44 results on '"Anglani M"'
Search Results
2. Spinal meningiomas: influence of cord compression and radiological features on preoperative functional status and outcome
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Baro, V., Moiraghi, A., Carlucci, V., Paun, L., Anglani, M., Saladino, A., Chioffi, F., D'AVELLA, D., Landi, A., Bartoli, A., Dimeco, F., Schaller, K., Denaro, L., and Tessitore, E.
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- 2022
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3. Multishell Diffusion MRI–Based Tractography of the Facial Nerve in Vestibular Schwannoma
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Castellaro, M., primary, Moretto, M., additional, Baro, V., additional, Brigadoi, S., additional, Zanoletti, E., additional, Anglani, M., additional, Denaro, L., additional, Dell’Acqua, R., additional, Landi, A., additional, Causin, F., additional, d’Avella, D., additional, and Bertoldo, A., additional
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- 2020
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4. Characterization of endolymphatic sac tumors and von Hippel-Lindau disease in the International Endolymphatic Sac Tumor Registry
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Bausch, B., Wellner, U., Peyre, M., Boedeker, C.C., Hes, F.J., Anglani, M., Campos, J.M. de, Kanno, H., Maher, E.R., Krauss, T., Sanso, G., Barontini, M., Letizia, C., Hader, C., Schiavi, F., Zanoletti, E., Suarez, C., Offergeld, C., Malinoc, A., Zschiedrich, S., Glasker, S., Bobin, S., Sterkers, O., Huy, P.T.B., Giraud, S., Links, T., Eng, C., Opocher, G., Richard, S., Neumann, H.P.H., Int Endolymphatic Sac Tumor ELST, Medical Genetics, and Surgical clinical sciences
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endocrine system diseases ,prevalence ,endolymphatic sac tumor ,urologic and male genital diseases ,von Hippel-Lindau ,neoplasms ,temporal bone MRI ,female genital diseases and pregnancy complications - Abstract
BACKGROUND: Endolymphatic sac tumors (ELSTs) are, with a prevalence of up to 16%, a component of von Hippel-Lindau (VHL) disease. Data from international registries regarding heritable fraction and characteristics, germline VHL mutation frequency, and prevalence are lacking. METHODS: Systematic registration of ELSTs from international centers of otorhinolaryngology and from multidisciplinary VHL centers' registries was performed. Molecular genetic analyses of the VHL gene were offered to all patients. RESULTS: Our population-based registry comprised 93 patients with ELST and 1789 patients with VHL. The prevalence of VHL germline mutations in apparently sporadic ELSTs was 39%. The prevalence of ELSTs in patients with VHL was 3.6%. ELST was the initial manifestation in 32% of patients with VHL-ELST. CONCLUSION: Prevalence of ELST in VHL disease is much lower compared to the literature. VHL-associated ELSTs can be the first presentation of the syndrome and mimic sporadic tumors, thus emphasizing the need of molecular testing in all presentations of ELST. © 2015 Wiley Periodicals, Inc. Head Neck 38: 673-679, 2016.
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- 2016
5. Galleria dell'Accademia: guida ufficiale [Accademia Gallery: official guide]
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Falletti, F., Anglani, M., and Rossi Rognoni, G.
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N4390-5098 ,N400-3990 ,MusIns - Abstract
La Galleria dell'Accademia è conosciuta nel mondo come Museo di Michelangelo, per il gruppo dei Prigioni e il David collocato nella Tribuna. Unica per la sua collezione di tavole a fondo oro, ospita numerosi dipinti a soggetto religioso di pittori della fine del Duecento, di contemporanei di Giotto quali Taddei Gaddi, Bernardo Daddi e gli Orcagna, e di maestri tardogotici di spicco come Giovanni da Milano e Lorenzo Monaco. Questo volume è la guida ufficiale della Galleria dell'Accademia e rappresenta quanto di più aggiornato e attendibile si possa desiderare per una corretta visita. Contiene la storia del museo, l'elenco completo di tutte le opere sala per sala, le piantine di tutte le sale, le immagini e i commenti di tutte le opere principali. ******* The Accademia Gallery is known worldwide as the Michelangelo Museum, for the group of Prisons and the David placed in the Tribuna. Unique for its collection of tables with a gold background, it houses numerous religious paintings by painters of the late thirteenth century, contemporaries by Giotto such as Taddei Gaddi, Bernardo Daddi and the Orcagna, and by prominent late Gothic masters such as Giovanni da Milano and Lorenzo Monk. This volume is the official guide of the Accademia Gallery and represents the most updated and reliable one could wish for a correct visit. It contains the history of the museum, the complete list of all the works room by room, the plans of all the rooms, the images and the comments of all the main works.
