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309 results on '"G. Della Marca"'

1. Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea

Author: E. Testani, E. De Corso, A. Losurdo, A. Fiorita, C. Vollono, G. Della Marca, and E. Scarano
Subjects: Otorhinolaryngology, RF1-547
Published: 2018
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2. Valutazione dell'attività muscolare faringea attraverso elettromiografia di superficie nasofaringea in pazienti disfagici affetti da ictus ischemico acuto

Author: N.M. Giannantoni, M. Minisci, V. Brunetti, E. Scarano, E. Testani, C. Vollono, E. De Corso, G. Bastanza, L. D'Alatri, and G. Della Marca
Subjects: Otorhinolaryngology, RF1-547
Abstract: La disfagia orofaringea è spesso presente durante la fase acuta di un ictus. Lo scopo di questo lavoro è stato quello di valutare se la registrazione elettromiografica di superficie tramite un elettrodo nasofaringeo può essere impiegata per testare l'attività muscolare del faringe nei pazienti con ictus acuto e se queste misurazioni elettrofisiologiche possono essere correlate con la valutazione clinica della deglutizione. Dal punto di vista clinico la severità del quadro è stata valutata mediante l'utilizzo della scala del National Institute of Health Stroke (NIHSS); la disfagia è stata valutata mediante il test di screening Gugging Swallowing Scale (GUSS); l'estensione della lesione ischemica alla TAC è stata misurata attraverso l'Alberta Stroke Programme Early CT Score (ASPECTS). Abbiamo valutato 70 pazienti di cui 50 disfagici (Dys+), e 20 non disfagici (Dys). Ciascun partecipante è stato sottoposto a un'elettromiografia di superficie registrata mediante un elettrodo NP costituito da un catetere di Teflon isolato in acciaio (lungo 16 cm e con un diametro in punta di 1,5 mm). L'elettrodo è stato inserito attraverso la cavità nasale, ruotato e posizionato approssimativamente 3 mm antero-inferiormente rispetto alla volta salpingo-palatina. Per ogni partecipante sono state registrate ed analizzate le risposte elettromiografiche di almeno quattro deglutizioni volontarie ripetute. La deglutizione induce sempre all'elettromiografia burst ripetitivi e polifasici di durata compresa fra 0,25 e 1 secondo, con un'ampiezza intorno ai 100-600mV. I disfagici hanno mostrano una maggiore durata del burst rilevato all'elettromiografia rispetto ai non disfagici, con una differenza statisticamente significativa (p < 0,001), ma non hanno mostrano differenze in termini di ampiezza del burst stesso (p = 0,775); quest'ultima invece era inversamente correlata con lo NIHSS score [r(48) = 0,31; p < 0,05)] e con lo ASPECTS score [r(48) = 0,27; p < 0,05]. Questi risultati suggeriscono che le registrazioni nasofaringee possono rappresentare un indice semi-quantitativo delle difficoltà deglutitorie secondarie a disfunzione faringea ed in particolare, i risultati dell'elettromiografia sarebbero indicativi di una ridotta motilità faringea durante la fase acuta di un ictus.
Published: 2016
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3. Ruolo della sleep endoscopy nella selezione dei pazienti affetti da sindrome delle apnee ostruttive durante il sonno di grado lieve moderato candidati a terapia ortodontica con dispositivo di avanzamento mandibolare

Author: E. DE CORSO, G. BASTANZA, G. DELLA MARCA, C. GRIPPAUDO, G. RIZZOTTO, M.R. MARCHESE, A. FIORITA, B. SERGI, D. MEUCCI, W. DI NARDO, G. PALUDETTI, and E. SCARANO
Subjects: Otorhinolaryngology, RF1-547
Abstract: Il trattamento con dispositivi di avanzamento mandibolare (MAD) rappresenta un’efficace alternativa terapeutica per i pazienti affetti da roncopatia semplice, OSAS di grado lieve/moderato e in casi selezionati di OSAS grave con scarsa tollerabilità alla terapia ventilatoria con C-PAP. Pertanto è importante identificare dei criteri oggettivi per selezionare i pazienti che possono beneficiare del trattamento con i sistemi di avanzamento mandibolare (MAD). In letteratura sono stati descritti vari fattori predittivi sia antropometrici che polisonnografici, mentre esistono ancora controversie circa il ruolo della Sleep Endoscopy e della manovra di avanzamento mandibolare bimanuale durante lo stesso esame come fattori predittivi del successo terapeutico con MAD. In questo studio descriviamo la nostra esperienza nel management di pazienti affetti da OSAS lieve/moderata trattati con MAD e selezionati mediante “sleep endoscopy”. Abbiamo eseguito una valutazione prospettica longitudinale di una serie consecutiva di pazienti giunti alla nostra osservazione con diagnosi di OSAS lieve/moderata e sottoposti a sleependoscopy. Durante il sonno indotto farmacologicamente è stata eseguita una delicata manovra di avanzamento mandibolare con escursione inferiore ai 5 mm e abbiamo riscontrato che in 30 dei 65 pazienti (46,2%) lo spazio respiratorio non migliorava in modo significativo a livello dei siti di ostruzione osservati, mentre in 35 dei 65 pazienti (53,8%) si osservava un miglioramento significativo tale da poter indicare terapia con MAD. In 7 dei 35 pazienti venivano riscontrate condizioni che ostacolavano l’applicazione del MAD per cui 28 dei 35 pazienti sono stati sottoposti a terapia con MAD. Dopo 3 mesi di trattamento abbiamo documentato un miglioramento significativo dell’indice di Epworth medio [(7,35 ± 2,8 vs 4,1 ± 2,2 (p < 0.05)], dell’AHI medio [(21.4 ± 6 eventi per ora verso 8,85 ± 6,9 (p < 0.05) ] e dell’ODI medio [(18.6 ± 8 eventi per ora versus 7 ± 5.8 (p < 0.05)]. Abbiamo inoltre osservato che l’AHI migliorava di almeno il 50% rispetto al basale nel 71.4% dei pazienti selezionati mediante sleep endoscopy. In questo studio, la terapia con i dispositivi di avanzamento mandibolare è stata prescritta con successo sulla base non soltanto dell’indice di apnea/ipopnea, ma anche dei reperti della sleep endoscopy e della manovra di avanzamento mandibolare, ottenendo una visione diretta degli effetti della protrusione mandibolare sullo spazio respiratorio in corrispondenza dei siti di ostruzione, e ottenendo una buona ottimizzazione della selezione dei pazienti per il trattamento con MAD.
Published: 2015
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4. Recurrent Subarachnoid Bleeding and Superficial Siderosis in a Patient with Histopathologically Proven Cerebral Amyloid Angiopathy

Author: P. Profice, F. Pilato, G. Della Marca, C. Colosimo, S. Gaudino, V. Arena, A. Pavone, and V. Di Lazzaro
Subjects: Amyloid angiopathy, Subarachnoid bleeding, Superficial siderosis, Neurology. Diseases of the nervous system, RC346-429
Abstract: A 68-year-old man with a history of hypertension presented with recurrent subarachnoid bleeding. Brain MRI showed superficial siderosis, and diagnostic cerebral angiograms did not show any intracranial vascular malformation or arterial aneurism. Post mortem neuropathological examination of the brain was consistent with a diagnosis of cerebral amyloid angiopathy. Clinicians should be aware that cerebral amyloid angiopathy should be considered in patients with unexplained recurrent subarachnoid bleeding, even in cases without familial clustering or transthyretin variant.
Published: 2011
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5. Validation study of the Richard’s Campbell Sleep Questionnaire in patients with acute stroke

Author: E. Rollo, V. Brunetti, T. Rozera, A. Broccolini, P. Caliandro, R. Di Iorio, G. Frisullo, V. Guglielmi, M. Monforte, R. Morosetti, C. Piano, and G. Della Marca
Subjects: General Medicine
Published: 2022
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6. Sleep and stroke-related delirium: A systematic review and meta-analysis

Author: V. Brunetti, E. Rollo, I. Scala, J. Marotta, C. Imperatori, and G. Della Marca
Subjects: General Medicine
Published: 2022
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7. Functional and radiological outcomes after bridging therapy versus direct thrombectomy in stroke patients with unknown onset: Bridging therapy versus direct thrombectomy in unknown onset stroke patients with 10-point ASPECTS

Author: Sergio Nappini, Laura Malfatto, Mirco Cosottini, Roberto Gandini, Andrea Zini, Roberto Gasparotti, Francesco Grillo, F. Granata, Marco Longoni, Guido Bigliardi, Mauro Bergui, Enrica Franchini, Michelangelo Mancuso, B. Bonetti, Danilo Toni, P. Castellini, M. Cappellari, G. Della Marca, Maria Ruggiero, Rossana Tassi, Domenico Inzitari, Samuele Cioni, Lucio Castellan, Patrizia Nencini, Roberto Menozzi, Elisa Francesca Maria Ciceri, Fabrizio Sallustio, Giovanni Pracucci, Emilio Lozupone, Alessio Comai, Salvatore Mangiafico, Stefano Vallone, Paolo Cerrato, F. Taglialatela, Mauro Magoni, Valentina Saia, A. De Vito, P. Zampieri, and Andrea Saletti
Subjects: thrombolysis, medicine.medical_specialty, medicine.medical_treatment, Alberta, Brain Ischemia, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Alberta *Brain Ischemia/drug therapy Cohort Studies Humans Retrospective Studies *Stroke/diagnostic imaging/drug therapy Thrombectomy Thrombolytic Therapy Treatment Outcome Aspects stroke thrombolysis unknown onset, medicine, ASPECTS, stroke, thrombectomy, unknown onset, Humans, Retrospective Studies, Thrombectomy, Thrombolytic Therapy, Treatment Outcome, Stroke, 030212 general & internal medicine, Prospective cohort study, Intracerebral hemorrhage, business.industry, Retrospective cohort study, Thrombolysis, Odds ratio, medicine.disease, Confidence interval, Neurology, Propensity score matching, Neurology (clinical), business, 030217 neurology & neurosurgery, Fibrinolytic agent
Abstract: BACKGROUND AND PURPOSE The aim was to assess functional and radiological outcomes after bridging therapy (intravenous thrombolysis plus mechanical thrombectomy) versus direct mechanical thrombectomy (MT) in unknown onset stroke patients. METHODS A cohort study was conducted on prospectively collected data from unknown onset stroke patients who received endovascular procedures at ≤6 h from symptom recognition or awakening time. RESULTS Of the 349 patients with a 10-point Alberta Stroke Program Early Computed Tomography Score (ASPECTS), 248 received bridging and 101 received direct MT. Of the 134 patients with 6-9-point ASPECTS, 123 received bridging and 111 received direct MT. Each patient treated with bridging was propensity score matched with a patient treated with direct MT for age, sex, study period, pre-stroke disability, stroke severity, type of stroke onset, symptom recognition to groin time (or awakening to groin time), ASPECTS and procedure time. In the two matched groups with 10-point ASPECTS (n = 73 vs. n = 73), bridging was associated with higher rates of excellent outcome (46.6% vs. 28.8%; odds ratio 2.302, 95% confidence interval 1.010-5.244) and successful recanalization (83.6% vs. 63%; odds ratio 3.028, 95% confidence interval 1.369-6.693) compared with direct MT; no significant association was found between bridging and direct MT with regard to rate of symptomatic intracerebral hemorrhage (0% vs. 1.4%). In the two matched groups with 6-9-point ASPECTS (n = 45 vs. n = 45), no significant associations were found between bridging and direct MT with regard to rates of excellent functional outcome (44.4% vs. 31.1%), successful recanalization (73.3% vs. 76.5%) and symptomatic intracerebral hemorrhage (0% vs. 0%). CONCLUSIONS Bridging at ≤ 6 h of symptom recognition or awakening time was associated with better functional and radiological outcomes in unknown onset stroke patients with 10-point ASPECTS.
Published: 2020

8. Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea

Author: Elisa Testani, G. Della Marca, C. Vollono, E. De Corso, Anna Losurdo, Emanuele Scarano, and Antonella Fiorita
Subjects: Male, medicine.medical_specialty, Sleep Apnea, Time Factors, PCO2, Apnea Centrale nel Sonno Emergenti dal Trattamento, CSA, Severity of Illness Index, pCO2, OSA, 03 medical and health sciences, Central sleep apnoea, Postoperative Complications, 0302 clinical medicine, Treatment Emergent Central Sleep Apnoea, stomatognathic system, Otology, Complex Sleep Apnoea, Humans, Medicine, Arterial pCO2, 030223 otorhinolaryngology, Central, UPPP, Obstructive sleep apnoea syndrome, Sleep Apnea, Obstructive, Obstructive, business.industry, Middle Aged, Sleep Apnea, Central, Sleep in non-human animals, nervous system diseases, respiratory tract diseases, Surgery, General Energy, Otorhinolaryngology, PCO, Breathing, Settore MED/31 - OTORINOLARINGOIATRIA, business, 030217 neurology & neurosurgery, Case Series and Reports
Abstract: Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCOApnee notturne centrali post chirurgia disostruttiva delle prime vie aeree nei pazienti affetti da OSAS.L’Apnea Centrale nel Sonno (CSA) è caratterizzata da un mancato input a compiere l’atto respiratorio durante il sonno e può verificarsi sia in condizioni fisiologiche che in condizioni patologiche. Un particolare tipo di CSA, definito come “Apnea Centrale nel Sonno Emergente dal Trattamento” (TECSA), può verificarsi dopo il trattamento della Sindrome delle Apnee Ostruttive durante il Sonno (OSAS), sia dopo ventiloterapia con CPAP che dopo intervento chirurgico. La TECSA è di solito transitoria e sembra correlata alla gravità dell’OSAS. Descriviamo un uomo di 51 anni affetto da OSAS grave, che ha sviluppato gravi e transitorie apnee centrali nel sonno, immediatamente dopo l’intervento chirurgico delle vie aeree superiori. Ipotizziamo che la CSA sia stata innescata dalla brusca variazione dei valori notturni di PCO
Published: 2018
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9. Clinical characteristics and outcome of patients with autoimmune encephalitis: clues for paraneoplastic aetiology

Author: Gabriele Monte, Gianvito Masi, G. Della Marca, Valentina Damato, Catello Vollono, Lucia Campetella, Raffaele Iorio, Amelia Evoli, Gregorio Spagni, and Claudia Papi
Subjects: medicine.medical_specialty, medicine.medical_treatment, Encephalopathy, Hashimoto Disease, Gastroenterology, 03 medical and health sciences, Mice, 0302 clinical medicine, Cerebrospinal fluid, Modified Rankin Scale, Internal medicine, medicine, Animals, Humans, autoimmune diseases, 030212 general & internal medicine, Autoantibodies, Autoimmune encephalitis, business.industry, Autoantibody, Cancer, Immunosuppression, medicine.disease, autoantibodies, Rats, Settore MED/26 - NEUROLOGIA, Neurology, Etiology, Encephalitis, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Background and purpose Autoimmune encephalitis (AE) represents a complex syndrome with diverse clinical manifestations and therapeutic outcomes. The aim of this study was to report the clinical characteristics and the long-term outcome of patients with paraneoplastic and idiopathic AE. Methods All patients with subacute encephalopathy admitted to the Neurology Department of our Institution from January 2012 to May 2019 were consecutively enrolled. Patients' serum and cerebrospinal fluid were tested for neural-specific autoantibodies by indirect immunofluorescence assays on mouse brain, rat neurons, cell-based assays and immunoblots. Outcome was assessed by the modified Rankin Scale score. Results From 107 adult patients with subacute encephalopathy, 50 patients were finally diagnosed with AE. Neural antibodies (Abs) were detected in 45/50 patients (90%). Leucine-rich glioma-inactivated protein 1 immunoglobulin G was the most frequent (6/50, 12%) Ab specific to neural surface antigens detected in adults with AE. Paraneoplastic encephalitis was diagnosed in 16/50 patients (32%). The presence of bilateral temporal lobe lesions on magnetic resonance imaging and cerebrospinal fluid restricted oligoclonal bands was associated with a higher probability to detect cancer at the time of AE diagnosis. All patients with Abs to neural surface antigens had a good outcome at last follow-up. Severe disability at AE onset and the lack of long-term immunosuppression predicted a poor outcome. Conclusions Leucine-rich glioma-inactivated protein 1 immunoglobulin G was the most frequent Ab detected. Patients with bilateral temporal lobe lesions and oligoclonal bands have a higher probability to harbour an occult tumour. In these patients, a strict surveillance and monitoring for cancer detection is recommended.
Published: 2019

10. Valutazione dell'attività muscolare faringea attraverso elettromiografia di superficie nasofaringea in pazienti disfagici affetti da ictus ischemico acuto

