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1. Impact of 2021 European Academy of Neurology/Peripheral Nerve Society diagnostic criteria on diagnosis and therapy of chronic inflammatory demyelinating polyradiculoneuropathy variants

Author

De&nbsp, Lorenzo, A, Liberatore, G, Doneddu, P, Manganelli, F, Cocito, D, Briani, C, Fazio, R, Mazzeo, A, Schenone, A, Di&nbsp, Stefano, V, Cosentino, G, Marfia, G, Benedetti, L, Carpo, M, Filosto, M, Antonini, G, Clerici, A, Luigetti, M, Matà, S, Rosso, T, Lucchetta, M, Siciliano, G, Lauria&nbsp, Pinter, G, Cavaletti, G, Inghilleri, M, Cantisani, T, Notturno, F, Ricciardi, D, Habetswallner, F, Spina, E, Peci, E, Salvalaggio, A, Falzone, Y, Strano, C, Gentile, L, Vegezzi, E, Mataluni, G, Cotti&nbsp, Piccinelli, S, Leonardi, L, Romano, A, Nobile-Orazio, E, Lorenzo A., Liberatore G., Doneddu P. E., Manganelli F., Cocito D., Briani C., Fazio R., Mazzeo A., Schenone A., Stefano V., Cosentino G., Marfia G. A., Benedetti L., Carpo M., Filosto M., Antonini G., Clerici A. M., Luigetti M., Matà S., Rosso T., Lucchetta M., Siciliano G., Pinter G., Cavaletti G., Inghilleri M., Cantisani T., Notturno F., Ricciardi D., Habetswallner F., Spina E., Peci E., Salvalaggio A., Falzone Y., Strano C., Gentile L., Vegezzi E., Mataluni G., Piccinelli S., Leonardi L., Romano A., Nobile-Orazio E., De&nbsp, Lorenzo, A, Liberatore, G, Doneddu, P, Manganelli, F, Cocito, D, Briani, C, Fazio, R, Mazzeo, A, Schenone, A, Di&nbsp, Stefano, V, Cosentino, G, Marfia, G, Benedetti, L, Carpo, M, Filosto, M, Antonini, G, Clerici, A, Luigetti, M, Matà, S, Rosso, T, Lucchetta, M, Siciliano, G, Lauria&nbsp, Pinter, G, Cavaletti, G, Inghilleri, M, Cantisani, T, Notturno, F, Ricciardi, D, Habetswallner, F, Spina, E, Peci, E, Salvalaggio, A, Falzone, Y, Strano, C, Gentile, L, Vegezzi, E, Mataluni, G, Cotti&nbsp, Piccinelli, S, Leonardi, L, Romano, A, Nobile-Orazio, E, Lorenzo A., Liberatore G., Doneddu P. E., Manganelli F., Cocito D., Briani C., Fazio R., Mazzeo A., Schenone A., Stefano V., Cosentino G., Marfia G. A., Benedetti L., Carpo M., Filosto M., Antonini G., Clerici A. M., Luigetti M., Matà S., Rosso T., Lucchetta M., Siciliano G., Pinter G., Cavaletti G., Inghilleri M., Cantisani T., Notturno F., Ricciardi D., Habetswallner F., Spina E., Peci E., Salvalaggio A., Falzone Y., Strano C., Gentile L., Vegezzi E., Mataluni G., Piccinelli S., Leonardi L., Romano A., and Nobile-Orazio E.

Abstract

Background and purpose: There are different criteria for the diagnosis of different variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) guidelines provide specific clinical criteria for each CIDP variant even if their therapeutical impact has not been investigated. Methods: We applied the clinical criteria for CIDP variants of the 2021 EAN/PNS guidelines to 369 patients included in the Italian CIDP database who fulfilled the 2021 EAN/PNS electrodiagnostic criteria for CIDP. Results: According to the 2021 EAN/PNS clinical criteria, 245 patients achieved a clinical diagnosis of typical CIDP or CIDP variant (66%). We identified 106 patients with typical CIDP (29%), 62 distal CIDP (17%), 28 multifocal or focal CIDP (7%), four sensory CIDP (1%), 27 sensory-predominant CIDP (7%), 10 motor CIDP (3%), and eight motor-predominant CIDP (2%). Patients with multifocal, distal, and sensory CIDP had milder impairment and symptoms. Patients with multifocal CIDP had less frequently reduced conduction velocity and prolonged F-wave latency and had lower levels of cerebrospinal fluid protein. Patients with distal CIDP more frequently had reduced distal compound muscle action potentials. Patients with motor CIDP did not improve after steroid therapy, whereas those with motor-predominant CIDP did. None of the patients with sensory CIDP responded to steroids, whereas most of those with sensory-predominant CIDP did. Conclusions: The 2021 EAN/PNS criteria for CIDP allow a better characterization of CIDP variants, permitting their distinction from typical CIDP and more appropriate treatment for patients.

Published
2024

2. Unclassified clinical presentations of chronic inflammatory demyelinating polyradiculoneuropathy

Author

Doneddu, P, Akyil, H, Manganelli, F, Briani, C, Cocito, D, Benedetti, L, Mazzeo, A, Fazio, R, Filosto, M, Cosentino, G, Di Stefano, V, Antonini, G, Marfia, G, Inghilleri, M, Siciliano, G, Clerici, A, Carpo, M, Schenone, A, Luigetti, M, Lauria, G, Mata, S, Rosso, T, Minicuci, G, Lucchetta, M, Cavaletti, G, Liberatore, G, Spina, E, Campagnolo, M, Peci, E, Germano, F, Gentile, L, Strano, C, Cotti Piccinelli, S, Vegezzi, E, Leonardi, L, Mataluni, G, Ceccanti, M, Schirinzi, E, Romozzi, M, Nobile-Orazio, E, Doneddu P. E., Akyil H., Manganelli F., Briani C., Cocito D., Benedetti L., Mazzeo A., Fazio R., Filosto M., Cosentino G., Di Stefano V., Antonini G., Marfia G. A., Inghilleri M., Siciliano G., Clerici A. M., Carpo M., Schenone A., Luigetti M., Lauria G., Mata S., Rosso T., Minicuci G. M., Lucchetta M., Cavaletti G., Liberatore G., Spina E., Campagnolo M., Peci E., Germano F., Gentile L., Strano C., Cotti Piccinelli S., Vegezzi E., Leonardi L., Mataluni G., Ceccanti M., Schirinzi E., Romozzi M., Nobile-Orazio E., Doneddu, P, Akyil, H, Manganelli, F, Briani, C, Cocito, D, Benedetti, L, Mazzeo, A, Fazio, R, Filosto, M, Cosentino, G, Di Stefano, V, Antonini, G, Marfia, G, Inghilleri, M, Siciliano, G, Clerici, A, Carpo, M, Schenone, A, Luigetti, M, Lauria, G, Mata, S, Rosso, T, Minicuci, G, Lucchetta, M, Cavaletti, G, Liberatore, G, Spina, E, Campagnolo, M, Peci, E, Germano, F, Gentile, L, Strano, C, Cotti Piccinelli, S, Vegezzi, E, Leonardi, L, Mataluni, G, Ceccanti, M, Schirinzi, E, Romozzi, M, Nobile-Orazio, E, Doneddu P. E., Akyil H., Manganelli F., Briani C., Cocito D., Benedetti L., Mazzeo A., Fazio R., Filosto M., Cosentino G., Di Stefano V., Antonini G., Marfia G. A., Inghilleri M., Siciliano G., Clerici A. M., Carpo M., Schenone A., Luigetti M., Lauria G., Mata S., Rosso T., Minicuci G. M., Lucchetta M., Cavaletti G., Liberatore G., Spina E., Campagnolo M., Peci E., Germano F., Gentile L., Strano C., Cotti Piccinelli S., Vegezzi E., Leonardi L., Mataluni G., Ceccanti M., Schirinzi E., Romozzi M., and Nobile-Orazio E.

