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2. Genetics in Parkinson's disease, state-of-the-art and future perspectives.

Author

Trevisan, L, Gaudio, A, Monfrini, E, Avanzino, L, Fonzo, A Di, and Mandich, P

Subjects
PARKINSON'S disease, GENETIC risk score, MOVEMENT disorders, GENETICS, TREMOR, HEREDITY, INDIVIDUALIZED medicine, ATTITUDE testing
Abstract

Background Parkinson's disease (PD) is the second most common neurodegenerative disorder and is clinically characterized by the presence of motor (bradykinesia, rigidity, rest tremor and postural instability) and non-motor symptoms (cognitive impairment, autonomic dysfunction, sleep disorders, depression and hyposmia). The aetiology of PD is unknown except for a small but significant contribution of monogenic forms. Sources of data No new data were generated or analyzed in support of this review. Areas of agreement Up to 15% of PD patients carry pathogenic variants in PD-associated genes. Some of these genes are associated with mendelian inheritance, while others act as risk factors. Genetic background influences age of onset, disease course, prognosis and therapeutic response. Areas of controversy Genetic testing is not routinely offered in the clinical setting, but it may have relevant implications, especially in terms of prognosis, response to therapies and inclusion in clinical trials. Widely adopted clinical guidelines on genetic testing are still lacking and open to debate. Some new genetic associations are still awaiting confirmation, and selecting the appropriate genes to be included in diagnostic panels represents a difficult task. Finally, it is still under study whether (and to which degree) specific genetic forms may influence the outcome of PD therapies. Growing points Polygenic Risk Scores (PRS) may represent a useful tool to genetically stratify the population in terms of disease risk, prognosis and therapeutic outcomes. Areas timely for developing research The application of PRS and integrated multi-omics in PD promises to improve the personalized care of patients. [ABSTRACT FROM AUTHOR]

Published
2024
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4. The Italian Dystonia Registry: rationale, design and preliminary findings

Author

Defazio, Giovanni, Esposito, M., Abbruzzese, G., Scaglione, C. L., Fabbrini, G., Ferrazzano, G., Peluso, S., Pellicciari, R., Gigante, A. F., Cossu, G., Arca, R., Avanzino, L., Bono, F., Mazza, M. R., Bertolasi, L., Bacchin, R., Eleopra, R., Lettieri, C., Morgante, F., Altavista, M. C., Polidori, L., Liguori, R., Misceo, S., Squintani, G., Tinazzi, M., Ceravolo, R., Unti, E., Magistrelli, L., Coletti Moja, M., Modugno, N., Petracca, M., Tambasco, N., Cotelli, M. S., Aguggia, M., Pisani, A., Romano, M., Zibetti, M., Bentivoglio, A. R., Albanese, A., Girlanda, P., and Berardelli, A.

Published
2017
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5. Correlation between Quality of Life and severity of Parkinson's Disease by assessing an optimal cut-off point on the Parkinson's Disease questionnaire (PDQ-39) as related to the Hoehn & Yahr (H&Y) scale

Author

Galeoto, G, Berardi, A, Colalelli, F, Pelosin, E, Mezzarobba, S, Avanzino, L, Valente, D, Tofani, M, and Fabbrini, G

Subjects
Adult, severity, Parkinson Disease, Parkinson, age, gender, quality of life, Cross-Sectional Studies, Female, Humans, Severity of Illness Index, Surveys and Questionnaires, Quality of Life
Abstract

Strong evidence shows that symptoms in individuals with Parkinson's Disease (PD) restrict both their independence and social participation, leading to a low Quality of Life (QoL). Conversely, a reduced QoL has a negative impact on symptoms. The aim is to evaluate the correlation between QoL and severity of PD by assessing the presence of an optimal cut-off point on the Parkinson's disease questionnaire (PDQ-39) as related to the HoehnYahr (HY) scale in a cohort of Italian adults with PD.A multicenter, cross-sectional study was performed. This study was conducted on a cohort of consecutive individuals. All participants were evaluated with the PDQ-39, and the severity of PD was recorded according to the HY scale by a neurologist. Receiver op-erating characteristic (ROC) curves and coordinates, visually inspected, were used to find cut-off points with optimal sensitivity and specificity. These were in turn used to determine the optimal PDQ-39 cut-off score for identifying disease severity according to HY stages.513 individuals were included in the study. The ROC curve analysis showed that QoL worsened with an increase in disease severity and age. Moreover, QoL was worse in females.The results of this study allowed for the correlation of QoL and disease severity in a cohort of individuals with PD. With this cut-off point, it is now possible to make a determination of QoL of an individual with PD at a certain stage of the disease, in a specific age range, and of a particular gender.

Published
2022

6. Correction to: The Italian Dystonia Registry: rationale, design and preliminary findings

Author

Defazio, Giovanni, Esposito, M., Abbruzzese, G., Scaglione, C. L., Fabbrini, G., Ferrazzano, G., Peluso, S., Pellicciari, R., Gigante, A. F., Cossu, G., Arca, R., Avanzino, L., Bono, F., Mazza, M. R., Bertolasi, L., Bacchin, R., Eleopra, R., Lettieri, C., Morgante, F., Altavista, M. C., Polidori, L., Liguori, R., Misceo, S., Squintani, G., Tinazzi, M., Ceravolo, R., Unti, E., Magistrelli, L., Coletti Moja, M., Modugno, N., Petracca, M., Tambasco, N., Cotelli, M. S., Aguggia, M., Pisani, A., Romano, M., Zibetti, M., Bentivoglio, A. R., Albanese, A., Girlanda, P., and Berardelli, A.

Published
2018
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8. Elettromiografia

Author

Pillastrini, P., Marchetti, M., Abbruzzese, G., Megighian, A., Avanzino, L., Marinelli, L., and Trompetto, C.

