309 results on '"Grandis, M."'
Search Results
102. LONG-TERM IMMUNOSUPPRESSIVE TREATMENT IN IMMUNE-MEDIATED NEUROMUSCULAR DISEASES: PRELIMINARY DATA OF A MULTICENTRIC RETROSPECTIVE OBSERVATIONAL STUDY
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Garnero, M., Gemelli, C., Fabbri, S., Grandis, M., Beronio, A., Giorli, E., Maestri, M., Callegari, I., Cortese, A., Eleonora Virgilio, Comi, C., Schenone, A., and Benedetti, L.
103. AN OBSERVATIONAL STUDY ON TAFAMIDIS FOR TRANSTHYRETIN-RELATED FAMILIAL AMYLOID POLYNEUROPATHY IN ITALY
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Pareyson, D., Merlini, G., Vita, G., Calabrese, D., Piscosquito, G., Gentile, L., Mazzeo, A., Pradotto, L. G., Mauro, A., Grandis, M., Schenone, A., Sabatelli, M., Luigetti, M., Santoro, L., Manganelli, F., Fabrizi, G. M., Cavallaro, T., Laura Piera OBICI, Russo, M., and Cortese, A.
104. Ascorbic acid in charcot-marie-tooth disease type 1A (CMTTRIAAL and CMT-TRAUK): A double-blind randomised trial
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Pareyson, D., Reilly, M. M., Schenone, A., Fabrizi, G. M., Cavallaro, T., Manganelli, L., Vita, G., Quattrone, A., Padua, L., Gemignani, F., Visioli, F., Laurà, M., Radice, D., Calabrese, D., Hughes, R. A. C., Solari, A., Salsano, C., Nanetti, L., Marelli, C., Scaioli, V., Ciano, C., Rimoldi, M., Lauria, G., Rizzetto, E., Camozzi, F., Narciso, E., Grandis, M., Monti-Bragadin, M., Nobbio, L., Casano, A., Bertolasi, L., Cabrini, I., Corrà, K., Rizzuto, N., Pisciotta, C., Maria Nolano, Mazzeo, A., Aguennouz, M., Di Leo, R., Majorana, G., Lanzano, N., Valenti, F., Valentino, P., Nisticò, R., Pirritano, D., Lucisano, A., Canino, M., Pazzaglia, C., Granata, G., Foschini, M., Brindani, F., Vitetta, F., Allegri, I., Bogani, P., Blake, J., Koltzenburg, M., Hutton, E., Lunn, M., Cavaletti, G., Galimberti, S., Ferrari, G., Santoro, L., Manganelli, F., and Sereda, M.
105. Gene symbol: GNE. Disease: Inclusion body myopathy
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Bruno, C., Grandis, M., denise cassandrini, Bellone, E., Mandich, P., and Gulli, R.
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Multienzyme Complexes ,Molecular Sequence Data ,Mutation, Missense ,Humans ,Myositis, Inclusion Body
106. DYSIMMUNE NEUROMUSCULAR DISEASES AND IMMUNOSUPPRESSIVE TREATMENTS, LONG TERM FOLLOW UP: A RETROSPECTIVE MULTI-CENTER OBSERVATIONAL STUDY
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martina garnero, Grandis, M., Demichelis, C. H., Gemelli, C., Mancardi, G. L., Schenone, A., and Benedetti, L.
107. TESTING OVERWORK WEAKNESS IN CHARCOT-MARIE-TOOTH (CMT) DISEASE: IS IT TRUE OR FALSE?
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Prada, V., LAURA MORI, Francini, L., Accogli, S., Ursino, G., Gemelli, C., Schizzi, S., Grandis, M., Bellone, E., Mandich, P., and Schenone, A.
108. MONITORING SAFETY AND EFFECTIVENESS OF TAFAMIDIS FOR TRANSTHYRETIN-RELATED FAMILIAL AMYLOID POLYNEUROPATHY IN ITALY: 24-MONTH LONGITUDINAL STUDY
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Pareyson, D., Merlini, G., Calabrese, D., Piscosquito, G., Lozza, A., Gentile, L., Stancanelli, C., Pradotto, L. G., Mauro, A., Grandis, M., Schenone, A., Santoro, L., Manganelli, F., Fabrizi, G. M., Cavallaro, T., Sabatelli, M., Bisogni, G., Luigetti, M., Russo, M., Mazzeo, A., Laura Piera OBICI, Vita, G., and Cortese, A.
109. JAM-C: A NEW LEUKEMIC STEM CELL BIOMARKER IN ACUTE MYELOID LEUKEMIA
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Grandis, M., Chretien, A. -S, Pouyet, L., Bardin, F., Bidaut, G., Mozziconacci, M. -J, Mancini, S., Balzano, M., Castellano, R., Prebet, T., Olive, D., Cyril Fauriat, Colette, Y., Vey, N., and Aurrand-Lions, M.
110. Tinetti and Berg balance scales correlate with disability in hereditary peripheral neuropathies: A preliminary study
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Monti Bragadin, M., Francini, L., Bellone, E., Grandis, M., Reni, L., Canneva, S., Gemelli, C., Ursino, G., Maggi, G., LAURA MORI, and Schenone, A.
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Adult ,Male ,Neurologic Examination ,Disability Evaluation ,Charcot-Marie-Tooth Disease ,Humans ,Disabled Persons ,Female ,Postural Balance ,Severity of Illness Index ,Retrospective Studies - Abstract
The combination of distal muscle weakness, sensory defects and feet deformities leads to disequilibrium in patients affected by Charcot-Marie-Tooth (CMT) neuropathy. Studies relating the outcome of balance scales and clinical severity of CMT are lacking.To evaluate the accuracy of the Tinetti Balance scale (TBS) and Berg Balance scale (BBS) in identifying balance disorders and quantifying disease severity in CMT patients.Observational study.University of Genoa-IRCCS AOU San Martino IST-Department of Neurology, Italy.Nineteen individuals with a diagnosis of CMT (12 females, 7 males, age 41.26±12.42).All subjects underwent an evaluation with both TBS and BBS. Disability was quantified with CMT neuropathy score (CMTNS). Moreover, a complete neurophysiological study was performed. Distal lower limbs strength was evaluated with MRC scale. Pearson rank order correlation was used to determine the correlation between the scores on the two tests and to identify an eventual correlation between TBS or BBS and the CMTNS.Both scales showed a highly significant negative correlation with the CMTNS (r=-0.78, P0.0005 and r=-0.77, P0.001, respectively) and distal weakness on the anterior tibial muscles (AT) (TBS: AT left: r=0.65, P0.005 and AT right: 0.59, P0.01; BBS: AT left r=+0.71, P0.001 and AT right r=+0.66, P0.005). We found also a highly significant, positive correlation between the two different balance scales (r=+0.9, P0.0001).TBS and BBS strongly correlate with disease disability and distal muscular weakness.Both TBS and BBS may play a relevant role in the assessment of disability in patients affected by CMT. Further studies are needed to validate our results in a larger population.
111. ANALYSIS OF A COHORT OF UNSOLVED CHARCOT-MARIE-TOOTH PATIENTS WITH NEXT GENERATION SEQUENCING PANEL
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Geroldi, A., Pezzini, I., Capponi, S., Trovato, R., Gulli, R., Gotta, F., Grandis, M., Ursino, G., Gemelli, C., Schenone, A., Reni, L., Lanteri, P., Filippo M Santorelli, Mandich, P., and Bellone, E.
112. CLINICAL FINDINGS FROM A LARGE SERIES OF CMT2I PATIENTS WITH MPZ P70S MUTATION
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Pisciotta, C., Saveri, P., Grandis, M., Prada, V., Lauria, G., Lombardi, R., Ciano, C., Milani, M., Taroni, F., D Antonio, M., and Davide Pareyson
113. Erratum to: Monitoring effectiveness and safety of Tafamidis in transthyretin amyloidosis in Italy: a longitudinal multicenter study in a non-endemic area
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Cortese A, Vita G, Luigetti M, Russo M, Bisogni G, Sabatelli M, Manganelli F, Santoro L, Cavallaro T, Gm, Fabrizi, Schenone A, Grandis M, Gemelli C, Mauro A, Lg, Pradotto, Gentile L, Stancanelli C, Lozza A, Stefano Perlini, and Piscosquito G
114. Guillain barré syndrome of axonal type in a multple sclerosis patient: Fortuitous association or linked disorders?
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Roccatagliata, L., Capello, E., Schenone, A., Inglese, M., Nobbio, L., Grandis, M., Maritato, F., Abbruzzese, M., and giovanni luigi mancardi
115. PRACTICAL AND PSYCHOLOGICAL DIFFICULTIES EXPERIENCED BY PATIENTS WITH HEREDITARY TRANSTHYRETIN AMYLOIDOSIS (HATTR) IN ITALY: PRELIMINARY RESULTS FROM THE TELETHON GUP 15010 STUDY
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Magliano, L., Citarelli, G., Obici, L., Sforzini, C., Di Buduo, E., Sabatelli, M., Luigetti, M., Bisogni, G., Grandis, M., Gemelli, C., Fabrizi, G., Cavallaro, T., Pareyson, D., Fenu, S., Santoro, L., Manganelli, F., Mauro, A., Pradotto, L., Antonini, G., Leonardi, L., Fiammetta Vanoli, Russo, M., Stancanelli, C., Mazzeo, A., and Vita, G.
116. hATTR ITALIAN REGISTRY: PRELIMINARY DATA FROM THE COLLABORATIVE NETWORK OF TELETHON GUP 15010 STUDY
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Russo, M., Merlini, G., Obici, L., Pacciolla, P., Fabrizi, G., Cavallaro, T., Sabatelli, M., Luigetti, M., Bisogni, G., Pareyson, D., Fenu, S., Calabrese, D., Rapezzi, C., Bartolomei, I., Grandis, M., Gemelli, C., Mauro, A., Pradotto, L., Santoro, L., Manganelli, F., Antonini, G., Leonardi, L., Fiammetta Vanoli, My, F., Gentile, L., Stancanelli, C., Mazzeo, A., and Vita, G.
117. TREADMILL, STRETCHING AND PROPRIOCEPTIVE (TRESPE) REHABILITATION PROGRAM IN CMT1A: THE ROLE OF 6-MWT IN THE EVALUATION OF PATIENTS AT BASELINE
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Schenone, A., Francini, L., Signori, A., Maggi, G., Bragadin, M. M., Bolla, S., Scorsone, D., Saporiti, R., Crimi, E., Davide Pareyson, Padua, L., Fabrizi, G. M., Grandis, M., and Mori, L.
118. LONGITUDINAL EVALUATION OF HAND FUNCTION IN PATIENTS AFFECTED BY CHARCOT-MARIE-TOOTH (CMT) NEUROPATHY WITH A SENSOR ENGINEERED GLOVE TEST (SEGT)
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Prada, V., Accogli, S., Francini, L., LAURA MORI, Ursino, G., Gemelli, C., Salerno, A., Grandis, M., Bellone, E., Maggi, G., and Schenone, A.
119. RITUXIMAB LONG-TERM EFFICACY IN ANTI-MAG POLYNEUROPATHY
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Garnero, M., Beronio, A., Briani, C., Campagnolo, M., Grandis, M., giovanni luigi mancardi, Schenone, A., and Benedetti, L.
120. Effect of the shape demagnetizing field on the stability of the Preisach diagram
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Arca, M, primary, Grandis, M, additional, and Pescetti, D, additional
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- 1988
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121. Guillain-Barré syndrome following chickenpox: a case series.
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Tatarelli, P., Garnero, M., Del Bono, V., Camera, M., Schenone, A., Grandis, M., Benedetti, L., and Viscoli, C.
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GUILLAIN-Barre syndrome ,DISEASE complications ,IMMUNOGLOBULINS ,CHICKENPOX ,DIAGNOSIS ,DISEASE risk factors - Abstract
Guillain–Barré syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy, usually triggered by an infectious episode, mostly of viral origin. Varicella zoster virus (VZV) is a rare cause of GBS, mainly in the case of latent infection reactivation. We report on three adult patients who developed GBS following chickenpox, after a short period of latency. They were promptly treated with intravenous immunoglobulin, and the first one with plasma exchange additionally. All the patients experienced almost complete clinical recovery. Our experience suggests that primary VZV infection constitutes a GBS triggering event. [ABSTRACT FROM PUBLISHER]
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- 2016
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122. 673P Magnetization transfer imaging in late-onset Pompe disease.