Abstract

Background To assess the ability of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) clinical criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) to include within their classification the whole spectrum of clinical heterogeneity of the disease and to define the clinical characteristics of the unclassifiable clinical forms. Methods The 2021 EAN/PNS clinical criteria for CIDP were applied to 329 patients fulfilling the electrodiagnostic (and in some cases also the supportive) criteria for the diagnosis of CIDP. Clinical characteristics were reviewed for each patient not strictly fulfilling the clinical criteria ('unclassifiable'). Results At study inclusion, 124 (37.5%) patients had an unclassifiable clinical presentation, including 110 (89%) with a typical CIDP-like clinical phenotype in whom some segments of the four limbs were unaffected by weakness ('incomplete typical CIDP'), 10 (8%) with a mild distal, symmetric, sensory or sensorimotor polyneuropathy confined to the lower limbs with cranial nerve involvement ('cranial nerve predominant CIDP') and 4 (1%) with a symmetric sensorimotor polyneuropathy limited to the proximal and distal areas of the lower limbs ('paraparetic CIDP'). Eighty-one (65%) patients maintained an unclassifiable presentation during the entire disease follow-up while 13 patients progressed to typical CIDP. Patients with the unclassifiable clinical forms compared with patients with typical CIDP had a milder form of CIDP, while there was no difference in the distribution patterns of demyelination. Conclusions A proportion of patients with CIDP do not strictly fulfil the 2021 EAN/PNS clinical criteria for diagnosis. These unclassifiable clinical phenotypes may pose diagnostic challenges and thus deserve more attention in clinical practice and research.

Published
2023

3. Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Sabet, A., George, K., Roberts, L., Carne, R., Blum, S., Henderson, R., Van Damme, P., Demeestere, J., Larue, S., D'Amour, C., Bril, V., Breiner, A., Kunc, P., Valis, M., Sussova, J., Kalous, T., Talab, R., Bednar, M., Toomsoo, T., Rubanovits, I., Gross-Paju, K., Sorro, U., Saarela, M., Auranen, M., Pouget, J., Attarian, S., Le Masson, G., Wielanek-Bachelet, A., Desnuelle, C., Delmont, E., Clavelou, P., Aufauvre, D., Schmidt, J., Zschuentssch, J., Sommer, C., Kramer, D., Hoffmann, O., Goerlitz, C., Haas, J., Chatzopoulos, M., Yoon, R., Gold, R., Berlit, P., Jaspert-Grehl, A., Liebetanz, D., Kutschenko, A., Stangel, M., Trebst, C., Baum, P., Bergh, F., Klehmet, J., Meisel, A., Klostermann, F., Oechtering, J., Lehmann, H., Schroeter, M., Hagenacker, T., Mueller, D., Sperfeld, A., Bethke, F., Drory, V., Algom, A., Yarnitsky, D., Murinson, B., Di Muzio, A., Ciccocioppo, F., Sorbi, S., Mata, S., Schenone, A., Grandis, M., Lauria, G., Cazzato, D., Antonini, G., Morino, S., Cocito, D., Zibetti, M., Yokota, T., Ohkubo, T., Kanda, T., Kawai, M., Kaida, K., Onoue, H., Kuwabara, S., Mori, M., Iijima, M., Ohyama, K., Baba, M., Tomiyama, M., Nishiyama, K., Akutsu, T., Yokoyama, K., Kanai, K., van Schaik, I.N., Eftimov, F., Notermans, N.C., Visser, N., Faber, C., Hoeijmakers, J., Rejdak, K., Chyrchel-Paszkiewicz, U., Casanovas Pons, C., Alberti Aguiló, M., Gamez, J., Figueras, M., Marquez Infante, C., Benitez Rivero, S., Lunn, M., Morrow, J., Gosal, D., Lavin, T., Melamed, I., Testori, A., Ajroud-Driss, S., Menichella, D., Simpson, E., Chi-Ho Lai, E., Dimachkie, M., Barohn, R.J., Beydoun, S., Johl, H., Lange, D., Shtilbans, A., Muley, S., Ladha, S., Freimer, M., Kissel, J., Latov, N., Chin, R., Ubogu, E., Mumfrey, S., Rao, T., MacDonald, P., Sharma, K., Gonzalez, G., Allen, J., Walk, D., Hobson-Webb, L., Gable, K., van Schaik, Ivo N, Bril, Vera, van Geloven, Nan, Hartung, Hans-Peter, Lewis, Richard A, Sobue, Gen, Lawo, John-Philip, Praus, Michaela, Mielke, Orell, Durn, Billie L, Cornblath, David R, and Merkies, Ingemar S J

Published
2018
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4. Prolonged distal motor latency of median nerve does not improve diagnostic accuracy for CIDP

Author

Spina, E, Doneddu, P, Liberatore, G, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Peci, E, Tronci, S, Ruiz, M, Piccinelli, S, Schenone, A, Leonardi, L, Gentile, L, Piccolo, L, Mataluni, G, Santoro, L, Nobile-Orazio, E, Manganelli, F, Spina E., Doneddu P. E., Liberatore G., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Peci E., Tronci S., Ruiz M., Piccinelli S. C., Schenone A., Leonardi L., Gentile L., Piccolo L., Mataluni G., Santoro L., Nobile-Orazio E., Manganelli F., Spina, E, Doneddu, P, Liberatore, G, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Peci, E, Tronci, S, Ruiz, M, Piccinelli, S, Schenone, A, Leonardi, L, Gentile, L, Piccolo, L, Mataluni, G, Santoro, L, Nobile-Orazio, E, Manganelli, F, Spina E., Doneddu P. E., Liberatore G., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Peci E., Tronci S., Ruiz M., Piccinelli S. C., Schenone A., Leonardi L., Gentile L., Piccolo L., Mataluni G., Santoro L., Nobile-Orazio E., and Manganelli F.

Abstract

Compression of the median nerve at the carpal tunnel can give demyelinating features and result in distal motor latency (DML) prolongation fulfilling the EFNS/PNS demyelinating criteria for chronic inflammatory demyelinating polyneuropathy (CIDP). Accordingly, being carpal tunnel syndrome (CTS) common in the general population, the EFNS/PNS guidelines recommend excluding the DML of the median nerve when DML prolongation may be consistent with median neuropathy at the wrist from CTS. The main aims of this study were to verify whether the inclusion of DML of the median nerve (when consistent with CTS) could improve electrophysiological diagnostic accuracy for CIDP and if the median nerve at the carpal tunnel was more prone to demyelination. We analyzed electrophysiological data from 499 patients included consecutively into the Italian CIDP Database. According to the EFNS/PNS criteria, 352 patients had a definite, 10 a probable, and 57 a possible diagnosis of CIDP, while 80 were not fulfilling the diagnostic criteria. The inclusion of DML prolongation of median nerve did not improve significantly the diagnostic accuracy for CIDP; overall diagnostic class changed in 6 out of 499 patients (1.2%) and electrodiagnostic class of CIDP changed from not fulfilling to possible in only 2 patients (2.5% of not-fulfilling patients). In conclusion, we can infer that excluding DML prolongation of median nerve does not increase the risk of missing a diagnosis of CIDP thus corroborating the current EFNS/PNS criteria.

Published
2022

5. The neurophysiological lesson from the Italian CIDP database

Author

Spina, E, Doneddu, P, Liberatore, G, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Peci, E, Tronci, S, Ruiz, M, Piccinelli, S, Schenone, A, Leonardi, L, Gentile, L, Piccolo, L, Mataluni, G, Santoro, L, Nobile-Orazio, E, Manganelli, F, Spina E., Doneddu P. E., Liberatore G., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Peci E., Tronci S., Ruiz M., Piccinelli S. C., Schenone A., Leonardi L., Gentile L., Piccolo L., Mataluni G., Santoro L., Nobile-Orazio E., Manganelli F., Spina, E, Doneddu, P, Liberatore, G, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Peci, E, Tronci, S, Ruiz, M, Piccinelli, S, Schenone, A, Leonardi, L, Gentile, L, Piccolo, L, Mataluni, G, Santoro, L, Nobile-Orazio, E, Manganelli, F, Spina E., Doneddu P. E., Liberatore G., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Peci E., Tronci S., Ruiz M., Piccinelli S. C., Schenone A., Leonardi L., Gentile L., Piccolo L., Mataluni G., Santoro L., Nobile-Orazio E., and Manganelli F.

Abstract

Introduction: Electrophysiological diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may be challenging. Thus, with the aim ofproviding some practical advice in electrophysiological approach to a patient with suspected CIDP, we analyzed electrophysiological data from 499 patients enrolled inthe Italian CIDP Database. Methods: We calculated the rate of each demyelinating feature, the rate of demyelinating features per nerve, the diagnostic rate for upper andlower limb nerves, and, using a ROC curve analysis, the diagnostic accuracy of each couple of nerves and each demyelinating feature, for every CIDP subtype.Moreover, we compared the electrophysiological data of definite and probable CIDP patients with those of possible and not-fulfilling CIDP patients, and by a logisticregression analysis, we estimated the odds ratio (OR) to make an electrophysiological diagnosis of definite or probable CIDP. Results: The ulnar nerve had the highestrate of demyelinating features and, when tested bilaterally, had the highest diagnostic accuracy except for DADS in which peroneal nerves were the most informative.In possible and not-fulfilling CIDP patients, a lower number of nerves and proximal temporal dispersion (TD) measurements had been performed compared to definiteand probable CIDP patients. Importantly, OR for each tested motor nerve and each TD measurement was 1.59 and 1.33, respectively. Conclusion: Our findingsdemonstrated that the diagnosis of CIDP may be missed due to inadequate or incomplete electrophysiological examination or interpretation. At the same time, thesedata taken together could be useful to draw a thoughtful electrophysiological approach to patients suspected of CIDP.