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- 2015
6. Characterization of endolymphatic sac tumors and von Hippel-Lindau disease in the international ELST registry
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Bausch, B, Wellner, U, Peyre, M, Boedeker, Cc, Hes, Fj, Anglani, M, de Campos JM, Kanno, H, Maher, Er, Krauss, T, Sansó, G, Barontini, M, Letizia, Claudio, Hader, C, Schiavi, F, Zanoletti, E, Suárez, C, Offergeld, C, Malinoc, A, Zschiedrich, S, Glasker, S, Bobin, S, Sterkers, O, Tran Ba Huy, P, Giraud, S, Links, T, Eng, C, Opocher, G, Richard, S, Neumann, Hp, and International ELST Consortium
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- 2015
7. Study of 'Shaken Baby Syndrome': Morphological and Diffusion MRI data
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Anastasi, G., Milardi, D., Milazzo, C., Cacciola, A., Facchin, Paola, DAL ZOTTO, Lara, Crema Falceri, G., Bua, M., Anglani, M., Marino, S., and Bramanti, P.
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- 2014
8. The finding of multiple pancreatic cysts and von Hippel Lindau disease
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Anglani, M., Opocher, G., Pomerri, Fabio, and Muzzio, PIER CARLO
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Abdomen ,Abdominal Viscera (Solid Organs) - Pancreas ,Pancreas - Abstract
Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: von Hippel-Lindau disease (VHL) is an autosomal dominant multisystem neoplastic disease with many different kind of lesions including multiple cysts of pancreas. Our purpose was to investigate the prevalence of multiple cysts of pancreas in NON-VHL...
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- 2010
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9. 7144 Predictive value and biologic significance of circulating tumor cells (CTC) in sporadic and von hippel lindau (VHL) renal cancer
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Zovato, S., primary, Opocher, G., additional, Rossi, E., additional, Indraccolo, S., additional, Amadori, A., additional, Pastorelli, D., additional, Lombardi, G., additional, Anglani, M., additional, and Zamarchi, R., additional
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- 2009
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10. Early red nucleus atrophy in relapse‐onset multiple sclerosis
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Sofia Zywicki, Francesco Causin, Maria Giulia Anglani, Martina Rubin, Massimo Filippi, Davide Poggiali, Silvia Franciotta, Andrea Lazzarotto, Paola Perini, Francesca Rinaldi, Paolo Gallo, Monica Margoni, Margoni, M., Poggiali, D., Zywicki, S., Rubin, M., Lazzarotto, A., Franciotta, S., Anglani, M. G., Causin, F., Rinaldi, F., Perini, P., Filippi, M., and Gallo, P.