Author: E. De Corso, Valerio Brunetti, Catello Vollono, Elisa Testani, Lucia D'Alatri, Emanuele Scarano, Nadia Mariagrazia Giannantoni, M. MiNisci, G. Bastanza, and G. Della Marca
Subjects: Nasal cavity, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Electromyography, 030204 cardiovascular system & hematology, medicine.disease, Dysphagia, Surgery, Pharyngeal muscles, Lesion, 03 medical and health sciences, 0302 clinical medicine, General Energy, medicine.anatomical_structure, Otorhinolaryngology, Swallowing, Otology, Internal medicine, medicine, Cardiology, medicine.symptom, business, Stroke, 030217 neurology & neurosurgery
Abstract: Oro-pharyngeal dysphagia is frequently present during the acute phase of stroke. The aim of the present study was to evaluate whether the recording of surface EMG using a nasopharyngeal (NP) electrode could be applied to evaluation of pharyngeal muscle activity in acute stroke patients and if this neurophysiological measure is related with clinical assessment of swallowing. Patients were examined and clinical severity was assessed with the National Institute of Health Stroke Scale (NIHSS) score; dysphagia was evaluated through bedside screening test using the Gugging Swallowing Scale (GUSS). Extension of the ischaemic lesion was measured by quantitative score, based on CT scan [Alberta Stroke Programme Early CT Score (ASPECTS)]. We analysed 70 patients; 50 were classified as dysphagic (Dys+), and 20 as non-dysphagic (Dys-). Each participant underwent a surface NP EMG recording performed with a NP electrode, made of a Teflon isolated steel catheter, with a length of 16 cm and a tip diameter of 1.5 mm. The electrode was inserted through the nasal cavity, rotated and positioned approximately 3 mm anteroinferior to the salpingo-palatine fold. At least four consecutive swallowing-induced EMG bursts were recorded and analysed for each participant. Swallowing always induced a repetitive, polyphasic burst of activation of the EMG, lasting around 0.25 to 1 sec, with an amplitude of around 100-600mV. Two parameters of the EMG potentials recorded with the NP electrode were analyzed: duration and amplitude. The duration of the EMG burst was increased in Dys+ patients with a statistically significant difference compared to Dys- patients (p < 0.001). The amplitude was slightly reduced in the Dys+ group, but statistically significant differences were not observed (p = 0,775). Nevertheless, the burst amplitude showed a significant inverse correlation with NIHSS [r(48) = -0.31; p < 0.05] and ASPECTS scores [r(48) = -0.27; p < 0.05], meaning that the burst amplitude progressively reduced with an increase of clinical severity (NIHSS) and topographic extension of brain lesions in CT (ASPECTS). These results suggest that NP recordings can give a semi-quantitative measure of swallowing difficulties originating from pharyngeal dysfunction, in fact, electromyographic findings suggest reduced pharyngeal motility.
Published: 2016
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11. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author: Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart, N Abdelhamid, D Abdul Rahman, M Abdul-Saheb, P Abreu, M Abroskina, F Abu Ahmad, S Accassat, M Acciaresi, A Adami, N Ahmad, F Ahmed, M Alberto Hawkes, F Alemseged, A Ali, R Altavilla, L Alwis, P Amarenco, S Amaro, LE Amaya Sanchez, A Amelia Pinto, SF Ameriso, H Amin, T Amino, AK Amjad, E Anagnostou, G Andersen, C Anderson, DC Anderson, M Andrea Falco, F Andres Mackinnon, D Andreu, M Androulakis, M Angel Gamero, G Angel Saredo, R Angeles Diaz, M Angels Font, S Anticoli, A Arauz, AA Arauz Gongora, P Araya, JF Arenillas Lara, S Arias Rivas, M Arnold, S Augustin, W Avelar, E Azevedo, V Babikian, A Bacellar, K Badalyan, HJ Bae, EM Baez Martinez, H Bagelmann, P Bailey, Z Bak, M Baker, A Balazs, D Baldaranov, I Balogun, T Balueva, Z Bankuti, M Bar, A Baranowska, J Bardutzky, S Barker Trejo, J Barlinn, F Baronnet, C Barroso, M Barteys, T Bartolottiova, A Barulin, M Bas, S Bashir, V Basile, R Bathe-Peters, R Bathula, C Batista, H Batur Caglayan, P Baumgartner, R Bazan, O Bazhenova, M Beaudry, J Beer, Y Behnam, C Beilei, A Beinlich, Y Bejot, A Belkin, OR Benavente, A Benjamin, V Berardi, D Bereczki, SD Berkowitz, J Berlingieri, W Berrios, J Berrouschot, M Bhandari, M Bhargavah, H Bicker, T Bicsak, M Bilik, D Bindila, J Birchenall, L Birnbaum, T Black, D Blacker, D Blacquiere, C Blanc-Labarre, C Blank, B Blazejewska-Hyzorek, S Bloch, E Bodiguel, E Bogdanov, L Boos, L Borcsik, N Bornstein, S Bouly, G Braga, I Bragado, MC Bravi, C Brokalaki, W Brola, R Brouns, D Bruce, J Brzoska-Mizgalska, B Buck, M Buksinska-Lisik, J Burke, M Burn, G Bustamante, L Cabrejo, K Cai, S Cajaraville, M Calejo, D Calvet, J Campillo, E Campos Costa, P Camps, H Can Alaydin, E Candeloro, C Canepa, CG Cantu Brito, M Cappellari, C Carcel, P Cardona Portela, F Cardoso, M Carek, M Carletti, J Carlos Portilla, P Caruso, I Casado-Naranjo, P Castellini, D Castro, F Castro Meira, A Cavallini, N Cayuela Caudevilla, S Cenciarelli, C Cereda, P Cerrone, A Chakrabarti, P Chaloulos-Iakovidis, A Chamorro, D Chandrasena, DI Chang, C Che, J Chembala, J Chen, Z Chen, T Chen, H Chen, X Chen, G Chen, L Chen, S Chen, B Cheripelli, M Chin, E Chiquete Anaya, M Chorazy, H Christensen, T Christensen, L Christian, F Chu, CS Chung, W Clark, R Clarke, S Claverie, E Clemente Agostoni, B Clissold, J Coelho, D Cohen, S Colakoglu, D Collas, R Condurso, SJ Connolly, D Consoli, C Constantin, AB Constantino Silva, L Contardo, A Corlobe, M Correia, C Correia, E Cortijo Garcia, B Coull, S Coutts, S Coveney, P Cras, R Crols, S Crozier, A Csanyi, L Csiba, K Csontos, R Csuha, L Cui, L Cunha, S Curtze, M Czerska, A Czlonkowska, M Czurko, M Czuryszkiewicz, M Dagnino, C Dai, A Daineko, G Dalek, D Damgaard, A Danese, K Dani, V Danku, W Dario Toledo, A Dávalos, A De Havenon, J De Keyser, N De Klippel, J De La Torre, A De Pauw, A De Smedt, R De Torres, MM De Vries Basson, J Dearborn, R Deganutto, M Degeorgia, I Deguchi, A Del Giudice, C Delcourt, R Delgado-Mederos, G Della Marca, B Delpont, S Deltour, DL Demets, M Dennis, J Desai, J Devine, I Dhollander, MT Di Mascio, M Diaconu, F Diaz Otero, J Dietzel, E Diez-Tejedor, N Ding, J Ding, M Diomedi, P Dioszeghy, M Distefano, V Domigo, E Dorodnicov, D Dossi, F Doubal, I Druzenko, P Du, J Du, T Duman, Y Duodu, D Dutta, L Dylewicz, J Eckstein, E Ehrensperger, S Ehrlich, G Einer Allende, B Elena Halac, S Elyas, M Endres, JM Engelbrecht, S Engelter, M Epinat, F Eren, M Esbjornsson, B Escribano, I Escudero, B Esisi, B Essa, M Esterbauer, N Evans, D Eveson, S Fabio, L Fang, S Fanta, M Fares, M Fatar, K Faust, A Favate, F Fazekas, M Federica Denaro, A Fedin, P Felipe Amaya, J Feng, K Ferencova, M Fernanda Gilli, MD Fernandez, PN Fernandez Pirrone, J Fernandez Vera, J Ferrari, A Ferreira, G Ferreira Junior, M Fidler, D Field, T Field, C Figueroa, J Fiksa, A Filipov, A Firstenfeld, L Fisch, U Fischer, M Fisselier, U Fiszer, F Fluri, G Fortea, K Fotherby, A Fraczek, E France, G Freitas, S Frey, M Frick, A Friedman, M Friedrich, G Frisullo, W Fryze, B Fuentes Gimeno, H Fujigasaki, K Fukuyama, A Furlan, G Furlanis, J Furnace, M Gabriel, E Gabriel Reich, RJ Gagliardi, F Galati, E Galli Giqueauk, A Gallina, E Gallinella, J Gallo, S Gangadharan, Y Gao, R Garcia Lopez, A Garcia Pastor, SM Garcia Sanchez, M Garnauf, P Garnier, D Gasecki, K Gasic, K Gasiorek, S Gasser, M Gaugg, M Gebreyohanns, K Gebura, J Geng, M Geniz Clavijo, K Georg Haeusler, R Geran, M Geremek, Z Gerocs, D Ghia, D Giannandrea, F Giatsidis, JA Gien Lopez, A Gil Nunez, L Gimenez, E Giralt, A Glabinski, D Gladstone, M Gliem, M Gluszkiewicz, R Goddeau, E Gogoleva, M Gokce, D Goldemund, K Golikov, A Gomes Neto, M Gomez Schneider, M Gomez-Choco, M Gomis, JF Gongora-Rivera, Y Gonysheva, L Gonzalez, ME Gonzalez Toledo, M Gottschal, I Gozdzik, S Grabowski, S Graf, D Green, D Greer, T Gregorio, S Greisenegger, I Greshnova, M Griebe, M Grzesik, J Guan, S Guarda, A Gueguen, C Guidoux, P Guillermo Povedano, B Guillon, V Guiraudg, G Gunathilagan, N Guryanova, V Gusev, G Gustavo Persi, R Gutiérrez, P Guyler, N Gyuker, V Hachinski, A Hajas, H Hallevi, G Hankey, GJ Hankey, L Hanouskova, L Hao, K Haraguchi, Y Haralur Sreekantaiah, S Haratz, D Hargroves, K Harkness, P Harmel, M Harrasser, RG Hart, M Harvey, R Hasan, Y Hasegawa, A Hassan, M Hattori, A Hatzitolios, M Hauk, T Hayashi, H Hayhoe, VS Hedna, M Heine, V Held, S Hellwig, J Henkner, N Henninger, S Hermans, J Hernandez, D Herrero, M Hervieu-Begue, R Herzig, L Hicken, M Hieber, M Hill, M Hirose, MC Hobeanu, B Hobson, M Hochstetter, J Hoe Heo, M Hoffmann, C Holmstedt, P Hon, KS Hong, Y Honma, A Horev, G Horgan, L Horvath, M Horvath, C Hoyer, D Huang, H Huang, B Huber, J Huhtakangas, M Hussain, S Igarashi, AM Iglesias Mohedano, J Ignacio Tembl, M Impellizzeri, Y Inanc, P Ioli, A Irina Aniculaesei, K Ishida, R Itabashi, H Iversen, A Jagolino, K Jakab, S Jander, H Janka, J Jankovych, J Jansen, L Jasek, M Javier Alet, L Javor, X Jin, P Jing, B Joachim, M Joan Macleod, M Johnson, J Jose Martin, C Joyner, K Judit Szabo, A Jun-Oconnell, R Jura, B Kaczorowska, J Kadlcikova, T Kahles, N Kakaletsis, I Kakuk, K Kalinowska, K Kaminska, C Kaneko, I Kanellos, P Kapeller, K Kapica-Topczewska, O Karasz, M Karlinski, JE Karlsson, K Kasa, E Kashaeva, SE Kasner, M Kaste, J Kasza, A Katalin Iljicsov, M Katsurayama, S Kaur, M Kawanishi, S Kaygorodtseva, K Ke, A Kei, J Keilitz, J Kellner, P Kelly, S Kelly, D Kemlink, M Kerekgyarto, I Keskinarkaus, D Khairutdinova, A Khanna, A Khaw, M Kholopov, C Khoumri, S Kirpicheva, H Kirshner, K Kitagawa, S Kittner, R Kivioja, F Klein, D Kleindorfer, T Kleinig, P Klivenyi, S Knecht, Y Kobayashi, A Kobayashi, M Koch, L Koehler, M Koivu, V Kolianov, I Koltsov, T Kondo, I Konkov, S Kopecky, E Korompoki, J Korpela, K Kosarz-Lanczek, A Koutroubi, K Kovacs, T Kovacs, H Kovacs, K Kowalczyk, M Kowalska, D Krajickova, M Kral, C Krarup Hansen, J Kraska, S Krebs, V Krejci, C Kremer, R Kreuzpointer, M Krzyzanowska, D Kucken, A Kulakowska, J Kunzmann, N Kurenkova, A Kuris, I Kurkowska-Jastrzebska, N Kurtenkova, O Kurushina, G Kusnick, M Kustova, T Kuwashiro, J Kwan Cha, A Lago, M Lagutenko, B Lajos, J Lambeck, C Lamy, A Landolfi, S Lanfranconi, W Lang, LB Lara Lezama, B Lara Rodriguez, T Largo, A Lasek-Bal, L Latte, V Lauer, P Lavados, R Le Bouc, R Leal Cantu, H Lechner, K Lecouturier, S Leder, J Lee, BC Lee, A Leger, E Leira, I Leisse, R Leker, G Lembo, L Lenskaya, J Leyden, G Li, M Li, S Li, J Li, G Liamis, H Liang, Z Liang, N Ligot, H Lin, R Lindert, A Lindgren, M Linna, T Litwin, K Liu, X Liu, L Llull, B Lohninger, M Longoni, C Loomis, D Lopes, M Lopez Fernandez, N Lopez Garza, A Lord, S Louw, R Lovasz, T Lowenkopf, Z Lu, SC Lubke-Detring, R Luder, S Lujan, B Luo, L Lupinogina, G Luschin, H Lutsep, A Lvova, J Ly, G.M. Grosse, H Ma, C Ma, M Machado, C Machado, S Macher, J Machetanz, F Macian-Montoro, E Mackey, A Mackey, G Maclean, J Maestre-Moreno, A Magadan, T Magyar, A Mahagney, A Majid, A Majjhoo, K Makaritsis, J Mandzia, M Mangas Guijarro, D Mangion, E Manios, S Mann, L Manning, C Manno, J Manuel Garcia, V Maqueda, M Mar Castellanos, M Mar Freijo, C Marando, S Marcela Lepera, J Marcos Couto, G Maria Bruera, L Maria Greco, A Maria Lorenzo, S Maria Obmann, A Maria Roa, C Marini, I Marinkovic, G Mario Sumay, C Mario Torres, M Marko, S Markova, H Markus, R Marsh, E Marsili, M Marta Esnaola, J Marta Moreno, J Marti-Fabregas, S Martina Angelocola, P Martínez Sánchez, N Martinez-Majander, S Martins, O Marzelik, S Mastrocola, G Matamala, A Matoltsy, B Matosevic, S Matsumoto, A Maud, G Mauri Cabdevila, Z May, Y Mayasi, A Mayr, T Mazzoli, K Mcarthur, L Mccullough, CE Medina Pech, F Medlin, M Mehdiratta, S Mehta, D Mehta, B Mehta, M Melis, E Melnikova, B Mendez, T Mendonca, JJ Mengual Chirifie, N Menon, A Mensch, E Meseguer, S Messe, K Metcalf, N Meyer, F Michas, N Micheletti, R Mikulik, H Milionis, B Miller, T Milling, C Minelli, J Minhas, M Minns, D Mircea, S Mishra, A Mismas, A Mistri, N Mitrovic, H Miyake, B Modrau, A Moey, C Molina, J Molina, A Molis, J Moller, S Molnar, F Moniche, C Monosi, V Monzani, M Moonis, R Morais, L Morales, A Morales, D Morar-Precup, F Moreton, C Moro, E Morozova, M Morton, T Morvan, E Morvan, T Motko, A Mowla, E Mozhejko, G Muddegowda, O Mudhar, T Mueller, C Muhl, KW Muir, H Mundl, S Munoz, C Murphy, S Murphy, A Murtuzova, T Musuka, J Mutzenbach, M Myint, W Mysliwy, M Naccarato, G Naeije, Y Nagakane, I Natarajan, D Navaratnam, A Nave, B Nazliel, K Nedeltchev, J Nel, H Nell, R Nemeth, L Nemeth, O Neto, K Ng, J Ngeh, L Nicolas Chialvo, T Nieminen, M Nikkanen, J Nikl, M Nikoforova, S Nishino, Y Nishiyama, X Njovane, S Nogawa, F Nombela, B Norrving, K Nosek, B Nowak, E Nowakowska-Sledz, G Ntaios, H Numminen, F Nunez, M Obadia, S Oberndorfer, A Obrezan, J Ochiai, W Oczkowski, MJ O'Donnell, A Odyniec, K Oh, M Ohira, Y Okamoto, M Okpala, S Okubo, L Olah, V Olavarria, J Oleszek, N Onat Demirci, V Ondar, G Ongun, K Ooyama, V Orosz, R Ortiz, G Osseby, E Österlund-Tauriala, C Ovesen, S Ozcekic Demirhan, J Ozdoba-Rot, S Ozturk, E Ozyurt, M Pablo Grecco, G Pablo Povedano, M Paciaroni, C Padiglioni, J Pagola, W Palasik, G Panczel, L Panos, G Papadopoulos, E Papadopoulou, A Papagiannis, V Papavasileiou, M Papina, JR Pardo De Donlebun, V Parisi, JM Park, J Pasten, N Patel, O Pavlik, M Pawelczyk, WF Peacock, H Pei, T Peisker, LF Pena Sedna, A Penn, S Pentek, E Pepper, L Pereira, K Perera, Y Perez, S Perez, P Perez Leguizamon, M Pernicka, R Perry, A Persico, Y Pesant, S Peska, D Peters, G Peters, L Pettigrew, T Phan, S Philippi, T Phinney, F Pico, A Pidal, B Piechowski-Jozwiak, A Pieroni, S Pineiro, V Piras, N Pizova, J Polanco, M Polin, A Polyakov, E Polychronopoulou, A Polymeris, D Popov, A Poppe, P Postorino, C Pozzerese, M Pradhan, L Prats, E Prazdnichkova, B Prendl, M Pretorius, P Profice, S Prokopenko, E Pudov, V Pujol Lereis, G Punzo Bravo, F Purroy, J Qiu, X Qu, V Quenardelle, H Quesada Garcia, L Radrizzani, A Radtke, T Raffelsberger, JM Ramirez Moreno, C Ramos-Estebanez, A Rani, P Rapantova, K Rashed, A Rasheed Nihara, J Rasmussen, L Redondo Robles, M Reif, P Reiner, P Rekova, A Renu, M Repetto, P Reyes, S Reyes Morales, JH Rha, J Ribeiro, S Ricci, C Richard, R Rigual, C Rinaldi, C Riveira Rodriguez, B Rizzato, TG Robinson, A Rocco, M Rodrigues, G Rodriguez, A Rodriguez Campello, F Rodriguez Lucci, M Rodriguez Yanez, C Roesler, C Roffe, R Roine, S Roine, A Roldan, F Romana Pezzella, M Romano, JS Roos, C Rosso, C Rostrup Kruuse, Y Roth, R Roukens, L Roveri, D Rozanski, J Rozniecki, C Rozsa, S Rudilosso, G Ruiz Ares, A Ruiz Franco, G Rum, J Ruuskanen, I Rybinnik, K Ryota, J Saarinen, V Saavedra, C Sabben, A Sabet, D Sagris, J Sahlas, N Sakai, P Salamanca, P Salgado, S Salig, T Salletmayr, M Salnikov, O Samoshkina, Y Samson, D Sanak, M Sànchez Cerón, P Santalucia, M Santamaria Cadavid, P Santiago, G Santo, B Sanz Cuesta, J Sargento, A Sarraj, K Sas, A Sas, O Satoshi, S Satsoglou, N Sattar, S Savitz, C Savopoulos, J Saw, M Sawicka, R Sawyer, T Scandura, N Schillinger, J Schindler, F Schlachetzki, I Schneider, R Schuppner, J Schurig, CJ Schwarzbach, M Sebejova, G Seidel, L Sekaran, D Selcuk, J Selvarajah, A Semerano, J Semjen, D Semushina, S Sen, M Seok Park, J Serena, O Serhat Tokgoz, W Serles, F Serrano, M Sevin, L Seynaeve, S Shah, N Shamalov, T Shang, M Sharma, A Sharrief, M Shazam Hussain, I Shchukin, W Shen, E Shepeleva, I Shinsuke, A Shmonin, A Shoamanesh, A Shuaib, A Shulga, G Sibolt, I Sibon, I Sicilia, M Siebert, E Sieczkowska, C Sila, AA Silva, D Silva, P Silva, Y Silva, M Silvestrini, Z Simony, A Simpkins, B Singh, D Sinha, I Sipos, O Skoda, P Skowron, M Skowronska, B Sliwinska, J Slonkova, A Smolkin, A Smyth, P Sobolewski, A Sobota, SI Sohn, M Soldatov, I Solganov, L Soloveva, E Solovyeva, N Sonntag, P Soors, M Sorgun, C Soriano, D Spence, K Spengos, L Sposato, G Staaf, K Stadler, L Stakhovskaya, K Stamatelopoulos, S Steinert, I Stetkarova, M Stiehm, R Stocker, J Stoinski, A Stoll, G Stotts, A Stumpp, P Sucapane, T Suenaga, X Sun, S Sundararajan, J Sung Kim, H Suzuki, N Svaneborg, G Szasz, W Szczuchniak, S Szczyrba, N Szegedi, A Szekely, Z Szewczyk, G Szilagyi, S Szlufik, K Szoboszlai, L Szpisjak, R Sztajzel, L Sztriha, SE Ta Wil, J Taggeselle, K Takamatsu, M Takao, W Taki, S Takizawa, M Talahma, A Tamayo, J Tan, D Tanne, A Tapanainen, T Tapiola, J Tarasiuk, T Tatlisumak, A Tayal, S Tcvetkova, P Teal, J Tejada Garcia, H Tejada Meza, D Tenora, M Terceno, A Terentiou, S Tezcan, D Thaler, A Thomson, E Thouvenot, M Tiainen, I Timberg, S Timsit, A Tinchon, D Tirschwell, C Togay Isikay, K Tokunaga, M Tolino, C Toloza, G Tomelleri, K Tomoyuki, LM Tomppo, Z Tong, L Tong, D Toni, J Torres, C Tossavainen, G Toth, A Tountopoulou, E Touze, M Tovar, K Toyoda, S Trillo, A Trommer, D Tropepi, D Tryambake, H Tu, S Tuetuencue, R Tumova, O Tumpula, G Turc, A Tutaj, J Tynkkynen, S Uchiyama, U Uchwat, L Uhrinyakova, R Ulku Acar, D Uluduz Ugurlu, X Urra, S Urui, M Usero Ruiz, D Vaclavik, K Vahedi, A Valikovics, J Valpas, P Van Acker, W Van Daele, G Vanderschueren, L Vanina Jure, R Varela, Z Varga, J Varvat, N Varvyanskaya, A Vasco Salgado, P Vasko, L Vass, S Vassilopoulou, I Vastagh, P Vazquez, L Vecsei, R Veltkamp, M Venti, M Verdugo, V Verocai, M Veronica Marroquin, C Veronica Simonsini, T Veverka, M Vigl, A Vila, C Vilar, JA Villanueva Osorio, J Virta, E Vitkova, B Voglsperger, J Volna, PA Von Weitzel-Mudersbach, N Vora, I Voznyuk, A Wach-Klink, A Wacongne, D Walters, Y Wang, J Wang, L Wang, X Wang, W Wang, N Wang, D Wang, H Wang, W Warnack, K Wartenberg, R Waters, M Waters, T Webb, J Weber, G Weiss, K Weissenborn, JI Weitz, B Weller, G Wen, G Weng, P Werner, D Werring, P Wester, W Whiteley, R Whiting, T Wijeratne, C Willems, L Wilson, C Wilson, T Winder, J Windt, A Winkler, A Winska-Tereszkiewicz, A Wisniewska, M Wittayer, A Wlodek, A Wojnarowska-Arendt, M Wolf, V Wolff, C Wolter, A Wong, H Wook Nah, H Worthmann, W Wu, S Wu, S Wunderlich, H Wurzinger, DG Wyse, B Xiao, W Xiaopeng, A Ximenez-Carrillo, L Xiong, Y Xiong, W Xiong, Y Xu, J Xu, Z Xu, B Yalo, T Yamada, M Yamasaki, L Yang, Y Yang, X Yang, Q Yang, B Yang, J Yang, I Yasuhiro, M Yee Lam, C Yegappan, S Yip, E Ylikallio, P Ylikotila, A Yongwon Jin, BW Yoon, Y Yoshida, L Yperzeele, H Yuan, H Yuasa, J Zalewska, C Zanferrari, E Zapata, D Zboznovits, I Zelenka, C Zhang, B Zhang, S Zhang, M Zhang, X Zhang, J Zhang, L Zhao, O Zhirnova, L Zhou, J Zielinska-Turek, I Zinchenko, M Ziomek, A Zitzmann, R Zweifler, J Zwiernik, Yperzeele, Laetitia, and NAVIGATE ESUS Investigators
Subjects: Male, International Cooperation, 030204 cardiovascular system & hematology, antiplatelet therapy, law.invention, Neurology (clinical), ischemic stroke, anticoagulation, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Stroke, education.field_of_study, Aspirin, Anticoagulant, Settore BIO/14, Middle Aged, 3. Good health, Treatment Outcome, N/A, Cardiology, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Female, medicine.drug, medicine.medical_specialty, medicine.drug_class, MEDLINE, Population, Foramen Ovale, Patent, Subgroup analysis, Article, Statistics, Nonparametric, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, education, Aged, business.industry, medicine.disease, Human medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract: Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.
Published: 2018
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12. Ruolo della sleep endoscopy nella selezione dei pazienti affetti da sindrome delle apnee ostruttive durante il sonno di grado lieve moderato candidati a terapia ortodontica con dispositivo di avanzamento mandibolare