Published
2022

6. Frequency and clinical correlates of anti-nerve antibodies in a large population of CIDP patients included in the Italian database

Author

Liberatore, G, De Lorenzo, A, Giannotta, C, Manganelli, F, Filosto, M, Cosentino, G, Cocito, D, Briani, C, Cortese, A, Fazio, R, Lauria, G, Clerici, A, Rosso, T, Marfia, G, Antonini, G, Cavaletti, G, Carpo, M, Doneddu, P, Spina, E, Cotti Piccinelli, S, Peci, E, Querol, L, Nobile-Orazio, E, Liberatore G., De Lorenzo A., Giannotta C., Manganelli F., Filosto M., Cosentino G., Cocito D., Briani C., Cortese A., Fazio R., Lauria G., Clerici A. M., Rosso T., Marfia G. A., Antonini G., Cavaletti G., Carpo M., Doneddu P. E., Spina E., Cotti Piccinelli S., Peci E., Querol L., Nobile-Orazio E., Liberatore, G, De Lorenzo, A, Giannotta, C, Manganelli, F, Filosto, M, Cosentino, G, Cocito, D, Briani, C, Cortese, A, Fazio, R, Lauria, G, Clerici, A, Rosso, T, Marfia, G, Antonini, G, Cavaletti, G, Carpo, M, Doneddu, P, Spina, E, Cotti Piccinelli, S, Peci, E, Querol, L, Nobile-Orazio, E, Liberatore G., De Lorenzo A., Giannotta C., Manganelli F., Filosto M., Cosentino G., Cocito D., Briani C., Cortese A., Fazio R., Lauria G., Clerici A. M., Rosso T., Marfia G. A., Antonini G., Cavaletti G., Carpo M., Doneddu P. E., Spina E., Cotti Piccinelli S., Peci E., Querol L., and Nobile-Orazio E.

Abstract

Objective: To investigate the frequency and clinical correlates of anti-nerve autoantibodies in an unselected series of Italian patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) Methods: Sera from 276 CIDP patients fulfilling the EFNS/PNS criteria and included in the Italian CIDP database were examined for the presence of anti-nerve autoantibodies. Results were correlated with the clinical data collected in the database. Results: Anti-neurofascin155 (NF155) antibodies were found in 9/258 (3.5%) patients, anti-contactin1 (CNTN1) antibodies in 4/258 (1.6%) patients, and anti-contactin-associated protein1 (Caspr1) in 1/197 (0.5%) patients, while none had reactivity to gliomedin or neurofascin 186. Predominance of IgG4 isotype was present in 7of the 9 examined patients. Anti-NF155 patients more frequently had ataxia, tremor, and higher CSF protein levels than antibody-negative patients. Anti-CNTN1 patients more frequently had a GBS-like onset, pain, and ataxia and had more severe motor impairment at enrollment than antibody-negative patients. They more frequently received plasmapheresis, possibly reflecting a less satisfactory response to IVIg or steroids. IgM antibodies against one or more gangliosides were found in 6.5% of the patients (17/260) and were more frequently directed against GM1 (3.9%). They were frequently associated with a progressive course, with a multifocal sensorimotor phenotype and less frequent cranial nerve involvement and ataxia. Conclusions: Anti-paranodal and anti-ganglioside antibodies are infrequent in patients with CIDP but are associated with some typical clinical association supporting the hypothesis that CIDP might be a pathogenically heterogeneous syndrome possibly explaining the different clinical presentations.

Published
2022

7. Risk of disease relapse, safety and tolerability of SARS-CoV-2 vaccination in patients with chronic inflammatory neuropathies

Author

Doneddu, P. E., Briani, C., Cocito, D., Manganelli, F., Fabrizi, G. M., Matà, S., Mazzeo, A., Fazio, R., Benedetti, L., Luigetti, M., Inghilleri, M., Ruiu, E., Siciliano, G., Cosentino, G., Marfia, G. A., Carpo, M., Filosto, M., Antonini, G., Notturno, F., Sotgiu, S., Cucurachi, L., Dell'Aquila, C., Bianchi, E., Rosso, T., Giordano, A., Fernandes, M., Campagnolo, M., Peci, E., Spina, E., Tagliapietra, M., Sperti, M., Gentile, L., Strano, C., Germano, F., Romozzi, M., Moret, F., Zarbo, I. R., Viola, D. V., Vegezzi, E., Mataluni, G., Cotti-Piccinelli, S., Leonardi, L., Carta, A., and Nobile-Orazio, E.

Subjects
COVID-19, SARS-CoV-2, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, vaccination, Settore MED/26
Published
2023

8. Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

Author

Liberatore, G, Manganelli, F, Doneddu, P, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, Nobile-Orazio, E, Gallia, F, Beronio, A, Piccolo, L, Fierro, B, Verrengia, E, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Sabatelli, M, Dacci, P, Schirinzi, E, Balducci, C, Liberatore G., Manganelli F., Doneddu P. E., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Mazzeo A., Antonini G., Cosentino G., Jann S., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Santoro L., Peci E., Tronci S., Ruiz M., Cotti Piccinelli S., Schenone A., Leonardi L., Toscano A., Mataluni G., Spina E., Gentile L., Nobile-Orazio E., Gallia F., Beronio A., Piccolo L., Fierro B., Verrengia E. P., Bianchi E., Beghi E., Scrascia F., Garnero M., Sabatelli M., Dacci P., Schirinzi E., Balducci C., Liberatore, G, Manganelli, F, Doneddu, P, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, Nobile-Orazio, E, Gallia, F, Beronio, A, Piccolo, L, Fierro, B, Verrengia, E, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Sabatelli, M, Dacci, P, Schirinzi, E, Balducci, C, Liberatore G., Manganelli F., Doneddu P. E., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Mazzeo A., Antonini G., Cosentino G., Jann S., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Luigetti M., Lauria G., Rosso T., Cavaletti G., Santoro L., Peci E., Tronci S., Ruiz M., Cotti Piccinelli S., Schenone A., Leonardi L., Toscano A., Mataluni G., Spina E., Gentile L., Nobile-Orazio E., Gallia F., Beronio A., Piccolo L., Fierro B., Verrengia E. P., Bianchi E., Beghi E., Scrascia F., Garnero M., Sabatelli M., Dacci P., Schirinzi E., and Balducci C.

Abstract

Background and purpose: The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria. Methods: The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed. Results: In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty-seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%). Conclusions: Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non-diagnostic nerve conduction studies.

Published
2021

9. Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

Author

Liberatore, G., Manganelli, F., Doneddu, P. E., Cocito, D., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Mazzeo, A., Antonini, G., Cosentino, G., Jann, S., Cortese, A., Marfia, G. A., Clerici, A. M., Siciliano, G., Carpo, M., Luigetti, M., Lauria, G., Rosso, T., Cavaletti, G., Santoro, L., Peci, E., Tronci, S., Ruiz, M., Cotti Piccinelli, S., Schenone, A., Leonardi, L., Toscano, A., Mataluni, G., Spina, E., Gentile, L., Nobile-Orazio, E., Gallia, F., Beronio, A., Piccolo, L., Fierro, B., Verrengia, E. P., Bianchi, E., Beghi, E., Scrascia, F., Garnero, M., Sabatelli, M., Dacci, P., Schirinzi, E., Balducci, C., Liberatore, G., Manganelli, F., Doneddu, P. E., Cocito, D., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Mazzeo, A., Antonini, G., Cosentino, G., Jann, S., Cortese, A., Marfia, G. A., Clerici, A. M., Siciliano, G., Carpo, M., Luigetti, M., Lauria, G., Rosso, T., Cavaletti, G., Santoro, L., Peci, E., Tronci, S., Ruiz, M., Cotti-Piccinelli, S., Schenone, A., Leonardi, L., Toscano, A., Mataluni, G., Spina, E., Gentile, L., Nobile-Orazio, E., Gallia, F., Beronio, A., Piccolo, L., Fierro, B., Verrengia, E. P., Bianchi, E., Beghi, E., Scrascia, F., Garnero, M., Sabatelli, M., Dacci, P., Toni, G., Schirinzi, E., Balducci, C., Liberatore, G, Manganelli, F, Doneddu, P, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, Nobile-Orazio, E, Gallia, F, Beronio, A, Piccolo, L, Fierro, B, Verrengia, E, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Sabatelli, M, Dacci, P, Schirinzi, E, and Balducci, C

Subjects
Pediatrics, medicine.medical_specialty, Response to therapy, Databases, Factual, Neural Conduction, Settore MED/26, 03 medical and health sciences, 0302 clinical medicine, Peripheral nerve, Retrospective Studie, Medicine, Humans, Medical history, In patient, 030212 general & internal medicine, Peripheral Nerves, Retrospective Studies, chronic inflammatory demyelinating polyradiculoneuropathy, business.industry, Polyradiculoneuropathy, Polyradiculopathy, medicine.disease, electrophysiology, Settore MED/26 - NEUROLOGIA, Neurology, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Clinical diagnosis, Peripheral Nerve, diagnostic criteria, National database, Neurology (clinical), business, 030217 neurology & neurosurgery, Human
Abstract

Background and purpose The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria. Methods The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed. Results In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty-seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%). Conclusions Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non-diagnostic nerve conduction studies.

