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1. Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

Author

Strambo, Davide, Marto, João Pedro, Ntaios, George, Nguyen, Thanh N., Michel, Patrik, Herzig, Roman, Członkowksa, Anna, Demeestere, Jelle, Yassin Mansour, Ossama, Georgiopoulos, Georgios, Nogueira, Raul G., Salerno, Alexander, Wegener, Susanne, Baumgartner, Philipp, Cereda, Carlo W., Bianco, Giovanni, Beyeler, Morin, Arnold, Marcel, Carrera, Emmanuel, Machi, Paolo, Altersberger, Valerian, Bonati, Leo, Gensicke, Henrik, Bolognese, Manuel, Peters, Nils, Wetzel, Stephan, Magriço, Marta, Nuno Ramos, João, Sargento-Freitas, João, Machado, Rita, Maia, Carolina, Machado, Egídio, Paiva-Nunes, Ana, Ferreira, Patrícia, Pinho-e-Melo, Teresa, Carvalho-Dias, Mariana, Paula, André, Alberto Correia, Manuel, Castro, Pedro, Azevedo, Elsa, Albuquerque, Luís, Nuno-Alves, José, Ferreira-Pinto, Joana, Meira, Torcato, Pereira, Liliana, Rodrigues, Miguel, Araújo, André, Rodrigues, Marta, Rocha, Mariana, Pereira-Fonseca, Ângelo, Ribeiro, Luís, Varela, Ricardo, Cappellari, Manuel, Zivelonghi, Cecilia, Sajeva, Giulia, Zini, Andrea, Gentile, Mauro, Forlivesi, Stefano, Migliaccio, Ludovica, Sessa, Maria, Pezzini, Alessandro, Sangalli, Davide, Zedde, Marialuisa, Pascarella, Rosario, Diamanti, Susanna, Beretta, Simone, Schwarz, Ghil, Frisullo, Giovanni, Marcheselli, Simona, Seners, Pierre, Sabben, Candice, Escalard, Simon, Piotin, Michel, Maier, Benjamin, Charbonnier, Guillaume, Vuillier, Fabrice, Legris, Loic, Cuisenier, Pauline, Vodret, Francesca R., Marnat, Gaultier, Liegey, Jean-Sebastien, Sibon, Igor, Flottmann, Fabian, Broocks, Gabriel, Gloyer, Nils-Ole, Bohmann, Ferdinand O., Hendrik Schaefer, Jan, Nolte, Christian H., Audebert, Heinrich, Siebert, Eberhard, Sykora, Marek, Lang, Wilfried, Ferrari, Julia, Mayer-Suess, Lukas, Knoflach, Michael, Gizewski, Elke-Ruth, Stolp, Jeffrey, Stolze, Lotte J., Coutinho, Jonathan M., Nederkoorn, Paul J., van-den-Wijngaard, Ido, de Meris, Joke, Lemmens, Robin, De Raedt, Sylvie, Vandervorst, Fenne, Pierre Rutgers, Matthieu, Guilmot, Antoine, Dusart, Anne, Bellante, Flavio, Calleja-Castaño, Patricia, Ostos, Fernando, Gonzalez-Ortega, Guillermo, Martín-Jiménez, Paloma, García-Madrona, Sebastian, Cruz-Culebras, Antonio, Vera, Rocio, Matute, Maria-Consuelo, Fuentes, Blanca, Alonso-de-Leciñana, María, Rigual, Ricardo, Díez-Tejedor, Exuperio, Pérez-Sánchez, Soledad, Montaner, Joan, Díaz-Otero, Fernando, Perez de la Ossa, Natalia, Flores-Pina, Belén, Muñoz-Narbona, Lucia, Chamorro, Angel, Rodríguez-Vázquez, Alejandro, Renú, Arturo, Ayo-Martin, Oscar, Hernandez-Fernandez, Francisco, Segura, Tomas, Tejada-Meza, Herbert, Hlaing, Thant, See, Isaiah, Simister, Robert, Werring, David J., Saxhaug Kristoffersen, Espen, Nordanstig, Annika, Jood, Katarina, Rentzos, Alexandros, Šimůnek, Libor, Krajíčková, Dagmar, Krajina, Antonín, Mikulík, Robert, Cviková, Martina, Vinklárek, Jan, Školoudík, David, Roubec, Martin, Hurtikova, Eva, Hrubý, Rostislav, Ostry, Svatopluk, Skoda, Ondrej, Pernicka, Marek, Kočí, Lubomír, Eichlová, Zuzana, Jíra, Martin, Kovář, Martin, Panský, Michal, Mencl, Pavel, Paloušková, Hana, Tomek, Aleš, Janský, Petr, Olšerová, Anna, Šrámek, Martin, Havlíček, Roman, Malý, Petr, Trakal, Lukáš, Fiksa, Jan, Slovák, Matěj, Karliński, Michał, Nowak, Maciej, Sienkiewicz-Jarosz, Halina, Bochynska, Anna, Wrona, Pawel, Homa, Tomasz, Sawczynska, Katarzyna, Slowik, Agnieszka, Wlodarczyk, Ewa, Wiącek, Marcin, Tomaszewska-Lampart, Izabella, Sieczkowski, Bartosz, Bartosik-Psujek, Halina, Bilik, Marta, Bandzarewicz, Anna, Dorobek, Malgorzata, Zielińska-Turek, Justyna, Nowakowska-Kotas, Marta, Obara, Krystian, Urbanowski, Paweł, Budrewicz, Sławomir, Guziński, Maciej, Świtońska, Milena, Rutkowska, Iwona, Sobieszak-Skura, Paulina, Łabuz-Roszak, Beata, Dębiec, Aleksander, Staszewski, Jacek, Stępień, Adam, Zwiernik, Jacek, Wasilewski, Grzegorz, Tiu, Cristina, Terecoasă, Elena-Oana, Radu, Razvan-Alexandru, Negrila, Anca, Dorobat, Bogdan, Panea, Cristina, Tiu, Vlad, Petrescu, Simona, Özcan-Özdemir, Atilla, Mahmoud, Mostafa, El-Samahy, Hussam, Abdelkhalek, Hazem, Al-Hashel, Jasem, Ibrahim Ismail, Ismail, Salmeen, Athari, Ghoreishi, Abdoreza, Sabetay, Sergiu, Gross, Hana, Klein, Piers, Abdalkader, Mohamad, Jabbour, Pascal, El Naamani, Kareem, Tjoumakaris, Stavropoula, Abbas, Rawad, Mohamed, Ghada-A., Chebl, Alex, Min, Jiangyong, Hovingh, Majesta, Tsai, Jenny, Khan, Muhib-A., Nalleballe, Krishna, Onteddu, Sanjeeva, Masoud, Hesham E., Michael, Mina, Kaur, Navreet, Maali, Laith, Abraham, Michael, Khandelwal, Priyank, Bach, Ivo, Ong, Melody, Babici, Denis, Khawaja, Ayaz-M., Hakemi, Maryam, Rajamani, Kumar, Cano-Nigenda, Vanessa, Arauz, Antonio, Amaya, Pablo, Llanos, Natalia, Arango, Akemi, Vences, Miguel A., Barrientos, José-Domingo, Caetano, Rayllene, Targa, Rodrigo, Scollo, Sergio, Yalung, Patrick, Nagendra, Shashank, Gaikwad, Abhijit, and Seo, Kwon-Duk

Published
2024
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2. Selective Cerebrospinal Fluid Hypothermia: Bioengineering Development and In Vivo Study of an Intraventricular Cooling Device (V-COOL)

Author

Beretta, Simone, Versace, Alessandro, Fiore, Gianfranco, Piola, Marco, Martini, Beatrice, Bigiogera, Vittorio, Coppadoro, Lorenzo, Mariani, Jacopo, Tinti, Lorenzo, Pirovano, Silvia, Monza, Laura, Carone, Davide, Riva, Matteo, Padovano, Giada, Galbiati, Gilda, Santangelo, Francesco, Rasponi, Marco, Padelli, Francesco, Giachetti, Isabella, Aquino, Domenico, Diamanti, Susanna, Librizzi, Laura, Bruzzone, Maria Grazia, De Curtis, Marco, Giussani, Carlo, Sganzerla, Erik P., and Ferrarese, Carlo

Published
2022
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3. Harmonization of sensorimotor deficit assessment in a registered multicentre pre-clinical randomized controlled trial using two models of ischemic stroke

Author

Valente, Alessia, Mariani, Jacopo, Seminara, Serena, Tettamanti, Mauro, Pignataro, Giuseppe, Perego, Carlo, Sironi, Luigi, Pedata, Felicita, Amantea, Diana, Bacigaluppi, Marco, Vinciguerra, Antonio, Diamanti, Susanna, Viganò, Martina, Santangelo, Francesco, Zoia, Chiara Paola, Rodriguez-Menendez, Virginia, Castiglioni, Laura, Rzemieniec, Joanna, Dettori, Ilaria, Bulli, Irene, Coppi, Elisabetta, Di Santo, Chiara, Cuomo, Ornella, Gullotta, Giorgia Serena, Butti, Erica, Bagetta, Giacinto, Martino, Gianvito, De Simoni, Maria-Grazia, Ferrarese, Carlo, Fumagalli, Stefano, and Beretta, Simone