Author: D. Meucci, G. Rizzotto, Emanuele Scarano, Antonella Fiorita, Cristina Grippaudo, G. Bastanza, E. De Corso, Gaetano Paludetti, W. Di Nardo, B Sergi, Maria Raffaella Marchese, and G. Della Marca
Subjects: Mandibular advancement splint, medicine.medical_specialty, business.industry, Oral appliance, Anthropometry, Surgery, General Energy, Otorhinolaryngology, Sleep endoscopy, Otology, Positive airway pressure, medicine, Breathing, Sleep (system call), business
Abstract: Il trattamento con dispositivi di avanzamento mandibolare (MAD) rappresenta un’efficace alternativa terapeutica per i pazienti affetti da roncopatia semplice, OSAS di grado lieve/moderato e in casi selezionati di OSAS grave con scarsa tollerabilità alla terapia ventilatoria con C-PAP. Pertanto è importante identificare dei criteri oggettivi per selezionare i pazienti che possono beneficiare del trattamento con i sistemi di avanzamento mandibolare (MAD). In letteratura sono stati descritti vari fattori predittivi sia antropometrici che polisonnografici, mentre esistono ancora controversie circa il ruolo della Sleep Endoscopy e della manovra di avanzamento mandibolare bimanuale durante lo stesso esame come fattori predittivi del successo terapeutico con MAD. In questo studio descriviamo la nostra esperienza nel management di pazienti affetti da OSAS lieve/moderata trattati con MAD e selezionati mediante “sleep endoscopy”. Abbiamo eseguito una valutazione prospettica longitudinale di una serie consecutiva di pazienti giunti alla nostra osservazione con diagnosi di OSAS lieve/moderata e sottoposti a sleependoscopy. Durante il sonno indotto farmacologicamente è stata eseguita una delicata manovra di avanzamento mandibolare con escursione inferiore ai 5 mm e abbiamo riscontrato che in 30 dei 65 pazienti (46,2%) lo spazio respiratorio non migliorava in modo significativo a livello dei siti di ostruzione osservati, mentre in 35 dei 65 pazienti (53,8%) si osservava un miglioramento significativo tale da poter indicare terapia con MAD. In 7 dei 35 pazienti venivano riscontrate condizioni che ostacolavano l’applicazione del MAD per cui 28 dei 35 pazienti sono stati sottoposti a terapia con MAD. Dopo 3 mesi di trattamento abbiamo documentato un miglioramento significativo dell’indice di Epworth medio [(7,35 ± 2,8 vs 4,1 ± 2,2 (p < 0.05)], dell’AHI medio [(21.4 ± 6 eventi per ora verso 8,85 ± 6,9 (p < 0.05) ] e dell’ODI medio [(18.6 ± 8 eventi per ora versus 7 ± 5.8 (p < 0.05)]. Abbiamo inoltre osservato che l’AHI migliorava di almeno il 50% rispetto al basale nel 71.4% dei pazienti selezionati mediante sleep endoscopy. In questo studio, la terapia con i dispositivi di avanzamento mandibolare è stata prescritta con successo sulla base non soltanto dell’indice di apnea/ipopnea, ma anche dei reperti della sleep endoscopy e della manovra di avanzamento mandibolare, ottenendo una visione diretta degli effetti della protrusione mandibolare sullo spazio respiratorio in corrispondenza dei siti di ostruzione, e ottenendo una buona ottimizzazione della selezione dei pazienti per il trattamento con MAD.
Published: 2015
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13. Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media

Author: P M Picciotti, Mario Rigante, L D'Alatri, G. Della Marca, E Scarano, and D Lucidi
Subjects: Electromyography, Eustachian Tube, Otitis Media, Rehabilitation, Adult, Male, Monitoring, Eustachian tube, Tensor veli palatini muscle, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Swallowing, Case-Control Studies, Deglutition, Electrodes, Female, Humans, Middle Aged, Middle Ear Ventilation, Monitoring, Physiologic, Tensor Tympani, Otorhinolaryngology2734 Pathology and Forensic Medicine, otorhinolaryngologic diseases, medicine, 030223 otorhinolaryngology, Physiologic, medicine.diagnostic_test, business.industry, General Medicine, Anatomy, Otitis, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, Anesthesia, Muscle dysfunction, Breathing, Settore MED/31 - OTORINOLARINGOIATRIA, medicine.symptom, business
Abstract: Background:The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing.Methods:Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed.Results:In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation.Conclusion:This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.
Published: 2017

14. Are stroke cases affected by sleep disordered breathings all the same?

Author: Maria Luisa Sacchetti and G. Della Marca
Subjects: Stroke patient, medicine.medical_treatment, Models, Biological, Clinical prognosis, Central sleep apnoea, Sleep Apnea Syndromes, Humans, Cpap treatment, Medicine, Effective treatment, cardiovascular diseases, Continuous positive airway pressure, Stroke, Continuous Positive Airway Pressure, stroke, sleep apnea, cycling alternating patterns, business.industry, General Medicine, medicine.disease, Sleep in non-human animals, nervous system diseases, respiratory tract diseases, Patient Outcome Assessment, Anesthesia, Sleep, business
Abstract: Sleep disordered breathings (SDB) worsens the clinical prognosis of stroke patients. Continuous positive airway pressure (CPAP) is a promising effective treatment. Unfortunately, not all patients are compliant with CPAP, suggesting that it is not appropriate for all patients with obstructive sleep apnoea (OSA) after stroke. People with the highest likelihood of benefiting have to be identified. We present a classification of cases with stroke and SDB to be adopted in order to identify the best responders to CPAP treatment. We propose to classify patients in four subgroups: (1) patients who terminate the apnoea by arousing from sleep; these cases are those affected either by an anatomical or a functional obstruction of upper airways that may precede or are the consequence of stroke; (2) cases that alternate OSA to central sleep apnoea (CSA) cause of an altered loop gain; (3) cases in whom ischemic damages have altered the sleep microstructure (CAP); (4) cases that manifest a CSA as the direct consequence of stroke on the central neuronal drive to breath. So far, no study has investigated the consequences of stroke on sleep microstructure. In order to better elucidate these relationships, when reviewing the PSG tracings of stroke patients, the microstructure of sleep should be systematically analysed.
Published: 2014
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15. Seizure-induced brain lesions: A wide spectrum of variably reversible MRI abnormalities

Author: J. Edwards, Massimo Caulo, C. Falcone, G.M. Di Lella, Simona Gaudino, Alfonso Cerase, Cesare Colosimo, Alessandro Cianfoni, and G. Della Marca
Subjects: Pathology, medicine.medical_specialty, Hippocampus, DWI, Status epilepticus, Brain damage, Corpus callosum, White matter, Magnetic resonance imaging, Neuroimaging, diffusion weighted imaging, medicine, Radiology, Nuclear Medicine and imaging, EEG, SE, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, status epilepticus, business.industry, General Medicine, Seizure, medicine.anatomical_structure, ADC, electroencephalographic, Gliosis, apparent diffusion coefficient, medicine.symptom, Differential diagnosis, business, Reversible changes, MRI
Abstract: Introduction MRI abnormalities in the postictal period might represent the effect of the seizure activity, rather than its structural cause. Material and Methods Retrospective review of clinical and neuroimaging charts of 26 patients diagnosed with seizure-related MR-signal changes. All patients underwent brain-MRI (1.5-Tesla, standard pre- and post-contrast brain imaging, including DWI-ADC in 19/26) within 7 days from a seizure and at least one follow-up MRI, showing partial or complete reversibility of the MR-signal changes. Extensive clinical work-up and follow-up, ranging from 3 months to 5 years, ruled out infection or other possible causes of brain damage. Seizure-induced brain-MRI abnormalities remained a diagnosis of exclusion. Site, characteristics and reversibility of MRI changes, and association with characteristics of seizures were determined. Results MRI showed unilateral (13/26) and bilateral abnormalities, with high (24/26) and low (2/26) T2-signal, leptomeningeal contrast-enhancement (2/26), restricted diffusion (9/19). Location of abnormality was cortical/subcortical, basal ganglia, white matter, corpus callosum, cerebellum. Hippocampus was involved in 10/26 patients. Reversibility of MRI changes was complete in 15, and with residual gliosis or focal atrophy in 11 patients. Reversibility was noted between 15 and 150 days (average, 62 days). Partial simple and complex seizures were associated with hippocampal involvement (p=0.015), status epilepticus with incomplete reversibility of MRI abnormalities (p=0.041). Conclusions Seizure or epileptic status can induce transient, variably reversible MRI brain abnormalities. Partial seizures are frequently associated with hippocampal involvement and status epilepticus with incompletely reversible lesions. These seizure-induced MRI abnormalities pose a broad differential diagnosis; increased awareness may reduce the risk of misdiagnosis and unnecessary intervention.
Published: 2013
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16. Psychological functioning measures in patients with primary insomnia and sleep state misperception

Author: Serena Dittoni, Marianna Mazza, R. Di Giacopo, Giuseppe Marano, Anna Losurdo, Elisa Testani, G. Della Marca, Benedetto Farina, Paolo Mariotti, Salvatore Mazza, and M. Di Nicola
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Psychometrics, Primary Insomnia, Population, Sleep state misperception, Polysomnography, Cohort Studies, Pittsburgh Sleep Quality Index, Sleep Initiation and Maintenance Disorders, medicine, Insomnia, Humans, Sleep study, Wakefulness, education, Psychiatry, Aged, Depressive Disorder, education.field_of_study, medicine.diagnostic_test, General Medicine, Middle Aged, medicine.disease, Anxiety Disorders, Self Concept, Neurology, Anxiety, Female, Sleep Stages, Neurology (clinical), medicine.symptom, Psychology, Clinical psychology
Abstract: Dittoni S, Mazza M, Losurdo A, Testani E, Di Giacopo R, Marano G,Di Nicola M, Farina B, Mariotti P, Mazza S, Della Marca G.Psychological functioning measures in patients with primary insomniaand sleep state misperception.Acta Neurol Scand 2013: DOI: 10.1111/ane.12078.© 2013 John Wiley & Sons A/SObjective – Sleep state misperception (SSM) is a term used in theInternational Classiﬁcation of Sleep Disorders to indicate people whomistakenly perceive their sleep as wakefulness. SSM is a form ofprimary insomnia. The aim of this study was to record psychologicalfunctioning measures (anxiety, depression, ability to feel pleasure,obsessive–compulsive traits) in a population of patients with primaryinsomnia and to evaluate the relationship between these measures andthe patients’ perception of their sleep. Materials and Methods –Seventy-six consecutive patients with primary insomnia were enrolled:34 men and 42 women, mean age 53.9 13.1. Sleep study includedthe following: Pittsburgh Sleep Quality Index, Epworth SleepinessScale, Berlin’s Questionnaire and home-based polysomnography.Psychometric evaluation included the following: Self-AdministeredAnxiety Scale, Beck’s Depression Inventory, Maudsley’s ObsessiveCompulsive Inventory, Snaith–Hamilton Pleasure Scale, EatingAttitude Test. Results – All patients with insomnia had psychometricscores higher than the general population, but very few patients, inboth groups, had anxiety or depression scores consistent with severemood or anxiety disorders. Comparisons between subjective andobjective scores conﬁrmed that most sleep parameters wereunderestimated. Patients with SSM had lower anxiety scores ascompared to patients without SSM. Conclusions – The study did notsucceed in identifying any predictor of sleep misperception.We speculate that a group of patients, rather than being extremelyworried by their insomnia, may have a sort of agnosia of their sleep.
Published: 2013
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17. Drug-induced sleep endoscopy as a selection tool for mandibular advancement therapy by oral device in patients with mild to moderate obstructive sleep apnoea