Published
2021

9. Detecting Sensitive Mobility Features for Parkinson's Disease Stages Via Machine Learning

Author

Mirelman, A., Frank, M., Melamed, M., Granovsky, L., Nieuwboer, A., Rochester, L., Din, S. Del, Avanzino, L., Pelosin, E., Bloem, B.R., Croce, U. Della, Cereatti, A., Bonato, P., Camicioli, R., Ellis, T., Hamilton, J.L., Hass, C.J., Almeida, Q.J., Inbal, M., Thaler, Avner, Shirvan, J., Cedarbaum, J.M., Giladi, N., Hausdorff, J.M., Mirelman, A., Frank, M., Melamed, M., Granovsky, L., Nieuwboer, A., Rochester, L., Din, S. Del, Avanzino, L., Pelosin, E., Bloem, B.R., Croce, U. Della, Cereatti, A., Bonato, P., Camicioli, R., Ellis, T., Hamilton, J.L., Hass, C.J., Almeida, Q.J., Inbal, M., Thaler, Avner, Shirvan, J., Cedarbaum, J.M., Giladi, N., and Hausdorff, J.M.

Abstract

Contains fulltext : 238527.pdf (Publisher’s version ) (Closed access), BACKGROUND: It is not clear how specific gait measures reflect disease severity across the disease spectrum in Parkinson's disease (PD). OBJECTIVE: To identify the gait and mobility measures that are most sensitive and reflective of PD motor stages and determine the optimal sensor location in each disease stage. METHODS: Cross-sectional wearable-sensor records were collected in 332 patients with PD (Hoehn and Yahr scale I-III) and 100 age-matched healthy controls. Sensors were adhered to the participant's lower back, bilateral ankles, and wrists. Study participants walked in a ~15-meter corridor for 1 minute under two walking conditions: (1) preferred, usual walking speed and (2) walking while engaging in a cognitive task (dual-task). A subgroup (n = 303, 67% PD) also performed the Timed Up and Go test. Multiple machine-learning feature selection and classification algorithms were applied to discriminate between controls and PD and between the different PD severity stages. RESULTS: High discriminatory values were found between motor disease stages with mean sensitivity in the range 72%-83%, specificity 69%-80%, and area under the curve (AUC) 0.76-0.90. Measures from upper-limb sensors best discriminated controls from early PD, turning measures obtained from the trunk sensor were prominent in mid-stage PD, and stride timing and regularity were discriminative in more advanced stages. CONCLUSIONS: Applying machine-learning to multiple, wearable-derived features reveals that different measures of gait and mobility are associated with and discriminate distinct stages of PD. These disparate feature sets can augment the objective monitoring of disease progression and may be useful for cohort selection and power analyses in clinical trials of PD. © 2021 International Parkinson and Movement Disorder Society.

Published
2021

10. Spread of segmental/multifocal idiopathic adult-onset dystonia to a third body site

Author

Ercoli, T., Erro, R., Fabbrini, G., Pellicciari, R., Girlanda, P., Terranova, C., Avanzino, L., Di Biasio, F., Barone, P., Esposito, M., De Joanna, G., Eleopra, R., Bono, F., Manzo, L., Bentivoglio, Anna Rita, Petracca, Martina, Mascia, M. M., Albanese, A., Castagna, A., Ceravolo, R., Altavista, M. C., Scaglione, C., Magistrelli, L., Zibetti, M., Bertolasi, L., Coletti Moja, M., Cotelli, M. S., Cossu, G., Minafra, B., Pisani, A., Misceo, S., Modugno, N., Romano, M., Cassano, D., Berardelli, A., Defazio, G., Cimino, P., Scannapieco, S., Ferrazzano, G., Brigandi, A., Habetswallner, F., Pascarella, A., Ialongo, Tamara, Ramella, M., Mazzucchi, S., Moschella, V., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Petracca M., Ialongo T., Ercoli, T., Erro, R., Fabbrini, G., Pellicciari, R., Girlanda, P., Terranova, C., Avanzino, L., Di Biasio, F., Barone, P., Esposito, M., De Joanna, G., Eleopra, R., Bono, F., Manzo, L., Bentivoglio, Anna Rita, Petracca, Martina, Mascia, M. M., Albanese, A., Castagna, A., Ceravolo, R., Altavista, M. C., Scaglione, C., Magistrelli, L., Zibetti, M., Bertolasi, L., Coletti Moja, M., Cotelli, M. S., Cossu, G., Minafra, B., Pisani, A., Misceo, S., Modugno, N., Romano, M., Cassano, D., Berardelli, A., Defazio, G., Cimino, P., Scannapieco, S., Ferrazzano, G., Brigandi, A., Habetswallner, F., Pascarella, A., Ialongo, Tamara, Ramella, M., Mazzucchi, S., Moschella, V., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Petracca M., and Ialongo T.

Abstract

Background: Adult-onset focal dystonia can spread to involve one, or less frequently, two additional body regions. Spread of focal dystonia to a third body site is not fully characterized. Materials and methods: We retrospectively analyzed data from the Italian Dystonia Registry, enrolling patients with segmental/multifocal dystonia involving at least two parts of the body or more. Survival analysis estimated the relationship between dystonia features and spread to a third body part. Results: We identified 340 patients with segmental/multifocal dystonia involving at least two body parts. Spread of dystonia to a third body site occurred in 42/241 patients (17.4%) with focal onset and 10/99 patients (10.1%) with segmental/multifocal dystonia at onset. The former had a greater tendency to spread than patients with segmental/multifocal dystonia at onset. Gender, years of schooling, comorbidity, family history of dystonia/tremor, age at dystonia onset, and disease duration could not predict spread to a third body site. Among patients with focal onset in different body parts (cranial, cervical, and upper limb regions), there was no association between site of focal dystonia onset and risk of spread to a third body site. Discussion and conclusion: Spread to a third body site occurs in a relative low percentage of patients with idiopathic adult-onset dystonia affecting two body parts. Regardless of the site of dystonia onset and of other demographic/clinical variables, focal onset seems to confer a greater risk of spread to a third body site in comparison to patients with segmental/multifocal dystonia at onset.

Published
2021

15. Do patients with Parkinson's disease with freezing of gait respond differently than those without to treadmill training augmented by virtual reality?

Author

Bekkers, E.M.J., Mirelman, A., Alcock, L., Rochester, L., Nieuwhof, F., Bloem, B.R., Pelosin, E., Avanzino, L., Cereatti, A., Croce, U. Della, Hausdorff, J.M., Nieuwboer, A., Bekkers, E.M.J., Mirelman, A., Alcock, L., Rochester, L., Nieuwhof, F., Bloem, B.R., Pelosin, E., Avanzino, L., Cereatti, A., Croce, U. Della, Hausdorff, J.M., and Nieuwboer, A.

