20 results on '"APPOLLONIO, ILDEBRANDO"'
Search Results
2. Dysgraphic features in motor neuron disease: a review.
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Aiello, Edoardo Nicolò, Feroldi, Sarah, Preti, Alice Naomi, Zago, Stefano, and Appollonio, Ildebrando Marco
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EXECUTIVE function ,NEUROPSYCHOLOGY ,SYSTEMATIC reviews ,MOTOR neuron diseases ,TASK performance ,RISK assessment ,DESCRIPTIVE statistics ,WRITTEN communication ,AGRAPHIA ,AUDITORY cortex ,DISEASE risk factors ,DISEASE complications - Abstract
Motor neuron disease (MND) patients can show oral language deficits mimicking those of frontotemporal degeneration (FTD). Although dysgraphic features have also been reported within the MND-FTD continuum, their characteristics and clinical relevance are still largely unexplored. Profiling writing disorders in MND patients can help further define their cognitive semiology and thus convey relevant clinical entailments. Therefore, this study aimed at reviewing evidence of writing impairment in MND patients. This review was implemented and reported by consulting Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Qualitative/quantitative measures of writing abilities in MND patients were the primary outcome. Both group studies and case reports/series were taken into consideration. Twenty contributions were included out of an initial N = 83. Potential biases in generalizing results were qualitatively controlled for by extracting background, disease-related, neuropsychological, and neuroanatomofunctional secondary outcomes. Fifteen studies assessed writing abilities in Japanese patients, whereas the remaining eight in western patients. Central dysgraphic features were reported in both neuropsychologically impaired and unimpaired MND patients. Non-phonologically plausible and morpho-syntactic errors were frequently reported. Although FTD was frequently co-occurent, neither cognitive nor language impairment fully accounted for writing impairment in some patients. By contrast, evidence of peripheral dysgraphia was scarce. Patients displaying writing deficits often presented with bulbar signs and perisylvian cortex involvement (including Exner's area and the left angular gyrus). Writing deficits proved to be associated with abnormalities in executive functioning and its neural substrates. Writing-to-dictation tasks as well as writing samples assessment proved to be useful to detect writing errors. Dysgraphic features in MND patients might be due to dysfunctions of the graphemic buffer. The lexico-semantic route appeared to be less involved. However, a mixed peripheral/central involvement cannot be ruled out. In this population, executive/attentive deficits are likely to contribute to writing errors as well. Writing deficits might thus be specific of MND patients' cognitive/language impairment profiles. The evaluation of writing abilities via writing-to-dictation/narrative writing tasks may be useful when assessing cognition/language in both neuropsychological-impaired and -unimpaired MND patients – especially when severe dysarthria/anarthria is present and prevents clinicians from assessing oral language. [ABSTRACT FROM AUTHOR]
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- 2022
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3. Trajectories of MMSE and MoCA scores across the healthy adult lifespan in the Italian population.
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Aiello, Edoardo Nicolò, Pasotti, Fabrizio, Appollonio, Ildebrando, and Bolognini, Nadia
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COGNITION disorders ,RESEARCH methodology evaluation ,MEDICAL screening ,DESCRIPTIVE statistics ,AGING ,COGNITIVE testing - Abstract
Background: This study compares the performance at the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) across the healthy adult lifespan in an Italian population sample. Methods: The MMSE and MoCA were administered to 407 Italian healthy native-speakers (165 males; age range 20–93 years; education range 4–25 years). A generalized Negative Binomial mixed model was run to profile MMSE and MoCA scores across 8 different age classes (≤ 30; 31–40; 41–50; 51–60; 61–70; 71–80; 81–85; ≥ 86) net of education and sex. Results: MMSE and MoCA total scores declined with age (p < 0.001), with the MoCA proving to be "more difficult" than the MMSE (p < 0.001). The Age*Test interaction (p < 0.001) indicates that the MoCA proved to profile a sufficiently linear involutional trend in cognition with advancing age and to be able to detect poorer cognitive performances in individuals aged ≥ 71 years. By contrast, MMSE scores failed in capturing the expected age-related trajectory, reaching a plateau in the aforementioned age classes. Discussion: The MoCA seems to be more sensitive than the MMSE in detecting age-related physiological decline of cognitive functioning across the healthy adult lifespan. The MoCA might be therefore more useful than the MMSE as a test for general cognitive screening aims. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Reduced phonemic fluency in progressive supranuclear palsy is due to dysfunction of dominant BA6.