Author: E, De Corso, G, Bastanza, G, Della Marca, C, Grippaudo, G, Rizzotto, M R, Marchese, A, Fiorita, B, Sergi, D, Meucci, W, Di Nardo, G, Paludetti, and E, Scarano
Subjects: Sleep Apnea, Obstructive, Polysomnography, Snoring, Osas, Endoscopy, respiratory tract diseases, BMI, Treatment Outcome, stomatognathic system, Obstructive sleep apnoea syndrome, Drug-induced sleep endoscopy, Mandibular advancement device, Humans, Prospective Studies, Mandibular Advancement, AHI
Abstract: Nowadays oral appliance therapy is recognised as an effective therapy for many patients with primary snoring and mild to moderate obstructive sleep apnoea (OSA), as well as those with more severe OSA who cannot tolerate positive airway pressure (PAP) therapies. For this reason, it is important to focus on objective criteria to indicate which subjects may benefit from treatment with a mandibular advancement device (MAD). Various anthropometric and polysomnographic predictors have been described in the literature, whereas there are still controversies about the role of drug-induced sleep endoscopy (DISE) and advancement bimanual manoeuvre as predictor factors of treatment outcome by oral device. Herein, we report our experience in treatment of mild moderate OSA by oral appliance selected by DISE. We performed a single institution, longitudinal prospective evaluation of a consecutive group of mild moderate patients with obstructive sleep apnoea syndrome who underwent DISE. During sleep endoscopy, gentle manoeuvre of mandibular advancement less than 5 mm was performed. In 30 of 65 patients (46.2%) we obtained an unsuccessful improvement of airway patency whereas in 35 of 65 patients (53.8%) the improvement was successful and patients were considered suitable for oral device application. Because 7 of 35 patients were excluded due to conditions interfering with oral appliance therapy, we finally treated 28 patients. After 3 months of treatment, we observed a significant improvement in the Epworth medium index [(7.35 ± 2.8 versus 4.1 ± 2.2 (p0.05)], in mean AHI [(21.4 ± 6 events per hour versus 8.85 ± 6.9 (p0.05)] and in mean ODI [(18.6 ± 8 events per hour to 7 ± 5.8 (p0.05)]. We observed that the apnoea/hypopnoea index (AHI) improved by up to 50% from baseline in 71.4% of patients selected after DISE for MAD therapy. In the current study, mandibular advancement splint therapy was successfully prescribed on the basis not only of severity of disease, as determined by the subject's initial AHI, but also by DISE findings combined with results of gentle mandibular advancement manoeuvre allowing direct view of the effects of mandibular protrusion on breathing spaces in obstruction sites, and showing good optimisation of selection of patients for oral device treatment.Il trattamento con dispositivi di avanzamento mandibolare (MAD) rappresenta un'efficace alternativa terapeutica per i pazienti affetti da roncopatia semplice, OSAS di grado lieve/moderato e in casi selezionati di OSAS grave con scarsa tollerabilità alla terapia ventilatoria con C-PAP. Pertanto è importante identificare dei criteri oggettivi per selezionare i pazienti che possono beneficiare del trattamento con i sistemi di avanzamento mandibolare (MAD). In letteratura sono stati descritti vari fattori predittivi sia antropometrici che polisonnografici, mentre esistono ancora controversie circa il ruolo della Sleep Endoscopy e della manovra di avanzamento mandibolare bimanuale durante lo stesso esame come fattori predittivi del successo terapeutico con MAD. In questo studio descriviamo la nostra esperienza nel management di pazienti affetti da OSAS lieve/moderata trattati con MAD e selezionati mediante "sleep endoscopy". Abbiamo eseguito una valutazione prospettica longitudinale di una serie consecutiva di pazienti giunti alla nostra osservazione con diagnosi di OSAS lieve/moderata e sottoposti a sleependoscopy. Durante il sonno indotto farmacologicamente è stata eseguita una delicata manovra di avanzamento mandibolare con escursione inferiore ai 5 mm e abbiamo riscontrato che in 30 dei 65 pazienti (46,2%) lo spazio respiratorio non migliorava in modo significativo a livello dei siti di ostruzione osservati, mentre in 35 dei 65 pazienti (53,8%) si osservava un miglioramento significativo tale da poter indicare terapia con MAD. In 7 dei 35 pazienti venivano riscontrate condizioni che ostacolavano l'applicazione del MAD per cui 28 dei 35 pazienti sono stati sottoposti a terapia con MAD. Dopo 3 mesi di trattamento abbiamo documentato un miglioramento significativo dell'indice di Epworth medio [(7,35 ± 2,8 vs 4,1 ± 2,2 (p0.05)], dell'AHI medio [(21.4 ± 6 eventi per ora verso 8,85 ± 6,9 (p0.05) ] e dell'ODI medio [(18.6 ± 8 eventi per ora versus 7 ± 5.8 (p0.05)]. Abbiamo inoltre osservato che l'AHI migliorava di almeno il 50% rispetto al basale nel 71.4% dei pazienti selezionati mediante sleep endoscopy. In questo studio, la terapia con i dispositivi di avanzamento mandibolare è stata prescritta con successo sulla base non soltanto dell'indice di apnea/ipopnea, ma anche dei reperti della sleep endoscopy e della manovra di avanzamento mandibolare, ottenendo una visione diretta degli effetti della protrusione mandibolare sullo spazio respiratorio in corrispondenza dei siti di ostruzione, e ottenendo una buona ottimizzazione della selezione dei pazienti per il trattamento con MAD.
Published: 2016

18. Evaluation of pharyngeal muscle activity through nasopharyngeal surface electromyography in a cohort of dysphagic patients with acute ischaemic stroke

Author: N M, Giannantoni, M, Minisci, V, Brunetti, E, Scarano, E, Testani, C, Vollono, E, De Corso, G, Bastanza, L, D'Alatri, and G, Della Marca
Subjects: Male, GUSS, Electromyography, Dysphagia, Surface EMG, Middle Aged, Nose, Brain Ischemia, Laryngology, Acute stroke, Nasopharyngeal electrode, Aged, Deglutition Disorders, Female, Humans, Pharyngeal Muscles, Pharynx, Prospective Studies, Stroke
Abstract: Oro-pharyngeal dysphagia is frequently present during the acute phase of stroke. The aim of the present study was to evaluate whether the recording of surface EMG using a nasopharyngeal (NP) electrode could be applied to evaluation of pharyngeal muscle activity in acute stroke patients and if this neurophysiological measure is related with clinical assessment of swallowing. Patients were examined and clinical severity was assessed with the National Institute of Health Stroke Scale (NIHSS) score; dysphagia was evaluated through bedside screening test using the Gugging Swallowing Scale (GUSS). Extension of the ischaemic lesion was measured by quantitative score, based on CT scan [Alberta Stroke Programme Early CT Score (ASPECTS)]. We analysed 70 patients; 50 were classified as dysphagic (Dys+), and 20 as non-dysphagic (Dys-). Each participant underwent a surface NP EMG recording performed with a NP electrode, made of a Teflon isolated steel catheter, with a length of 16 cm and a tip diameter of 1.5 mm. The electrode was inserted through the nasal cavity, rotated and positioned approximately 3 mm anteroinferior to the salpingo-palatine fold. At least four consecutive swallowing-induced EMG bursts were recorded and analysed for each participant. Swallowing always induced a repetitive, polyphasic burst of activation of the EMG, lasting around 0.25 to 1 sec, with an amplitude of around 100-600mV. Two parameters of the EMG potentials recorded with the NP electrode were analyzed: duration and amplitude. The duration of the EMG burst was increased in Dys+ patients with a statistically significant difference compared to Dys- patients (p0.001). The amplitude was slightly reduced in the Dys+ group, but statistically significant differences were not observed (p = 0,775). Nevertheless, the burst amplitude showed a significant inverse correlation with NIHSS [r(48) = -0.31; p0.05] and ASPECTS scores [r(48) = -0.27; p0.05], meaning that the burst amplitude progressively reduced with an increase of clinical severity (NIHSS) and topographic extension of brain lesions in CT (ASPECTS). These results suggest that NP recordings can give a semi-quantitative measure of swallowing difficulties originating from pharyngeal dysfunction, in fact, electromyographic findings suggest reduced pharyngeal motility.La disfagia orofaringea è spesso presente durante la fase acuta di un ictus. Lo scopo di questo lavoro è stato quello di valutare se la registrazione elettromiografica di superficie tramite un elettrodo nasofaringeo può essere impiegata per testare l’attività muscolare del faringe nei pazienti con ictus acuto e se queste misurazioni elettrofisiologiche possono essere correlate con la valutazione clinica della deglutizione. Dal punto di vista clinico la severità del quadro è stata valutata mediante l’utilizzo della scala del National Institute of Health Stroke (NIHSS); la disfagia è stata valutata mediante il test di screening Gugging Swallowing Scale (GUSS); l’estensione della lesione ischemica alla TAC è stata misurata attraverso l’Alberta Stroke Programme Early CT Score (ASPECTS). Abbiamo valutato 70 pazienti di cui 50 disfagici (Dys+), e 20 non disfagici (Dys–). Ciascun partecipante è stato sottoposto a un’elettromiografia di superficie registrata mediante un elettrodo NP costituito da un catetere di Teflon isolato in acciaio (lungo 16 cm e con un diametro in punta di 1,5 mm). L’elettrodo è stato inserito attraverso la cavità nasale, ruotato e posizionato approssimativamente 3 mm antero-inferiormente rispetto alla volta salpingo-palatina. Per ogni partecipante sono state registrate ed analizzate le risposte elettromiografiche di almeno quattro deglutizioni volontarie ripetute. La deglutizione induce sempre all’elettromiografia burst ripetitivi e polifasici di durata compresa fra 0,25 e 1 secondo, con un’ampiezza intorno ai 100-600mV. I disfagici hanno mostrano una maggiore durata del burst rilevato all’elettromiografia rispetto ai non disfagici, con una differenza statisticamente significativa (p0,001), ma non hanno mostrano differenze in termini di ampiezza del burst stesso (p = 0,775); quest’ultima invece era inversamente correlata con lo NIHSS score [r(48) = –0,31; p0,05)] e con lo ASPECTS score [r(48) = –0,27; p0,05]. Questi risultati suggeriscono che le registrazioni nasofaringee possono rappresentare un indice semi-quantitativo delle difficoltà deglutitorie secondarie a disfunzione faringea ed in particolare, i risultati dell’elettromiografia sarebbero indicativi di una ridotta motilità faringea durante la fase acuta di un ictus.
Published: 2016

19. Recurrent Subarachnoid Bleeding and Superficial Siderosis in a Patient with Histopathologically Proven Cerebral Amyloid Angiopathy

Author: Paolo Profice, Simona Gaudino, G. Della Marca, Fabio Pilato, Cesare Colosimo, Antonino Pavone, V. Di Lazzaro, and Vincenzo Arena
Subjects: medicine.medical_specialty, Pathology, Superficial siderosis, Familial clustering, lcsh:RC346-429, Subarachnoid bleeding, Intracranial vascular malformation, medicine, Brain mri, In patient, neurosurgery, cardiovascular diseases, lcsh:Neurology. Diseases of the nervous system, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, biology, business.industry, medicine.disease, Transthyretin, Amyloid angiopathy, biology.protein, Neurology (clinical), Neurosurgery, Cerebral amyloid angiopathy, Published: May 2011, business
Abstract: A 68-year-old man with a history of hypertension presented with recurrent subarachnoid bleeding. Brain MRI showed superficial siderosis, and diagnostic cerebral angiograms did not show any intracranial vascular malformation or arterial aneurism. Post mortem neuropathological examination of the brain was consistent with a diagnosis of cerebral amyloid angiopathy. Clinicians should be aware that cerebral amyloid angiopathy should be considered in patients with unexplained recurrent subarachnoid bleeding, even in cases without familial clustering or transthyretin variant.
Published: 2011

20. A Sleep Study in Cluster Headache

Author: G. Di Trapani, Paolo Mariotti, Marco Rubino, G. Della Marca, Alessandro Capuano, and Catello Vollono
Subjects: Male, Sleep Wake Disorders, medicine.medical_specialty, Hypothalamus, Posterior, Polysomnography, Cluster Headache, Sleep spindle, Non-rapid eye movement sleep, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Sleep study, Neuroscience of sleep, Slow-wave sleep, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, Sleep in non-human animals, Anesthesia, Cardiology, Neurology (clinical), Sleep, K-complex, business, 030217 neurology & neurosurgery
Abstract: Cluster headache (CH) is a primary headache with a close relation to sleep. CH presents a circa-annual rhythmicity; attacks occur preferably during the night, in rapid eye movement (REM) sleep, and they are associated with autonomic and neuroendocrine modifications. The posterior hypothalamus is the key structure for the biological phenomenon of CH. Our aim is to describe a 55-year-old man presenting a typical episodic CH, in whom we performed a prolonged sleep study, consisting of a 9-week actigraphic recording and repeated polysomnography, with evaluation of both sleep macrostructure and microstructure. During the acute bout of the cluster we observed an irregular sleep-wake pattern and abnormalities of REM sleep. After the cluster phase these alterations remitted. We conclude that CH was associated, in this patient, with sleep dysregulation involving the biological clock and the arousal mechanisms, particularly in REM. All these abnormalities are consistent with posterior hypothalamic dysfunction.
Published: 2006
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21. The detection of neural autoantibodies in patients with antiepileptic-drug-resistant epilepsy predicts response to immunotherapy

Author: G. Della Marca, Raffaele Iorio, Anna Paola Batocchi, Gabriella Colicchio, Giovanni Assenza, Mario Tombini, Amelia Evoli, Valentina Damato, Alessandro Marti, Antonella Benvenga, Paolo Maria Rossini, Catello Vollono, and Domenico Plantone
Subjects: Adult, Male, autoimmune epilepsy, medicine.medical_treatment, Drug Resistance, Epilepsy, Mice, Cerebrospinal fluid, Antigen, medicine, Animals, Humans, synaptic antigens, Autoantibodies, Frozen section procedure, biology, business.industry, Autoantibody, Radioimmunoassay, Immunotherapy, Middle Aged, antiepileptic drug resistant epilepsy, leucine-rich glioma inactivated 1, medicine.disease, Settore MED/26 - NEUROLOGIA, Treatment Outcome, Neurology, Immunology, biology.protein, Anticonvulsants, Female, Neurology (clinical), Antibody, business
Abstract: Background and purpose The detection of antibodies binding neural antigens in patients with epilepsy has led to the definition of ‘autoimmune epilepsy’. Patients with neural antibodies not responding to antiepileptic drugs (AEDs) may benefit from immunotherapy. Aim of this study was to evaluate the frequency of autoantibodies specific to neural antigens in patients with epilepsy and their response to immunotherapy. Methods Eighty-one patients and 75 age- and sex-matched healthy subjects (HS) were enrolled in the study. Two groups of patients were included: 39 patients with epilepsy and other neurological symptoms and/or autoimmune diseases responsive to AEDs (group 1) and 42 patients with AED-resistant epilepsy (group 2). Patients' serum and cerebrospinal fluid were evaluated for the presence of autoantibodies directed to neural antigens by indirect immunofluorescence on frozen sections of mouse brain, cell-based assays and a radioimmunoassay. Patients with AED-resistant epilepsy and neural autoantibodies were treated with immunotherapy and the main outcome measure was the reduction in seizure frequency. Results Neural autoantibodies were detected in 22% of patients (18/81), mostly from the AED-resistant epilepsy group (P = 0.003), but not in HS. Indirect immunofluorescence on mouse brain revealed antibodies binding to unclassified antigens in 10 patients. Twelve patients received immunotherapy and nine (75%) achieved >50% reduction in seizure frequency. Conclusions A significant proportion of patients with AED-resistant epilepsy harbor neural-specific autoantibodies. The detection of these antibodies, especially of those binding to synaptic antigens, may predict a favorable response to immunotherapy, thus overcoming AED resistance.
Published: 2014

22. RESTLESS LEGS SYNDROME WITH PERIODIC LIMB MOVEMENTS: A POSSIBLE CAUSE OF IDIOPATHIC HYPERCKEMIA

Author: Elisa Testani, Catello Vollono, Serena Dittoni, Roberto Frusciante, G. Della Marca, Serenella Servidei, F. Madia, Anna Losurdo, and Michela Catteruccia
Subjects: Adult, Male, myalgia, medicine.medical_specialty, Time Factors, Neurology, Movement, Laboratory finding, Muscle hypertrophy, Young Adult, Creatin Kinase, Restless Legs Syndrome, Internal medicine, medicine, Humans, Restless legs syndrome, Creatine Kinase, Aged, Web site, Leg, Movement Disorders, business.industry, Middle Aged, medicine.disease, Surgery, body regions, Settore MED/26 - NEUROLOGIA, Increased serum creatine kinase, Healthy individuals, Female, Neurology (clinical), medicine.symptom, Sleep, business
Abstract: Idiopathic hyperCKemia is characterized by persistently increased serum creatine kinase (CK) encountered in healthy individuals with no evidence of neuromuscular diseases.1 They may complain of fatigue, cramps, and myalgia; these nonspecific symptoms overlap with the wide spectrum of limb discomfort reported by patients with restless legs syndrome (RLS). Nevertheless, hyperCKemia is not a laboratory finding in RLS. We describe 7 patients with idiopathic hyperCKemia in whom the diagnostic workup revealed the presence of RLS with periodic limb movements in sleep (PLMS). ### Methods. Seven patients (6 men, age 22–69 years; table) referred to a center for neuromuscular diseases for severe, persistent myalgia in the lower limbs, fatigue, and cramps were included. Laboratory tests revealed hyperCKemia, confirmed in at least 3 consecutive samples, at 30-day intervals, at rest. No patient reported assumption of statins or exposure to toxins. All showed lower limbs muscle hypertrophy, particularly of quadriceps and calves (figure e-1 on the Neurology ® Web site at www.neurology.org). Patients underwent an …
Published: 2009
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23. 16. Functional connectivity in fronto-temporal focal epilepsy from EEG analysis: A study via graph theory

Author: F. Vecchio, F. Miraglia, G. Curcio, G. Della Marca, C. Vollono, E. Mazzucchi, and P.M. Rossini
Subjects: Neurology, Physiology (medical), Neurology (clinical), Sensory Systems
Published: 2015
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24. Snoring in twins

Author: G. Gallus, Marco Zucconi, Salvatore Smirne, G Della Marca, Vincenza Castronovo, Alessandro Oldani, Luigi Ferini-Strambi, Giliola Calori, FERINI STRAMBI, Luigi, Calori, G, Oldani, A, Della Marca, G, Zucconi, M, Castronovo, V, Gallus, G, and Smirne, S.
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Multivariate analysis, Dizygotic twin, Concordance, Monozygotic twin, Body Mass Index, Sex Factors, Sleep Apnea Syndromes, Internal medicine, Diseases in Twins, Twins, Dizygotic, Familial predisposition, Genetic predisposition, Humans, Medicine, Medical history, business.industry, musculoskeletal, neural, and ocular physiology, Smoking, Snoring, Age Factors, Twins, Monozygotic, Middle Aged, nervous system diseases, respiratory tract diseases, Endocrinology, population characteristics, Female, business, Body mass index, psychological phenomena and processes, Clinical psychology
Abstract: Snoring is a prerequisite for obstructive sleep apnoea (OSA) and is known to run in families. Recent studies have provided sufficient evidence for a familial predisposition to OSA. In our study, 492 monozygotic and 284 dizygotic twins were contacted by telephone and asked to attend an interview which included questions of life habits, medical history, sleep habits and disorders, with particular emphasis on snoring. Our study showed that the probandwise concordance rate for habitual snoring was higher in monozygotic twins than in dizygotic ones, but the difference was not significant. The comparison of concordant pairs for habitual snoring vs. concordant pairs for non-snoring confirmed that habitual snoring is significantly associated with older age, male gender, higher body mass index (BMI), smoking and respiratory diseases. The multivariate analysis in the discordant groups confirmed that BMI is more strongly associated to habitual snoring in dizygotic twins than in the monozygotic ones. Our logistic analysis showed that other variables, such as smoking and respiratory diseases, are associated with habitual snoring in dizygotic pairs, but not in monozygotic ones. These findings suggest a genetic predisposition to habitual snoring.
Published: 1995
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25. Cortical connectivity in fronto-temporal focal epilepsy from EEG analysis: A study via graph theory