Abstract

Contains fulltext : 220639pub.pdf (Publisher’s version ) (Closed access) Contains fulltext : 220639pos.pdf (Author’s version postprint ) (Open Access), Background. People with Parkinson's disease and freezing of gait (FOG+) have more falls, postural instability and cognitive impairment compared with FOG-. Objective. To conduct a secondary analysis of the V-TIME study, a randomized, controlled investigation showing a greater reduction of falls after virtual reality treadmill training (TT + VR) compared with usual treadmill walking (TT) in a mixed population of fallers. We addressed whether these treadmill interventions led to similar gains in FOG+ as in FOG-. Methods. A total of 77 FOG+ and 44 FOG- were assigned randomly to TT + VR or TT. Participants were assessed pre- and posttraining and at 6 months' follow-up. Main outcome was postural stability assessed by the Mini Balance Evaluation System Test (Mini-BEST) test. Falls were documented using diaries. Other outcomes included the New Freezing of Gait Questionnaire (NFOG-Q) and the Trail Making Test (TMT-B). Results. Mini-BEST scores and the TMT-B improved in both groups after training (P = .001), irrespective of study arm and FOG subgroup. However, gains were not retained at 6 months. Both FOG+ and FOG- had a greater reduction of falls after TT + VR compared with TT (P = .008). NFOG-Q scores did not change after both training modes in the FOG+ group. Conclusions. Treadmill walking (with or without VR) improved postural instability in both FOG+ and FOG-, while controlling for disease severity differences. As found previously, TT + VR reduced falls more than TT alone, even among those with FOG. Interestingly, FOG itself was not helped by training, suggesting that although postural instability, falls and FOG are related, they may be controlled by different mechanisms.

Published
2020

16. Falls risk in relation to activity exposure in high-risk older adults

Author

Magaziner, J., Rochester, L., Hausdorff, J.M., Mirelman, A., Della Croce, U., Cereatti, A., Nieuwhof, F., Olde Rikkert, M.G.M., Bloem, B.R., Avanzino, L., Pelosin, E., Bekkers, E.M.J., Nieuwboer, A., Lord, S., Galna, B., Del Din, S., Magaziner, J., Rochester, L., Hausdorff, J.M., Mirelman, A., Della Croce, U., Cereatti, A., Nieuwhof, F., Olde Rikkert, M.G.M., Bloem, B.R., Avanzino, L., Pelosin, E., Bekkers, E.M.J., Nieuwboer, A., Lord, S., Galna, B., and Del Din, S.

Abstract

Background Physical activity is linked to many positive health outcomes, stimulating the development of exercise programs. However, many falls occur while walking and so promoting activity might paradoxically increase fall rates, causing injuries, and worse quality of life. The relationship between activity exposure and fall rates remains unclear. We investigated the relationship between walking activity (exposure to risk) and fall rates before and after an exercise program (V-TIME). Methods One hundred and nine older fallers, 38 fallers with mild cognitive impairment (MCI), and 128 fallers with Parkinson’s disease (PD) were randomly assigned to one of two active interventions: treadmill training only or treadmill training combined with a virtual reality component. Participants were tested before and after the interventions. Free-living walking activity was characterized by volume, pattern, and variability of ambulatory bouts using an accelerometer positioned on the lower back for 1 week. To evaluate that relationship between fall risk and activity, a normalized index was determined expressing fall rates relative to activity exposure (FRA index), with higher scores indicating a higher risk of falls per steps taken. Results At baseline, the FRA index was higher for fallers with PD compared to those with MCI and older fallers. Walking activity did not change after the intervention for the groups but the FRA index decreased significantly for all groups (p ≤ .035). Conclusions This work showed that V-TIME interventions reduced falls risk without concurrent change in walking activity. We recommend using the FRA index in future fall prevention studies to better understand the nature of intervention programs.

Published
2020

17. Does acute peripheral trauma contribute to idiopathic adult-onset dystonia?

Author

Defazio, G., Fabbrini, G., Erro, R., Albanese, Alberto, Barone, P., Zibetti, M., Esposito, M., Pellicciari, R., Avanzino, L., Bono, F., Eleopra, R., Bertolasi, L., Altavista, M. C., Cotelli, M. S., Ceravolo, R., Scaglione, C., Bentivoglio, Anna Rita, Cossu, G., Coletti Moja, M., Girlanda, P., Misceo, S., Pisani, A., Mascia, M. M., Ercoli, T., Tinazzi, M., Maderna, L., Minafra, B., Magistrelli, L., Romano, M., Aguggia, M., Tambasco, N., Castagna, A., Cassano, D., Berardelli, A., Ferrazzano, G., Lalli, S., Silvestre, F., Manganelli, F., Di Biasio, F., Marchese, R., Demonte, G., Santangelo, D., Devigili, G., Durastanti, V., Turla, M., Mazzucchi, S., Petracca, Martina, Oppo, V., Barbero, P., Morgante, F., Di Lazzaro, G., Squintani, G., Modugno, N., Albanese A. (ORCID:0000-0002-5864-0006), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Petracca M., Defazio, G., Fabbrini, G., Erro, R., Albanese, Alberto, Barone, P., Zibetti, M., Esposito, M., Pellicciari, R., Avanzino, L., Bono, F., Eleopra, R., Bertolasi, L., Altavista, M. C., Cotelli, M. S., Ceravolo, R., Scaglione, C., Bentivoglio, Anna Rita, Cossu, G., Coletti Moja, M., Girlanda, P., Misceo, S., Pisani, A., Mascia, M. M., Ercoli, T., Tinazzi, M., Maderna, L., Minafra, B., Magistrelli, L., Romano, M., Aguggia, M., Tambasco, N., Castagna, A., Cassano, D., Berardelli, A., Ferrazzano, G., Lalli, S., Silvestre, F., Manganelli, F., Di Biasio, F., Marchese, R., Demonte, G., Santangelo, D., Devigili, G., Durastanti, V., Turla, M., Mazzucchi, S., Petracca, Martina, Oppo, V., Barbero, P., Morgante, F., Di Lazzaro, G., Squintani, G., Modugno, N., Albanese A. (ORCID:0000-0002-5864-0006), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), and Petracca M.