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Croce, M., Naz, F., Barzaghi, L., Paoletti, M., Mongini, T., Gasperini, S., Filosto, M., Maggi, L., Sechi, A., Grandis, M., Sacchini, M., Sciacco, M., Vercelli, L., Bonizzoni, C., Bergsland, N., Santini, F., Deligianni, X., Ravaglia, S., and Pichiecchio, A.
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MAGNETIZATION transfer , *GLYCOGEN storage disease type II , *CENTRAL nervous system diseases , *DISEASE progression , *MACROMOLECULES - Abstract
Magnetization transfer imaging (MTI) evaluates the exchange of magnetization between protons in free water molecules and protons bound to macromolecules, including lipids. Widely used in the study of central nervous system diseases, its application in the neuromuscular field has been previously explored only in a Spanish cohort of patients with late-onset Pompe disease (LOPD). To investigate the potential role of MTR as an early biomarker of muscle involvement, we here evaluate magnetization transfer ratio (MTR) and fat fraction (FF) in patients with LOPD in various stages of disease compared to healthy controls (HCs). Quantitative muscle MRI (qMRI) was performed on 31 LOPD patients (21 with mild and 10 with moderate/severe clinical involvement) and 31 matched HCs using 3T MRI. FF and MTR were measured in 11 thigh muscles. Correlations between FF and MTR were assessed. Additionally, FF and MTR were compared between groups of HCs vs. early vs. moderate/severe LOPD. We also explored whether MTR can detect muscle involvement in not yet fat-infiltrated muscles (FF ≤ 10%) in early LOPD. MTR of thigh muscles with FF ≤ 10% was significantly lower in LOPD compared to HCs. Changes in MTR could be detected even in mildly symptomatic patients, particularly in the medial and posterior compartments (Mann-Whitney U: p < 0.05). MTR and FF were inversely correlated in all subjects groups. We found significant differences in MTR and FF changes at the group level between mild and moderate/severe vs HCs. We conclude that MTI has potentially high sensitivity to detect mild muscle fiber damage, even before fat replacement has occurred, making it a useful biomarker to monitor early signs of disease, disease progression, and the efficacy of treatment approaches (Sanofi company provided support for this study, but had no role in study design, data collection and analysis, decision to publish, or preparation of the abstract). (The first and second authors contributed equally to this work) [ABSTRACT FROM AUTHOR]
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- 2024
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123. 580P SYNE-1 and SYNE-2 mutations: expanding the phenotype and genotype spectrum of Nesprin myopathy.
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Cheli, M., Marchetto, G., Gibertini, S., Bruno, C., Filosto, M., Lattanzi, G., Fiorillo, C., Grandis, M., Malandrini, A., Maioli, M., Mandich, P., Massa, R., Matà, S., Melani, F., Maggi, L., Rubegni, A., Santorelli, F., Tonin, P., Cassandrini, D., and Vattemi, G.
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SINGLE nucleotide polymorphisms , *NUCLEAR membranes , *MUSCULAR dystrophy , *NUCLEAR proteins , *MYOCARDIUM - Abstract
Nesprins are a family of spectrin-repeat proteins located at the nuclear envelope which play an important role in nuclear morphology and mechano-transduction. Nesprin-1 and Nesprin-2, encoded by the synaptic nuclear envelope SYNE1 and SYNE2 , are highly expressed in cardiac and skeletal muscle. Mutations in SYNE1 have been associated with the autosomal dominant Emery‐Dreifuss Muscular Dystrophy (EDMD) type 4, Congenital Muscular Dystrophy, and Arthrogryposis Multiplex Congenita while mutations in SYNE2 only with Emery‐Dreifuss muscular dystrophy type 5. In this study, we aimed at defining the clinical characteristics, histopathological features and molecular profile of 54 patients carrying single nucleotide variants in SYNE1 and SYNE2 genes. Multiple algorithms were used to predict the deleteriousness of the variants and only variants with Combined Annotation Dependent Depletion (CADD) scores ≥20 were selected. In our cohort 56% of patients were women; 60% of patients had late onset myopathy and 23% of patients presented with EDMD-like phenotype. In 80% of patients muscle biopsy showed myopathic signs, with dystrophic changes in the 28% of cases. The subcellular localization of Nesprin-1 and -2 and their co-localization with Emerin, an inner nuclear membrane protein, were evaluated by immunofluorescence in muscle tissue from 21 patients and neither reduced nuclear staining nor mislocalization of both nesprins were detected. Our data provide a further insight into the clinical phenotypes and muscle pathology associated with SYNE1 or SYNE2 mutations and suggest that immunohistochemistry does not represent a useful diagnostic tool. [ABSTRACT FROM AUTHOR]
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- 2024
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124. 555P Assessment of IBM-FRS total score and specific domains in a large cohort of inclusion body myositis patients.
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Vicino, A., Lauletta, A., Barbaccia, A., Valentino, L., Cheli, M., Saccani, E., Grandis, M., Coccia, M., Barp, A., Ravaglia, S., Bortolani, S., Ruggiero, L., Mongini, T., Verriello, L., Vattemi, G., Filosto, M., Liguori, R., Rodolico, C., Garibaldi, M., and Maggi, L.
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INCLUSION body myositis , *OLDER people , *FLEXOR muscles , *MUSCLE diseases , *DISEASE duration - Abstract
Inclusion body myositis (IBM) is among the most frequent acquired muscle diseases in the adult and elderly population, with onset typically > 45 years old. IBM is characterized by initially selective weakness of the quadriceps and deep finger flexors muscles, with a slow generalization and progression of weakness over the patient's lifespan. Disease monitoring may be assessed through the validated "Inclusion body myositis functional rating scale" (IBM-FRS), assessing symptoms and functional limitations in a given moment. However, poor data have been reported on IBM-FRS and its correlation with clinical features in large cohorts of IBM patients. In this cross-sectional study, we investigated the correlation of IBM-FRS specific functional domains with demographic and clinical variables in a large group of IBM patients. The following domains were considered: 1. dysphagia (item 1); 2. arm function (items 2-4); 3. independence (items 5-7); 4. leg function (items 8-10). Overall, 123 patients were included, 41 females (33%), with median age at onset of 64 (range 28 – 83), with onset in 6 patients younger than 45 years old. Walking ability was lost in 13 (10.5%), non-invasive ventilation (NIV) was needed in 13 (10.5%) and percutaneous gastrostomy (PEG) in 7 (5.6%). At IBM-FRS scoring, median age was 74 (range 44-90) and median disease duration was 8 years (range 1-42). Median IBM-FRS total score was 25 (range 3-40). When analyzing specific domains, longer disease duration significantly correlated with domains 2 (p=0.038), 3 (p=0.031) and 4 (p<0.001); age at baseline correlated with groups 2 (p=0.029), 3 (p=0.05) and 4 (p=0.008). Domain 1 correlated with female gender (p=0.001), onset with dysphagia (p=0.025) and PEG (p<0.001). Loss of walking ability correlated with domains 2, 3 and 4 (all p<0.001). No correlation was found between specific domains and age at onset or NIV. Preliminary analysis identified correlations between specific domains of IBM-FRS and clinical variables with implications for patients' stratification. Further studies are needed to investigate longitudinal changes of IBM-FRS and its domains over time. [ABSTRACT FROM AUTHOR]
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- 2024
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125. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study
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F. Maldonado, E.D. Amundarain, S. Tsikriki, S. Yasin Wayhs, H. Berty Gutiérrez, A. Gritsan, P. Gradisek, Raimund Helbok, A. Efthymiou, Ankur Luthra, A. Marudi, A. Cotoia, L. Lencastre, Karim Asehnoune, Stefan Wolf, C. Thompson, Federico Pozzi, C. Hawthorne, M. Anglada, C. Vrettou, D. Glorieux, P. Kafle, M. Sekhon, R. Freitas, W. Sellami, Nino Stocchetti, Rafael Badenes, E. Provaznikova, G. Audibert, A. Blandino Ortiz, L. Rajbanshi, Hasin Afzal Ahmed, P. Kurtz, F. Magni, J. Thomsen, C. Diakaki, R. Pérez-Araos, E.E. Stamou, Marco Carbonara, K. Kojder, K. Vrbica, E. Picetti, L. Mebis, M.I. Gonzalez Perez, M.O. Holm, B. Pons, B. Monleon, S. Silva, N. Kovac, E. Kontoudaki, H. Westy Hoffmeyer, K. Nilam, M. Jibaja, G. Nardai, P. Bresil, A. Gempeler, Kristina Fuest, A. Rigamonti, M. Abdelaty, C.Y. Chan, C. Iasonidou, Giuseppe Citerio, S. Khomiakov, C. Bonetti, Andrea Cortegiani, Hervé Quintard, G.A. Gasca López, Y.B. Roka, V. Buldini, Laura Galarza, T. Bajracharya, J. Kletecka, G.S. Shrestha, G. Kyriazopoulos, M.E. Giménez, S. Maskey, C. Pacheco, A. Giugni, A. Kolias, P. Cavaleiro, S.A. Ñamendys Silva, S. Grotheer, Samyuktha Anand, Y Arabi, R. Siviter, O. Idowu, Z. Olson, H.S. Eddelien, Paola Rebora, A. Soragni, R. Sonneville, M. Fencl, Demosthenes Makris, M. Casanova, Francesca Graziano, S. Del Bianco, M. F. García, L. Corral, P. Morelli, F. Villa, F. Assunção, O. Sabelnikovs, M. Reade, Anselmo Caricato, E. Palli, M. Lamperti, S. Van De Velde, Francesca Elli, B. Soyer, A. Giannopoulos, M. Grandis, M. Simoes, J.P. Miroz, Summit Dev Bloria, I. Calamai, P. Biston, Ilaria Alice Crippa, S.M. Zerbi, E. Bertellini, M. Smitt, N. Pantelas, P. Banco, K. Sharma, C. Gelormini, J. Dibu, H. Sapra, S. Kozar, D. Gupta, P. Duque, Sanjeev Sivakumar, I. Brunetti, S.M. Krieg, S. Abed Maillard, A. Lores, M. Levin, Fabio Silvio Taccone, P. Lavicka, J.B. Andersen, R. Cinotti, Jean Louis Vincent, V. Davidovich, Geert Meyfroidt, P. Forjan, M. Škoti, G. Koukoulitsios, A. Dimoula, I. Seppelt, Ahmad Ozair, J.H. Mejia-Mantilla, Lara Prisco, M. Celaya Lopez, M. Fumale, R. Lightfoot, Rajeev Chauhan, R. Mendoza, J.M. Montes, A. Izzi, G. Domeniconi, E. Stival, J. Padilla Juan, C. Gakuba, V. Blazquez, A. Alsudani, K. Tánczos, D.H. Kandamby, L. Albrecht, L.J.Y. Dominguez, Carlo Giussani, Muhammed Elhadi, B. Majholm, E. Mouloudi, Jose I. Suarez, S.F. Ribaric, M.C. Casadio, L.L. Rivera, L. Pariente, W. Videtta, M. Lucca, Guillaume Besch, D. Olson, M.D. Arias Verdu, R. Soley, A. Lindner, Mauro Oddo, M.C. Quartarone, M.M. Khan, P. López Ojeda, Ainhoa Serrano, H.P. Shum, E. Ioannoni, T. Egmose Larsen, A. Motta, E. Favre Eva, S. Muehlschlegel, D. Pearson, A. Caillard, J. Skola, B. Kilapong, Nidhi Panda, Irene Aragão, D. Batista, J.L. Pinedo Portilla, Chiara Robba, Donald E. G. Griesdale, N. Dovbysh, Stefan J. Schaller, E.D. Hallt, N. Milivojevic, V. Spatenkova, J. Roberts, Robba, Chiara, Graziano, Francesca, Rebora, Paola, Elli, Francesca, Giussani, Carlo, Oddo, Mauro, Meyfroidt, Geert, Helbok, Raimund, Taccone, Fabio S, Prisco, Lara, Vincent, Jean-Loui, Suarez, Jose I, Stocchetti, Nino, Citerio, Giuseppe, Abdelaty, M., Abed Maillard, S., Ahmed, H., Albrecht, L., Alsudani, A., Amundarain, E.D., Anand, S., Andersen, J.B., Anglada, M., Arabi, Y, Aragao, I., Arias Verdu, M.D., Asehnoune, K., Assunção, F., Audibert, G., Badenes, R., Bajracharya, T., Banco, P., Batista, D., Bertellini, E., Berty