Published
2021

10. Frequency of diabetes and other comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy and their impact on clinical presentation and response to therapy

Author

Doneddu, P, Cocito, D, Manganelli, F, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Bianchi, E, Jann, S, Mazzeo, A, Antonini, G, Cosentino, G, Marfia, G, Cortese, A, Clerici, A, Carpo, M, Schenone, A, Siciliano, G, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Beghi, E, Liberatore, G, Santoro, L, Spina, E, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Verrengia, E, Gentile, L, Leonardi, L, Mataluni, G, Piccolo, L, Nobile-Orazio, E, Doneddu P. E., Cocito D., Manganelli F., Fazio R., Briani C., Filosto M., Benedetti L., Bianchi E., Jann S., Mazzeo A., Antonini G., Cosentino G., Marfia G. A., Cortese A., Clerici A. M., Carpo M., Schenone A., Siciliano G., Luigetti M., Lauria G., Rosso T., Cavaletti G., Beghi E., Liberatore G., Santoro L., Spina E., Peci E., Tronci S., Ruiz M., Cotti Piccinelli S., Verrengia E. P., Gentile L., Leonardi L., Mataluni G., Piccolo L., Nobile-Orazio E., Doneddu, P, Cocito, D, Manganelli, F, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Bianchi, E, Jann, S, Mazzeo, A, Antonini, G, Cosentino, G, Marfia, G, Cortese, A, Clerici, A, Carpo, M, Schenone, A, Siciliano, G, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Beghi, E, Liberatore, G, Santoro, L, Spina, E, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Verrengia, E, Gentile, L, Leonardi, L, Mataluni, G, Piccolo, L, Nobile-Orazio, E, Doneddu P. E., Cocito D., Manganelli F., Fazio R., Briani C., Filosto M., Benedetti L., Bianchi E., Jann S., Mazzeo A., Antonini G., Cosentino G., Marfia G. A., Cortese A., Clerici A. M., Carpo M., Schenone A., Siciliano G., Luigetti M., Lauria G., Rosso T., Cavaletti G., Beghi E., Liberatore G., Santoro L., Spina E., Peci E., Tronci S., Ruiz M., Cotti Piccinelli S., Verrengia E. P., Gentile L., Leonardi L., Mataluni G., Piccolo L., and Nobile-Orazio E.

Abstract

Objectives To determine the prevalence of different comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and their impact on outcome, treatment choice and response. Methods Using a structured questionnaire, we collected information on comorbidities from 393 patients with CIDP fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society criteria included in the Italian CIDP database. Results One or more comorbidities were reported by 294 patients (75%) and potentially influenced treatment choice in 192 (49%) leading to a less frequent use of corticosteroids. Response to treatment did not differ, however, from that in patients without comorbidities. Diabetes (14%), monoclonal gammopathy of undetermined significance (MGUS) (12%) and other immune disorders (16%) were significantly more frequent in patients with CIDP than expected in the general European population. Patients with diabetes had higher disability scores, worse quality of life and a less frequent treatment response compared with patients without diabetes. Patients with IgG-IgA or IgM MGUS had an older age at CIDP onset while patients with other immune disorders had a younger age at onset and were more frequently females. IgM MGUS was more frequent in patients with motor CIDP than in patients with typical CIDP. Conclusions Comorbidities are frequent in patients with CIDP and in almost 50% of them have an impact on treatment choice. Diabetes, MGUS and other immune diseases are more frequent in patients with CIDP than in the general population. Only diabetes seems, however, to have an impact on disease severity and treatment response possibly reflecting in some patients a coexisting diabetic neuropathy.

Published
2020

11. Impact of environmental factors and physical activity on disability and quality of life in CIDP

Author

Doneddu, P, Bianchi, E, Cocito, D, Manganelli, F, Fazio, R, Filosto, M, Beghi, E, Mazzeo, A, Cosentino, G, Cortese, A, Jann, S, Clerici, A, Antonini, G, Siciliano, G, Marfia, G, Briani, C, Lauria, G, Rosso, T, Cavaletti, G, Carpo, M, Benedetti, L, Schenone, A, Liberatore, G, Peci, E, Spina, E, Tronci, S, Cotti Piccinelli, S, Toscano, A, Gentile, L, Piccolo, L, Leonardi, L, Mataluni, G, Ruiz, M, Sabatelli, M, Santoro, L, Nobile-Orazio, E, Gallia, F, Velardo, D, Topa, A, Cotti-Piccinelli, S, Todeschini, A, Cabona, C, Zuppa, A, Callegari, I, Verrengia, E, Scrascia, F, Garnero, M, Luigetti, M, Dacci, P, Schirinzi, E, Balducci, C, Doneddu P. E., Bianchi E., Cocito D., Manganelli F., Fazio R., Filosto M., Beghi E., Mazzeo A., Cosentino G., Cortese A., Jann S., Clerici A. M., Antonini G., Siciliano G., Marfia G. A., Briani C., Lauria G., Rosso T., Cavaletti G., Carpo M., Benedetti L., Schenone A., Liberatore G., Peci E., Spina E., Tronci S., Cotti Piccinelli S., Toscano A., Gentile L., Piccolo L., Leonardi L., Mataluni G., Ruiz M., Sabatelli M., Santoro L., Nobile-Orazio E., Gallia F., Velardo D., Topa A., Cotti-Piccinelli S., Todeschini A., Cabona C., Zuppa A., Callegari I., Verrengia E. P., Scrascia F., Garnero M., Luigetti M., Dacci P., Schirinzi E., Balducci C., Doneddu, P, Bianchi, E, Cocito, D, Manganelli, F, Fazio, R, Filosto, M, Beghi, E, Mazzeo, A, Cosentino, G, Cortese, A, Jann, S, Clerici, A, Antonini, G, Siciliano, G, Marfia, G, Briani, C, Lauria, G, Rosso, T, Cavaletti, G, Carpo, M, Benedetti, L, Schenone, A, Liberatore, G, Peci, E, Spina, E, Tronci, S, Cotti Piccinelli, S, Toscano, A, Gentile, L, Piccolo, L, Leonardi, L, Mataluni, G, Ruiz, M, Sabatelli, M, Santoro, L, Nobile-Orazio, E, Gallia, F, Velardo, D, Topa, A, Cotti-Piccinelli, S, Todeschini, A, Cabona, C, Zuppa, A, Callegari, I, Verrengia, E, Scrascia, F, Garnero, M, Luigetti, M, Dacci, P, Schirinzi, E, Balducci, C, Doneddu P. E., Bianchi E., Cocito D., Manganelli F., Fazio R., Filosto M., Beghi E., Mazzeo A., Cosentino G., Cortese A., Jann S., Clerici A. M., Antonini G., Siciliano G., Marfia G. A., Briani C., Lauria G., Rosso T., Cavaletti G., Carpo M., Benedetti L., Schenone A., Liberatore G., Peci E., Spina E., Tronci S., Cotti Piccinelli S., Toscano A., Gentile L., Piccolo L., Leonardi L., Mataluni G., Ruiz M., Sabatelli M., Santoro L., Nobile-Orazio E., Gallia F., Velardo D., Topa A., Cotti-Piccinelli S., Todeschini A., Cabona C., Zuppa A., Callegari I., Verrengia E. P., Scrascia F., Garnero M., Luigetti M., Dacci P., Schirinzi E., and Balducci C.