Abstract

Background: Acute peripheral trauma is a controversial risk factor for idiopathic dystonia. Materials and methods: We retrospectively analyzed data from the Italian Dystonia Registry regarding the occurrence of acute peripheral trauma severe enough to require medical attention in 1382 patients with adult-onset idiopathic dystonia and 200 patients with acquired adult-onset dystonia. Results: Patients with idiopathic and acquired dystonia showed a similar burden of peripheral trauma in terms of the number of patients who experienced trauma (115/1382 vs. 12/200, p = 0.3) and the overall number of injuries (145 for the 1382 idiopathic patients and 14 for the 200 patients with secondary dystonia, p = 0.2). Most traumas occurred before the onset of idiopathic or secondary dystonia but only a minority of such injuries (14 in the idiopathic group, 2 in the acquired group, p = 0.6) affected the same body part as that affected by dystonia. In the idiopathic group, the elapsed time between trauma and dystonia onset was 8.1 ± 9.2 years; only six of the 145 traumas (4.1%) experienced by 5/1382 idiopathic patients (0.36%) occurred one year or less before dystonia onset; in the acquired dystonia group, the two patients experienced prior trauma to the dystonic body part 5 and 6 years before dystonia development. Discussion and conclusion: Our data suggest that the contribution of peripheral acute trauma to idiopathic dystonia is negligible, if anything, and likely involves only a small subset of patients.

Published
2020

18. Correlation between Quality of Life and severity of Parkinson's Disease by assessing an optimal cut-off point on the Parkinson's Disease questionnaire (PDQ-39) as related to the Hoehn & Yahr (H&Y) scale.

Author

Galeoto, G., Berardi, A., Colalelli, F., Pelosin, E., Mezzarobba, S., Avanzino, L., Valente, D., Tofani, M., and Fabbrini, G.

Subjects
PARKINSON'S disease, QUALITY of life, SOCIAL participation, RECEIVER operating characteristic curves, CROSS-sectional method
Abstract

Purpose. Strong evidence shows that symptoms in individuals with Parkinson's Disease (PD) restrict both their independence and social participation, leading to a low Quality of Life (QoL). Conversely, a reduced QoL has a negative impact on symptoms. The aim is to evaluate the correlation between QoL and severity of PD by assessing the presence of an optimal cut-off point on the Parkinson's disease questionnaire (PDQ-39) as related to the Hoehn &Yahr (H&Y) scale in a cohort of Italian adults with PD. Methods. A multicenter, cross-sectional study was performed. This study was conducted on a cohort of consecutive individuals. All participants were evaluated with the PDQ-39, and the severity of PD was recorded according to the H&Y scale by a neurologist. Receiver operating characteristic (ROC) curves and coordinates, visually inspected, were used to find cut-off points with optimal sensitivity and specificity. These were in turn used to determine the optimal PDQ-39 cut-off score for identifying disease severity according to H&Y stages. Results. 513 individuals were included in the study. The ROC curve analysis showed that QoL worsened with an increase in disease severity and age. Moreover, QoL was worse in females. Conclusions. The results of this study allowed for the correlation of QoL and disease severity in a cohort of individuals with PD. With this cut-off point, it is now possible to make a determination of QoL of an individual with PD at a certain stage of the disease, in a specific age range, and of a particular gender. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Correction to: The Italian Dystonia Registry: rationale, design and preliminary findings (Neurological Sciences, (2017), 38, 5, (819-825), 10.1007/s10072-017-2839-3)

Author

Defazio, G., Esposito, M., Abbruzzese, G., Scaglione, C. L., Fabbrini, G., Ferrazzano, G., Peluso, S., Pellicciari, R., Gigante, A. F., Cossu, G., Arca, R., Avanzino, L., Bono, F., Mazza, M. R., Bertolasi, L., Bacchin, R., Eleopra, R., Lettieri, C., Morgante, F., Altavista, M. C., Polidori, L., Liguori, R., Misceo, S., Squintani, G., Tinazzi, M., Ceravolo, R., Unti, E., Magistrelli, L., Coletti Moja, M., Modugno, N., Petracca, M., Tambasco, N., Cotelli, M. S., Aguggia, M., Pisani, A., Romano, M., Zibetti, M., Bentivoglio, A. R., Albanese, A., Girlanda, P., and Berardelli, A.

Subjects
Settore MED/26 - NEUROLOGIA, Dystonia, Neurology (clinical), Psychiatry and Mental Health, Risk factors, Epidemiology
Published
2018

34. Spread of dystonia in patients with idiopathic adult-onset laryngeal dystonia

Author

Esposito, M., Fabbrini, G., Ferrazzano, G., Berardelli, A., Peluso, S., Cesari, U., Gigante, A. F., Bentivoglio, Anna Rita, Petracca, Martina, Erro, R., Barone, P., Schirinzi, T., Eleopra, R., Avanzino, L., Romano, M., Scaglione, C. L., Cossu, G., Morgante, F., Minafra, B., Zibetti, M., Coletti Moja, M., Turla, Mario, Fadda, L., Defazio, G., Bentivoglio, A. R. (ORCID:0000-0002-9663-095X), Petracca, M., Esposito, M., Fabbrini, G., Ferrazzano, G., Berardelli, A., Peluso, S., Cesari, U., Gigante, A. F., Bentivoglio, Anna Rita, Petracca, Martina, Erro, R., Barone, P., Schirinzi, T., Eleopra, R., Avanzino, L., Romano, M., Scaglione, C. L., Cossu, G., Morgante, F., Minafra, B., Zibetti, M., Coletti Moja, M., Turla, Mario, Fadda, L., Defazio, G., Bentivoglio, A. R. (ORCID:0000-0002-9663-095X), and Petracca, M.

Abstract

Background and purpose: Adult-onset laryngeal dystonia (LD) can be isolated or can be associated with dystonia in other body parts. Combined forms can be segmental at the onset or can result from dystonia spread to or from the larynx. The aim of this study was to identify the main clinical and demographic features of adult-onset idiopathic LD in an Italian population with special focus on dystonia spread. Methods: Data were obtained from the Italian Dystonia Registry (IDR) produced by 37 Italian institutions. Clinical and demographic data of 71 patients with idiopathic adult-onset LD were extracted from a pool of 1131 subjects included in the IDR. Results: Fifty of 71 patients presented a laryngeal focal onset; the remaining subjects had onset in other body regions and later laryngeal spread. The two groups did not show significant differences of demographic features. 32% of patients with laryngeal onset reported spread to contiguous body regions afterwards and in most cases (12 of 16 subjects) dystonia started to spread within 1 year from the onset. LD patients who remained focal and those who had dystonia spread did not show other differences. Conclusions: Data from IDR show that dystonic patients with focal laryngeal onset will present spread in almost one-third of cases. Spread from the larynx occurs early and is directed to contiguous body regions showing similarities with clinical progression of blepharospasm. This study gives a new accurate description of LD phenomenology that may contribute to improving the comprehension of dystonia pathophysiology.