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Isella, Valeria, Licciardo, Daniele, Ferri, Francesca, Crivellaro, Cinzia, Morzenti, Sabrina, Appollonio, Ildebrando, and Ferrarese, Carlo
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PROGRESSIVE supranuclear palsy ,VERBAL behavior ,QUESTIONNAIRES ,SPEECH - Abstract
Background: Reduced phonemic fluency is extremely frequent in progressive supranuclear palsy (PSP), but its neural correlate is yet to be defined. Objective: We explored the hypothesis that poor fluency in PSP might be due to neurodegeneration within a dominant frontal circuit known to be involved in speech fluency, including the opercular area, the superior frontal cortex (BA6), and the frontal aslant tract connecting these two regions. Methods: We correlated performance on a letter fluency task (F, A, and S, 60 s for each letter) with brain metabolism as measured with Fluoro-deoxy-glucose Positron Emission Tomography, using Statistical Parametric Mapping, in 31 patients with PSP. Results: Reduced letter fluency was associated with significant hypometabolism at the level of left BA6. Conclusion: Our finding is the first evidence that in PSP, as in other neurogical disorders, poor self-initiated, effortful verbal retrieval appears to be linked to dysfunction of the dominant opercular-aslant-BA6 circuit. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Equating Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores: conversion norms from a healthy Italian population sample.
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Aiello, Edoardo Nicolò, Pasotti, Fabrizio, Appollonio, Ildebrando, and Bolognini, Nadia
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PUBLIC health surveillance ,HEALTH status indicators ,MEDICAL screening ,NEUROPSYCHOLOGICAL tests ,PSYCHOMETRICS ,PSYCHOSOCIAL factors ,DESCRIPTIVE statistics ,COGNITIVE testing - Abstract
Background: This study aimed to provide equating norms for the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) from a sample of healthy Italian adults. Methods: Four-hundred and seven Italian healthy adults (165 males, 242 females; mean age = 60.61 ± 13.74 years, range= 20–93; mean education = 12.2 ± 4.42 years, range= 4–25) were administered the MMSE and the MoCA. 'MMSE-to-MoCA' and 'MoCA-to-MMSE' conversion tables were derived via log-linear smoothing equi-percentile equating (LSEE). Equivalence between empirical and conversion-derived scores was determined with a two one-sided test (TOST) procedure. Results: Conversion-derived scores were statistically equivalent to empirical ones for both the MMSE (p = 0.948) and the MoCA (p = 0.437). The LSEE yielded impossible/unreliable conversion estimates for floor scores on both tests, whereas conversions for uppermost scores were highly consistent. Discussion: The present data will help avoid inter-rater heterogeneity in cross-sectionally and longitudinally adopting either one of the two cognitive screening tests, and to retrospective analyze data collected via either one test or the other. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Brand new norms for a good old test: Northern Italy normative study of MiniMental State Examination.
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Foderaro, Giuseppe, Isella, Valeria, Mazzone, Andrea, Biglia, Elena, Di Gangi, Marco, Pasotti, Fabrizio, Sansotera, Flavia, Grobberio, Monica, Raimondi, Vanessa, Mapelli, Cristina, Ferri, Francesca, Impagnatiello, Valentina, Ferrarese, Carlo, and Appollonio, Ildebrando Marco
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COGNITION disorders diagnosis ,AGE distribution ,COGNITION ,NEUROPSYCHOLOGICAL tests ,PSYCHOLOGICAL tests - Abstract
Aim: Mini-Mental State Examination (MMSE) is one of the most used tests for the screening of global cognition in patients with neurological and medical disorders. Norms for the Italian version of the test were published in the 90 s; more recent norms were published in 2020 for Southern Italy only. In the present study, we computed novel adjustment coefficients, equivalent scores and cut-off value for Northern Italy (Lombardia and Veneto) and Italian speaking Switzerland.Methods: We recruited 361 healthy young and old (range: 20-95 years) individuals of both sexes (men: 156, women: 205) and from different educational levels (range: 4-22 years). Neuropsychiatric disorders and severe medical conditions were excluded with a questionnaire and cognitive deficits and were ruled out with standardized neuropsychological tests assessing the main cognitive domains. We used a slightly modified version of MMSE: the word 'fiore' was replaced with 'pane' in verbal recalls to reduce the common interference error 'casa, cane, gatto'. The effect of socio-demographic features on performance at MMSE was assessed via multiple linear regression, with test raw score as dependent variable and sex, logarithm of 101-age and square root of schooling as predictors.Results: Mean raw MMSE score was 28.8 ± 1.7 (range: 23-30). Multiple linear regression showed a significant effect of all socio-demographic variables and reported a value of R2 = 0.26. The new cut off was ≥ 26 /30.Conclusion: We provide here updated norms for a putatively more accurate version of Italian MMSE, produced in a Northern population but potentially valid all over Italy. [ABSTRACT FROM AUTHOR]- Published
- 2022
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7. Telephone Interview for Cognitive Status (TICS): Italian adaptation, psychometrics and diagnostics.