Author: F. Miraglia, F. Vecchio, G. Curcio, G. Della Marca, C. Vollono, E. Mazzucchi, and P.M. Rossini
Subjects: Neurology, Physiology (medical), Neurology (clinical), Sensory Systems
Published: 2016
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26. ID 127 – Small world characteristics of cortical connectivity in acute stroke

Author: Giuseppe Reale, N. Di Giannantoni, F. Miraglia, G. Della Marca, Chiara Iacovelli, F. Vecchio, P.M. Rossini, Pietro Caliandro, Luca Padua, and Giordano Lacidogna
Subjects: medicine.diagnostic_test, Stroke patient, Brain cortex, Ischemia, Alpha (ethology), Electroencephalography, medicine.disease, Sensory Systems, Lateralization of brain function, Lesion, Neurology, Physiology (medical), medicine, Neurology (clinical), medicine.symptom, Psychology, Neuroscience, Acute stroke
Abstract: Objective After cerebral ischemia, disruption and subsequent reorganization of functional connections occur both locally and remote to the lesion. Recently, brain complexity has been described using the graph theory, an elegant approach which depicts important properties of complex systems by quantifying topologies of network representations. We tested whether ischemic stroke may determine changes in smallworldness of cortical networks as measured by cortical sources of EEG. Methods Graph characteristics of EEG of 30 consecutive stroke patients in acute stage (no more than 5 days after the event) were examined. Connectivity analysis was performed using eLORETA in both hemispheres. Results Network rearrangements are mainly detected in delta, theta and alpha bands. Similar findings were observed in both hemispheres regardless the side of ischemic lesion: bilaterally decreased smallworldness in the delta band; similar modification observed in the theta band, but statistically significant only in left hemisphere stroke patients. Conclusions After an acute stroke, brain cortex rearranges its network connections diffusely, in a frequency-dependent modality in order to face the new anatomical and functional condition. Modifications in distinct frequencies suggests that the network remodelling occurs with different modalities. Key message Stroke-related brain network reorganization could reflect a not negligible adaptive process.
Published: 2016
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27. Snoring and Nocturnal Oxygen Desaturations in an Italian Middle-aged Male Population

Author: Salvatore Smirne, G Della Marca, Vincenza Castronovo, Alessandro Oldani, Luigi Ferini-Strambi, S. Palazzi, and Marco Zucconi
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, education.field_of_study, Sleep disorder, medicine.diagnostic_test, Cross-sectional study, business.industry, Population, Apnea, Polysomnography, Nocturnal, Critical Care and Intensive Care Medicine, medicine.disease, Ambulatory, Physical therapy, medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, education, business, Body mass index
Abstract: Recent studies have suggested that portable monitoring may be a valid means of finding respiratory disturbances in epidemiologic research on a large scale. The aim of this cross-sectional study was to evaluate by means of an appropriately validated portable instrument (MESAM 4) the nocturnal oxygen desaturations in a representative sample of adult male population in North Italy. We randomly chose 750 subjects: 399 subjects (53.2 percent) agreed to participate and a complete evaluation of nocturnal recording was possible in 349 subjects (87.5 percent). Seventeen percent of subjects were every-night snorers; a number of oxygen desaturations per hour (ODI) >10 was found in 13.7 percent, and an ODI >20 resulted in 4.8 percent. Age, neck circumference corrected for height, snoring time (measured by MESAM), and self-reported snoring were the variables best explaining ODI in our multivariate approach. This study reports the highest prevalence, using nocturnal oxygen desaturation indices as marker, of sleep-disordered breathing than any reported until now in a general population.
Published: 1994
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28. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain

