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209. Management of Huntington’s disease: role of tetrabenazine

Author

de Tommaso, Marina

Subjects
Therapeutics and Clinical Risk Management
Abstract

Marina de Tommaso, Claudia Serpino, Vittorio SciruicchioNeurological and Psychiatric Sciences Department, University of Bari Aldo Moro, Bari, ItalyAbstract: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder characterized by progressive involuntary movements, neuropsychiatric disturbances, and cognitive impairment. The use of tetrabenazine (TBZ), a specific inhibitor of vesicular monoamine transporter, is approved for chorea in HD patients. We aimed to review the medical literature concerning the efficacy and tolerability of TBZ in the treatment of HD patients and to report our personal experience about TBZ use in a cohort of HD patients. We searched PubMed (1960 to July 2010) using the following keywords: “tetrabenazine” + “huntington’s disease + chorea”. We included randomized controlled trials, open-label trials, and retrospective studies. We excluded case reports and studies conducted on fewer than 20 patients. In addition, we retrospectively evaluated 2 years’ follow-up of TBZ treatment on motor and cognitive performances and functional abilities in 28 HD patients, compared with 10 patients treated by other neuroleptics (clotiapine). Only four papers fulfilled the requested criteria. In the first study, which included 84 randomized outpatients, TBZ showed a significant improvement of chorea compared with placebo. In the open-label study extension, TBZ confirmed its efficacy on chorea, with a frequent occurrence of withdrawals due to side effects. In a retrospective study of long-term efficacy, 63 patients under TBZ therapy for an average period of 34 months showed a stable effect on chorea, despite a slight reduction of effect over time. In a telephone survey conducted on a total of 118 patients affected by different movement disorders, TBZ showed the most favorable effect for the 28 included HD patients. Our HD patients showed a slight deterioration of motor performances over time that was nonsignificant compared with TBZ or clotiapine treatments. Despite the fact that the global effect of TBZ seems positive in HD, more attention on evaluating symptomatic treatments for cognitive and psychiatric deterioration as well as motor deterioration would alleviate this devastating disorder until a neuroprotective treatment becomes available.Keywords: Huntington’s disease, symptomatic treatment, tetrabenazine

Published
2011

213. Experimental pain processing in individuals with cognitive impairment: current state of the science

Author

Defrin, Ruth, Defrin, Ruth, Amanzio, Martina, de Tommaso, Marina, Dimova, Violeta, Filipović, Saša, Finn, David P., Gimenez-Llort, Lydia, Invitto, Sara, Jensen-Dahm, Christina, Lautenbacher, Stefan, Oosterman, Joukje M., Petrini, Laura, Pick, Chaim G., Pickering, Gisele, Vase, Lene, Kunz, Miriam, Defrin, Ruth, Defrin, Ruth, Amanzio, Martina, de Tommaso, Marina, Dimova, Violeta, Filipović, Saša, Finn, David P., Gimenez-Llort, Lydia, Invitto, Sara, Jensen-Dahm, Christina, Lautenbacher, Stefan, Oosterman, Joukje M., Petrini, Laura, Pick, Chaim G., Pickering, Gisele, Vase, Lene, and Kunz, Miriam

Abstract

Cognitive impairment (Cl) can develop during the course of ageing and is a feature of many neurological and neurodegenerative diseases. Many individuals with Cl have substantial, sustained, and complex health care needs, which frequently include pain. However, individuals With Cl can have difficulty communicating the features of their pain to others, which in turn presents a significant challenge for effective diagnosis and treatment of their pain. Herein, we review the literature on responsivity of individuals with Cl to experimental pain stimuli. We discuss pain responding across a large number of neurological and neurodegenerative disorders in which Cl is typically present. Overall, the existing data suggest that pain processing is altered in most individuals with Cl compared with cognitively intact matched controls. The precise nature of these alterations varies with the type of Cl (or associated clinical condition) and may also depend on the type of pain stimulation used and the type of pain responses assessed. Nevertheless, it is clear that regardless of the etiology of Cl, patients do feel noxious stimuli, with more evidence for hypersensitivity than hyposensitivity to these stimuli compared with cognitively unimpaired individuals. Our current understanding of the neurobiological mechanisms underpinning these alterations is limited but may be enhanced through the use of animal models of Cl, which also exhibit alterations in nociceptive responding. Further research using additional behavioural indices of pain is warranted. Increased understanding of altered experimental pain processing in Cl will facilitate the development of improved diagnostic and therapeutic approaches for pain in individuals with Cl.