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Aiello, Edoardo Nicolò, Esposito, Antonella, Giannone, Ilaria, Diana, Lorenzo, Appollonio, Ildebrando, and Bolognini, Nadia
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RESEARCH evaluation ,TELEPHONES ,COGNITION ,PSYCHOMETRICS ,SENSITIVITY & specificity (Statistics) - Abstract
Background: Telephone-based cognitive screening (TBCS) is crucial to telehealth care of neurological patients, prevention campaigns, and epidemiological studies on cognitive impairment. The Telephone Interview for Cognitive Status (TICS) is one of the most widespread and psychometrically/diagnostically sound TBCS test, with several versions developed worldwide (e.g., with and without a delayed recall item). In Italy, only attempts of adaptation and preliminary evidence of its statistical features have been provided so far. This study thus aimed at (1) developing an Italian version of the TICS and assessing its (2) psychometric and (3) diagnostic properties.Methods: A back-translated and culturally adapted version of the TICS was developed. Three-hundred and sixty-five healthy individuals from different regions of Italy (147 males, 216 females; age: 53.2 ± 16 years; education: 13 ± 4.5 years) were administered the TICS and the Italian telephone-based Mini-Mental State Examination (Itel-MMSE). Validity was tested by convergence and at the structure level, whereas reliability as internal consistency, test-retest, and inter-rater. Diagnostic accuracy, item difficulty, and discrimination were also examined.Results: The TICS featured a single component and its score converged with that of the Itel-MMSE (rs = .37). Reliability was excellent as inter-rater (ICC = .94), good as test-retest (ICC = .78), and acceptable as internal consistency (Cronbach's α = .63). Accuracy was high as tested against the Itel-MMSE (AUC = .83) and did not improve when adding the delayed recall. Backward subtraction was the most difficult and discriminative task.Discussion: The Italian TICS is a valid, reliable, and diagnostically accurate TBCS test. The original format of the TICS can be thus adopted in both clinical and research settings. [ABSTRACT FROM AUTHOR]- Published
- 2022
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8. Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults.
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Aiello, Edoardo Nicolò, Esposito, Antonella, Appollonio, Ildebrando, and Bolognini, Nadia
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COGNITION disorders diagnosis ,EXECUTIVE function ,PREDICTIVE tests ,RESEARCH evaluation ,AGE distribution ,RESEARCH methodology ,NEUROPSYCHOLOGICAL tests ,DESCRIPTIVE statistics ,COGNITIVE testing ,SENSITIVITY & specificity (Statistics) ,RECEIVER operating characteristic curves ,ADULTS ,MIDDLE age ,OLD age - Abstract
Background: Sub-clinical cognitive efficiency deficits of a dysexecutive nature are moderately prevalent in healthy older adults and negatively affect their functional outcomes. To screen for such dysfunctions, the Frontal Assessment Battery (FAB) provided promising evidence, although its diagnostic properties have not been tested to date. This study thus aimed at exploring the performance on the FAB of a large sample of Italian healthy adults and comparing it in individuals aged < 75 years vs. ≥ 75 years. Methods: Four hundred and seventy-five healthy adults (169 males, 306 females, age: 61.1 ± 15.1; education 11.7 ± 4.6) were administered the FAB and the Montreal Cognitive Assessment (MoCA). Sensitivity, specificity, positive and negative predictive values and likelihood ratios were computed through receiver-operating characteristics analyses by addressing an above- vs. below-cutoff performance on the MoCA as the state variable (as including measures of executive functioning). Results: The FAB overall showed good accuracy (AUC = 0.71–0.76), although higher for healthy older adults. A trend towards higher specificity (64.4–80.3%) than sensitivity (61.1–77.8%) was found, despite these metrics being comparable in healthy older adults. Negative predictive values (0.98–0.99) were systematically higher than positive predictive values (0.05–0.24), whereas consistent post-test probabilities were detected (positive likelihood ratios: 2.19–3.35; negative likelihood ratios: 0.28–0.48). Discussion: The FAB is an accurate test for the first-level assessment of dysexecutive-related global cognitive inefficiency in the general population, despite being moderately conservative as far as both its pre- and post-test features are concerned. Its diagnostic value is more informative for individuals aged ≥ 75 years. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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9. The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy.