Gutiérrez, H., Besch, G., Biston, P., Blandino Ortiz, A., Blazquez, V., Bloria, S., Bonetti, C., Bresil, P., Brunetti, I., Buldini, V., Caillard, A., Calamai, I., Carbonara, M., Caricato, A., Casadio, M.C., Casanova, M., Cavaleiro, P., Celaya Lopez, M., Chan, C.Y., Chauhan, R., Cinotti, R., Corral, L., Cortegiani, A., Cotoia, A., Crippa, I.A., Davidovich, V., Del Bianco, S., Diakaki, C., Dibu, J., Dimoula, A., Domeniconi, G., Dominguez, L.J.Y., Dovbysh, N., Duque, P., Eddelien, H.S., Efthymiou, A., Egmose Larsen, T., Elhadi, M., Favre Eva, E., Fencl, M., Forjan, P., Freitas, R., Fuest, K., Fumale, M., Gakuba, C., Galarza, L., García, M.F., Gasca López, G.A., Gelormini, C., Gempeler, A., Giannopoulos, A., Giménez, M.E., Giugni, A., Glorieux, D., Gonzalez Perez, M.I., Gradisek, P., Grandis, M., Griesdale, D., Gritsan, A., Grotheer, S., Gupta, D., Hallt, E.D., Hawthorne, C., Helbok, R., Holm, M.O., Iasonidou, C., Idowu, O., Ioannoni, E., Izzi, A., Jibaja, M., Kafle, P., Kandamby, D.H., Khan, M.M., Khomiakov, S., Kilapong, B., Kletecka, J., Kojder, K., Kolias, A., Kontoudaki, E., Koukoulitsios, G., Kovac, N., Kozar, S., Krieg, S.M., Kurtz, P., Kyriazopoulos, G., Lamperti, M., Lavicka, P., Lencastre, L., Levin, M., Lightfoot, R., Lindner, A., López Ojeda, P., Lores, A., Lucca, M., Luthra, A., Magni, F., Majholm, B., Makris, D., Maldonado, F., Marudi, A., Maskey, S., Mebis, L., Mejia-Mantilla, J.H., Mendoza, R., Milivojevic, N., Miroz, J.P., Monleon, B., Montes, J.M., Morelli, P., Motta, A., Mouloudi, E., Muehlschlegel, S., Ñamendys Silva, S.A., Nardai, G., Nilam, K., Olson, D., Ozair, A., Pacheco, C., Padilla Juan, J., Palli, E., Panda, N., Pantelas, N., Pariente, L., Pearson, D., Pérez-Araos, R., Picetti, E., Pinedo Portilla, J.L., Pons, B., Pozzi, F., Provaznikova, E., Quartarone, M.C., Quintard, H., Rajbanshi, L., Reade, M., Ribaric, S.F., Rigamonti, A., Rivera, L.L., Roberts, J., Roka, Y.B., Sabelnikovs, O., Sapra, H., Schaller, S.J., Sekhon, M., Sellami, W., Seppelt, I., Serrano, A., Sharma, K., Shrestha, G.S., Shum, H.P., Silva, S., Simoes, M., Sivakumar, S., Siviter, R., Skola, J., Škoti, M., Smitt, M., Soley, R., Sonneville, R., Soragni, A., Soyer, B., Spatenkova, V., Stamou, E.E., Stival, E., Olson, Z., Tánczos, K., Thompson, C., Thomsen, J., Tsikriki, S., Van De Velde, S., Videtta, W., Villa, F., Vrbica, K., Vrettou, C., Westy Hoffmeyer, H., Wolf, S., Yasin Wayhs, S., Zerbi, S.M., Robba, C, Graziano, F, Rebora, P, Elli, F, Giussani, C, Oddo, M, Meyfroidt, G, Helbok, R, Taccone, F, Prisco, L, Vincent, J, Suarez, J, Stocchetti, N, Citerio, G, and Investigators, SYNAPSE-ICU
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Male ,Intracranial Pressure ,Glasgow Outcome Scale ,Malalties cerebrals ,intensive care unit ,law.invention ,Cohort Studies ,0302 clinical medicine ,law ,Brain Injuries, Traumatic ,Medicine ,acute brain injury ,Prospective Studies ,Prospective cohort study ,Unitats de cures intensives ,Intracranial pressure ,Intensive care units ,Middle Aged ,Intensive care unit ,Intensive Care Units ,Hypertension ,Intracranial pressure monitoring ,Female ,Hipertensió ,Brain diseases ,Adult ,medicine.medical_specialty ,Critical Care ,Traumatic brain injury ,Intracranial pressure, monitoring, brain injury ,03 medical and health sciences ,Internal medicine ,Intensive care ,Settore MED/41 - ANESTESIOLOGIA ,Humans ,Glasgow Coma Scale ,Aged ,Monitoring, Physiologic ,business.industry ,030208 emergency & critical care medicine ,ICP ,medicine.disease ,Brain Injuries ,Neurology (clinical) ,Intracranial Hypertension ,business ,030217 neurology & neurosurgery - Abstract
Background: The indications for intracranial pressure (ICP) monitoring in patients with acute brain injury and the effects of ICP on patients’ outcomes are uncertain. The aims of this study were to describe current ICP monitoring practises for patients with acute brain injury at centres around the world and to assess variations in indications for ICP monitoring and interventions, and their association with long-term patient outcomes. Methods: We did a prospective, observational cohort study at 146 intensive care units (ICUs) in 42 countries. We assessed for eligibility all patients aged 18 years or older who were admitted to the ICU with either acute brain injury due to primary haemorrhagic stroke (including intracranial haemorrhage or subarachnoid haemorrhage) or traumatic brain injury. We included patients with altered levels of consciousness at ICU admission or within the first 48 h after the brain injury, as defined by the Glasgow Coma Scale (GCS) eye response score of 1 (no eye opening) and a GCS motor response score of at least 5 (not obeying commands). Patients not admitted to the ICU or with other forms of acute brain injury were excluded from the study. Between-centre differences in use of ICP monitoring were quantified by using the median odds ratio (MOR). We used the therapy intensity level (TIL) to quantify practice variations in ICP interventions. Primary endpoints were 6 month mortality and 6 month Glasgow Outcome Scale Extended (GOSE) score. A propensity score method with inverse probability of treatment weighting was used to estimate the association between use of ICP monitoring and these 6 month outcomes, independently of measured baseline covariates. This study is registered with ClinicalTrial.gov, NCT03257904. Findings: Between March 15, 2018, and April 30, 2019, 4776 patients were assessed for eligibility and 2395 patients were included in the study, including 1287 (54%) with traumatic brain injury, 587 (25%) with intracranial haemorrhage, and 521 (22%) with subarachnoid haemorrhage. The median age of patients was 55 years (IQR 39–69) and 1567 (65%) patients were male. Considerable variability was recorded in the use of ICP monitoring across centres (MOR 4·5, 95% CI 3·8–4·9 between two randomly selected centres for patients with similar covariates). 6 month mortality was lower in patients who had ICP monitoring (441/1318 [34%]) than in those who were not monitored (517/1049 [49%]; p
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- 2021
126. Psychosocial burden and professional and social support in patients with hereditary transthyretin amyloidosis (ATTRv) and their relatives in Italy
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Magliano, Lorenza, Obici, Laura, Sforzini, Claudia, Mazzeo, Anna, Russo, Massimo, Cappelli, Francesco, Fenu, Silvia, Luigetti, Marco, Tagliapietra, Matteo, Gemelli, Chiara, Leonardi, Luca, Tozza, Stefano, Pradotto, Luca Guglielmo, Citarelli, Giulia, Mauro, Alessandro, Manganelli, Fiore, Antonini, Giovanni, Grandis, Marina, Fabrizi, Gian Maria, Sabatelli, Mario, Pareyson, Davide, Perfetto, Federico, Merlini, Giampaolo, Vita, Giuseppe, Giulia, Bisogni, Daniela, Calabrese, Davide, Cardellini, Silvia, Casagrande, Tiziana, Cavallaro, Eleonora Di Buduo, Andrea Di Paolantonio, Gentile, Luca, Graceffa, Anita Maria Stella, Sara, Massucco, Alessandra, Milesi, Stefania, Morino, Roberta, Mussinelli, Paola, Saveri, Daniele, Severi, Magliano, Lorenza, Obici, Laura, Sforzini, Claudia, Mazzeo, Anna, Russo, Massimo, Cappelli, Francesco, Fenu, Silvia, Luigetti, Marco, Tagliapietra, Matteo, Gemelli, Chiara, Leonardi, Luca, Tozza, Stefano, Pradotto, Luca Guglielmo, Citarelli, Giulia, Mauro, Alessandro, Manganelli, Fiore, Antonini, Giovanni, Grandis, Marina, Fabrizi, Gian Maria, Sabatelli, Mario, Pareyson, Davide, Perfetto, Federico, Merlini, Giampaolo, Vita, Giuseppe, Magliano, L., Obici, L., Sforzini, C., Mazzeo, A., Russo, M., Cappelli, F., Fenu, S., Luigetti, M., Tagliapietra, M., Gemelli, C., Leonardi, L., Tozza, S., Pradotto, L. G., Citarelli, G., Mauro, A., Manganelli, F., Antonini, G., Grandis, M., Fabrizi, G. M., Sabatelli, M., Pareyson, D., Perfetto, F., Merlini, G., Vita, G., Bisogni, G., Calabrese, D., Cardellini, D., Casagrande, S., Cavallaro, T., Dibuduo, E., Dipaolantonio, A., Gentile, L., Graceffa, A., Massucco, S., Milesi, A., Morino, S., Mussinelli, R., Saveri, P., and Severi, D.
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0301 basic medicine ,Adult ,medicine.medical_specialty ,Activities of daily living ,media_common.quotation_subject ,Psychological intervention ,lcsh:Medicine ,ATTRv ,Burden ,Caregiving ,Hereditary transthyretin amyloidosis ,Professional support ,Social network support ,Amyloid Neuropathies, Familial ,Humans ,Italy ,Surveys and Questionnaires ,Quality of Life ,Social Support ,Disease ,030105 genetics & heredity ,Amyloid Neuropathies ,Hereditary transthyretin amyloidosis, ATTRv, Burden, Professional support, Social network support, Caregiving ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Quality of life (healthcare) ,Familial ,medicine ,Pharmacology (medical) ,Psychiatry ,Genetics (clinical) ,media_common ,Social network ,business.industry ,Research ,lcsh:R ,General Medicine ,Hereditary transthyretin amyloidosi ,Settore MED/26 - NEUROLOGIA ,Feeling ,business ,Psychosocial ,030217 neurology & neurosurgery - Abstract
Background Hereditary transthyretin amyloidosis (hATTR), alias ATTR variant (ATTRv) is a severe and disabling disease causing sensory and motor neuropathy, autonomic dysfunction, and cardiomyopathy. The progressive decline of patient’s functional autonomy negatively affects the patient’s quality of life and requires increasing involvement of relatives in the patient’s daily life. Family caregiving may become particularly demanding when the patient is no longer able to move independently. This study is focused on the psychosocial aspects of ATTRv from the patient and relative perspectives. In particular, it explored: the practical and psychological burdens experienced by symptomatic patients with ATTRv and their key relatives and the professional and social network support they may rely on; whether burden varied in relation to patients’ and relatives’ socio-demographic variables, patients’ clinical variables, and perceived professional and social network support; and, any difference in burden and support between patients and their matched relatives. Methods The study was carried out on symptomatic patients included in the ATTRv Italian national registry and living with at least one adult relative not suffering from severe illness and being free from ATTRv symptoms. Patients and relatives’ assessments were performed using validated self-reported tools. Results Overall, 141 patients and 69 relatives were evaluated. Constraints of leisure activities, feelings of loss and worries for the future were the consequences of ATTRv most frequently reported by patients and relatives. Both in patients and their relatives, the burden increased with the duration of symptoms and the level of help in daily activities needed by the patient. In the 69 matched patient-relative pairs, the practical burden was significantly higher among the patients than among their relatives, while the psychological burden was similar in the two groups. Moreover, compared to their relatives, patients with ATTRv reported higher levels of professional and social network support. Conclusions These results show that ATTRv is a disease affecting quality of life of both patients and their families. Supporting interventions should be guaranteed to patients, to facilitate their adaptation to the disease, and to their families, to cope as best as possible with the difficulties that this pathology may involve.