Published
2015

215. Experimental pain processing in individuals with cognitive impairment

Author

Defrin, Ruth, primary, Amanzio, Martina, additional, de Tommaso, Marina, additional, Dimova, Violeta, additional, Filipovic, Sasa, additional, Finn, David P., additional, Gimenez-Llort, Lydia, additional, Invitto, Sara, additional, Jensen-Dahm, Christina, additional, Lautenbacher, Stefan, additional, Oosterman, Joukje M., additional, Petrini, Laura, additional, Pick, Chaim G., additional, Pickering, Gisele, additional, Vase, Lene, additional, and Kunz, Miriam, additional

Published
2015
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219. Optimizing the long-term management of chronic migraine with onabotulinumtoxinA in real life.

Author

Tassorelli, Cristina, Tedeschi, Gioacchino, Sarchielli, P, Pini, Luigi Alberto, Grazzi, Licia, Geppetti, Pierangelo, De Tommaso, Marina, Aguggia, Marco, Cortelli, P, and Martelletti, Paolo

Abstract

Introduction: Management of chronic migraine is challenging. OnabotulinumtoxinA (OBT-A) is the only medication licensed for prevention of chronic migraine, and has been widely adopted in clinical practice. Limited data is available on its long-term use. Areas covered: Data from controlled trials are combined with available data on the long-term use of OBT-A in real-life studies, with information obtained in a recent survey among Italian headache centers, and the clinical experience of the authors. Six areas were identified as relevant to patients with chronic migraine: 1) definition of responders to OBT-A; 2) management of responders to OBT-A; 3) optimal timing of prophylaxis with OBT-A; 4) position of OBT-A in prevention of chronic migraine; 5) management of medication overuse, and 6) patient education. Expert commentary: This review provides an update on the latest evidence regarding the long-term use of OBT-A in chronic migraine and analyzes the critical issues in the decision-making process that emerge from the analysis of the literature and routine practice. A treatment algorithm is proposed for the adoption in the daily practice. [ABSTRACT FROM PUBLISHER]

Published
2018
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223. Post-coma persons with multiple disabilities use assistive technology for their leisure engagement and communication

Author

Lancioni, Giulio E., primary, Singh, Nirbhay N., additional, O'Reilly, Mark F., additional, Sigafoos, Jeff, additional, Oliva, Doretta, additional, Buonocunto, Francesca, additional, Sacco, Valentina, additional, D'Amico, Fiora, additional, Navarro, Jorge, additional, Lanzilotti, Crocifissa, additional, De Tommaso, Marina, additional, and Megna, Marisa, additional

Published
2014
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225. Neuromodulation of chronic headaches:position statement from the European Headache Federation

Author

Martelletti, Paolo, Jensen, Rigmor H, Antal, Andrea, Arcioni, Roberto, Brighina, Filippo, de Tommaso, Marina, Franzini, Angelo, Fontaine, Denys, Heiland, Max, Jürgens, Tim P, Leone, Massimo, Magis, Delphine, Paemeleire, Koen, Palmisani, Stefano, Paulus, Walter, May, Arne, Martelletti, Paolo, Jensen, Rigmor H, Antal, Andrea, Arcioni, Roberto, Brighina, Filippo, de Tommaso, Marina, Franzini, Angelo, Fontaine, Denys, Heiland, Max, Jürgens, Tim P, Leone, Massimo, Magis, Delphine, Paemeleire, Koen, Palmisani, Stefano, Paulus, Walter, and May, Arne

Published
2013

227. Management of Huntington’s disease: role of tetrabenazine

Author

de Tommaso,Marina, Serpino,Claudia, Sciruicchio,Vittorio, de Tommaso,Marina, Serpino,Claudia, and Sciruicchio,Vittorio