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Aiello, Edoardo Nicolò, Gramegna, Chiara, Esposito, Antonella, Gazzaniga, Valentina, Zago, Stefano, Difonzo, Teresa, Maddaluno, Ottavia, Appollonio, Ildebrando, and Bolognini, Nadia
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REFERENCE values ,COGNITION ,PSYCHOMETRICS ,DESCRIPTIVE statistics - Abstract
Background: The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage; (iii) information on sensitivity and discriminative capability at the item level. Methods: Five hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females; age: 63.4 ± 15, 21–96; education: 11.3 ± 4.6, 1–25) were administered the MoCA. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Average ESs were also computed. Agreement with previous ESs classification was assessed via Cohen's k. Results: Age and education significantly predicted all MoCA measures except for Orientation, which was related to age only. No sex differences were detected when tested along with age and education. Substantial disagreements with previous ESs classifications were detected. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. Discussion: Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Delirium in your house: a survey during General Practitioner-programmed home visits.
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Tremolizzo, Lucio, Bargossi, Lorena, Storti, Benedetta, Ferrarese, Carlo, Bellelli, Giuseppe, and Appollonio, Ildebrando
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SCIENTIFIC observation ,HOME care services ,PHYSICIAN-patient relations ,POLYPHARMACY ,MEDICAL screening ,MOTOR neuron diseases ,DEMENTIA patients ,BENZODIAZEPINES ,DELIRIUM ,DISEASE prevalence ,AT-risk people ,DESCRIPTIVE statistics ,MEDICAL appointments ,DRUG utilization ,TRANQUILIZING drugs ,COMORBIDITY ,DISEASE complications ,OLD age - Abstract
Objectives: To assess the prevalence of delirium (DEL) among older patients living at home and periodically visited by their General Practitioners (GPs). Design: Observational study. Setting: In Italy, programmed home visits by the GPs are regularly scheduled for their vulnerable and frail patients who are often on poly-drug regimens and suffering from dementia. Participants: N = 102 patients among those receiving programmed home visits by n = 6 GP based in the Brianza area (Lombardy). Measurements: Patients were screened for delirium with the Italian version of the 4AT, with a score ≥ 4 considered as a positive indicator for DEL. The Charlson Comorbidity Index (CCI), the Short Physical Performance Battery (SPPB), the presence of dementia, and benzodiazepine (BZD) use were recorded. Results: DEL+ was detected in almost half of the recruited sample (44.1%), and it was clearly associated with increased comorbidity and decreased motor abilities. Pre-existing dementia was documented in most of DEL+ patients (71.1%), while this was the case for only a minority of DEL- (5.2%, p < 0.00001). Analogously, BZD use was over-represented in the DEL+ group with respect to the DEL− one (73.3% vs. 22.8%, p < 0.00001). Conclusions: DEL prevalence as detected by GP during programmed home visits is surprisingly high, and related to motor impairment, comorbidities (among which dementia), and BZD use. DEL prompt recognition should be one of the goals of GP-programmed home visits, since this treatable and preventable condition is associated to an elevated burden of frailty and risk of death. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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11. Generation and validation of algorithms to identify subjects with dementia using administrative data.