Published
2023
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4. Divergence Between Clinical Trial Evidence and Actual Practice in Use of Dual Antiplatelet Therapy After Transient Ischemic Attack and Minor Stroke

Author

De Matteis, Eleonora, De Santis, Federico, Ornello, Raffaele, Censori, Bruno, Puglisi, Valentina, Vinciguerra, Luisa, Giossi, Alessia, Di Viesti, Pietro, Inchingolo, Vincenzo, Fratta, Giovanni Matteo, Diomedi, Marina, Bagnato, Maria Rosaria, Cenciarelli, Silvia, Bedetti, Chiara, Padiglioni, Chiara, Tassinari, Tiziana, Saia, Valentina, Russo, Alessandro, Petruzzellis, Marco, Mezzapesa, Domenico Maria, Caccamo, Martina, Rinaldi, Giuseppe, Bavaro, Alessandra, Paciaroni, Maurizio, Mosconi, Maria Giulia, Foschi, Matteo, Querzani, Pietro, Muscia, Francesco, Gallo Cassarino, Serena, Candelaresi, Paolo, De Mase, Antonio, Guarino, Maria, Cupini, Letizia Maria, Sanzaro, Enzo, Zini, Andrea, La Spada, Salvatore, Palmieri, Carmela, Sepe, Federica Nicoletta, Beretta, Simone, Paci, Cristina, Caggia, Emanuele Alessandro, De Angelis, Maria Vittoria, Bonanni, Laura, Volpi, Gino, Tassi, Rossana, Pistoia, Francesca, Scoditti, Umberto, Tonon, Agnese, Viticchi, Giovanna, Ruzza, Giampietro, Nencini, Patrizia, Cavallini, Anna, Toni, Danilo, Ricci, Stefano, Sacco, Simona, Acciarri, Maria Cristina, Alessi, Chiara, Angelocola, Stefania Martina, Ajdinaj, Paola, Barbarini, Leonardo, Barone, Valentina, Baruffi, Maraia Cristina, Bassi, Chiara, Beccia, Mario, Bellavia, Simone, Biscetti, Leonardo, Bonaffini, Novella, Bolamperti, Laura, Bongioanni, Maria Roberta, Brienza, Marianna, Bruzzone, Gian Luca, Cameriere, Valentina, Campagnaro, Alessandro, Cappellani, Roberto, Cappellari, Manuel, Caputi, Luigi, Cardinali, Patrizio, Coppo, Lorenzo, De Boni, Antonella, De Franco, Ivo Giuseppe, De Luca, Cristina, Diamanti, Susanna, Di Blasio, Francesco, Di Carmine, Caterina, Di Lisi, Filomena, Di Giovanni, Anna, Faini, Claudia, Ferrarese, Carlo, Fleetwood, Thomas, Fortini, Alberto, Frisullo, Giovanni, Galotto, Debora, Genovese, Antonio, Gentile, Luana, Invernizzi, Paolo, La Starza, Sara, Letteri, Federica, Manobianca, Giovanni, Mannino, Marina, Marcon, Michela, Masato, Maela, Mazzacane, Federico, Menegazzo, Elisabetta, Menichetti, Chiara, Monaco, Daniela, Naldi, Federica, Nannucci, Serena, Occhipinti, Clorinda, Orsucci, Daniele, Paolucci, Silvia, Passarelli, Francesco, Papiri, Giulio, Pelliccioni, Giuseppe, Perini, Francesco, Pinto, Vincenza, Potente, Eleonora, Puca, Emanuele, Ricciardi, Maria Chiara, Roberti, Cinzia, Romoli, Michele, Rondelli, Francesca, Rota, Eugenia, Russo, Monia, Sacchini, Elisa, Sanna, Alessandra, Scaglione, Gaspare, Scalvini, Andrea, Scala, Irene, Scarpato, Ciro, Servillo, Giovanna, Sgarlata, Eleonora, Silvestrini, Mauro, Simonetto, Marco, Spina, Emanuele, Tarletti, Roberto, Terruso, Valeria, Tocco, Pierluigi, Tudisco, Laura, Valcamonica, Gloria, Valente, Martina, Vista, Marco, Zito, Antonio, and Zivelonghi, Cecilia

Published
2023
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5. Neutrophils predominate the immune signature of cerebral thrombi in COVID-19 stroke patients

Author

Genchi, Angela, Semerano, Aurora, Schwarz, Ghil, Dell’Acqua, Beatrice, Gullotta, Giorgia Serena, Sampaolo, Michela, Boeri, Enzo, Quattrini, Angelo, Sanvito, Francesca, Diamanti, Susanna, Bergamaschi, Andrea, Grassi, Stefano, Podini, Paola, Panni, Pietro, Michelozzi, Caterina, Simionato, Franco, Scomazzoni, Francesco, Remida, Paolo, Valvassori, Luca, Falini, Andrea, Ferrarese, Carlo, Michel, Patrik, Saliou, Guillaume, Hajdu, Steven, Beretta, Simone, Roveri, Luisa, Filippi, Massimo, Strambo, Davide, Martino, Gianvito, and Bacigaluppi, Marco

Published
2022
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7. REMOTE ISCHEMIC CONDITIONING IN ACUTE ISCHEMIC STROKE: A MULTICENTER TRANSLATIONAL STUDY (TRICS)

Author

Diamanti, S, FERRARESE, CARLO, DIAMANTI, SUSANNA, Diamanti, S, FERRARESE, CARLO, and DIAMANTI, SUSANNA

Abstract

Numerose terapie, che si diceva potessero migliorare l'esito nei modelli animali di ictus utilizzati nella ricerca, alla fine hanno fallito negli studi clinici. Le revisioni sistematiche degli studi sperimentali sull'ictus hanno ripetutamente messo in dubbio la solidità e l'utilità predittiva degli studi condotti in singoli laboratori a causa di valutazioni di bassa qualità, bias di pubblicazione, mancanza di dati su animali di sesso femminile, anziani o con comorbidità. L'idea innovativa di uno studio preclinico randomizzato controllato (PRCT) multicentrico si sta sviluppando come un passo cruciale prima di passare dal modello animale alla sperimentazione clinica, al fine di ottimizzare la traslazione della terapia dal bancone del laboratorio al letto del paziente. Per colmare il divario tra il laboratorio e l’ambito clinico, l'Organizzazione Italiana Ictus (ISO) ha istituito una rete nazionale di laboratori di ricerca preclinica sull'ictus. Questi laboratori conducono progetti di ricerca traslazionale multicentrici su trattamenti altamente promettenti per l'ictus ischemico sperimentale. Una potenziale terapia neuroprotettiva per l'ictus è il condizionamento ischemico remoto (RIC). Infatti, precedenti studi esplorativi monocentrici hanno documentato l'efficacia del RIC nel ridurre il danno ischemico cerebrale. Applicando un’ischemia transitoria all'arto, questo trattamento mira ad attivare i meccanismi endogeni di tolleranza ischemica, con conseguente risposta sistemica protettiva contro il danno cerebrale. L'ISO Basic Science Network ha lanciato un programma multicentrico di ricerca traslazionale sul RIC. Questo programma prevede uno studio preclinico multicentrico sull'ictus ischemico sperimentale (TRICS-BASIC) e uno studio clinico multicentrico randomizzato di fase II sul condizionamento ischemico remoto in pazienti con ictus acuto entro 9 ore dall'esordio e non candidabili alle terapie di ricanalizzazione (TRICS-9), i cui risultati preliminari sono illustr, Numerous therapies, that were said to improve outcome in animal stroke models used in research, ultimately failed in clinical trials. Systematic reviews of experimental stroke studies have continually questioned the robustness and predictive utility of single-laboratory studies due to low-quality ratings, publication bias, lack of data from female animals, older animals, or those with comorbidities. The novel idea of a multicenter preclinical randomised controlled trial (pRCT) is developing as a crucial step before moving from animal modeling to clinical trial in order to optimize the translation of therapy efficacy from bench to bedside. To bridge the gap between the bench and the bedside, the Italian Stroke Organization (ISO) Basic Science has established a national network of preclinical stroke research labs. These labs conduct multicentre translational research projects on highly promising treatments in experimental ischemic stroke. A putative neuroprotective therapy for stroke is remote ischemic conditioning (RIC). Indeed, previous single-center, exploratory investigations have reported the effectiveness of RIC in decreasing ischemic brain damage. By inflicting a subliminal ischemic injury on the limb, this treatment aims to activate the endogenous mechanism of ischemic tolerance, resulting in a protective systemic response against brain injury. The ISO Basic Science Network launched a multicenter translational research program on RIC. This program provides for a multicenter pre-clinical study of experimental ischemic stroke (TRICS-BASIC) and a multi-center randomized phase II clinical trial on remote ischemic conditioning in patients with acute stroke within 9 hours of onset who are not eligible to recanalization therapies (TRICS-9), whose preliminary results are illustrated in this thesis.