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Adult ,Male ,Cerebellum ,Adolescent ,cerebellum ,Red nucleus ,Lesion volume ,050105 experimental psychology ,MRI ,red nucleus ,Midbrain ,Young Adult ,03 medical and health sciences ,Multiple Sclerosis, Relapsing-Remitting ,0302 clinical medicine ,Atrophy ,Interposed nucleus ,medicine ,Humans ,0501 psychology and cognitive sciences ,Radiology, Nuclear Medicine and imaging ,Gray Matter ,Research Articles ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Multiple sclerosis ,05 social sciences ,Anatomy ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,medicine.anatomical_structure ,Neurology ,Female ,Neurology (clinical) ,Brainstem ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
No study has investigated red nucleus (RN) atrophy in multiple sclerosis (MS) despite cerebellum and its connections are elective sites of MS‐related pathology. In this study, we explore RN atrophy in early MS phases and its association with cerebellar damage (focal lesions and atrophy) and physical disability. Thirty‐seven relapse‐onset MS (RMS) patients having mean age of 35.6 ± 8.5 (18–56) years and mean disease duration of 1.1 ± 1.5 (0–5) years, and 36 age‐ and sex‐matched healthy controls (HC) were studied. Cerebellar and RN lesions and volumes were analyzed on 3 T‐MRI images. RMS did not differ from HC in cerebellar lobe volumes but significantly differed in both right (107.84 ± 13.95 mm3 vs. 99.37 ± 11.53 mm3, p = .019) and left (109.71 ± 14.94 mm3 vs. 100.47 ± 15.78 mm3, p = .020) RN volumes. Cerebellar white matter lesion volume (WMLV) inversely correlated with both right and left RN volumes (r = −.333, p = .004 and r = −.298, p = .010, respectively), while no correlation was detected between RN volumes and mean cortical thickness, cerebellar gray matter lesion volume, and supratentorial WMLV (right RN: r = −.147, p = .216; left RN: r = −.153, p = .196). Right, but not left, RN volume inversely correlated with midbrain WMLV (r = −.310, p = .008), while no correlation was observed between whole brainstem WMLV and either RN volumes (right RN: r = −.164, p = .164; left RN: r = −.64, p = .588). Finally, left RN volume correlated with vermis VIIb (r = .297, p = .011) and right interposed nucleus (r = .249, p = .034) volumes. We observed RN atrophy in early RMS, likely resulting from anterograde axonal degeneration starting in cerebellar and midbrain WML. RN atrophy seems a promising marker of neurodegeneration and/or cerebellar damage in RMS., The cerebellum and the brainstem are major sites of pathology in multiple sclerosis (MS) and their involvement, although frequently asymptomatic, is known to be associated with a more severe prognosis. We explored RN atrophy in early MS phases and its association with cerebellar damage and physical disability. We observed RN atrophy in early relapse‐onset (RMS), likely resulting from anterograde axonal degeneration starting in cerebellar and midbrain WML. RN atrophy seems a promising marker of neurodegeneration and/or cerebellar damage in RMS.
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- 2020
11. The Role of Cognitive Reserve in Protecting Cerebellar Volumes of Older Adults with mild Cognitive Impairment.
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Devita M, Debiasi G, Anglani M, Ceolin C, Mazzonetto I, Begliomini C, Cauzzo S, Raffaelli C, Lazzarin A, Ravelli A, Bordignon A, De Rui M, Sergi G, Bertoldo A, Mapelli D, and Coin A
- Abstract
The present study aims to investigate the relationship between cerebellar volumes and cognitive reserve in individuals with Mild Cognitive Impairment (MCI). A description of proxies of cerebellar cognitive reserve in terms of different volumes across lobules is also provided. 36 individuals with MCI underwent neuropsychological (MoCA, MMSE, Clock test, CRIq) assessment and neuroimaging acquisition with magnetic resonance imaging at 3 T. Simple linear correlations were applied between cerebellar volumes and cognitive measures. Multiple linear regression models were then used to estimate standardized regression coefficients and 95% confidence intervals. Simple linear correlations between cerebellar lobules volumes and cognitive features highlighted a significant association between CRIq_Working activity and specific motor cerebellar volumes: Left_V (ρ = 0.40, p = 0.02), Right_V (r = 0.42, p = 0.002), Vermis_VIIIb (ρ = 0.47, p = 0.003), Left_X (ρ = -0.46, p = 0.002) and Vermis_X (r = 0.35, p = 0.03). Furthermore, CRIq_Working activity scores correlated with certain cerebellar lobules implicated in cognition: Left_Crus_II, Vermis VIIb, Left_IX. MMSE was associated only with the Right_VIIB volume (r = 0.35, p = 0.02), while Clock Drawing Test scores correlated with both Left_Crus_I and Right_Crus_I (r = -0.42 and r = 0.42, p = 0.02, respectively). This study suggests that a higher cognitive reserve is associated with specific cerebellar lobule volumes and that Working activity may play a predominant role in this association. These findings contribute to the understanding of the relationship between cerebellar volumes and cognitive reserve, highlighting the potential modulatory role of Working activity on cerebellum response to cognitive decline., (© 2024. The Author(s).)
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- 2024
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12. Multifocal recurrent neuralgic amyotrophy in an immunocompromised patient.
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Briani C, Salvalaggio A, Anglani M, Imbergamo S, Pravato S, Marasca M, Cacciavillani M, and Gasparotti R
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- Humans, Immunocompromised Host, Brachial Plexus Neuritis diagnostic imaging, Brachial Plexus Neuritis etiology
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- 2024
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13. Choroid plexus volume in multiple sclerosis can be estimated on structural MRI avoiding contrast injection.