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DiFrancesco, Jacopo C., Pina, Alessandra, Giussani, Giorgia, Cortesi, Laura, Bianchi, Elisa, Cavalieri d'Oro, Luca, Amodio, Emanuele, Nobili, Alessandro, Tremolizzo, Lucio, Isella, Valeria, Appollonio, Ildebrando, Ferrarese, Carlo, and Beghi, Ettore
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DEMENTIA ,NEUROPSYCHOLOGICAL tests ,CHOLINESTERASE inhibitors ,GENERAL practitioners ,ALGORITHMS ,DATABASES ,MEDICAL records ,DISEASE prevalence ,QUESTIONNAIRES ,ECONOMIC aspects of diseases - Abstract
Objectives: To generate and validate algorithms for the identification of individuals with dementia in the community setting, by the interrogation of administrative records, an inexpensive and already available source of data.Methods: We collected and anonymized information on demented individuals 65 years of age or older from ten general practitioners (GPs) in the district of Brianza (Northern Italy) and compared this with the administrative data of the local health protection agency (Agenzia per la Tutela della Salute). Indicators of the disease in the administrative database (diagnosis of dementia in the hospital discharge records; use of cholinesterase inhibitors/memantine; neuropsychological tests; brain CT/MRI; outpatient neurological visits) were used separately and in different combinations to generate algorithms for the detection of patients with dementia.Results: When used individually, indicators of dementia showed good specificity, but low sensitivity. By their combination, we generated different algorithms: I-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests (specificity 97.9%, sensitivity 52.5%); II-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests or brain CT/MRI or neurological visit (sensitivity 90.8%, specificity 70.6%); III-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests or brain CT/MRIMRI and neurological visit (specificity 89.3%, sensitivity 73.3%).Conclusions: These results show that algorithms obtained from administrative data are not sufficiently accurate in classifying patients with dementia, whichever combination of variables is used for the identification of the disease. Studies in large patient cohorts are needed to develop further strategies for identifying patients with dementia in the community setting. [ABSTRACT FROM AUTHOR]- Published
- 2019
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12. Correction to: The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy.
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Aiello, Edoardo Nicolò, Gramegna, Chiara, Esposito, Antonella, Gazzaniga, Valentina, Zago, Stefano, Difonzo, Teresa, Maddaluno, Ottavia, Appollonio, Ildebrando, and Bolognini, Nadia
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PSYCHOMETRICS ,COGNITIVE testing - Published
- 2022
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13. Neuroleptic Equivalent Dose Differences and Behavioral and Psychological Symptoms of Dementia.
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Tremolizzo, Lucio, Tironi, Marco, Ferrarese, Carlo, and Appollonio, Ildebrando
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PHARMACEUTICAL arithmetic ,DIAGNOSIS of dementia ,RISK management in business ,ANTIPSYCHOTIC agents ,RESEARCH methodology ,RESEARCH ,RESEARCH funding ,TIME ,BEHAVIOR disorders ,RETROSPECTIVE studies - Abstract
No abstract available [ABSTRACT FROM AUTHOR]
- Published
- 2013
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14. Founder effect and estimation of the age of the Progranulin Thr272fs mutation in 14 Italian pedigrees with frontotemporal lobar degeneration
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Borroni, Barbara, Bonvicini, Cristian, Galimberti, Daniela, Tremolizzo, Lucio, Papetti, Alice, Archetti, Silvana, Turla, Marinella, Alberici, Antonella, Agosti, Chiara, Premi, Enrico, Appollonio, Ildebrando, Rainero, Innocenzo, Ferrarese, Carlo, Gennarelli, Massimo, Scarpini, Elio, and Padovani, Alessandro
- Subjects
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FRONTAL lobe diseases , *TEMPORAL lobe , *NEURODEGENERATION , *GENETIC mutation , *FRONTOTEMPORAL dementia , *GENEALOGY - Abstract
Abstract: Progranulin (PGRN) mutations have been recognized to be monogenic causes of frontotemporal lobar degeneration (FTLD). PGRN Thr272fs mutation in the Italian population has been previously identified. In the present study, we evaluated the occurrence of a founder effect studying 8 polymorphic microsatellite markers flanking the PGRN gene in 14 apparently unrelated families. We identified a common haplotype associated with PGRN Thr272fs carriers, assuming common ancestry. The inferred age analysis (range between 260 [95% credible set: 227–374] and 295 [95% credible set: 205–397] generations) places the introduction of the mutation back to the Neolithic era when the Celts, the population of that period, settled in Northern Italy. PGRN Thr272fs mutation appears to be as either behavioral frontotemporal dementia (80%) or primary progressive aphasia (20%), it was equally distributed between male and female, and the mean age at onset was 59.6 ± 5.9 (range 53–68). In 14 families, autosomal dominant pattern of inheritance was present in 64.2% of cases. No clinical predictors of disease onset were demonstrated. The identification of a large cohort of frontotemporal lobar degeneration (FTLD) patients with homogeneous genetic background well may be used in the search of disease modulators to elucidate genotype-phenotype correlations of progranulopathies. [Copyright &y& Elsevier]
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- 2011
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15. Clinical and neuroanatomical characterization of the semantic behavioral variant of frontotemporal dementia in a multicenter Italian cohort.