Abstract

A few observational studies and randomized trials suggest that exercise and rehabilitation may improve activity limitation and quality of life (QoL) in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but the impact of other modifiable factors on the severity of the disease is not well understood. Using a structured questionnaire, we collected data on lifestyle and dietary habits of the patients included in the Italian CIDP database to investigate the possible influence of modifiable lifestyle factors on disability and QoL. Questionnaire data were available for 323 patients. The effect of lifestyle and dietary exposures on impairment, disability and QoL was evaluated using logistic regression models, adjusting for age, sex, disease duration, physical activity and smoking. Physical activity was associated with lower sensory impairment by the ISS scale, less disability by the INCAT and RODS scale and a better QoL in all the domains of EURO-QoL scale with the exception of anxiety/depression. None of the other parameters had an impact on these scales. This study adds evidence to the possible role of physical activity in improving symptom severity, disability and QoL in patients with CIDP. None of the other environmental factors investigated appeared to have an impact on the severity and health perception of CIDP.

Published
2020

12. Relevance of diagnostic investigations in chronic inflammatory demyelinating poliradiculoneuropathy: Data from the Italian CIDP database

Author

Liberatore, G, Manganelli, F, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Sabatelli, M, Lauria, G, Rosso, T, Nobile Orazio, E, Doneddu, P, Gallia, F, Nobile-Orazio, E, Peci, E, Tronci, S, Santoro, L, Spina, E, Ruiz, M, Piccinelli, S, Beronio, A, Toscano, A, Gentile, L, Mataluni, G, Piccolo, L, Callegari, I, Fierro, B, Pinuccia, V, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Schenone, A, Luigetti, M, Dacci, P, Leonardi, L, Schirinzi, E, Balducci, C, Cavaletti, G, Liberatore G., Manganelli F., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Sabatelli M., Lauria G., Rosso T., Nobile Orazio E., Doneddu P. E., Gallia F., Nobile-Orazio E., Peci E., Tronci S., Santoro L., Spina E., Ruiz M., Piccinelli S. C., Beronio A., Toscano A., Gentile L., Mataluni G., Piccolo L., Callegari I., Fierro B., Pinuccia V. E., Bianchi E., Beghi E., Scrascia F., Garnero M., Schenone A., Luigetti M., Dacci P., Leonardi L., Schirinzi E., Balducci C., Cavaletti G., Liberatore, G, Manganelli, F, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Sabatelli, M, Lauria, G, Rosso, T, Nobile Orazio, E, Doneddu, P, Gallia, F, Nobile-Orazio, E, Peci, E, Tronci, S, Santoro, L, Spina, E, Ruiz, M, Piccinelli, S, Beronio, A, Toscano, A, Gentile, L, Mataluni, G, Piccolo, L, Callegari, I, Fierro, B, Pinuccia, V, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Schenone, A, Luigetti, M, Dacci, P, Leonardi, L, Schirinzi, E, Balducci, C, Cavaletti, G, Liberatore G., Manganelli F., Cocito D., Fazio R., Briani C., Filosto M., Benedetti L., Antonini G., Cosentino G., Jann S., Mazzeo A., Cortese A., Marfia G. A., Clerici A. M., Siciliano G., Carpo M., Sabatelli M., Lauria G., Rosso T., Nobile Orazio E., Doneddu P. E., Gallia F., Nobile-Orazio E., Peci E., Tronci S., Santoro L., Spina E., Ruiz M., Piccinelli S. C., Beronio A., Toscano A., Gentile L., Mataluni G., Piccolo L., Callegari I., Fierro B., Pinuccia V. E., Bianchi E., Beghi E., Scrascia F., Garnero M., Schenone A., Luigetti M., Dacci P., Leonardi L., Schirinzi E., Balducci C., and Cavaletti G.

Abstract

The objective of our work was to report the clinical features and the relevance of diagnostic investigations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We retrospectively reviewed data from patients with a clinical diagnosis of CIDP included in a national database. Among the 500 included patients with a clinical diagnosis of CIDP, 437 patients (87%) fulfilled the European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP (definite in 407, probable in 26, possible in four). In 352 patients (86%) motor nerve conduction abnormalities consistent with demyelination were sufficient for the diagnosis of definite CIDP. In 55 patients, this diagnosis required the addition of one or two (from probable or from possible CIDP, respectively) supportive tests, while in 20 cases they improved the diagnosis from possible to probable CIDP, seven patients did not change diagnosis. Considering these 85 patients, cerebrospinal fluid studies were performed in 79 cases (93%) upgrading the certainty of diagnosis in 59% of examined patients. Sensory nerve conduction studies (NCS) were performed in 85% of patients with an improvement of diagnosis in 32% of cases. Nerve biopsy and ultrasound and magnetic resonance imaging (US/MRI) exams resulted positive in about 40% of examined patients, but they were performed in few patients (7 patients and 16 patients, respectively). A response to the therapy was present in 84% of treated patients (n = 77), contributing to support the diagnosis in 40 patients in whom the other supportive criteria were not sufficient. In most patients with CIDP the diagnosis is possible solely with motor NCS while other investigations may help improving the diagnosis in a minority of patients.

Published
2020

13. Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy

Author

Liberatore, G, Giannotta, C, Sajeev, B, Morenghi, E, Terenghi, F, Gallia, F, Doneddu, P, Manganelli, F, Cocito, D, Filosto, M, Antonini, G, Cosentino, G, Marfia, G, Clerici, A, Lauria, G, Rosso, T, Cavaletti, G, Nobile-Orazio, E, Liberatore G., Giannotta C., Sajeev B. P., Morenghi E., Terenghi F., Gallia F., Doneddu P. E., Manganelli F., Cocito D., Filosto M., Antonini G., Cosentino G., Marfia G. A., Clerici A. M., Lauria G., Rosso T., Cavaletti G., Nobile-Orazio E., Liberatore, G, Giannotta, C, Sajeev, B, Morenghi, E, Terenghi, F, Gallia, F, Doneddu, P, Manganelli, F, Cocito, D, Filosto, M, Antonini, G, Cosentino, G, Marfia, G, Clerici, A, Lauria, G, Rosso, T, Cavaletti, G, Nobile-Orazio, E, Liberatore G., Giannotta C., Sajeev B. P., Morenghi E., Terenghi F., Gallia F., Doneddu P. E., Manganelli F., Cocito D., Filosto M., Antonini G., Cosentino G., Marfia G. A., Clerici A. M., Lauria G., Rosso T., Cavaletti G., and Nobile-Orazio E.

Abstract

For the diagnosis of anti-MAG polyneuropathy the commercial ELISA manufacturer currently recommends a cut-off of 1000 Bühlmann Titer Units (BTU). We analyzed sera from 80 anti-MAG neuropathy patients and 383 controls (with other neuropathies or healthy controls) to assess the ELISA sensitivity and specificity at different thresholds. A better combination of sensitivity/specificity was found at a threshold >1500 BTU than at >1000 BTU. The best value of specificity was obtained at threshold >7000 BTU. There was a diagnostic grey area between 1500 and 7000 BTU in which the clinical phenotypes as well as electrophysiological studies need to be carefully assessed particularly to differentiate CIDP and anti-MAG neuropathy.

Published
2020

14. Risk factors for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): antecedent events, lifestyle and dietary habits. Data from the Italian CIDP Database

Author

Doneddu, P, Bianchi, E, Cocito, D, Manganelli, F, Fazio, R, Filosto, M, Mazzeo, A, Cosentino, G, Cortese, A, Jann, S, Clerici, A, Antonini, G, Siciliano, G, Luigetti, M, Marfia, G, Briani, C, Lauria, G, Rosso, T, Cavaletti, G, Carpo, M, Benedetti, L, Beghi, E, Liberatore, G, Santoro, L, Peci, E, Tronci, S, Cotti Piccinelli, S, Toscano, A, Piccolo, L, Verrengia, E, Leonardi, L, Schirinzi, E, Mataluni, G, Ruiz, M, Dacci, P, Nobile-Orazio, E, Doneddu P. E., Bianchi E., Cocito D., Manganelli F., Fazio R., Filosto M., Mazzeo A., Cosentino G., Cortese A., Jann S., Clerici A. M., Antonini G., Siciliano G., Luigetti M., Marfia G. A., Briani C., Lauria G., Rosso T., Cavaletti G., Carpo M., Benedetti L., Beghi E., Liberatore G., Santoro L., Peci E., Tronci S., Cotti Piccinelli S., Toscano A., Piccolo L., Verrengia E. P., Leonardi L., Schirinzi E., Mataluni G., Ruiz M., Dacci P., Nobile-Orazio E., Doneddu, P, Bianchi, E, Cocito, D, Manganelli, F, Fazio, R, Filosto, M, Mazzeo, A, Cosentino, G, Cortese, A, Jann, S, Clerici, A, Antonini, G, Siciliano, G, Luigetti, M, Marfia, G, Briani, C, Lauria, G, Rosso, T, Cavaletti, G, Carpo, M, Benedetti, L, Beghi, E, Liberatore, G, Santoro, L, Peci, E, Tronci, S, Cotti Piccinelli, S, Toscano, A, Piccolo, L, Verrengia, E, Leonardi, L, Schirinzi, E, Mataluni, G, Ruiz, M, Dacci, P, Nobile-Orazio, E, Doneddu P. E., Bianchi E., Cocito D., Manganelli F., Fazio R., Filosto M., Mazzeo A., Cosentino G., Cortese A., Jann S., Clerici A. M., Antonini G., Siciliano G., Luigetti M., Marfia G. A., Briani C., Lauria G., Rosso T., Cavaletti G., Carpo M., Benedetti L., Beghi E., Liberatore G., Santoro L., Peci E., Tronci S., Cotti Piccinelli S., Toscano A., Piccolo L., Verrengia E. P., Leonardi L., Schirinzi E., Mataluni G., Ruiz M., Dacci P., and Nobile-Orazio E.

