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1. Signs and symptoms of COVID-19 in patients with multiple sclerosis

Author

Schiavetti I., Carmisciano L., Ponzano M., Cordioli C., Cocco E., Marfia G. A., Inglese M., Filippi M., Radaelli M., Bergamaschi R., Immovilli P., Capobianco M., De Rossi N., Brichetto G., Scandellari C., Cavalla P., Pesci I., Confalonieri P., Perini P., Trojano M., Lanzillo R., Tedeschi G., Comi G., Battaglia M. A., Patti F., Salvetti M., Sormani M. P., Abbadessa G., Aguglia U., Allegorico L., Rossi Allegri B. M., Alteno A., Amato M. P., Annovazzi P., Antozzi C., Appendino L., Arena S., Baione V., Balgera R., Barcella V., Baroncini D., Barrila C., Bellacosa A., Bellucci G., Bergamaschi V., Bezzini D., Biolzi B., Bisecco A., Bonavita S., Borriello G., Bosa C., Bosco A., Bovis F., Bozzali M., Brambilla L., Brescia Morra V., Buccafusca M., Bucciantini E., Bucello S., Buscarinu M. C., Cabboi M. P., Calabrese M., Calabria F., Caleri F., Camilli F., Caniatti L. M., Cantello R., Capra R., Capuano R., Carta P., Celani M. G., Cellerino M., Cerqua R., Chisari C., Clerici R., Clerico M., Cola G., Conte A., Conti M. Z., Cordano C., Cordera S., Corea F., Correale C., Cottone S., Crescenzo F., Curti E., d'Ambrosio A., D'Amico E., Danni M. C., d'Arma A., Dattola V., de Biase S., De Luca G., De Mercanti S. F., De Mitri P., De Stefano N., Della Cava F. M., Cava M. D., Di Lemme S., di Napoli M., Di Sapio A., Docimo R., Dutto A., Evangelista L., Fanara S., Fantozzi R., Ferraro D., Ferro M. T., Fioretti C., Fratta M., Frau J., Fronza M., Furlan R., Gajofatto A., Gallo A., Gallo P., Gasperini C., Ghazaryan A., Giometto B., Gobbin F., Govone F., Granella F., Grange E., Grasso M. G., Grimaldi L. M. E., Guareschi A., Guaschino C., Guerrieri S., Guidetti D., Juergenson I. B., Iaffaldano P., Ianniello A., Iasevoli L., Imperiale D., Infante M. T., Iodice R., Iovino A., Konrad G., Landi D., Lapucci C., Lavorgna L., L'Episcopo M. R., Leva S., Liberatore G., Lo Re M., Longoni M., Lopiano L., Lorefice L., Lucchini M., Lus G., Maimone D., Malentacchi M., Mallucci G., Malucchi S., Mancinelli C. R., Mancinelli L., Manganotti P., Maniscalco G. T., Mantero V., Marangoni S., Marastoni D., Marinelli F., Marti A., Boneschi Martinelli F., Masserano Z. F., Matta F., Mendozzi L., Meucci G., Miante S., Miele G., Milano E., Mirabella M., Missione R., Moccia M., Moiola L., Montepietra S., MontiBragadin M., Montini F., Motta R., Nardone R., Gabri Nicoletti C., Nobile-Orazio E., Nozzolillo A., Onofrj M., Orlandi R., Palmieri A., Paolicelli D., Pasquali L., Pasto L., Pedrazzoli E., Petracca M., Petrone A., Piantadosi C., Pietroboni A. M., Pinardi F., Portaccio E., Pozzato M., Pozzilli C., Prosperini L., Protti A., Ragonese P., Rasia S., Realmuto S., Repice A., Rigoni E., Rilla M. T., Rinaldi F., Romano C. M., Ronzoni M., Rovaris M., Ruscica F., Sabattini L., Salemi G., Saraceno L., Sartori A., Sbragia E., Scarano G. I., Scarano V., Sessa M., Sgarito C., Sibilia G., Siciliano G., Signori A., Signoriello E., Sinisi L., Sireci F., Sola P., Solaro C., Sotgiu S., Sparaco M., Stromillo M. L., Strumia S., Susani E. L., Tabiadon G., Teatini F., Tomassini V., Tonietti S., Torri V., Tortorella C., Toscano S., Totaro R., Trotta M., Turano G., Ulivelli M., Valentino M., Vaula G., Vecchio D., Vercellino M., Verrengia E. P., Vianello M., Virgilio E., Vitetta F., Vollaro S., Zaffaroni M., Zampolini M., Zarbo I. R., Zito A., Zuliani L., Schiavetti, Irene, Carmisciano, Luca, Ponzano, Marta, Cordioli, Cinzia, Cocco, Eleonora, Marfia, Girolama Alessandra, Inglese, Matilde, Filippi, Massimo, Radaelli, Marta, Bergamaschi, Roberto, Immovilli, Paolo, Capobianco, Marco, De Rossi, Nicola, Brichetto, Giampaolo, Scandellari, Cinzia, Cavalla, Paola, Pesci, Ilaria, Confalonieri, Paolo, Perini, Paola, Trojano, Maria, Lanzillo, Roberta, Tedeschi, Gioacchino, Comi, Giancarlo, Battaglia, Mario Alberto, Patti, Francesco, Salvetti, Marco, Sormani, Maria Pia, Gianmarco, Abbadessa, Umberto, Aguglia, Allegorico, Lia, Beatrice Maria Rossi Allegri, Anastasia, Alteno, Amato, MARIA PIA, Pietro, Annovazzi, Carlo, Antozzi, Lucia, Appendino, Sebastiano, Arena, Viola, Baione, Roberto, Balgera, Valeria, Barcella, Damiano, Baroncini, Caterina, Barrilà, Alessandra, Bellacosa, Gianmarco, Bellucci, Valeria, Bergamaschi, Daiana, Bezzini, Beatrice, Biolzi, Bisecco, Alvino, Simona, Bonavita, Giovanna, Borriello, Chiara, Bosa, Antonio, Bosco, Francesca, Bovi, Marco, Bozzali, Laura, Brambilla, BRESCIA MORRA, Vincenzo, Maria, Buccafusca, Elisabetta, Bucciantini, Sebastiano, Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano, Calabrese, Francesca, Calabria, Francesca, Caleri, Federico, Camilli, Luisa Maria Caniatti, Roberto, Cantello, Ruggero, Capra, Rocco, Capuano, Patrizia, Carta, Maria Grazia Celani, Maria, Cellerino, Raffaella, Cerqua, Clara, Chisari, Raffaella, Clerici, Marinella, Clerico, Gaia, Cola, Antonella, Conte, Marta Zaffira Conti, Christian, Cordano, Susanna, Cordera, Francesco, Corea, Claudio, Correale, Salvatore, Cottone, Francesco, Crescenzo, Erica, Curti, Alessandro, D’Ambrosio, Emanuele, D’Amico, Maura Chiara Danni, Alessia, D’Arma, Vincenzo, Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Stefano, Fabio Maria Della Cava, Marco Della Cava, Sonia Di Lemme, Mario di Napoli, Alessia Di Sapio, Renato, Docimo, Anna, Dutto, Luana, Evangelista, Salvatore, Fanara, Roberta, Fantozzi, Diana, Ferraro, Maria Teresa Ferrò, Cristina, Fioretti, Mario, Fratta, Jessica, Frau, Marzia, Fronza, Roberto, Furlan, Alberto, Gajofatto, Gallo, Antonio, Paolo, Gallo, Claudio, Gasperini, Anna, Ghazaryan, Bruno, Giometto, Francesca, Gobbin, Flora, Govone, Franco, Granella, Erica, Grange, Grasso, MARIA GRAZIA, Grimaldi, Luigi M. E., Angelica, Guareschi, Clara, Guaschino, Simone, Guerrieri, Donata, Guidetti, Ina Barbara Juergenson, Pietro, Iaffaldano, Ianniello, Antonio, Luigi, Iasevoli, Daniele, Imperiale, Maria Teresa