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Ghirelli A, Spinelli EG, Canu E, Basaia S, Castelnovo V, Cecchetti G, Sibilla E, Domi T, Magnani G, Caso F, Caroppo P, Prioni S, Villa C, Rossi G, Tremolizzo L, Appollonio I, Verde F, Ticozzi N, Silani V, Filippi M, and Agosta F
- Subjects
- Humans, Female, Italy, Male, Middle Aged, Aged, Temporal Lobe pathology, Temporal Lobe diagnostic imaging, Cohort Studies, Neuropsychological Tests, Aphasia, Primary Progressive pathology, Aphasia, Primary Progressive diagnostic imaging, Retrospective Studies, Gray Matter pathology, Gray Matter diagnostic imaging, Frontotemporal Dementia pathology, Frontotemporal Dementia diagnostic imaging, Frontotemporal Dementia physiopathology, Magnetic Resonance Imaging, Atrophy pathology
- Abstract
Background: Semantic behavioral variant frontotemporal dementia (sbvFTD) is a neurodegenerative condition presenting with specific behavioral and semantic derangements and predominant atrophy of the right anterior temporal lobe (ATL). The objective was to evaluate clinical, neuropsychological, neuroimaging, and genetic features of an Italian sbvFTD cohort, defined according to recently proposed guidelines, compared to semantic variant primary progressive aphasia (svPPA) and behavioral variant FTD (bvFTD) patients., Methods: Fifteen sbvFTD, sixty-three bvFTD, and twenty-five svPPA patients and forty controls were enrolled. Patients underwent clinical, cognitive evaluations, and brain MRI. Symptoms of bvFTD patients between onset and first visit were retrospectively recorded and classified as early and late. Grey matter atrophy was investigated using voxel-based morphometry., Results: sbvFTD experienced early criteria-specific symptoms: world, object and person-specific semantic loss (67%), complex compulsions and rigid thought (60%). Sequentially, more behavioral symptoms emerged (apathy/inertia, loss of empathy) along with non-criteria-specific symptoms (anxiety, suspiciousness). sbvFTD showed sparing of attentive/executive functions, especially compared to bvFTD and better language functions compared to svPPA. All sbvFTD patients failed at the famous face recognition test and more than 80% failed in understanding written metaphors and humor. At MRI, sbvFTD had predominant right ATL atrophy, almost specular to svPPA. Three sbvFTD patients presented pathogenic genetic variants., Conclusion: We replicated the application of sbvFTD diagnostic guidelines in an independent Italian cohort, demonstrating that the presence of person-specific semantic knowledge loss and mental rigidity, along with preserved executive functions and a predominant right ATL atrophy with sparing of frontal lobes, should prompt a diagnosis of sbvFTD., (© 2024. The Author(s).)
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- 2024
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16. Clinimetrics of the cognitive section of the Italian ALS Cognitive Behavioral Screen (ALS-CBS™).