Abstract

Background and purpose: The role of lifestyle and dietary habits and antecedent events has not been clearly identified in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Methods: Information was collected about modifiable environmental factors and antecedent infections and vaccinations in patients with CIDP included in an Italian CIDP Database. Only patients who reported not having changed their diet or the lifestyle habits investigated in the study after the appearance of CIDP were included. The partners of patients with CIDP were chosen as controls. Gender-matched analysis was performed with randomly selected controls with a 1:1 ratio of patients and controls. Results: Dietary and lifestyle data of 323 patients and 266 controls were available. A total of 195 cases and 195 sex-matched controls were used in the analysis. Patients eating rice at least three times per week or eating fish at least once per week appeared to be at decreased risk of acquiring CIDP. Data on antecedent events were collected in 411 patients. Antecedent events within 1–42 days before CIDP onset were reported by 15.5% of the patients, including infections in 12% and vaccinations in 1.5%. Patients with CIDP and antecedent infections more often had an acute onset of CIDP and cranial nerve involvement than those without these antecedent events. Conclusions: The results of this preliminary study seem to indicate that some dietary habits may influence the risk of CIDP and that antecedent infections may have an impact on the onset and clinical presentation of the disease.

Published
2020

15. Relevance of diagnostic investigations in chronic inflammatory demyelinating poliradiculoneuropathy: Data from the Italian CIDP database

Author

Liberatore, G., Manganelli, F., Cocito, D., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Antonini, G., Cosentino, G., Jann, S., Mazzeo, A., Cortese, A., Marfia, G. A., Clerici, A. M., Siciliano, G., Carpo, M., Sabatelli, M., Lauria, G., Rosso, T., Nobile Orazio, E., Doneddu, P. E., Gallia, F., Nobile-Orazio, E., Peci, E., Tronci, S., Santoro, L., Spina, E., Ruiz, M., Piccinelli, S. C., Beronio, A., Toscano, A., Gentile, L., Mataluni, G., Piccolo, L., Callegari, I., Fierro, B., Pinuccia, V. E., Bianchi, E., Beghi, E., Scrascia, F., Garnero, M., Schenone, A., Luigetti, M., Dacci, P., Leonardi, L., Schirinzi, E., Balducci, C., Cavaletti, G., Liberatore, G, Manganelli, F, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Antonini, G, Cosentino, G, Jann, S, Mazzeo, A, Cortese, A, Marfia, G, Clerici, A, Siciliano, G, Carpo, M, Sabatelli, M, Lauria, G, Rosso, T, Nobile Orazio, E, Doneddu, P, Gallia, F, Nobile-Orazio, E, Peci, E, Tronci, S, Santoro, L, Spina, E, Ruiz, M, Piccinelli, S, Beronio, A, Toscano, A, Gentile, L, Mataluni, G, Piccolo, L, Callegari, I, Fierro, B, Pinuccia, V, Bianchi, E, Beghi, E, Scrascia, F, Garnero, M, Schenone, A, Luigetti, M, Dacci, P, Leonardi, L, Schirinzi, E, Balducci, C, Cavaletti, G, Liberatore, G., Manganelli, F., Cocito, D., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Antonini, G., Cosentino, G., Jann, S., Mazzeo, A., Cortese, A., Marfia, G. A., Clerici, A. M., Siciliano, G., Carpo, M., Sabatelli, M., Lauria, G., Rosso, T., Nobile Orazio, E., Doneddu, P. E., Gallia, F., Nobile-Orazio, E., Peci, E., Tronci, S., Santoro, L., Spina, E., Ruiz, M., Piccinelli, S. C., Beronio, A., Toscano, A., Gentile, L., Mataluni, G., Piccolo, L., Callegari, I., Fierro, B., Pinuccia, V. E., Bianchi, E., Beghi, E., Scrascia, F., Garnero, M., Schenone, A., Luigetti, M., Dacci, P., Leonardi, L., Schirinzi, E., Balducci, C., and Cavaletti, G.

Subjects
medicine.medical_specialty, peripheral neuropathy, Response to therapy, Motor nerve, CIDP, Settore MED/26, chronic inflammatory demyelinating neuropathy, diagnostic criteria, EMG, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, In patient, Nerve biopsy, medicine.diagnostic_test, business.industry, General Neuroscience, Polyradiculoneuropathy, medicine.disease, Chronic inflammatory demyelinating neuropathy, Diagnostic criteria, Peripheral neuropathy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Clinical diagnosis, Neurology (clinical), business, 030217 neurology & neurosurgery, Sensory nerve
Abstract

The objective of our work was to report the clinical features and the relevance of diagnostic investigations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We retrospectively reviewed data from patients with a clinical diagnosis of CIDP included in a national database. Among the 500 included patients with a clinical diagnosis of CIDP, 437 patients (87%) fulfilled the European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP (definite in 407, probable in 26, possible in four). In 352 patients (86%) motor nerve conduction abnormalities consistent with demyelination were sufficient for the diagnosis of definite CIDP. In 55 patients, this diagnosis required the addition of one or two (from probable or from possible CIDP, respectively) supportive tests, while in 20 cases they improved the diagnosis from possible to probable CIDP, seven patients did not change diagnosis. Considering these 85 patients, cerebrospinal fluid studies were performed in 79 cases (93%) upgrading the certainty of diagnosis in 59% of examined patients. Sensory nerve conduction studies (NCS) were performed in 85% of patients with an improvement of diagnosis in 32% of cases. Nerve biopsy and ultrasound and magnetic resonance imaging (US/MRI) exams resulted positive in about 40% of examined patients, but they were performed in few patients (7 patients and 16 patients, respectively). A response to the therapy was present in 84% of treated patients (n = 77), contributing to support the diagnosis in 40 patients in whom the other supportive criteria were not sufficient. In most patients with CIDP the diagnosis is possible solely with motor NCS while other investigations may help improving the diagnosis in a minority of patients.

Published
2020

17. Brivaracetam as Early Add-On Treatment in Patients with Focal Seizures: A Retrospective, Multicenter, RealWorld Study

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Cerulli Irelli, E., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Di Gennaro, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Gangitano, M., La Neve, A., Mecarelli, O., Montalenti, E., Morano, A., Piazza, F., Pizzanelli, C., Pulitano, P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Di Giacomo, R., Di Liberto, A., Domina, E., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fisco, G., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giallonardo, A. T., Giorgi, F. S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Milano, C., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quarato, P. P., Quintas, R., Renna, R., Rizzo, G. R., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Vaudano, A. E., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., Zummo, L., Lattanzi, Simona, Canafoglia, Laura, Canevini, Maria Paola, Casciato, Sara, Cerulli Irelli, Emanuele, Chiesa, Valentina, Dainese, Filippo, De Maria, Giovanni, Didato, Giuseppe, Di Gennaro, Giancarlo, Falcicchio, Giovanni, Fanella, Martina, Ferlazzo, Edoardo, Gangitano, Massimo, La Neve, Angela, Mecarelli, Oriano, Montalenti, Elisa, Morano, Alessandra, Piazza, Federico, Pizzanelli, Chiara, Pulitano, Patrizia, Ranzato, Federica, Rosati, Eleonora, Tassi, Laura, and Di Bonaventura, Carlo

Subjects
Antiseizure medication, Focal seizures, Brivaracetam, Epilepsy, Neurology, Settore MED/26 - Neurologia, Neurology (clinical), Settore MED/26, Settore MED/39 - Neuropsichiatria Infantile
Abstract

Introduction: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Most real-world research on BRV has focused on refractory epilepsy. The aim of this analysis was to assess the 12-month effectiveness and tolerability of adjunctive BRV when used as early or late adjunctive treatment in patients included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). Methods: BRIVAFIRST was a 12-month retrospective, multicenter study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of sustained seizure response, sustained seizure freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs. Data were compared for patients treated with add-on BRV after 1-2 (early add-on) and ≥ 3 (late add-on) prior antiseizure medications. Results: A total of 1029 patients with focal epilepsy were included in the study, of whom 176 (17.1%) received BRV as early add-on treatment. The median daily dose of BRV at 12months was 125 (100-200) mg in the early add-on group and 200 (100-200) in the late add-on group (p

Published
2022

21. Correction to: Adjunctive Brivaracetam in Focal Epilepsy: Real‑World Evidence from the BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) (CNS Drugs, (2021), 35, 12, (1289-1301), 10.1007/s40263-021-00856-3)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., and Zummo, L.