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Visani V, Pizzini FB, Natale V, Tamanti A, Anglani M, Bertoldo A, Calabrese M, and Castellaro M
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- Humans, Reproducibility of Results, Choroid Plexus diagnostic imaging, Magnetic Resonance Imaging, Signal-To-Noise Ratio, Multiple Sclerosis diagnostic imaging
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We compared choroid plexus (ChP) manual segmentation on non-contrast-enhanced (non-CE) sequences and reference standard CE T1- weighted (T1w) sequences in 61 multiple sclerosis patients prospectively included. ChP was separately segmented on T1w, T2-weighted (T2w) fluid-attenuated inversion-recovery (FLAIR), and CE-T1w sequences. Inter-rater variability assessed on 10 subjects showed high reproducibility between sequences measured by intraclass correlation coefficient (T1w 0.93, FLAIR 0.93, CE-T1w 0.99). CE-T1w showed higher signal-to-noise ratio and contrast-to-noise ratio (CE-T1w 23.77 and 18.49, T1w 13.73 and 7.44, FLAIR 13.09 and 10.77, respectively). Manual segmentation of ChP resulted 3.073 ± 0.563 mL (mean ± standard deviation) on T1w, 3.787 ± 0.679 mL on FLAIR, and 2.984 ± 0.506 mL on CE-T1w images, with an error of 28.02 ± 19.02% for FLAIR and 3.52 ± 12.61% for T1w. FLAIR overestimated ChP volume compared to CE-T1w (p < 0.001). The Dice similarity coefficient of CE-T1w versus T1w and FLAIR was 0.67 ± 0.05 and 0.68 ± 0.05, respectively. Spatial error distribution per slice was calculated after nonlinear coregistration to the standard MNI152 space and showed a heterogeneous profile along the ChP especially near the fornix and the hippocampus. Quantitative analyses suggest T1w as a surrogate of CE-T1w to estimate ChP volume.Relevance statement To estimate the ChP volume, CE-T1w can be replaced by non-CE T1w sequences because the error is acceptable, while FLAIR overestimates the ChP volume. This encourages the development of automatic tools for ChP segmentation, also improving the understanding of the role of the ChP volume in multiple sclerosis, promoting longitudinal studies.Key points • CE-T1w sequences are considered the reference standard for ChP manual segmentation.• FLAIR sequences showed a higher CNR than T1w sequences but overestimated the ChP volume.• Non-CE T1w sequences can be a surrogate of CE-T1w sequences for manual segmentation of ChP., (© 2024. The Author(s).)
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- 2024
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14. White Matter Tract Density Index Prediction Model of Overall Survival in Glioblastoma.
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Salvalaggio A, Pini L, Gaiola M, Velco A, Sansone G, Anglani M, Fekonja L, Chioffi F, Picht T, Thiebaut de Schotten M, Zagonel V, Lombardi G, D'Avella D, and Corbetta M
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- Humans, Male, Female, Middle Aged, Prognosis, Brain pathology, Retrospective Studies, Glioblastoma diagnostic imaging, Glioblastoma surgery, Glioblastoma drug therapy, White Matter diagnostic imaging, White Matter pathology, Brain Neoplasms diagnostic imaging, Brain Neoplasms surgery, Brain Neoplasms genetics
- Abstract
Importance: The prognosis of overall survival (OS) in patients with glioblastoma (GBM) may depend on the underlying structural connectivity of the brain., Objective: To examine the association between white matter tracts affected by GBM and patients' OS by means of a new tract density index (TDI)., Design, Setting, and Participants: This prognostic study in patients with a histopathologic diagnosis of GBM examined a discovery cohort of 112 patients who underwent surgery between February 1, 2015, and November 30, 2020 (follow-up to May 31, 2023), in Italy and 70 patients in a replicative cohort (n = 70) who underwent surgery between September 1, 2012, and November 30, 2015 (follow-up to May 31, 2023), in Germany. Statistical analyses were performed from June 1, 2021, to May 31, 2023. Thirteen and 12 patients were excluded from the discovery and the replicative sets, respectively, because of magnetic resonance imaging artifacts., Exposure: The density of white matter tracts encompassing GBM., Main Outcomes and Measures: Correlation, linear regression, Cox proportional hazards regression, Kaplan-Meier, and prediction analysis were used to assess the association between the TDI and OS. Results