: BPs were identified in most participants with the spontaneous movements. The BPs with spontaneous movements were mostly localized in the medial frontocentral regions. The BPs with the instructed movements were localized primarily in the central regions and had larger amplitude., Conclusion: Presence of a BP before movement does not depend on instruction and may be independent of conscious volition. The amplitude of the BP may depend on the amount of attention., Significance: This study shows that the presence of a BP before movement is not an "artifact" of the experimental instructions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier B.V.)
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- 2020
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44. Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan.
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Iannaccone S, Castellazzi P, Tettamanti A, Houdayer E, Brugliera L, de Blasio F, Cimino P, Ripa M, Meloni C, Alemanno F, and Scarpellini P
- Subjects
- Adult, Aged, COVID-19, Coronavirus Infections virology, Female, Hospitals, Humans, Italy, Male, Middle Aged, Pandemics, Pneumonia, Viral virology, SARS-CoV-2, Telemedicine methods, Betacoronavirus, Coronavirus Infections rehabilitation, Critical Pathways, Physical and Rehabilitation Medicine methods, Pneumonia, Viral rehabilitation, Subacute Care methods
- Abstract
The rapid evolution of the health emergency linked to the spread of severe acute respiratory syndrome coronavirus 2 requires specifications for the rehabilitative management of patients with coronavirus disease 2019 (COVID-19). The symptomatic evolution of patients with COVID-19 is characterized by 2 phases: an acute phase in which respiratory symptoms prevail and a postacute phase in which patients can show symptoms related to prolonged immobilization, to previous and current respiratory dysfunctions, and to cognitive and emotional disorders. Thus, there is the need for specialized rehabilitative care for these patients. This communication reports the experience of the San Raffaele Hospital of Milan and recommends the setup of specialized clinical pathways for the rehabilitation of patients with COVID-19. In this hospital, between February 1 and March 2, 2020, about 50 patients were admitted every day with COVID-19 symptoms. In those days, about 400 acute care beds were created (intensive care/infectious diseases). In the following 30 days, from March 2 to mid-April, despite the presence of 60 daily arrivals to the emergency department, the organization of patient flow between different wards was modified, and several different units were created based on a more accurate integration of patients' needs. According to this new organization, patients were admitted first to acute care COVID-19 units and then to COVID-19 rehabilitation units, post-COVID-19 rehabilitation units, and/or quarantine/observation units. After hospital discharge, telemedicine was used to follow-up with patients at home. Such clinical pathways should each involve dedicated multidisciplinary teams composed of pulmonologists, physiatrists, neurologists, cardiologists, physiotherapists, neuropsychologists, occupational therapists, speech therapists, and nutritionists., (Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2020
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45. Nutritional management of COVID-19 patients in a rehabilitation unit.
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Brugliera L, Spina A, Castellazzi P, Cimino P, Arcuri P, Negro A, Houdayer E, Alemanno F, Giordani A, Mortini P, and Iannaccone S
- Subjects
- COVID-19, Coronavirus Infections complications, Coronavirus Infections virology, Humans, Malnutrition virology, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral virology, SARS-CoV-2, Treatment Outcome, Betacoronavirus, Coronavirus Infections rehabilitation, Dietary Supplements, Malnutrition prevention & control, Nutrition Therapy methods, Pneumonia, Viral rehabilitation
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- 2020
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46. Uncertain Effectiveness of Prophylactic Anticonvulsive Medication in Predicting Cognitive Outcome of Neurosurgical Patients.
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Iannaccone S, Spina A, Alemanno F, Della Rosa PA, Houdayer E, Raggi A, Riccio L, Brugliera L, and Mortini P
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- Aged, Aged, 80 and over, Cognition physiology, Female, Humans, Italy epidemiology, Male, Middle Aged, Neurosurgical Procedures adverse effects, Pre-Exposure Prophylaxis methods, Prognosis, Retrospective Studies, Treatment Outcome, Anticonvulsants administration & dosage, Cognition drug effects, Levetiracetam administration & dosage, Neurosurgical Procedures trends, Pre-Exposure Prophylaxis trends, Uncertainty
- Abstract
Objectives: To evaluate the influence of prophylactic anticonvulsive medication, above all levetiracetam monotherapy, in predicting the cognitive outcome of neurosurgical patients with post-traumatic brain injury, intracerebral hemorrhage, and encephalic tumors., Methods: We examined data concerning 232 of 327 adult patients admitted to the Neurorehabilitation Department of the San Raffaele Hospital (Milan, Italy) after discharge from the Neurosurgery Department. Cognitive status was evaluated by means of the "Mini-Mental State" examination and the Functional Independence Measure at baseline and at the end of a rehabilitation care with an average duration of about four weeks., Results: The vast majority of the patients were treated with levetiracetam. Our data showed a negative role of antiepileptic drugs on cognitive recovery in a cohort of neurosurgical patients., Conclusions: Knowing thoroughly the effects of antiepileptic drugs in rehabilitation outcome is of fundamental importance. This study represents the only large series analyzing these aspects in the rehabilitation of neurosurgical patients. Antiepileptic drugs should be managed to ensure patients the best possible cognitive outcome. Further evidence from good-quality trials is required to assess the clinical effectiveness of prophylactic anticonvulsive medication in predicting the cognitive outcome of neurosurgical patients who are treated with rehabilitation., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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47. Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome.
