149 results on '"Quatrale, R"'
Search Results
102. The power spectral analysis of the monocular and binocular visual evoked potentials
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Serra, G., VALERIA TUGNOLI, Eleopra, R., Quatrale, R., and Navarra, R.
103. Botulinum toxin for the treatment of focal hyperhidrosis,La tossina botulinica nel trattamento delle iperidrosi focali
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Tugnoli, V., Roberto Eleopra, Quatrale, R., Capone, J. G., Sensi, M., and Gastaldo, E.
104. Neurophysiological evaluation of the muscular hypotrophy after immobilization
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Serra, G., VALERIA TUGNOLI, Eleopra, R., Quatrale, R., Faccini, R., and Basaglia, N.
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Adult ,Physiology ,Neurology (clinical) ,Immobilization ,Muscular Atrophy ,Electromyography ,Humans ,NO - Abstract
Muscular hypotrophy due to arm or leg immobilization (MH) in absence of neuromuscular pathologies was tested by EMG spectral analysis, in order to identify a possible neurophysiological method able to analyze this kind of particular clinical picture. Two different groups of patients were tested. In group 1 the patients were suffering from vastus medialis muscle MH due to meniscus surgery, in group 2 the patients were suffering from biceps brachii muscle MH after humerus fracture. A significant difference between normal and pathological muscles was found and the methods may be useful in the neurophysiological evaluation of MH.
105. [Quantitative analysis of central and peripheral acoustic pathway conduction in man]
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Serra G, Quatrale R, Munerati V, Mc, Cristofori, Tugnoli V, and Roberto Eleopra
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Electrophysiology ,Acoustic Stimulation ,Evoked Potentials, Auditory ,Humans ,Brain Stem
106. The role of soinatosensory evoked potentials in spinal surgery,Il ruolo dei potenziali evocati somatosensoriali nella chirurgia spinale
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Quatrale, R., Gastaldo, E., Diozzi, E., and VALERIA TUGNOLI
107. Efficacy of erythropoietin in amyotrophic lateral sclerosis: a multicentre, randomised, double blind, placebo controlled, phase III study (IPOS TRIAL)
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Lauria, G., Dalla Bella, E., Borghero, G., Capasso, M., Caponnetto, C., Chiò, A., Corbo, M., Eleopra, R., Fazio, R., Filosto, M., Giannini, F., Granieri, E., La Bella, V., Logroscino, G., JESSICA MANDRIOLI, Mazzini, L., Monsurrò, Mr, Mora, G., Morino, S., Pietrini, V., Quatrale, R., Rizzi, R., Salvi, F., Siciliano, G., Sorarù, G., Volanti, P., Tramacere, I., and Filippini, G.
108. Botulinum toxin in the treatment of spasticity,Il trattamento della spasticità con tossina botulinica
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Eleopra, R., Quatrale, R., and VALERIA TUGNOLI
109. [Treatment of spasticity with botulinum toxin]
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Roberto Eleopra, Quatrale R, and Tugnoli V
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Botulinum Toxins ,Anti-Dyskinesia Agents ,Muscle Spasticity ,Humans
110. La tossina botulinica nel trattamento delle iperidrosi focali
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Tugnoli, V., Eleopra, R., Quatrale, R., Jay Guido Capone, Sensi, M., and Gastaldo, E.
111. The excitability of the trigeminal motor system in sleep bruxism: A transcranial magnetic stimulation and brainstem reflex study
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Gastaldo E, Quatrale R, Graziani A, Eleopra R, Tugnoli V, Tola MR, and Enrico Granieri
112. The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson’s disease
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L Grasso, Silvia Ramat, Simone Gallerini, Paolo Barone, G. Di Brigida, D. Fogli, Tommaso Scaravilli, M. Braga, Alessandra Nicoletti, M. Romeno, Paolo Martinelli, G. Gurgone, Cesare Colosimo, E. Pilleri, V. Sorbello, S. Amidei, F. Pennisi, Francesco Iemolo, Giorgio Trianni, Vincenzo Toni, E. Milan, Raffaele Palladino, D. Benincasa, Giovanni Pezzoli, M. G. Randisi, Alfredo Petrone, Arianna Guidubaldi, R. Alfano, Tania P. Avarello, A. Scaglioni, Anna Rita Bentivoglio, C. Modica, L. Ferigo, M. Manfredi, Domenico Consoli, Giuseppe Meco, Giampiero Volpe, S. Griffini, Francesca Morgante, R. Scala, G. Nordera, Angelo Antonini, G. Floris, Roberto Erro, R. Muoio, Salvatore Zappulla, Luigi Bartolomei, Edo Bottacchi, Antonio Pisani, V. Petretta, Giovanni Fabbrini, G. Ciacci, L. Maiello, G. Ceravolo, M. Di Giovanni, V. Nastasi, Rocco Quatrale, D. Tiple, Marcello Deriu, S. Lanfranchi, Marianna Capecci, Alberto Albanese, T. Cuomo, Francesco E. Pontieri, Vincenzo Moschella, G. Sciortino, F. A. De Falco, S. Biguzzi, Leonardo Lopiano, Marina Picillo, C. Alesi, D. De Gaspari, Michele Abrignani, Gabriella Santangelo, Fabrizio Stocchi, R. Luciano, M. Baratti, R. M. Giglia, Cesa Scaglione, B. Troianiello, Giovanni Abbruzzese, M. Mucchiut, F. Pepe, S. Zanini, L. Capus, N. Caravona, Giovanni Cossu, V. Agnetti, G. Albani, L. Kiferle, E. Giaccaglini, Roberto Marconi, M. Iellamo, R. Marano, D. Medici, Monica Ulivelli, G. A. Cocco, M. Perini, P. Del Dotto, Rosa M. Gaglio, Rodolfo Savica, C. Logi, G. Ciccarelli, P. Massimo, M. Pesare, Antonino Cannas, Roberto Ceravolo, P. Simone, Letterio Morgante, P. Soliveri, S. Meoni, Picillo, M., Palladino, R., Erro, R., Alfano, R., Colosimo, C., Marconi, R., Antonini, A., Barone, P., Morgante, L., Benincasa, D., Quatrale, R., Biguzzi, S., Braga, M., Ceravolo, G., Capecci, M., Meco, G., Caravona, N., Scala, R., De Falco, F. A., Pezzoli, G., De Gaspari, D., Bottacchi, E., Di Giovanni, M., Cannas, A., Floris, G., Gallerini, S., Grasso, L., Gaglio, R. M., Gurgone, G., Volpe, G., Zappulla, S., Ceravolo, R., Kiferle, L., Ramat, S., Meoni, S., Pisani, A., Moschella, V., Morgante, F., Savica, R., Pepe, F., Ciccarelli, G., Petretta, V., Giglia, R. M., Randisi, M. G., Iemolo, F., Avarello, T. P., Romeno, M., Santangelo, G., Stocchi, F., Sciortino, G., Sorbello, V., Nicoletti, A., Tiple, D., Fabbrini, G., Bentivoglio, A., Pontieri, F. E., Guidubaldi, A., Muoio, R., Toni, V., Del Dotto, P., Logi, C., Ciacci, G., Ulivelli, M., Perini, M., Lanfranchi, S., Griffini, S., Troianiello, B., Baratti, M., Amidei, S., Consoli, D., Iellamo, M., Cuomo, T., Scaglioni, A., Medici, D., Manfredi, M., Abbruzzese, G., Di Brigida, G., Cocco, G. A., Agnetti, V., Cossu, G., Deriu, M., Abrignani, M., Modica, C., Albani, G., Milan, E., Martinelli, P., Scaglione, C., Mucchiut, M., Zanini, S., Pennisi, F., Soliveri, P., Albanese, A., Massimo, P., Bartolomei, L., Capus, L., Ferigo, L., Marano, R., Nastasi, V., Luciano, R., Maiello, L., Simone, P., Fogli, D., Lopiano, L., Pesare, M., Nordera, G., Pilleri, E., Scaravilli, T., Giaccaglini, E., Alesi, C., Petrone, A., and Trianni, G.
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Male ,Neurology ,Parkinson's disease ,Constipation ,Heterogeneity ,Parkinson ,Phenotype ,Prodromal ,Sex ,PROGRESSION ,Disease ,0302 clinical medicine ,Apathy ,Neuroradiology ,Original Communication ,Cognition ,Parkinson Disease ,030211 gastroenterology & hepatology ,Female ,medicine.symptom ,NONMOTOR SYMPTOMS ,Life Sciences & Biomedicine ,PRIAMO study group ,Human ,medicine.medical_specialty ,Clinical Neurology ,Prodromal Symptoms ,Prodromal Symptom ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Clinical phenotype ,Aged ,Science & Technology ,Neurology & Neurosurgery ,business.industry ,1103 Clinical Sciences ,Biomarker ,medicine.disease ,DYSFUNCTION ,Biomarkers ,Neurology (clinical) ,Neurosciences & Neurology ,business ,1109 Neurosciences ,030217 neurology & neurosurgery - Abstract
Objectives To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson’s disease at early stages. Methods A total of 385 Parkinson’s disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women). Results As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only. Conclusions Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson’s disease may impact disease phenotype.
