9 results on '"Laura D’Acunto"'
Search Results
2. Skin wetness sensitivity across body sites commonly affected by pain in people with migraine
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Alex Buoite Stella, Davide Filingeri, Gabriele Garascia, Laura D’Acunto, Giovanni Furlanis, Antonio Granato, Paolo Manganotti, Buoite Stella, A., Filingeri, D., Garascia, G., D'Acunto, L., Furlanis, G., Granato, A., and Manganotti, P.
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Cross-Sectional Studie ,Male ,Adult ,Migraine Disorders ,humidity ,Pain ,sensory testing ,Middle Aged ,Prospective Studie ,Young Adult ,headache ,hygrosensation ,pain ,Cross-Sectional Studies ,Female ,Humans ,Prospective Studies ,Skin Temperature ,Migraine Disorder ,Neurology ,Neurology (clinical) ,Human - Abstract
OBJECTIVE: The objective of this study was to evaluate skin wetness perception and thermal sensitivity in people with migraine and similar healthy controls.BACKGROUND: Environmental triggers, such as cold and humidity, are known triggers for pain in people with migraine. Sensory inputs might be implicated in such heightened responses to cold-humid environments, such that a migraine-induced hypersensitivity to cold wetness could be present in people with migraine. However, we lack empirical evidence on skin thermal and wetness sensitivity across skin sites commonly associated with reported pain in migraine, such as the forehead.METHODS: This prospective cross-sectional observational study, conducted in a university hospital setting, evaluated skin wetness perceptions and thermal sensations to wet non-noxious warm-wet, neutral-wet, and cold-wet stimuli applied to the forehead, the posterior neck, and the index finger pad of 12 patients with migraine (mean and standard deviation for age 44.5 ± 13.2 years, 7/12 [58%] women) and 36 healthy controls (mean and standard deviation for age 39.4 ± 14.6 years, 18/36 [50%] women).RESULTS: On the forehead, people with migraine reported a significantly higher wetness perception than healthy controls across all thermal stimulus (15.1 mm, 95% confidence interval [CI]: 1.8 to 28.5, p = 0.027, corresponding to ~ 15% difference), whereas no significant differences were found on the posterior neck nor on the index finger pad. We found no differences among groups in overall thermal sensations (-8.3 mm, 95% CI: -24.0 to 7.3, p = 0.291; -7.8 mm, 95% CI: -25.3 to 9.7, p = 0.375; and 12.4 mm, 95% CI: -4.0 to 28.9, p = 0.133; forehead, posterior neck, and index finger, respectively).CONCLUSION: These findings indicate that people with migraine have a heightened sensitivity to skin wetness on the forehead area only, which is where pain attacks occur. Future studies should further explore the underlying mechanisms (e.g., TRPM8-mediated cold-wet allodynia) that lead to greater perception of wetness in people with migraine to better understand the role of environmental triggers in migraine.
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- 2022
3. A novel computed tomography perfusion-based quantitative tool for evaluation of perfusional abnormalities in migrainous aura stroke mimic
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Antonio Granato, Roberta Pozzi Mucelli, Giovanni Furlanis, Maja Ukmar, Miloš Ajčević, Laura D’Acunto, Paolo Manganotti, Granato, A., D'Acunto, L., Ajcevic, M., Furlanis, G., Ukmar, M., Mucelli, R. A. P., and Manganotti, P.
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medicine.medical_specialty ,Neurology ,Aura ,Perfusion scanning ,Dermatology ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Image processing ,Neuroimaging ,Internal medicine ,CT perfusion imaging ,Humans ,Medicine ,030212 general & internal medicine ,Cerebrovascular disease ,Stroke mimics ,Migraine ,Neuroradiology ,Epilepsy ,business.industry ,Penumbra ,General Medicine ,medicine.disease ,Perfusion ,Stroke ,Psychiatry and Mental health ,Cerebrovascular Circulation ,Cardiology ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery - Abstract
Background: Migrainous aura (MA) represents the third most common stroke mimic (SM). Advanced neuroimaging is pivotal in the assessment of patients with focal neurological acute symptoms. We investigated brain perfusion alterations in MA-SM patients using a novel CT perfusion (CTP)-based quantitative approach in order to improve differential diagnosis between MA and acute stroke. Methods: We processed and analysed the clinical and neuroimaging CTP data, acquired within 4.5 h from symptom onset, of patients with acute focal neurological symptoms receiving a final diagnosis of MA. The differences between ROI, compatible with MA symptoms, and contralateral side were automatically estimated in terms of asymmetry index (AI%) by the newly developed tool for mean transit time (MTT), CBF, and cerebral blood volume (CBV) CTP parameters. The AI% ≥ 10% was considered significant. Results: Out of 923 admitted patients, 14 patients with MA were included. In 13 out of 14 cases, a significant pattern of hypoperfusion was observed by quantitative analysis in at least one of the CTP maps. In 7 patients, all three CTP maps were significantly altered. In particular, MTT-AI% increased in 11 (79%) cases, while CBF-AI% and CBV-AI% decreased in 12 (86%) and in 9 (64%) patients, respectively. All CBV values were above ischemic stroke core threshold and all MTT-AI were below ischemic penumbra threshold. Conclusions: Our data suggest that a novel CTP-quantitative approach may detect during MA a moderate hypoperfusion pattern in the cerebral regions compatible with aura symptoms. The use of this novel tool could support differential diagnosis between MA and acute stroke.