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Aiello EN, Greco LC, La Tona A, Solca F, Torre S, Carelli L, Pain D, Radici A, Lizio A, Casiraghi J, Cerri F, Brugnera A, Compare A, Woolley S, Murphy J, Tremolizzo L, Appollonio I, Verde F, Silani V, Ticozzi N, Lunetta C, Sansone VA, and Poletti B
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- Humans, Reproducibility of Results, Neuropsychological Tests, Italy, Cognition physiology, Cognition Disorders diagnosis, Cognition Disorders etiology, Amyotrophic Lateral Sclerosis complications, Amyotrophic Lateral Sclerosis diagnosis, Amyotrophic Lateral Sclerosis psychology, Cognitive Dysfunction diagnosis
- Abstract
Background: The present study aimed at (1) providing further validity and reliability evidence for the Italian version of the cognitive section of the ALS Cognitive Behavioral Screen (ALS-CBS™) and (2) testing its diagnostics within an Italian ALS cohort, as well as at (3) exploring its capability to discriminate patients from healthy controls (HCs)., Methods: N = 293 non-demented ALS patients were administered the cognitive sections of the ALS-CBS™ and Edinburgh Cognitive and Behavioural ALS Screen (ECAS). N = 96 HCs demographically matched with N = 96 patients were also administered the cognitive section of the ALS-CBS™. In patients, factorial and construct validity, internal reliability, and diagnostics against a defective score on the cognitive section of the ECAS were tested. Case-control discrimination was assessed via a logistic regression., Results: ALS-CBS™ cognitive subscales were underpinned by a simple, unidimensional structure, internally reliable (McDonald's ω = 0.74), and mostly related with ECAS executive and fluency scores (r
s = 0.54-0.71). Both raw and age- and education-adjusted scores on the cognitive section of the ALS-CBS™ accurately detected ECAS-defined cognitive impairment (AUC = 0.80 and .88, respectively), yielding optimal error-based, information-based and unitary diagnostics. A cut-off of < 15.374 was identified on adjusted scores. The test was able to discriminate patients from HCs (p < 0.001)., Discussion: The cognitive section of the Italian ALS-CBS™ is a valid, reliable, and diagnostically sound ALS-specific screener for detecting frontotemporal, executive-/attentive-based cognitive inefficiency in non-demented ALS patients, being also able to discriminate them from normotypical individuals., (© 2022. Fondazione Società Italiana di Neurologia.)- Published
- 2023
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17. Psychometrics, diagnostics and usability of Italian tools assessing behavioural and functional outcomes in neurological, geriatric and psychiatric disorders: a systematic review.
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Aiello EN, D'Iorio A, Montemurro S, Maggi G, Giacobbe C, Bari V, Di Tella GS, Pischedda F, Bolognini N, Appollonio I, Arcara G, and Santangelo G
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- Humans, Aged, Psychometrics, Reproducibility of Results, Italy, Quality of Life, Mental Disorders diagnosis, Mental Disorders therapy
- Abstract
Background: Psychometric instruments assessing behavioural and functional outcomes (BFIs) in neurological, geriatric and psychiatric populations are relevant towards diagnostics, prognosis and intervention. However, BFIs often happen not to meet methodological-statistical standards, thus lowering their level of recommendation in clinical practice and research. This work thus aimed at (1) providing an up-to-date compendium on psychometrics, diagnostics and usability of available Italian BFIs and (2) delivering evidence-based information on their level of recommendation., Methods: This review was pre-registered (PROSPERO ID: CRD42021295430) and performed according to PRISMA guidelines. Several psychometric, diagnostic and usability measures were addressed as outcomes. Quality assessment was performed via an ad hoc checklist, the Behavioural and Functional Instrument Quality Assessment., Results: Out of an initial N = 830 reports, 108 studies were included (N = 102 BFIs). Target constructs included behavioural/psychiatric symptoms, quality of life and physical functioning. BFIs were either self- or caregiver-/clinician-report. Studies in clinical conditions (including neurological, psychiatric and geriatric ones) were the most represented. Validity was investigated for 85 and reliability for 80 BFIs, respectively. Criterion and factorial validity testing were infrequent, whereas content and ecological validity and parallel forms were almost never addressed. Item response theory analyses were seldom carried out. Diagnostics and norms lacked for about one-third of BFIs. Information on administration time, ease of use and ceiling/floor effects were often unreported., Discussion: Several available BFIs for the Italian population do not meet adequate statistical-methodological standards, this prompting a greater care from researchers involved in their development., (© 2022. The Author(s).)
- Published
- 2022
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18. Italian telephone-based Mini-Mental State Examination (Itel-MMSE): item-level psychometric properties.