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- 2021
113. Caregiver burden and its related factors in advanced Parkinson's disease: data from the PREDICT study
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Leonardo Lopiano, Paolo Solla, Mariachiara Sensi, Giovanni Defazio, Rocco Quatrale, Nicola Tambasco, Anna Maria Costanzo, Pietro Marano, Angelo Antonini, Umberto di Luzio Paparatti, Francesco E. Pontieri, Nicola Modugno, Alessandro Tessitore, Gabriella Melzi, Margherita Canesi, Giuliana Gualberti, Anna Latorre, Tessitore, A., Marano, P., Modugno, N., Pontieri, F. E., Tambasco, N., Canesi, M., Latorre, A., Lopiano, L., Sensi, M., Quatrale, R., Solla, P., Defazio, G., Melzi, G., Costanzo, A. M., Gualberti, G., di Luzio Paparatti, U., and Antonini, A.
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Male ,Neurology ,Parkinson's disease ,Apomorphine ,Cross-sectional study ,Socioeconomic Factor ,Antiparkinson Agents ,Levodopa ,0302 clinical medicine ,Quality of life ,Cost of Illness ,Drug Combination ,advanced parkinson’s disease ,Surveys and Questionnaires ,80 and over ,Surveys and Questionnaire ,030212 general & internal medicine ,Aged, 80 and over ,Advanced Parkinson’s disease ,Caregiver burden ,Intestinal infusion ,Levodopa/carbidopa ,Neurology (clinical) ,Carbidopa ,Parkinson Disease ,Middle Aged ,3. Good health ,Distress ,Drug Combinations ,Treatment Outcome ,Caregivers ,Italy ,Patient Satisfaction ,Antiparkinson Agent ,Female ,medicine.drug ,Human ,medicine.medical_specialty ,Aged ,Cross-Sectional Studies ,Family ,Humans ,Quality of Life ,Socioeconomic Factors ,levodopa/carbidopa ,03 medical and health sciences ,Patient satisfaction ,medicine ,Cross-Sectional Studie ,caregiver burden ,business.industry ,intestinal infusion ,quality of life ,Correction ,medicine.disease ,Caregiver ,Physical therapy ,business ,030217 neurology & neurosurgery - Abstract
Introduction: Caring for a person with Parkinson’s disease (PD) is associated with an increased risk of psychiatric morbidity and persistent distress. The objective of this study was to describe the burden and the related factors of caregivers of advanced PD (APD) patients either treated with continuous dopaminergic delivery systems or standard therapy. Methods: This cross-sectional, epidemiologic study conducted in 13 Italian sites enrolled PD patients treated with continuous dopaminergic delivering systems [either levodopa/carbidopa intestinal gel (LCIG) infusion or continuous subcutaneous apomorphine infusion (CSAI)] or continuation of standard of care (SOC) with a caregiver. Patient quality of life (QoL) and caregiver burden were assessed using the Parkinson’s Disease Questionnaire (PDQ-8) and Zarit Burden Inventory (ZBI), respectively. Results: 126 patients (mean age 69.3 ± 8years) and their caregivers (mean age 57.9 ± 12.9) were enrolled. Most caregivers were spouses. Fifty-three patients were treated with LCIG, 19 with CSAI, and 54 with SOC. Mean ZBI scores were 29.6 ± 14.4 for LCIG, 35.8 ± 20.2 for CSAI, and 31.4 ± 16.0 for SOC. Caregivers of LCIG, CSAI, and SOC patients showed no burden or mild/moderate burden in 74, 53, and 63% of the cases, respectively. Mean PDQ-8 scores were 11.25 ± 5.67, 11.26 ± 5.55, and 14.22 ± 6.51 in LCIG, CSAI, and SOC patients. Neurologists considered patients “very much or much improved” in 89, 58, and 13% of the LCIG, CSAI, and SOC groups using the Clinical Global Impression–Global Improvement Scale. Predictors significantly associated with caregiver burden were patients and caregivers’ judgment of QoL and caregivers’ need to change work. Conclusions: Caregiver burden showed a tendency to be lower when patients are treated with LCIG than with CSAI or SOC.
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- 2017
114. Brain interstitial nociceptin/orphanin FQ levels are elevated in Parkinson's disease
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Patrizia Romualdi, Michele Simonato, Sara Biguzzi, Silvio Sarubbo, Roberto Eleopra, Matteo Marti, Carlo Conti, Sanzio Candeletti, Christian Lettieri, Michele Alessandro Cavallo, Rocco Quatrale, Francesco Latini, Mariachiara Sensi, Michele Morari, Silvia Zucchini, Marti M, Sarubbo S, Latini F, Cavallo M, Eleopra R, Biguzzi S, Lettieri C, Conti C, Simonato M, Zucchini S, Quatrale R, Sensi M, Candeletti S, Romualdi P, and Morari M.
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Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,Microdialysis ,Substantia nigra ,Rats, Sprague-Dawley ,Young Adult ,CEREBROSPINAL FLUID ,Adrenergic Agents ,Dopamine ,Internal medicine ,medicine ,Haloperidol ,Animals ,Humans ,Oxidopamine ,Aged ,Aged, 80 and over ,Analysis of Variance ,Behavior, Animal ,business.industry ,Parkinsonism ,Brain ,HUMAN ,Parkinson Disease ,MICRODYALISIS ,Middle Aged ,medicine.disease ,NOCICEPTIN ,Rats ,nervous system diseases ,Nociceptin receptor ,Subthalamic nucleus ,Disease Models, Animal ,Endocrinology ,Globus pallidus ,Neurology ,Gene Expression Regulation ,Opioid Peptides ,nervous system ,Female ,Neurology (clinical) ,business ,PARKINSON'S DISEASE ,medicine.drug ,Antipsychotic Agents - Abstract
Expression and release of nociceptin/orphanin FQ (N/OFQ) are elevated in the substantia nigra reticulata of 6- hydroxydopamine-hemilesioned rats, suggesting a pathogenic role for N/OFQ in Parkinson's disease. In this study, we investigated whether elevation of N/OFQ expression in 6-hy- droxydopamine-hemilesioned rats selectively occurs in sub- stantia nigra and whether hypomotility following acute halo- peridol administration is accompanied by a rise in nigral N/ OFQ levels. Moreover, to prove a link between N/OFQ and idiopathic Parkinson's disease in humans, we measured N/ OFQ levels in the cerebrospinal fluid of parkinsonian patients undergoing surgery for deep brain stimulation. In situ hybrid- ization demonstrated that dopamine depletion was associated with increase of N/OFQ expression in substantia nigra (com- pacta 1160%, reticulata 1105%) and subthalamic nucleus (145%), as well as reduction in caudate putamen (220%). No change was observed in globus pallidus, nucleus accum- bens, thalamus, and motor cortex. Microdialysis coupled to the bar test allowed to demonstrate that acute administration of haloperidol (0.8 and 3 mg/kg) increased nigral N/OFQ lev- els (maximally of 147% and 153%, respectively) in parallel with akinesia. A correlation with preclinical studies was found by analyzing N/OFQ levels in humans. Indeed, N/OFQ levels were found to be 3.5-fold elevated in the cerebrospi- nal fluid of parkinsonian patients (148 fmol/ml) compared with nonparkinsonian neurologic controls (41 fmol/ml). These data represent the first clinical evidence linking N/ OFQ to idiopathic Parkinson's disease in humans. They strengthen the pathogenic role of N/OFQ in the modulation of parkinsonism across species and provide a rationale for developing N/OFQ receptor antagonists as antiparkinsonian drugs. 2010 Movement Disorder Society
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- 2010
115. Active and non-active secondary progressive multiple sclerosis patients exhibit similar disability progression: results of an Italian MS registry study (ASPERA).
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Chisari CG, Amato MP, Di Sapio A, Foschi M, Iaffaldano P, Inglese M, Fermo SL, Lugaresi A, Lus G, Mascoli N, Montepietra S, Pesci I, Quatrale R, Salemi G, Torri Clerici V, Totaro R, Valentino P, Filippi M, and Patti F
- Abstract
'Active' and 'non-active' secondary progressive MS (SPMS) have distinct pathophysiological mechanisms and clinical characteristics, but there is still no consensus regarding the frequency of these MS forms in the real-world setting. We aimed to evaluate the frequency of 'active' and 'non-active' SPMS in a large cohort of Italian MS patients and the differences in terms of clinical and MRI characteristics and disease progression. This multicenter study collected data about MS patients who have transitioned to the SP form in the period between 1st January 2014 and 31st December 2019 and followed by the MS centers contributing to the Italian MS Registry. Patients were divided into 'active SPMS' and 'non-active SPMS', based on both reported MRI data and relapse activity in the year before conversion to SPMS. Out of 68,621, 8,316 (12.1%) patients were diagnosed with SPMS. Out of them, 872 (10.5%) were classified into patients with either 'active' or 'non-active' SPMS. A total of 237 were classified into patients with 'active SPMS' (27.2%) and 635 as 'non-active SPMS' (72.8%). 'Non-active SPMS' patients were older, with a longer disease duration compared to those with 'active SPMS'. The percentages of patients showing progression independent of relapse activity (PIRA) at 24 months were similar between 'active' and 'non-active' SPMS patients (67 [27.4%] vs 188 [29.6%]; p = 0.60). In the 'active' group, 36 (15.2%) patients showed relapse-associated worsening (RAW). Comparison of the survival curves to EDSS 6 and 7 according to disease activity did not show significant differences (p = 0.68 and p = 0.71). 'Active' and 'non-active' SPMS patients had a similar risk of achieving disability milestones, suggesting that progression is primarily attributed to PIRA and only to a small extent to disease activity., (© 2024. The Author(s).)
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- 2024
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116. A comparison of natalizumab and ocrelizumab on disease progression in multiple sclerosis.