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- 2020
4. Lost diagnoses in not otherwise specified headache in Emergency Department
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Antonio Granato, Franco Cominotto, Paolo Manganotti, Maria Elisa Morelli, Giulia Bellavita, and Laura D’Acunto
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Neurology ,Migraine Disorders ,Medicine ,Humans ,Medical diagnosis ,Facial Neuralgia ,Neuroradiology ,Retrospective Studies ,business.industry ,Not Otherwise Specified ,Headache ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Hospitalization ,Migraine ,Female ,Neurology (clinical) ,Headaches ,medicine.symptom ,business ,Emergency Service, Hospital - Abstract
The diagnosis of Not Otherwise Specified (NOS) headaches in the Emergency Department (ED) is frequent despite many specialist visits performed. The aim of the study was to examine specialist visits carried out in the patients discharged from ED with diagnosis of NOS headache to evaluate discrepancies between specialist and ED diagnosis at discharge. We retrospectively (1.6.2018–31.12.2018) analyzed all the patients admitted with non-traumatic headache to the ED of the tertiary-care University Hospital of Trieste. We evaluated the patients discharged from ED with a final diagnosis of NOS headache and who underwent at least one specialist examination. Demographic data, specialist and ED diagnosis were analyzed. One hundred twenty-four patients (93 F, 31 M, mean age 44 ± 15 years) were included. 71.8% of patients were examined only by a neurologist, 12.9% by non-neurologists, 15.3% by both neurologist and non-neurologist. Only 37% of the patients received a precise diagnosis. Neurologist made a diagnosis slightly more frequently than the other consultants (40.5% vs 37.5%). Neurologists diagnosed primary headaches, headaches secondary to neurological diseases, and facial neuralgia, instead non-neurologists diagnosed only headaches secondary to non-neurological diseases. Primary headaches were diagnosed in 25.7% of cases, migraine being the most frequent. Physicians did not report any specialist diagnoses in the ED discharge sheet. Specialist consultants made specific diagnoses in about one-third of patients that were not reported as final in the discharge records by the ED physician. This leads to a loss of diagnoses and to an overestimation of NOS headache.
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- 2020
5. Early putamen hypertrophy and ongoing hippocampus atrophy predict cognitive performance in the first ten years of relapsing-remitting multiple sclerosis
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Maria Elisa Morelli, Arianna Sartori, Alessio Bratina, A. Bosco, Alessandro Dinoto, Paolo Manganotti, Laura D’Acunto, Sara Baldini, Morelli, Maria Elisa, Baldini, Sara, Sartori, Arianna, D’Acunto, Laura, Dinoto, Alessandro, Bosco, Antonio, Bratina, Alessio, and Manganotti, Paolo
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medicine.medical_specialty ,Neurology ,Multiple Sclerosis ,Dermatology ,Neuropsychological Tests ,Asymptomatic ,Hippocampus ,Atrophy ,Cognitive impairment ,Hypertrophy ,Putamen ,03 medical and health sciences ,0302 clinical medicine ,Hippocampu ,Cognition ,Multiple Sclerosis, Relapsing-Remitting ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Effects of sleep deprivation on cognitive performance ,Neuroradiology ,business.industry ,Multiple sclerosis ,Neuropsychology ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,nervous system ,Neurology (clinical) ,medicine.symptom ,business ,Cognition Disorders ,030217 neurology & neurosurgery - Abstract
Background The first years of relapsing-remitting multiple sclerosis (RRMS) constitute the most vulnerable phase for the progression of cognitive impairment (CImp), due to a gradual decrease of compensatory mechanisms. In the first 10 years of RRMS, the temporal volumetric changes of deep gray matter structures must be clarified, since they could constitute reliable cognitive biomarkers for diagnostic, prognostic, and therapeutic purposes. Methods Forty-five cognitively asymptomatic patients with RRMS lasting ≤ 10 years, and with a brain MRI performed in a year from the neuropsychological evaluation (Te-MRI), were included. They performed the Brief International Cognitive Assessment battery for MS. Thirty-one brain MRIs performed in the year of diagnosis (Td-MRI) and 13 brain MRIs of age- and sex-matched healthy controls (HCs) were also included in the study. The relationships between clinical features, cognitive performances, and Te- and Td-MRI volumes were statistically analyzed. Results Cognitively preserved (CP) patients had significantly increased Td-L-putamen (P = 0.035) and Td-R-putamen volume (P = 0.027) with respect to cognitively impaired (CI) ones. CI patients had significantly reduced Te-L-hippocampus (P = 0.019) and Te-R-hippocampus volume (P = 0.042) compared, respectively, with Td-L-hippocampus and Td-R-hippocampus volume. Td-L-putamen volume (P = 0.011) and Te-L-hippocampus volume (P = 0.023) were independent predictors of the Symbol Digit Modalities Test score in all patients (r2 = 0.31, F = 6.175, P = 0.001). Conclusion In the first years of RRMS, putamen hypertrophy and hippocampus atrophy could represent promising indices of cognitive performance and reserve, and become potentially useful tools for diagnostic, prognostic, and therapeutic purposes.