Infante, Iodice, Rosa, Iovino, Aniello, Giovanna, Konrad, Doriana, Landi, Caterina, Lapucci, Luigi, Lavorgna, Maria Rita L’Episcopo, Serena, Leva, Giuseppe, Liberatore, Marianna Lo Re, Marco, Longoni, Leonardo, Lopiano, Lorena, Lorefice, Matteo, Lucchini, Lus, Giacomo, Maimone, Davide, Maria, Malentacchi, Giulia, Mallucci, Simona, Malucchi, Chiara Rosa Mancinelli, Luca, Mancinelli, Paolo, Manganotti, Giorgia Teresa Maniscalco, Vittorio, Mantero, Sabrina, Marangoni, Damiano, Marastoni, Fabiana, Marinelli, Marti, NICOLA ALESSANDRO, Filippo Boneschi Martinelli, Zoli Federco Masserano, Francesca, Matta, Laura, Mendozzi, Giuseppe, Meucci, Silvia, Miante, Giuseppina, Miele, Eva, Milano, Massimiliano, Mirabella, Rosanna, Missione, Moccia, Marcello, Lucia, Moiola, Sara, Montepietra, Margherita, Montibragadin, Federico, Montini, Roberta, Motta, Raffaele, Nardone, Carolina Gabri Nicoletti, Eduardo, Nobile‐orazio, Nozzolillo, Agostino, Marco, Onofrj, Riccardo, Orlandi, Anna, Palmieri, Damiano, Paolicelli, Livia, Pasquali, Luisa, Pastò, Elisabetta, Pedrazzoli, Petracca, Maria, Alfredo, Petrone, Carlo, Piantadosi, Pietroboni, Anna M., Federica, Pinardi, Emilio, Portaccio, Mattia, Pozzato, Pozzilli, Carlo, Luca, Prosperini, Alessandra, Protti, Paolo, Ragonese, Sarah, Rasia, Sabrina, Realmuto, Anna, Repice, Eleonora, Rigoni, Maria Teresa Rilla, DELLA RATTA RINALDI, Francesca, Calogero Marcello Romano, Marco, Ronzoni, Marco, Rovari, Francesca, Ruscica, Loredana, Sabattini, Giuseppe, Salemi, Lorenzo, Saraceno, Alessia, Sartori, Arianna, Sartori, Elvira, Sbragia, Giuditta Ilaria Scarano, Valentina, Scarano, Maria, Sessa, Caterina, Sgarito, Sibilia, Grazia, Gabriele, Siciliano, Alessio, Signori, Signoriello, Elisabetta, Sinisi, Leonardo, Francesca, Sireci, Patrizia, Sola, Claudio, Solaro, Stefano, Sotgiu, Maddalena, Sparaco, Maria Laura Stromillo, Silvia, Strumia, Emanuela Laura Susani, Giulietta, Tabiadon, Francesco, Teatini, Valentina, Tomassini, Simone, Tonietti, Valentina, Torri, Tortorella, Carla, Simona, Toscano, Rocco, Totaro, Maria, Trotta, Gabriella, Turano, Monica, Ulivelli, Manzo, Valentino, Giovanna, Vaula, Domizia, Vecchio, Marco, Vercellino, Elena Pinuccia Verrengia, Marika, Vianello, Eleonora, Virgilio, Francesca, Vitetta, Vollaro, Stefano, Mauro, Zaffaroni, Mauro, Zampolini, Ignazio Roberto Zarbo, Antonio, Zito, and Luigi Zuliani, Schiavetti, I., Carmisciano, L., Ponzano, M., Cordioli, C., Cocco, E., Marfia, G. A., Inglese, M., Filippi, M., Radaelli, M., Bergamaschi, R., Immovilli, P., Capobianco, M., De Rossi, N., Brichetto, G., Scandellari, C., Cavalla, P., Pesci, I., Confalonieri, P., Perini, P., Trojano, M., Lanzillo, R., Tedeschi, G., Comi, G., Battaglia, M. A., Patti, F., Salvetti, M., Sormani, M. P., Abbadessa, G., Aguglia, U., Allegorico, L., Rossi Allegri, B. M., Alteno, A., Amato, M. P., Annovazzi, P., Antozzi, C., Appendino, L., Arena, S., Baione, V., Balgera, R., Barcella, V., Baroncini, D., Barrila, C., Bellacosa, A., Bellucci, G., Bergamaschi, V., Bezzini, D., Biolzi, B., Bisecco, A., Bonavita, S., Borriello, G., Bosa, C., Bosco, A., Bovis, F., Bozzali, M., Brambilla, L., Brescia Morra, V., Buccafusca, M., Bucciantini, E., Bucello, S., Buscarinu, M. C., Cabboi, M. P., Calabrese, M., Calabria, F., Caleri, F., Camilli, F., Caniatti, L. M., Cantello, R., Capra, R., Capuano, R., Carta, P., Celani, M. G., Cellerino, M., Cerqua, R., Chisari, C., Clerici, R., Clerico, M., Cola, G., Conte, A., Conti, M. Z., Cordano, C., Cordera, S., Corea, F., Correale, C., Cottone, S., Crescenzo, F., Curti, E., D'Ambrosio, A., D'Amico, E., Danni, M. C., D'Arma, A., Dattola, V., de Biase, S., De Luca, G., De Mercanti, S. F., De Mitri, P., De Stefano, N., Della Cava, F. M., Cava, M. D., Di Lemme, S., di Napoli, M., Di Sapio, A., Docimo, R., Dutto, A., Evangelista, L., Fanara, S., Fantozzi, R., Ferraro, D., Ferro, M. T., Fioretti, C., Fratta, M., Frau, J., Fronza, M., Furlan, R., Gajofatto, A., Gallo, A., Gallo, P., Gasperini, C., Ghazaryan, A., Giometto, B., Gobbin, F., Govone, F., Granella, F., Grange, E., Grasso, M. G., Grimaldi, L. M. E., Guareschi, A., Guaschino, C., Guerrieri, S., Guidetti, D., Juergenson, I. B., Iaffaldano, P., Ianniello, A., Iasevoli, L., Imperiale, D., Infante, M. T., Iodice, R., Iovino, A., Konrad, G., Landi, D., Lapucci, C., Lavorgna, L., L'Episcopo, M. R., Leva, S., Liberatore, G., Lo Re, M., Longoni, M., Lopiano, L., Lorefice, L., Lucchini, M., Lus, G., Maimone, D., Malentacchi, M., Mallucci, G., Malucchi, S., Mancinelli, C. R., Mancinelli, L., Manganotti, P., Maniscalco, G. T., Mantero, V., Marangoni, S., Marastoni, D., Marinelli, F., Marti, A., Boneschi Martinelli, F., Masserano, Z. F., Matta, F., Mendozzi, L., Meucci, G., Miante, S., Miele, G., Milano, E., Mirabella, M., Missione, R., Moccia, M., Moiola, L., Montepietra, S., Montibragadin, M., Montini, F., Motta, R., Nardone, R., Gabri Nicoletti, C., Nobile-Orazio, E., Nozzolillo, A., Onofrj, M., Orlandi, R., Palmieri, A., Paolicelli, D., Pasquali, L., Pasto, L., Pedrazzoli, E., Petracca, M., Petrone, A., Piantadosi, C., Pietroboni, A. M., Pinardi, F., Portaccio, E., Pozzato, M., Pozzilli, C., Prosperini, L., Protti, A., Ragonese, P., Rasia, S., Realmuto, S., Repice, A., Rigoni, E., Rilla, M. T., Rinaldi, F., Romano, C. M., Ronzoni, M., Rovaris, M., Ruscica, F., Sabattini, L., Salemi, G., Saraceno, L., Sartori, A., Sbragia, E., Scarano, G. I., Scarano, V., Sessa, M., Sgarito, C., Sibilia, G., Siciliano, G., Signori, A., Signoriello, E., Sinisi, L., Sireci, F., Sola, P., Solaro, C., Sotgiu, S., Sparaco, M., Stromillo, M. L., Strumia, S., Susani, E. L., Tabiadon, G., Teatini, F., Tomassini, V., Tonietti, S., Torri, V., Tortorella, C., Toscano, S., Totaro, R., Trotta, M., Turano, G., Ulivelli, M., Valentino, M., Vaula, G., Vecchio, D., Vercellino, M., Verrengia, E. P., Vianello, M., Virgilio, E., Vitetta, F., Vollaro, S., Zaffaroni, M., Zampolini, M., Zarbo, I. R., Zito, A., and Zuliani, L.