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Iaffaldano P, Lucisano G, Guerra T, Paolicelli D, Portaccio E, Inglese M, Foschi M, Patti F, Granella F, Romano S, Cavalla P, De Luca G, Gallo P, Bellantonio P, Gallo A, Montepietra S, Di Sapio A, Vianello M, Quatrale R, Spitaleri D, Clerici R, Torri Clerici V, Cocco E, Brescia Morra V, Marfia GA, Boccia VD, Filippi M, Amato MP, and Trojano M
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- Humans, Female, Male, Adult, Middle Aged, Multiple Sclerosis drug therapy, Multiple Sclerosis, Relapsing-Remitting drug therapy, Registries, Italy, Natalizumab adverse effects, Antibodies, Monoclonal, Humanized adverse effects, Antibodies, Monoclonal, Humanized pharmacology, Antibodies, Monoclonal, Humanized administration & dosage, Disease Progression, Immunologic Factors adverse effects, Immunologic Factors pharmacology, Immunologic Factors administration & dosage
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Objective: No direct comparisons of the effect of natalizumab and ocrelizumab on progression independent of relapse activity (PIRA) and relapse-associated worsening (RAW) events are currently available. We aimed to compare the risk of achieving first 6 months confirmed PIRA and RAW events and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 in a cohort of naïve patients treated with natalizumab or ocrelizumab from the Italian Multiple Sclerosis Register., Methods: Patients with a first visit within 1 year from onset, treated with natalizumab or ocrelizumab, and ≥3 visits were extracted. Pairwise propensity score-matched analyses were performed. Risk of reaching the first PIRA, RAW, and EDSS 4.0 and 6.0 events were estimated using multivariable Cox proportional hazards models. Kaplan-Meier curves were used to show cumulative probabilities of reaching outcomes., Results: In total, 770 subjects were included (natalizumab = 568; ocrelizumab = 212) and the propensity score-matching retrieved 195 pairs. No RAW events were found in natalizumab group and only 1 was reported in ocrelizumab group. A first PIRA event was reached by 23 natalizumab and 25 ocrelizumab exposed patients; 7 natalizumab- and 10 ocrelizumab-treated patients obtained an irreversible EDSS 4.0, while 13 natalizumab- and 15 ocrelizumab-treated patients reached an irreversible EDSS 6.0. No differences between the two groups were found in the risk (HR, 95%CI) of reaching a first PIRA (1.04, 0.59-1.84; p = 0.88) event, an irreversible EDSS 4.0 (1.23, 0.57-2.66; p = 0.60) and 6.0 (0.93, 0.32-2.68; p = 0.89)., Interpretation: Both medications strongly suppress RAW events and, in the short term, the risk of achieving PIRA events, EDSS 4.0 and 6.0 milestones is not significantly different., (© 2024 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)
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- 2024
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117. The Italian hub-and-spoke network for the emergency neurology management.
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Micieli G, Cortelli P, Del Sette M, Cavallini A, Zanferrari C, De Falco A, Quatrale R, Maria G, Cossu G, Haggiag S, Pezzella FR, Zedde ML, and Rea F
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Objective: The aim of the present study was to assess emergency neurology management in Italy by comparing patients admitted to the hub and spoke hospitals., Methods: Data obtained from the annual Italian national survey (NEUDay) investigating the activity and facilities of neurology in the emergency room conducted in November 2021 were considered. Information for each patient who received a neurologic consultation after accessing the emergency room was acquired. Data on facilities were also gathered, including hospital classification (hub vs spoke), number of consultations, presence of neurology and stroke unit, number of beds, availability of neurologist, radiologist, neuroradiologist, and instrumental diagnostic accessibility., Results: Overall, 1,111 patients were admitted to the emergency room and had neurological consultation across 153 facilities (out of the 260 Italian ones). Hub hospitals had significantly more beds, availability of neurological staff, and instrumental diagnostic accessibility. Patients admitted to hub hospital had a greater need for assistance (higher number of yellow/red codes at neurologist triage). A higher propensity to be admitted to hub centers for cerebrovascular problems and to receive a diagnosis of stroke was observed., Conclusions: The identification of hub and spoke hospitals is strongly characterized by the presence of beds and instrumentation mainly dedicated to acute cerebrovascular pathologies. Moreover, the similarity in the number and type of accesses between hub and spoke hospitals suggests the need to look for adequate identification of all the neurological pathologies requiring urgent treatment., (© 2023. Fondazione Società Italiana di Neurologia.)
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- 2023
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118. Correction to: The Italian hub‑and‑spoke network for the emergency neurology management.
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Micieli G, Cortelli P, Del Sette M, Cavallini A, Zanferrari C, De Falco A, Quatrale R, Maria G, Cossu G, Haggiag S, Pezzella FR, Zedde ML, and Rea F
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- 2023
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119. Models of care in emergency neurology: from the Neuro Fast Track to the emergency neurologist-a position paper of the Italian Association for Emergency Neurology (ANEU).
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Micieli G, Cortelli P, Del Sette M, Quatrale R, Cavallini A, Zedde ML, Zanferrari C, de Falco A, Guarino M, Cossu G, Haggiag S, Pezzella FR, Porreca A, Pistoia F, Andreone V, Giometto B, Gasperini C, Giorli E, Salmaggi A, Lattanzi S, Labate CR, Rinaldi G, Melis M, Caggia E, Volpi G, Passadore P, Corea F, and Franco GM
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- Humans, Emergencies, Emergency Service, Hospital, Italy, Neurologists, Neurology
- Abstract
I n the context of an adequate health care organization, the figure of the neurologist as an emergency operator (in the emergency room-ER-and/or in a dedicated outpatient clinic) is crucial for an effective functional connection with the territory (and therefore with general practitioners), a reduction in inappropriate ER accesses, specific diagnostic and therapeutic approaches to neurological emergencies in the ER and a reduction in nonspecific or even unnecessary instrumental investigations. In this position paper of the Italian Association of Emergency Neurology (ANEU: Associazione Neurologia dell'Emergenza Urgenza), these issues are addressed, and two important organizational solutions are proposed: 1) The Neuro Fast Track, as an outpatient organization approach strongly linked to general practitioners and non-neurological specialists and dedicated to cases with deferrable urgency (to be assessed within 72 h) 2) The identification of an emergency neurologist, who is engaged in ER assessments as a consultant and involved in the management of the semi-intensive care unit of the emergency neurology and the stroke unit according to an appropriate rotation, as well as in consultations for patients with neurological emergencies in inpatient wards The possibility of computerizing the screening of patients with deferrable urgency in the Neuro Fast Track is described. A dedicated app represents an important tool that can facilitate the identification of patients for whom deferred assessment is appropriate, the scheduling of neurological examinations and reductions in the booking time through a more rapid approach to specialist assessment and subsequent investigations., (© 2023. Fondazione Società Italiana di Neurologia.)
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- 2023
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120. Neurological complications in adult allogeneic hematopoietic stem cell transplant patients: Incidence, characteristics and long-term follow-up in a multicenter series.
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Wieczorek M, Mariotto S, Ferrari S, Mosna F, Micò MC, Borghero C, Dubbini MV, Malagola M, Skert C, Andreini A, De Marco B, Polo D, Tfaily A, Krampera M, Grassi A, Candoni A, Ranzato F, Volonghi I, Quatrale R, Benedetti F, and Tecchio C
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- Adult, Follow-Up Studies, Humans, Incidence, Retrospective Studies, Transplantation, Homologous adverse effects, Central Nervous System Diseases etiology, Graft vs Host Disease epidemiology, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects
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Neurological complications (NCs) represent a diagnostic and clinical challenge in allogeneic hematopoietic stem cell transplant (alloHSCT) patients. We retrospectively analyzed NC incidence, etiology, timing, characteristics, outcome, and long-term effects in 2384 adult patients transplanted in seven Italian institutions between January 2007 and December 2019. Ninety-three (3.9%) patients were affected by 96 NCs that were infectious (29.2%), immune/inflammatory (26%), drug-related (12.5%), cerebrovascular (5.2%), metabolic (3.1%), related to central nervous system disease relapse (11.5%) and malignancy (3.1%), or undefined (9.4%). Six patients (6.4%) had neurological manifestations of chronic graft-versus-host disease (GVHD). NCs occurred on average at day +128 (from -5 to +4063). Early (< day +120) and late NCs had similar frequencies (46.9% vs 53.1%, p = 0.39). Thirty-one patients (33.3%) were affected by acute or chronic GVHD at the NC onset. With a median follow-up of 25.4 (0.4-163) months, the overall mortality due to NCs was 22.6%. The median time between NC onset and death was 36 (1-269) days. Infectious NCs were the main cause (61.9%) of NC-related mortality. A persistent neurological impairment occurred in 20.4% patients, 57.9% of whom being affected by immune/inflammatory NCs. This study highlights the rare, yet severe impact of alloHSCT-associated NCs on patient survival and long-term functional ability., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
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- 2022
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121. Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige).
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Manganotti P, Naccarato M, Scali I, Cappellari M, Bonetti B, Burlina A, Turinese E, Bogo S, Teatini F, Franchini E, Caneve G, Ruzza G, Gaudenzi A, Bombardi R, Bozzato G, Padoan R, Gentile C, Rana M, Turazzini M, Alessandra D, Brigo F, Nardone R, Quatrale R, Menegazzo E, Masato M, Novello S, Passadore P, Baldi A, Valentinis L, Baracchini C, Pieroni A, Basile AM, Semplicini C, Piffer S, Giometto B, Tonello S, Bonifatti DM, Lorenzut S, Merlino G, Valente MR, Paladin F, Tonon A, de Luca C, Perini F, Centonze S, and Bovi P
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- Communicable Disease Control, Humans, Italy epidemiology, Pandemics, Retrospective Studies, SARS-CoV-2, COVID-19, Stroke epidemiology, Stroke therapy
- Abstract
Background: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke., Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies., Results: In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers., Conclusions: Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution., (© 2021. The Author(s).)