Published
2023

8. sj-pdf-1-jcb-10.1177_0271678X231159958 - Supplemental material for Harmonization of sensorimotor deficit assessment in a registered multicentre pre-clinical randomized controlled trial using two models of ischemic stroke

Author

Valente, Alessia, Mariani, Jacopo, Seminara, Serena, Tettamanti, Mauro, Pignataro, Giuseppe, Perego, Carlo, Sironi, Luigi, Pedata, Felicita, Amantea, Diana, Bacigaluppi, Marco, Vinciguerra, Antonio, Diamanti, Susanna, Viganò, Martina, Santangelo, Francesco, Zoia, Chiara Paola, Rodriguez-Menendez, Virginia, Castiglioni, Laura, Rzemieniec, Joanna, Dettori, Ilaria, Bulli, Irene, Coppi, Elisabetta, Di Santo, Chiara, Cuomo, Ornella, Gullotta, Giorgia Serena, Butti, Erica, Bagetta, Giacinto, Martino, Gianvito, De Simoni, Maria-Grazia, Ferrarese, Carlo, Fumagalli, Stefano, and Beretta, Simone

Subjects
110320 Radiology and Organ Imaging, FOS: Clinical medicine, FOS: Biological sciences, Medicine, Cell Biology, 110305 Emergency Medicine, 110306 Endocrinology, Biochemistry, 69999 Biological Sciences not elsewhere classified, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231159958 for Harmonization of sensorimotor deficit assessment in a registered multicentre pre-clinical randomized controlled trial using two models of ischemic stroke by Alessia Valente, Jacopo Mariani, Serena Seminara, Mauro Tettamanti, Giuseppe Pignataro, Carlo Perego, Luigi Sironi, Felicita Pedata, Diana Amantea, Marco Bacigaluppi, Antonio Vinciguerra, Susanna Diamanti, Martina Viganò, Francesco Santangelo, Chiara Paola Zoia, Virginia Rodriguez-Menendez, Laura Castiglioni, Joanna Rzemieniec, Ilaria Dettori, Irene Bulli, Elisabetta Coppi, Chiara Di Santo, Ornella Cuomo, Giorgia Serena Gullotta, Erica Butti, Giacinto Bagetta, Gianvito Martino, Maria-Grazia De Simoni, Carlo Ferrarese, Stefano Fumagalli, Simone Beretta and for the TRICS study group in Journal of Cerebral Blood Flow & Metabolism

Published
2023
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9. Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry

Author

Marto, João Pedro, Strambo, Davide, Ntaios, George, Nguyen, Thanh N, Herzig, Roman, Czlonkowska, Anna, Demeestere, Jelle, Mansour, Ossama Yassin, Salerno, Alexander, Wegener, Susanne, Baumgartner, Philipp, Cereda, Carlo W, Bianco, Giovanni, Beyeler, Morin, Arnold, Marcel, Carrera, Emmanuel, Machi, Paolo, Altersberger, Valerian, Bonati, Leo, Gensicke, Henrik, Bolognese, Manuel, Peters, Nils, Wetzel, Stephan, Magriço, Marta, Ramos, João Nuno, Sargento-Freitas, João, Machado, Rita, Maia, Carolina, Machado, Egídio, Nunes, Ana Paiva, Ferreira, Patricia, Pinho E Melo, Teresa, Dias, Mariana Carvalho, Paula, André, Correia, Manuel Alberto, Castro, Pedro, Azevedo, Elsa, Albuquerque, Luís, Alves, José Nuno, Ferreira-Pinto, Joana, Meira, Torcato, Pereira, Liliana, Rodrigues, Miguel, Araujo, Andre Pinho, Rodrigues, Marta, Rocha, Mariana, Pereira-Fonseca, Ângelo, Ribeiro, Luís, Varela, Ricardo, Malheiro, Sofia, Cappellari, Manuel, Zivelonghi, Cecilia, Sajeva, Giulia, Zini, Andrea, Gentile, Mauro, Forlivesi, Stefano, Migliaccio, Ludovica, Sessa, Maria, La Gioia, Sara, Pezzini, Alessandro, Sangalli, Davide, Zedde, Marialuisa, Pascarella, Rosario, Ferrarese, Carlo, Beretta, Simone, Diamanti, Susanna, Schwarz, Ghil, Frisullo, Giovanni, Marcheselli, Simona, Seners, Pierre, Sabben, Candice, Escalard, Simon, Piotin, Michel, Maïer, Benjamin, Charbonnier, Guillaume, Vuillier, Fabrice, Legris, Loïc, Cuisenier, Pauline, Vodret, Francesca R, Marnat, Gaultier, Liegey, Jean-Sebastien, Sibon, Igor, Flottmann, Fabian, Broocks, Gabriel, Gloyer, Nils-Ole, Bohmann, Ferdinand O, Schaefer, Jan Hendrik, Nolte, Christian, Audebert, Heinrich J, Siebert, Eberhard, Sykora, Marek, Lang, Wilfried, Ferrari, Julia, Mayer-Suess, Lukas, Knoflach, Michael, Gizewski, Elke Ruth, Stolp, Jeffrey, Stolze, Lotte J, Coutinho, Jonathan M, Nederkoorn, Paul, van den Wijngaard, Ido, De Meris, Joke, Lemmens, Robin, De Raedt, Sylvie, Vandervorst, Fenne, Rutgers, Matthieu Pierre, Guilmot, Antoine, Dusart, Anne, Bellante, Flavio, Calleja-Castaño, Patricia, Ostos, Fernando, González-Ortega, Guillermo, Martín-Jiménez, Paloma, García-Madrona, Sebastian, Cruz-Culebras, Antonio, Vera, Rocio, Matute, Maria Consuelo, Fuentes, Blanca, Alonso-de-Leciñana, María, Rigual, Ricardo, Díez-Tejedor, Exuperio, Perez-Sanchez, Soledad, Montaner, Joan, Díaz-Otero, Fernando, Pérez-de-la-Ossa, Natalia, Flores-Pina, Belén, Muñoz-Narbona, Lucia, Chamorro, Angel, Rodríguez-Vázquez, Alejandro, Renú, Arturo, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Segura, Tomas, Tejada-Meza, Herbert, Sagarra-Mur, Daniel, Serrano-Ponz, Marta, Hlaing, Thant, See, Isaiah, Simister, Robert, Werring, David, Kristoffersen, Espen Saxhaug, Nordanstig, Annika, Jood, Katarina, Rentzos, Alexandros, Šimůnek, Libor, Krajíčková, Dagmar, Krajina, Antonín, Mikulik, Robert, Cviková, Martina, Vinklárek, Jan, Školoudík, David, Roubec, Martin, Hurtikova, Eva, Hrubý, Rostislav, Ostry, Svatopluk, Skoda, Ondrej, Pernicka, Marek, Jurak, Lubomir, Eichlová, Zuzana, Jíra, Martin, Kovar, Martin, Panský, Michal, Mencl, Pavel, Palouskova, Hana, Tomek, Aleš, Janský, Petr, Olšerová, Anna, Sramek, Martin, Havlicek, Roman, Malý, Petr, Trakal, Lukáš, Fiksa, Jan, Slovák, Matěj, Karlinski, Michal Adam, Nowak, Maciej, Sienkiewicz-Jarosz, Halina, Bochynska, Anna, Wrona, Pawel, Homa, Tomasz, Sawczynska, Katarzyna, Slowik, Agnieszka, Wlodarczyk, Ewa, Wiacek, Marcin, Tomaszewska-Lampart, Izabella, Sieczkowski, Bartosz, Bartosik-Psujek, Halina, Bilik, Marta, Bandzarewicz, Anna, Dorobek, Malgorzata, Zielinska-Turek, Justyna, Nowakowska-Kotas, Marta, Obara, Krystian, Urbanowski, Paweł, Budrewicz, Slawomir, Guziński, Maciej, Świtońska, Milena, Rutkowska, Iwona, Sobieszak-Skura, Paulina, Labuz-Roszak, Beata M, Debiec, Aleksander, Staszewski, Jacek, Stępień, Adam, Zwiernik, Jacek, Wasilewski, Grzegorz, Tiu, Cristina, Terecoasă, Elena Oana, Radu, Razvan Alexandru, Negrila, Anca, Dorobat, Bogdan, Panea, Cristina, Tiu, Vlad, Petrescu, Simona, Ozdemir, Atilla, Mahmoud, Mostafa, El-Samahy, Hussam, Abdelkhalek, Hazem, Al-Hashel, Jasem, Ismail, Ismail Ibrahim, Salmeen, Athari, Ghoreishi, Abdoreza, Sabetay, Sergiu Ionut, Gross, Hana, Klein, Piers, Abdalkader, Mohamad, Jabbour, Pascal, El Naamani, Kareem, Tjoumakaris, Stavropoula, Abbas, Rawad, Mohamed, Ghada A, Chebl, Alex, Min, Jiangyong, Hovingh, Majesta, Tsai, Jenney P, Khan, Muhib, Nalleballe, Krishna, Onteddu, Sanjeeva, Masoud, Hesham, Michael, Mina, Kaur, Navreet, Maali, Laith, Abraham, Michael G, Khandelwal, Priyank, Bach, Ivo, Ong, Melody, Babici, Denis, Khawaja, Ayaz M, Hakemi, Maryam, Rajamani, Kumar, Cano-Nigenda, Vanessa, Arauz, Antonio, Amaya, Pablo, Llanos, Natalia, Arango, Akemi, Vences, Miguel Ángel, Barrientos Guerra, Jose Dominguo, Caetano, Rayllene, Martins, Rodrigo Targa, Scollo, Sergio Daniel, Yalung, Patrick Matic, Nagendra, Shashank, Gaikwad, Abhijit, Seo, Kwon-Duk, Georgiopoulos, Georgios, Nogueira, Raul G, Michel, Patrik, Neurology, Clinical sciences, Neuroprotection & Neuromodulation, Faculty of Medicine and Pharmacy, Biology, and Brussels Heritage Lab

Subjects
Fibrinolytic Agents/therapeutic use, Cerebral Hemorrhage/complications, Stroke/epidemiology, Brain Ischemia/complications, Treatment Outcome, Ischemic Stroke/epidemiology, COVID-19/complications, Humans, Cohort studies, Endovascular Procedures/adverse effects, Registries, Neurology (clinical), 610 Medicine & health, Intracranial Hemorrhages/etiology, Thrombolytic Therapy/adverse effects, Research Article
Abstract

Background and ObjectivesCOVID-19–related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.MethodsThis was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).ResultsOf a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16–2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20–2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23–1.99), 24-hour mortality (OR 2.47; 95% CI 1.58–3.86), and 3-month mortality (OR 1.88; 95% CI 1.52–2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26–1.60).DiscussionPatients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non–COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis.Trial Registration InformationThe study was registered under ClinicalTrials.gov identifierNCT04895462.