Subjects
Multiple Sclerosis, Anosmia, Clinical Sciences, neurological disorders, Neurodegenerative, Settore MED/26, demyelinating disease, COVID-19, demyelinating diseases, disease-modifying treatment, multiple sclerosis, Humans, neurological disorder, Aged, Neurology & Neurosurgery, SARS-CoV-2, Pain Research, Neurosciences, Brain Disorders, Settore MED/26 - NEUROLOGIA, Good Health and Well Being, Neurology, multiple sclerosi, Neurology (clinical), MuSC-19 Study Group, Ageusia, Human
Abstract

Background and purpose: Clinical outcomes of multiple sclerosis (MS) patients affected by coronavirus disease 2019 (COVID-19) have been thoroughly investigated, but a further analysis on main signs and symptoms and their risk factors still needs attention. The objective of this study was to group together and describe based on similarity the most common signs and symptoms of COVID-19 in MS patients and identify all factors associated with their manifestation. Method: Logistic and linear regression models were run to recognize factors associated with each pooled group of symptoms and their total number. Results: From March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of COVID-19. Ageusia and anosmia was less frequent in older people (odds ratio [OR] 0.98; p=0.005) and more in smoker patients (OR 1.39; p=0.049). Smoke was also associated with an incremental number of symptoms (OR 1.24; p=0.031), substance abuse (drugs or alcohol), conjunctivitis and rash (OR 5.20; p=0.042) and the presence of at least one comorbidity with shortness of breath, tachycardia or chest pain (OR 1.24; p=0.008). Some disease-modifying therapies were associated with greater frequencies of certain COVID-19 symptoms (association between anti-CD20 therapies and increment in the number of concomitant symptoms: OR 1.29; p=0.05). Differences in frequencies between the three waves were found for flu-like symptoms (G1, p=0.024), joint or muscle pain (G2, p=0.013) and ageusia and anosmia (G5, p < 0.001). All cases should be referred to variants up to Delta. Conclusion: Several factors along with the choice of specific therapeutic approaches might have a different impact on the occurrence of some COVID-19 symptoms.

Published
2022

2. Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis

Author

D'Amico E., Zanghi A., Sciandra M., Lanzillo R., Callari G., Cortese A., Lus G., Lucchini M., Buccafusca M., Bonavita S., Gallo A., Curti E., Gajofatto A., Signoriello E., Bisecco A., Gobbin F., Ferro M. T., Ferrazzano G., Sparaco M., Valentino P., Mirabella M., Granella F., Bresciamorra V., Grimaldi L. M. E., Patti F., Borriello G., Grossi P., Carotenuto A., Siena E., Tsantes E., Giugno A., Abbadessa G. M., Chisari C. G., D'Amico, Emanuele, Zanghì, Aurora, Sciandra, Mariangela, Lanzillo, Roberta, Callari, Graziella, Cortese, Antonio, Lus, Giacomo, Lucchini, Matteo, Buccafusca, Maria, Bonavita, Simona, Gallo, Antonio, Curti, Erica, Gajofatto, Alberto, Signoriello, Elisabetta, Bisecco, Alvino, Gobbin, Francesca, Ferrò, Maria Teresa, Ferrazzano, Gina, Sparaco, Maddalena, Valentino, Paola, Mirabella, Massimiliano, Granella, Franco, Brescia Morra, Vincenzo, Grimaldi, Luigi Maria Edoardo, Patti, Francesco, D'Amico, E., Zanghi, A., Sciandra, M., Lanzillo, R., Callari, G., Cortese, A., Lus, G., Lucchini, M., Buccafusca, M., Bonavita, S., Gallo, A., Curti, E., Gajofatto, A., Signoriello, E., Bisecco, A., Gobbin, F., Ferro, M. T., Ferrazzano, G., Sparaco, M., Valentino, P., Mirabella, M., Granella, F., Bresciamorra, V., Grimaldi, L. M. E., Patti, F., Borriello, G., Grossi, P., Carotenuto, A., Siena, E., Tsantes, E., Giugno, A., Abbadessa, G. M., and Chisari, C. G.

Subjects
Adult, Data Analysis, Male, medicine.medical_specialty, Neurology, Efficacy, Toluidines, Dimethyl Fumarate, Hydroxybutyrates, Relapsing-Remitting, Multiple sclerosis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, Internal medicine, Teriflunomide, Nitriles, medicine, Humans, Multiple sclerosi, 030212 general & internal medicine, Neuroradiology, Dimethyl fumarate, Proportional hazards model, business.industry, Safety, Female, Italy, Middle Aged, Crotonates, Immunosuppressive Agents, medicine.disease, Settore MED/26 - NEUROLOGIA, Event data, chemistry, Cohort, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: The introduction of oral disease-modifying therapies (DMTs) for relapsing–remitting multiple sclerosis (RRMS) changed algorithms of RRMS treatment. Objectives: To compare the effectiveness of treatment with dimethyl fumarate (DMF) and teriflunomide (TRF) in a large multicentre Italian cohort of RRMS patients. Materials and Methods: Patients with RRMS who received treatment with DMF and TRF between January 1st, 2012 and December 31st, 2018 from twelve MS centers were identified. The events investigated were “time-to-first-relapse”, “time-to-Magnetic-Resonance-Imaging (MRI)-activity” and “time-to-disability-progression”. Results: 1445 patients were enrolled (1039 on DMF, 406 on TRF) and followed for a median of 34months. Patients on TRF were older (43.5 ± 8.6 vs 38.8 ± 9.2years), with a predominance of men and higher level of disability (p < 0.001 for all). Patients on DMF had a higher number of relapses and radiological activity (p 38DMF = 3.83, CI = 1.11 to 13.23, p = 0.033). Both DMTs controlled similarly MRI activity and disability progression. Conclusions: Patients on DMF had higher relapse-free survival time than TRF group after the first 38 months ontherapy.

Published
2020

3. Cytoskeletal changes and ubiquitin expression in dystrophic axons of Seitelberger's disease

Author

Moretto G, Sparaco M, Monaco S, Bruno BONETTI, and Rizzuto N

Subjects
Inclusion Bodies, Motor Neurons, Medulla Oblongata, Seitelberger disease, Intermediate Filaments, axonal spheroids, Infant, neurofilaments, Axons, Immunoenzyme Techniques, Cytoskeletal Proteins, Spinal Cord, Central Nervous System Diseases, Tubulin, ubiquitin, Humans, Ubiquitins, tubulin
Abstract

Central nervous system specimens of 4 cases of Infantile Neuroaxonal Dystrophy (Seitelberger's disease) were processed for Bodian's silver stain and for immunostaining with antibodies against neurofilaments (NF), tubulin and ubiquitin (UBQ). Reactivity to NF and UBQ was restricted to spheroids of small size; swellings larger than 30 mu were negative, in spite of their positivity to Bodian's silver stain. Reactivity to tubulin was evident only in normal fibers, whereas no positive material was observed in dystrophic axons. These findings suggest that loss of microtubules (MT) and denaturation of NF might play a crucial role in the mechanisms responsible for the formation of axonal spheroids; in addition the focal activation of the UBQ system suggests an attempt of the neuron to remove abnormal material even at sites remote from the perikaryon.