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- 2021
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122. Correction to: Caregiver burden and its related factors in advanced Parkinson's disease: data from the PREDICT study.
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Tessitore A, Marano P, Modugno N, Pontieri FE, Tambasco N, Canesi M, Latorre A, Lopiano L, Sensi M, Quatrale R, Solla P, Defazio G, Melzi G, Costanzo AM, Gualberti G, di Luzio Paparatti U, and Antonini A
- Abstract
The original version of this article unfortunately contained a mistake. In the Figure.
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- 2020
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123. Motor and non-motor outcomes in patients with advanced Parkinson's disease treated with levodopa/carbidopa intestinal gel: final results of the GREENFIELD observational study.
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Lopiano L, Modugno N, Marano P, Sensi M, Meco G, Solla P, Gusmaroli G, Tamma F, Mancini F, Quatrale R, Zangaglia R, Bentivoglio A, Eleopra R, Gualberti G, Melzi G, and Antonini A
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Drug Combinations, Female, Follow-Up Studies, Gastrostomy, Gels, Humans, Italy epidemiology, Male, Mental Status and Dementia Tests, Middle Aged, Parkinson Disease epidemiology, Prospective Studies, Retrospective Studies, Treatment Outcome, Antiparkinson Agents administration & dosage, Carbidopa administration & dosage, Infusion Pumps, Jejunum drug effects, Levodopa administration & dosage, Parkinson Disease diagnosis, Parkinson Disease drug therapy
- Abstract
Introduction: The GREENFIELD observational study assessed the effect of levodopa/carbidopa intestinal gel (LCIG) on motor and non-motor symptoms, and the related impact on patient quality of life and caregiver burden up to 8 years., Methods: Final results of a large Italian cohort of patients who started LCIG in routine care between 2007 and 2014 are presented. Comparison between baseline (before LCIG) and follow-up visits on yearly basis (visit 2/3) is reported. Primary endpoint was Unified Parkinson's Disease Rating Scale (UPDRS-IV) Item 39; secondary endpoints were UPDRS I and II, dyskinesia items, PD Quality of Life Questionnaire-39, Parkinson's Disease Sleep Scale-2, Gait and Falls Questionnaire, Questionnaire on Impulsive Disorders, and Relative Stress Scale., Results: Overall, 145 patients from 14 centers were assessed with a mean time since LCIG start of 2.8 ± 1.7 years at visit 2. The mean UPDRS-IV item 39 score showed significant reductions compared to baseline (mean score 2.0 ± 0.81) at visit 2 (mean score 0.9 ± 0.69; - 55%; p < 0.001) and at visit 3 (mean score 1.0 ± 0.75; - 50%; p < 0.001). At visit 3, significant reductions were observed for dyskinesia duration score (- 28%; p < 0.001), dyskinesia disability (- 40%; p < 0.001), and painful dyskinesia (- 50%; p < 0.001). Overall, 40 (27.6%) patients experienced 49 serious adverse events which were considered related to PEG/J procedure or to device in 16.3% of the cases., Conclusions: The results of this study support the long-term efficacy of LCIG on PD symptoms as well as on activities of daily living. The adverse events were consistent with the established LCIG safety profile.
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- 2019
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124. Caregiver burden and its related factors in advanced Parkinson's disease: data from the PREDICT study.
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Tessitore A, Marano P, Modugno N, Pontieri FE, Tambasco N, Canesi M, Latorre A, Lopiano L, Sensi M, Quatrale R, Solla P, Defazio G, Melzi G, Costanzo AM, Gualberti G, di Luzio Paparatti U, and Antonini A
- Subjects
- Aged, Aged, 80 and over, Antiparkinson Agents administration & dosage, Apomorphine administration & dosage, Carbidopa administration & dosage, Cross-Sectional Studies, Drug Combinations, Family psychology, Female, Humans, Italy, Levodopa administration & dosage, Male, Middle Aged, Parkinson Disease drug therapy, Parkinson Disease psychology, Patient Satisfaction, Quality of Life, Socioeconomic Factors, Surveys and Questionnaires, Treatment Outcome, Caregivers psychology, Cost of Illness, Parkinson Disease therapy
- Abstract
Introduction: Caring for a person with Parkinson's disease (PD) is associated with an increased risk of psychiatric morbidity and persistent distress. The objective of this study was to describe the burden and the related factors of caregivers of advanced PD (APD) patients either treated with continuous dopaminergic delivery systems or standard therapy., Methods: This cross-sectional, epidemiologic study conducted in 13 Italian sites enrolled PD patients treated with continuous dopaminergic delivering systems [either levodopa/carbidopa intestinal gel (LCIG) infusion or continuous subcutaneous apomorphine infusion (CSAI)] or continuation of standard of care (SOC) with a caregiver. Patient quality of life (QoL) and caregiver burden were assessed using the Parkinson's Disease Questionnaire (PDQ-8) and Zarit Burden Inventory (ZBI), respectively., Results: 126 patients (mean age 69.3 ± 8 years) and their caregivers (mean age 57.9 ± 12.9) were enrolled. Most caregivers were spouses. Fifty-three patients were treated with LCIG, 19 with CSAI, and 54 with SOC. Mean ZBI scores were 29.6 ± 14.4 for LCIG, 35.8 ± 20.2 for CSAI, and 31.4 ± 16.0 for SOC. Caregivers of LCIG, CSAI, and SOC patients showed no burden or mild/moderate burden in 74, 53, and 63% of the cases, respectively. Mean PDQ-8 scores were 11.25 ± 5.67, 11.26 ± 5.55, and 14.22 ± 6.51 in LCIG, CSAI, and SOC patients. Neurologists considered patients "very much or much improved" in 89, 58, and 13% of the LCIG, CSAI, and SOC groups using the Clinical Global Impression-Global Improvement Scale. Predictors significantly associated with caregiver burden were patients and caregivers' judgment of QoL and caregivers' need to change work., Conclusions: Caregiver burden showed a tendency to be lower when patients are treated with LCIG than with CSAI or SOC.
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- 2018
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125. Papillary fibroelastoma, unusual cause of stroke in a young man: a case report.
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Grolla E, Dalla Vestra M, Zoffoli G, D'Ascoli R, Critelli A, Quatrale R, Mangino D, and Rigo F
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- Adult, Cardiac Surgical Procedures methods, Diagnosis, Differential, Echocardiography, Transesophageal, Fibroma diagnosis, Fibroma surgery, Heart Neoplasms diagnosis, Heart Neoplasms surgery, Humans, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Cine, Male, Papillary Muscles, Postoperative Period, Tomography, X-Ray Computed, Fibroma complications, Heart Neoplasms complications, Stroke etiology
- Abstract
Background: Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors., Case Presentation: We describe a rare case of a 28-Year-old man that while playing football, had a sudden onset of neurological deficit: aphasia, right hemiparesis and right facial numbness. Transthoracic echocardiography (TTE) showed a 10x10 mm mass attached to the anterior mitral valve leaflet. The patient was treated surgically for the prevention of further embolic complications. Histologic examination of the resected mass revealed a papillary fibroelastoma. It is the third most frequent primary cardiac tumor, after myxoma and fibroma, and the most common primary tumor of heart valves. Despite the benign nature of this tumor, it carries very high risk of embolic complications. The successful complete resection of the papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent., Conclusions: Differential diagnosis of cardiac masses requires clinical informations, laboratory tests, blood cultures and appropriate use of imaging modalities. Papillary fibroelastoma is a potential cause of embolic stroke in the young. The prompt surgical excision of papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent.
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- 2017
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126. Which patients discontinue? Issues on Levodopa/carbidopa intestinal gel treatment: Italian multicentre survey of 905 patients with long-term follow-up.
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Sensi M, Cossu G, Mancini F, Pilleri M, Zibetti M, Modugno N, Quatrale R, Tamma F, and Antonini A
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- Disease Progression, Drug Combinations, Female, Health Surveys, Humans, Italy, Longitudinal Studies, Male, Retrospective Studies, Substance Withdrawal Syndrome etiology, Antiparkinson Agents administration & dosage, Carbidopa administration & dosage, Gels therapeutic use, Intestines physiology, Levodopa administration & dosage, Parkinson Disease drug therapy
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Objectives: To report the results of a national survey aimed at quantifying the current level of diffusion of Levodopa/carbidopa intestinal gel (LCIG) in Italy., Methods: Sixty Parkinson's Disease (PD) specialists in Italy were invited to complete a survey covering issues on clinical and practical aspects of LCIG therapy., Results: Clinical features of 905 patients were collected retrospectively. The majority of centres reported the use of a multidisciplinary team, biochemistry testing, neurophysiological and neuropsychological tests before and after treatment, in addition to caregivers' training and patient's follow as outpatients. Most centres (60%) used internal guidelines for patient selection. The overall rate of adverse events was 55.1%. Weight loss, chronic polyneuropathy and stoma infection were the most frequently reported. 40% of centres used replacement therapy with Vitamin B12 and Folic acid from the start of LCIG and continued this for the duration of treatment. The rate of discontinuation was of 25.7% overall, with 9.5% of cases occurring in the first year. The main causes of withdrawal were device-related complications, disease progression (comorbidity, severe dementia) and caregiver and/or patient dissatisfaction., Conclusions: In Italy LCIG infusion is managed in a uniform manner at a clinical, practical and organizational level even though the selection criteria are not standardized through the country. The high percentage of patients remaining on treatment in the short- and long-term follow-up confirms effectiveness of treatment, careful follow-up, and appropriate patient and caregivers training., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
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- 2017
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127. Motor outcomes in patients with advanced Parkinson's disease treated with levodopa/carbidopa intestinal gel in Italy: an interim analysis from the GREENFIELD observational study.