Published
2022
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10. Additional file 2 of Neutrophils predominate the immune signature of cerebral thrombi in COVID-19 stroke patients

Author

Genchi, Angela, Semerano, Aurora, Schwarz, Ghil, Dell���Acqua, Beatrice, Gullotta, Giorgia Serena, Sampaolo, Michela, Boeri, Enzo, Quattrini, Angelo, Sanvito, Francesca, Diamanti, Susanna, Bergamaschi, Andrea, Grassi, Stefano, Podini, Paola, Panni, Pietro, Michelozzi, Caterina, Simionato, Franco, Scomazzoni, Francesco, Remida, Paolo, Valvassori, Luca, Falini, Andrea, Ferrarese, Carlo, Michel, Patrik, Saliou, Guillaume, Hajdu, Steven, Beretta, Simone, Roveri, Luisa, Filippi, Massimo, Strambo, Davide, Martino, Gianvito, and Bacigaluppi, Marco

Abstract

Additional file 2: Table S1: General clinical, radiological and laboratory characteristics and comparison between COVID-19 patients and pre-infection LVO stroke patients.

Published
2022
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11. Additional file 1 of Neutrophils predominate the immune signature of cerebral thrombi in COVID-19 stroke patients

Author

Genchi, Angela, Semerano, Aurora, Schwarz, Ghil, Dell���Acqua, Beatrice, Gullotta, Giorgia Serena, Sampaolo, Michela, Boeri, Enzo, Quattrini, Angelo, Sanvito, Francesca, Diamanti, Susanna, Bergamaschi, Andrea, Grassi, Stefano, Podini, Paola, Panni, Pietro, Michelozzi, Caterina, Simionato, Franco, Scomazzoni, Francesco, Remida, Paolo, Valvassori, Luca, Falini, Andrea, Ferrarese, Carlo, Michel, Patrik, Saliou, Guillaume, Hajdu, Steven, Beretta, Simone, Roveri, Luisa, Filippi, Massimo, Strambo, Davide, Martino, Gianvito, and Bacigaluppi, Marco

Subjects
cardiovascular diseases
Abstract

Additional file 1: Figure S1. Structural and immune characterization of thrombi of stroke patients with COVID-19 or pre-existing infections. (A) Characterization of the structural components. RBCs+ area median [IQR] in thrombi of COVID-19: 62.9 [IQR 25.9-73.8] and pre-infections stroke patients: 42.6 [IQR 30.4-58.5]; p=0.73; CD61+ area in thrombi of COVID-19: 41 [IQR 13-48] and pre-infections stroke patients: 25 [IQR 15.1-43.9]; p=0.68; vWF+ area in thrombi of COVID-19: 33 [IQR 20.8-41.5] and pre-inf: 43 [IQR 35.3-50]; p=0.19; Fibrin+ area in COVID-19: 27.1 [IQR 9.2-50.4] and pre-infections stroke patients: 8.8 [IQR 2.6-33.4]; p=0.15, Mann Whitney. (B) Characterization of the immune cell signature. Neutrophil number, MPO+ cells/mm2, median [IQR], in thrombi of COVID-19: 2110 [IQR 1754-2580] and pre-infections stroke patients: 985.1 [IQR 690.7-1573] p=0.008; NET content, CitH3+ area in thrombi of COVID-19: 8.4 [IQR 6.6-50.7] and pre-infections stroke patients: 12.2 [IQR 4.1-32.2] p=0.69; T cells number, CD3+ cells/mm2 in thrombi of COVID-19: 61.6 [IQR 48.1-91.6] and pre-infections stroke patients: 117.4 [IQR 31.7-144.9] p=0.92; B cells number, CD20+ cells/mm2 in thrombi of COVID-19: 6.3 [IQR 5.2-14.3] and pre-infections stroke patients: 20.8 [IQR 6.6-32.6] p=0.17, Mann Whitney. (C) Neutrophil to lymphocyte ratio (tNLR) in thrombi of COVID-19: 30.3 [IQR 25.9-44.4] and pre-infections stroke patients: 8.2 [IQR 5.9-19.1] p=0.02; macrophages number, CD68 PGM1+ cells/mm2 in thrombi of COVID-19: 623.4 [IQR 455.9-1588] and pre-infections stroke patients: 580 [IQR 206.7-1639] p=0.54; complement C5b-C9+ area in thrombi of COVID-19: 0.1028 [IQR 0.013- 0.206] and pre-infections stroke patients: 0.037 [IQR 0.004- 0.762] p=0.918, Mann Whitney. C. Quantification of ACE2 (median [IQR]) ACE2+ area in thrombi of COVID-19: 0.05 [IQR 0.01-0.06] and pre-infections stroke patients: 0.5 [IQR 0.02-1.7] p=0.34 and endothelial cells, CD34+ area in thrombi of COVID-19: 0.23 [IQR 0.12-0.71] and pre-infections stroke patients: 0.07 [IQR 0.05-0.24] p=0.06, Mann Whitney. The graphs represent the median and IQR, each dot in the scatter plot represents the thrombus of one patient, n=7 and n=8-10 for thrombi of COVID-19 and pre-infection stroke patients respectively.

Published
2022
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12. Multi-Center Randomized Phase II Clinical Trial on Remote Ischemic Conditioning in Acute Ischemic Stroke Within 9 Hours of Onset in Patients Ineligible to Recanalization Therapies (TRICS-9): Study Design and Protocol

Author

Diamanti, Susanna, primary, Beretta, Simone, additional, Tettamanti, Mauro, additional, Sacco, Simona, additional, Sette, Giuliano, additional, Ornello, Raffaele, additional, Tiseo, Cindy, additional, Caponnetto, Valeria, additional, Beccia, Mario, additional, Alivernini, Diletta, additional, Costanzo, Rocco, additional, and Ferrarese, Carlo, additional

Published
2021
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13. Serum naturally occurring anti-TDP-43 auto-antibodies are increased in amyotrophic lateral sclerosis

Author

Conti, E, Sala, G, Diamanti, S, Casati, M, Lunetta, C, Gerardi, F, Tarlarini, C, Mosca, L, Riva, N, Falzone, Y, Filippi, M, Appollonio, I, Ferrarese, C, Tremolizzo, L, Conti, Elisa, Sala, Gessica, Diamanti, Susanna, Casati, Marco, Lunetta, Christian, Gerardi, Francesca, Tarlarini, Claudia, Mosca, Lorena, Riva, Nilo, Falzone, Yuri, Filippi, Massimo, Appollonio, Ildebrando, Ferrarese, Carlo, Tremolizzo, Lucio, Conti, E, Sala, G, Diamanti, S, Casati, M, Lunetta, C, Gerardi, F, Tarlarini, C, Mosca, L, Riva, N, Falzone, Y, Filippi, M, Appollonio, I, Ferrarese, C, Tremolizzo, L, Conti, Elisa, Sala, Gessica, Diamanti, Susanna, Casati, Marco, Lunetta, Christian, Gerardi, Francesca, Tarlarini, Claudia, Mosca, Lorena, Riva, Nilo, Falzone, Yuri, Filippi, Massimo, Appollonio, Ildebrando, Ferrarese, Carlo, and Tremolizzo, Lucio

Abstract

Amyotrophic Lateral Sclerosis (ALS) patients express significant clinical heterogeneity that often hinders a correct diagnostic definition. Intracellular deposition of TDP-43, a protein involved in RNA metabolism characterizes the pathology. Interestingly, this protein can be detected in serum, wherein cognate naturally-occurring auto-antibodies (anti-TDP-43 NAb) might be also present, albeit they have never been documented before. In this exploratory study, we quantified the levels of both anti-TDP-43 NAb and TDP-43 protein as putative accessible markers for improving the ALS diagnostic process by using ELISA in N = 70 ALS patients (N = 4 carrying TARDBP mutations), N = 40 age-comparable healthy controls (CTRL), N = 20 motor neuron disease mimics (MN-m), N = 20 Alzheimer's disease (AD) and N = 15 frontotemporal lobar degeneration (FTLD) patients. Anti-TDP-43 NAb were found to be significantly increased in ALS patients compared to all the other groups (p < 0.001). On the other hand, the distribution of serum levels of TDP-43 protein was highly variable among the various groups. Levels were increased in ALS patients, albeit the highest values were detected in MN-m patients. NAb and protein serum levels failed to correlate. For the first time, we report that serum anti-TDP-43 NAb are detectable in human serum of both healthy controls and patients affected by a variety of neurodegenerative disorders; furthermore, their levels are increased in ALS patients, representing a potentially interesting trait core marker of this disease. Further studies are needed to clarify the exact role of the NAb. This information might be extremely useful for paving the way toward targeting TDP-43 by immunotherapy in ALS.