4. Disability assessment using Google Maps

Author

Francesca Trojsi, Domenico Ippolito, Paolo Ragonese, Sabrina Esposito, Giacomo Lus, Giovanna Borriello, Gioacchino Tedeschi, Maddalena Sparaco, Gianmarco Abbadessa, Luigi Lavorgna, Francesco Brigo, Elisabetta Signoriello, Marinella Clerico, Pietro Iaffaldano, Roberta Lanzillo, Simona Bonavita, Raffaele Palladino, Rosa Gemma Viterbo, Simone Cepparulo, Marcello Moccia, Maria Troiano, Lavorgna, L., Iaffaldano, P., Abbadessa, G., Lanzillo, R., Esposito, S., Ippolito, D., Sparaco, M., Cepparulo, S., Lus, G., Viterbo, R., Clerico, M., Trojsi, F., Raganose, P., Borriello, G., Signoriello, E., Palladino, R., Moccia, M., Brigo, F., Troiano, M., Tedeschi, G., Bonavita, S., Lavorgna L., Iaffaldano P., Abbadessa G., Lanzillo R., Esposito S., Ippolito D., Sparaco M., Cepparulo S., Lus G., Viterbo R., Clerico M., Trojsi F., Ragonese P., Borriello G., Signoriello E., Palladino R., Moccia M., Brigo F., Troiano M., Tedeschi G., and Bonavita S.

Subjects
medicine.medical_specialty, Neurology, Multiple Sclerosis, Concordance, Ambulatory disorders, Dermatology, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Internal medicine, medicine, Google Maps, Humans, 030212 general & internal medicine, Depression (differential diagnoses), Ambulatory disorder, Fatigue, Neuroradiology, Expanded Disability Status Scale, business.industry, General Medicine, Odds ratio, Confidence interval, Search Engine, Psychiatry and Mental health, Cross-Sectional Studies, Ambulatory, e-Health, Original Article, Neurology (clinical), business, Digital health, 030217 neurology & neurosurgery
Abstract

Objectives To evaluate the concordance between Google Maps® application (GM®) and clinical practice measurements of ambulatory function (e.g., Ambulation Score (AS) and respective Expanded Disability Status Scale (EDSS)) in people with multiple sclerosis (pwMS). Materials and methods This is a cross-sectional multicenter study. AS and EDSS were calculated using GM® and routine clinical methods; the correspondence between the two methods was assessed. A multinomial logistic model is investigated which demographic (age, sex) and clinical features (e.g., disease subtype, fatigue, depression) might have influenced discrepancies between the two methods. Results Two hundred forty-three pwMS were included; discrepancies in AS and in EDDS assessments between GM® and routine clinical methods were found in 81/243 (33.3%) and 74/243 (30.4%) pwMS, respectively. Progressive phenotype (odds ratio [OR] = 2.8; 95% confidence interval [CI] 1.1–7.11, p = 0.03), worse fatigue (OR = 1.03; 95% CI 1.01–1.06, p = 0.01), and more severe depression (OR = 1.1; 95% CI 1.04–1.17, p = 0.002) were associated with discrepancies between GM® and routine clinical scoring. Conclusion GM® could easily be used in a real-life clinical setting to calculate the AS and the related EDSS scores. GM® should be considered for validation in further clinical studies. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05389-7.

Published
2021

5. Lifestyle and Mediterranean diet adherence in a cohort of Southern Italian patients with Multiple Sclerosis

Author

G. Tedeschi, Alessio Signori, Francesca Trojsi, Simona Bonavita, Luigi Lavorgna, V. Brescia Morra, Antonio Gallo, Simone Cepparulo, Luca Carmisciano, Camilla Russo, Maddalena Sparaco, Elisabetta Signoriello, G. T. Maniscalco, Sabrina Esposito, Giacomo Lus, Francesco Saccà, R Lanzillo, Esposito, S, Sparaco, M, Maniscalco, G T, Signoriello, E, Lanzillo, R, Russo, C, Carmisciano, L, Cepparulo, S, Lavorgna, L, Gallo, A, Trojsi, F, Brescia Morra, V, Lus, G, Tedeschi, G, Saccà, F, Signori, A, Bonavita, S, Esposito, S., Sparaco, M., Maniscalco, G. T., Signoriello, E., Lanzillo, R., Russo, C., Carmisciano, L., Cepparulo, S., Lavorgna, L., Gallo, A., Trojsi, F., Brescia Morra, V., Lus, G., Tedeschi, G., Sacca, F., Signori, A., and Bonavita, S.

Subjects
medicine.medical_specialty, Multiple Sclerosis, Mediterranean diet, Physical examination, Systemic inflammation, Diet, Mediterranean, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Internal medicine, medicine, Outpatient clinic, Humans, Multiple sclerosi, 030212 general & internal medicine, Life Style, Retrospective Studies, Cross-Sectional Studie, Expanded Disability Status Scale, medicine.diagnostic_test, business.industry, Multiple sclerosis, General Medicine, medicine.disease, Cardiovascular risk, Lifestyle, Cross-Sectional Studies, Neurology, Italy, Cohort, Neurology (clinical), medicine.symptom, business, Body mass index, 030217 neurology & neurosurgery, Human
Abstract

Background/objectives Several studies supported the beneficial effects of the Mediterranean diet (MeDi) on chronic diseases. In Multiple Sclerosis (MS), the MeDi might interfere with systemic inflammatory state, gut microbiota, and comorbidities. The Med Diet Score (MDS) estimates the adherence to the MeDi and the cardiovascular (CV) risk. Aims of our study were i) to photograph lifestyle and diet habits of a southern Italy cohort of people with MS (pwMS), and ii) to investigate the impact of the MeDi on MS clinical outcomes. Subjects/methods We conducted a multi-center, cross-sectional study, enrolling 435 consecutive consenting pwMS, attending the outpatient clinics for routine follow-up visits. Participants underwent a clinical examination and a 29-item self-administered questionnaire on life and dietary habits. Disease phenotype, Expanded Disability Status Scale (EDSS), MS Severity Score (MSSS), waist circumference (WC), Body Mass Index (BMI), therapies, and comorbidities, were updated. MDS was assessed and correlated with current and retrospective clinical data. Results 75.8% of respondents were interested in nutrition, 72.8% were non-smokers, 52.9% performed physical activity, and 45.6% used food supplements. MDS was higher in pwMS with normal WC (p = 0.031), and inversely correlated with MSSS (p = 0.013) and EDSS (p = 0.012) at survey time. MDS did not correlate with the total number of relapses (before and after diagnosis) (p = 0.372). Metabolic comorbidities were associated with an increased 10-year CV risk (r = 0.85, p = 0.002). Conclusion Our findings suggest a putative beneficial effect of the MeDi on WC, MS course and disability. Given the role of chronic systemic inflammation in maintenance of autoimmunity and secondary neurodegeneration, both involved in long-term disability, we may suppose a beneficial effect of the MeDi on MS long-term disability outcomes, probably mediated by a modulation of the gut microbiota and the low-grade chronic systemic inflammation.