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- 2020
127. Pregnancy in Charcot-Marie-Tooth disease: Data from the Italian CMT national registry
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Chiara Pisciotta 1, Daniela Calabrese 1, Lucio Santoro 2, Irene Tramacere 1, Fiore Manganelli 2, Gian Maria Fabrizi 3, Angelo Schenone, Tiziana Cavallaro 3, Marina Grandis, Stefano C Previtali 4, Isabella Allegri 5, Luca Padua, Costanza Pazzaglia 6, Paola Saveri 1, Aldo Quattrone 7, Paola Valentino 8, Stefano Tozza 2, Luca Gentile 9, Md Massimo Russo 9, Anna Mazzeo 9, Maria Claudia Trapasso 5, Fabio Parazzini 10, Giuseppe Vita 9, Davide Pareyson 1, Italian CMT Network, Pisciotta, C., Calabrese, D., Santoro, L., Tramacere, I., Manganelli, F., Fabrizi, G. M., Schenone, A., Cavallaro, T., Grandis, M., Previtali, S. C., Allegri, I., Padua, L., Pazzaglia, C., Saveri, P., Quattrone, A., Valentino, P., Tozza, S., Gentile, L., Russo, M., Mazzeo, A., Trapasso, M. C., Parazzini, F., Vita, G., and Pareyson, D.
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Registrie ,Placenta Previa ,0302 clinical medicine ,Retrospective Studie ,Charcot-Marie-Tooth Disease ,Pregnancy ,Abortion, Spontaneou ,Birth Weight ,Registries ,Obstetric Labor Complication ,education.field_of_study ,030219 obstetrics & reproductive medicine ,postpartum bleeding ,Obstetrics ,disease course ,Pregnancy Outcome ,Gestational age ,Middle Aged ,Symptom Flare Up ,Italy ,Premature birth ,Charcot-Marie-Tooth disease ,Gestation ,Premature Birth ,Female ,Human ,Adult ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Birth weight ,Population ,Gestational Age ,Article ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,delivery complications ,education ,Breech Presentation ,Aged ,Retrospective Studies ,business.industry ,Cesarean Section ,Postpartum Hemorrhage ,Infant, Newborn ,medicine.disease ,Placenta previa ,Obstetric Labor Complications ,nervous system diseases ,Abortion, Spontaneous ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo collect information on frequency of pregnancy and delivery complications in Charcot-Marie-Tooth (CMT) disease and on CMT course during pregnancy.MethodsThrough an ad hoc online questionnaire, we investigated pregnancy and neuropathy course in women with CMT adhering to the Italian CMT Registry. Data were compared to those of controls (recruited among friends and unaffected relatives) and the Italian (or other reference) population.ResultsWe collected data on 193 pregnancies from 86 women with CMT (age 20–73 years) with 157 deliveries (81.4%) after a mean of 38.6 gestational weeks. In women with CMT, there were no differences compared to controls (59 pregnancies and 46 deliveries from 24 controls) and the reference population for miscarriages (11.4%) and planned (21.0%) and emergency (14.0%) cesarean sections. We found a significantly higher frequency of placenta previa (1.6% vs 0.4%), abnormal fetal presentations (8.4% vs 4.5%), and preterm deliveries (20.3% vs 6.9%; most in week 34–36 of gestation) compared to reference populations. Excluding twins, newborn weight did not differ from the reference population. Postpartum bleeding rate in patients with CMT (2.1%) was similar to that of the general population (2.4%). CMT status worsened during 18 of 193 pregnancies (9.3%) with no recovery in 16 of them and with similar figures in the CMT1A and non-CMT1A subtypes.ConclusionsWe observed higher rates of placenta previa, abnormal presentations, and preterm deliveries in CMT, but pregnancy outcome and newborn weight and health were similar to those of the reference populations. Worsening of CMT is not infrequent and occurs not only in CMT1A. Pregnant women with CMT should be monitored with particular care.
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- 2020
128. Nusinersen safety and effects on motor function in adult spinal muscular atrophy type 2 and 3
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Veria Vacchiano, Luca Bello, Renato Mantegazza, Eustachio D'Errico, Tiziana Mongini, Riccardo Zanin, Gabriele Siciliano, Francesca Trojsi, Elena Saccani, Federica Cerri, Marina Grandis, Michela Coccia, Stefano C. Previtali, Alessandra Govoni, Massimiliano Filosto, L. Passamano, Giovanni Pavesi, Luisa Politano, Mauro Silvestrini, Claudia Caponnetto, Silvia Bonanno, Virginia Bozzoni, Manfredi Ferraro, Elena Pegoraro, Raffaella Tanel, Lorenzo Verriello, Angelo Schenone, Sara Bortolani, Lorenzo Maggi, Angela Berardinelli, Giacomo P. Comi, Megi Meneri, Rocco Liguori, Gianni Sorarù, G. Marrosu, Mara Turri, Luca Caumo, Irene Tramacere, Rachele Piras, Giulia Ricci, Isabella Laura Simone, Maggi, Lorenzo, Bello, Luca, Bonanno, Silvia, Govoni, Alessandra, Caponnetto, Claudia, Passamano, Luigia, Grandis, Marina, Trojsi, Francesca, Cerri, Federica, Ferraro, Manfredi, Bozzoni, Virginia, Caumo, Luca, Piras, Rachele, Tanel, Raffaella, Saccani, Elena, Meneri, Megi, Vacchiano, Veria, Ricci, Giulia, Soraru', Gianni, D'Errico, Eustachio, Tramacere, Irene, Bortolani, Sara, Pavesi, Giovanni, Zanin, Riccardo, Silvestrini, Mauro, Politano, Luisa, Schenone, Angelo, Previtali, Stefano Carlo, Berardinelli, Angela, Turri, Mara, Verriello, Lorenzo, Coccia, Michela, Mantegazza, Renato, Liguori, Rocco, Filosto, Massimiliano, Marrosu, Gianni, Siciliano, Gabriele, Simone, Isabella Laura, Mongini, Tiziana, Comi, Giacomo, Pegoraro, Elena, Maggi L., Bello L., Bonanno S., Govoni A., Caponnetto C., Passamano L., Grandis M., Trojsi F., Cerri F., Ferraro M., Bozzoni V., Caumo L., Piras R., Tanel R., Saccani E., Meneri M., Vacchiano V., Ricci G., Soraru' G., D'Errico E., Tramacere I., Bortolani S., Pavesi G., Zanin R., Silvestrini M., Politano L., Schenone A., Previtali S.C., Berardinelli A., Turri M., Verriello L., Coccia M., Mantegazza R., Liguori R., Filosto M., Marrosu G., Siciliano G., Simone I.L., Mongini T., Comi G., and Pegoraro E.
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Male ,Pediatrics ,spinal muscular atrophy type 3 ,Vital Capacity ,spinal muscular atrophy type 2 ,Oligonucleotides ,Walking ,Spinal Muscular Atrophies of Childhood ,Cohort Studies ,Efficacy ,0302 clinical medicine ,Forced Expiratory Volume ,Age of Onset ,Young adult ,Injections, Spinal ,Sitting Position ,0303 health sciences ,Middle Aged ,Psychiatry and Mental health ,Treatment Outcome ,Italy ,Female ,Nusinersen ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Spinal ,Walk Test ,Injections ,Young Adult ,03 medical and health sciences ,Rating scale ,medicine ,Humans ,Aged ,Functional Status ,Oligonucleotides, Antisense ,Retrospective Studies ,Antisense ,030304 developmental biology ,business.industry ,Retrospective cohort study ,Spinal muscular atrophy ,medicine.disease ,Surgery ,Neurology (clinical) ,Age of onset ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo retrospectively investigate safety and efficacy of nusinersen in a large cohort of adult Italian patients with spinal muscular atrophy (SMA).MethodsInclusion criteria were: (1) clinical and molecular diagnosis of SMA2 or SMA3; (2) nusinersen treatment started in adult age (>18 years); (3) clinical data available at least at baseline (T0-beginning of treatment) and 6 months (T6).ResultsWe included 116 patients (13 SMA2 and 103 SMA3) with median age at first administration of 34 years (range 18–72). The Hammersmith Functional Rating Scale Expanded (HFMSE) in patients with SMA3 increased significantly from baseline to T6 (median change +1 point, pConclusionsOur data provide further evidence of nusinersen safety and efficacy in adult SMA2 and SMA3, with the latter appearing to be cumulative over time. In patients with extremely advanced disease, effects on residual motor function are less clear.
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- 2020
129. Low Sensitivity of Bone Scintigraphy in Detecting Phe64Leu Mutation-Related Transthyretin Cardiac Amyloidosis
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Rachele Bonfiglioli, Camillo Autore, Claudio Rapezzi, Gianluca Di Bella, Federico Perfetto, Giacomo Tini, Marco Canepa, Agnese Milandri, Maria Beatrice Musumeci, Marina Grandis, Stefano Perlini, Francesco Cappelli, Filomena My, Domitilla Russo, Marco Luigetti, Musumeci M.B., Cappelli F., Russo D., Tini G., Canepa M., Milandri A., Bonfiglioli R., Di Bella G., My F., Luigetti M., Grandis M., Autore C., Perlini S., Perfetto F., and Rapezzi C.
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Male ,Predictive Value of Test ,Technetium Tc 99m Medronate ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Left ventricular hypertrophy ,Technetium Compound ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Retrospective Studie ,Prealbumin ,Medicine ,Whole Body Imaging ,Mutation ,Diphosphonates ,biology ,medicine.diagnostic_test ,Middle Aged ,cardiac amyloidosi ,medicine.anatomical_structure ,Diphosphonate ,Italy ,Cohort ,Tracer uptake ,Cardiology ,Radiopharmaceutical ,Female ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,Bone and Bone ,Human ,medicine.medical_specialty ,phe64Leu mutation ,bone scintigraphy ,cardiac amyloidosis ,Phe64Leu mutation ,Reproducibility of Result ,Bone and Bones ,NO ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,Humans ,Genetic Predisposition to Disease ,Radiology, Nuclear Medicine and imaging ,Interventricular septum ,Radionuclide Imaging ,Cardiomyopathie ,Aged ,Retrospective Studies ,Amyloid Neuropathies, Familial ,business.industry ,Reproducibility of Results ,nutritional and metabolic diseases ,medicine.disease ,Technetium Compounds ,Transthyretin ,Bone scintigraphy ,Cardiac amyloidosis ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,biology.protein ,Radiopharmaceuticals ,business - Abstract
Objectives The aim of this study was to assess the diagnostic accuracy of bone scintigraphy in a large multicenter cohort of patients with cardiac amyloidotic involvement and Phe64Leu transthyretin (TTR) mutation. Background Diagnostic accuracy of bone scintigraphy for transthyretin-related cardiac amyloidosis (TTR-CA) is considered extremely high, enabling this technique to be the noninvasive diagnostic standard for TTR-CA. Nevertheless, this approach has not been systematically validated across the entire spectrum of TTR mutations. Methods A total of 55 patients with Phe64Leu TTR mutation were retrospectively analyzed and evaluated between 1993 and 2018 at 7 specialized Italian tertiary centers. Cardiac involvement was defined as presence of an end-diastolic interventricular septum thickness ≥12 mm, without other possible causes of left ventricular hypertrophy (i.e., arterial hypertension or valvulopathies). A technetium-99m (99mTc)–diphosphonate (DPD) or 99mTc–hydroxyl-methylene-diphosphonate (HMDP) bone scintigraphy was reviewed, and visual scoring was evaluated according to Perugini’s method. Results Among 26 patients with definite cardiac involvement, 19 underwent 99mTc-DPD or 99mTc-HMDP bone scintigraphy. Of them, 17 (89.5%) patients had low or absent myocardial bone tracer uptake, whereas only 2 (10.5%) showed high-grade myocardial uptake. The sensitivity and the accuracy of bone scintigraphy in detecting TTR-CA were 10.5% and 37%, respectively. Patients with cardiac involvement and low or absent bone tracer uptake were similar to those with high-grade myocardial uptake in terms of age, sex, and electrocardiographic and echocardiographic findings. Conclusions The sensitivity of bone scintigraphy (DPD and HMDP) in detecting TTR-CA is extremely low in patients with Phe64Leu TTR mutation, suggesting the need to assess diagnostic accuracy of bone scintigraphy to identify cardiac involvement across a wider spectrum of TTR mutations.