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Alemanno F, Houdayer E, Emedoli D, Locatelli M, Mortini P, Mandelli C, Raggi A, and Iannaccone S
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- Activities of Daily Living, Adult, Affect, Aged, Body Image, Female, Humans, Italy, Male, Middle Aged, Virtual Reality, Chronic Pain physiopathology, Chronic Pain psychology, Chronic Pain rehabilitation, Exercise Movement Techniques, Low Back Pain physiopathology, Low Back Pain psychology, Low Back Pain rehabilitation, Neurological Rehabilitation, Quality of Life
- Abstract
Objectives: Chronic pain, such as low-back pain, can be a highly disabling condition degrading people's quality of life (QoL). Not every patient responds to pharmacological therapies, thus alternative treatments have to be developed. The chronicity of pain can lead to a somatic dysperception, meaning a mismatch between patients' own body perception and its actual physical state. Since clinical evaluation of pain relies on patients' subjective reports, a body image disruption can be associated with an incorrect pain rating inducing incorrect treatment and a possible risk of drug abuse. Our aim was to reduce chronic low-back pain through a multimodal neurorehabilitative strategy using innovative technologies to help patients regain a correct body image., Methods: Twenty patients with chronic low-back pain were included. Before and after treatment, patients underwent: a neurological exam; a neuro-psychological evaluation testing cognitive functions (memory, attention, executive functions) and personality traits, QoL and mood; pain ratings; sensorimotor functional abilities' testing. Patients underwent a 6 week-neurorehabilitative treatment (total 12 sessions) using virtual reality (VRRS system, Khymeia, Italy). Treatment consisted on teaching patients to execute correct movements with the painful body parts to regain a correct body image, based on the augmented multisensory feedback (auditory, visual) provided by the VRRS., Results: Our data showed significant reductions in all pain rating scale scores (p<0.05); significant improvements of QoL in the domains of physical functioning, physical role functioning, bodily pain, vitality, and social role functioning; improvements in cognitive functions (p<0.05); improvements in functional scales (p<0.05) and mood (p = 0.04)., Conclusion: This non-pharmacological approach was able to act on the multi-dimensional aspects of pain and improved patients' QoL, pain intensity, mood and patient's functional abilities., Competing Interests: The authors have declared that no competing interests exist.
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- 2019
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48. Trigeminal Neuralgia: Toward a Multimodal Approach.
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Spina A, Mortini P, Alemanno F, Houdayer E, and Iannaccone S
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- Anxiety psychology, Botulinum Toxins, Type A therapeutic use, Combined Modality Therapy, Deep Brain Stimulation methods, Depression psychology, Humans, Neuromuscular Agents therapeutic use, Neurosurgical Procedures, Quality of Life, Transcranial Magnetic Stimulation methods, Trigeminal Neuralgia psychology, Anticonvulsants therapeutic use, Electric Stimulation Therapy methods, Microvascular Decompression Surgery methods, Radiosurgery methods, Rhizotomy methods, Trigeminal Neuralgia therapy
- Abstract
Objectives: Trigeminal neuralgia (TN) is the most common cranial neuralgia in adults, with a slight prevalence in women. Antiepileptic drugs represent the mainstay of the medical treatment, whereas microvascular decompression is the best option in case of neurovascular conflict. Although these treatments showed a good rate of efficacy, they can be contraindicated in some patients and >50% of patients undergoing these treatments will present recurrence of pain in the following months. In this majority of patients, pain becomes chronic and can severely affect their quality of life and cause cognitive disturbances, such as anxiety and depression., Methods: The purpose of this study was to review the efficacy and safety of current treatment modalities for TN, as well as to propose a multimodal approach for those patients presenting with a chronic form of TN., Results: Current treatment modalities have been reviewed. Actual pain evaluation systems and the neuropsychologic features of TN have been analyzed in order to propose an alternative treatment algorithm., Discussion: Chronic pain can also lead to the misperception of patients' own selves leading to enhanced pain perception and altering therapeutic outcomes. Thus, there is the need to define a personalized multimodal approach of treatment, taking into account other available TN therapies and the neuropsychologic aspect of chronic pain., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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49. Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players.
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Chieffo R, Straffi L, Inuggi A, Gonzalez-Rosa JJ, Spagnolo F, Coppi E, Nuara A, Houdayer E, Comi G, and Leocani L
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- Adult, Age Factors, Algorithms, Analysis of Variance, Brain Mapping, Child, Child, Preschool, Evoked Potentials, Motor, Female, Hand physiology, Humans, Male, Models, Theoretical, Movement, Transcranial Magnetic Stimulation, Young Adult, Motor Cortex physiology, Neuronal Plasticity physiology, Psychomotor Performance
- Abstract
Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere.
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- 2016
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50. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.
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Houdayer E, Cursi M, Nuara A, Zanini S, Gatti R, Comi G, and Leocani L
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- Adult, Electric Stimulation, Electroencephalography, Female, Humans, Learning physiology, Male, Motor Cortex anatomy & histology, Nerve Net anatomy & histology, Neural Inhibition physiology, Transcranial Magnetic Stimulation, Evoked Potentials, Motor physiology, Functional Laterality physiology, Motor Cortex physiology, Music, Nerve Net physiology, Neuronal Plasticity physiology
- Abstract
The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits.
- Published
- 2016
- Full Text
- View/download PDF
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