Published
2021

6. A snapshot on patient-reported outcome measures of people with multiple sclerosis on first-line therapies in a real world setting

Author

Luigi Lavorgna, Teresa Costabile, Luca Carmisciano, R Lanzillo, N. Frattaruolo, Giacomo Lus, Alvino Bisecco, Alessio Signori, Simona Bonavita, A. Strianese, G. T. Maniscalco, V. Brescia Morra, Maddalena Sparaco, Elisabetta Signoriello, Simone Cepparulo, Francesco Saccà, Camilla Russo, Lanzillo, R, Sparaco, M, Lavorgna, L, Carmisciano, L, Signoriello, E, Signori, A, Costabile, T, Maniscalco, G T, Saccà, F, Cepparulo, S, Russo, C V, Bisecco, A, Frattaruolo, N, Strianese, A, Lus, G, Brescia Morra, V, Bonavita, S, Lanzillo, R., Sparaco, M., Lavorgna, L., Carmisciano, L., Signoriello, E., Signori, A., Costabile, T., Maniscalco, G. T., Sacca, F., Cepparulo, S., Russo, C. V., Bisecco, A., Frattaruolo, N., Strianese, A., Lus, G., Brescia Morra, V., and Bonavita, S.

Subjects
medicine.medical_specialty, Neurology, Multiple Sclerosis, Disease-modifying therapies, First-line therapies, Multiple sclerosis, Patient-reported outcomes, Dermatology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, Teriflunomide, medicine, Humans, Multiple sclerosi, Disease-modifying therapie, 030212 general & internal medicine, Effects of sleep deprivation on cognitive performance, Patient Reported Outcome Measures, Glatiramer acetate, First-line therapie, Aged, business.industry, Cognition, General Medicine, Glatiramer Acetate, medicine.disease, humanities, Psychiatry and Mental health, chemistry, Physical therapy, Quality of Life, Patient-reported outcome, Neurology (clinical), Analysis of variance, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background: Patient-reported outcomes (PROs) may help patients and clinicians in selecting disease-modifying therapies (DMTs) for multiple sclerosis (MS). Objective: To evaluate PRO differences among first-line DMTs for relapsing-remitting (RR) people with MS (pwMS). Methods: Multicenter study. RR pwMS on first-line DMTs completed Fatigue Severity Scale (FSS), PROs Indices for MS (PRIMUS), 36-item Short-Form Health Survey (SF-36), treatment satisfaction questionnaire for medication (TSQM), Beck Depression Inventory-II (BDI-II), and Symbol Digit Modalities Test (SDMT). Differences among PROs across DMTs were tested by ANOVA. Multivariable linear regressions were used to investigate associations between PROs and the treatment group. Results: Two-hundred eighty pwMS were enrolled: 56% were on interferons (INF), 22% on dimethylfumarate (DMF), 13% on glatiramer acetate, and 9% on teriflunomide (Teri). Compared with INF, pwMS on Teri were the oldest, with higher disability, worst depression at BDI, worst cognitive performances at SDMT (p = 0.001), fatigue at FSS (p = 0.001), and activity limitation and quality of life respectively at PRIMUS (p = 0.005) and SF-36 Mental Composite Score (p < 0.001); pwMS on DMF reported highest side effects and, together with pwMS on Teri, better treatment satisfaction at TSQM. Conclusions: Compared with INF-treated patients, pwMS on DMF and Teri reported the best treatment satisfaction, although DMF-treated pwMS reported higher side effects and those on Teri the worst QoL and fatigue; however, the older age, higher disability and depression, and worse cognitive performance of pwMS on Teri suggest to be careful in evaluating these results.

Published
2019

7. Association between relapses, stress, and depression in people with multiple sclerosis during the COVID-19 pandemic

Author

Maddalena Sparaco, Giuseppina Miele, Luigi Lavorgna, Gianmarco Abbadessa, Simona Bonavita, Sparaco, M., Miele, G., Lavorgna, L., Abbadessa, G., and Bonavita, S.

Subjects
Pandemic, Stre, Depression, SARS-CoV-2, COVID-19, Dermatology, General Medicine, Multiple Sclerosis, Chronic Progressive, Stress, Multiple sclerosis, Psychiatry and Mental health, Multiple Sclerosis, Relapsing-Remitting, Recurrence, Multiple Sclerosi, Humans, Neurology (clinical), Relapse, Pandemics, Human
Abstract

Background Stress is a potential trigger for clinical and radiological activity in Multiple Sclerosis (MS). COVID-19 pandemic has been a relevant source of mental distress in people with MS (pwMS) and deeply impacted on disease management. Objective To investigate the association between stress, anxiety, depression, and risk of relapse during the COVID-19 pandemic. Methods From an electronic database used for clinical practice, we extracted data of relapsing–remitting (RR) or relapsing-progressive (RP) MS patients and calculated the annualized relapse rate (ARR) during 2019 and 2020. From 01/12/2020 to 30/12/2020, enrolled patients were invited to fill in a Google Forms survey to investigate depression, anxiety, stress, and Post-Traumatic Stress Disorder (PTSD). Results We selected 216 patients with RR or RP-MS to calculate ARR: compared to 2019, in 2020 there was a significant increase in ARR (p = 0.0142). Over 216 selected pwMS, 154 completed the survey. Matching the survey responses and incidence of relapses in 2020, there was a significant association between relapses and stress (p = 0.030) and relapses and depression (p = 0.011), but not between relapses and anxiety (p = 0.130) or PTSD (p = 0.279). Conclusions Our results support the hypothesis that pandemic-related stress is associated to clinical exacerbations, both as a possible consequence of the COVID-19 impact on MS care.

Published
2022

8. 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, Lavorgna, Luigi, Spina, E., Tedeschi, G., Russo, A., Trojsi, F., Iodice, R., Tozza, S., Iovino, A., Iodice, F., Abbadessa, G., di Lorenzo, F., Miele, G., Maida, E., Cerullo, G., Sparaco, M., Silvestro, M., Leocani, L., Bonavita, S., Manganelli, F., and Lavorgna, L.

Subjects
Migraine Disorders, Headache, COVID-19, Reproducibility of Results, Tele-rehabilitation, Dermatology, General Medicine, Telemedicine, Psychiatry and Mental health, Telehealth, Humans, Original Article, Neurology (clinical), Child, Pandemics, Migraine
Abstract

Background Migraine affects more than a billion people all over the world and requires critical employment of healthcare resources. Telemedicine could be a reasonable tool to manage people suffering from headaches, and it received a big push from the COVID-19 pandemic. Objective This review aims to propose a practical approach for the virtual management of these patients. Methods To do this, we conducted a literature search, including 32 articles relevant to the topic treated in this review. Results The most challenging step in telemedicine applied to practical neurology remains the clinical assessment, but through a careful headache history and a recently proposed entirely virtual neurological assessment, this hitch can be easily overcome. Electronic diary compilations and virtual administration of disability-measuring scales, conversely, are the key features of effective long-term follow-up although we do not have apps that met the criteria of scientific reliability. Furthermore, tele-rehabilitation seems to be effective and has demonstrated to be a solution to alternatively treat chronic patients at home, and can be considered part of the remote management of headache patients. Moreover, virtual management of headaches finds an application in specific communities of patients, as pediatric patients and for rural communities of low- and middle-income countries suffer from health disparities, with inadequate resources and knowledge gaps. Conclusion Telemedicine could be promising for patients with no regular or convenient access to headache specialists and seems to be a priority in managing migraine patients to avoid non-urgent hospitalizations

Published
2022

9. Clinical effectiveness of different natalizumab interval dosing schedules in a large Italian population of patients with multiple sclerosis

Author

Chisari, CLARA GRAZIA, Grimaldi Luigi Maria, Salemi, Giuseppe, Ragonese, Paolo, Iaffaldano, Pietro, Bonavita, Simona, Sparaco, Maddalena, Rovaris, Marco, D'Arma, Alessia, Lugaresi, Alessandra, Ferrò Maria Teresa, Grossi, Paola, Di Sapio Alessia, Cocco, Eleonora, Granella, Franco, Curti, Erica, Lepore, Vito, Trojano, Maria, Patti, Francesco, on behalf of the Italian MS Register Study Group, Chisari, Clara Grazia, Grimaldi, Luigi Maria, Salemi, Giuseppe, Ragonese, Paolo, Iaffaldano, Pietro, Bonavita, Simona, Sparaco, Maddalena, Rovaris, Marco, D'Arma, Alessia, Lugaresi, Alessandra, Ferrò, Maria Teresa, Grossi, Paola, Di Sapio, Alessia, Cocco, Eleonora, Granella, Franco, Curti, Erica, Lepore, Vito, Trojano, Maria, Patti, Francesco, Chisari C.G., Grimaldi L.M., Salemi G., Ragonese P., Iaffaldano P., Bonavita S., Sparaco M., Rovaris M., D'Arma A., Lugaresi A., Ferro M.T., Grossi P., DI Sapio A., Cocco E., Granella F., Curti E., Lepore V., Trojano M., and Patti F.