were compared with common prognostic factors of GBM, including age, performance status, O6-methylguanine-DNA methyltransferase methylation, and extent of surgery., Results: In the discovery cohort (n = 99; mean [SD] age, 62.2 [11.5] years; 29 female [29.3%]; 70 male [70.7%]), the TDI was significantly correlated with OS (r = -0.34; P < .001). This association was more stable compared with other prognostic factors. The TDI showed a significant regression pattern (Cox: hazard ratio, 0.28 [95% CI, 0.02-0.55; P = .04]; linear: t = -2.366; P = .02). and a significant Kaplan-Meier stratification of patients as having lower or higher OS based on the TDI (log-rank test = 4.52; P = .03). Results were confirmed in the replicative cohort (n = 58; mean [SD] age, 58.5 [11.1] years, 14 female [24.1%]; 44 male [75.9%]). High (24-month cutoff) and low (18-month cutoff) OS was predicted based on the TDI computed in the discovery cohort (accuracy = 87%)., Conclusions and Relevance: In this study, GBMs encompassing regions with low white matter tract density were associated with longer OS. These findings indicate that the TDI is a reliable presurgical outcome predictor that may be considered in clinical trials and clinical practice. These findings support a framework in which the outcome of GBM depends on the patient's brain organization.
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- 2023
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15. Alemtuzumab following natalizumab is more effective in adult-onset than paediatric-onset multiple sclerosis.
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Puthenparampil M, Gaggiola M, Miscioscia A, Mauceri VA, De Napoli F, Zanotelli G, Anglani M, Nosadini M, Sartori S, Perini P, Rinaldi F, and Gallo P
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Background: Paediatric-onset multiple sclerosis (POMS) therapeutic approach derives from of adult-onset multiple sclerosis (AOMS) tailored algorithms., Objectives: To evaluate in a common clinical scenario the efficacy and safety of alemtuzumab (ALZ) in POMS and AOMS., Methods: All patients switching from natalizumab (NTZ) to ALZ for safety concerns (high anti-John Cunningham Virus Antibody Index value, anti-JCV Index) were enrolled in this single-centre, retrospective, case-control open-label study., Results: Ten POMS and 27 AOMS were followed up for 51.3 months. After month 12, we found a lower risk of clinical or radiological relapses among AOMS patients and among patients with older age at ALZ (both p < 0.05). Survival analysis revealed an increased risk of relapse in POMS compared with AOMS (logrank p = 0.00498) and patients starting ALZ before age 22.75 years than the elder ones (logrank p = 0.0018). Survival analysis did not disclose any difference between AOMS and POMS (logrank p = 0.27) in terms of progression independent of any relapse activity (PIRA). In addition, no evidence of relapse-associated worsening was observed. Autoimmune events were reported by 5 AOMS and no POMS (29.4% versus 0.0%, p = 0.057), and survival analysis was not significant (logrank p = 0.0786)., Conclusion: ALZ seems more effective in AOMS than in POMS following NTZ. These findings underrate ALZ effectiveness when shifting from NTZ in POMS., Competing Interests: M.P. reports grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy and Novartis; consultancy for Novartis, Biogen Italy and Sanofi Genzyme; board membership Sanofi Genzyme, Novartis and Biogen Italy. M.G., A.M., V.M.A., F.D.N., G.Z., M.N. and S.S. have nothing to disclose. P.P. reports grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis and Roche; consultancy for Novartis, Biogen Italy, Sanofi Genzyme and Roche. F.R. report grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis; consultancy for Novartis, Biogen Italy and Sanofi Genzyme. P.G. reports grant from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis, Roche and Bristol Myers Squibb; consultancy for Novartis, Biogen Italy, Sanofi Genzyme, Roche and Bristol Myers Squibb; board membership Sanofi Genzyme, Novartis, Biogen Italy, Roche, Merck Serono and Bristol Myers Squibb., (© The Author(s), 2023.)
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- 2023
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16. Caspr1 antibodies autoimmune paranodopathy with severe tetraparesis: Potential relevance of antibody titers in monitoring treatment response.