Published
2021

22. Correction to: Adjunctive Brivaracetam in Focal Epilepsy: Real‑World Evidence from the BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) (CNS Drugs, (2021), 10.1007/s40263-021-00856-3)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., and Zummo, L.

Published
2021

23. Adjunctive Brivaracetam in Focal Epilepsy: Real-World Evidence from the BRIVAracetam add-on First Italian netwoRk STudy (BRIVAFIRST)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Di Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., Zummo, L., Lattanzi S., Canafoglia L., Canevini M.P., Casciato S., Chiesa V., Dainese F., De Maria G., Didato G., Falcicchio G., Fanella M., Ferlazzo E., Fisco G., Gangitano M., Giallonardo A.T., Giorgi F.S., La Neve A., Mecarelli O., Montalenti E., Piazza F., Pulitano P., Quarato P.P., Ranzato F., Rosati E., Tassi L., and Di Bonaventura C.

Subjects
medicine.medical_specialty, business.industry, Context (language use), Brivaracetam, medicine.disease, Discontinuation, law.invention, Psychiatry and Mental health, Epilepsy, Randomized controlled trial, Tolerability, focal epilepsy, add-on therapy, seizure, law, Concomitant, Internal medicine, Medicine, Pharmacology (medical), Neurology (clinical), Levetiracetam, Original Research Article, business, medicine.drug
Abstract

Background: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Studies performed in a naturalistic setting are a useful complement to characterize the drug profile. Objective: This multicentre study assessed the effectiveness and tolerability of adjunctive BRV in a large population of patients with focal epilepsy in the context of real-world clinical practice. Methods: The BRIVAFIRST (BRIVAracetam add-on First Italian netwoRk STudy) was a retrospective, multicentre study including adult patients prescribed adjunctive BRV. Patients with focal epilepsy and 12-month follow-up were considered. Main outcomes included the rates of seizure‐freedom, seizure response (≥50% reduction in baseline seizure frequency), and treatment discontinuation. The incidence of adverse events (AEs) was also considered. Analyses by levetiracetam (LEV) status and concomitant use of strong enzyme-inducing antiseizure medications (EiASMs) and sodium channel blockers (SCBs) were performed. Results: A total of 1029 patients with a median age of 45years (33–56) was included. At 12 months, 169 (16.4%) patients were seizure-free and 383 (37.2%) were seizure responders. The rate of seizure freedom was 22.3% in LEV-naive patients, 7.1% in patients with prior LEV use and discontinuation due to insufficient efficacy, and 31.2% in patients with prior LEV use and discontinuation due to AEs (p&nbsp

Published
2021

24. Altered resting state attentional networks in diabetic neuropathic pain

Author

Cauda, F., D'Agata, F., Sacco, K., Duca, S., Cocito, D., Paolasso, I., Isoardo, G., and Geminiani, G.

Subjects
Chronic pain -- Diagnosis, Chronic pain -- Physiological aspects, Diabetic neuropathies -- Prognosis, Diabetic neuropathies -- Physiological aspects, Nervous system -- Research, Nervous system -- Physiological aspects, Health, Psychology and mental health
Published
2010

26. Chronic inflammatory demyelinating polyradiculoneuropathy: can we make a diagnosis in patients not fulfilling electrodiagnostic criteria?

Author

Liberatore, G, Manganelli, F, Doneddu, Pe, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, Ga, Clerici, Am, Siciliano, G, Carpo, M, Luigetti, M, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Piccinelli, Sc, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, and Nobile-Orazio, E

Subjects
therapy, CIDP, EFNS/PNS
Published
2020

30. Frequency of diabetes and other comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy and their impact on clinical presentation and response to therapy

Author

Doneddu, P. E., Cocito, D., Manganelli, F., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Bianchi, E., Jann, S., Mazzeo, A., Antonini, Gabriele, Cosentino, G., Marfia, G. A., Cortese, A., Clerici, Anna Marina, Carpo, M., Schenone, A., Siciliano, Giovanni, Luigetti, Marco, Lauria, G., Rosso, T., Cavaletti, G., Beghi, E., Liberatore, G., Santoro, Luca, Spina, E., Peci, E., Tronci, S., Ruiz, M., Cotti Piccinelli, S., Verrengia, E. P., Gentile, L., Leonardi, L., Mataluni, G., Piccolo, L., Nobile-Orazio, E., Antonini G., Clerici A. M., Siciliano G., Luigetti M. (ORCID:0000-0001-7539-505X), Santoro L., Doneddu, P. E., Cocito, D., Manganelli, F., Fazio, R., Briani, C., Filosto, M., Benedetti, L., Bianchi, E., Jann, S., Mazzeo, A., Antonini, Gabriele, Cosentino, G., Marfia, G. A., Cortese, A., Clerici, Anna Marina, Carpo, M., Schenone, A., Siciliano, Giovanni, Luigetti, Marco, Lauria, G., Rosso, T., Cavaletti, G., Beghi, E., Liberatore, G., Santoro, Luca, Spina, E., Peci, E., Tronci, S., Ruiz, M., Cotti Piccinelli, S., Verrengia, E. P., Gentile, L., Leonardi, L., Mataluni, G., Piccolo, L., Nobile-Orazio, E., Antonini G., Clerici A. M., Siciliano G., Luigetti M. (ORCID:0000-0001-7539-505X), and Santoro L.

Abstract

Objectives To determine the prevalence of different comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and their impact on outcome, treatment choice and response. Methods Using a structured questionnaire, we collected information on comorbidities from 393 patients with CIDP fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society criteria included in the Italian CIDP database. Results One or more comorbidities were reported by 294 patients (75%) and potentially influenced treatment choice in 192 (49%) leading to a less frequent use of corticosteroids. Response to treatment did not differ, however, from that in patients without comorbidities. Diabetes (14%), monoclonal gammopathy of undetermined significance (MGUS) (12%) and other immune disorders (16%) were significantly more frequent in patients with CIDP than expected in the general European population. Patients with diabetes had higher disability scores, worse quality of life and a less frequent treatment response compared with patients without diabetes. Patients with IgG-IgA or IgM MGUS had an older age at CIDP onset while patients with other immune disorders had a younger age at onset and were more frequently females. IgM MGUS was more frequent in patients with motor CIDP than in patients with typical CIDP. Conclusions Comorbidities are frequent in patients with CIDP and in almost 50% of them have an impact on treatment choice. Diabetes, MGUS and other immune diseases are more frequent in patients with CIDP than in the general population. Only diabetes seems, however, to have an impact on disease severity and treatment response possibly reflecting in some patients a coexisting diabetic neuropathy.

Published
2020

31. Risk factors for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): antecedent events, lifestyle and dietary habits. Data from the Italian CIDP Database

Author

Doneddu, P. E., Bianchi, E., Cocito, D., Manganelli, F., Fazio, R., Filosto, M., Mazzeo, A., Cosentino, G., Cortese, A., Jann, S., Clerici, A. M., Antonini, G., Siciliano, G., Luigetti, M., Marfia, G. A., Briani, C., Lauria, G., Rosso, T., Cavaletti, G., Carpo, M., Benedetti, L., Beghi, E., Liberatore, G., Santoro, L., Peci, E., Tronci, S., Cotti Piccinelli, S., Toscano, A., Piccolo, L., Verrengia, E. P., Leonardi, L., Schirinzi, E., Mataluni, G., Ruiz, M., Dacci, P., Nobile-Orazio, E., Luigetti M. (ORCID:0000-0001-7539-505X), Doneddu, P. E., Bianchi, E., Cocito, D., Manganelli, F., Fazio, R., Filosto, M., Mazzeo, A., Cosentino, G., Cortese, A., Jann, S., Clerici, A. M., Antonini, G., Siciliano, G., Luigetti, M., Marfia, G. A., Briani, C., Lauria, G., Rosso, T., Cavaletti, G., Carpo, M., Benedetti, L., Beghi, E., Liberatore, G., Santoro, L., Peci, E., Tronci, S., Cotti Piccinelli, S., Toscano, A., Piccolo, L., Verrengia, E. P., Leonardi, L., Schirinzi, E., Mataluni, G., Ruiz, M., Dacci, P., Nobile-Orazio, E., and Luigetti M. (ORCID:0000-0001-7539-505X)

