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5. Unmet needs and gaps in the identification of secondary progression in multiple sclerosis: a Southern Italy healthcare professionals’ perspective

Author

Lus, Giacomo, Bassano, Marco André, Brescia Morra, Vincenzo, Bonavita, Simona, Gallo, Antonio, Maimone, Davide, Malerba, Laura, Maniscalco, Giorgia Teresa, Saccà, Francesco, Salemi, Giuseppe, Turrini, Renato, Cottone, Salvatore, Sessa, Edoardo, Buccafusca, Maria, and Grimaldi, Luigi Maria Edoardo

Published
2023
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6. Telemedicine application to headache: a critical review

Author

Spina, Emanuele, Tedeschi, Gioacchino, Russo, Antonio, Trojsi, Francesca, Iodice, Rosa, Tozza, Stefano, Iovino, Aniello, Iodice, Francesco, Abbadessa, Gianmarco, di Lorenzo, Francesco, Miele, Giuseppina, Maida, Elisabetta, Cerullo, Giovanni, Sparaco, Maddalena, Silvestro, Marcello, Leocani, Letizia, Bonavita, Simona, Manganelli, Fiore, and Lavorgna, Luigi

Published
2022
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11. Disability assessment using Google Maps

Author

Lavorgna, Luigi, Iaffaldano, Pietro, Abbadessa, Gianmarco, Lanzillo, Roberta, Esposito, Sabrina, Ippolito, Domenico, Sparaco, Maddalena, Cepparulo, Simone, Lus, Giacomo, Viterbo, Rosa, Clerico, Marinella, Trojsi, Francesca, Ragonese, Paolo, Borriello, Giovanna, Signoriello, Elisabetta, Palladino, Raffaele, Moccia, Marcello, Brigo, Francesco, Troiano, Maria, Tedeschi, Gioacchino, and Bonavita, Simona

Published
2022
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18. Correction to: Disability assessment using Google Maps

Author

Lavorgna, Luigi, Iaffaldano, Pietro, Abbadessa, Gianmarco, Lanzillo, Roberta, Esposito, Sabrina, Ippolito, Domenico, Sparaco, Maddalena, Cepparulo, Simone, Lus, Giacomo, Viterbo, Rosa, Clerico, Marinella, Trojsi, Francesca, Ragonese, Paolo, Borriello, Giovanna, Signoriello, Elisabetta, Palladino, Raffaele, Moccia, Marcello, Brigo, Francesco, Troiano, Maria, Tedeschi, Gioacchino, and Bonavita, Simona

Published
2022
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19. Pain, quality of life, and religiosity in people with multiple sclerosis

Author

Abbadessa Gianmarco, Bonavita Simona, Trojsi Francesca, Sparaco Maddalena, Lavorgna Luigi, Miele Giuseppina, Ippolito Domenico, Sparaco, Maddalena, Miele, Giuseppina, Abbadessa, Gianmarco, Ippolito, Domenico, Trojsi, Francesca, Lavorgna, Luigi, and Bonavita, Simona

Subjects
Multiple Sclerosis, Visual analogue scale, media_common.quotation_subject, Pain, Dermatology, Religiosity, Faith, Quality of life (healthcare), Surveys and Questionnaires, Spirituality, Humans, Medicine, Multiple sclerosi, media_common, Expanded Disability Status Scale, business.industry, Multiple sclerosis, General Medicine, medicine.disease, Prayer, Religion, Psychiatry and Mental health, Quality of Life, Neurology (clinical), business, Clinical psychology
Abstract

Purpose To investigate in multiple sclerosis (MS) patients, the relationship between pain and religiosity and to determine whether distinct dimensions of religiosity were associated with quality of life. Methods MS patients during clinical follow-up filled out the visual analogue scale for pain (VAS), the Mc Gill questionnaire (McGQ), the 36-Item Short Form Health Survey (SF-36), and the religious attitude scale (RAS), and expanded disability status scale (EDSS) was assessed. Results Ninety-two MS patients were enrolled, only two declined. There was a negative correlation between religious practice and faith and some domains of the SF-36 and a positive correlation between sensory, affective, and evaluative aspects of pain (at McGQ) and religious practices, and between evaluative aspects of pain (at McGQ) and faith. EDSS was significantly higher in practitioner believers compared to not practitioners. Conclusions More disabled MS patients, with worse quality of life, also due to physical pain, find a source of comfort in faith and religious practices. Pain is not relieved by prayer; therefore, we may guess that in MS the poor beneficial effect of religiosity and practice on pain perception may be linked to a structural/functional damage of neural circuits involved in reducing pain during prayer.