Published
2021

14. Head down tilt 15° in experimental intracerebral hemorrhage: a randomized non-inferiority safety trial

Author

Beretta, S, Versace, A, Martini, B, Viganò, M, Diamanti, S, Pini, C, Paternò, G, Carone, D, Mariani, J, Monza, L, Riva, M, Padovano, G, Rossi, E, Citerio, G, Castoldi, G, Padelli, F, Giachetti, I, Aquino, D, Giussani, C, Sganzerla, E, Ferrarese, C, Beretta, Simone, Versace, Alessandro, Martini, Beatrice, Viganò, Martina, Diamanti, Susanna, Pini, Cristiano, Paternò, Giovanni, Carone, Davide, Mariani, Jacopo, Monza, Laura, Riva, Matteo, Padovano, Giada, Rossi, Emanuela, Citerio, Giuseppe, Castoldi, Giovanna, Padelli, Francesco, Giachetti, Isabella, Aquino, Domenico, Giussani, Carlo, Sganzerla, Erik P, Ferrarese, Carlo, Beretta, S, Versace, A, Martini, B, Viganò, M, Diamanti, S, Pini, C, Paternò, G, Carone, D, Mariani, J, Monza, L, Riva, M, Padovano, G, Rossi, E, Citerio, G, Castoldi, G, Padelli, F, Giachetti, I, Aquino, D, Giussani, C, Sganzerla, E, Ferrarese, C, Beretta, Simone, Versace, Alessandro, Martini, Beatrice, Viganò, Martina, Diamanti, Susanna, Pini, Cristiano, Paternò, Giovanni, Carone, Davide, Mariani, Jacopo, Monza, Laura, Riva, Matteo, Padovano, Giada, Rossi, Emanuela, Citerio, Giuseppe, Castoldi, Giovanna, Padelli, Francesco, Giachetti, Isabella, Aquino, Domenico, Giussani, Carlo, Sganzerla, Erik P, and Ferrarese, Carlo

Abstract

Background: Head down tilt 15° (HDT15°), applied before recanalization, increases collateral flow and improves outcome in experimental ischemic stroke. For its simplicity and low cost, HDT15° holds considerable potential to be developed as an emergency treatment of acute stroke in the pre-hospital setting, where hemorrhagic stroke is the major mimic of ischemic stroke. In this study, we assessed safety of HDT15° in the acute phase of experimental intracerebral hemorrhage. Methods: Intracerebral hemorrhage was produced by stereotaxic injection of collagenase in Wistar rats. A randomized non-inferiority trial design was used to assign rats to HDT15° or flat position (n=64). HDT15° was applied for 1 hour during the time window of hematoma expansion. The primary outcome was hematoma volume at 24 hours. Secondary outcomes were mass effect, mortality and functional deficit in the main study and acute changes of intracranial pressure, hematoma growth and cardiorespiratory parameters in separate sets of randomized animals (n=32). Results: HDT15° achieved the specified criteria of non-inferiority for hematoma volume at 24 hours. Mass effect, mortality and functional deficit at 24 hours showed no difference in the two groups. HDT15° induced a mild increase in intracranial pressure with respect to the pre-treatment values (+ 2.91 +/- 1.76 mmHg). HDT15° had a neutral effect on MRI-based analysis of hematoma growth and cardiorespiratory parameters. Conclusions: Application of HDT15° in the hyperacute phase of experimental intracerebral hemorrhage does not worsen early outcome. Further research is needed to implement HDT15° as an emergency collateral therapeutic for acute stroke.

Published
2021

16. Multicentre translational Trial of Remote Ischaemic Conditioning in Acute Ischaemic Stroke (TRICS): protocol of multicentre, parallel group, randomised, preclinical trial in female and male rat and mouse from the Italian Stroke Organization (ISO) Basic Science networkMulticentre translational Trial of Remote Ischaemic Conditioning in Acute Ischaemic Stroke (TRICS): protocol of multicentre, parallel group, randomised, preclinical trial in female and male rat and mouse from the Italian Stroke Organization (ISO) Basic Science network

Author

Tettamanti, Mauro, primary, Beretta, Simone, additional, Pignataro, Giuseppe, additional, Fumagalli, Stefano, additional, Perego, Carlo, additional, Sironi, Luigi, additional, Pedata, Felicita, additional, Amantea, Diana, additional, Bacigaluppi, Marco, additional, Vinciguerra, Antonio, additional, Valente, Alessia, additional, Diamanti, Susanna, additional, Mariani, Jacopo, additional, Viganò, Martina, additional, Santangelo, Francesco, additional, Zoia, Chiara Paola, additional, Rogriguez-Menendez, Virginia, additional, Castiglioni, Laura, additional, Rzemieniec, Joanna, additional, Dettori, Ilaria, additional, Bulli, Irene, additional, Coppi, Elisabetta, additional, Gullotta, Giorgia Serena, additional, Bagetta, Giacinto, additional, Martino, Gianvito, additional, Ferrarese, Carlo, additional, and De Simoni, Maria Grazia, additional

Published
2020
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17. Multicentre translational Trial of Remote Ischaemic Conditioning in Acute Ischaemic Stroke (TRICS): protocol of multicentre, parallel group, randomised, preclinical trial in female and male rat and mouse from the Italian Stroke Organization (ISO) Basic Science network

Author

Tettamanti, M, Beretta, S, Pignataro, G, Fumagalli, S, Perego, C, Sironi, L, Pedata, F, Amantea, D, Bacigaluppi, M, Vinciguerra, A, Valente, A, Diamanti, S, Mariani, J, Viganò, M, Santangelo, F, Zoia, C, Rogriguez-Menendez, V, Castiglioni, L, Rzemieniec, J, Dettori, I, Bulli, I, Coppi, E, Gullotta, G, Bagetta, G, Martino, G, Ferrarese, C, De Simoni, M, Tettamanti, Mauro, Beretta, Simone, Pignataro, Giuseppe, Fumagalli, Stefano, Perego, Carlo, Sironi, Luigi, Pedata, Felicita, Amantea, Diana, Bacigaluppi, Marco, Vinciguerra, Antonio, Valente, Alessia, Diamanti, Susanna, Mariani, Jacopo, Viganò, Martina, Santangelo, Francesco, Zoia, Chiara Paola, Rogriguez-Menendez, Virginia, Castiglioni, Laura, Rzemieniec, Joanna, Dettori, Ilaria, Bulli, Irene, Coppi, Elisabetta, Gullotta, Giorgia Serena, Bagetta, Giacinto, Martino, Gianvito, Ferrarese, Carlo, De Simoni, Maria Grazia, Tettamanti, M, Beretta, S, Pignataro, G, Fumagalli, S, Perego, C, Sironi, L, Pedata, F, Amantea, D, Bacigaluppi, M, Vinciguerra, A, Valente, A, Diamanti, S, Mariani, J, Viganò, M, Santangelo, F, Zoia, C, Rogriguez-Menendez, V, Castiglioni, L, Rzemieniec, J, Dettori, I, Bulli, I, Coppi, E, Gullotta, G, Bagetta, G, Martino, G, Ferrarese, C, De Simoni, M, Tettamanti, Mauro, Beretta, Simone, Pignataro, Giuseppe, Fumagalli, Stefano, Perego, Carlo, Sironi, Luigi, Pedata, Felicita, Amantea, Diana, Bacigaluppi, Marco, Vinciguerra, Antonio, Valente, Alessia, Diamanti, Susanna, Mariani, Jacopo, Viganò, Martina, Santangelo, Francesco, Zoia, Chiara Paola, Rogriguez-Menendez, Virginia, Castiglioni, Laura, Rzemieniec, Joanna, Dettori, Ilaria, Bulli, Irene, Coppi, Elisabetta, Gullotta, Giorgia Serena, Bagetta, Giacinto, Martino, Gianvito, Ferrarese, Carlo, and De Simoni, Maria Grazia

Abstract

Introduction Multicentre preclinical randomised controlled trials (pRCT) are emerging as a necessary step to confirm efficacy and improve translation into the clinic. The aim of this project is to perform two multicentre pRCTs (one in rats and one in mice) to investigate the efficacy of remote ischaemic conditioning (RIC) in an experimental model of severe ischaemic stroke. Methods and analysis Seven research laboratories within the Italian Stroke Organization (ISO) Basic Science network will participate in the study. Transient endovascular occlusion of the proximal right middle cerebral artery will be performed in two species (rats and mice) and in both sexes. Animals will be randomised to receive RIC by transient surgical occlusion of the right femoral artery, or sham surgery, after reperfusion. Blinded outcome assessment will be performed for dichotomised functional neuroscore (primary endpoint) and infarct volume (secondary endpoint) at 48 hours. A sample size of 80 animals per species will yield 82% power to detect a significant difference of 30% in the primary outcome in both pRCTs. Analyses will be performed in a blind status and according to an intention-to-treat paradigm. The results of this study will provide robust, translationally oriented, high-quality evidence on the efficacy of RIC in multiple species of rodents with large ischaemic stroke. Ethics and dissemination This is approved by the Animal Welfare Regulatory Body of the University of Milano Bicocca, under project license from the Italian Ministry of Health. Trial results will be subject to publication according to the definition of the outcome presented in this protocol.