Abstract

Background and purpose: The role of lifestyle and dietary habits and antecedent events has not been clearly identified in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Methods: Information was collected about modifiable environmental factors and antecedent infections and vaccinations in patients with CIDP included in an Italian CIDP Database. Only patients who reported not having changed their diet or the lifestyle habits investigated in the study after the appearance of CIDP were included. The partners of patients with CIDP were chosen as controls. Gender-matched analysis was performed with randomly selected controls with a 1:1 ratio of patients and controls. Results: Dietary and lifestyle data of 323 patients and 266 controls were available. A total of 195 cases and 195 sex-matched controls were used in the analysis. Patients eating rice at least three times per week or eating fish at least once per week appeared to be at decreased risk of acquiring CIDP. Data on antecedent events were collected in 411 patients. Antecedent events within 1–42 days before CIDP onset were reported by 15.5% of the patients, including infections in 12% and vaccinations in 1.5%. Patients with CIDP and antecedent infections more often had an acute onset of CIDP and cranial nerve involvement than those without these antecedent events. Conclusions: The results of this preliminary study seem to indicate that some dietary habits may influence the risk of CIDP and that antecedent infections may have an impact on the onset and clinical presentation of the disease.

Published
2020

32. Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

Author

Liberatore, G, Manganelli, F, Doneddu, P E, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, G A, Clerici, A M, Siciliano, G, Carpo, M, Luigetti, Marco, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, Nobile-Orazio, E, Luigetti, M (ORCID:0000-0001-7539-505X), Liberatore, G, Manganelli, F, Doneddu, P E, Cocito, D, Fazio, R, Briani, C, Filosto, M, Benedetti, L, Mazzeo, A, Antonini, G, Cosentino, G, Jann, S, Cortese, A, Marfia, G A, Clerici, A M, Siciliano, G, Carpo, M, Luigetti, Marco, Lauria, G, Rosso, T, Cavaletti, G, Santoro, L, Peci, E, Tronci, S, Ruiz, M, Cotti Piccinelli, S, Schenone, A, Leonardi, L, Toscano, A, Mataluni, G, Spina, E, Gentile, L, Nobile-Orazio, E, and Luigetti, M (ORCID:0000-0001-7539-505X)

Abstract

Background and purpose: The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria. Methods: The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed. Results: In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty-seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%). Conclusions: Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non-diagnostic nerve conduction studies.

Published
2020

45. Long-term safety and efficacy of subcutaneous immunoglobulin IgPro20 in CIDP: PATH extension study

Author

van Schaik, Ivo N, Mielke, Orell, Bril, Vera, van Geloven, Nan, Hartung, Hans-Peter, Lewis, Richard A, Sobue, Gen, Lawo, John-Philip, Praus, Michaela, Durn, Billie L, Cornblath, David R, Merkies, Ingemar SJ, Sabet, A, George, K, Roberts, L, Carne, R, Blum, S, Henderson, R, Van Damme, P, Demeestere, J, Larue, S, D'Amour, C, Bril, V, Breiner, A, Kunc, P, Michal, V, Sussova, J, Tomas, K, Talab, R, Michal, B, Toomsoo, T, Rubanovits, I, Gross-Paju, K, Sorro, U, Saarela, M, Auranen, M, Pouget, J, Attarian, S, Le Masson, G, Wielanek-Bachelet, A, Desnuelle, C, Delmont, E, Clavelou, P, Aufauvre, D, Schmidt, J, Zschumtszsch, J, Sommer, C, Kramer, D, Hoffmann, O, Goerlitz, C, Haas, J, Chatzopoulos, M, Yoon, R, Gold, R, Berlit, P, Jaspert-Grehl, A, Liebetanz, D, Kutschenko, A, Stangel, M, Trebst, C, Baum, P, Bergh, F, Klehmet, J, Meisel, A, Klostermann, F, Oechtering, J, Lehmann, H, Schroeter, M, Hagenacker, T, Mueller, D, Sperfeld, A, Bethke, F, Drory, V, Algom, A, Yarnitsky, D, Murinson, B, Di Muzio, A, Ciccocioppo, F, Sorbi, S, Mata, S, Schenone, A, Grandis, M, Lauria, G, Cazzato, D, Antonini, G, Morino, S, Cocito, D, Zibetti, M, Yokota, T, Ohkubo, T, Kanda, T, Kawai, M, Kaida, K, Onoue, H, Kuwabara, S, Mori, M, Iijima, M, Ohyama, K, Baba, M, Tomiyama, M, Nishiyama, K, Akutsu, T, Yokoyama, K, Kanai, K, van Schaik, IN, Eftimov, F, Notermans, NC, Visser, N, Faber, C, Hoeijmakers, J, Rejdak, K, Chyrchel-Paszkiewicz, U, Casanovas Pons, C, Antonia, M, Gamez, J, Salvado, M, Marquez Infante, C, Benitez, S, Lunn, M, Morrow, J, Gosal, D, Lavin, T, Melamed, I, Testori, A, Ajroud-Driss, S, Menichella, D, Simpson, E, Lai, E Chi-Ho, Dimachkie, M, Barohn, RJ, Beydoun, S, Johl, H, Lange, D, Shtilbans, A, Muley, S, Ladha, S, Freimer, M, Kissel, J, Latov, N, Chin, R, Ubogu, E, Mumfrey, S, Rao, T, MacDonald, P, Sharma, K, Gonzalez, G, Allen, J, Walk, D, Hobson-Webb, L, Gable, K, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Hagenacker, Tim (Beitragende*r), HUS Neurocenter, Neurologian yksikkö, Clinicum, Department of Neurosciences, Academic Medical Center, and CSL Behring

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Injections, Subcutaneous, Medizin, Chronic inflammatory demyelinating polyneuropathy, Subcutaneous immunoglobulin, INFLAMMATORY DEMYELINATING POLYNEUROPATHY, Gastroenterology, 3124 Neurology and psychiatry, law.invention, 03 medical and health sciences, MUSCLE STRENGTH, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Humans, Medicine, Prospective Studies, Dosing, Adverse effect, Prospective cohort study, Aged, 030304 developmental biology, 0303 health sciences, MMN, business.industry, Extension study, 3112 Neurosciences, Immunoglobulins, Intravenous, Polyradiculoneuropathy, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Neurology, Immunoglobulin G, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

PATH study group., [Objective] To investigate the long-term safety and efficacy of weekly subcutaneous IgPro20 (Hizentra, CSL Behring) in chronic inflammatory demyelinating polyneuropathy (CIDP)., [Methods] In a 48-week open-label prospective extension study to the PATH study, patients were initially started on 0.2 g/kg or on 0.4 g/kg weekly and—if clinically stable—switched to 0.2 g/kg weekly after 24 weeks. Upon CIDP relapse on the 0.2 g/kg dose, 0.4 g/kg was (re)initiated. CIDP relapse was defined as a deterioration by at least 1 point in the total adjusted Inflammatory Neuropathy Cause and Treatment score., [Results] Eighty-two patients were enrolled. Sixty-two patients initially received 0.4 g/kg, 20 patients 0.2 g/kg weekly. Seventy-two received both doses during the study. Sixty-six patients (81%) completed the 48-week study duration. Overall relapse rates were 10% in 0.4 g/kg–treated patients and 48% in 0.2 g/kg–treated patients. After dose reduction from 0.4 to 0.2 g/kg, 51% (27/53) of patients relapsed, of whom 92% (24 of 26) improved after reinitiation of the 0.4 g/kg dose. Two-thirds of patients (19/28) who completed the PATH study without relapse remained relapse-free on the 0.2 g/kg dose after dose reduction in the extension study. Sixty-two patients had adverse events (AEs) (76%), of which most were mild or moderate with no related serious AEs., [Conclusions] Subcutaneous treatment with IgPro20 provided long-term benefit at both 0.4 and 0.2 g/kg weekly doses with lower relapse rates on the higher dose. Long-term dosing should be individualized to find the most appropriate dose in a given patient. Classification of evidence This study provides Class IV evidence that for patients with CIDP, long-term treatment with SCIG beyond 24 weeks is safe and efficacious., This study was supported by CSL Behring.

Published
2019
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50. RITUXIMAB IN ANTI-MAG POLYNEUROPATHY

Author

Benedetti, L, Gobbi, M, Ghiglione, E, Vigo, T, Carpo, M, Cocito, D, Briani, C, Caporale, C M, Abbruzzese, M, Mancardi, G, and Schenone, A

Published
2005

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