Published
2021

20. Unmet needs and gaps in the identification of secondary progression in multiple sclerosis: a Southern Italy healthcare professionals’ perspective

Author

Lus, Giacomo, primary, Bassano, Marco André, additional, Brescia Morra, Vincenzo, additional, Bonavita, Simona, additional, Gallo, Antonio, additional, Maimone, Davide, additional, Malerba, Laura, additional, Maniscalco, Giorgia Teresa, additional, Saccà, Francesco, additional, Salemi, Giuseppe, additional, Turrini, Renato, additional, Cottone, Salvatore, additional, Sessa, Edoardo, additional, Buccafusca, Maria, additional, and Grimaldi, Luigi Maria Edoardo, additional

Published
2022
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22. Telemedicine for management of patients with amyotrophic lateral sclerosis through COVID-19 tail

Author

Bombaci, Alessandro, Abbadessa, Gianmarco, Trojsi, Francesca, Leocani, Letizia, Bonavita, Simona, Lavorgna, Luigi, Gioacchino Tedeschi, Giovanni Mancardi, Alessandro Padovani, Marinella Clerico, Francesco Brigo, Roberta Lanzillo, Antonio Russo, Bruno Giometto, Giulia Straccia, Rosa Iodice, Sebastiano Bucello, Pietro Annovazzi, Marcello Moccia, Luca Prosperini, Maria Laura Stromillo, Anna Maria Repice, Giuseppina Miele, Alberto Lerario, Antonio De Martino, Francesco Iodice, Francesco Di Lorenzo, Luca Cuffaro, Michele Romoli, Marcello Silvestro, Carlo Alberto Artusi, Bombaci, Alessandro, Abbadessa, Gianmarco, Trojsi, Francesca, Leocani, Letizia, Bonavita, Simona, Lavorgna, Luigi, Bombaci, A., Abbadessa, G., Trojsi, F., Leocani, L., Bonavita, S., Lavorgna, L., Tedeschi, G., Mancardi, G., Padovani, A., Clerico, M., Brigo, F., Lanzillo, R., Russo, A., Giometto, B., Straccia, G., Iodice, R., Bucello, S., Annovazzi, P., Moccia, M., Prosperini, L., Stromillo, M. L., Repice, A. M., Miele, G., Lerario, A., De Martino, A., Iodice, F., Di Lorenzo, F., Cuffaro, L., Romoli, M., Silvestro, M., Artusi, C. A., Bombaci, A, Abbadessa, G, Trojsi, F, Leocani, L, Bonavita, S, Lavorgna, L, Tedeschi, G, Mancardi, G, Padovani, A, Clerico, M, Brigo, F, Lanzillo, R, Russo, A, Giometto, B, Straccia, G, Iodice, R, Bucello, S, Annovazzi, P, Moccia, M, Prosperini, L, Stromillo, M, Repice, A, Miele, G, Lerario, A, De Martino, A, Iodice, F, Di Lorenzo, F, Cuffaro, L, Romoli, M, Silvestro, M, Artusi, C, Alessandro, Bombaci, Gianmarco, Abbadessa, Francesca, Trojsi, Letizia, Leocani, Simona, Bonavita, Luigi, Lavorgna, Tedeschi, Gioacchino, Mancardi, Giovanni, Padovani, Alessandro, Clerico, Marinella, Brigo, Francesco, Lanzillo, Roberta, Russo, Antonio, Giometto, Bruno, Straccia, Giulia, Iodice, Rosa, Bucello, Sebastiano, Annovazzi, Pietro, Moccia, Marcello, Prosperini, Luca, Laura Stromillo, Maria, Maria Repice, Anna, Miele, Giuseppina, Lerario, Alberto, De Martino, Antonio, Iodice, Francesco, Di Lorenzo, Francesco, Cuffaro, Luca, Romoli, Michele, Silvestro, Marcello, and Alberto Artusi, Carlo