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Aiello EN, Esposito A, Pucci V, Mondini S, Bolognini N, and Appollonio I
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- Aged, Aged, 80 and over, Female, Humans, Italy, Male, Psychometrics, Telephone
- Abstract
Background: The Italian telephone-based Mini-Mental State Examination (Itel-MMSE), despite being psychometrically sound, has shown relevant ceiling effects, which may negatively impact the interpretation of its scores. In address to overcome such an issue, this study aimed at providing item-level insights on the Itel-MMSE through Item Response Theory (IRT) analyses., Methods: Five-hundred and sixty-seven healthy Italian adults (227 males, 340 females; mean age: 51 ± 17 years, range 18-96; mean education: 13.31 ± 4.3 years). A two-parameter logistic IRT model was implemented to assess item discrimination and difficulty of the Itel-MMSE. Construct unidimensionality, statistical independence of items, and model and item fit were tested. Informativity levels were also assessed graphically., Results: With respect to the Itel-MMSE total score, ceiling effects were found in 92.7% of participants. Unidimensionality was violated; both model and item fit were poor; a few items showed statistical dependence. Both the whole test and its items proved to be scarcely informative, especially for medium-to-high levels of ability, except for attention and spatial orientation subtests, which consistently yielded the highest discriminative capability., Discussion: The Itel-MMSE appears to be most informative in low-performing healthy individuals. However, the present findings should not lead practitioners to aprioristically equate ceiling effects/low informativity to clinical uselessness. Items assessing attention and, to a lesser extent, spatial orientation appear to be the most informative., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
- Published
- 2022
- Full Text
- View/download PDF
19. ALS Cognitive Behavioral Screen (ALS-CBS): normative values for the Italian population and clinical usability.
- Author
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Tremolizzo L, Lizio A, Santangelo G, Diamanti S, Lunetta C, Gerardi F, Messina S, La Foresta S, Riva N, Falzone Y, Filippi M, Woolley SC, Sansone VA, Siciliano M, Ferrarese C, and Appollonio I
- Subjects
- Adult, Aged, Aged, 80 and over, Behavioral Symptoms etiology, Cognitive Dysfunction etiology, Female, Humans, Italy, Male, Middle Aged, Reference Values, Young Adult, Amyotrophic Lateral Sclerosis complications, Behavioral Symptoms diagnosis, Cognitive Dysfunction diagnosis, Neuropsychological Tests standards
- 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
- Full Text
- View/download PDF
20. Frequency and clinical features of Lewy body dementia in Italian memory clinics.
- Author
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Farina E, Baglio F, Caffarra P, Magnani G, Scarpini E, Appollonio I, Bascelli C, Cheldi A, Nemni R, Franceschi M, Messa G, Mantovani F, Bellotti M, Olivotto F, Alberoni M, Isella V, Regazzoni R, Schiatti E, Vismara C, Falautano M, Barbieri A, Restelli I, Fetoni V, Donato M, Zuffi M, and Castiglioni S
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Diagnostic Imaging, Electroencephalography, Female, Hospitals, Psychiatric, Humans, Italy, Lewy Body Disease diagnosis, Male, Middle Aged, Neuropsychological Tests, Prevalence, Psychotropic Drugs therapeutic use, Retrospective Studies, Autonomic Nervous System Diseases epidemiology, Behavioral Symptoms epidemiology, Lewy Body Disease complications, Lewy Body Disease psychology, Perceptual Disorders epidemiology
- Abstract
Background: The latest developments in Lewy Body Dementia (DLB) raise some controversies on clinical features, neuroimaging and therapy. The aim of our study is to determine clinical, neuropsychological, neuroimaging and EEG profile of DLB through retrospective and prospective data of 102 patients., Methods: data were collected with an analytical form that was developed by an expertise of neurologists., Results: DLB represented 4.8% of the dementia population, with no sex difference. Family history of dementia was common (24.5%), while familiarity for parkinsonism was rare (4.9%). Cognitive disturbances were the predominant clinical presentation at onset (49%), followed by behavioral symptoms (29.4%) and parkinsonism (21.6%). Clinical features at consultation were: memory disturbances (almost all cases), symmetrical (68.6%) or asymmetrical (18.6%) parkinsonism, cognitive fluctuations (49%), visuospatial deficits (53.9%), and visual hallucinations (44.1%). Autonomic signs were present in a third of the cases, while sleep disorders were present in 44.1%. Some clinical response to antiparkinsonian drugs was evident in half of the cases. MRI, SPET, EEG and Neuropsychiatric Inventory data were available in a subgroup of patients., Conclusions: Most of our data were in accordance with the previous literature. However, some data underline the relationship between DLB, Alzheimer's and Parkinson's disease.
- Published
- 2009
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