Author: H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. Lane, A. Hofman, M. Verin, T. Matilla, P. Bedoucha, J. Roche, M. Lai, M. Collard, A. Ugarte, F. Gallecho, D. Silbersweig, C. Kennard, J. P. Azulay, T. W. Ho, P. L. I. Dellemijn, R. Girardello, F. Baas, B. Voss, F. Rozenberg, E. M. Brocker, V. Stanev, A. A. J. Soeterboek, A. Marra, A. Rey, E. Ertem, M. Sawradewicz-Rybak, J. De Keyser, P. Cavallari, F. Proust, Y. Chevalier, H. C. Hansen, D. Leys, C. A. Davie, K. Hoang-Xuan, C. Bairati, H. van Crevel, Thomas T. Warner, B. Bompais, A. Dobbeleir, T Campbell, C. Macko, C. J. M. Klijn, M. Dussallant, T. P. Berlit, W. Rozenbaum, M. J. van den Bent, W. A. Rocca, M. Muller, H. Hundemer, U. Zifko, M. Campera, F. Drislane, D. Ranoux, T. M. Kloss, Anil Kumar, I. Ruolt, C. Bargnani, B. Marescau, N. A. Losseff, S. Notermans, B. Kint, E. T. Burke, C. Aykut, J. Matias Guiu, P. Maquet, T. Drogendijk, M. Leone, K. von Ammon, M. Pepeliarska, C. Prados, L. DiGiamberardino, T. Logtenberg, G. Lenoir, I. Castaldo, Damhaut, M. Radionova, G. Sirabian, R. Navon, Giovanni Antonini, K. Al Moutaery, E. Chamas, R. Schönhuber, M. Giannini, B. Debilly, I. Labatut, H. Henon, J. A. Egido, M. Baudrimont, J. N. Lorenzo, J. E. C. Bromberg, R. Antonacci, J. J. Vilchez, T. Moulin, B. Rautenstrauss, Giovanni Meola, J. Noth, S Mammi, P. Laforet, F. Lopez, C. Gehring, S. Bort, G. Rancurel, D. Decamps, S. Kostadinova, Y. Shapira, B. Neundoerfer, D. Chavrot, M. Solimena, J. P. Salier, W. Deberdt, R. Hoff-Jörgensen, A. Messina, S. Meairs, G. Rosoklija, E. Nelis, I. Bertran, C. Ertekin, J. Lohmeyer, Mitermayer Galvao dos Reis, L. Calo, E. Maccagnano, A. P. Hays, J. Verlooy, M. G. Forno, T. Blanco, L. Bail, Gabriella Silvestri, J. Montero, F. Bertrand, R. T. Ghnassia, C. Besses, T. Sereghy, F. Shalit, G. Bogliun, S. Braghi, St. Baykouchev, C. Franke, A. Lasa, L. C. Archard, J. Kriebel, S. Shaunak, M. Nocito, Alexander Tsiskaridze, E. Manfredini, T. Seigal, David G. Gadian, M. Barlas, J. D. Degos, C. Seeber, J. Caemert, J. L. Mas, R. B. Pepinsky, M. G. D'Angelo, N. Baumann, S. Yorifuji, H. P. Endtz, M. A. Cassatella, R. A. C. Hughes, V. Golzi, A. Bittencourt, A. Ferreira, M. Sanson, C. Alper, M. Vermeulen, M. A. A. van Walderveen, E. Alexiou, C. H. Lucas, M. Fiorelli, Y. N. Debbink, R. Gil, S. Congia, T. Banerjee, J. M. Bouchard, A. N. Pinto, A. Ceballos-Baumann, G. Grollier, P. I. M. Schmitz, M. D. Catata, N. Lahat, N. S. Rao, P. Papathanasopoulos, J. Valls-Solé, D. Claus, G. Schroter, A. Castro, C. Videbaek, R. Martinez Dreke, A. D. Platts, M. Hermesl, A. C. PeÇanha-Martins, M. Cardoso Silva, P. Masnou, M. J. A. Tanner, Ch. Confavreux, B. Mishu, H. Rasmussen, L. Valenciano, Carlo Pozzilli, S. W. Li, V. Salzman, Y. Vashtang, Massimo Franceschi, M. Severo, G. Deuschl, S. Setien, G. Mariani, A. Protti, J. Castillo, M. J. B. Taphoorn, M. Frontali, I. Milonas, D. Decoq, J. A. Navarro, S. Castellvi-Pel, C. Ertikin, M. Urtasun, Y. Lajat, B. E. Kendall, E. Verdu, B. Gueguen, E. Boisen, R. Couderc, A Danek, JM Stevens, F. Nicoli, L. Feltri, M. L. Vazquez-Andre, J. A. Morgan-Hughes, L. D'Angelo, F. Y. Liew, L. F. Pascual, J. Patrignani Ochoa, Vittorio Martinelli, J. Cophignon, L. Zhang, S. Martin, J. F. Meder, H. C. Buschmann, L. Bertin, J. van Gijn, A. Barreiro, A. Cools, C. Leon, A. Berod, E. A. Anllo, E. Zanette, L. Petrov, R. Barona, B. Gallicchio, P. J. Cozzone, N. Diederich, G. Cancel, L. Schelosky, P. Orizaola, K. Yulug, S. Ozer, Valeria A. Sansone, B. Guiraud-Chaumeil, K. Voigt, P. Labauge, M. Eoli, J. Zhu, J. Aguirre, M. Ferrarini, B. Zyluk, E. Planas, A. Cadilha, C. Tortorella, H. Bismuth, C. E. Counsell, A. Laun, A. Ferlini, Rio J. Montalban, N. Biary, L. Becker, M. Fardeau, M. Poloni, V. M. S. de Bruin, C. Fornada, J. Barros, E. Ganzmann, E. Touze, D. Wallach, J. Peila, H. Fujimura, M. T. Iba-Zizen, G. Macchi, C. Villoslada, R. Gouider, Ph. Rondepierre, P. Grummich, P. Chiodi, C. Conte, M. Michels, P. Annunziata, G. Semana, C. Sommer, J. Vajsar, D. Zekin, J. Kulisevsky, David G. Munoz, B. Jacotot, M. Magoni, A. Luxen, T. Garcia-Silva, S. Di Cesare, Christophe Tzourio, M. Gomori, I. Picomell, L. Santoro, F. Villa, Giovanni Pennisi, T. Ribalta, J. M. Molto, L. Marzorati, P. Loiseau, F. Gemignani, A. Gironell, J. Wissel, A. Prusinski, F. Cailloux, P. Villanueva-Hemandez, P. Cozzone, T. Del Ser, J. Sans-Sabrafen, M. Zappia, P. W. A. Willems, G. Tchernia, D. Gardeur, R. Bauer, F. Palomo, H. Metz, S. Lamoureux, C. Chastang, I. Reinhard, A. Goldfarb, S. Harder, Jordi Río, C. Ozkara, E. Tekinsoy, P. Vontobell, J. De Recondo, M. Rabasa, L. Lacomblez, F. Boon, Dgt Thomas, V. Palma, Renato Mantegazza, A. Dervis, M. Nueckel, B. YalÇinerner, I. Duran, G. Dalla Volta, A. Zubimendi, J. Pinheiro, A. Marbini, Xavier Montalban, H. Wekerle, X. Pereira Monteino, F. Crespo, F. Koskas, N. Battistini, C. Ruiz, H. Offner, J. de Pommery, P. Kanovsky, J. Y. Barnett, J. Pardo, G. Tomei, R. Rene, H. M. Lokhorst, P. Thajeb, H. Bilgin, D. McGehee, R. Fahsold, L. Morgante, Katie Sidle, C. Delwaide, M. N. Diaye, P. H. Rice, A. Creange, C. Sabev, K. Stephan, K. WeilBenborn, G. Magnani, L. Grymonprez, F. Cardellach, M. Kaps, N. G. Meco, F. Vega, V. Bonifati, A. Desomer, M. Baldy-Moulinier, G. Kvale, F. J. Authier, B. Yegen, T. Ho, J. M. Rozet, E. A. Cabanis, L. Bruce, L. Ambrosoli, M. A. Petrella, M. Hernandez, P. Timmings, H. B. van der Worp, F. Mahieux, A. Urbano-Marquez, D. A. Krendel, A. A. Garcia, R. Divari, R. Michalowicz, M. R. Piedmonte, M. Bondavalli, M. Zanca, P. F. Ippel, Onofre Combarros, B. Tavitian, E. Hirsch, I. Anastasopoulos, A. Roses, A. Köhler, P. Vienna, V. Timmerman, P. Sergi, F. Cornelio, A. Di Pasquale, R. Verleger, S. Castellvirel, J. Proano, B. van Moll, F. Rubio, W. Hacke, I. Lavenu, L. Zetta, M. W. Tas, N. Bittmann, M. Bonamini, O. R. Hommes, V. Dousset, N. Afsar, S. Belal, R. R. Myers, J. Goes, Giuseppe Vita, E. Clementi, V. G. Karepov, M. Jueptner, A Vincent, P. Emmrich, Th. Heb, A. Caballo, J. Gallego, T. Mokrusch, C. Perla, L. Gebuhrer, O. Titlbach, Alessandro Prelle, A. Czlonkowska, M. Russo, D. Hadjiev, T. S. Chkhikvishvili, M. Oehlschlager, G. Becker, I. Günther, E. N. Stenager, J. Garcia Agundez, J. Casademont, J. Batlle, S. Podobnik-Sarkanji, C. Alonso-Villaverde, B. Delaguillaume, B. Genc, B. Mazoyer, A. Rodriguez-Al-barino, Ch. Hilger, B. Ferrero, R. Price, W. Grisold, L. Fuhry, D. Oulbani, D. Ewing, A. Petkov, W. Walther, A. Gokyigit, John Newsom-Davis, J. Tayot, D. Seliak, G. Pelliccioni, D. Campagne, K. Kessler, F. Boureau, D. Perani, J. P. N'Guyen, N. Tchalucova, B. A. Antin-Ozerkis, C. Lacroix, B. D. Aronovich, I. H. Jenkins, E. A. dos Reis, M. Hortells, H. M. Meinck, H. Ch. Buschmann, S. C. J. M. Jacobs, T. Wetter, P. Creissard, N. Martinez, J. Weidenfeldl, H. J. Sturenburg, G. Damlacik, V. Gracia, J. C. Turpin, A. Pou-Serradell, J. P. Vincent, T. Gagoshidze, U. Ozkutlu, M. McLeod, K. Siegfried, I. Tchaoussoglou, J. Hildebrand, S. Kowalska, M. C. Picot, G. Galardin, L. Crevits, F. Andreetta, S. Larumbe-Lobalde, G. de la Sierra, J. C. Alvarez-Cermeno, R. J. Seitz, P. L. Oey, L. Ptacek, A. M. J. Paans, A. Wirrwar, A. Schmied, J. Uilchez, H. Tounsi, D. Hipola, V. Avoledo, Y. Hirata, P. Vermersch, T. M. Aisonobe, J. Valls-SoIè, H. Staunton, J. Dichgans, R. Karabudak, I. Dones, G. Porta, E. Janssens, Maria Martinez, J. M. Fernandez-Real, R. Villagra, Y. Yoshino, C. Kabus, K. Schimrigk, I. Girard-Buttaz, F. Piccoli, F. Aichner, P. Zuchegna, S. M. Al Deeb, F. Bono, N. Busquets, A. Jobert, Patrizia Ciscato, M. Martin, L. Polman, S. Darbra, V. Le Cam-Duchez, F. Baldissera, B. Baykan-Kurt, D. Guez, M. Bratoeva, H. Matsui, M. Mila, H. Perron, L. Bjorge, G. Husby, Steven T. DeKosky, D. R. Cornblath, J. M. Gabriel, J. J. Poza, Y. Wu, A. Toscano, R. P. Kleyweg, J. Kuhnen, S. O. Confort-Gouny, A. Barcelo, A. M. Conti, C. Fiol, C. Steichen-Wiehn, J. Rodes, M. Cavenaile, C. Vedeler, M. Drlicek, C. Argentino, M. L. Peris, A. Cervello, A. Z. GinaÏ, S. Yancheva, D. Passingham, S. Aoba, D. L. Lopez, T. Rechlin, K. Sonka, L. Grazzi, V. Folnegovic-Smalc, Maurizio Moggio, S. Rivaud, F. G. I. Jennekens, C. H. Hartard, H. Meierkord, G. Stocklin, M. D. Catala, W. C. McKay, E. Salmon, C. Navarro, I. Pastor, L. Canafoglia, M. De Braekeleer, P. K. Thomas, C. Mocellini, C. Pierre-Jerome, M. C. Dalakas, P. Pollak, M. Levivier, Niall Quinn, G. E. Rivolta, Z. Tunca, H. Zeumer, J. Garcia Tena, St. Guily, P. Gaudray, Johannes Kornhuber, V. Petrunjashev, R. Montesanti, R. J. Abbott, H. Petit, G. Kiteva-Trencevska, F. Carletto, C. Ramo, I. M. Pino, P. Beau, G. F. Mennuni, F. Moschian, F. Meneghini, B. Zdziarska, B. Fontaine, C. Stephens, G. Meco, K. Reiners, G. Badlan, M. Sessa, I. Degaey, S. M. Hassan, C. Albani, F. Caroeller, M. Schroeder, G. Savettieri, A. Novelletto, R. Kurita, P. Oschmann, I. Plaza, M. Oliveres, Simone Spuler, A. Molins, M. Schwab, J. R. Kalden, C. P. Gennaula, Y. Baklan, O. Picard, J. M. Léger, B. Mokri, E. Ghidoni, M. Jacob, D. Deplanque, W. JÄnisch, C. De Andres, P. De Deyn, G. Guomundsson, B. Herron, J. Barado, J. L. Gastaut, Guglielmo Scarlato, F. Poron, Nicola Jones, H. Teisserenc, C. P. Hawkins, A. J. Steck, H. C. Chandler, S. Blanc, J. H. Faiss, Jm. Soler Insa, I. Sarova-Ponchas, M. Malberin, A. Sackmann, G. De Vuono, K. Kaiser-Rub, K. Badhia, E. Szwabowska-Orzeszko, S. Ramm, C. Jodice, G. Franck, J. Marta-Moreno, R. Sciolla, C. Fritz, A. Attaccalite, F. Weber, E. Neuman, M. Cannata, A. Rodriguez, I. Nachainkin, R. Raffaele, T. S. Yu, N. Losseff, E. Fabrizio, C. Khati, M. Keipes, M. P. Ortega, M. Ramos-Alvarez, E. Brambilla, A. Tarasov, K. H. Wollinsky, O. B. Paulson, F. Boller, G. Bozzato, H. Wagnur, R. Canton, D. Testa, E. Kutluaye, M. Calopa, D. Smadja, G. Malatesta, F. Baggi, A. Stracciari, G. Daral, G. Avanzini, J. Perret, J. Arenas, P. Boon, I. Gomes, A. Vortmeyer, P. Cesaro, S. Venz, E. Bernd Ringelstein, N. Milani, D. Laplane, P. Seibel, E. Tournier-Lasserve, Alexis Brice, L. Motti, E. Wascher, R. J. Abbot, F. Miralles, A. Turon, P. De Camilli, G. Luz, G. C. Guazzi, S. Tekin, F. Lesoin, T. Kryst, N. Lannoy, F. Gerstenbrand, S. Ballivet, H. A. M. van Diemen, J. Lopez-ArLandis, P. Bell, A. Silvani, M. A. Garcia, S. Vorstrup, D. Langdon, S. Ueno, B. Sander, V. Ozurk, C. Gurses, P. Berlit, J. M. Martinez-Lage, M. Treacy, S. O. Rodiek, S. Cherninkova, J. Grimaud, P. Marozzi, K. Hasert, S. Goldman, S. H. Ingwersen, A. Taghavy, T. Roig, R. Harper, I. Sarova-Pinchas, Anthony H.V. Schapira, R. Lebtahi, A. Vidaller, B. Stankov, D. Link, J. p. Malin, V. Petrova, Ludwig Kappos, J. L. Ochoa, T. Torbergsen, M. Carpo, M. Donato, Simon Shorvon, J. Mieszkowski, J. Perez-Serra, Raymond Voltz, G. Comi, S. Rafique, A. Perez-Sempere, N. Khalfallah, S. Bailleul, M. Borgers, S. Banfi, S. Mossman, A. Laihinen, G. Filippini, R. A. Grunewald, E. Stern, H. D. Herrmann, A. G. Droogan, P. Xue, A. Grilo, L. La Mantia, J. H. J. Wokke, S. Pizzul, Kie Kian Ang, S. Rapaport, W. Szaplyko, B. Romero, P. Brunet, A. 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Navasa, J. Ballabriga, G. Broggi, T. Gudeva, C. Rose, J. Vion-Dury, J. A. Gastaut, J. Pniewski, Nicola J. Robertson, G. Kohncke, M. Billot, S. Gok, E. Castellli, F. Denktas, P. Bazzi, F. Spinelli, I. F. Moseley, C. D. Mardsen, B. Barbiroli, O. M. Koriech, A. Miller, Hiroaki Yoshikawa, F. X. Borruat, J. Zielasek, P. Le Coz, J. Pascual, A. Drouet, L. T. Giron, F. Schondube, R. Midgard, M. Alizadeh, M. Liguori, Lionel Ginsberg, L. Harms, C. Tilgner, G. Tognoni, F. Molteni, Mar Tintoré, M. Psylla, C. Goulon-Goeau, M. V. Aguilar, Massimo Filippi, K. H. Mauritz, Thomas V. Fernandez, C. Basset, S. Rossi, P. Meneses, B. Jandolo, T. Locatelli, D. Shechtcr, C. Magnani, R. Ferri, Bruno Dubois, J. M. Warier, S. Berges, F. Idiman, M. Schabet, R. R. Diehl, P. D'aurelio, M. Musior, Reinhard Hohlfeld, P. Smeyers, M. Olivé, A. Riva, C. A. Broere, N. Egund, S. Franceschetti, V. Bonavita, Nicola Canal, E. Timmermans, M. Ruiz, S. Barrandon, G. Vasilaski, B. Deweer, L. Galiano, S. F. T. M. de Bruijn, L. Masana, A. Goossens, B. Heye, K. Lauer, Heinz Gregor Wieser, Stephen R. Williams, B. Garavaglia, A. P. Sempere, F. Grigoletto, P. Poindron, R. Lopez-Pajares, I. Leite, T. A. McNell, C. Caucheteur, J. M. Giron, A. D. Collins, P. Freger, J. Sanhez Del Rio, D. A. Harn, K. Lindner, S. S. Scherer, G. Serve, M. Juncadella, X. Estivill, R. Binkhorst, M. Anderson, B. Tekinsoy, C. Sagan, T. Anastopoulos, G. Japaridze, S. Guillou, F. Erminio, Jon Sussman, P. G. Oomes, D. S. Rust, S. Mascheroni, O. Berger, M. Peresson, K. V. Toyka, T. W. Polder, M. Huberman, B. Arpaci, H. Ramtami, I. Martinez, Ph. Violon, P. P. Gazzaniga Pozzill, R. Ruda, P. Auzou, J. Parker, S. P. Morrissey, Jiahong Zhu, F. Rotondi, P. Baron, W. Schmid, P. Doneda, M. Spadaro, M. C. Nargeot, I. Banchs, J.S.P. van den Berg, R. Ferrai, M. Robotti, M. Fredj, Pedro M. Rodríguez Cruz, B. Erne, D. G. Piepgras, M. C. Arne-Bes, J. Escudero, C. Goetz, A. R. Naylor, M. Hallett, O. Abramsky, E. Bonifacio, L. E. Larsson, R. Pellikka, P. Valalentino, D. Guidetti, B. Buchwald, C. H. Lücking, D. Gauvreau, F. Pfaff, A. Ben Younes-Chennoufi, R. Kiefer, R. Massot, K. A. Hossmann, L. Werdelin, P. J. Baxter, U. Ziflo, S. Allaria, C. D. Marsden, M. Cabaret, S. P. Mueller, E. Calabrese, R. Colao, S. I. Bekkelund, M. Yilmaz, O. Oktem-Tanor, R. Gine, M. E. Scheulen, J. Beuuer, A. Melo, Z. Gulay, M. D. Have, C. Frith, D. Liberati, J. Gozlan, P. Rondot, Ch. Brunholzl, M. Pocchiari, J. Pena, L. Moiola, C. Salvadori, A. Cabello, T. Catarci, S. Webb, C. Dettmers, N. A. Gregson, Alexandra Durr, F. Iglesias, U. Knorr, L. Ferrini-Strambi, F. Kruggel, P. Allard, A. Coquerel, P. Genet, F. Vinuels, C. Oberwittler, A. Torbicki, P. Leffers, B. Renault, B. Fauser, C. Ciano, G. Uziel, J. M. Gibson, F. Anaya, C. Derouesné, C. N. Anagnostou, M. Kaido, W. Eickhoff, G. Talerico, M. L. Berthier, A. Capdevila, M. Alons, D. Rezek, E. Wondrusch, U. Kauerz, D. Mateo, M. A. Chornet, Holon, N. Pinsard, I. Doganer, E. Paoino, H. Strenge, C. Diaz, J. R. Brasic, W. Heide, I. Santilli, W. M. Korn, D. Selcuki, M. J. Barrett, D. Krieger, T. Leon, T. Houallah, M. Tournilhac, C. Nos, D. Chavot, F. Barbieri, F. J. Jimenez-Jimenez, J. Muruzabal, K. Poeck, A. Sennlaub, L. M. Iriarte, L. G. Lazzarino, C. Sanz, P. A. Fischer, S. D. Shorvon, R. Hoermann, F. Delecluse, M. Krams, O. Corabianu, F. H. Hochberg, Christopher J. Mathias, B. Debachy, C. M. Poser, L. Delodovici, A. Jimenez-Escrig, F. Baruzzi, F. Godenberg, D. Cucinotta, P. J. Garcia Ruiz, K. Maier-Hauff, P. R. Bar, R. Mezt, R. Jochens, S. Karakaneva, C. Roberti, E. Caballero, Joseph E. Parisi, M. Zamboni, T. Lacasa, B. Baklan, J. C. Gautier, J. A. Martinez-Matos, W. Pollmann, G. Thomas, L. Verze, E. Chleide, R. Alvarez Sala, I. Noel, E. Albuisson, O. Kastrup, S. I. Rapoport, H. J. Braune, H. Lörler, M. Le Merrer, A. Biraben, S. Soler, S. J. Taagholt, U. Meyding-Lamadé, K. Bleasdale-Barr, Isabella Moroni, Y. Campos, J. Matias-Guiu, G. Edan, M. G. Bousser, John B. Clark, J. Garcia de Yebenes, N. K. Olsen, P. Hitzenberger, S. Einius, Aj Thompson, Ch. J. Vecht, T. Crepin-Leblond, Klaus L. Leenders, A. Di Muzio, L. Georgieva, René Spiegel, K. Sabey, D. Ménégalli, J. Meulstee, U. Liszka, P. Giral, C. Sunol, J. M. Espadaler, A. D. Crockar, K. Varli, G. Giraud, P. J. Hülser, A. Benazzouz, A. Reggio, M. Salvatore, K. Genc, M. Kushnir, S. Barbieri, J. Ph. Azulay, M. Gianelli, N. Bathien, A. AlMemar, F. Hentati, I. Ragueneau, F. Chiarotti, R. C. F. Smits, A. K. Asbury, F. Lacruz, B. Muller, Alan J. Thompson, Gordon Smith, K. Schmidt, C. Daems Monpeun, Juergen Weber, A. Arboix, G. R. Fink, A. M. Cobo, M. Ait Kaci Ahmed, E. Gencheva, Israel-Biet, G. Schlaug, P. De Jonghe, Philip Scheltens, K. Toyka, P. Gonzalez-Porque, A. Cila, J. M. Fernandez, P. Augustin, J. Siclia, S. Medaglini, D. E. Ziogas, A. Feve, L. Kater, G. J. E. Rinkel, D. Leppert, Rüdiger J. Seitz, S. Ried, C. Turc-Carel, G. Smeyers, F. Godinho, M. Czygan, M. Rijntjes, E. Aversa, M. Frigo, Leif Østergaard, J. L. Munoz Blanco, A. Cruz-Matinez, J. De Reuck, C. Theillet, T. Barroso, V. Oikonen, Florence Lebert, M. Kilinc, C. Cordon-Cardon, G. Stoll, E. Thiery, F. Pulcinelli, J. Solski, M. Schmiegelow, L. J. Polman, P. Fernandez-Calle, C. Wikkelso, M. Ben Hamida, M. Laska, E. Kott, W. Sulkowski, C. Lucas, N. M. Bornstein, D. Schmitz, M. W. Lammers, A. de Louw, R. J. S. Wise, P. A. van Darn, C. Antozzi, P. Villanueva, P. H. E. Hilkens, C. Constantin, W. Ricart, A. Wolf, M. Gamba, P. Maguire, Alessandro Padovani, B. M. Patten, Marie Sarazin, H. Ackermann, L. Durelli, S. Timsit, Sebastian Jander, B. W. Scheithauer, G. Demir, J. P. Neau, P. Barbanti, A. Brand, N. AraÇ, V. Fischer-Gagnepain, R. Marchioli, G. Serratrice, C. Maugard-Louboutin, G. T. Spencer, D. Lücke, G. Mainardi, K. Harmant Van Rijckevorsel, G. B. Creel, R. Manzanares, Francesco Fortunato, A. May, J. Workman, K. Johkura, E. Fernandez, Carlo Colosimo, L. Calliauw, L. Bet, Félix F. Cruz-Sánchez, M. Dhib, H. Meinardi, F. Carrara, J. Kuehnen, C. Peiro, H. Lassmann, K. Skovgaard Olsen, A. McDonald, L. Sciulli, A. Cobo, A. Monticelli, B. Conrad, J. Bagunya, J. Benitez, V. Desnizza, B. Dupont, O. Delrieu, D. Moraes, J. J. Heimans, F. Garcia Rio, M. Matsumto, A. Fernandez, R. Nermni, R. Chalmers, M. J. Marchau, F. Aguado, P. Velupillai, P. J. Martin, P. Tassan, V. Demarin, A. Engelien, T. Gerriets, Comar, J. L. Carrasco, J. P. Pruvo, A. Lopez de Munain, D. Pavitt, J. Alarcon, Chris H. Polman, B. Guldin, N. Yeni, Hartmut Brückmann, N. Wilczak, H. Szwed, R. Causaran, G. Kyriazis, M. E. Westarp, M. Gasparini, N. Pecora, J. M. Roda, E. Lang, V. Scaioli, David R. Fish, D. Caputo, O. Gratzl, R. Mercelis, A. Perretti, G. Steimetz, I. Link, C. Rigoletto, A. Catafau, G. Lucotte, M. Buti, G. Fagiolari, A. Piqueras, C. Godinot, J. C. Meurice, Erodriguez J. Dominigo, F. Lionnet, H. Grzelec, David J. Brooks, P. M. G. Munro, F. X. Weilbach, M. Maiwald, W. Split, B. Widjaja-Cramer, V. Ozturk, J. Colas, E. Brizioli, J. Calleja, L. Publio, M. Desi, R. Soffietti, P. Cortinovis-Tourniaire, E. F. Gonano, G. Cavaletti, S. Uselli, K. Westerlind, H. Betuel, C. O. Dhiver, H. Guggenheim, M. Hamon, R. Fazio, P. Lehikoinen, A. Esser, B. Sadzot, G. Fink, Angelo Antonini, D. Bendahan, V. Di Carlo, G. Galardi, A. F. Boller, M. Aksenova, Del Fiore, V. de la Sayette, H. Chabriat, A. Nicoletti, A. Dilouya, M. L. Harpin, E. Rouillet, J. Stam, A. Wolters, M. R. Delgado, Eduardo Tolosa, G. Said, A. J. Lees, L. Rinaldi, A. Schulze-Bonhage, MA Ron, C. Lefebvre, E. W. Radü, R. Alvarez, M. L. Bots, P. Reganati, S. Palazzi, A. Poggi, N. J. Scolding, V. Sazdovitch, T. Moreau, E. Maes, M. A. Estelies, P. Petkova, Jose-Felix Marti-Masso, G De La Meilleure, N. Mullatti, M. Rodegher, N. C. Notermans, T. A. T. Warner, S. Aktan, J. P. Louboutin, L. Volpe, C. Scheidt, W. Aust, C. M. Wiles, U. Schneider, S. K. Braekken, W. R. Willems, K. Usuku, Peter M. Rothwell, C. Talamon, M. L. Sacchetti, A. Codina, M. H. Marion, A. Santoro, J. Roda, A. Bordoni, D. J. Taylor, S. Ertas, H. H. Emmen, J. Vichez, V. BesanÇon, R. E. Passingham, M. L. Malosio, A. Vérier, M. Bamberg, A. W. Hansen, E. Mostacero, G. Gaudriault, Marie Vidailhet, B. Birebent, K. Strijckmans, F. Giannini, T. Kammer, I. Araujo, J. Nowicki, E. Nikolov, A. Hutzelmann, R. Gherardi, J. Verroust, L. Austoni, A. Scheller, A. Vazquez, S. Matheron, H. Holthausen, J. M. Gerard, M. Bataillard, S. Dethy, V. H. Patterson, V. Ivanez, N. P. Hirsch, F. Ozer, M. Sutter, C. Jacomet, M. Mora, Bruno Colombo, A. Sarropoulos, T. H. Papapetropoulos, M. Schwarz, D. S. Dinner, N. Acarin, B. Iandolo, J. O. Riis, P. R. J. Barnes, F. Taroni, J. Kazenwadel, L. Torre, A. Lugaresi, I. L. Henriques, S. Pauli, S. Alfonso, Pedro Quesada, A. S. T. Planting, J. M. Castilla, Thomas Gasser, M. Van der Linden, A. Alfaro, E. Nobile-Orazio, G. Popova, W. Vaalburg, F. G. A. van der Mech, L. Williams, F. Medina, J. P. Vernant, J. Yaouanq, B. Storch-Hagenlocher, A. Potemkowski, R. Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. Bauermann, Nereo Bresolin, J. Vallée, B. C. Jacobs, A. Campos, Werner Poewe, J. A. Villanueva, A. W. Kornhuber, A. Malafosse, E. Diez-Tejedor, G. Jungreia, M. J. A. Puchner, A. Komiyama, O. Saribas, V. Volpini, L. Geremia, S. Bressi, A. Nibbio, Timothy E. Bates, T. z. Tzonev, E. Ideman, G. A. Damlacik, G. Martino, G. Crepaldi, T. Martino, Kjell Någren, E. Idiman, D. Samuel, J. M. Perez Trullen, Y. van der Graaf, J. O. Thorell, M. J. M. Dupuis, E. Sieber, R. D'Alessandro, C. Cazzaniga, J. Faiss, A. Tanguy, A. Schick, I. Hoksergen, A. Cardozo, R. Shakarishvili, G. K. Wennlng, J. L. Marti-Vilalta, J. Weissenbach, I. L. Simone, Amalia C. Bruni, Darius J. Adams, C. Weiller, A. Pietrangeli, F. Croria, C. Vigo-Pelfrey, Patricia Limousin, A. Ducros, G. Conti, O. Lindvall, E. Richter, M. Zuffi, A. Nappo, T. Riise, J. Wijdenes, M. J. Fernandez, J. Rosell, P. Vermersh, S. Servidei, M. S. C. Verdugo, F. Gouttiere, W. Solbach, M. Malbezin, I. S. Watanabe, A. Tumac, W. I. McDonald, D. A. Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg
Subjects: Neurology, business.industry, Media studies, Library science, Medicine, Neurology (clinical), business
Published: 1994
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29. Right Hemiparesis in Right Carotid Stenosis

Author: G. Della Marca, Paolo Profice, Fabio Pilato, V. Di Lazzaro, A. Santoliquido, and Aldobrando Broccolini
Subjects: Male, medicine.medical_specialty, Atherectomy, Ticlopidine, Neurological examination, Physiology (medical), Internal medicine, Atorvastatin, medicine, Humans, Thromboplastin, Carotid Stenosis, Pyrroles, Aged, Ultrasonography, Prothrombin time, biology, medicine.diagnostic_test, business.industry, Anticholesteremic Agents, Emergency department, medicine.disease, Combined Modality Therapy, Troponin, stroke, Clopidogrel, Surgery, Paresis, Stenosis, Settore MED/26 - NEUROLOGIA, Diffusion Magnetic Resonance Imaging, Treatment Outcome, Blood pressure, Heptanoic Acids, biology.protein, Cardiology, Creatine kinase, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors
Abstract: A 72-year-old right-handed man with a history of hypertension and past smoking, taking low-dose aspirin therapy (100 mg once a day) for cardiovascular prevention, presented with sudden onset of right hemiparesis and confusion. The right hemiparesis improved during the following days, but the patient was still confused. He arrived at the emergency department 6 days after the onset of symptoms. On neurological examination, the patient showed mild disorientation both in time and in place; no other neurological signs could be elicited. Blood pressure was 160/90 mm Hg. Blood count, prothrombin time, activated thromboplastin time, ionogram, C-reactive protein, troponin Ic, and creatine kinase were normal. ECG revealed normal sinus rhythm (76 bpm). Extracranial …
Published: 2011