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- 2020
130. Decision Making over Multiple Criteria to Assess News Credibility in Microblogging Sites
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Marco Viviani, Gabriella Pasi, Marco De Grandis, Pasi, G, De Grandis, M, and Viviani, M
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Microblogging ,Computer science ,Process (engineering) ,02 engineering and technology ,Data science ,020204 information systems ,Credibility ,0202 electrical engineering, electronic engineering, information engineering ,Multiple criteria ,Intermediation ,020201 artificial intelligence & image processing ,Social media ,Misinformation ,Web content ,Credibility, Microblogging, Fake News, Multi-Criteria Decision Making, Aggregation Operators, Linguistic Quantifiers - Abstract
Locating Web content useful to specific user needs and tasks concerns nowadays, in many circumstances, to assess the credibility of the content itself. With the diffusion of social media and the possibility for everyone to become a content generator, the problem of assessing information credibility has become a major research issue, in particular in microblogging sites, where fake news, hoaxes and other kinds of misinformation are diffused almost without any traditional form of trusted intermediation. In this paper, we propose an approach based on multiple criteria associated with news, on which the use of aggregation operators guided by linguistic quantifiers allow the modeling of the decision maker behavior into the news credibility assessment process. The operation and the evaluation of the approach are illustrated by considering the Twitter microblogging platform.
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- 2020
131. Fake News Detection in Microblogging Through Quantifier-Guided Aggregation
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Marco Viviani, Gabriella Pasi, Marco De Grandis, De Grandis, M, Pasi, G, and Viviani, M
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Process (engineering) ,Microblogging ,Computer science ,Credibility ,INF/01 - INFORMATICA ,User-generated content ,020206 networking & telecommunications ,Context (language use) ,Aggregation operator ,02 engineering and technology ,Fake new ,Multi-Criteria Decision Making ,Multiple-criteria decision analysis ,Social media ,World Wide Web ,Data dependency ,0202 electrical engineering, electronic engineering, information engineering ,User-Generated Content ,020201 artificial intelligence & image processing - Abstract
Nowadays, big volumes of User-Generated Content (UGC) spread across various kinds of social media. In microblogging, UCG can be generated in the form of ‘newsworthy’ posts, i.e., related to information that has a public utility for the people. In this context, being the UGC diffused without almost any traditional form of trusted external control, the possibility of incurring in possible fake news is far from remote. For this reason, several approaches for fake news detection in microblogging have been proposed upto now, mostly based on machine learning techniques. In this paper, an ongoing work based on the use of the Multi-Criteria Decision Making (MCDM) paradigm to detect fake news is proposed. The aim is to reduce data dependency in building the model, and to have flexible control over the choices behind the fake news detection process.
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- 2019
132. Monitoring effectiveness and safety of Tafamidis in transthyretin amyloidosis in Italy: a longitudinal multicenter study in a non-endemic area
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Andrea Cortese, Chiara Gemelli, Fiore Manganelli, Davide Pareyson, Claudia Stancanelli, Giuseppe Piscosquito, Anna Mazzeo, Gianluca Vita, Marco Luigetti, Lucio Santoro, Tiziana Cavallaro, Luca Gentile, Alessandro Mauro, Mario Sabatelli, Stefano Perlini, Laura Obici, Alessandro Lozza, Luca Pradotto, Margherita Russo, Daniela Calabrese, Angelo Schenone, Giulia Bisogni, Marina Grandis, Gian Maria Fabrizi, Cortese, A., Vita, G., Luigetti, M., Russo, M., Bisogni, G., Sabatelli, M., Manganelli, Fiore, Santoro, Lucio, Cavallaro, T., Fabrizi, G. M., Schenone, A., Grandis, M., Gemelli, C., Mauro, A., Pradotto, L. G., Gentile, L., Stancanelli, C., Lozza, A., Perlini, S., Piscosquito, G., Calabrese, D., Mazzeo, A., Obici, L., and Pareyson, D.
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Male ,Tafamidis ,Amyloid polyneuropathy ,Neurology ,Cardiomyopathy ,Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Transthyretin ,chemistry.chemical_compound ,0302 clinical medicine ,Prealbumin ,Tafamidi ,Longitudinal Studies ,Stage (cooking) ,Aged, 80 and over ,Benzoxazoles ,biology ,Amyloidosis ,Middle Aged ,amyloid polyneuropathy ,tafamidis ,transthyretin ,Prognosis ,Settore MED/26 - NEUROLOGIA ,Treatment Outcome ,Italy ,Disease Progression ,Female ,Neurology (clinical) ,Adult ,medicine.medical_specialty ,03 medical and health sciences ,Internal medicine ,Severity of illness ,medicine ,Humans ,Aged ,Amyloid Neuropathies, Familial ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,Surgery ,chemistry ,Mutation ,biology.protein ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Tafamidis is a transthyretin (TTR) stabilizer able to prevent TTR tetramer dissociation. There have been a few encouraging studies on Tafamidis efficacy in early-onset inherited transthyretin amyloidosis (ATTR) due to Val30Met mutation. However, less is known about its efficacy in later disease stages and in non-Val30Met mutations. We performed a multi-center observational study on symptomatic ATTR patients prescribed to receive Tafamidis. We followed up patients according to a standardized protocol including general medical, cardiological and neurological assessments at baseline and every 6 months up to 3 years. Sixty-one (42 males) patients were recruited. Only 28 % of enrolled subjects had the common Val30Met mutation, mean age of onset was remarkably late (59 years) and 18 % was in advanced disease stage at study entry. Tafamidis proved safe and well-tolerated. One-third of patients did not show significant progression along 36 months, independently from mutation type and disease stage. Neurological function worsened particularly in the first 6 months but progression slowed significantly thereafter. Autonomic function remained stable in 33 %, worsened in 56 % and improved in 10 %. Fifteen percent of patients showed cardiac disease progression and 30 % new onset of cardiomyopathy. Overall, Tafamidis was not able to prevent functional progression of the disease in 23 (43 %) subjects, including 16 patients who worsened in their walking ability and 12 patients who reached a higher NYHA score during the follow-up period. A higher mBMI at baseline was associated with better preservation of neurological function. In conclusion, neuropathy and cardiomyopathy progressed in a significant proportion of patients despite treatment. However, worsening of neurological function slowed after the first 6 months and also subjects with more advanced neuropathy, as well as patients with non-Val30Met mutation, benefited from treatment. Body weight preservation is an important favorable prognostic factor.
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- 2016
133. MYH7-related myopathies: clinical, histopathological and imaging findings in a cohort of Italian patients
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Marina Fanin, Roberto Massa, Marina Mora, Guja Astrea, Adele D'Amico, Carlo Minetti, Lorenzo Maggi, Sara Gibertini, Denise Cassandrini, Filippo M. Santorelli, Marina Pedemonte, Liliana Vercelli, Tiziana Mongini, Federica Trucco, Luca Bello, Giacomo Brisca, Claudio Bruno, Marina Grandis, Lucia Ruggiero, Gian Luca Vita, Lucio Santoro, Antonio Petrucci, Rosanna Trovato, Lucia Morandi, Chiara Fiorillo, Paolo Broda, Enrico Bertini, Elena Pegoraro, Eugenio Mercuri, Olimpia Musumeci, Sonia Messina, Carmelo Rodolico, Vincenzo Nigro, Giorgio Tasca, Marika Pane, Antonio Toscano, Maria Sframeli, Marco Savarese, Fiorillo, C., Astrea, G., Savarese, M., Cassandrini, D., Brisca, G., Trucco, F., Pedemonte, M., Trovato, R., Ruggiero, L., Vercelli, L., D'Amico, A., Tasca, G., Pane, M., Fanin, M., Bello, L., Broda, P., Musumeci, O., Rodolico, C., Messina, S., Vita, G. L., Sframeli, M., Gibertini, S., Morandi, L., Mora, M., Maggi, L., Petrucci, A., Massa, R., Grandis, M., Toscano, A., Pegoraro, E., Mercuri, E., Bertini, E., Mongini, T., Santoro, L., Nigro, V., Minetti, C., Santorelli, F. M., Bruno, C., Ruggiero, Lucia, and Santoro, Lucio
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0301 basic medicine ,Male ,Pathology ,Cardiomyopathy ,0302 clinical medicine ,Myosin ,Genetics(clinical) ,Pharmacology (medical) ,Child ,Genetics (clinical) ,Medicine(all) ,education.field_of_study ,medicine.diagnostic_test ,Medicine (all) ,Hypertrophic cardiomyopathy ,General Medicine ,Anatomy ,Middle Aged ,Magnetic Resonance Imaging ,Pedigree ,Phenotype ,Lower Extremity ,Child, Preschool ,Female ,Muscle biopsy ,medicine.symptom ,Human ,Adult ,Weakness ,medicine.medical_specialty ,Adolescent ,Genotype ,Population ,Distal myopathy ,Settore MED/26 ,Muscle MRI ,03 medical and health sciences ,Young Adult ,Muscular Diseases ,medicine ,Humans ,education ,Myopathy ,Muscle, Skeletal ,Aged ,Myosin Heavy Chains ,Cardiac Myosin ,business.industry ,Muscular Disease ,Research ,Whole exome sequencing ,Infant, Newborn ,Myosin Heavy Chain ,Myosin heavy chain ,Infant ,medicine.disease ,030104 developmental biology ,Mutation ,MYH7 ,business ,Cardiac Myosins ,030217 neurology & neurosurgery - Abstract
Background Myosin heavy chain 7 (MYH7)-related myopathies are emerging as an important group of muscle diseases of childhood and adulthood, with variable clinical and histopathological expression depending on the type and location of the mutation. Mutations in the head and neck domains are a well-established cause of hypertrophic cardiomyopathy whereas mutation in the distal regions have been associated with a range of skeletal myopathies with or without cardiac involvement, including Laing distal myopathy and Myosin storage myopathy. Recently the spectrum of clinical phenotypes associated with mutations in MYH7 has increased, blurring this scheme and adding further phenotypes to the list. A broader disease spectrum could lead to misdiagnosis of different congenital myopathies, neurogenic atrophy and other neuromuscular conditions. Results As a result of a multicenter Italian study we collected clinical, histopathological and imaging data from a population of 21 cases from 15 families, carrying reported or novel mutations in MYH7. Patients displayed a variable phenotype including atypical pictures, as dropped head and bent spine, which cannot be classified in previously described groups. Half of the patients showed congenital or early infantile weakness with predominant distal weakness. Conversely, patients with later onset present prevalent proximal weakness. Seven patients were also affected by cardiomyopathy mostly in the form of non-compacted left ventricle. Muscle biopsy was consistent with minicores myopathy in numerous cases. Muscle MRI was meaningful in delineating a shared pattern of selective involvement of tibialis anterior muscles, with relative sparing of quadriceps. Conclusion This work adds to the genotype-phenotype correlation of MYH7-relatedmyopathies confirming the complexity of the disorder. Electronic supplementary material The online version of this article (doi:10.1186/s13023-016-0476-1) contains supplementary material, which is available to authorized users.