Published
2020

18. Urinary neopterin, a new marker of the neuroinflammatory status in amyotrophic lateral sclerosis

Author

Lunetta, C, Lizio, A, Gerardi, F, Tarlarini, C, Filippi, M, Riva, N, Tremolizzo, L, Diamanti, S, Dellanoce, C, Mosca, L, Sansone, V, Campolo, J, Lunetta, Christian, Lizio, Andrea, Gerardi, Francesca, Tarlarini, Claudia, Filippi, Massimo, Riva, Nilo, Tremolizzo, Lucio, Diamanti, Susanna, Dellanoce, Cinzia Carla, Mosca, Lorena, Sansone, Valeria Ada, Campolo, Jonica, Lunetta, C, Lizio, A, Gerardi, F, Tarlarini, C, Filippi, M, Riva, N, Tremolizzo, L, Diamanti, S, Dellanoce, C, Mosca, L, Sansone, V, Campolo, J, Lunetta, Christian, Lizio, Andrea, Gerardi, Francesca, Tarlarini, Claudia, Filippi, Massimo, Riva, Nilo, Tremolizzo, Lucio, Diamanti, Susanna, Dellanoce, Cinzia Carla, Mosca, Lorena, Sansone, Valeria Ada, and Campolo, Jonica

Abstract

Objective: To comprehensively assess whether neopterin in urine could be a candidate biomarker for determining the neuroinflammatory status in ALS. Methods: We performed an observational, cross-sectional study in 81 pALS, 68 age- and sex-comparable healthy controls (HC), 14 patients affected by MS and 24 OND patients. ALS patients underwent a neurological evaluation to assess the global functional status evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) and the disease progression rate. Urinary neopterin concentrations were determined by high-performance liquid chromatography method and were recorded at the time of first examination to assess their effect on disease severity and survival. Results: Urinary neopterin was significantly higher in pALS (263.90 [198.71-474.90]) compared to MS (155.28 [131.74-190.38], p = < .001), OND patients (205.60 [158.96-299.41], p = 0.04) and HC (169.55 [134.91-226.10], p < .001). Moreover, a significant negative correlation was found between neopterin level and the severity of symptoms evaluated by ALSFRS-R total score (r = - 0.46, p < .001) and its subscores (bulbar r = - 0.34, p = 0.002; motor r = - 0.33, p = 0.003; respiratory r = - 0.53, p < .001), also adjusting for the effect of sex, site of onset, age at evaluation and time from onset to evaluation. Conclusions: Our finding indicates that urine neopterin is elevated in ALS, emphasizing the role of the cell-mediated inflammation in the disease. Moreover, whether confirmed in further studies, our results will underline the neopterin's potential use as non-invasive clinical biomarker of ALS, to discriminate patients possibly candidates to clinical interventions aimed to interfere the neuroinflammatory processes.

Published
2020

19. ALS Cognitive Behavioral Screen (ALS-CBS): normative values for the Italian population and clinical usability

Author

Tremolizzo, L, Lizio, A, Santangelo, G, Diamanti, S, Lunetta, C, Gerardi, F, Messina, S, La Foresta, S, Riva, N, Falzone, Y, Filippi, M, Woolley, S, Sansone, V, Siciliano, M, Ferrarese, C, Appollonio, I, Sala, G, Tremolizzo, Lucio, Lizio, Andrea, Santangelo, Gabriella, Diamanti, Susanna, Lunetta, Christian, Gerardi, Francesca, Messina, Sonia, La Foresta, Stefania, Riva, Nilo, Falzone, Yuri, Filippi, Massimo, Woolley, Susan C, Sansone, Valeria Ada, Siciliano, Mattia, Ferrarese, Carlo, Appollonio, Ildebrando, Tremolizzo, L, Lizio, A, Santangelo, G, Diamanti, S, Lunetta, C, Gerardi, F, Messina, S, La Foresta, S, Riva, N, Falzone, Y, Filippi, M, Woolley, S, Sansone, V, Siciliano, M, Ferrarese, C, Appollonio, I, Sala, G, Tremolizzo, Lucio, Lizio, Andrea, Santangelo, Gabriella, Diamanti, Susanna, Lunetta, Christian, Gerardi, Francesca, Messina, Sonia, La Foresta, Stefania, Riva, Nilo, Falzone, Yuri, Filippi, Massimo, Woolley, Susan C, Sansone, Valeria Ada, Siciliano, Mattia, Ferrarese, Carlo, and Appollonio, Ildebrando

Abstract

Amyotrophic lateral sclerosis (ALS) patients often express cognitive and behavioral dysfunctions within the so-called “frontotemporal spectrum disorders.” Guidelines recommend screening of such dysfunctions, albeit only ALS dedicated tools are eventually suitable, due to the profound motor limitations induced by the disease. ALS Cognitive Behavioral Screen (ALS-CBS) is such a screening tool but normative data are not available, limiting its widespread implementation. Our aim consisted in producing normative data for the Italian version of the ALS-CBS. The scale was administered to n = 458 healthy controls with different age and education. Following translation and back translation of the original version of the test, normative data and correction scores for the ALS-CBS cognitive subtest (ALS-CBSci) were generated. Furthermore, n = 100 ALS consecutive outpatients with a wide range of cognitive and motor severity underwent to the ALS-CBS, besides FAB and Weigl sorting test (WST), in order to check its usability. Completion rate was 100% for ALS-CBS and WST, and 68% for the FAB. Corrected ALS-CBS scores showed 12% detection rate of significant cognitive dysfunction with a moderate kappa with FAB and WST. For the ALS-CBS behavioral subtest (ALS-CBSbi), a caregiver was available for n = 81 ALS patients and asked to complete the subset. The detection rate for behavioral dysfunction was 55.5%, and a mild correlation between with the Caregiver Burden Inventory was present (r = − 0.26, p = 0.04). In conclusion, we offer here normative data for the ALS-CBS, a handy tool for screening frontotemporal spectrum dysfunctions in ALS patients, and confirm its usability and validity in an outpatient setting.

Published
2020

20. Beyond RCTs: Short-term dual antiplatelet therapy in secondary prevention of ischemic stroke and transient ischemic attack

Author

De Matteis, Eleonora, Ornello, Raffaele, De Santis, Federico, Foschi, Matteo, Romoli, Michele, Tassinari, Tiziana, Saia, Valentina, Cenciarelli, Silvia, Bedetti, Chiara, Padiglioni, Chiara, Censori, Bruno, Puglisi, Valentina, Vinciguerra, Luisa, Guarino, Maria, Barone, Valentina, Zedde, Marialuisa, Grisendi, Ilaria, Diomedi, Marina, Bagnato, Maria Rosaria, Petruzzellis, Marco, Mezzapesa, Domenico Maria, Di Viesti, Pietro, Inchingolo, Vincenzo, Cappellari, Manuel, Zenorini, Mara, Candelaresi, Paolo, Andreone, Vincenzo, Rinaldi, Giuseppe, Bavaro, Alessandra, Cavallini, Anna, Moraru, Stefan, Querzani, Pietro, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Frisullo, Giovanni, Muscia, Francesco, Paciaroni, Maurizio, Mosconi, Maria Giulia, Zini, Andrea, Leone, Ruggiero, Palmieri, Carmela, Cupini, Letizia Maria, Marcon, Michela, Tassi, Rossana, Sanzaro, Enzo, Paci, Cristina, Viticchi, Giovanna, Orsucci, Daniele, Falcou, Anne, Diamanti, Susanna, Tarletti, Roberto, Nencini, Patrizia, Rota, Eugenia, Sepe, Federica Nicoletta, Ferrandi, Delfina, Caputi, Luigi, Volpi, Gino, Spada, Salvatore La, Beccia, Mario, Rinaldi, Claudia, Mastrangelo, Vincenzo, Di Blasio, Francesco, Invernizzi, Paolo, Pelliccioni, Giuseppe, De Angelis, Maria Vittoria, Bonanni, Laura, Ruzza, Giampietro, Caggia, Emanuele Alessandro, Russo, Monia, Tonon, Agnese, Acciarri, Maria Cristina, Anticoli, Sabrina, Roberti, Cinzia, Manobianca, Giovanni, Scaglione, Gaspare, Pistoia, Francesca, Fortini, Alberto, De Boni, Antonella, Sanna, Alessandra, Chiti, Alberto, Barbarini, Leonardo, Caggiula, Marcella, Masato, Maela, Del Sette, Massimo, Passarelli, Francesco, Roberta Bongioanni, Maria, Toni, Danilo, Ricci, Stefano, and Sacco, Simona