30. Reduced cerebral cortex inhibition in dystonia: direct evidence in humans

Author: Fabio Pilato, Michele Dileone, G. Della Marca, V. Di Lazzaro, Paolo Mazzone, P.A. Tonali, Antonio Oliviero, Angelo Insola, and Paolo Profice
Subjects: Adult, medicine.medical_treatment, Central nervous system, Biophysics, Pyramidal Tracts, Inhibitory postsynaptic potential, Physiology (medical), medicine, Reaction Time, Humans, Aged, Dystonia, Cerebral Cortex, Analysis of Variance, Motor control, Electroencephalography, Neural Inhibition, Middle Aged, medicine.disease, Evoked Potentials, Motor, Transcranial Magnetic Stimulation, Sensory Systems, Transcranial magnetic stimulation, medicine.anatomical_structure, Neurology, Cerebral cortex, Brain stimulation, Sensory Thresholds, Female, Neurology (clinical), Psychology, Neuroscience, Motor cortex
Abstract: Objective: A loss of inhibition in central motor circuits resulting in abnormal motor control is the hypothesised cause of dystonia. So far, changes in inhibitory function of cerebral cortex in dystonia, have been revealed only indirectly by recording muscle responses evoked by transcranial magnetic stimulation (TMS) of the brain. The aim of present study was to evaluate more directly cerebral cortex changes in dystonia. We had the almost unique opportunity to record directly motor cortex output after brain stimulation, in a dystonic patient who had epidural electrodes implanted in the upper cervical cord. Methods: We evaluated descending activity evoked by single and paired pulse TMS together with the inhibitory effects produced by afferent stimuli on TMS evoked activity, and compared the results with those obtained in thirteen subjects with no central nervous system abnormality who also had cervical spinal electrodes. Results: The intrinsic inhibitory activity produced by paired TMS of the motor cortex, and the inhibitory effects produced by afferent inputs, were suppressed in the patient with dystonia. Conclusions: These findings provide a direct evidence of the abnormality in motor cortex inhibitory systems in dystonia. Significance: The abnormality in cortical inhibitory system might have a role in the pathophysiology of dystonia.
Published: 2008

31. 6. Hyperventilation increases brain connectivity in healthy subjects and in focal cryptogenic epileptic patients

Author: Elisa Testani, Edoardo Mazzucchi, C. Di Blasi, Nadia Mariagrazia Giannantoni, Anna Losurdo, G. Della Marca, Leonardo Lapenta, C. Vollono, Valentina Gnoni, and Valerio Brunetti
Subjects: medicine.diagnostic_test, Low resolution, Healthy subjects, Alpha (ethology), Electroencephalography, medicine.disease, Sensory Systems, medicine.anatomical_structure, Neurology, Migraine, Physiology (medical), Scalp, Anesthesia, Hyperventilation, medicine, Neurology (clinical), medicine.symptom, Activation method, Psychology
Abstract: Hyperventilation is a widely used EEG activation method. Aim of the study was to evaluate the modifications in brain connectivity due to hyperventilation in normal subjects and in cryptogenic focal epileptic patients. We examined EEG recordings from 19 scalp electrodes of 22 normal subjects and 22 focal cryptogenic epileptic patients. Exclusion criteria were: migraine, cerebrovascular disease, MRI abnormalities and use of drugs, apart from Antiepileptic drugs in epileptic group. We selected segments before (PRE), during (HYPER) and five minutes after (POST) hyperventilation. We analyzed neural generators through low resolution electromagnetic tomography (sLORETA) for the following bands: delta (1–4 Hz), theta (5–7 Hz), alpha (8–13 Hz), beta (14–30 Hz) and gamma (31–60 Hz). We also computed EEG lagged coherence between 19 Regions Of Interest for the same bands. Finally, we performed intergroup analysis of Mean Lagged Coherence. In both groups hyperventilation significantly increases EEG ( p p p
Published: 2015
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32. Transient MRI abnormalities in a case of occipital lobe epilepsy with favorable outcome

Author: Cesare Colosimo, Carmen Barba, Salvatore Mazza, G. Della Marca, Gabriella Silvestri, and Pietro Attilio Tonali
Subjects: Male, Pathology, medicine.medical_specialty, Adolescent, Favorable prognosis, Electroencephalography, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Favorable outcome, Macropsia, medicine.diagnostic_test, business.industry, Generalized seizure, Magnetic resonance imaging, General Medicine, medicine.disease, Prognosis, Magnetic Resonance Imaging, Treatment Outcome, Neurology, Occipital lobe epilepsy, Anticonvulsants, Neurology (clinical), Radiology, Epilepsies, Partial, Occipital Lobe, business, Sharp wave, 030217 neurology & neurosurgery
Abstract: We describe the case of a 13-year-old boy, in good health, with transient occipital MRI abnormalities just after one generalized seizure and the appearance of macropsia. The EEG showed a 3–5 Hz sub-continuous left occipital activity, with sporadic sharp waves. Macropsia disappeared in 2 years. This case may suggest that the presence of transient MRI abnormalities does not exclude a favorable prognosis.
Published: 2006

33. Relapsing demyelinating disease after chicken pox in a child

Author: G. Della Marca, P.A. Tonali, Anna Paola Batocchi, G. Baranello, Paolo Mariotti, Donald H. Gilden, Piero Valentini, Cesare Colosimo, Marcella Caggiula, and Giovanni Frisullo
Subjects: Hepatitis B virus, business.industry, viruses, Encephalomyelitis, Acute Disseminated, Varicella zoster virus, Congenital cytomegalovirus infection, virus diseases, medicine.disease, medicine.disease_cause, Measles, Virus, Lethargy, Chickenpox, Recurrence, Child, Preschool, Immunology, Demyelinating disease, medicine, Humans, Female, Neurology (clinical), Chicken Pox, business, Demyelinating Diseases
Abstract: Post-infectious encephalomyelitis (PIE), an inflammatory demyelinating disorder, usually begins days to weeks after virus (usually measles, Epstein–Barr virus [EBV], cytomegalovirus [CMV], or varicella zoster virus [VZV]) or mycoplasma infection, and after vaccination with hepatitis B virus,1 Bordetella pertussis , and possibly influenza virus.2 The mechanism by which the infectious agent triggers demyelination is uncertain. Two days after varicella infection, a 3-year-old girl developed fever, confusion, lethargy, and status epilepticus. CSF was acellular with normal protein and glucose, without oligoclonal bands (OGBs) or amplifiable VZV DNA, and no VZV IgM or IgG antibody in serum or CSF. Brain CT revealed diffuse white matter edema. After IV treatment with ceftriaxone, acyclovir, clonazepam, and phenobarbital, seizures stopped and mental status was normal. Neurologic signs included increased DTRs, greater on the left, and ankle clonus bilaterally. Twenty days later, she became febrile. Neurologic signs consisted of ataxia with dysmetria bilaterally and intention tremor in the arms. Serum contained VZV IgM antibody, and VZV IgG was 6,800 international units (IU) per liter (normal < 50 IU/L). There was no amplifiable VZV DNA in blood. CSF was acellular, protein 31 mg%; …
Published: 2006

34. Dysfunction of arousal systems in sleep-related migraine without aura

Author: G, Della Marca, C, Vollono, M, Rubino, G, Di Trapani, P, Mariotti, and P A, Tonali
Subjects: Adult, Male, Migraine without Aura, Sleep Wake Disorders, Polysomnography, Brain, Humans, Sleep, REM, Female, Middle Aged, Arousal, Sleep
Abstract: Primary headaches are closely related to sleep. Modifications in the patterns of arousal during sleep have been reported in migraine, especially in the nights preceding a headache attack. We aimed at evaluating the pattern of arousal from sleep in a group of patients affected by sleep-related migraine. We enrolled 10 consecutive patients, three males and seven females, aged between 20 and 62 years, who presented frequent attacks of migraine without aura (more than five per month), closely related to sleep (more than one-half of the attacks occurred during sleep, causing an awakening). A control group was studied, matched for age and sex. Patients and controls underwent a full-night polysomnographic study, following adaptation; arousal pattern was studied by the scoring of the high-frequency EEG arousal and by the cyclic alternating pattern (CAP). Migraineurs showed a lower CAP rate in non-rapid eye movement (NREM) sleep and, in particular, a lower number of A1 phases (low-frequency, high-amplitude EEG bursts) compared with the controls. Migraineurs also showed a lower index of high-frequency EEG arousals during rapid eye movement (REM) sleep. The reduction in the CAP rate indicates a lower level of arousal fluctuation in NREM sleep. The reduced arousal index in REM suggests a dysfunction in neural structures involved in both the control of REM sleep and the pathophysiology of migraine, such as the hypothalamus and the brainstem.
Published: 2006

35. Aryepiglottic fold cyst causing obstructive sleep apnea syndrome

Author: Pasqualina Maria Picciotti, Stefania Agostino, G. Della Marca, Emanuele Scarano, and S. Galla
Subjects: Adult, Male, medicine.medical_specialty, Microsurgery, Sleep Apnea, Obstructive, Sleep Apnea, business.industry, Cysts, Obstructive, Polysomnography, General Medicine, medicine.disease, Epiglottis, Obstructive sleep apnea, Laryngeal Diseases, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, Humans, Cyst, Settore MED/31 - OTORINOLARINGOIATRIA, business, Aryepiglottic fold
Published: 2006

36. Hypnic headache: actigraphic and polysomnographic study of a case

Author: Catello Vollono, G. Della Marca, Alessandro Capuano, Marco Rubino, C Calì, Serenella Servidei, G. Di Trapani, A De Angelis, and D. Mei
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Headache Disorders, Hypnic headache, Amitriptyline, Polysomnography, Sleep, REM, General Medicine, Analgesics, Non-Narcotic, Middle Aged, medicine.disease, Settore MED/26 - NEUROLOGIA, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Female, 030212 general & internal medicine, Neurology (clinical), business, 030217 neurology & neurosurgery
Published: 2005

37. Reduced sensorimotor inhibition in the ipsilesional motor cortex in a patient with chronic stroke of the paramedian thalamus

Author: I. Holler, G. Della Marca, A. Molina León, J. Florensa Vila, V. Di Lazzaro, Hartwig R. Siebner, A. Oliviero, and J. Tejeira Álvarez
Subjects: Adult, medicine.medical_treatment, Central nervous system, Thalamus, Sensory system, Thalamic Diseases, Midbrain, Physiology (medical), Medicine, Humans, Afferent Pathways, business.industry, Motor Cortex, Neural Inhibition, Somatosensory Cortex, Magnetic Resonance Imaging, Sensory Systems, Electric Stimulation, Median Nerve, body regions, Transcranial magnetic stimulation, Stroke, medicine.anatomical_structure, Neurology, Somatosensory evoked potential, Chronic Disease, Wakefulness, Female, Neurology (clinical), business, Neuroscience, Motor cortex
Abstract: Objective Unilateral or bilateral paramedian infarction in the region of the thalamus and upper midbrain may lead to hypersomnia. To determine whether unilateral infarction of the paramedian thalamus leads to changes in excitability of ipsilesional primary motor hand area (M1). Methods We describe a patient with chronic stroke of the right dorsomedian and intralaminar thalamic nuclei, who suffered from mild persistent hypersomnia. We studied the excitability of the right and left M1 with transcranial magnetic stimulation (TMS) in the patient, and in 10 healthy controls. Results In contrast to healthy controls, contralateral electrical stimulation of the median nerve failed to induce short-latency afferent inhibition (SAI) in the ipsilesional M1. Other measures of corticomotor excitability and somatosensory evoked potentials were normal. Conclusions The selective loss of ipsilateral SAI in a patient with paramedian thalamic stroke suggests that during wakefulness, the intact paramedian thalamus facilitates the excitability of intracortical inhibitory circuits, which process thalamocortical sensory inputs in the ipsilateral M1. This preliminary finding suggests that measurements of SAI may provide a means of probing the integrity of some neural pathways, which are involved in the control of wakefulness and arousal. Significance In addition to the established role of the paramedian thalamus in arousal and memory, our observation suggests that thalamocortical projections from the paramedian thalamus contribute to the integration of sensory input at the cortical level during wakefulness.
Published: 2005

38. 61. EEG topography of sleep and wakefulness in patients with Mild Cognitive Impairment and Alzheimer Disease: Preliminary data

Author: I. Truglia, Fabio Moroni, G. Della Marca, P.M. Rossini, Susanna Cordone, Cristina Marzano, L. De Gennaro, and Michela Ferrara
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Sleep spindle, Electroencephalography, Audiology, EEG-fMRI, Sleep in non-human animals, Non-rapid eye movement sleep, Sensory Systems, Neurology, Physiology (medical), mental disorders, medicine, Wakefulness, Neurology (clinical), K-complex, Psychology, Neuroscience, psychological phenomena and processes, Slow-wave sleep
Abstract: Quantitative analysis of EEG during wakefulness in AD/MCI patients shows a slowing of EEG rhytms, in terms of increase of delta activity and decrease of alpha activity. Some studies show differences in AD/MCI patients even in EEG sleep: an increase in stage 1, number and length of intra-night awakenings, a decrease of Slow Wave Sleep (SWS) and REM sleep. Given the strong relation (bidirectional) between EEG sleep and wakefullness rhythms, the objective of the study is to assess EEG topography during sleep (REM and NREM) and wakefulness, and to assess relationship between sleep EEG modifications and subsequent variations in wakefulness EEG. 8 patients AD, 13 MCI and 9 elderly healthy people performed one-night sleep PSG recordings (19 cortical electrods, EOG, EMG) and wakefulness EEG recordings (5 min with eyes open and 5 min with eyes closed). Analyses of EEG topography of wakefulness, REM and NREM sleep suggest significant differences between MCI groups vs. controls within the alpha band, in terms of lower EEG activity within this frequency range in patients in occipital and temporal derivations compared to controls. Although preliminary, data of EEG topography seems showing the same functional variations both in sleep and wakefulness. Hence, the observed slowing may be an electrophysiological evidence of neurodegenerative processes at a cortical level.
Published: 2013
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39. Functional involvement of cerebral cortex in human narcolepsy

Author: P.A. Tonali, E. Saturno, Antonio Oliviero, Viviana Versace, V. Di Lazzaro, G. Della Marca, Michele Dileone, G. Mennuni, and Fabio Pilato
Subjects: Adult, Male, Lateral hypothalamus, medicine.medical_treatment, Excessive daytime sleepiness, Magnetics, Neural Pathways, medicine, Humans, Wakefulness, Narcolepsy, Cerebral Cortex, Orexins, Neocortex, Neuropeptides, Intracellular Signaling Peptides and Proteins, Motor Cortex, Neural Inhibition, Middle Aged, medicine.disease, Evoked Potentials, Motor, Electric Stimulation, Transcranial magnetic stimulation, medicine.anatomical_structure, Neurology, Cerebral cortex, Hypothalamic Area, Lateral, Female, Neurology (clinical), medicine.symptom, Nerve Net, Psychology, Sleep, Neuroscience, Motor cortex
Abstract: The pathophysiology of human narcolepsy is still poorly understood. The hypoactivity of some neurotransmitter systems has been hypothesised on the basis of the canine model. To determine whether narcolepsy is associated with changes in excitability of the cerebral cortex, we assessed the excitability of the motor cortex with transcranial magnetic stimulation (TMS) in 13 patients with narcolepsy and in 12 control subjects. We used several TMS paradigms that can provide information on the excitability of the motor cortex. Resting and active motor thresholds were higher in narcoleptic patients than in controls and intracortical inhibition was more pronounced in narcoleptic patients. No changes in the other evaluated measures were detected. These results are consistent with an impaired balance between excitatory and inhibitory intracortical circuits in narcolepsy that leads to cortical hypoexcitability. We hypothesise that the deficiency of the excitatory hypocretin/orexin-neurotransmitter-system in narcolepsy is reflected in changes of cortical excitability since circuits originating in the lateral hypothalamus and in the basal forebrain project widely to the neocortex, including motor cortex. This abnormal excitability of cortical networks could be the physiological correlate of excessive daytime sleepiness and it could be the substrate for allowing dissociated states of wakefulness and sleep to emerge suddenly while patients are awake, which constitute the symptoms of narcolepsy.
Published: 2004

40. Influence of cholinergic circuitries in generation of high-frequency somatosensory evoked potentials

Author: G. Della Marca, Pietro Attilio Tonali, N Paciello, Alessandro Capuano, Catello Vollono, Marco Rubino, M. Valeriani, and Domenico Restuccia
Subjects: Adult, Male, Phenylcarbamates, Rivastigmine, Somatosensory system, chemistry.chemical_compound, Physiology (medical), Evoked Potentials, Somatosensory, Neural Pathways, medicine, Reaction Time, Humans, Cholinergic neuron, Neurotransmitter, Cerebral Cortex, Brain Mapping, Scalp, Electroencephalography, Somatosensory Cortex, Acetylcholinesterase, Sensory Systems, Acetylcholine, Electric Stimulation, Median Nerve, Neurology, chemistry, Somatosensory evoked potential, GABAergic, Cholinergic, Neurology (clinical), Carbamates, Cholinesterase Inhibitors, Neuroscience, medicine.drug
Abstract: Objective : High-frequency oscillations (HFOs) evoked by upper limb stimulation reflect highly synchronised spikes generated in the somatosensory human system. Since acetylcholine produces differential modulation in subgroups of neurons, we would determine whether cholinergic drive influences HFOs. Methods : We recorded somatosensory evoked potentials (SEPs) from 31 scalp electrodes in 7 healthy volunteers, before and after single administration of rivastigmine, an inhibitor of central acetylcholinesterase. Right median nerve SEPs have been analysed after digital narrow bandpass filtering (500–700 Hz). Raw data were further submitted to Brain Electrical Source analysis (BESA) to evaluate the respective contribution of lemniscal, thalamic and cortical sources. Lastly, we analysed by Fast Fourier transform spectral changes after drug administration in the 10–30 ms latency range. Results : Rivastigmine administration caused a significant increase of HFOs in the 18–28 ms latency range. Wavelets occurring before the onset latency of the conventional N20 SEP did not show any significant change. A similar increase concerned the strength of cortical dipolar sources in our BESA model. Lastly, we found a significant power increase of the frequency peak at about 600 Hz in P3-F3 traces after drug intake. Conclusions : Our findings demonstrate that the cortical component of HFOs is significantly enhanced by cholinergic activation. Pyramidal chattering cells, which are capable to discharge high-frequency bursts, are mainly modulated by cholinergic inputs; by contrast, acetylcholine does not modify the firing rate of fast-spiking GABAergic interneurons. We thus discuss the hypothesis that cortical HFOs are mainly generated by specialised pyramidal cells.
Published: 2003

41. S21.3 Rivastigmine treatment for REM behavior disorder in Parkinson's disease (PD)

Author: Anna Rita Bentivoglio, Davide Quaranta, Paolo Mariotti, G. Della Marca, and R. Di Giacopo
Subjects: Rivastigmine, Rem behavior disorder, Parkinson's disease, Neurology, business.industry, Physiology (medical), medicine, Neurology (clinical), medicine.disease, business, Neuroscience, Sensory Systems, medicine.drug
Published: 2011
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42. P368: Association between dysphagia and OSAS in acute stroke patients