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134. Six-minute walk test as outcome measure of fatigability in adults with spinal muscular atrophy treated with nusinersen.
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Govoni A, Ricci G, Bonanno S, Bello L, Magri F, Meneri M, Torri F, Caponnetto C, Passamano L, Grandis M, Trojsi F, Cerri F, Gadaleta G, Capece G, Caumo L, Tanel R, Saccani E, Vacchiano V, Sorarù G, D'Errico E, Tramacere I, Bortolani S, Rolle E, Gellera C, Zanin R, Silvestrini M, Politano L, Schenone A, Previtali SC, Berardinelli A, Turri M, Verriello L, Coccia M, Mantegazza R, Liguori R, Filosto M, Maioli MA, Simone IL, Mongini T, Corti S, Manca ML, Pegoraro E, Siciliano G, Comi GP, and Maggi L
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- Humans, Male, Female, Adult, Retrospective Studies, Middle Aged, Young Adult, Treatment Outcome, Cohort Studies, Adolescent, Outcome Assessment, Health Care, Follow-Up Studies, Oligonucleotides therapeutic use, Walk Test, Fatigue drug therapy, Fatigue etiology, Fatigue physiopathology, Fatigue diagnosis, Muscular Atrophy, Spinal drug therapy, Muscular Atrophy, Spinal physiopathology
- Abstract
Introduction/aims: Fatigue (subjective perception) and fatigability (objective motor performance worsening) are relevant aspects of disability in individuals with spinal muscular atrophy (SMA). The effect of nusinersen on fatigability in SMA patients has been investigated with conflicting results. We aimed to evaluate this in adult with SMA3., Methods: We conducted a multicenter retrospective cohort study, including adult ambulant patients with SMA3, data available on 6-minute walk test (6MWT) and Hammersmith Functional Motor Scale-Expanded (HFMSE) at baseline and at least at 6 months of treatment with nusinersen. We investigated fatigability, estimated as 10% or higher decrease in walked distance between the first and sixth minute of the 6MWT, at baseline and over the 14-month follow-up., Results: Forty-eight patients (56% females) were included. The 6MWT improved after 6, 10, and 14 months of treatment (p < 0.05). Of the 27 patients who completed the entire follow-up, 37% improved (6MWT distance increase ≥30 m), 48.2% remained stable, and 14.8% worsened (6MWT distance decline ≥30 m). Fatigability was found at baseline in 26/38 (68%) patients and confirmed at subsequent time points (p < 0.05) without any significant change over the treatment period. There was no correlation between fatigability and SMN2 copy number, sex, age at disease onset, age at baseline, nor with 6MWT total distance and baseline HFMSE score., Discussion: Fatigability was detected at baseline in approximately 2/3 of SMA3 walker patients, without any correlation with clinical features, included motor performance. No effect on fatigability was observed during the 14-month treatment period with nusinersen., (© 2024 The Author(s). Muscle & Nerve published by Wiley Periodicals LLC.)
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- 2024
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135. Genetic deletion of JAM-C in preleukemic cells rewires leukemic stem cell gene expression program in AML.
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Grenier JMP, Testut C, Bal M, Bardin F, De Grandis M, Gelsi-Boyer V, Vernerey J, Delahaye M, Granjeaud S, Zemmour C, Spinella JF, Chavakis T, Mancini SJC, Boher JM, Hébert J, Sauvageau G, Vey N, Schwaller J, Hospital MA, Fauriat C, and Aurrand-Lions M
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- Animals, Humans, Mice, Disease Models, Animal, Gene Deletion, Hematopoietic Stem Cells metabolism, Immunoglobulins, Longitudinal Studies, Cell Adhesion Molecules metabolism, Cell Adhesion Molecules genetics, Gene Expression Regulation, Leukemic, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute metabolism, Leukemia, Myeloid, Acute pathology, Neoplastic Stem Cells metabolism, Neoplastic Stem Cells pathology
- Abstract
Abstract: The leukemic stem cell (LSC) score LSC-17 based on a stemness-related gene expression signature is an indicator of poor disease outcome in acute myeloid leukemia (AML). However, it is not known whether "niche anchoring" of LSC affects disease evolution. To address this issue, we conditionally inactivated the adhesion molecule JAM-C (Junctional Adhesion Molecule-C) expressed by hematopoietic stem cells (HSCs) and LSCs in an inducible mixed-lineage leukemia (iMLL)-AF9-driven AML mouse model. Deletion of Jam3 (encoding JAM-C) before induction of the leukemia-initiating iMLL-AF9 fusion resulted in a shift from long-term to short-term HSC expansion, without affecting disease initiation and progression. In vitro experiments showed that JAM-C controlled leukemic cell nesting irrespective of the bone marrow stromal cells used. RNA sequencing performed on leukemic HSCs isolated from diseased mice revealed that genes upregulated in Jam3-deficient animals belonged to activation protein-1 (AP-1) and tumor necrosis factor α (TNF-α)/NF-κB pathways. Human orthologs of dysregulated genes allowed to identify a score that was distinct from, and complementary to, the LSC-17 score. Substratification of patients with AML using LSC-17 and AP-1/TNF-α genes signature defined 4 groups with median survival ranging from <1 year to a median of "not reached" after 8 years. Finally, coculture experiments showed that AP-1 activation in leukemic cells was dependent on the nature of stromal cells. Altogether, our results identify the AP-1/TNF-α gene signature as a proxy of LSC anchoring in bone marrow niches, which improves the prognostic value of the LSC-17 score. This trial was registered at www.ClinicalTrials.gov as #NCT02320656., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
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- 2024
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136. Clinical and genetic features of CMT2T in Italian patients confirm the importance of MME pathogenic variants in idiopathic, late-onset axonal neuropathies.
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Geroldi A, La Barbera A, Mammi A, Origone P, Gaudio A, Ponti C, Sanguineri F, Matà S, Sperti M, Carboni I, Bellone E, Gotta F, Gemelli C, Massucco S, Valeria G, Marinelli L, Grandis M, Bisogni G, Sabatelli M, Piscosquito G, Esposito G, Schenone A, Manganelli F, Mandich P, Tozza S, and Luigetti M
- Abstract
Background and Aims: Since 2016, biallelic mutations in the membrane metalloendopeptidase (MME) gene have been associated with late-onset recessive CMT2 (CMT2T). More recently, heterozygous mutations have also been identified in familial and sporadic patients with late-onset axonal neuropathy, ranging from subclinical to severe. This indicates that the heterozygous MME variants may not be fully penetrant, or alternatively, that they may be a potential risk factor for neuropathy. Here, we describe the clinical, neurophysiological, and genetic findings of 32 CM2T Italian patients., Methods: The patients were recruited from four different Italian referral centers. Following a comprehensive battery of neurological, electrophysiological, and laboratory examinations, the patients' DNA was subjected to sequencing in order to identify any variants in the gene. Bioinformatic and modeling analyses were performed to evaluate the identified variants' effects., Results: We observe a relatively mild axonal sensory-motor neuropathy with a greater impairment of the lower extremities. Biallelic and monoallelic patients exhibit comparable disease severity, with an earlier onset observed in those with biallelic variants. When considering a subgroup with more than 10 years of disease, it becomes evident that biallelic patients exhibit a more severe form of neuropathy. This suggests that they are more prone to quick progression., Interpretation: CM2T has been definitively defined as a late-onset neuropathy, with a typical onset in the fifth to sixth decades of life and a more rapidly progressing worsening for biallelic patients. CMT2T can be included in the neuropathies of the elderly, particularly if MME variants heterozygous patients are included., (© 2024 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society.)
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- 2024
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137. Long-term treatment of hereditary transthyretin amyloidosis with patisiran: multicentre, real-world experience in Italy.
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Gentile L, Mazzeo A, Briani C, Casagrande S, De Luca M, Fabrizi GM, Gagliardi C, Gemelli C, Forcina F, Grandis M, Guglielmino V, Iabichella G, Leonardi L, Lozza A, Manganelli F, Mussinelli R, My F, Occhipinti G, Fenu S, Russo M, Romano A, Salvalaggio A, Tagliapietra M, Tozza S, Palladini G, Obici L, and Luigetti M
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- Humans, Italy, Male, Female, Middle Aged, Retrospective Studies, Aged, Treatment Outcome, RNA, Small Interfering therapeutic use, Quality of Life, Amyloid Neuropathies, Familial drug therapy, Amyloid Neuropathies, Familial complications
- Abstract
Background: Hereditary transthyretin (ATTRv, v for variant) amyloidosis with polyneuropathy is a rare disease caused by mutations in the transthyretin gene. In ATTRv amyloidosis, multisystem extracellular deposits of amyloid cause tissue and organ dysfunction. Patisiran is a small interfering RNA molecule drug that reduces circulating levels of mutant and wild-type TTR proteins. Prior to its regulatory approval, patisiran was available in Italy through a compassionate use programme (CUP). The aim of this study was to analyse the long-term outcomes of patients who entered into the CUP., Methods: This was a multicentre, observational, retrospective study of patients with ATTRv amyloidosis treated with patisiran. The analysis included change from baseline to 12, 24, 36 and 48 months in familial amyloid polyneuropathy (FAP) stage, polyneuropathy disability (PND) class, neuropathy impairment score (NIS), modified body mass index (mBMI), Compound Autonomic Dysfunction Test (CADT), Karnofsky Performance Status (KPS) scale and Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) questionnaire. Safety data were also analysed., Results: Forty patients from 11 Italian centres were enrolled: 23 in FAP 1 (6 in PND 1 and 17 in PND 2) and 17 in FAP 2 (8 in PND 3a and 9 in PND 3b) stage. In this population, the mean NIS at baseline was 71.4 (± 27.8); mBMI, 917.1 (± 207) kg/m
2 ; KPS, 67.1 (± 14.0); Norfolk QoL-DN, 62.2 (± 25.2); and CADT, 13.2 (± 3.3). Statistical analysis showed few significant differences from baseline denoting disease stability. No new safety signals emerged., Conclusions: Patisiran largely stabilised disease in patients with ATTRv amyloidosis., (© 2024. The Author(s).)- Published
- 2024
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138. Next-generation sequencing in Charcot-Marie-Tooth: a proposal for improvement of ACMG guidelines for variant evaluation.
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Geroldi A, Mammi A, Gaudio A, Patrone S, La Barbera A, Origone P, Ponti C, Sanguineri F, Massucco S, Marinelli L, Grandis M, Schenone A, Mandich P, Bellone E, and Gotta F
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- Humans, Genetic Variation, Genomics methods, Practice Guidelines as Topic, Mutation, Charcot-Marie-Tooth Disease genetics, Charcot-Marie-Tooth Disease diagnosis, High-Throughput Nucleotide Sequencing methods, Genetic Testing methods, Genetic Testing standards
- Abstract
Background: The application of massive parallel sequencing technologies in the molecular analysis of Charcot-Marie-Tooth (CMT) has enabled the rapid and cost-effective identification of numerous potentially significant variants for diagnostic purposes. The objective is to reduce the number of variants, focusing only on those with pathogenic significance. The 2015 American College of Medical Genetics and Genomics (ACMG) guidelines aid in achieving this goal, but it is now evident that a pathology or gene-specific review of these rules is essential to avoid misinterpretations that may result from blindly applying the criteria. This study demonstrates how revised ACMG criteria, combined with CMT-specific literature data and expertise, can alter the final classification of a variant., Methods: We reviewed ACMG criteria based on current knowledge of CMT and provided suggestions for adapting them to the specificities of CMT., Results: Of the 226 index patients analysed, a diagnostic yield of 20% was obtained. It is worth noting that the 9% of cases had their final diagnosis changed with the application of the revised criteria, often resulting in the loss of the pathogenic classification of a variant., Conclusions: The widespread availability of high-throughput sequencing technologies has enabled genetic testing even for laboratories without specific disease expertise. Disease-specific ACMG criteria can be a valuable tool to prevent the proliferation of variants of uncertain significance and the misinterpretation of variants., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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139. Clinical, Histopathologic, and Genetic Features of Patients With Myofibrillary and Distal Myopathies: Experience From the Italian Network.