Abstract

Marina de Tommaso, Claudia Serpino, Vittorio SciruicchioNeurological and Psychiatric Sciences Department, University of Bari Aldo Moro, Bari, ItalyAbstract: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder characterized by progressive involuntary movements, neuropsychiatric disturbances, and cognitive impairment. The use of tetrabenazine (TBZ), a specific inhibitor of vesicular monoamine transporter, is approved for chorea in HD patients. We aimed to review the medical literature concerning the efficacy and tolerability of TBZ in the treatment of HD patients and to report our personal experience about TBZ use in a cohort of HD patients. We searched PubMed (1960 to July 2010) using the following keywords: “tetrabenazine” + “huntington’s disease + chorea”. We included randomized controlled trials, open-label trials, and retrospective studies. We excluded case reports and studies conducted on fewer than 20 patients. In addition, we retrospectively evaluated 2 years’ follow-up of TBZ treatment on motor and cognitive performances and functional abilities in 28 HD patients, compared with 10 patients treated by other neuroleptics (clotiapine). Only four papers fulfilled the requested criteria. In the first study, which included 84 randomized outpatients, TBZ showed a significant improvement of chorea compared with placebo. In the open-label study extension, TBZ confirmed its efficacy on chorea, with a frequent occurrence of withdrawals due to side effects. In a retrospective study of long-term efficacy, 63 patients under TBZ therapy for an average period of 34 months showed a stable effect on chorea, despite a slight reduction of effect over time. In a telephone survey conducted on a total of 118 patients affected by different movement disorders, TBZ showed the most favorable effect for the 28 included HD patients. Our HD patients showed a slight deterioration of motor perfor

Published
2011

228. Reply to the letter: Headaches during/after SARS‐CoV‐2 infection/vaccination can be primary and secondary as well as acute and chronic, by Finsterer J and Mehri S.

Author

Mitsikostas, Dimos‐Dimtirios D., Caronna, Edoardo, De Tommaso, Marina, Deligianni, Christina I., Ekizoglu, Esme, Bolay, Hayrunnisa, Göbel, Carl H., Kristoffersen, Espen Saxhaug, Lampl, Christian, Moro, Elena, Pozo‐Rosich, Patricia, Sellner, Johann, Terwindt, Gisela, and Irimia‐Sieira, Pablo

Subjects
*PRIMARY headache disorders, *SARS-CoV-2, *HEADACHE, *POST-acute COVID-19 syndrome, *VACCINATION, *INFECTION
Abstract

This document is a reply to a letter regarding headaches during or after SARS-CoV-2 infection or vaccination. The authors address five points raised in the letter, including the distinction between acute COVID-19 and long COVID syndrome, the presence of facial pain as a complication, the classification of headaches as primary or secondary, the consideration of other causes of secondary headaches, and the rarity of cerebral sinus thrombosis in the context of SARS-CoV-2 infection or vaccination. The authors provide detailed responses to each point, clarifying their position and supporting their conclusions with evidence from the literature. [Extracted from the article]

Published
2024
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229. Altered processing of sensory stimuli in patients with migraine

Author

de Tommaso, Marina, primary, Ambrosini, Anna, additional, Brighina, Filippo, additional, Coppola, Gianluca, additional, Perrotta, Armando, additional, Pierelli, Francesco, additional, Sandrini, Giorgio, additional, Valeriani, Massimiliano, additional, Marinazzo, Daniele, additional, Stramaglia, Sebastiano, additional, and Schoenen, Jean, additional

Published
2014
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231. Assessing learning as a possible sign of consciousness in post-coma persons with minimal responsiveness

Author

Lancioni, Giulio E., primary, Bosco, Andrea, additional, Olivetti Belardinelli, Marta, additional, Singh, Nirbhay N., additional, O’Reilly, Mark F., additional, Sigafoos, Jeff, additional, Buonocunto, Francesca, additional, Navarro, Jorge, additional, Lanzilotti, Crocifissa, additional, D’Amico, Fiora, additional, and De Tommaso, Marina, additional

Published
2014
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232. Update on laser-evoked potential findings in fibromyalgia patients in light of clinical and skin biopsy features

Author

de Tommaso, Marina, primary, Nolano, Maria, additional, Iannone, Florenzo, additional, Vecchio, Eleonora, additional, Ricci, Katia, additional, Lorenzo, Marta, additional, Delussi, Marianna, additional, Girolamo, Francesco, additional, Lavolpe, Vito, additional, Provitera, Vincenzo, additional, Stancanelli, Annamaria, additional, Lapadula, Giovanni, additional, and Livrea, Paolo, additional