Author: Nadia Mariagrazia Giannantoni, Valerio Brunetti, Valentina Gnoni, G. Della Marca, Aldobrando Broccolini, Giovanni Frisullo, Roberta Morosetti, Elisa Testani, Anna Losurdo, Fabio Pilato, Pietro Caliandro, P. Profice, C. Di Blasi, and P.M. Rossini
Subjects: medicine.medical_specialty, Neurology, business.industry, Neuropsychology, medicine.disease, Clinical neurophysiology, Dysphagia, Apraxia, Sensory Systems, Supramarginal gyrus, Physiology (medical), Internal medicine, Aphasia, medicine, Physical therapy, Cardiology, Neurology (clinical), medicine.symptom, business, Stroke
Abstract: s of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S145 behavioural patterns and neural substrates of aphasic and apraxic deficits after left-hemispheric stroke, neuropsychological testing and statistical lesion analyses were performed in 50 sub-acute stroke patients. Methods: Eight neuropsychological tests were administered to detect and characterise aphasic and apraxic deficits. Voxel-based lesion symptom mapping (VLSM) was performed to identify lesion sites associated with aphasic and apraxic deficits as well as combinations thereof. Results: Behaviourally, half of all patients or two-thirds of the 37 aphasic patients suffered from co-morbid aphasia and apraxia. While 24% (n=12) of the patients exhibited aphasia without apraxia, apraxia without aphasia was rare (n=2, 4%). As expected, VLSM revealed that aphasic deficits were associated with lesions to left inferior frontal, superior temporal and supramarginal gyrus. Apraxic deficits correlated with lesions to left inferior frontal gyrus, the central region, and parietal lesions for imitation. Lesions to the opercular part of the left inferior frontal gyrus (i.e. Brodmann’s area 44 as part of Broca’s region) led to combined apraxic and aphasic deficits. Conclusions: This is the first study which demonstrates the lesion site for comorbidity of aphasia and apraxia. Our findings stress the importance of Brodmann’s area 44 (as part of Broca’s region) as an interface between language and praxis. P367 High frequency deep rTMS over the right homologous Broca’s region improves naming in chronic post-stroke aphasia: a pilot study R. Chieffo1, F. Ferrari1, P. Battista1, E. Houdayer1, A. Nuara1, F. Alemanno1, J. Abutalebi1, A. Zangen2, G. Comi1, S.F. Cappa1, L. Leocani1 1Scientific Institute Hospital San Raffaele, Milan, Italy, Italy; 2Department of Life Sciences Ben-Gurion University, Beer-Sheva, Israel, Israel Objective: This study aimed to compare the effect of excitatory, inhibitory and sham rTMS delivered with H-coil over the right inferior frontal gyrus (IFG) in chronic post-stroke aphasic patients. Methods: Five right-handed post-stroke aphasic patients underwent a picture naming task before and immediately after each of three sessions of rTMS: excitatory (10 Hz), inhibitory (1 Hz) and sham rTMS, in random sequence and separated by at least one week. Results: Only the excitatory 10 Hz stimulation was associated with a significant improvement in naming performance, (p=0.043) and was significantly more effective than 1Hz rTMS (p=0.043). Conclusions: A single session of excitatory deep brain rTMS over the right IFG with H-coil significantly improves naming in right-handed chronic post-stroke aphasic patients. This result is in line with the hypothesis of a positive, rather than detrimental role, of the right hemisphere in chronic aphasia due to a left-hemispheric stroke. P368 Association between dysphagia and OSAS in acute stroke patients C. Di Blasi, G. Della Marca, A. Broccolini, F. Pilato, P. Profice, G. Frisullo, P. Caliandro, R. Morosetti, V. Brunetti, N.M. Giannantoni, E. Testani, A. Losurdo, V. Gnoni, P.M. Rossini Catholic University, Geriatric, Neuroscience and Orthopedic, Rome, Italy Introduction: Co-occurrence of dysphagia and Obstructive sleep apnoea (OSAS) may negatively impact clinical course in stroke. Objective: The objective of this study is to evaluate the correlation between dysphagia and sleep apnoea in acute stroke patients. Methods: Inclusion criteria: ischemic or hemorrhagic stroke (≤48 hours). Exclusion criteria: NIH stroke scale
Published: 2014
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43. P993: Circadian hyperactivity of the lower limb nociceptive system in idiopathic restless legs syndrome: a CO2 laser evoked potential study

Author: R. Miliucci, D. Virdis, P.M. Rossini, D. Ferraro, Massimiliano Valeriani, A. Losurdo, G. Della Marca, C. Vollono, D. Le Pera, and E. Testani
Subjects: medicine.medical_specialty, Co2 laser, Laser-Evoked Potentials, Stimulation, medicine.disease, Sensory Systems, Lower limb, Nociception, Neurology, Disinhibition, Physiology (medical), Anesthesia, medicine, Physical therapy, Neurology (clinical), Circadian rhythm, Restless legs syndrome, medicine.symptom, Psychology
Abstract: Aim of the study was to assess the A-delta nociceptive system during the night and afternoon in idiopathic Restless Legs Syndrome (RLS) patients, by recording the Laser Evoked Potentials (LEPs). We studied 11 patients (mean age 53.40 ± 18.59 years; 6 males, 5 females) affected by idiopathic RLS. LEPs were recorded to stimulation of the right foot, hand and perioral region. LEPs were recorded at night (between 9.00 PM and 11.00 PM) and in the early afternoon (between 1.00 PM and 3.00 PM). Two consecutive averages (20 trials each) were obtained for each stimulation site. LEPs were recorded from 3 recording electrodes placed at Cz, Fz, and T3 sites of the 10–20 International System. In RLS patients, we found a significant increase of N2–P2 amplitude after foot stimulation during nighttime session ( p = 0.008) when compared to daytime. The N2/P2 amplitude after hand and face stimulation was not significantly different during both sessions ( p > 0.05). We did not find any impairment of the Adelta-fiber system. However, there is a prevailing activity of the Adelta nociceptive system of lower limbs during nighttime. These findings suggest, in idiopathic RLS, a circadian disinhibition in the central processing of the lower limb Adelta-fiber inputs.
Published: 2014
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44. P39: Effects of hyperventilation on brain connectivity

Author: C. Di Blasi, Edoardo Mazzucchi, Anna Losurdo, Valentina Gnoni, G. Della Marca, Valerio Brunetti, P.M. Rossini, Elisa Testani, Nadia Mariagrazia Giannantoni, and C. Vollono
Subjects: Neurology, business.industry, Physiology (medical), Hyperventilation, Medicine, Neurology (clinical), medicine.symptom, business, Neuroscience, Sensory Systems
Published: 2014
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45. EPA-0267 – Polysomnographic findings in a cohort of chronic insomnia patients with benzodiazepines abuse

Author: Valentina Gnoni, Elisa Testani, Leonardo Lapenta, Anna Losurdo, C. Di Blasi, L. Janiri, Serena Dittoni, Salvatore Mazza, M. Di Nicola, Marianna Mazza, Giuseppe Marano, P. Bria, G. Della Marca, Nadia Mariagrazia Giannantoni, and V. Brunetta
Subjects: medicine.medical_specialty, Sleep disorder, Neurology, medicine.diagnostic_test, media_common.quotation_subject, Polysomnography, medicine.disease, Non-rapid eye movement sleep, Psychiatry and Mental health, Internal medicine, Anesthesia, Cohort, medicine, Heart rate variability, Psychology, Cohort study, Vigilance (psychology), media_common
Abstract: Study objectives to evaluate sleep modifications induced by chronic benzodiazepines (BDZs) abuse. Methods cohort study, comparison of sleep measures between BDZs abusers and controls. Drug Addiction Unit (Institute of Psychiatry) and Unit of Sleep Disorder (Institute of Neurology) of the Catholic University in Rome. Six outpatients were enrolled, (4 men and 2 women, mean age 53.3±14.8, range: 34 - 70 years) affected by BDZ chronic abuse; 55 healthy controls (23 men and 32 women, mean age 54.2 ±13.0, range: 27–76 years). All patients underwent clinical evaluation, psychometric measures, ambulatory polysomnography, scoring of sleep macrostructure and microstructure (power spectral fast-frequency EEG arousal, Cyclic Alternating Pattern - CAP), Heart Rate Variability. Results BDZs abusers had relevant modification of sleep macrostructure and a marked reduction of fast-frequency EEG arousal in NREM (Patients: 6.6±3.7 events/hour, Controls 13.7±4.9 events/hour, U-test: 294, p=0.002) and REM (Patients: 8.4±2.4 events/hour, Controls 13.3±5.1 events/hour, U-test: 264, p=0.016), and of CAP rate (Patients: 15.0±8.6%, Controls: 51.2±12.1%, U-test: 325, p Discussion BDZs abusers have reduction of arousals associated with increased number of nocturnal awakenings and severe impairment of sleep architecture. The effect of chronic BDZs abuse on sleep may be described as a severe impairment of arousal dynamics; the result is the inability to modulate levels of vigilance.
Published: 2014
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46. Teaching NeuroImages: Transient epileptic amnesia

Author: Fabio Pilato, Serena Dittoni, Elisa Testani, G. Della Marca, P. Profice, Valentina Gnoni, Salvatore Colicchio, Anna Losurdo, V. Di Lazzaro, and Cesare Colosimo
Subjects: Male, Abdominal discomfort, Epilepsy, business.industry, Brain, Retrograde amnesia, medicine.disease, Magnetic Resonance Imaging, Head trauma, Transient epileptic amnesia, Amnesia, Transient Global, Anesthesia, medicine, Humans, Neurology (clinical), business, Aged
Abstract: A 71-year-old man presented recurrent transient episodes of anterograde and retrograde amnesia, since age 60 years, with a frequency of 10 per month. The attacks, preceded by vague abdominal discomfort, lasted from a few minutes to 2–3 hours. History was unremarkable except for a head trauma; he took no drugs. MRI showed a left meningoencephalocele, likely posttraumatic, in the …
Published: 2010
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47. Is ESES/CSWS a strictly age-related disorder?

Author: Stefano Marchetti, M Guazzelli, G. Della Marca, Gf Mennuni, L Iuvone, Paolo Mariotti, and Salvatore Mazza
Subjects: Adult, medicine.medical_specialty, Pediatrics, Polysomnography, PET study, Central nervous system disease, Epilepsy, Status Epilepticus, Gyrus, Physiology (medical), medicine, Humans, Slow-wave sleep, medicine.diagnostic_test, Cognitive disorder, Brain, Magnetic resonance imaging, medicine.disease, Sensory Systems, Surgery, Settore MED/26 - NEUROLOGIA, medicine.anatomical_structure, Neurology, Positron emission tomography, Female, Neurology (clinical), ESES/CSWS, Psychology, Sleep, Tomography, Emission-Computed
Abstract: Objectives : We report on a case of ESES/CSWS observed in a patient of 21 years and still persisting at the age of 25. Cases of ESES/CSWS have never been previously described in adult patients. ESES/CSWS is considered to be related to the degree of maturation of the central nervous system, and therefore strictly age-related. Methods : Our case of ESES/CSWS was observed in a 21 year old woman referred for cognitive and behavioral disorders. She had previously had epileptic fits, but was seizure free at that time. The patient underwent a full-night polygraphic recording, which showed a typical ESES/CSWS pattern, with a Spike-and-Wave Index >85%. Polysomnography was repeated 9 times in a 4 year follow-up, during which the ESES/CSWS condition persisted, despite the pharmacological treatments. The patient also underwent cerebral magnetic resonance imaging and fludeoxyglucose F 18 positron emission tomography (PET). Results : The PET study revealed reduced metabolic activity within the lower gyrus of the right parietal lobe, but no significant difference between subcortical structures and cortical mantle was seen. MRI scans were normal. Conclusions : This observation suggests that ESES/CSWS might not always be an age-related condition. Sleep EEG recordings should always be performed in patients with behavioral disorders and a history of epileptic fits.
Published: 2000

48. Levetiracetam can be effective in the treatment of restless legs syndrome with periodic limb movements in sleep: report of two cases

Author: G. Mennuni, Marianna Mazza, Catello Vollono, Pietro Attilio Tonali, Paolo Mariotti, Salvatore Mazza, and G. Della Marca
Subjects: medicine.medical_specialty, Letter, levetiracetam, Epworth Sleepiness Scale, Dopaminergic, Piracetam, medicine.disease, Nocturnal Myoclonus Syndrome, Settore MED/26 - NEUROLOGIA, Psychiatry and Mental health, Rating scale, mental disorders, Restlesslegs, medicine, Physical therapy, Surgery, Neurology (clinical), Levetiracetam, Restless legs syndrome, Psychology, Motor Restlessness, medicine.drug
Abstract: Restless legs syndrome (RLS) is an awake phenomenon characterised by an intense, irresistible urge to move the legs, sensory complaints, and motor restlessness. RLS is usually associated with periodic limb movements in sleep (PLMS). Clinical evidence suggests that dopaminergic agents are the treatment of first choice. Dopaminergic treatment is usually effective, but many patients develop augmentation.1 Augmentation is the worsening of RLS symptoms attributable to a specific therapeutic intervention; its primary feature is a shift of RLS symptoms to an earlier time than was typical at symptom onset during the initial course of beneficial stable treatment.2 Augmentation requires the withdrawal of dopaminergic agents. Anticonvulsants may be used if the response to dopaminergic agents is not adequate or if augmentation occurs.1 We describe two patients affected by RLS with PLMS who became unresponsive to the traditional dopaminergic agents and developed augmentation. Both patients were treated with the antiepileptic drug levetiracetam and showed a clear and persistent clinical improvement of both RLS symptoms and PLMS. The clinical assessment and follow up included: subjective evaluation of symptoms and their impact on everyday life by means of the International Restless Legs Syndrome Study Group (IRLSSG) rating scale; evaluation of daytime sleepiness with the Epworth sleepiness scale; a suggested immobilisation test …
Published: 2006
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49. Development of a software system of video-integrated analysis made for the motion detection and analysis of sleep. A

Author: Riccardo Maviglia, C. Vollono, Michele Scatena, Serena Dittoni, G. Della Marca, and Manuela Pennisi
Subjects: business.industry, Computer science, Frame (networking), Pattern recognition, Motion detection, General Medicine, Pearson product-moment correlation coefficient, Motion (physics), symbols.namesake, Statistics, symbols, Software system, Sensitivity (control systems), Artificial intelligence, Software analysis pattern, business, System software
Abstract: Introduction The study aims to validate the system for the automatic analysis of the video-polygraphic, comparing with traditional methods of visual analysis. In particular, we will: detect motor activity and compare the analysis of PLM by classical methods: video-actigraphy versus Immobilization Test. Analyze the results of motion detection by comparing epoch by epoch. Materials and methods 24 Patients studied with Immobilization Test in sleep laboratory and video analysis. Movement study with video analysis offline through software system composed by ManyCam, WebCamXP, ZoneMinder, ZoneMinderAnalyzer (ZMA), Actiwatch Activity & Sleep Analysis 7. The motion was classified according to the AAMS criteria and calculated the leg movement and the motion sequence. The video analysis was performed with combined use of ManyCam and WebCamXP which permits obtain an IP virtual Camera. ZMA use the provided data by video analysis performed with ZoneMinder. ZM reveals the differences of video frame in input, quantifies them and then stores them in a database SQL. ZMA divides the time in epochs of x seconds and calculates for those epochs compatible values with these obtained through polygraphic analysis used the database data. The obtained data are transformed in a format readable by Psg software analysis. The results obtained were compared with the analysis performed by the system software (Zoneminder). The comparison was made epoch by epoch. Results The video analysis offline offers an approach to study the motion during sleep, not always visible with the classic video system and with EMG electrodes on the surface. This system permits an analysis of body movements, along witih those of the face and the limbs. The ManyCam and WebCamXP system is more complete in comparison on macrostructure sleep, visual analysis of body movements, spectral analysis of EMG and actigraphy analysis. We analyzed a total of 4512 times. Time-period analysis, the coefficient K Cohen has established a degree of agreement between ZM and Immobilization Test equal to 0.252. The Bland–Altman analysis confirmed that scores of ZM were not significantly different from those obtained with test Immobilization. The results of the analysis of Bland–Altman show a substantial overlap between the scores obtained with ZM and Immobilization Test with a slight tendency to overestimate ZM motor events. The Pearson coefficient, equal to 0.2523 (corresponding to a significance value of p Conclusion Our study makes it possible to collect the following conclusions:The motor pattern analyzed with different methods shows a substantial overlap; Zoneminder allows detection of motor events also minimal compared with the analysis carried out visually test of immobilization. By adjusting the sensitivity of motion detection you can ’analyze a specific body area or a specific region. From our study shows an easy applicability of the method especially in long recordings, allowing effective results with cost containment. This method also allows the non-invasive nature of the system on patient therefore making themselves available for recordings of newborns and infants.
Published: 2013
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50. 134. Heart Rate Variability in sleep-related migraine

Author: Salvatore Colicchio, Salvatore Mazza, Serena Dittoni, Valentina Gnoni, Elisa Testani, G. Della Marca, Anna Losurdo, C. Vollono, and C. Di Blasi
Subjects: Sleep Stages, Mean age, medicine.disease, Sleep in non-human animals, Sensory Systems, Quiet wakefulness, Arousal, Large sample, Neurology, Migraine, Physiology (medical), Anesthesia, medicine, Heart rate variability, Neurology (clinical), Psychology
Abstract: The aim of our study was to investigate the reciprocal interactions among sleep, ANS and occurrence of migraine attacks. We studied 8 consecutive patients with sleep-related migraine (two men and six women, mean age 41.9 ± 13.9), and high frequency of attacks (>5/month). Patients were evaluated during a headache-free period. Patient underwent full-night laboratory video-polysomnography and Heart Rate Variability (HRV) analysis and were compared with a large sample of normal subjects. For the HRV analysis, in time and frequency domain, we selected periods of 5 min period, from quiet wakefulness (W), stage 2 (N2) and 3 (N3) of N-REM, and REM sleep (R). We found a statistically significant reduction of LF/HF ratio during N2 and N3 sleep stages in migraineurs compared with controls. The ANS activity in migraineurs showed an higher level of fluctuation compared with normal subjects, with an increase of parasympathetic activation during N-REM sleep. This finding could be consequent to a subtle chronic sympathetic dysfunction which could manifest selectively, or become more evident, during sleep, and could represent a further measure of reduced arousability. The simultaneous involvement of the autonomic, arousal and pain systems suggest an involvement of the hypothalamic orexinergic pathways.
Published: 2013
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