Subjects
medicine.medical_specialty, Telemedicine, Neurology, Coronavirus disease 2019 (COVID-19), Clinical Neurology, Monitoring, Ambulatory, Context (language use), Disease, Review Article, Dermatology, Tele-health, Teleneurology, ALS patients, COVID-19, Remote monitoring, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, Humans, 030212 general & internal medicine, Amyotrophic lateral sclerosis, Intensive care medicine, business.industry, Amyotrophic Lateral Sclerosis, General Medicine, medicine.disease, Psychiatry and Mental health, ALS patient, Neurology (clinical), Neurosurgery, business, 030217 neurology & neurosurgery
Abstract

Over the last months, due to coronavirus disease (COVID-19) pandemic, containment measures have led to important social restriction. Healthcare systems have faced a complete rearrangement of resources and spaces, with the creation of wards devoted to COVID-19 patients. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. Telemedicine may allow meet the needs of these patients. In this commentary, we briefly discuss the digital tools to remotely monitor and manage ALS patients. Focusing on detecting disease progression and preventing life-threatening conditions, we propose a toolset able to improve ALS management during this unprecedented situation.

Published
2020
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25. Correction to: Disability assessment using Google Maps

Author

Lavorgna, Luigi, primary, Iaffaldano, Pietro, additional, Abbadessa, Gianmarco, additional, Lanzillo, Roberta, additional, Esposito, Sabrina, additional, Ippolito, Domenico, additional, Sparaco, Maddalena, additional, Cepparulo, Simone, additional, Lus, Giacomo, additional, Viterbo, Rosa, additional, Clerico, Marinella, additional, Trojsi, Francesca, additional, Ragonese, Paolo, additional, Borriello, Giovanna, additional, Signoriello, Elisabetta, additional, Palladino, Raffaele, additional, Moccia, Marcello, additional, Brigo, Francesco, additional, Troiano, Maria, additional, Tedeschi, Gioacchino, additional, and Bonavita, Simona, additional

Published
2021
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26. Multiple sclerosis and genetic polymorphisms in fibrinogen-mediated hemostatic pathways: a case–control study

Author

Abbadessa, Gianmarco, primary, Miele, Giuseppina, additional, Di Pietro, Andrea, additional, Sparaco, Maddalena, additional, Palladino, Raffaele, additional, Armetta, Ignazio, additional, D’Elia, Giovanna, additional, Trojsi, Francesca, additional, Signoriello, Elisabetta, additional, Lus, Giacomo, additional, Lavorgna, Luigi, additional, and Bonavita, Simona, additional

Published
2021
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27. Disability assessment using Google Maps

Author

Lavorgna, Luigi, primary, Iaffaldano, Pietro, additional, Abbadessa, Gianmarco, additional, Lanzillo, Roberta, additional, Esposito, Sabrina, additional, Ippolito, Domenico, additional, Sparaco, Maddalena, additional, Cepparulo, Simone, additional, Lus, Giacomo, additional, Viterbo, Rosa, additional, Clerico, Marinella, additional, Trojsi, Francesca, additional, Ragonese, Paolo, additional, Borriello, Giovanna, additional, Signoriello, Elisabetta, additional, Palladino, Raffaele, additional, Moccia, Marcello, additional, Brigo, Francesco, additional, Troiano, Maria, additional, Tedeschi, Gioacchino, additional, and Bonavita, Simona, additional

Published
2021
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28. Singular cases of Alzheimer’s disease disclose new and old genetic “acquaintances”

Author

Coppola, Cinzia, primary, Saracino, Dario, additional, Oliva, Mariano, additional, Cipriano, Lorenzo, additional, Puoti, Gianfranco, additional, Pappatà, Sabina, additional, Di Fede, Giuseppe, additional, Catania, Marcella, additional, Ricci, Martina, additional, Cimini, Sara, additional, Giaccone, Giorgio, additional, Bonavita, Simona, additional, and Rossi, Giacomina, additional

Published
2020
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30. How to manage with telemedicine people with neuromuscular diseases?