Subjects
Adult, medicine.medical_specialty, Population, multiple sclerosis, Drug Administration Schedule, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, natalizumab, 0302 clinical medicine, Natalizumab, Dosing schedules, Internal medicine, medicine, Humans, Immunologic Factors, natalizumab, risk stratification, multiple sclerosis, safety, effectiveness, Dosing, education, Proportional Hazards Models, Retrospective Studies, 030304 developmental biology, 0303 health sciences, education.field_of_study, Proportional hazards model, business.industry, Multiple sclerosis, Retrospective cohort study, Middle Aged, medicine.disease, Psychiatry and Mental health, Treatment Outcome, Italy, Tolerability, Settore MED/26 - Neurologia, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug
Abstract

IntroductionNatalizumab (NTZ) is one of the most effective treatment options for multiple sclerosis (MS) treatment. Our study aimed to evaluate the effectiveness of NTZ when administered according to the extended dosing strategy compared with standard 4-weekly administration in a large Italian MS population.Materials and methodsThis retrospective multicentre study included patients with relapsing-remitting MS (RR-MS) who received NTZ administrations between the 1 June 2012 and the 15 May 2018 and were followed by the ‘Italian MS Register’. All patients with MS were stratified into two groups based on NTZ administration schedule: standard interval dosing (SID) patients who received infusions on average from 28 to 32 days (median 30) and extended interval dosing (EID) including patients who have been infused with interval between 33 and 49 days (median 43). Clinical data were assessed at baseline (before starting NTZ), after 12 (T1) and 24 months (T2) of treatment.ResultsOut of 5231 patients with RR-MS screened, 2092 (mean age 43.2±12.0, 60.6% women) were enrolled. A total of 1254 (59.9%) received NTZ according to SID, and 838 (40.1%) according to EID. At 12 and 24 months, no differences in terms of annualised relapse rate and disability status were found between the two groups. Progression index and confirmed disability worsening were similar between the two groups.DiscussionThe use of NTZ with an extended interval schedule showed similar effectiveness compared with SID. Unchanged clinical efficacy of EID schedule may raise the question of a possible advantage in terms of tolerability and safety.

Published
2020

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

Author

Raffaele Palladino, Ignazio Armetta, Giuseppina Miele, Francesca Trojsi, Luigi Lavorgna, Giovanna D'Elia, Gianmarco Abbadessa, Andrea Di Pietro, Elisabetta Signoriello, Giacomo Lus, Maddalena Sparaco, Simona Bonavita, Abbadessa, G., Miele, G., Di Pietro, A., Sparaco, M., Palladino, R., Armetta, I., D'Elia, G., Trojsi, F., Signoriello, E., Lus, G., Lavorgna, L., and Bonavita, S.

Subjects
Oncology, medicine.medical_specialty, Multiple Sclerosis, Population, Single-nucleotide polymorphism, Dermatology, Fibrinogen, Polymorphism, Single Nucleotide, Hemostatics, Hemostatic, Internal medicine, medicine, Factor V Leiden, Humans, Multiple sclerosi, Genetic Predisposition to Disease, Allele, Polymorphism, education, education.field_of_study, Coagulation, biology, business.industry, Multiple sclerosis, Case-control study, Factor V, General Medicine, medicine.disease, Psychiatry and Mental health, Case-Control Studies, biology.protein, Neurology (clinical), business, Polymorphisms, Case-Control Studie, medicine.drug, Human
Abstract

Introduction Blood coagulation constituents might exert immunomodulatory functions in the CNS and may trigger neuroinflammation and demyelination. We evaluated whether particular single-nucleotide polymorphisms (SNPs), thought to be involved in fibrinogen-mediated hemostatic pathways, are overrepresented in patients with MS compared with controls. Methods The case–control study consisted of 119 MS patients recruited consecutively at our clinic, and 68 healthy controls. Afterwards, we created a cumulative genetic risk score (CGRS) which included the 5 selected hemostatic risk alleles (Beta-Fibrinogen 455G/A, Glycoprotein IIIa P1A2, Factor V Leiden, Factor V H2R, and Prothrombin 20210G/A). Multivariate ordinal logistic regression and multivariate multinomial logistic regression were applied to evaluate the effect of CGRS on MS susceptibility. Results The FGB 455 G/A and Factor V H1299R variants might be associated with MS status, in the recessive and dominant model, respectively. A cumulative association of the five SNPs investigated with the disease was observed. Discussion We found that MS patients carried more pro-hemostatic variants than healthy controls. An increasing number of unfavorable alleles might increase the likelihood of being in the MS group, in the cumulative analysis. Our findings encourage to evaluating these variants in a larger population-based cohort.

Published
2022

11. CD19 Cell Count at Baseline Predicts B Cell Repopulation at 6 and 12 Months in Multiple Sclerosis Patients Treated with Ocrelizumab

Author

Girolama Alessandra Marfia, Giuseppina Miele, Giacomo Lus, Doriana Landi, Rosanna Missione, Paola Cavalla, Maddalena Sparaco, Paola Valentino, Luigi Lavorgna, Simona Bonavita, Gianmarco Abbadessa, Antonio De Martino, Elisabetta Signoriello, Marco Vercellino, Chiara Bosa, Abbadessa, G., Miele, G., Cavalla, P., Valentino, P., Marfia, G. A., Signoriello, E., Landi, D., Bosa, C., Vercellino, M., De Martino, A., Missione, R., Sparaco, M., Lavorgna, L., Lus, G., and Bonavita, S.

Subjects
0301 basic medicine, medicine.medical_specialty, Every Six Months, Health, Toxicology and Mutagenesis, Cell, Settore MED/26, Antibodies, Monoclonal, Humanized, multiple sclerosis, Gastroenterology, Article, CD19, 03 medical and health sciences, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, ocrelizumab, Internal medicine, Multiple Sclerosi, medicine, Humans, CD20, Lymphocyte Count, B cell, Kinetic, B-Lymphocytes, medicine.diagnostic_test, biology, business.industry, Multiple sclerosis, Public Health, Environmental and Occupational Health, B-Lymphocyte, Magnetic resonance imaging, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, kinetics, biology.protein, schedule, Medicine, Ocrelizumab, business, 030217 neurology & neurosurgery, medicine.drug, Human
Abstract

Background: The kinetics of B cell repopulation in MS patients treated with Ocrelizumab is highly variable, suggesting that a fixed dosage and time scheduling might be not optimal. We aimed to investigate whether B cell repopulation kinetics influences clinical and radiological outcomes and whether circulating immune asset at baseline affects B cell repopulation kinetics. Methods: 218 MS patients treated with Ocrelizumab were included. Every six months we collected data on clinical and magnetic resonance imaging (MRI) activity and lymphocyte subsets at baseline. According to B cell counts at six and twelve months, we identified two groups of patients, those with fast repopulation rate (FR) and those with slow repopulation rate (SR). Results: A significant reduction in clinical and radiological activity was found. One hundred fifty-five patients had complete data and received at least three treatment cycles (twelve-month follow-up). After six months, the FR patients were 41/155 (26.45%) and 10/41 (29.27%) remained non-depleted after twelve months. FR patients showed a significantly higher percentage of active MRI scan at twelve months (17.39% vs. 2.53%, p = 0,008). Furthermore, FR patients had a higher baseline B cell count compared to patients with an SR (p = 0.02 and p = 0.002, at the six- and twelve-month follow-ups, respectively). Conclusion: A considerable proportion of MS patients did not achieve a complete CD19 cell depletion and these patients had a higher baseline CD19 cell count. These findings, together with the higher MRI activity found in FR patients, suggest that the Ocrelizumab dosage could be tailored depending on CD19 cell counts at baseline in order to achieve complete disease control in all patients.