Abstract

Background and purpose: Randomized controlled trials (RCTs) proved the efficacy of short-term dual antiplatelet therapy (DAPT) in secondary prevention of minor ischemic stroke or high-risk transient ischemic attack (TIA). We aimed at evaluating effectiveness and safety of short-term DAPT in real-world, where treatment use is broader than in RCTs.Methods: READAPT (REAl-life study on short-term Dual Antiplatelet treatment in Patients with ischemic stroke or Transient ischemic attack) (NCT05476081) was an observational multicenter real-world study with a 90-day follow-up. We included patients aged 18+ receiving short-term DAPT soon after ischemic stroke or TIA. No stringent NIHSS and ABCD2score cut-offs were applied but adherence to guidelines was recommended. Primary effectiveness outcome was stroke (ischemic or hemorrhagic) or death due to vascular causes, primary safety outcome was moderate-to-severe bleeding. Secondary outcomes were the type of ischemic and hemorrhagic events, disability, cause of death, and compliance to treatment.Results: We included 1920 patients; 69.9% started DAPT after an ischemic stroke; only 8.9% strictly followed entry criteria or procedures of RCTs. Primary effectiveness outcome occurred in 3.9% and primary safety outcome in 0.6% of cases. In total, 3.3% cerebrovascular ischemic recurrences occurred, 0.2% intracerebral hemorrhages, and 2.7% bleedings; 0.2% of patients died due to vascular causes. Patients with NIHSS score ⩽5 and those without acute lesions at neuroimaging had significantly higher primary effectiveness outcomes than their counterparts. Additionally, DAPT start >24 h after symptom onset was associated with a lower likelihood of bleeding.Conclusions: In real-world, most of the patients who receive DAPT after an ischemic stroke or a TIA do not follow RCTs entry criteria and procedures. Nevertheless, short-term DAPT remains effective and safe in this population. No safety concerns are raised in patients with low-risk TIA, more severe stroke, and delayed treatment start.

Published
2024
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21. Neutrophils predominate the immune signature of cerebral thrombi in COVID-19 stroke patients

Author

Angela Genchi, Aurora Semerano, Ghil Schwarz, Beatrice Dell’Acqua, Giorgia Serena Gullotta, Michela Sampaolo, Enzo Boeri, Angelo Quattrini, Francesca Sanvito, Susanna Diamanti, Andrea Bergamaschi, Stefano Grassi, Paola Podini, Pietro Panni, Caterina Michelozzi, Franco Simionato, Francesco Scomazzoni, Paolo Remida, Luca Valvassori, Andrea Falini, Carlo Ferrarese, Patrik Michel, Guillaume Saliou, Steven Hajdu, Simone Beretta, Luisa Roveri, Massimo Filippi, Davide Strambo, Gianvito Martino, Marco Bacigaluppi, Genchi, Angela, Semerano, Aurora, Schwarz, Ghil, Dell'Acqua, Beatrice, Gullotta, Giorgia Serena, Sampaolo, Michela, Boeri, Enzo, Quattrini, Angelo, Sanvito, Francesca, Diamanti, Susanna, Bergamaschi, Andrea, Grassi, Stefano, Podini, Paola, Panni, Pietro, Michelozzi, Caterina, Simionato, Franco, Scomazzoni, Francesco, Remida, Paolo, Valvassori, Luca, Falini, Andrea, Ferrarese, Carlo, Michel, Patrik, Saliou, Guillaume, Hajdu, Steven, Beretta, Simone, Roveri, Luisa, Filippi, Massimo, Strambo, Davide, Martino, Gianvito, Bacigaluppi, Marco, Genchi, A, Semerano, A, Schwarz, G, Dell'Acqua, B, Gullotta, G, Sampaolo, M, Boeri, E, Quattrini, A, Sanvito, F, Diamanti, S, Bergamaschi, A, Grassi, S, Podini, P, Panni, P, Michelozzi, C, Simionato, F, Scomazzoni, F, Remida, P, Valvassori, L, Falini, A, Ferrarese, C, Michel, P, Saliou, G, Hajdu, S, Beretta, S, Roveri, L, Filippi, M, Strambo, D, Martino, G, and Bacigaluppi, M

Subjects
Male, Mechanical Thrombolysis, Neutrophils, Brain Ischemia, Pathology and Forensic Medicine, Cellular and Molecular Neuroscience, Humans, Endovascular treatment, Prospective Studies, cardiovascular diseases, RC346-429, Aged, Aged, 80 and over, Immunity, Cellular, Ischemic stroke, SARS-CoV-2, Research, Neutrophil, COVID-19, Thrombosis, Angiotensin-Converting Enzyme 2/blood, Angiotensin-Converting Enzyme 2/genetics, Angiotensin-Converting Enzyme 2/immunology, Brain Ischemia/blood, Brain Ischemia/genetics, Brain Ischemia/immunology, COVID-19/blood, COVID-19/genetics, COVID-19/immunology, Female, Immunity, Cellular/physiology, Intracranial Thrombosis/blood, Intracranial Thrombosis/genetics, Intracranial Thrombosis/immunology, Mechanical Thrombolysis/methods, Middle Aged, Neutrophils/immunology, Neutrophils/metabolism, SARS-CoV-2/genetics, SARS-CoV-2/immunology, SARS-CoV-2/metabolism, Stroke/blood, Stroke/genetics, Stroke/immunology, SARS-CoV2, Stroke, Thrombosi, Neurology. Diseases of the nervous system, Angiotensin-Converting Enzyme 2, Neurology (clinical), Intracranial Thrombosis
Abstract

Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thrombotic events. Ischemic stroke in COVID-19 patients entails high severity and mortality rates. Here we aimed to analyze cerebral thrombi of COVID-19 patients with large vessel occlusion (LVO) acute ischemic stroke to expose molecular evidence for SARS-CoV-2 in the thrombus and to unravel any peculiar immune-thrombotic features. We conducted a systematic pathological analysis of cerebral thrombi retrieved by endovascular thrombectomy in patients with LVO stroke infected with COVID-19 (n = 7 patients) and non-covid LVO controls (n = 23). In thrombi of COVID-19 patients, the SARS-CoV-2 docking receptor ACE2 was mainly expressed in monocytes/macrophages and showed higher expression levels compared to controls. Using polymerase chain reaction and sequencing, we detected SARS-CoV-2 Clade20A, in the thrombus of one COVID-19 patient. Comparing thrombus composition of COVID-19 and control patients, we noted no overt differences in terms of red blood cells, fibrin, neutrophil extracellular traps (NETs), von Willebrand Factor (vWF), platelets and complement complex C5b-9. However, thrombi of COVID-19 patients showed increased neutrophil density (MPO+ cells) and a three-fold higher Neutrophil-to-Lymphocyte Ratio (tNLR). In the ROC analysis both neutrophils and tNLR had a good discriminative ability to differentiate thrombi of COVID-19 patients from controls. In summary, cerebral thrombi of COVID-19 patients can harbor SARS-CoV2 and are characterized by an increased neutrophil number and tNLR and higher ACE2 expression. These findings suggest neutrophils as the possible culprit in COVID-19-related thrombosis. Graphical Abstract

Published
2022

22. Multicentre translational Trial of Remote Ischaemic Conditioning in Acute Ischaemic Stroke (TRICS): protocol of multicentre, parallel group, randomised, preclinical trial in female and male rat and mouse from the Italian Stroke Organization (ISO) Basic Science network

Author

Diana Amantea, Luigi Sironi, Carlo Perego, Virginia Rogriguez-Menendez, Ilaria Dettori, Stefano Fumagalli, Maria Grazia De Simoni, Elisabetta Coppi, Giacinto Bagetta, Simone Beretta, Irene Bulli, Giorgia Serena Gullotta, Mauro Tettamanti, Joanna Rzemieniec, Antonio Vinciguerra, Laura Castiglioni, Susanna Diamanti, Carlo Ferrarese, Alessia Valente, Giuseppe Pignataro, Jacopo Mariani, Chiara Zoia, Martina Viganò, Marco Bacigaluppi, Felicita Pedata, Gianvito Martino, Francesco Santangelo, Tettamanti, M, Beretta, S, Pignataro, G, Fumagalli, S, Perego, C, Sironi, L, Pedata, F, Amantea, D, Bacigaluppi, M, Vinciguerra, A, Valente, A, Diamanti, S, Mariani, J, Viganò, M, Santangelo, F, Zoia, C, Rogriguez-Menendez, V, Castiglioni, L, Rzemieniec, J, Dettori, I, Bulli, I, Coppi, E, Gullotta, G, Bagetta, G, Martino, G, Ferrarese, C, De Simoni, M, Tettamanti, Mauro, Beretta, Simone, Pignataro, Giuseppe, Fumagalli, Stefano, Perego, Carlo, Sironi, Luigi, Pedata, Felicita, Amantea, Diana, Bacigaluppi, Marco, Vinciguerra, Antonio, Valente, Alessia, Diamanti, Susanna, Mariani, Jacopo, Viganò, Martina, Santangelo, Francesco, Zoia, Chiara Paola, Rogriguez-Menendez, Virginia, Castiglioni, Laura, Rzemieniec, Joanna, Dettori, Ilaria, Bulli, Irene, Coppi, Elisabetta, Gullotta, Giorgia Serena, Bagetta, Giacinto, Martino, Gianvito, Ferrarese, Carlo, and De Simoni, Maria Grazia