Author

Spina, Emanuele, Trojsi, Francesca, Tozza, Stefano, Iovino, Aniello, Iodice, Rosa, Passaniti, Carla, Abbadessa, Gianmarco, Bonavita, Simona, Leocani, Letizia, Tedeschi, Gioacchino, Manganelli, Fiore, and Lavorgna, Luigi

Abstract

Introduction: COVID-19 pandemic radically transformed our daily clinical practice, raising the need not to lose close contact with patients without being able to see them face-to-face. These issues are even more felt and evident in fragile patients, as those affected by neuromuscular disease. An important help came from new digital technologies that allow clinicians to remotely monitor health status and any deterioration of chronically ill patients. Methods: In this mini-review, an initiative of the "Digital Technologies, Web and Social Media Study Group" of the Italian Society of Neurology, we propose to analyze the approach to neuromuscular patients by looking over raising evidence on the main cornerstones of Telemedicine (TM): clinician-patient interaction, remote clinical assessment, remote monitoring, and digital therapeutics. In particular, we explored the strategies developed by researchers and their impact on the physical and emotional status of the patients, with particular focusing on their adherence to the program of virtual monitoring. Results: TM plays an important role in each of four stages of approach to neuromuscular disease, having demonstrated validity in keep close clinical patient interaction, clinical assessment, remote monitoring, and telerehabilitation. Nevertheless, there is no remote alternative to electrophysiological testing neither validate tools to assess disability. Conclusion: The role of TM in neuromuscular care is yet underestimated but is crucial, beyond the pandemic era. Further development of TM is advisable, through making specific apps, remotely controlled by clinicians, and making more engaging clinicians-patients interaction. Last, it is necessary to ensure adequate internet access to everyone. [ABSTRACT FROM AUTHOR]

Published
2021
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32. Stroke and digital technology: a wake-up call from COVID-19 pandemic.

Author

Iodice, Francesco, Romoli, Michele, Giometto, Bruno, Clerico, Marinella, Tedeschi, Gioacchino, Bonavita, Simona, Leocani, Letizia, and Lavorgna, Luigi

Subjects
COVID-19 pandemic, DIGITAL technology, STROKE, SOCIAL sciences education, SARS-CoV-2
Abstract

Introduction: The pandemic has implemented the need for new digital technologies as useful tools during the emergency and the long recovery phase that will follow. SARS-CoV-2 has strongly impacted stroke care with significant contraction in a number of patients treated. Methods: This mini-review is an initiative of the "Digital Technologies, Web and Social Media Study Group" of the Italian Society of Neurology and briefly discusses digital tools for managing the acute phase and the rehabilitation after stroke, even considering the new apps that will improve the process of remote monitoring of patients after discharge at home. Results: Telemedicine and digital technologies could play a role in each of the three stroke-belt stages: hyperacute treatment and reperfusion, acute care, etiological classification and secondary prevention and rehabilitation. Conclusion: The global emergency represented by the COVID-19 pandemic can be the stimulus to accelerate the digitalization process in the field of stroke for the use of new methods on a large scale. [ABSTRACT FROM AUTHOR]

Published
2021
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33. Telemedicine for management of patients with amyotrophic lateral sclerosis through COVID-19 tail.

Author

Bombaci, Alessandro, Abbadessa, Gianmarco, Trojsi, Francesca, Leocani, Letizia, Bonavita, Simona, Lavorgna, Luigi, on behalf of the Digital Technologies, Web and Social Media Study Group of the Italian Society of Neurology, Tedeschi, Gioacchino, Mancardi, Giovanni, Padovani, Alessandro, Clerico, Marinella, Brigo, Francesco, Lanzillo, Roberta, Russo, Antonio, Giometto, Bruno, Straccia, Giulia, Iodice, Rosa, Bucello, Sebastiano, Annovazzi, Pietro, and Moccia, Marcello

Subjects
AMYOTROPHIC lateral sclerosis, COVID-19, TELEMEDICINE, NEUROLOGICAL disorders, EXTRATERRESTRIAL resources
Abstract