Published
2018

35. Clinical variables associated with treatment changes in Parkinson’s disease: results from the longitudinal phase of the REASON study

Author

Abbruzzese, Giovanni, Barone, Paolo, Ceravolo, Roberto, Fabbrini, Giovanni, Lessi, Patrizia, Ori, Alessandra, Simoni, Lucia, Tinazzi, Michele, Antonini, Angelo, Melone, MAB, Schettino, C, Capaldo, G, Iemolo, F, Sanzaro, E, Ceravolo, MG, Capecci, M, Andrenelli, E, Pontieri, FE, Pellicano, C, Benincasa, D, Fabbrini, G, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, MA, Spagnolo, F, Scaglioni, A, Abrignani, G, Abbruzzese, G, Avanzino, L, Tamburini, T, Antonini, A, Facchini, S, Biundo, R, Altavista, MC, Roberti, C, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Tinazzi, M, Ottaviani, S, Ajena, D, Trianni, G, Caggiula, M, Valenti, G, My, F, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Asteggiano, G, L’Episcopo, MR, Saracco, E, Barone, P, Picillo, M, Moccia, M, Onofrj, M, Thomas, A, Denaro, A, Marini, C, De Santis, F, Spagnoli, V, L’Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A., Abbruzzese, Giovanni, Barone, Paolo, Ceravolo, Roberto, Fabbrini, Giovanni, Lessi, Patrizia, Ori, Alessandra, Simoni, Lucia, Tinazzi, Michele, Antonini, Angelo, Melone, Mab, Schettino, C, Capaldo, G, Iemolo, F, Sanzaro, E, Ceravolo, Mg, Capecci, M, Andrenelli, E, Pontieri, Fe, Pellicano, C, Benincasa, D, Fabbrini, G, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, Ma, Spagnolo, F, Scaglioni, A, Abrignani, G, Abbruzzese, G, Avanzino, L, Tamburini, T, Antonini, A, Facchini, S, Biundo, R, Altavista, Mc, Roberti, C, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Tinazzi, M, Ottaviani, S, Ajena, D, Trianni, G, Caggiula, M, Valenti, G, My, F, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Asteggiano, G, L’Episcopo, Mr, Saracco, E, Barone, P, Picillo, M, Moccia, M, Onofrj, M, Thomas, A, Denaro, A, Marini, C, De Santis, F, Spagnoli, V, L’Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, and Marchet, A.

Subjects
Male, medicine.medical_specialty, Clinical variables, Neurology, Parkinson's disease, Motor symptoms, Non-motor symptoms, Parkinson’s disease, Treatment persistence, Aged, Female, Humans, Longitudinal Studies, Middle Aged, Parkinson Disease, Physician's Role, Severity of Illness Index, Treatment Outcome, Neurology (clinical), Psychiatry and Mental Health, 2708, Longitudinal Studie, Dermatology, Disease, Internal medicine, motor symptoms,non-motor symptoms, Parkinson’s disease,treatment persistence, Severity of illness, Medicine, Neuroradiology, business.industry, musculoskeletal, neural, and ocular physiology, General Medicine, medicine.disease, nervous system diseases, cardiovascular system, Physical therapy, Neurosurgery, business, Human
Abstract

To assess over a period of 9 months in a sample of Italian Parkinson’s disease (PD) patients reasons leading the neurologist to modify dopaminergic treatment and patients’ causes of dissatisfaction with ongoing therapy. To evaluate the influence of disease severity on therapy persistence. A disease severity balanced sample of PD patients with stable anti-parkinsonian drugs (APD) treatment was enrolled and evaluated every 3 months. Patients requiring APD treatment modifications were discontinued from the study. The probability to modify APD treatment is greater for higher motor (UPDRS scores) and non-motor symptoms (NMSS score) severity. Both from neurologist’s and patient’s perspective, motor symptoms were the main determinants underlying APD treatment modifications. Non-motor symptoms were cause of dissatisfaction with ongoing APD treatment for 52 % of the patients, while only 36 % of the neurologists considered these as valid reasons for therapy change. REASON is the first study in PD patients that prospectively examined reasons driving APD treatment changes. Results show that the disease severity significantly increases the probability of APD treatment change. Patients attribute greater relevance than neurologists to non-motor symptoms as reason requiring treatment changes. This confirms that patient and neurologist perceptions only partially overlap.

Published
2015

36. Spread of dystonia in patients with idiopathic adult-onset laryngeal dystonia

Author

Esposito, M., primary, Fabbrini, G., additional, Ferrazzano, G., additional, Berardelli, A., additional, Peluso, S., additional, Cesari, U., additional, Gigante, A. F., additional, Bentivoglio, A. R., additional, Petracca, M., additional, Erro, R., additional, Barone, P., additional, Schirinzi, T., additional, Eleopra, R., additional, Avanzino, L., additional, Romano, M., additional, Scaglione, C. L., additional, Cossu, G., additional, Morgante, F., additional, Minafra, B., additional, Zibetti, M., additional, Coletti Moja, M., additional, Turla, M., additional, Fadda, L., additional, and Defazio, G., additional

Published
2018
Full Text
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37. Adherence to anti-Parkinson drug therapy in the 'REASON' sample of Italian patients with Parkinson's disease: the linguistic validation of the Italian version of the 'Morisky Medical Adherence Scale-8 items'