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Bortolani S, Savarese M, Vattemi G, Bonanno S, Falzone YM, Pugliese A, Primiano G, Sancricca C, Lopergolo D, Greco G, Gemelli C, Ravaglia S, Bencivenga RP, Velardo D, Magri F, Valentino ML, Cheli M, Torchia E, Lucchini M, Petrucci A, Ricci G, Garibaldi M, Astrea G, Rubegni A, Angelini CI, Ariatti A, Santorelli FM, Ruggieri A, Antonini G, Siciliano G, Filosto M, Mirabella M, Liguori R, Comi GP, Ruggiero L, Grandis M, Massa R, Malandrini A, Servidei S, Mongini TE, Rodolico C, Toscano A, Previtali SC, Tonin P, Diaz-Manera J, Monforte M, Ricci E, Maggi L, and Tasca G
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- Humans, Female, Male, Middle Aged, Italy, Adult, Retrospective Studies, Aged, Distal Myopathies genetics, Distal Myopathies pathology, Distal Myopathies epidemiology, Myopathies, Structural, Congenital genetics, Myopathies, Structural, Congenital pathology
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Background and Objectives: The diagnostic process for myofibrillar myopathies (MFM) and distal myopathies (DM) is particularly complex because of the large number of causative genes, the existence of still molecularly undefined disease entities, and the overlapping features between the 2 categories. This study aimed to characterize a large cohort of patients affected by MFM and DM and identify the most important diagnostic and prognostic aspects of these diseases., Methods: Patients with either a myopathological diagnosis of MFM or a clinical diagnosis of DM were included in this retrospective multicentric national study. Demographic, genetic, clinical, and histopathologic data of anonymized patients were collected from the neuromuscular centers of the Italian Association of Myology network., Results: Data regarding 132 patients with MFM (mean age 57.0 ± 15.8 years, 49% female) and 298 patients with DM (mean age 50.7 ± 15.9 years, 40% female) were gathered from 20 neuromuscular centers. 69 patients fulfilled the criteria for both groups (distal myopathies with myofibrillar pathology, DM-MP). Molecular confirmation was achieved in 63% of the patients. Fifty-two percent of the patients with MFM carried pathogenic variants in either DES (n = 30), MYOT (n = 20), or DNAJB6 (n = 18), which were also the most frequent disease-causing genes in DM-MP, while GNE (n = 44) and MYH7 (n = 23) were the genes most commonly carrying pathogenic variants in DM. The mean age at onset varied from <25 years in patients with causative variants in MYH7 and DYSF to 59 years in patients with myotilinopathies. Cardiac involvement was reported in 29% of patients with MFM and 16% of patients with DM, with DES and MYH7 variants significantly associated with the development of cardiomyopathy. Respiratory impairment was more prevalent in patients with TTN and DES variants and rare in other disorders such as GNE myopathy and dysferlinopathies, which were instead associated, together with DNAJB6 -related and PLIN4 -related myopathies, with the risk of losing ambulation during the disease course., Discussion: The Italian cohort of patients with MFM and DM recapitulates the phenotypic heterogeneity and the partial overlap between the 2 groups. However, in relative contrast to the encountered phenotypic variability, only 5 genes accounted for most of the molecular diagnoses. Specific genetic entities are associated with significantly increased risk of developing cardiorespiratory complications or loss of ambulation, which has relevant prognostic implications.
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- 2024
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140. Correction to: Long-term treatment of hereditary transthyretin amyloidosis with patisiran: multicentre, real-world experience in Italy.
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Gentile L, Mazzeo A, Briani C, Casagrande S, De Luca M, Fabrizi GM, Gagliardi C, Gemelli C, Forcina F, Grandis M, Guglielmino V, Iabichella G, Leonardi L, Lozza A, Manganelli F, Mussinelli R, My F, Occhipinti G, Fenu S, Russo M, Romano A, Salvalaggio A, Tagliapietra M, Tozza S, Palladini G, Obici L, and Luigetti M
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- 2024
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141. Phenotypic spectrum of myelin protein zero-related neuropathies: a large cohort study from five mutation clusters across Italy.
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Bertini A, Gentile L, Cavallaro T, Tozza S, Saveri P, Russo M, Massucco S, Falzone YM, Bellone E, Taioli F, Geroldi A, Occhipinti G, Ferrarini M, Cavalca E, Crivellari L, Mandich P, Balistreri F, Magri S, Taroni F, Previtali SC, Schenone A, Grandis M, Manganelli F, Fabrizi GM, Mazzeo A, Pareyson D, and Pisciotta C
- Abstract
Background: We aimed to investigate the clinical features of a large cohort of patients with myelin protein zero ( MPZ )-related neuropathy, focusing on the five main mutation clusters across Italy., Methods: We retrospectively gathered a minimal data set of clinical information in a series of patients with these frequent mutations recruited among Italian Charcot-Marie-Tooth (CMT) registry centres, including disease onset/severity (CMTES-CMT Examination Score), motor/sensory symptoms and use of orthotics/aids., Results: We collected data from 186 patients: 60 had the p.Ser78Leu variant ('classical' CMT1B; from Eastern Sicily), 42 the p.Pro70Ser (CMT2I; mainly from Lombardy), 38 the p.Thr124Met (CMT2J; from Veneto), 25 the p.Ser44Phe (CMT2I; from Sardinia) and 21 the p.Asp104ThrfsX13 (mild CMT1B; from Apulia) mutation. Disease severity (CMTES) was higher (p<0.001) in late-onset axonal forms (p.Thr124Met=9.2±6.6; p.Ser44Phe=7.8±5.7; p.Pro70Ser=7.6±4.8) compared with p.Ser78Leu (6.1±3.5) patients. Disease progression (ΔCMTES/year) was faster in the p.Pro70Ser cohort (0.8±1.0), followed by p.Ser44Phe (0.7±0.4), p.Thr124Met (0.4±0.5) and p.Ser78Leu (0.2±0.4) patients. Disease severity (CMTES=1.2±1.5), progression (ΔCMTES/year=0.1±0.4) and motor involvement were almost negligible in p.Asp104ThrfsX13 patients, who, however, frequently (78%, p<0.001) complained of neuropathic pain. In the other four clusters, walking difficulties were reported by 69-85% of patients, while orthotic and walking aids use ranged between 40-62% and 16-28%, respectively., Conclusions: This is the largest MPZ (and late-onset CMT2) cohort ever collected, reporting clinical features and disease progression of 186 patients from five different clusters across Italy. Our findings corroborate the importance of differentiating between 'classical' childhood-onset demyelinating, late-onset axonal and mild MPZ -related neuropathy, characterised by different pathomechanisms, in view of different therapeutic targets., Competing Interests: Competing interests: GMF acknowledges donations from Pfizer to support research activities of his Research Unit, financial support from Akcea, Kedrion, Pfizer for participation in national and international meetings and from Akcea, Alnylam and Pharnext for participation in Advisory Boards; MG acknowledges donations from Sanofi Genzyme to support research activities of her Research Unit, financial support from Alnylam and Sanofi Genzyme for participation in national and international Meetings, participation in Advisory Board of Pfizer, speaker honorarium from Sanofi Genzyme; AM acknowledges financial support from Pfizer, Alnylam and Akcea for participation in national and international meetings, participation in Advisory Board of Pfizer, Alnylam and Akcea; DP acknowledges participation in Advisory Board of Inflectis, Alnylam, Akcea, Arvinas, Augustine Tx, DTx; ST is supported by the Ministry of University and Research (MUR), National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006) - A multiscale integrated approach to the study of the nervous system in health and disease (DN. 1553 11.10.2022). AB, LG, TC, PS, MR, SM, YMF, EM, FT, AG, GO, MF, EC, LC, PM, FB, SM, FT, SCP, AS, FM, CP report no disclosure., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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142. Early Onset Inherited Peripheral Neuropathies: The Experience of a Specialized Referral Center for Genetic Diagnosis Achievement.
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Geroldi A, Ponti C, Mammi A, Patrone S, Gotta F, Trevisan L, Sanguineri F, Origone P, Gaudio A, La Barbera A, Cataldi M, Gemelli C, Massucco S, Schenone A, Lanteri P, Fiorillo C, Grandis M, Mandich P, and Bellone E
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- Humans, Child, Genetic Testing, Phenotype, Mutation, Charcot-Marie-Tooth Disease diagnosis, Charcot-Marie-Tooth Disease genetics
- Abstract
Background: Charcot-Marie-Tooth disease (CMT) is a heterogeneous group of inherited peripheral neuropathies. Although the typical disease onset is reported in the second decade, earlier onsets are not uncommon. To date, few studies on pediatric populations have been conducted and the achievement of molecular diagnosis remains challenging., Methods: During the last 24 years we recruited 223 patients with early-onset hereditary peripheral neuropathies (EOHPN), negative for PMP22 duplication, 72 of them referred by a specialized pediatric hospital. Genetic testing for CMT-associated genes has been carried out with a range of different techniques., Results: Of the 223 EOHPN cases, 43% were classified as CMT1 (demyelinating), 49% as CMT2 (axonal), and 8% as CMTi (intermediate). Genetic diagnosis was reached in 51% of patients, but the diagnostic yield increased to 67% when focusing only on cases from the specialized pediatric neuromuscular centers. Excluding PMP22 rearrangements, no significant difference in diagnostic rate between demyelinating and axonal forms was identified. De novo mutations account for 38% of cases., Conclusions: This study describes an exhaustive picture of EOHPN in an Italian referral genetic center and analyzes the molecular diagnostic rate of a heterogeneous cohort compared with one referred by a specialized pediatric center. Our data identify MPZ, MFN2, GDAP1, and SH3TC2 genes as the most frequent players in EOHPN. Our study underlines the relevance of a specific neurological pediatric expertise to address the genetic testing and highlights its importance to clarify possible unexpected results when neuropathy is only a secondary clinical sign of a more complex phenotype., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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143. A comparative study of two routinely used protocols for ex vivo erythroid differentiation.
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Godard A, Seute R, Grimaldi A, Granier T, Chiaroni J, El Nemer W, and De Grandis M
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- Humans, Cell Differentiation, Erythrocytes, Erythropoiesis physiology, Antigens, CD34, Erythroid Precursor Cells, Hematopoietic Stem Cells, Erythropoietin
- Abstract
Background: Erythropoiesis is a complex developmental process in which a hematopoietic stem cell undergoes serial divisions and differentiates through well-defined stages to give rise to red blood cells. Over the last decades, several protocols have been developed to perform ex vivo erythroid differentiation, allowing investigation into erythropoiesis and red cell production in health and disease., Results: In the current study, we compared the two commonly used protocols by assessing the differentiation kinetics, synchronisation, and cellular yield, using molecular and cellular approaches. Peripheral blood CD34
+ cells were cultured in a two-phase (2P) or a four-phase (4P) liquid culture (LC) and monitored for 20 days. Both protocols could recapitulate all stages of erythropoiesis and generate reticulocytes, although to different extents. Higher proliferation and viability rates were achieved in the 4P-LC, with a higher degree of terminal differentiation and enucleation, associated with higher levels of the erythroid-specific transcription factors GATA-1, KLF-1, and TAL-1. Although the 2P-LC protocol was less efficient regarding terminal erythroid differentiation and maturation, it showed a higher yield of erythroid progenitors in the erythropoietin (EPO)-free expansion phase., Conclusions: We provide data supporting the use of one protocol or the other to study the biological processes occurring in the early or late stages of erythroid differentiation, depending on the physiological process or pathological defect under investigation in a given study., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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144. Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease.