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Lopiano L, Modugno N, Marano P, Sensi M, Meco G, Cannas A, Gusmaroli G, Tamma F, Mancini F, Quatrale R, Costanzo AM, Gualberti G, Melzi G, di Luzio Paparatti U, and Antonini A
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- Activities of Daily Living, Aged, Aged, 80 and over, Antiparkinson Agents administration & dosage, Carbidopa administration & dosage, Drug Combinations, Female, Gels, Humans, Infusions, Parenteral, Italy, Levodopa administration & dosage, Male, Middle Aged, Quality of Life, Antiparkinson Agents pharmacology, Carbidopa pharmacology, Levodopa pharmacology, Outcome Assessment, Health Care, Parkinson Disease drug therapy
- Abstract
Several levodopa/carbidopa intestinal gel (LCIG) studies showed a significant reduction of OFF time and a significant increase of ON time, as well as a reduction of dyskinesia, and improvement of non-motor symptoms and quality of life. However, few studies have been conducted in a large population for more than 3 years. Interim outcomes from GREENFIELD observational study on a large Italian cohort of advanced PD patients who started LCIG in routine care between 2007 and 2014, still on treatment at the enrollment, are presented. Comparison between baseline (before LCIG start) and visit 1 (at enrollment) is reported. Primary endpoint was Unified Parkinson's Disease Rating Scale (UPDRS) IV Item 39; secondary endpoints were UPDRS I and II, as outcome of quality of life. Overall, 145 of 148 enrolled patients from 14 Movement Disorder Centers in Italy were evaluable with a mean LCIG treatment period of 1.38 ± 1.66 years at enrollment. Compared with baseline, the mean score regarding daily time spent in OFF (UPDRS IV Item 39) at visit 1 significantly decreased from 2.1 ± 0.8 to 0.9 ± 0.7 (57 % reduction vs baseline, P < 0.0001); UPDRS IV improved by 39 % (P < 0.0001); scores for dyskinesia duration and disability were reduced by 28 % (1.8 ± 1.0-1.3 ± 0.9; P < 0.0001) and 33 % (1.5 ± 1.1 to 1.0 ± 1.0; P < 0.0001), respectively; and the scores for painful dyskinesia and early morning dystonia were reduced by 56 % (0.9 ± 1.0-0.4 ± 0.7; P < 0.0001) and 25 % (0.4 ± 0.5-0.3 ± 0.5; P < 0.001), respectively. The preliminary results of this interim analysis support the efficacy of LCIG on motor complications and activities of daily living., Competing Interests: Compliance with ethical standards Funding This work was funded by AbbVie Srl. AbbVie participated in the study design, research, data collection, analysis and interpretation of data, and writing, reviewing, and approving the publication. Conflict of interest Angelo Antonini has received compensation for consultancy and speaker related activities from UCB, Boston Scientific, Boheringer Ingelheim, AbbVie, Zambon; he also received research support from Mundipharma, Neureca foundation, the Italian Ministry Research Grant RF-2010-2319551, and Horizon 2020 Program Grant No. 643706. He serves as consultant for Boheringer–Ingelheim for legal cases on pathological gambling. Antonino Cannas, Graziano Gusmaroli, Leonardo Lopiano, Francesca Mancini, Pietro Marano, Nicola Modugno, Rocco Quatrale, Mariachiara Sensi, and Filippo Tamma have received honoraria for consulting services and symposia from AbbVie. Anna Maria Costanzo, Giuliana Gualberti, Gabriella Melzi, and Umberto di Luzio Paparatti are employees of AbbVie Italy and may own AbbVie stocks/options. No further conflict of interest have been declared by authors.
- Published
- 2016
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128. Erythropoietin in amyotrophic lateral sclerosis: a multicentre, randomised, double blind, placebo controlled, phase III study.
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Lauria G, Dalla Bella E, Antonini G, Borghero G, Capasso M, Caponnetto C, Chiò A, Corbo M, Eleopra R, Fazio R, Filosto M, Giannini F, Granieri E, La Bella V, Logroscino G, Mandrioli J, Mazzini L, Monsurrò MR, Mora G, Pietrini V, Quatrale R, Rizzi R, Salvi F, Siciliano G, Sorarù G, Volanti P, Tramacere I, and Filippini G
- Subjects
- Adult, Aged, Amyotrophic Lateral Sclerosis mortality, Double-Blind Method, Epoetin Alfa, Erythropoietin adverse effects, Female, Humans, Male, Middle Aged, Recombinant Proteins adverse effects, Recombinant Proteins therapeutic use, Treatment Outcome, Amyotrophic Lateral Sclerosis drug therapy, Erythropoietin therapeutic use
- Abstract
Objective: To assess the efficacy of recombinant human erythropoietin (rhEPO) in amyotrophic lateral sclerosis (ALS)., Methods: Patients with probable laboratory-supported, probable or definite ALS were enrolled by 25 Italian centres and randomly assigned (1:1) to receive intravenous rhEPO 40,000 IU or placebo fortnightly as add-on treatment to riluzole 100 mg daily for 12 months. The primary composite outcome was survival, tracheotomy or >23 h non-invasive ventilation (NIV). Secondary outcomes were ALSFRS-R, slow vital capacity (sVC) and quality of life (ALSAQ-40) decline. Tolerability was evaluated analysing adverse events (AEs) causing withdrawal. The randomisation sequence was computer-generated by blocks, stratified by centre, disease severity (ALSFRS-R cut-off score of 33) and onset (spinal or bulbar). The main outcome analysis was performed in all randomised patients and by intention-to-treat for the entire population and patients stratified by severity and onset. The study is registered, EudraCT 2009-016066-91., Results: We randomly assigned 208 patients, of whom 5 (1 rhEPO and 4 placebo) withdrew consent and 3 (placebo) became ineligible (retinal thrombosis, respiratory insufficiency, SOD1 mutation) before receiving treatment; 103 receiving rhEPO and 97 placebo were eligible for analysis. At 12 months, the annualised rate of death (rhEPO 0.11, 95% CI 0.06 to 0.20; placebo: 0.08, CI 0.04 to 0.17), tracheotomy or >23 h NIV (rhEPO 0.16, CI 0.10 to 0.27; placebo 0.18, CI 0.11 to 0.30) did not differ between groups, also after stratification by onset and ALSFRS-R at baseline. Withdrawal due to AE was 16.5% in rhEPO and 8.3% in placebo. No differences were found for secondary outcomes., Conclusions: RhEPO 40,000 IU fortnightly did not change the course of ALS., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
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- 2015
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129. Validation of the Italian version of the Movement Disorder Society--Unified Parkinson's Disease Rating Scale.
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Antonini A, Abbruzzese G, Ferini-Strambi L, Tilley B, Huang J, Stebbins GT, Goetz CG, Barone P, Bandettini di Poggio M, Fabbrini G, Di Stasio F, Tinazzi M, Bovi T, Ramat S, Meoni S, Pezzoli G, Canesi M, Martinelli P, Maria Scaglione CL, Rossi A, Tambasco N, Santangelo G, Picillo M, Morgante L, Morgante F, Quatrale R, Sensi M, Pilleri M, Biundo R, Nordera G, Caria A, Pacchetti C, Zangaglia R, Lopiano L, Zibetti M, Zappia M, Nicoletti A, Quattrone A, Salsone M, Cossu G, Murgia D, Albanese A, and Del Sorbo F
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- Disability Evaluation, Factor Analysis, Statistical, Female, Humans, Italy, Male, Neuropsychological Tests, Reproducibility of Results, Severity of Illness Index, Translations, Movement Disorders, Neurologic Examination methods, Neurologic Examination standards, Parkinson Disease diagnosis, Societies, Medical standards
- Abstract
The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has been available in English since 2008. As part of this process, the MDS-UPDRS organizing team developed guidelines for development of official non-English translations. We present here the formal process for completing officially approved non-English versions of the MDS-UPDRS and specifically focus on the first of these versions in Italian. The MDS-UPDRS was translated into Italian and tested in 377 native-Italian speaking PD patients. Confirmatory and exploratory factor analyses determined whether the factor structure for the English-language MDS-UPDRS could be confirmed in data collected using the Italian translation. To be designated an 'Official MDS translation,' the Comparative Fit Index (CFI) had to be ≥0.90 relative to the English-language version. For all four parts of the Italian MDS-UPDRS, the CFI, in comparison with the English-language data, was ≥0.94. Exploratory factor analyses revealed some differences between the two datasets, however these differences were considered to be within an acceptable range. The Italian version of the MDS-UPDRS reaches the criterion to be designated as an Official Translation and is now available for use. This protocol will serve as outline for further validation of this in multiple languages.
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- 2013
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130. The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life.
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Antonini A, Barone P, Marconi R, Morgante L, Zappulla S, Pontieri FE, Ramat S, Ceravolo MG, Meco G, Cicarelli G, Pederzoli M, Manfredi M, Ceravolo R, Mucchiut M, Volpe G, Abbruzzese G, Bottacchi E, Bartolomei L, Ciacci G, Cannas A, Randisi MG, Petrone A, Baratti M, Toni V, Cossu G, Del Dotto P, Bentivoglio AR, Abrignani M, Scala R, Pennisi F, Quatrale R, Gaglio RM, Nicoletti A, Perini M, Avarello T, Pisani A, Scaglioni A, Martinelli PE, Iemolo F, Ferigo L, Simone P, Soliveri P, Troianiello B, Consoli D, Mauro A, Lopiano L, Nastasi G, and Colosimo C
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Motor Skills Disorders epidemiology, Motor Skills Disorders psychology, Parkinson Disease epidemiology, Parkinson Disease psychology, Prospective Studies, Disability Evaluation, Disease Progression, Motor Skills Disorders diagnosis, Parkinson Disease diagnosis, Quality of Life psychology
- Abstract
Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.