Over the last months, due to coronavirus disease (COVID-19) pandemic, containment measures have led to important social restriction. Healthcare systems have faced a complete rearrangement of resources and spaces, with the creation of wards devoted to COVID-19 patients. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. Telemedicine may allow meet the needs of these patients. In this commentary, we briefly discuss the digital tools to remotely monitor and manage ALS patients. Focusing on detecting disease progression and preventing life-threatening conditions, we propose a toolset able to improve ALS management during this unprecedented situation. [ABSTRACT FROM AUTHOR]

Published
2021
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34. A simple measure of cognitive reserve is relevant for cognitive performance in MS patients

Author

Della Corte, Marida, primary, Santangelo, Gabriella, additional, Bisecco, Alvino, additional, Sacco, Rosaria, additional, Siciliano, Mattia, additional, d’Ambrosio, Alessandro, additional, Docimo, Renato, additional, Cuomo, Teresa, additional, Lavorgna, Luigi, additional, Bonavita, Simona, additional, Tedeschi, Gioacchino, additional, and Gallo, Antonio, additional

Published
2018
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36. Assessing disability and relapses in multiple sclerosis on tele-neurology.

Author

Moccia, Marcello, Lanzillo, Roberta, Brescia Morra, Vincenzo, Bonavita, Simona, Tedeschi, Gioacchino, Leocani, Letizia, Lavorgna, Luigi, and Digital Technologies Web and Social Media Study Group of the Italian Society of Neurology

Subjects
COVID-19, DISABILITIES, MULTIPLE sclerosis, COGNITIVE testing, CHRONIC diseases
Abstract

Background: As a consequence of the coronavirus disease 2019 (COVID-19) pandemic, a large amount of consultations will be delivered through tele-medicine, especially for diseases causing chronic disability and requiring immunomodulatory treatments, such as multiple sclerosis (MS).Methods: We have hereby reviewed available tools for tele-neurology examination in MS, including components of neurological examination that can be assessed through video, patient-reported outcome measures (PROMs), and digital technology.Results: Overall, we have suggested a battery for assessing MS disability and relapses on tele-medicine, which brings together conventional examination, PROMs (e.g., Patient Determined Disease Steps, MS Impact Scale), and cognitive tests (Symbol Digit Modalities Test) that can be delivered remotely and in multiple languages.Discussion: The use of common tools for neurological examination could improve tele-neurology practice for both general neurologists and MS specialists, and quality of care for people with MS. [ABSTRACT FROM AUTHOR]

Published
2020
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38. MRI and steroid-responsive encephalopathy associated with autoimmune thyroiditis: first report of conus medullaris involvement and literature review of the known neuroimaging profiles

Author

Lorenzo Cipriano, Giuseppina Miele, Lorenzo Ugga, Gianmarco Abbadessa, Ferdinando Caranci, Simona Bonavita, Cipriano, Lorenzo, Miele, Giuseppina, Ugga, Lorenzo, Abbadessa, Gianmarco, Caranci, Ferdinando, and Bonavita, Simona

Subjects
Psychiatry and Mental health, Conus medullari, SREAT, Neurology (clinical), Dermatology, General Medicine, Encephalopathy, Hashimoto
Abstract

BackgroundSteroid-responsiveencephalopathy associated with autoimmune thyroiditis (SREAT) is a rare butpotentially reversible autoimmune encephalopathy. The most frequentneuroimaging correlates are normal brain MRI or non-specific white matterhyperintensities.MethodsWe present the first description of conus medullaris involvement, also providing an extensive review of MRI patterns described so far.ResultsOur results show that in less than 30% of cases, it is possible to find focal SREAT neuroanatomical correlates. Among these, T2w/FLAIR temporal hyperintensities are the most frequent, followed by basal ganglia/thalamic and brainstem involvement, respectively.ConclusionsUnfortunately, spinal cord investigation is an uncommon practice in the diagnostic approach of encephalopathies, thus neglecting potential pathological lesions of the medulla spinalis. In our opinion, the extension of the MRI study to the cervical, thoracic, and lumbosacral regions may allow finding new, and hopefully specific, anatomical correlates.