Subjects
0301 basic medicine, medicine.medical_specialty, Italian Stroke Organization (ISO) Basic Science, Basic science, neuroscore, lcsh:Medicine, MCA occlusion, 03 medical and health sciences, 0302 clinical medicine, Occlusion, Ischaemic stroke, medicine, Clinical endpoint, Protocol, TRICS, cerebral ischemia, Remote ischemic conditioning, rat and mouse, Stroke, Protocol (science), business.industry, lcsh:R, Sham surgery, General Medicine, medicine.disease, 030104 developmental biology, Infarct volume, Physical therapy, Remote ischaemic conditioning (RIC), Settore BIO/14 - Farmacologia, Settore MED/26 - Neurologia, business, sperimental stroke, 030217 neurology & neurosurgery
Abstract

Introduction Multicentre preclinical randomised controlled trials (pRCT) are emerging as a necessary step to confirm efficacy and improve translation into the clinic. The aim of this project is to perform two multicentre pRCTs (one in rats and one in mice) to investigate the efficacy of remote ischaemic conditioning (RIC) in an experimental model of severe ischaemic stroke. Methods and analysis Seven research laboratories within the Italian Stroke Organization (ISO) Basic Science network will participate in the study. Transient endovascular occlusion of the proximal right middle cerebral artery will be performed in two species (rats and mice) and in both sexes. Animals will be randomised to receive RIC by transient surgical occlusion of the right femoral artery, or sham surgery, after reperfusion. Blinded outcome assessment will be performed for dichotomised functional neuroscore (primary endpoint) and infarct volume (secondary endpoint) at 48 hours. A sample size of 80 animals per species will yield 82% power to detect a significant difference of 30% in the primary outcome in both pRCTs. Analyses will be performed in a blind status and according to an intention-to-treat paradigm. The results of this study will provide robust, translationally oriented, high-quality evidence on the efficacy of RIC in multiple species of rodents with large ischaemic stroke. Ethics and dissemination This is approved by the Animal Welfare Regulatory Body of the University of Milano Bicocca, under project license from the Italian Ministry of Health. Trial results will be subject to publication according to the definition of the outcome presented in this protocol. Trial registration number PCTE0000177.

Published
2020

23. Recanalization Outcomes and Procedural Complications in Patients With Acute Ischemic Stroke and COVID-19 Receiving Endovascular Treatment.

Author

Marto JP, Strambo D, Ntaios G, Nguyen TN, Wrona P, Escalard S, Marcheselli S, Mansour OY, Fuentes B, Dorobek M, Nowakowska-Kotas M, Terecoasa EO, Coutinho JM, Carvalho-Dias M, Calleja P, Sargento-Freitas J, Paiva-Nunes A, Šrámek M, Khandelwal P, Meira T, Abdalkader M, Jabbour P, Kovář M, Ayo-Martin O, Michel P, Herzig R, Członkowksa A, Demeestere J, Nogueira RG, Salerno A, Wegener S, Baumgartner P, Cereda CW, Bianco G, Beyeler M, Arnold M, Carrera E, Machi P, Altersberger V, Bonati L, Gensicke H, Bolognese M, Peters N, Wetzel S, Magriço M, Nuno Ramos J, Machado R, Maia C, Machado E, Ferreira P, Pinho-E-Melo T, Paula A, Correia MA, Castro P, Azevedo E, Albuquerque L, Nuno-Alves J, Ferreira-Pinto J, Pereira L, Rodrigues M, Araújo A, Rodrigues M, Rocha M, Pereira-Fonseca Â, Ribeiro L, Varela R, Malheiro S, Cappellari M, Zivelonghi C, Sajeva G, Zini A, Mauro G, Stefano F, Migliaccio L, Sessa M, Gioia S, Pezzini A, Sangalli D, Zedde M, Pascarella R, Ferrarese C, Beretta S, Diamanti S, Schwarz G, Frisullo G, Seners P, Sabben C, Piotin M, Maier B, Charbonnier G, Vuillier F, Legris L, Cuisenier P, Vodret FR, Marnat G, Liegey JS, Sibon I, Flottmann F, Broocks G, Gloyer NO, Bohmann FO, Schaefer JH, Nolte CH, Audebert H, Siebert E, Sykora M, Lang W, Ferrari J, Mayer-Suess L, Knoflach M, Gizewski ER, Stolp J, Stolze LJ, Nederkoorn PJ, van-den-Wijngaard I, de Meris J, Lemmen R, De Raedt S, Vandervorst F, Rutgers MP, Guilmot A, Dusart A, Bellante F, Ostos F, Gonzalez-Ortega G, Martín-Jiménez P, García-Madrona S, Cruz-Culebras A, Vera R, Matute MC, Alonso-de-Leciñana M, Rigual R, Díez-Tejedor E, Pérez-Sánchez S, Montaner J, Díaz-Otero F, Perez-de-la-Ossa N, Flores-Pina B, Muñoz-Narbona L, Chamorro A, Rodríguez-Vázquez A, Renú A, Hernandez-Fernandez F, Segura T, Tejada-Meza H, Sagarra-Mur D, Serrano-Ponz M, Hlaing T, See I, Simister R, Werring DJ, Kristoffersen ES, Nordanstig A, Jood K, Rentzos A, Šimu Ne L, Krajíčková D, Krajina A, Mikulík R, Cviková M, Vinklárek J, Školoudík D, Roubec M, Hurtikova E, Hrubý R, Ostry S, Skoda O, Pernicka M, Kočí L, Eichlová Z, Jíra M, Panský M, Mencl P, Paloušková H, Tomek A, Janský P, Olšerová A, Havlíček R, Malý P, Trakal L, Fiksa J, Slovák M, Karlińsk M, Nowak M, Sienkiewicz-Jarosz H, Bochynska A, Homa T, Sawczynska K, Slowik A, Wlodarczyk E, Wiącek M, Tomaszewska-Lampart I, Sieczkowski B, Bartosik-Psujek H, Bilik M, Bandzarewicz A, Zielińska-Turek J, Obara K, Urbanowski P, Budrewicz S, Guziński M, Świtońska M, Rutkowska I, Sobieszak-Skura P, Łabuz-Roszak B, Dębiec A, Staszewski J, Stępień A, Zwiernik J, Wasilewski G, Tiu C, Radu RA, Negrila A, Dorobat B, Panea C, Tiu V, Petrescu S, Özcan-Özdemir A, Mahmoud M, El-Samahy H, Abdelkhalek H, Al-Hashel J, Ibrahim Ismail I, Salmeen A, Ghoreishi A, Sabetay S, Gross H, Klein P, El Naamani K, Tjoumakaris S, Abbas R, Mohamed GA, Chebl A, Min J, Hovingh M, Tsai JP, Khan MA, Nalleballe K, Onteddu S, Masoud HE, Michael M, Kaur N, Maali L, Abraham M, Bach I, Ong M, Babici D, Khawaja AM, Hakemi M, Rajamani K, Cano-Nigenda V, Arauz A, Amaya P, Llanos N, Arango A, Vences MA, Barrientos JD, Caetano R, Targa R, Scollo S, Yalung P, Nagendra S, Gaikwad A, and Seo KD

Published
2025
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24. Prognostic Value of Signal Abnormalities on Brain MRI in Post-Anoxic Super-Refractory Status Epilepticus: A Single-Center Retrospective Study.

Author

Diamanti S, Pasini F, Capraro C, Patassini M, Bianchi E, Pozzi M, Normanno M, Coppo A, Remida P, Avalli L, Ferrarese C, Foti G, and Beretta S

Subjects
Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Prognosis, Hypoxia-Ischemia, Brain diagnostic imaging, Hypoxia-Ischemia, Brain mortality, Hypoxia-Ischemia, Brain complications, Adult, Brain diagnostic imaging, Brain physiopathology, Status Epilepticus diagnostic imaging, Status Epilepticus mortality, Magnetic Resonance Imaging
Abstract

Background: Epileptiform activity, including status epilepticus (SE), occurs in up to one-third of comatose survivors of cardiac arrest and may predict poor outcome. The relationship between SE and hypoxic-ischemic brain injury (HIBI) is not established., Methods: This is a single-center retrospective study on consecutive patients with post-anoxic super-refractory SE. HIBI was graded as non-widespread (group 1) or widespread (group 2) by qualitative analysis of DWI/ADC and T2w-FLAIR. Between-group differences in the rate of poor neurological outcome at 6 months (primary outcome), SE resolution and consciousness recovery before discharge, and mortality at 6 months (secondary outcomes) were investigated., Results: From January 2011 to February 2023, 40 patients were included. HIBI was widespread in 45% of patients and non-widespread in 55%. The rate of poor neurological outcome at 6 months was 27% in group 1 and 83% in group 2 (OR 12.8, CI 95% [2.5-64.3], p = 0.002). The rate of consciousness recovery before discharge was 73% in group 1 versus 22% in group 2 (OR 8.8, CI 95% [1.9-40.3], p = 0.005). SE resolved in 95% of patients in group 1 versus 67% in group 2 (OR 10.5, CI 95% [1.1-97.9], p = 0.039). Mortality rate at 6 months was 27% in group 1 versus 50% in group 2 (OR 0.4, CI 95% [0.1-1.9], p = 0.303)., Conclusion: Patients with widespread HIBI had higher odds of poor outcome at 6 months, lower probability of SE resolution and of consciousness recovery before discharge compared to those with non-widespread HIBI. Mortality at 6 months did not differ significantly between the two groups., (© 2025 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Published
2025
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