Author

Fabbrini, G, Abbruzzese, G, Barone, P, Antonini, A, Tinazzi, M, Castegnaro, G, Rizzoli, S, Morisky, De, Lessi, P, Abbruzzese G, Cr, Ceravolo, R, Melone, M, Schettino, C, Califano, F, Ceravolo, M, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Stampanoni Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De Santis, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Ori, A, Pirondi, S, Roncari, B, Sala, S, Sgarbi, S, Simoni, L, Trevisan, F, Zanoli, L, Fabbrini, G, Abbruzzese, G, Antonini, A, Barone, P, Ceravolo, R, Tinazzi, M, Melone, Mariarosa Anna Beatrice, Schettino, C, Califano, F, Ceravolo, Mg, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, Fe, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, Gioacchino, Tessitore, Alessandro, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, Ma, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, Mc, Roberti, C, Asteggiano, G, L'Episcopo, Mr, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Nullm, nullDel Sette, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Nullm, nullStampanoni Bassi, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, Nulli, nullLa Farina, Nulls, nullZambito Marsala, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, Nullf, nullDe Santi, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Lessi, P, Castegnaro, G, Ori, A, Pirondi, S, Rizzoli, S, Roncari, B, Sala, S, Sgarbi, S, Simoni, L, Trevisan, F, Zanoli, L., Fabbrini, G., Abbruzzese, G., Barone, P., Antonini, A., Tinazzi, M., Castegnaro, G., Rizzoli, S., Morisky, D. E., Lessi, P., Ceravolo, R., Melone, M. A., Schettino, C., Califano, F., Ceravolo, M. G., Capecci, M., Andrenelli, E., Iemolo, F., Spadaro, D., Carnemolla, A., Pontieri, F. E., Pellicano, C., Benincasa, D., Pietracupa, S., Latorre, A., Tedeschi, G., Tessitore, A., Giordano, A., Bonuccelli, U., Frosini, D., Vanelli, F., Comi, G., Volonte, M. A., Spagnolo, F., Scaglioni, A., Abrignani, G., Avanzino, L., Tamburini, T., Facchini, S., Biundo, R., Altavista, M. C., Roberti, C., Asteggiano, G., L'Episcopo, M. R., Saracco, E., Avarello, T., Bono, G., Riboldazzi, G., Leva, S., Del Sette, M., Carabelli, E., Traverso, E., Michelucci, R., Nassetti, S., Pasini, E., Padovani, A., Cottini, E., Bigni, B., Ruggieri, S., Modugno, N., Fischetti, M., Stefani, A., Pierantozzi, M., Stampanoni Bassi, M., Ottaviani, S., Ajena, D., Trianni, G., My, F., Caggiula, M., Valenti, G., Grioli, S., La Farina, I., Zambito Marsala, S., Marchini, C., Gioulis, M., Picillo, M., Moccia, M., Denaro, A., Sebastianelli, L., Onofrj, M., Thomas, A., Marini, C., De Santis, F., Spagnoli, V., L'Erario, R., Passadore, P., Belgrado, E., Mucchiut, M., Priori, A., Cogiamanian, F., Marchet, A., Ori, A., Pirondi, S., Roncari, B., Sala, S., Sgarbi, S., Simoni, L., Trevisan, F., Morisky, De, Comi, Giancarlo, and REASON study, Group

Subjects
Predictive validity, Male, Translation, Parkinson's disease, Adherence, Comprehension, Validation, Aged, Antiparkinson Agents, Female, Humans, Parkinson Disease, Translations, Medication Adherence, Surveys and Questionnaires, Neurology (clinical), Psychiatry and Mental Health, 2708, MEDLINE, Dermatology, Disease, Linguistic validation, Pharmacotherapy, Quality of life, Medicine, business.industry, General Medicine, Parkinson’s disease, medicine.disease, Psychiatry and Mental health, Antiparkinson Agent, Settore MED/26 - Neurologia, business, Human, Clinical psychology
Abstract

Information about patients' adherence to therapy represents a primary issue in Parkinson's disease (PD) management. To perform the linguistic validation of the Italian version of the self-rated 8-Item Morisky Medical Adherence Scale (MMAS-8) and to describe in a sample of Italian patients affected by PD the adherence to anti-Parkinson drug therapy and the association between adherence and some socio-demographic and clinical features. MMAS-8 was translated into Italian language by two independent Italian mother-tongue translators. The consensus version was then back-translated by an English mother-tongue translator. This translation process was followed by a consensus meeting between the authors of translation and investigators and then by two comprehension tests. The translated version of the MMAS-8 scale was then administered at the baseline visit of the "REASON" study (Italian Study on the Therapy Management in Parkinson's disease: Motor, Non-Motor, Adherence and Quality Of Life Factors) in a large sample of PD patients. The final version of the MMAS-8 was easily understood. Mean ± SD MMAS-8 score was 6.1 ± 1.2. There were no differences in adherence to therapy in relationship to disease severity, gender, educational level or decision to change therapy. The Italian version of MMAS-8, the key tool of the REASON study to assess the adherence to therapy, has shown to be understandable to patients with PD. Patients enrolled in the REASON study showed medium therapy adherence.

Published
2013

38. Reasons driving treatment modification in Parkinson's disease: Results from the cross-sectional phase of the REASON study

Author

Tinazzi, M, Abbruzzese, G, Antonini, A, Ceravolo, R, Fabbrini, G, Lessi, P, Barone, P, REASON Study Group:Abruzzese, G, Lido, V, Melone, M, Schettino, C, Califano, F, Ceravolo, M, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del, S, Carabelli, M, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La Farina, I, Zambito Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De Santis, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A, Tinazzi, M, Abbruzzese, G, Antonini, A, Ceravolo, R, Fabbrini, G, Lessi, P, Barone, P, Lido, V, Melone, M, Schettino, C, Califano, F, Ceravolo, Mg, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, Pontieri, F, Pellicano, C, Benincasa, D, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Avanzino, L, Tamburini, T, Facchini, S, Biundo, R, Altavista, M, Roberti, C, Asteggiano, G, L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, Del, Sette, M, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, Bassi, M, Ottaviani, S, Ajena, D, Trianni, G, My, F, Caggiula, M, Valenti, G, Grioli, S, La, Farina, I, Zambito, Marsala, S, Marchini, C, Gioulis, M, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, De, Santi, F, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, Marchet, A., Tinazzi, M., Abbruzzese, G., Antonini, A., Ceravolo, R., Fabbrini, G., Lessi, P., Barone, P., Melone, M. A. B., Schettino, C., Califano, F., Ceravolo, M. G., Capecci, M., Andrenelli, E., Iemolo, F., Spadaro, D., Carnemolla, A., Pontieri, F. E., Pellicano, C., Benincasa, D., Pietracupa, S., Latorre, A., Tedeschi, G., Tessitore, A., Giordano, A., Bonuccelli, U., Frosini, D., Vanelli, F., Comi, G., Volonte, M. A., Spagnolo, F., Scaglioni, A., Abrignani, G., Avanzino, L., Tamburini, T., Facchini, S., Biundo, R., Altavista, M. C., Roberti, C., Asteggiano, G., L'Episcopo, M. R., Saracco, E., Avarello, T., Bono, G., Riboldazzi, G., Leva, S., Del Sette, M., Carabelli, E., Traverso, E., Michelucci, R., Nassetti, S., Pasini, E., Padovani, A., Cottini, E., Bigni, B., Ruggieri, S., Modugno, N., Fischetti, M., Stefani, A., Pierantozzi, M., Stampanoni Bassi, M., Ottaviani, S., Ajena, D., Trianni, G., My, F., Caggiula, M., Valenti, G., Grioli, S., La Farina, I., Zambito Marsala, S., Marchini, C., Gioulis, M., Picillo, M., Moccia, M., Denaro, A., Sebastianelli, L., Onofrj, M., Thomas, A., Marini, C., De Santis, F., Spagnoli, V., L'Erario, R., Passadore, P., Belgrado, E., Mucchiut, M., Priori, A., Cogiamanian, F., Lessi, and Comi, Giancarlo