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- 2012
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131. Frontal assessment battery scores and non-motor symptoms in parkinsonian disorders.
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Marconi R, Antonini A, Barone P, Colosimo C, Avarello TP, Bottacchi E, Cannas A, Ceravolo MG, Ceravolo R, Cicarelli G, Gaglio RM, Giglia L, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Del Dotto P, De Gaspari D, Grasso L, Morgante F, Santangelo G, Fabbrini G, and Morgante L
- Subjects
- Aged, Aged, 80 and over, Attention Deficit Disorder with Hyperactivity epidemiology, Cardiovascular Diseases epidemiology, Fatigue epidemiology, Female, Gastrointestinal Diseases epidemiology, Humans, Kidney Diseases epidemiology, Logistic Models, Longitudinal Studies, Lung Diseases epidemiology, Male, Middle Aged, Predictive Value of Tests, Skin Diseases epidemiology, Sleep Wake Disorders epidemiology, Surveys and Questionnaires, Cognition Disorders diagnosis, Cognition Disorders epidemiology, Frontal Lobe physiopathology, Neuropsychological Tests, Parkinsonian Disorders epidemiology, Parkinsonian Disorders pathology
- Abstract
Using data from the PRIAMO study, we investigated non-motor symptoms (NMS) versus frontal lobe dysfunction in patients with idiopathic Parkinson disease (PD); 808 patients with PD and 118 with atypical parkinsonisms (AP) were consecutively enrolled at 55 Centers in Italy. Twelve categories of NMS were investigated. Cognitive impairment was defined as a Mini-Mental Status Evaluation score ≤ 23.8 and frontal lobe dysfunction as a Frontal Assessment Battery (FAB) score ≤ 3.48. Multivariable logistic regression was used to identify predictor of frontal lobe dysfunction in 524 PD patients, and a generalized linear model was used for each of the six FAB items. Not only the total FAB scores but also the single FAB items were lower in AP versus PD (p ≤ 0.005). Age (OR = 1.05), cognitive impairment (OR = 9.54), lack of cardiovascular symptoms (OR = 3.25), attention or memory problems (OR = 0.59) and treatment with L: -DOPA (OR = 5.58) were predictors of frontal lobe dysfunction. MMSE was negatively associated with all FAB items (β ≤ -0.16) and age with all FAB items but prehension behavior (β ≤ -0.01). Previous use of L: -DOPA was negatively associated with verbal fluency (β = -0.32) possibly acting as surrogate marker of disease duration. Cognitive impairment is a predictor of frontal lobe dysfunction. Among NMS, lack of attention or memory problems were negatively associated with frontal impairment. Further studies are nonetheless needed to better identify the predictors of frontal impairment in PD patients.
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- 2012
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132. Spinal anesthesia and minimal invasive laminotomy for paddle electrode placement in spinal cord stimulation: technical report and clinical results at long-term followup.
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Sarubbo S, Latini F, Tugnoli V, Quatrale R, Granieri E, and Cavallo MA
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- Adult, Aged, Failed Back Surgery Syndrome diagnosis, Failed Back Surgery Syndrome pathology, Failed Back Surgery Syndrome surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pain Measurement, Paresthesia pathology, Paresthesia surgery, Spinal Cord pathology, Spinal Cord surgery, Spinal Diseases pathology, Anesthesia, Spinal methods, Electric Stimulation Therapy methods, Electrodes, Implanted, Minimally Invasive Surgical Procedures methods, Spinal Diseases surgery
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Object: We arranged a mini-invasive surgical approach for implantation of paddle electrodes for SCS under spinal anesthesia obtaining the best paddle electrode placement and minimizing patients' discomfort. We describe our technique supported by neurophysiological intraoperative monitoring and clinical results., Methods: 16 patients, affected by neuropathic pain underwent the implantation of paddle electrodes for spinal cord stimulation in lateral decubitus under spinal anesthesia. The paddle was introduced after flavectomy and each patient confirmed the correct distribution of paresthesias induced by intraoperative test stimulation. VAS and patients' satisfaction rate were recorded during the followup and compared to preoperative values., Results: No patients reported discomfort during the procedure. In all cases, paresthesias coverage of the total painful region was achieved, allowing the best final electrode positioning. At the last followup (mean 36.7 months), 87.5% of the implanted patients had a good rate of satisfaction with a mean VAS score improvement of 70.5%., Conclusions: Spinal cord stimulation under spinal anesthesia allows an optimal positioning of the paddle electrodes without any discomfort for patients or neurosurgeons. The best intraoperative positioning allows a better postoperative control of pain, avoiding the risk of blind placements of the paddle or further surgery for their replacement.
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- 2012
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133. Brain interstitial nociceptin/orphanin FQ levels are elevated in Parkinson's disease.
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Marti M, Sarubbo S, Latini F, Cavallo M, Eleopra R, Biguzzi S, Lettieri C, Conti C, Simonato M, Zucchini S, Quatrale R, Sensi M, Candeletti S, Romualdi P, and Morari M
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- Adrenergic Agents toxicity, Adult, Aged, Aged, 80 and over, Analysis of Variance, Animals, Antipsychotic Agents pharmacology, Behavior, Animal drug effects, Brain drug effects, Disease Models, Animal, Female, Gene Expression Regulation drug effects, Haloperidol therapeutic use, Humans, Male, Microdialysis methods, Middle Aged, Opioid Peptides cerebrospinal fluid, Opioid Peptides genetics, Oxidopamine toxicity, Parkinson Disease cerebrospinal fluid, Parkinson Disease drug therapy, Parkinson Disease etiology, Rats, Rats, Sprague-Dawley, Young Adult, Nociceptin, Brain metabolism, Gene Expression Regulation physiology, Opioid Peptides metabolism, Parkinson Disease pathology
- Abstract
Expression and release of nociceptin/orphanin FQ (N/OFQ) are elevated in the substantia nigra reticulata of 6-hydroxydopamine-hemilesioned rats, suggesting a pathogenic role for N/OFQ in Parkinson's disease. In this study, we investigated whether elevation of N/OFQ expression in 6-hydroxydopamine-hemilesioned rats selectively occurs in substantia nigra and whether hypomotility following acute haloperidol administration is accompanied by a rise in nigral N/OFQ levels. Moreover, to prove a link between N/OFQ and idiopathic Parkinson's disease in humans, we measured N/OFQ levels in the cerebrospinal fluid of parkinsonian patients undergoing surgery for deep brain stimulation. In situ hybridization demonstrated that dopamine depletion was associated with increase of N/OFQ expression in substantia nigra (compacta +160%, reticulata +105%) and subthalamic nucleus (+45%), as well as reduction in caudate putamen (-20%). No change was observed in globus pallidus, nucleus accumbens, thalamus, and motor cortex. Microdialysis coupled to the bar test allowed to demonstrate that acute administration of haloperidol (0.8 and 3 mg/kg) increased nigral N/OFQ levels (maximally of +47% and +53%, respectively) in parallel with akinesia. A correlation with preclinical studies was found by analyzing N/OFQ levels in humans. Indeed, N/OFQ levels were found to be approximately 3.5-fold elevated in the cerebrospinal fluid of parkinsonian patients (148 fmol/ml) compared with nonparkinsonian neurologic controls (41 fmol/ml). These data represent the first clinical evidence linking N/OFQ to idiopathic Parkinson's disease in humans. They strengthen the pathogenic role of N/OFQ in the modulation of parkinsonism across species and provide a rationale for developing N/OFQ receptor antagonists as antiparkinsonian drugs.
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- 2010
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134. Effect of Globus Pallidus internus stimulation on gait in multifocal dystonia: a case study.
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Manca M, Mancini M, Ferraresi G, Chiari L, Sensi M, Cavallo M, and Quatrale R
- Subjects
- Biomechanical Phenomena, Disability Evaluation, Electrodes, Implanted, Female, Gait physiology, Gait Disorders, Neurologic etiology, Gait Disorders, Neurologic physiopathology, Humans, Leg innervation, Leg physiopathology, Middle Aged, Muscle, Skeletal innervation, Muscle, Skeletal physiopathology, Neurologic Examination, Outcome Assessment, Health Care, Recovery of Function physiology, Task Performance and Analysis, Treatment Outcome, Walking physiology, Basal Ganglia physiopathology, Deep Brain Stimulation methods, Dystonic Disorders physiopathology, Dystonic Disorders therapy, Gait Disorders, Neurologic therapy, Globus Pallidus physiology
- Published
- 2010
- Full Text
- View/download PDF
135. Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study.