Published
2023

39. Dementia care and COVID-19 pandemic: a necessary digital revolution

Author

Gioacchino Tedeschi, Francesco Di Lorenzo, Luca Cuffaro, Letizia Leocani, Luigi Lavorgna, Simona Bonavita, Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L., Lavorgna, L., Cuffaro, L, Di Lorenzo, F, Bonavita, S, Tedeschi, G, Leocani, L, Lavorgna, L, Cuffaro, Luca, Di Lorenzo, Francesco, Bonavita, Simona, Tedeschi, Gioacchino, Leocani, Letizia, and Lavorgna, Luigi

Subjects
Telemedicine, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Clinical Neurology, Dermatology, Teleneurology, computer.software_genre, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Videoconferencing, Pandemic, mental disorders, medicine, Digital technology, Dementia, Humans, 030212 general & internal medicine, Pandemics, COVID, business.industry, SARS-CoV-2, COVID-19, General Medicine, medicine.disease, Psychiatry and Mental health, Neurology, Smartphone app, Neurology (clinical), Medical emergency, Smartphone, business, Coronavirus Infections, Digital Revolution, computer, Alzheimer’s disease, 030217 neurology & neurosurgery, Clinical progression
Abstract

Due to the COVID-19 pandemic, most memory clinics have had to suspend their activities. On the other hand, international dementia experts have recommended to provide urgently worldwide support for people living with dementia. This situation urges to play out new strategies to guarantee adequate care. Telemedicine and digital technology (DT) devices, such as smartphones, can be very helpful in remote monitoring and care. Technological devices such as videoconference or smartphone apps might be used for follow-up visits and support to patients and caregivers and to acquire digital markers of clinical progression. Hopefully, this dramatic situation would facilitate the process of progressive familiarization of neurologists with telemedicine and DT approach.

Published
2020
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40. BDNF Val66Met polymorphism and brain volumes in multiple sclerosis

Author

Laura Marcuccio, Antonio Russo, Marco Comerci, M. L. De Bonis, Alessandro Tessitore, G. Tedeschi, D. Dinacci, Simona Bonavita, Bruno Alfano, G. Servillo, Luigi Lavorgna, O. Picconi, Rosaria Sacco, Antonio Gallo, Patrizia Galletti, Dinacci, D, Tessitore, Alessandro, Russo, Antonio, DE BONIS, Ml, Lavorgna, L, Picconi, O, Sacco, R, Bonavita, Simona, Gallo, Antonio, Servillo, G, Marcuccio, L, Comerci, M, Galletti, P, Alfano, B, and Tedeschi, Gioacchino

Subjects
Adult, Male, Brain atrophy, medicine.medical_specialty, Multiple Sclerosis, Neurology, Adolescent, Genotype, DNA Mutational Analysis, Dermatology, Polymorphism, Single Nucleotide, White matter, Disability Evaluation, Young Adult, Methionine, Atrophy, Gene Frequency, Internal medicine, Image Processing, Computer-Assisted, medicine, Humans, Allele, Pathological, Brain-derived neurotrophic factor, Analysis of Variance, BDNF polymorphism, Brain-Derived Neurotrophic Factor, Multiple sclerosis, Brain, Valine, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Psychiatry and Mental health, medicine.anatomical_structure, Endocrinology, Case-Control Studies, Regression Analysis, Female, Neurology (clinical), Psychology, Neuroscience, MRI
Abstract

Brain derived neurotrophic factor (BDNF) regulates several CNS physiological and pathological processes. To investigate in multiple sclerosis (MS) patients, the relationship between the Val66Met polymorphism of BDNF and clinical markers of disease activity and MRI markers of focal and diffuse brain pathologies. 45 MS patients and 34 healthy controls (HCs) were genotyped and subjected to clinical-MRI examination. Global white matter fraction (gWM-f), gray matter-f (GM-f), cerebrospinal fluid-f (CSF-f), and abnormal WM-f were measured. We studied 26 Val/Val and 19 Val/Met patients and 23 Val/Val and 11 Val/Met HCs. We found that Val/Val patients had lower GM-f and higher CSF-f than Val/Val HCs; such differences were not statistically significant comparing Val/Met patients to HCs. The regression analysis showed that both Val/Met genotype and relapse number were associated with lower CSF-f. Our data suggest that Met allele might be a protective factor against MS as it is associated to a lower brain atrophy.

Published
2010

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