Subjects
Male, Pediatrics, Parkinson's disease, anti-Parkinson drugs, motor symptoms, non-motor symptoms, Practice Patterns, Socioeconomic Factor, Motor symptoms, Severity of Illness Index, Antiparkinson Agents, Cohort Studies, Motor symptom, Practice Patterns, Physicians', Stage (cooking), Anti-Parkinson drug, Anti-Parkinson drugs, Non-motor symptoms, Aged, Female, Humans, Middle Aged, Parkinson Disease, Patient Satisfaction, Socioeconomic Factors, Geriatrics and Gerontology, Neurology (clinical), Neurology, musculoskeletal, neural, and ocular physiology, Antiparkinson Agent, cardiovascular system, Settore MED/26 - Neurologia, Treatment modification, Human, medicine.medical_specialty, Non-motor symptom, Disease severity, medicine, In patient, Physicians', business.industry, Advanced stage, medicine.disease, nervous system diseases, Physical therapy, Treatment decision making, Cohort Studie, business
Abstract

OBJECTIVES: To assess the association between clinical and socio-demographic features and anti-Parkinson drug (APD) treatment modifications in patients with PD and to describe neurologist and patient opinions regarding the need for changes in APD therapy. METHODS: Subjects with PD with stable APD treatment over ≥3 months prior to baseline were enrolled and evaluated for socio-demographic data, disability, disease severity and neurologist and patient views on the need to modify APD treatment. RESULTS: 775 Patients were included, 51% with Hoehn and Yahr (HY) stage 1-2 (early PD) and 49% with HY stage 2.5-4 (advanced PD). Neurologists modified APD treatment in 255 patients, 97 (25%) early PD and 158 (41%; p < 0.0001) advanced PD. APD modification was strongly associated with a low educational level and UPDRS part IV score. The most common reasons behind the APD therapy changes among neurologists were presence/worsening of motor or non-motor symptoms (88% and 37% of subjects respectively). Out of 216 patients, 92% and 51% were willing to undergo APD changes to therapy because of the presence/worsening of motor or non-motor symptoms. CONCLUSIONS: Neurologist decision to change APD therapy and patients reasons for dissatisfaction with it can be prevalently attributed to the presence/worsening of motor symptoms and motor fluctuations in the advanced stages. Non-motor symptoms were considered more often by patients. The patient educational level played a key role in treatment decision.

Published
2013

40. Sensory-motor integration in focal dystonia

Author

Avanzino, L., Tinazzi, M., Ionta, S., and Fiorio, M.

Subjects
Cerebral Cortex/pathology, Cerebral Cortex/physiopathology, Dystonic Disorders/pathology, Dystonic Disorders/physiopathology, Humans, Movement/physiology, Neural Pathways/physiopathology, Sensation/physiology
Abstract

Traditional definitions of focal dystonia point to its motor component, mainly affecting planning and execution of voluntary movements. However, focal dystonia is tightly linked also to sensory dysfunction. Accurate motor control requires an optimal processing of afferent inputs from different sensory systems, in particular visual and somatosensory (e.g., touch and proprioception). Several experimental studies indicate that sensory-motor integration - the process through which sensory information is used to plan, execute, and monitor movements - is impaired in focal dystonia. The neural degenerations associated with these alterations affect not only the basal ganglia-thalamic-frontal cortex loop, but also the parietal cortex and cerebellum. The present review outlines the experimental studies describing impaired sensory-motor integration in focal dystonia, establishes their relationship with changes in specific neural mechanisms, and provides new insight towards the implementation of novel intervention protocols. Based on the reviewed state-of-the-art evidence, the theoretical framework summarized in the present article will not only result in a better understanding of the pathophysiology of dystonia, but it will also lead to the development of new rehabilitation strategies.

Published
2015

41. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial

Author

Mirelman, A., Rochester, L., Maidan, I., Del Din, S., Alcock, L., Nieuwhof, F., Olde Rikkert, M.G.M., Bloem, B.R., Pelosin, E., Avanzino, L., Abbruzzese, G., Dockx, K., Bekkers, E., Giladi, N., Nieuwboer, A., Hausdorff, J.M., Mirelman, A., Rochester, L., Maidan, I., Del Din, S., Alcock, L., Nieuwhof, F., Olde Rikkert, M.G.M., Bloem, B.R., Pelosin, E., Avanzino, L., Abbruzzese, G., Dockx, K., Bekkers, E., Giladi, N., Nieuwboer, A., and Hausdorff, J.M.