- Author
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Colosimo C, Morgante L, Antonini A, Barone P, Avarello TP, Bottacchi E, Cannas A, Ceravolo MG, Ceravolo R, Cicarelli G, Gaglio RM, Giglia L, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Del Dotto P, Simoni L, and Marconi R
- Subjects
- Aged, Cross-Sectional Studies, Female, Humans, Italy epidemiology, Lewy Body Disease epidemiology, Longitudinal Studies, Male, Middle Aged, Multiple System Atrophy epidemiology, Neurodegenerative Diseases epidemiology, Prevalence, Supranuclear Palsy, Progressive epidemiology, Parkinson Disease, Secondary epidemiology, Parkinsonian Disorders epidemiology
- Abstract
The PRIAMO study is a cross-sectional longitudinal observational study aimed at describing epidemiology and evolution of non-motor symptoms (NMS) in patients with different forms of parkinsonism recruited in 55 Italian centres and evaluated over 24 months. In this paper, we are reporting prevalence and clinical characteristics of NMS in patients with atypical and secondary parkinsonism. Out of 1307 consecutive patients with a diagnosis of parkinsonism, 83 patients had vascular parkinsonism (VP), 34 had multiple system atrophy (MSA), 30 had progressive supranuclear palsy (PSP), 14 had dementia with Lewy bodies (DLB) and 11 had corticobasal degeneration (CBD). MSA and DLB had the highest number of NMS domains and symptoms, respectively. Gastrointestinal symptoms, pain, urinary problems and postural instability due to orthostatic hypotension were most frequent in MSA. Sleep disturbances were also common with a prevalence of approximately 70% in all diagnostic groups but CBD (36%). Psychiatric symptoms and attention and memory impairment were frequently observed in all diagnoses but were most prevalent among DLB patients, whereas the prevalence of skin and respiratory disorders was rather low in all forms, ranging between 10 and 30%. Atypical parkinsonism patients also reported a low QoL, with no significant differences among the different forms, whereas PD and VP patients had a better QoL.
- Published
- 2010
- Full Text
- View/download PDF
136. Pallidal stimulation for segmental dystonia: long term follow up of 11 consecutive patients.
- Author
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Sensi M, Cavallo MA, Quatrale R, Sarubbo S, Biguzzi S, Lettieri C, Capone JG, Tugnoli V, Tola MR, and Eleopra R
- Subjects
- Adult, Disability Evaluation, Dystonic Disorders genetics, Dystonic Disorders immunology, Dystonic Disorders physiopathology, Female, Functional Laterality, Humans, Longitudinal Studies, Magnetic Resonance Imaging methods, Male, Middle Aged, Molecular Chaperones genetics, Outcome Assessment, Health Care, Retrospective Studies, Severity of Illness Index, Time Factors, Deep Brain Stimulation methods, Dystonic Disorders therapy, Globus Pallidus physiology
- Abstract
Pallidal stimulation is a convincing and valid alternative for primary generalized dystonia refractory to medical therapy or botulinum toxin. However, the clinical outcome reported in literature is variable most likely because of heterogeneity DBS techniques employed and /or to clinical dystonic pattern of the patients who undergo surgery. In this study, we report the long term follow up of a homogeneous group of eleven subjects affected by segmental dystonia who were treated with bilateral stimulation of the Globus Pallidus pars interna (GPi) from the years 2000 to 2008. All the patients were evaluated, before surgery and at 6-12-24-36 months after the treatment, in accordance with the Burke Fahn Marsden Dystonia Rating Scale (BFMDRS). Our study indicates that DBS promotes an early and significant improvement at 6 months with an even and a better outcome later on. The analysis of specific sub items of the BFMDRS revealed an earlier and striking benefit not only as far as segmental motor function of the limbs but also for the complex cranial functions like face, (eyes and mouth), speech and swallowing, differently from results reported in primary generalized dystonia. Deep Brain Stimulation of GPi should be considered a valid indication for both generalized and segmental dystonia when other therapies appear ineffective.
- Published
- 2009
- Full Text
- View/download PDF
137. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease.
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Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, Bottacchi E, Cannas A, Ceravolo G, Ceravolo R, Cicarelli G, Gaglio RM, Giglia RM, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, and Dotto PD
- Subjects
- Aged, Antiparkinson Agents therapeutic use, Anxiety epidemiology, Anxiety etiology, Anxiety psychology, Cognition Disorders epidemiology, Cognition Disorders etiology, Cognition Disorders psychology, Depression epidemiology, Depression etiology, Depression psychology, Fatigue epidemiology, Fatigue etiology, Fatigue psychology, Female, Gastrointestinal Diseases epidemiology, Gastrointestinal Diseases etiology, Gastrointestinal Diseases psychology, Humans, Italy epidemiology, Male, Middle Aged, Olfaction Disorders epidemiology, Olfaction Disorders etiology, Olfaction Disorders psychology, Pain epidemiology, Pain etiology, Pain psychology, Parkinson Disease complications, Parkinson Disease drug therapy, Sleep Disorders, Intrinsic epidemiology, Sleep Disorders, Intrinsic etiology, Sleep Disorders, Intrinsic psychology, Urination Disorders epidemiology, Urination Disorders etiology, Urination Disorders psychology, Parkinson Disease psychology, Quality of Life
- Abstract
We performed a multicenter survey using a semistructured interview in 1,072 consecutive patients with Parkinson's disease (PD) enrolled during 12 months in 55 Italian centers to assess the prevalence of nonmotor symptoms (NMSs), their association with cognitive impairment, and the impact on patients' quality of life (QoL). We found that 98.6% of patients with PD reported the presence of NMSs. The most common were as follows: fatigue (58%), anxiety (56%), leg pain (38%), insomnia (37%), urgency and nocturia (35%), drooling of saliva and difficulties in maintaining concentration (31%). The mean number of NMS per patient was 7.8 (range, 0-32). NMS in the psychiatric domain were the most frequent (67%). Frequency of NMS increased along with the disease duration and severity. Patients with cognitive impairment reported more frequently apathy, attention/memory deficit, and psychiatric symptoms. Apathy was the symptom associated with worse PDQ-39 score but also presence of fatigue, attention/memory, and psychiatric symptoms had a negative impact on QoL. These findings further support a key role for NMS in the clinical frame of PD and the need to address them specifically in clinical trials using dedicated scales., (2009 Movement Disorder Society.)
- Published
- 2009
- Full Text
- View/download PDF
138. Botulinum toxin type A reduces capsaicin-evoked pain and neurogenic vasodilatation in human skin.
- Author
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Tugnoli V, Capone JG, Eleopra R, Quatrale R, Sensi M, Gastaldo E, Tola MR, and Geppetti P
- Subjects
- Adult, Capsaicin, Erythema chemically induced, Erythema drug therapy, Erythema physiopathology, Female, Hot Temperature, Humans, Male, Middle Aged, Neuralgia chemically induced, Neuralgia physiopathology, Pain Threshold drug effects, Skin blood supply, Skin innervation, Botulinum Toxins, Type A administration & dosage, Neuralgia drug therapy, Neuromuscular Agents administration & dosage, Vasodilation drug effects
- Abstract
The effect of Botulinum Toxin type A (BoNT/A) on pain and neurogenic vasodilatation induced by application to the human skin of thermal stimuli and capsaicin was evaluated in a double blind study. A capsaicin cream (0.5 ml of a 0.075%) was applied to the skin of both forearms of eighteen subjects randomly pretreated with either BoNT/A (Botox) or 0.9% saline (NS). Capsaicin was applied to a skin area either inside (protocol A) or adjacent to the BoNT/A treated area (protocol B). Pre-treatment with BoNT/A did not affect thermal-specific and thermal-pain thresholds (by quantitative sensory testing). However, capsaicin-induced pain sensation (by a visual analogue scale), flare area (by acetate sheet) and changes in cutaneous blood flow (CBF, by laser Doppler flowmetry) were reduced when capsaicin was administered inside (protocol A) the BoNT/A treated area. In Protocol B, capsaicin-induced pain was unchanged, and capsaicin-induced flare/increase in CBF were reduced only in the area treated with BoNT/A, but not in the BoNT/A untreated area. Results indicate that (i) BoNT/A reduces capsaicin-induced pain and neurogenic vasodilatation without affecting the transmission of thermal and thermal-pain modalities; (ii) reduction in capsaicin-induced pain occurs only if capsaicin is administered into the BoNT/A pretreated area; (iii) reduction in neurogenic vasodilatation by BoNT/A does not contribute to its analgesic action. BoNT/A could be tested for the treatment of conditions characterised by neurogenic inflammation and inflammatory pain.
- Published
- 2007
- Full Text
- View/download PDF
139. Clinical use of non-A botulinum toxins: botulinum toxin type C and botulinum toxin type F.
- Author
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Eleopra R, Tugnoli V, Quatrale R, Rossetto O, Montecucco C, and Dressler D
- Subjects
- Adult, Aged, Animals, Blepharoptosis physiopathology, Drug Resistance, Female, Humans, Male, Mice, Mice, Inbred BALB C, Middle Aged, Muscle Weakness drug therapy, Torticollis physiopathology, Blepharoptosis drug therapy, Botulinum Toxins therapeutic use, Torticollis drug therapy
- Abstract
Botulinum neurotoxin (BoNT) serotype A is commonly used in the treatment of focal dystonia, but some patients are primarily or become secondarily resistant to it. Consequently, other serotypes have to be used when immuno-resistance is proven. In the literature, patients with focal dystonia have been treated with BoNT serotype F with clinical benefit but with short lasting effects. Recently, BoNT serotype C has been used with positive clinical outcome. An update on the clinical use of BoNT serotype F and BoNT serotype C is provided.