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Bertini A, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Tagliapietra M, Grandis M, Previtali SC, Falzone YM, Allegri I, Padua L, Pazzaglia C, Tramacere I, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Gentile L, Russo M, Mazzeo A, Vita G, Prada V, Zuccarino R, Ferraro F, Pisciotta C, and Pareyson D
- Subjects
- Humans, Orthotic Devices, Lower Extremity, Shoes, Patient Acuity, Charcot-Marie-Tooth Disease therapy
- Abstract
Background: Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty., Methods: We administered to Italian CMT Registry patients an online ad hoc questionnaire investigating use, complications and perceived benefit/tolerability/emotional distress of shoe inserts, orthopaedic shoes, AFOs and other orthoses/aids. Patients were also asked to fill in the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire, rating satisfaction with currently used AFO and related services., Results: We analysed answers from 266 CMT patients. Seventy per cent of subjects were prescribed lower limb orthoses, but 19% did not used them. Overall, 39% of subjects wore shoe inserts, 18% orthopaedic shoes and 23% AFOs. Frequency of abandonment was high: 24% for shoe inserts, 28% for orthopaedic shoes and 31% for AFOs. Complications were reported by 59% of patients and were more frequently related to AFOs (69%). AFO users experienced greater emotional distress and reduced tolerability as compared with shoe inserts (p<0.001) and orthopaedic shoes (p=0.003 and p=0.045, respectively). Disease severity, degree of foot weakness, customisation and timing for customisation were determinant factors in AFOs' tolerability. Quality of professional and follow-up services were perceived issues., Conclusions: The majority of CMT patients is prescribed shoe inserts, orthopaedic shoes and/or AFOs. Although perceived benefits and tolerability are rather good, there is a high rate of complications, potentially inappropriate prescriptions and considerable emotional distress, which reduce the use of AFOs. A rational, patient-oriented and multidisciplinary approach to orthoses prescription must be encouraged., Competing Interests: Competing interests: GMF acknowledges donations from Pfizer to support research activities of his Research Unit, financial support from Akcea, Kedrion, Pfizer for participation in national and international meetings and from Akcea, Alnylam and Pharnext for participation in Advisory Boards; MG acknowledges donations from Sanofi Genzyme to support research activities of her Research Unit, financial support from Alnylam and Sanofi Genzyme for participation in national and international Meetings, participation in Advisory Board of Pfizer, speaker honorarium from Sanofi Genzyme; AM acknowledges financial support from Pfizer, Alnylam and Akcea for participation in national and international meetings, participation in Advisory Board of Pfizer, Alnylam and Akcea; GV acknowledges donations from Pfizer and PTC to support research activities and participation in Advisory Board of Pfizer, Alnylam, Akcea and Pharnext; DP acknowledges participation in Advisory Board of Inflectis, Alnylam, Akcea, Arvinas, Augustine Tx, DTx. AB, IT, GMF, AS, LS, TC, MT, SCP, MS, IA, LP, CP. DC, PS, AQ, PV, ST, LG, MR, AM, SP, GDD, CP report no disclosure., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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145. DAG1 haploinsufficiency is associated with sporadic and familial isolated or pauci-symptomatic hyperCKemia.
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Traverso M, Baratto S, Iacomino M, Di Duca M, Panicucci C, Casalini S, Grandis M, Falace A, Torella A, Picillo E, Onore ME, Politano L, Nigro V, Innes AM, Barresi R, Bruno C, Zara F, Fiorillo C, and Scala M
- Subjects
- Humans, Dystroglycans genetics, Dystroglycans metabolism, Haploinsufficiency, Muscle, Skeletal pathology, Muscular Dystrophies genetics, Muscular Diseases pathology
- Abstract
DAG1 encodes for dystroglycan, a key component of the dystrophin-glycoprotein complex (DGC) with a pivotal role in skeletal muscle function and maintenance. Biallelic loss-of-function DAG1 variants cause severe muscular dystrophy and muscle-eye-brain disease. A possible contribution of DAG1 deficiency to milder muscular phenotypes has been suggested. We investigated the genetic background of twelve subjects with persistent mild-to-severe hyperCKemia to dissect the role of DAG1 in this condition. Genetic testing was performed through exome sequencing (ES) or custom NGS panels including various genes involved in a spectrum of muscular disorders. Histopathological and Western blot analyses were performed on muscle biopsy samples obtained from three patients. We identified seven novel heterozygous truncating variants in DAG1 segregating with isolated or pauci-symptomatic hyperCKemia in all families. The variants were rare and predicted to lead to nonsense-mediated mRNA decay or the formation of a truncated transcript. In four cases, DAG1 variants were inherited from similarly affected parents. Histopathological analysis revealed a decreased expression of dystroglycan subunits and Western blot confirmed a significantly reduced expression of beta-dystroglycan in muscle samples. This study supports the pathogenic role of DAG1 haploinsufficiency in isolated or pauci-symptomatic hyperCKemia, with implications for clinical management and genetic counseling., (© 2023. The Author(s), under exclusive licence to European Society of Human Genetics.)
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- 2024
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146. Red Blood Cell Contribution to Thrombosis in Polycythemia Vera and Essential Thrombocythemia.
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Grenier JMP, El Nemer W, and De Grandis M
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- Humans, Erythrocytes pathology, Polycythemia Vera, Thrombocythemia, Essential complications, Thrombosis complications, Thrombocytosis pathology
- Abstract
Polycythemia vera (PV) and essential thrombocythemia (ET) are myeloproliferative neoplasms (MPN) characterized by clonal erythrocytosis and thrombocytosis, respectively. The main goal of therapy in PV and ET is to prevent thrombohemorrhagic complications. Despite a debated notion that red blood cells (RBCs) play a passive and minor role in thrombosis, there has been increasing evidence over the past decades that RBCs may play a biological and clinical role in PV and ET pathophysiology. This review summarizes the main mechanisms that suggest the involvement of PV and ET RBCs in thrombosis, including quantitative and qualitative RBC abnormalities reported in these pathologies. Among these abnormalities, we discuss increased RBC counts and hematocrit, that modulate blood rheology by increasing viscosity, as well as qualitative changes, such as deformability, aggregation, expression of adhesion proteins and phosphatidylserine and release of extracellular microvesicles. While the direct relationship between a high red cell count and thrombosis is well-known, the intrinsic defects of RBCs from PV and ET patients are new contributors that need to be investigated in depth in order to elucidate their role and pave the way for new therapeutical strategies.
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- 2024
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147. Respiratory involvement and sleep-related disorders in CMT1A: case report and review of the literature.
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Massucco S, Schenone C, Faedo E, Gemelli C, Bellone E, Marinelli L, Pareyson D, Pisciotta C, Mongini T, Schenone A, and Grandis M
- Abstract
Sleep-disordered breathing has been reported in Charcot-Marie-Tooth disease (CMT) type 1A in association with diaphragmatic weakness and sleep apnea syndrome, mainly of the obstructive type (OSA). Improvement has been observed not only in sleep quality but also in neuropathy symptoms in CMT1A patients with OSA following the initiation of continuous positive airway pressure. We report the cases of two siblings affected by CMT1A associated with hemidiaphragm relaxatio necessitating nocturnal non-invasive ventilation (NIV). Two twins, now 42 years old, with a family history of CMT1A, received a genetic diagnosis of CMT1A at the age of 16. Over the years, they developed a slowly worsening gait disorder and a decline in fine motor hand movements, currently presenting with moderate disability (CMTES:13). At the age of 40, they both started complaining of daytime sleepiness, orthopnea, and exertional dyspnea. They received a diagnosis of relaxatio of the right hemidiaphragm associated with impairment of nocturnal ventilation and they both have benefited from nocturnal NIV. Disorders of breathing during sleep may be underestimated in CMT1A since routine investigations of sleep quality are rarely performed. Our two clinical cases and a literature review suggest the importance of inquiring about symptoms of excessive daytime sleepiness and respiratory disturbances in individuals with CMT1A, even in the absence of severe neuropathy. In the presence of compatible symptoms, a pneumological assessment, along with an overnight polysomnogram and lung function tests, should be performed. Recognizing sleep-related symptoms is essential for providing accurate treatment and improving the quality of life for patients with CMT1A., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Massucco, Schenone, Faedo, Gemelli, Bellone, Marinelli, Pareyson, Pisciotta, Mongini, Schenone and Grandis.)
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- 2024
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148. Skeletal muscle involvement in biallelic SORD mutations: case report and review of the literature.
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Massucco S, Gemelli C, Bellone E, Geroldi A, Patrone S, Mandich P, Scarsi E, Faedo E, Marinelli L, Mongini T, Traverso M, Baratto S, Schenone A, Fiorillo C, and Grandis M
- Subjects
- Male, Humans, Adolescent, Muscle, Skeletal pathology, Mutation, Phenotype, Pedigree, L-Iditol 2-Dehydrogenase genetics, Charcot-Marie-Tooth Disease genetics
- Abstract
Biallelic mutations in the sorbitol dehydrogenase ( SORD ) gene have been identified as a genetic cause of autosomal recessive axonal Charcot-Marie-Tooth disease 2 (CMT2) and distal hereditary motor neuropathy (dHMN). We herein review the main phenotypes associated with SORD mutations and report the case of a 16-year-old man who was referred to our outpatient clinic for a slowly worsening gait disorder with wasting and weakness of distal lower limbs musculature. Since creatine phosphokinase (CPK) values were persistently raised (1.5fold increased) and a Next-Generation Sequencing CMT-associated panel failed in identifying pathogenic variants, a muscle biopsy was performed with evidence of alterations suggestive of a protein surplus distal myopathy. Finally, Whole-Exome Sequencing (WES) identified two pathogenic SORD variants in the heterozygous state: c.458C > A (p.Ala153Asp) and c.757delG (p.Ala253Glnfs*27). This is an isolated report of compound heterozygosity for two SORD mutations associated with clinical and histological signs of skeletal muscle involvement, expanding the phenotypic expression of SORD mutations., Competing Interests: The Authors declare no conflict of interest., (©2023 Gaetano Conte Academy - Mediterranean Society of Myology, Naples, Italy.)
- Published
- 2023
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149. Daytime sleepiness and sleep quality in Charcot-Marie-Tooth disease.
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Bellofatto M, Gentile L, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Scarlato M, Allegri I, Padua L, Pazzaglia C, Villani F, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Russo M, Mazzeo A, Vita G, Piacentini S, Didato G, Pisciotta C, and Pareyson D
- Subjects
- Humans, Sleep Quality, Sleepiness, Sleep, Fatigue etiology, Surveys and Questionnaires, Charcot-Marie-Tooth Disease complications, Disorders of Excessive Somnolence etiology, Sleep Wake Disorders epidemiology, Sleep Wake Disorders etiology
- Abstract
Background: Sleep abnormalities have been reported in Charcot-Marie-Tooth disease (CMT), but data are scanty. We investigated their presence and correlation in a large CMT patients' series., Methods: Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were administered to CMT patients of the Italian registry and controls. ESS score > 10 indicated abnormal daytime somnolence, PSQI score > 5 bad sleep quality. We analyzed correlation with disease severity and characteristics, Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Body Mass Index, drug use., Results: ESS and PSQI questionnaires were filled by 257 and 253 CMT patients, respectively, and 58 controls. Median PSQI score was higher in CMT patients than controls (6 vs 4, p = 0.006), with no difference for ESS score. Abnormal somnolence and poor sleep quality occurred in 23% and 56% of patients; such patients had more frequently anxiety/depression, abnormal fatigue, and positive sensory symptoms than those with normal ESS/PSQI. Moreover, patients with PSQI score > 5 had more severe disease (median CMT Examination Score, CMTES, 8 vs 6, p = 0.006) and more frequent use of anxiolytic/antidepressant drugs (29% vs 7%, p < 0.001)., Conclusions: Bad sleep quality and daytime sleepiness are frequent in CMT and correlated with anxiety, depression and fatigue, confirming that different components affect sleep. Sleep disorders, such as sleep apnea and restless leg syndrome, not specifically investigated here, are other factors known to impact on sleep quality and somnolence. CMT patients' management must include sleep behavior assessment and evaluation of its correlated factors, including general distress and fatigue., (© 2023. The Author(s).)
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- 2023
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150. Correction to: Daytime sleepiness and sleep quality in Charcot-Marie-Tooth disease.
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Bellofatto M, Gentile L, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Scarlato M, Allegri I, Padua L, Pazzaglia C, Villani F, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Russo M, Mazzeo A, Vita G, Piacentini S, Didato G, Pisciotta C, and Pareyson D
- Published
- 2023
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