Abstract

Contains fulltext : 167962.pdf (publisher's version ) (Closed access), BACKGROUND: Age-associated motor and cognitive deficits increase the risk of falls, a major cause of morbidity and mortality. Because of the significant ramifications of falls, many interventions have been proposed, but few have aimed to prevent falls via an integrated approach targeting both motor and cognitive function. We aimed to test the hypothesis that an intervention combining treadmill training with non-immersive virtual reality (VR) to target both cognitive aspects of safe ambulation and mobility would lead to fewer falls than would treadmill training alone. METHODS: We carried out this randomised controlled trial at five clinical centres across five countries (Belgium, Israel, Italy, the Netherlands, and the UK). Adults aged 60-90 years with a high risk of falls based on a history of two or more falls in the 6 months before the study and with varied motor and cognitive deficits were randomly assigned by use of computer-based allocation to receive 6 weeks of either treadmill training plus VR or treadmill training alone. Randomisation was stratified by subgroups of patients (those with a history of idiopathic falls, those with mild cognitive impairment, and those with Parkinson's disease) and sex, with stratification per clinical site. Group allocation was done by a third party not involved in onsite study procedures. Both groups aimed to train three times per week for 6 weeks, with each session lasting about 45 min and structured training progression individualised to the participant's level of performance. The VR system consisted of a motion-capture camera and a computer-generated simulation projected on to a large screen, which was specifically designed to reduce fall risk in older adults by including real-life challenges such as obstacles, multiple pathways, and distracters that required continual adjustment of steps. The primary outcome was the incident rate of falls during the 6 months after the end of training, which was assessed in a modified intenti

Published
2016

43. Reasons driving treatment modification in Parkinson's disease: results from the cross-sectional phase of the REASON study

Author

Michele, Tinazzi, Giovanni, Abbruzzese, Antonini, Angelo, Roberto, Ceravolo, Giovanni, Fabbrini, Patrizia, Lessi, Barone, Paolo, Giovanni, Abruzzese, Venezia, Lido, M A, B Melone, Schettino, C, Califano, F, G Ceravolo, M, Capecci, M, Andrenelli, E, Iemolo, F, Spadaro, D, Carnemolla, A, E Pontieri, F, Pellicano, C, Benincasa, D, Fabbrini, G, Pietracupa, S, Latorre, A, Tedeschi, G, Tessitore, A, Giordano, A, Bonuccelli, U, Frosini, D, Vanelli, F, Comi, G, A Volonté, M, Spagnolo, F, Scaglioni, A, Abrignani, G, Abbruzzese, G, Avanzino, L, Tamburini, T, Antonini, A, Facchini, S, Biundo, R, C Altavista, M, Roberti, C, Asteggiano, G, R L'Episcopo, M, Saracco, E, Avarello, T, Bono, G, Riboldazzi, G, Leva, S, M Del Sette, Carabelli, E, Traverso, E, Michelucci, R, Nassetti, S, Pasini, E, Padovani, A, Cottini, E, Bigni, B, Ruggieri, S, Modugno, N, Fischetti, M, Stefani, A, Pierantozzi, M, M Stampanoni Bassi, Tinazzi, M, Ottaviani, S, Ajena, D, Trianni, G, F, My, Caggiula, M, Valenti, G, Grioli, S, I La Farina, S Zambito Marsala, Marchini, C, Gioulis, M, Barone, P, Picillo, M, Moccia, M, Denaro, A, Sebastianelli, L, Onofrj, M, Thomas, A, Marini, C, F De Santis, Spagnoli, V, L'Erario, R, Passadore, P, Belgrado, E, Mucchiut, M, Priori, A, Cogiamanian, F, and Marchet, A

Published
2013

44. Diagnostic agreement in patients with psychogenic movement disorders

Author

Morgante, F, Edwards, Mj, Espay, Aj, Fasano, A, Mir, P, Martino, D, Bovi, Tommaso, Tinazzi, Michele, Cossu, G, Murgia, D, Modugno, N, Pellecchia, Mt, Rizzo, G, Scaglione, C, Martinelli, P, Fabbrini, G, Berardelli, A, Arabia, G, Nicoletti, G, Avanzino, L, Marinelli, L, Abbruzzese, G, Boero, G, Cantalupo, Gaetano, Cilia, R, Claudia, Dell'Aquila, Iliceto, G, Tortorella, C, Defazio, G, Di Leo, R, Girlanda, P, Elia, A, Petracca, M, Luigetti, M, and Zappia, M.

Subjects
Adult, Male, psychogenic movement disorders, diagnostic criteria, interobserver agreement, epidemiology, phenomenology, facial distortion, Severity of Illness Index, facial movement disorders, Article, Young Adult, Humans, psychogenic dystonia, psychogenic blepharospasm, Aged, Neurologic Examination, Psychiatric Status Rating Scales, Movement Disorders, Reproducibility of Results, Middle Aged, Psychophysiologic Disorders, psychogenic facial movement disorders, Neurology, Female, facial movement disorders, psychogenic movement disorders, psychogenic facial movement disorders, psychogenic dystonia, psychogenic blepharospasm, facial distortion
Abstract

The reliability and applicability of published diagnostic criteria for psychogenic movement disorders (PMDs) have never been examined.Eight movement disorder and six general neurologists rated 14 patients diagnosed with PMD and 14 patients diagnosed with organic movement disorders. Raters provided a dichotomous judgment (i.e., psychogenic or organic) upon review of video-based movement phenomenology and a category of diagnostic certainty based on the Fahn-Williams and Shill-Gerber criteria after accessing standardized clinical information. We measured interobserver agreement on the diagnosis and clinical certainty judgment of PMD.In both groups of raters, agreements were "fair" on the video-based dichotomous judgment, but improved to "substantial" after access to standardized clinical information. "Slight" to "poor" agreement was reached for the "probable" and "possible" categories of diagnostic certainty corresponding to both diagnostic criteria.Diagnosis according to clinical available criteria for PMD yields poor diagnostic agreement.

Published
2012

45. Diagnostic agreement in psychogenic movement disorders

Author

Morgante, F, Bovi, T, Fasano, A, Pellecchia, M, Rizzo, G, Scaglione, C, Cossu, G, Modugno, N, Arabia, G, Avanzino, L, Ciclia, R, Dell'Aquila, C, Elia, A, Marinelli, L, Abbruzzese, G, Berardelli, A, Defazio, G, Fabbrini, G, Girlanda, P, Iliceto, G, Martinelli, P, Nicoletti, G, Tinazzi, M, Zappia, Mario, Boero, G, Cantalupo, G, DI LEO, R, Luigetti, M, Tortora, C, Edwards, M, Espay, A, Mir, P, and Martino, D.

Published
2010

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