Published
2013
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233. Neuromodulation of chronic headaches: position statement from the European Headache Federation

Author

Martelletti, Paolo, primary, Jensen, Rigmor H, additional, Antal, Andrea, additional, Arcioni, Roberto, additional, Brighina, Filippo, additional, de Tommaso, Marina, additional, Franzini, Angelo, additional, Fontaine, Denys, additional, Heiland, Max, additional, Jürgens, Tim P, additional, Leone, Massimo, additional, Magis, Delphine, additional, Paemeleire, Koen, additional, Palmisani, Stefano, additional, Paulus, Walter, additional, and May, Arne, additional

Published
2013
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234. Technology-aided recreation and communication opportunities for post-coma persons affected by lack of speech and extensive motor impairment

Author

Lancioni, Giulio E., primary, Singh, Nirbhay N., additional, O’Reilly, Mark F., additional, Sigafoos, Jeff, additional, Buonocunto, Francesca, additional, Sacco, Valentina, additional, Navarro, Jorge, additional, Lanzilotti, Crocifissa, additional, D’Amico, Fiora, additional, Sasanelli, Giovanni, additional, De Tommaso, Marina, additional, and Megna, Marisa, additional

Published
2013
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238. Therapeutic approach to pain in neurodegenerative diseases: current evidence and perspectives.

Author

de Tommaso, Marina, Kunz, Miriam, and Valeriani, Massimiliano

Abstract

Introduction: Neurodegenerative diseases are increasing in parallel to the lengthening of survival. The management of Alzheimer’s disease (AD) and other dementias, Parkinson’s disease (PD) and PD-related disorders, and motor neuron diseases (MND), is mainly targeted to motor and cognitive impairment, with special care for vital functions such as breathing and feeding. Areas covered: The present review focuses on chronic pain in main neurodegenerative diseases, addressing current evidence on pain therapeutic management, pain frequency and clinical features, and possible pathophysiological mechanisms. The search on PubMed had no time limits and was performed by searching for the following key issues: pain, dementia, Alzheimer disease, Parkinson’s disease, extrapyramidal disorders, motoneuronal disease, Amyotrophic lateral sclerosis, FXTAS, frequency, pathophysiology, treatments, therapy, efficacy, opioids, side effects. No controlled therapeutic trials and guidelines are currently available. The effects of current therapies such as L-Dopa or riluzole on pain symptoms are not clear. Emerging evidences on the possible anti-nociceptive effects of cannabis or botulinum toxin might be available soon. Expert commentary: Pain needs to be better evaluated and fully considered in the global management of neurodegenerative disease because a more focused treatment may have a positive impact on the global burden of these devastating disorders. [ABSTRACT FROM PUBLISHER]

Published
2017
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240. Testing a novel method for improving wayfinding by means of a P3b Virtual Reality Visual Paradigm in normal aging.

Author

Tommaso, Marina, Ricci, Katia, Delussi, Marianna, Montemurno, Anna, Vecchio, Eleonora, Brunetti, Antonio, and Bevilacqua, Vitoantonio

Subjects
*VIRTUAL reality, *COMPUTER simulation, *CYBERSPACE, *AGING, *ELECTRODES
Abstract

Background: We propose a virtual reality (VR) model, reproducing a house environment, where color modification of target places, obtainable by home automation in a real ambient, was tested by means of a P3b paradigm. The target place (bathroom door) was designed to be recognized during a virtual wayfinding in a realistic reproduction of a house environment. Different color and luminous conditions, easily obtained in the real ambient from a remote home automation control, were applied to the target and standard places, all the doors being illuminated in white (W), and only target doors colored with a green (G) or red (R) spotlight. Three different Virtual Environments (VE) were depicted, as the bathroom was designed in the aisle (A), living room (L) and bedroom (B). EEG was recorded from 57 scalp electrodes in 10 healthy subjects in the 60-80 year age range (O-old group) and 12 normal cases in the 20-30 year age range (Y-young group). Results: In Young group, all the target stimuli determined a significant increase in P3b amplitude on the parietal, occipital and central electrodes compared to frequent stimuli condition, whatever was the color of the target door, while in elderly group the P3b obtained by the green and red colors was significantly different from the frequent stimulus, on the parietal, occipital, and central derivations, while the White stimulus did not evoke a significantly larger P3b with respect to frequent stimulus. Discussion: The modulation of P3b amplitude, obtained by color and luminance change of target place, suggests that cortical resources, able to compensate the age-related progressive loss of cognitive performance, need to be facilitated even in normal elderly. The event-related responses obtained by virtual reality may be a reliable method to test the environmental feasibility to age-related cognitive changes. [ABSTRACT FROM AUTHOR]

Published
2016
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241. Laser-evoked potential habituation and central sensitization symptoms in childhood migraine.