Published
2021

12. Gait abnormalities in minimally disabled people with Multiple Sclerosis: A 3D-motion analysis study

Author

Luigi Lavorgna, Giuseppe Sorrentino, Roberta Minino, Marianna Liparoti, Rosaria Rucco, Rocco Capuano, Simona Bonavita, Maddalena Sparaco, Pierpaolo Sorrentino, Marida Della Corte, Valeria Agosti, Liparoti, M., Della Corte, M., Rucco, R., Sorrentino, P., Sparaco, M., Capuano, R., Minino, R., Lavorgna, L., Agosti, V., Sorrentino, G., Bonavita, S., Institut de Neurosciences des Systèmes (INS), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Three-dimensional Motion analysi, Kinematics, Cognitive functions, Dual task paradigm, MRI, Three-dimensional Motion analysis, Adult, Biomechanical Phenomena, Cognitive Dysfunction, Executive Function, Female, Gait Disorders, Neurologic, Humans, Magnetic Resonance Imaging, Middle Aged, Multiple Sclerosis, Relapsing-Remitting, Settore M-PED/04 - Pedagogia Sperimentale, 0302 clinical medicine, Gait (human), Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Subclinical infection, Settore M-EDF/01 - Metodi e Didattiche delle Attivita' Motorie, Neuropsychology, Cognition, General Medicine, Kinematic, Neurology, Settore M-EDF/02 - Metodi e Didattiche delle Attivita' Sportive, Settore MED/26 - Neurologia, Cognitive function, medicine.symptom, Human, medicine.medical_specialty, Gait Disorders, Neurologic, Multiple Sclerosis, Relapsing-Remitting, Asymptomatic, 03 medical and health sciences, Physical medicine and rehabilitation, Atrophy, Expanded Disability Status Scale, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, Multiple sclerosis, medicine.disease, Settore ING-INF/06 - Bioingegneria Elettronica e Informatica, Neurology (clinical), business, human activities, 030217 neurology & neurosurgery
Abstract

Background People with Relapsing-Remitting Multiple Sclerosis (pwRR-MS), may be affected by subclinical gait impairment. The Expanded Disability Status Scale, the most used scale to assess MS related disability, may be insensitive to subclinical gait disability. Minor gait abnormalities may be detected by three Dimensional-Gait Analysis (3D-GA). Objectives To investigate gait pattern in minimally disabled pwRR-MS by 3D-GA during walking (single task, SinT), and cognitive dual tasks (CogDT) and to evaluate correlations between altered gait parameters, cognitive scores, lesion load (LL) and brain atrophy measures. Methods Twenty-two pwRR-MS and twenty-one healthy controls (HCs), underwent neuropsychological (NP) evaluation, and brain MRI to assess brain volumes and lesion load (only in pwRR-MS) and 3D-GA. Results Both pwRR-MS and HCs were considered cognitively preserved (CP). During SinT pwRR-MS, compared to HCs, showed an impairment of velocity (increase of cycle time), stability (increase of stance time, swing time and coefficients of variability (CV) of swing time) and kinematic (increase of ankle dorsiflexion) parameters. During CogDT, the changes of velocity and stability parameters observed in SinT were confirmed. Moreover, a statistically significant increase of the double limb support was observed. Regarding the kinematic parameters, during CogDT, an increase of ankle dorsiflexion during mid and terminal stance phases of gait cycle was observed. No significant correlations were found between gait abnormalities and cognitive status or MRI structural damage in both groups. Conclusions The subclinical abnormal gait in asymptomatic and CP pwRR-MS, may be detected by 3D-GA.

Published
2019

13. Cardiovascular autonomic individual profile of relapsing-remitting multiple sclerosis patients and risk of extending cardiac monitoring after first dose fingolimod

Author

Francesca Frigerio, Simona Bonavita, Clara Grazia Chisari, Assunta Bianco, Emilio Vanoli, Gianluigi Mancardi, Marta Bartezaghi, Nicola Montano, Silvia Rossi, Massimiliano Mirabella, Fabio Badilini, Maddalena Sparaco, Francesco Patti, Renato Turrini, Giuseppe De Angelis, Alice Laroni, Vanoli, E., Montano, N., De Angelis, G., Badilini, F., Mirabella, M., Bonavita, S., Patti, F., Bianco, A., Sparaco, M., Chisari, C., Laroni, A., Frigerio, F., Bartezaghi, M., Rossi, S., Turrini, R., and Mancardi, G.

Subjects
Adult, Male, medicine.medical_specialty, Autonomic system, Adolescent, medicine.medical_treatment, Asymptomatic, Electrocardiography, Young Adult, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, Heart Rate, Internal medicine, Heart rate, medicine, Humans, Heart rate variability, Prospective Studies, 030212 general & internal medicine, Aged, Fingolimod Hydrochloride, business.industry, Multiple sclerosis, Therapeutic effect, Autonomic system, Fingolimod, Heart rate variability, Safety, Fingolimod, Middle Aged, medicine.disease, Autonomic Agents, Settore MED/26 - NEUROLOGIA, Neurology, Cardiology, Female, Neurology (clinical), Drug Monitoring, medicine.symptom, Cardiac monitoring, Safety, business, Atrioventricular block, 030217 neurology & neurosurgery, medicine.drug
Abstract

Fingolimod exerts its therapeutic effect in multiple sclerosis by modulating sphingosine-1P receptors which are expressed in the heart mediating fingolimod first dose effects. Understanding potential interactions of baseline characteristics and autonomic profile with fingolimod first dose effects may add novel safety information and help explain cases requiring extension of the 6-hour ECG monitoring period. We aimed at characterizing the patient population treated with the first dose of fingolimod in clinical practice in an observational, multicenter, prospective 6-hours (up to 24) study. ECG was recorded for 15 min before first fingolimod administration and for 6 h after. Heart rate (HR) and HR variability in the frequency domain were derived from ECG traces. Out of the 625 enrolled patients, 580 (92.8%) were discharged at the sixth hour after fingolimod first dose; 45 (7.2%) required monitoring extension. Data confirm the well characterized cardiovascular fingolimod profile upon treatment initiation. Ten (1.6%) patients showed an atrioventricular block, all asymptomatic and self-resolving. Normalized spectral power in the High Frequency band (marking vagal modulation) and previous annualized relapse rate were independently correlated with the probability of undergoing extended monitoring. Our results could provide useful information for the stratification and individualized monitoring of MS patients prescribed with fingolimod.