- Published
- 2006
- Full Text
- View/download PDF
140. Different types of botulinum toxin in humans.
- Author
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Eleopra R, Tugnoli V, Quatrale R, Rossetto O, and Montecucco C
- Subjects
- Adult, Electric Stimulation methods, Evoked Potentials, Motor drug effects, Evoked Potentials, Motor radiation effects, Female, Humans, Injections, Intramuscular methods, Male, Middle Aged, Time Factors, Anti-Dyskinesia Agents classification, Anti-Dyskinesia Agents pharmacology, Botulinum Toxins classification, Botulinum Toxins pharmacology, Muscle, Skeletal drug effects
- Abstract
In humans, botulinum neurotoxin (BoNT) serotype A (BoNT/A) is a useful therapeutic tool, but different BoNT serotypes may be useful when a specific immune resistance related to BoNT/A is proved. BoNT serotype F (BoNT/F) was injected into human muscles but its effects are shorter compared to BoNT/A, whereas BoNT serotype B (BoNT/B) is effective in humans only if injected at very high doses. BoNT serotype C (BoNT/C) has a general profile of action similar to BoNT/A. Nevertheless, a comparison between these different BoNTs in human has not yet been reported. To establish the general profile of these different BoNTs in humans and the spread in near and untreated muscles we conducted an electrophysiological evaluation in 12 healthy volunteers by injecting BoNT/A (BOTOX 15MU), BoNT/B (NeuroBloc 1500MU), BoNT/F (15MU), BoNT/C (15MU) and a saline solution (placebo) in the abductor digiti minimi muscle (ADM) in a double-blind manner. The compound muscle action potential (CMAP) amplitude variation, before and at 2, 4, 6 and 8 weeks after the injections, was evaluated in the ADM, the fourth dorsal interosseus, the first dorsal interosseus and the abductor pollicis brevis APB. We detected an earlier recovery for BoNT/F when compared to the other BoNTs. No significant differences in the local or distant BoNT spread was observed among the different serotypes. We conclude that in humans, BoNT/B and BoNT/C have a general profile similar to BoNT/A and as such these serotypes could be alternative therapies to BoNT/A. BoNT/F might be useful when only a short duration of neuromuscular blockade is required., (Copyright 2004 Movement Disorder Society)
- Published
- 2004
- Full Text
- View/download PDF
141. [Treatment of spasticity with botulinum toxin].
- Author
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Eleopra R, Quatrale R, and Tugnoli V
- Subjects
- Humans, Anti-Dyskinesia Agents therapeutic use, Botulinum Toxins therapeutic use, Muscle Spasticity drug therapy
- Published
- 2003
142. Botulism-like syndrome after botulinum toxin type A injections for focal hyperhidrosis.
- Author
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Tugnoli V, Eleopra R, Quatrale R, Capone JG, Sensi M, and Gastaldo E
- Subjects
- Adult, Female, Humans, Syndrome, Botulinum Toxins, Type A adverse effects, Botulism chemically induced, Hyperhidrosis drug therapy
- Published
- 2002
- Full Text
- View/download PDF
143. Botulinum neurotoxin serotypes A and C do not affect motor units survival in humans: an electrophysiological study by motor units counting.
- Author
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Eleopra R, Tugnoli V, Quatrale R, Gastaldo E, Rossetto O, De Grandis D, and Montecucco C
- Subjects
- Animals, Botulinum Toxins administration & dosage, Botulinum Toxins therapeutic use, Botulinum Toxins, Type A administration & dosage, Botulinum Toxins, Type A therapeutic use, Cell Count, Cells, Cultured, Dystonia drug therapy, Electric Stimulation, Electrophysiology, Hemifacial Spasm drug therapy, Humans, Kinetics, Male, Mice, Neuromuscular Junction physiology, Phrenic Nerve physiology, Botulinum Toxins pharmacology, Botulinum Toxins, Type A pharmacology, Cell Survival, Motor Neurons physiology, Neuromuscular Agents pharmacokinetics
- Abstract
Objectives: Botulinum neurotoxin serotype A (BoNT/A) is a valid therapy for dystonia but repeated BoNT/A injections may induce a clinical immuno-resistance that could be overcome by using other BoNT serotypes. In vitro experiments and our preliminary investigations in vivo, indicate that botulinum neurotoxin serotype C (BoNT/C) could be an effective alternative to BoNT/A. Moreover, in cultured neurons 'in vitro' BoNT/C has been reported to be more toxic than BoNT/A., Methods: To verify this possibility, we compare the effect of BoNT/C and BoNT/A on the motor units count in humans by using the electrophysiological motor unit number estimation (MUNE) technique ('multiple point nerve stimulation'). Preliminarily, BoNT/C and BoNT/A dosage was calibrated in a mouse hemidiaphragm neuromuscular junction preparation. Subsequently, 8 volunteers were treated with 3IU of BoNT/C in the extensor digitorum brevis muscle of one foot and 3IU of BoNT/A in the contralateral one. Other 4 subjects were similarly injected at higher doses (10IU of BoNT/C or BoNT/A) to detect a possible dose-toxic effect., Results: In both groups, no statistically significant variations in MUNE counting or single motor unit potential size were detected after 4 months from injections, when it was evident a recovery from the BoNTs blockade., Conclusions: We conclude that BoNT/C, similarly to BoNT/A, is safe and effective in humans and it could be proposed for a clinical use.
- Published
- 2002
- Full Text
- View/download PDF
144. The role of gustatory flushing in Frey's syndrome and its treatment with botulinum toxin type A.
- Author
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Tugnoli V, Marchese Ragona R, Eleopra R, Quatrale R, Capone JG, Pastore A, Montecucco C, and De Grandis D
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Flushing drug therapy, Humans, Male, Middle Aged, Sweating drug effects, Botulinum Toxins, Type A therapeutic use, Neuromuscular Agents therapeutic use, Sweating, Gustatory drug therapy, Sweating, Gustatory physiopathology
- Abstract
After parotid surgery, gustatory sweating and flushing occur more frequently, the former reportedly in 15-100% of cases, while no reliable data are available for the latter. Although botulinum toxin (BoNT) is effective in controlling sweating, little is known about its effect on flushing. In 17 patients suffering from Frey's syndrome after parotid surgery, we studied the gustatory flushing phenomenon as compared to gustatory sweating, analyzing their frequency, area, type of stimulus and response to BoNT administration. Cutaneous blood flow (CBF) was monitored by laser Doppler flowmetry (LDF) on affected and unaffected areas of the cheek in basal conditions and after meals, before and then 1 month after starting the BoNT injections. The Minor test was used to identify the sweating area. Flushing was observed in 7 of 17 patients after masticatory activity, spicy meals or citrus fruits. No clinical data correlated with any presence of flushing. Flushing regressed completely after BoNT administration and CBF reached similar values in the affected and unaffected sites. No adverse effects were observed. BoNT administration proved an effective and safe treatment for gustatory sweating and flushing in patients with Frey's syndrome.
- Published
- 2002
- Full Text
- View/download PDF
145. Hypokaliemic rhabdomyolysis associated with liquorice ingestion: report of an atypical case.
- Author
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Barrella M, Lauria G, Quatrale R, and Paolino E
- Subjects
- Arm, Humans, Male, Middle Aged, Muscle, Skeletal pathology, Glycyrrhiza poisoning, Hypokalemia chemically induced, Plants, Medicinal, Rhabdomyolysis chemically induced
- Abstract
We here present an unusual case of hypokaliemic rhabdomyolysis, characterised by a sthenic deficit exclusively involving the distal muscles of the upper limbs and secondary to chronic glycyrrhizic acid intoxication, and by the absence of even ictal arterial hypertension. We discuss the etiopathogenetic bases and the risks related to the development of this secondary hypokaliemic syndrome, also in relation to other concomitant risk factors such as prolonged physical exercise and exposure to low temperatures.
- Published
- 1997
- Full Text
- View/download PDF
146. [Quantitative analysis of central and peripheral acoustic pathway conduction in man].
- Author
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Serra G, Quatrale R, Munerati V, Cristofori MC, Tugnoli V, and Eleopra R
- Subjects
- Electrophysiology, Evoked Potentials, Auditory, Humans, Acoustic Stimulation, Brain Stem physiology
- Published
- 1986
147. Neurophysiological evaluation of the muscular hypotrophy after immobilization.
- Author
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Serra G, Tugnoli V, Eleopra R, Quatrale R, Faccini R, and Basaglia N
- Subjects
- Adult, Electromyography methods, Humans, Muscular Atrophy diagnosis, Muscular Atrophy etiology, Immobilization, Muscular Atrophy physiopathology
- Abstract
Muscular hypotrophy due to arm or leg immobilization (MH) in absence of neuromuscular pathologies was tested by EMG spectral analysis, in order to identify a possible neurophysiological method able to analyze this kind of particular clinical picture. Two different groups of patients were tested. In group 1 the patients were suffering from vastus medialis muscle MH due to meniscus surgery, in group 2 the patients were suffering from biceps brachii muscle MH after humerus fracture. A significant difference between normal and pathological muscles was found and the methods may be useful in the neurophysiological evaluation of MH.
- Published
- 1989
148. Solute and water secretion by the eccrine sweat glands of the rat.
- Author
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Quatrale RP and Laden K
- Subjects
- Animals, Rats, Sweat metabolism, Sodium metabolism, Sweat Glands metabolism, Water-Electrolyte Balance
- Published
- 1968
- Full Text
- View/download PDF
149. The effect of ADH on eccrine sweating in the rat.
- Author
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Quatrale RP and Speir EH
- Subjects
- Animals, Depression, Chemical, Foot, Injections, Subcutaneous, Male, Potassium analysis, Rats, Secretory Rate drug effects, Sodium analysis, Sweat analysis, Vasoconstrictor Agents pharmacology, Water-Electrolyte Balance drug effects, Sweat Glands drug effects, Sweating drug effects, Vasopressins pharmacology
- Published
- 1970
- Full Text
- View/download PDF
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