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Observational prospective population-based incidence study. The main objective of this study was to assess the incidence of traumatic spinal cord injuries (TSCIs) and incidence rates, in order to provide estimates by age, gender, characteristics and cause. This study was conducted at acute-care spinal cord injury (SCI) hospitals and SCI centers from 11 Italian regions, between 1 October 2013 and 30 September 2014. Data of all consecutive patients with acute TSCI who met the inclusion criteria were obtained through case reporting by clinicians. The data were collected into a web database. Incidence rates and incidence rate ratios were calculated and stratified by age, gender, cause, level and completeness. From 50% of the entire population of Italy, 445 new cases of TSCI were included. The crude incidence rate of TSCI was 14.7 cases per million per year (95% CI: 13.4–16.4); the overall male to female ratio was 4:1 and the mean age was 54. Complete information was available in 85% of the sample and revealed tetraplegia in 58% and incomplete lesion in 67% of cases. The leading cause of TSCI was falls (40.9%) followed by road traffic accidents (33.5%). The leading cause was falls for patients over 55 and road traffic accidents for patients under 55. The changing trend of TSCI epidemiology concerns the increase in the average age of TSCI people and the increase of both cervical and incomplete lesions. The etiology shows the primacy of falls over road traffic accidents and suggests the need for a change in prevention policies.

Background Intermittent self catheterization questionnaire (ISC-Q) is a questionnaire exploring four issues related to self-intermittent catheterization (ISC): ease of use, convenience, discreteness and psychological well-being. The aim of the study was to develop and validate the Italian version of the ISC-Q. Methods Two independent translations of the ISC-Q were performed and compared by an expert committee. A back translation to English was made by a linguistic expert, blinded to the original version. Patients using ISC to void their bladder were from 19 different spinal cord units; questionnaires were examined anonymously in a single center. A subgroup of 47 patients repeated the test at 2 weeks distance and completed the Qualiveen questionnaire to assess the convergent validity of ISC-Q. The internal consistency was determined from Cronbach's α coefficient. Criterion validity was determined through the concurrent use of Qualiveen. Reliability was performed by Intraclass Correlation Coefficient and test-retest. The sensitivity was determined by the effect size-based estimate for small change (ES) and Minimal Detectable Change 95 (MDC95). In the study 217 subjects (65.6% males, 34.4% females) were enrolled. Mean age: 43±10.1 years. Mean duration of ISC: 3.3±6.9 years. Results Cronbach's α ranged from 0.79 to 0.81. Pearson correlation between the different parts of ISC-Q and total score ranged from 0.24 to 0.78. ICC values were higher than 0.9. Convergent validity was faint to null. ES ranged from 3.8 to 6 points. MDC95 ranged from 4.1 to 12.1. Conclusions The Italian ISC-Q has the same psychometric characteristics of the original questionnaire. ISC-Q is a valid, reliable and sensitive patient related outcome, specifically focused on ISC. our work provides a new validated measure for Italian patients to explore in future studies the role and impact of ISC.

Twelve ataxic subjects (seven with Friedreich's heredo-ataxia and five with a cerebellar vascular or traumatic lesion) were examined by way of urodynamic evaluation. The results explain the role the cerebellum plays in the modulation of the micturition reflex and confirm the importance of bilateral encephalic damage in causing vesico-sphincteral malfunctioning and the important role of the lateral myelon cords in transporting bladder proprioceptive sensitivity.

Attention impairments are frequent in stroke patients with important consequences on the rehabilitation outcomes and quality of life. The aim of the study was to perform a comprehensive assessment of selective and intensive attention processes in a large population of brain-damaged patients, evaluating the influence of the side and site of the brain lesion, the time from stroke, and the concomitant presence of aphasia or neglect. We assessed 204 patients with a first unilateral brain lesion and 42 healthy individuals with three subtests of the Test of Attentional Performance (TAP): Alertness, Go-No Go, and Divided Attention. 44.4% of patients had an impairment in both intensive and selective aspects of attention, 5.6% had deficits only in the intensive component, and 31.8% had deficits only in selective tasks. More than 80% of the patients fell below the cut-off point on at least one task. Patients with a right hemispheric lesion (RHL) were more impaired than patients with a left hemispheric lesion (LHL) especially in tonic and phasic alertness. Patients with total anterior infarcts (TACI) presented the worst profile compared to other stroke subtypes, with a difference between total and lacunar subtypes in the Alertness test, independent of the presence of warning. Patients in the chronic phase had shorter RTs than acute patients only in the Alertness test. In patients with LHL, the presence of aphasia was associated with a greater deficit in selective attention. In patients with RHL, the presence of unilateral neglect was associated with impaired alertness and selective attention. Attention deficits are common after a unilateral first stroke. In keeping with the hierarchical organization of attention functions, results confirm the important role of the right hemisphere for the intensive components of attention, also highlighting the involvement of left hemisphere functioning for the selective aspects, possibly indicating a role of its linguistic functions.