Author

de Tommaso, Marina, Sciruicchio, Vittorio, Ricci, Katia, Montemurno, Anna, Gentile, Francesco, Vecchio, Eleonora, Barbaro, Maria Grazia Foschino, Simeoni, Michele, Goffredo, Marvita, and Livrea, Paolo

Subjects
*EVOKED potentials (Electrophysiology), *SENSITIZATION (Neuropsychology), *HABITUATION (Neuropsychology), *MIGRAINE in children, *DIAGNOSIS, *THERAPEUTICS, *LEARNING, *MIGRAINE, *NEUROPHYSIOLOGY, *PAIN threshold
Abstract

Objectives: Few studies have addressed central sensitization symptoms and pain processing in childhood migraine. Our aims were to examine pain sensitivity and responses, including habituation, evoked by CO2 laser stimuli (laser-evoked potentials (LEPs)) in a cohort of children with migraine compared to non-migraine controls and to determine the correlation between LEP features and signs of central sensitization.Methods: Thirty-five patients 8-15 years of age with migraines without aura were evaluated during the inter-critical phase and were compared to 17 controls. LEPs were analyzed, and their main features were correlated with clinical symptoms including allodynia and pericranial tenderness.Results: The laser-evoked pain threshold was lower and the N2P2 vertex complex amplitude was higher in children with migraines. Furthermore, habituation of vertex waves of LEPs clearly showed a tendency toward progressive amplitude enhancement in the migraine group. Acute allodynia and inter-critical pericranial tenderness correlated with trigeminal LEP features, particularly with the abnormal habituation pattern.Discussion: Abnormalities of pain processing and symptoms of central sensitization appear to be characteristics of children with migraine. Reduced habituation and progressive amplification of cortical responses to laser stimuli indicate an overactive nociceptive system at the onset of migraine, and this hyperactivity may subtend allodynia and pericranial tenderness. Future prospective trials may aid in the early identification of clinical phenotypes that display a tendency to develop into the chronic form of migraine, warranting a timely therapeutic approach. [ABSTRACT FROM AUTHOR]

Published
2016
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243. Care@Home: Methodology, Goals and Project Experimentation Activities.

Author

Borrelli, Gianfranco, Pistoia, Massimo, Casacci, Paolo, Leone, Alessandro, Siciliano, Pietro, de Tommaso, Marina, Vecchio, Eleonora, Delussi, Marianna, Greco, Antonio, Sancarlo, Daniele, Giuliani, Francesco, De Benedictis, Cataldo, Savino, Nicola, Rametta, Paola, Molendini, Vincenzo, D'Alessandro, Leonardo, and Spalluto, Gianfranco

Published
2015
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246. Technology-aided leisure and communication opportunities for two post-coma persons emerged from a minimally conscious state and affected by multiple disabilities

Author

Lancioni, Giulio E., primary, O’Reilly, Mark F., additional, Singh, Nirbhay N., additional, Sigafoos, Jeff, additional, Buonocunto, Francesca, additional, Sacco, Valentina, additional, Navarro, Jorge, additional, Lanzilotti, Crocifissa, additional, De Tommaso, Marina, additional, Megna, Marisa, additional, and Oliva, Doretta, additional

Published
2013
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249. Promoting adaptive behavior in persons with acquired brain injury, extensive motor and communication disabilities, and consciousness disorders

Author

Lancioni, Giulio E., primary, Singh, Nirbhay N., additional, O’Reilly, Mark F., additional, Sigafoos, Jeff, additional, Belardinelli, Marta Olivetti, additional, Buonocunto, Francesca, additional, Sacco, Valentina, additional, Navarro, Jorge, additional, Lanzilotti, Crocifissa, additional, De Tommaso, Marina, additional, Megna, Marisa, additional, and Badagliacca, Francesco, additional

Published
2012
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