Published
2019

14. Fake news, influencers and health-related professional participation on the Web: A pilot study on a social-network of people with Multiple Sclerosis

Author

G. Tedeschi, Daniela Buonanno, Gianmarco Abbadessa, L. Rosa, Luigi Lavorgna, Simona Bonavita, Alvino Bisecco, Francesca Trojsi, Maddalena Sparaco, Marcello Moccia, Domenico Ippolito, M. De Stefano, Marinella Clerico, Sabrina Esposito, V. Brescia Morra, C. Cenci, Giorgia Teresa Maniscalco, Patrizia Montella, R Lanzillo, Lavorgna, L., De Stefano, M., Sparaco, Rosa, Moccia, M., Abbadessa, Pietro, Montella, P., Buonanno, D., Esposito, S., Clerico, M., Cenci, Beniamino, Trojsi, F., Lanzillo, R., Rosa, L., Morra, V. Brescia, Ippolito, D., Maniscalco, G., Bisecco, A., Tedeschi, G., Bonavita, S., Lavorgna, L, De Stefano, M, Sparaco, M, Moccia, M, Abbadessa, G, Montella, P, Buonanno, D, Esposito, S, Clerico, M, Cenci, C, Trojsi, F, Lanzillo, R, Rosa, L, Morra, Vb, Ippolito, D, Maniscalco, G, Bisecco, A, Tedeschi, G, and Bonavita, S

Subjects
Male, Multiple Sclerosis, 020205 medical informatics, Digital health, E-health, Fake news, Influencers, Female, Health Personnel, Humans, Interpersonal Relations, Italy, Pilot Projects, Internet, Physician-Patient Relations, Social Networking, Neurology, Neurology (clinical), Internet privacy, 02 engineering and technology, Computer-assisted web interviewing, Fake new, 03 medical and health sciences, Influencer, 0302 clinical medicine, Multiple Sclerosi, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Confidentiality, Misinformation, Web community, business.industry, Information seeking, General Medicine, Influencer marketing, The Internet, business, 030217 neurology & neurosurgery
Abstract

Background Over the last few decades, patients have increasingly been searching for health information on the Internet. This aspect of information seeking is important, especially for people affected by chronic pathologies and require lifelong treatment and management. These people are usually very well informed about the disease but are nonetheless vulnerable to hopes of being cured or saved, often amplified by misinformation, myths, legends, and therapies that are not always scientifically proven. Many studies suggest that some individuals prefer to rely on the Internet as their main source of information, often hindering the patient-doctor relationship. A professional approach is imperative to maintain confidentiality, honesty, and trust in the medical profession. Objective we aimed to examine, in a medically supervised Italian web community (SMsocialnetwotk.com) dedicated to people with Multiple Sclerosis (pwMS), the posts shared by users and to verify the reliability of contents of posts shared by users pinpointed as Influencers through an online questionnaire. Methods we grouped the posts published on SMsocialnetwork from April to June 2015 into those with medical content (scientifically correct or fake news), and those related to social interactions. Later, we gave a questionnaire to the community asking to identify the three users/Influencers providing the most reliable advice for everyday life with MS and the three users/Influencers providing the most useful information about MS treatments. Results 308 posts reported scientific and relevant medical information, whereas 72 posts included pieces of fake news. 1420 posts were of general interest. Four out of the 6 Influencers had written only posts with correct medical information (3 were pwMS, 1 was a Neurologist) and never any fake news. The remaining 2 appointed Influencers (2 pwMS) had written only posts about general interests. Conclusion the identification of fake news and their authors has shown that the latter are never appointed as Influencers. SMsocialnetwork.com acted as a “web safe environment” where the Influencers contributed by sharing only correct medical information and never fake news. We speculate that the presence of neurologists and psychologists supervising the information flow might have contributed to reduce the risk of fake news spreading and to avoid their acquisition of authoritative meaning.

Published
2018

15. Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study

Author

G. Tedeschi, Alvino Bisecco, Fabrizio Esposito, Luigi Lavorgna, Sabrina Esposito, Alessandro d’Ambrosio, M. Della Corte, Daniele Corbo, Maddalena Sparaco, Sossio Cirillo, Simona Bonavita, Renato Docimo, Antonio Gallo, Rosaria Sacco, Bonavita, Simona, Sacco, R, Della Corte, M, Esposito, S, Sparaco, M, D'Ambrosio, Alessandro, Docimo, R, Bisecco, Alvino, Lavorgna, L, Corbo, D, Cirillo, Sossio, Gallo, Antonio, Esposito, F, and Tedeschi, Gioacchino

Subjects
Adult, Male, medicine.medical_specialty, Resting-state functional magnetic resonance imaging, Audiology, Multiple sclerosis, Multiple Sclerosis, Relapsing-Remitting, medicine, Humans, Cognitive rehabilitation therapy, Cognitive impairment, Cognitive rehabilitation, fMRI, Cognitive reserve, Cerebral Cortex, medicine.diagnostic_test, Neuropsychology, Cognition, Middle Aged, Magnetic Resonance Imaging, Cognitive training, Treatment Outcome, Neurology, Practice, Psychological, Therapy, Computer-Assisted, Posterior cingulate, Female, Neurology (clinical), Nerve Net, Cognition Disorders, Psychology, Functional magnetic resonance imaging, Neuroscience, Psychomotor Performance, Stroop effect
Abstract

To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p < 0.01), PASAT 3" (p < 0.00), PASAT 2" (p < 0.03), SRT-D (p < 0.02), and 10/36 SPART-D (p < 0.04); as well as a significant increase of the FC of the DMN in the posterior cingulate cortex (PCC) and bilateral inferior parietal cortex (IPC). After cCR, a significant negative correlation between Stroop Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve.

Published
2015

16. The THRombolysis and STatins (THRaST) study

Author

Giampiero Galletti, Rinaldo M. Colombo, Vincenzo Di Lazzaro, Maria Concetta Altavista, Umberto Scoditti, Daniele Orrico, Maria Sessa, Gaetano Procaccianti, Massimo Del Sette, Manuel Cappellari, Fabio Brusaferri, Giuseppe Moretto, Giuseppe Martini, Gabriele Greco, Serena Monaco, Alessandro Adami, Andrea Zini, Fabio Chiodo-Grandi, Claudio Grassa, Paolo Bovi, Maria Guarino, Domenico Consoli, Anna Cavallini, Maria Vittoria Calloni, Mauro Zampolini, Tiziana Tassinari, Simone Beretta, Francesco Federico, Danilo Toni, Luigi Maria Specchio, Maurizio Paciaroni, Maurizia Rasura, Carlo Gandolfo, Simona Marcheselli, Armando Mancini, Alessandro Pezzini, Marco Sparaco, Bruno Passarella, Maurizio Melis, Giorgio Silvestrelli, Rossella Sciolla, Mauro Furlan, Giovanni Orlandi, L. Adobbati, Luigi Bettoni, Patrizia Nencini, Maria Roberta Bongioanni, Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, and Toni, D

Subjects
Male, Multivariate analysis, Time Factors, medicine.medical_treatment, Severity of Illness Index, non presente, Retrospective Studie, Modified Rankin Scale, Outcome Assessment, Health Care, 80 and over, Prospective Studies, Multivariate Analysi, Stroke, Aged, 80 and over, Neurologic Examination, Fibrinolytic Agent, Thrombolysis, Middle Aged, stroke, X-Ray Computed, Tissue Plasminogen Activator, Cardiology, Female, Human, medicine.medical_specialty, thrombolysis, Tomography Scanners, X-Ray Computed, Logistic Model, Time Factor, Article, Outcome Assessment (Health Care), Arts and Humanities (miscellaneous), Fibrinolytic Agents, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Retrospective Studies, Intracerebral hemorrhage, Tomography Scanners, business.industry, Odds ratio, medicine.disease, Confidence interval, Surgery, Prospective Studie, Logistic Models, Multicenter study, Multivariate Analysis, Hydroxymethylglutaryl-CoA Reductase Inhibitor, Neurology (clinical), Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

Objective: To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis. Methods: Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death. Results: Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007). Conclusion: Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome. © 2013 American Academy of Neurology.

Published
2013

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