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- 2019
6. Adherence to guidelines of treatment of non-traumatic headache in the emergency department
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Paolo Manganotti, Laura D’Acunto, Maria Elisa Morelli, Antonio Granato, Franco Cominotto, Granato, A., Morelli, M. E., Cominotto, F., D'Acunto, L., and Manganotti, P.
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Adult ,Male ,medicine.medical_specialty ,Neurology ,Headache Disorders, Primary ,Metoclopramide ,medicine.drug_class ,International Classification of Headache Disorders ,Non-traumatic headache ,Triptans ,Hospitals, University ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Headache Disorders, Secondary ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Emergency department ,business.industry ,Not Otherwise Specified ,Headache ,General Medicine ,Length of Stay ,Middle Aged ,Treatment ,Ketorolac ,Italy ,Sedative ,Female ,International Classification of Headache Disorder ,Neurology (clinical) ,Guideline Adherence ,business ,Emergency Service, Hospital ,030217 neurology & neurosurgery ,medicine.drug - Abstract
To evaluate therapies employed in patients presenting to the emergency department (ED) with a chief complaint of non-traumatic headache to check if guidelines are followed. A 6-month retrospective analysis of the ED records of all the patients who referred to the ED of the University Hospital of Trieste for non-traumatic headache was performed. Out of 37.335 admissions, 336 patients were selected (0.9%). Diagnosis at discharge was primary headache (25.6%), secondary headache (40.5%), and headache “not otherwise specified” (33.9%). One-hundred-ninety-three patients were treated in mono- (51.8%) or poly-therapy (48.2%), with NSAIDs (46.5%), benzodiazepines (13.4%), antiemetics (10.7%), analgesics (8.3%), opioids (1.6%), triptans (1.5%), and other drugs (17.7%). NSAIDs, particularly ketorolac, are the class of drugs most often prescribed in ED, independently of the discharge diagnosis. Metoclopramide is rarely used in monotherapy (4%), but it is the drug most frequently used in association with NSAIDs (19.3%). Only two migraineurs received triptans. Mean time spent in ED was 231 ± 130 min, which was significantly longer in patients who received treatment (272 ± 141 vs. 177 ± 122 min; p = 0.003). No drugs had any side effects. In accordance with the current guidelines, NSAIDs monotherapy or in association with antiemetics were the drugs most often prescribed in ED. Opioids were rarely used probably because of potential sedative side effects. Only very few patients received triptans. Special attention should be drawn also in ED to apply the International Classification of Headache Disorders criteria, which can lead to clarify the diagnosis and receive the specific treatment.
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- 2019
7. T1-hyperintensity in the pulvinar unrelated to fabry disease or other causes of basal ganglia mineralization: A case report
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Laura D’Acunto, Paolo Manganotti, Christoph Scheurer, Fabrizio Rinaldi, Francesco Brigo, Luca Panebianco, and Bruna Nucera
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Pathology ,medicine.medical_specialty ,Neurology ,Basal ganglia ,medicine ,Neurology (clinical) ,Mineralization (soil science) ,Biology ,medicine.disease ,Fabry disease ,Hyperintensity - Published
- 2021
8. Clinical variability and the role of diagnostic criteria of cerebral amyloid angiopathy-related inflammation (CAA-RI): A case series
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Francesco Biaduzzini, Alessio Bratina, Fulvio Pasquin, Paolo Manganotti, Arianna Sartori, Laura D’Acunto, Alessandro Dinoto, and Valentina Tommasini
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Pathology ,medicine.medical_specialty ,Neurology ,business.industry ,medicine ,Inflammation ,Neurology (clinical) ,Cerebral amyloid angiopathy ,medicine.symptom ,medicine.disease ,business - Published
- 2021
9. Migraine and COVID-19 lockdown
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Sasha Olivo, Paolo Manganotti, Alex Buoite Stella, Antonio Granato, Laura D’Acunto, and Giovanni Furlanis
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medicine.medical_specialty ,Neurology ,Coronavirus disease 2019 (COVID-19) ,Migraine ,business.industry ,medicine ,Neurology (clinical) ,Psychiatry ,business ,medicine.disease ,Article - Published
- 2021
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