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Bresciani L, Salvalaggio A, Vegezzi E, Visentin A, Fortuna A, Anglani M, Cacciavillani M, Masciocchi S, Scaranzin S, Carecchio M, Martinuzzi A, Gastaldi M, and Briani C
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- Female, Humans, Adult, Rituximab therapeutic use, Antibodies, Contactins, Autoantibodies, Immunoglobulins, Intravenous therapeutic use, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating drug therapy
- Abstract
Aim: Nodopathies and paranodopathies are autoimmune neuropathies associated with antibodies to nodal-paranodal antigens (neurofascin 140/186 and 155, contactin-1, contactin-associated protein 1 [Caspr1]) characterized by peculiar clinical features, poor response to standard immunotherapies (e.g., intravenous immunoglobulins, IVIg). Improvement after anti-CD20 monoclonal antibody therapy has been reported. Data on Caspr1 antibodies pathogenicity are still preliminary, and longitudinal titers have been poorly described., Methods: We report on a young woman who developed a disabling neuropathy with antibodies to the Caspr1/contactin-1 complex showing a dramatic improvement after rituximab therapy, mirrored by the decrease of antibody titers., Results: A 26-year-old woman presented with ataxic-stepping gait, severe motor weakness at four limbs, and low frequency postural tremor. For neurophysiological evidence of demyelinating neuropathy, she was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy and treated with IVIg without benefit. MRI showed symmetrical hypertrophy and marked signal hyperintensity of brachial and lumbosacral plexi. Cerebrospinal fluid showed 710 mg/dL protein. Despite intravenous methylprednisolone, the patient progressively worsened, and became wheelchair-bound. Antibodies to nodal-paranodal antigens were searched for by ELISA and cell-based assay. Anticontactin/Caspr1 IgG4 antibodies resulted positive. The patient underwent rituximab therapy with slow progressive improvement that mirrored the antibodies titer, measured throughout the disease course., Conclusions: Our patient had a severe progressive course with early disability and axonal damage, and slow recovery starting only a few months after antibody-depleting therapy. The close correlation between titer, disability, and treatment, supports the pathogenicity of Caspr1 antibodies, and suggest that their longitudinal evaluation might provide a potential biomarker to evaluate treatment response., (© 2023 The Authors. Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society.)
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- 2023
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17. The dynamic functional connectivity fingerprint of high-grade gliomas.
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Moretto M, Silvestri E, Facchini S, Anglani M, Cecchin D, Corbetta M, and Bertoldo A
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- Humans, Neural Pathways, Brain, Brain Mapping, Magnetic Resonance Imaging, Brain Neoplasms diagnostic imaging, Glioma diagnostic imaging
- Abstract
Resting state fMRI has been used in many studies to investigate the impact of brain tumours on functional connectivity (FC). However, these studies have so far assumed that FC is stationary, disregarding the fact that the brain fluctuates over dynamic states. Here we utilised resting state fMRI data from 33 patients with high-grade gliomas and 33 healthy controls to examine the dynamic interplay between resting-state networks and to gain insights into the impact of brain tumours on functional dynamics. By employing Hidden Markov Models, we demonstrated that functional dynamics persist even in the presence of a high-grade glioma, and that patients exhibited a global decrease of connections strength, as well as of network segregation. Furthermore, through a multivariate analysis, we demonstrated that patients' cognitive scores are highly predictive of pathological dynamics, thus supporting our hypothesis that functional dynamics could serve as valuable biomarkers for better understanding the traits of high-grade gliomas., (© 2023. The Author(s).)
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- 2023
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18. Patterns of gray and white matter functional networks involvement in glioblastoma patients: indirect mapping from clinical MRI scans.
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Sansone G, Pini L, Salvalaggio A, Gaiola M, Volpin F, Baro V, Padovan M, Anglani M, Facchini S, Chioffi F, Zagonel V, D'Avella D, Denaro L, Lombardi G, and Corbetta M
- Abstract
Background: Resting-state functional-MRI studies identified several cortical gray matter functional networks (GMNs) and white matter functional networks (WMNs) with precise anatomical localization. Here, we aimed at describing the relationships between brain's functional topological organization and glioblastoma (GBM) location. Furthermore, we assessed whether GBM distribution across these networks was associated with overall survival (OS)., Materials and Methods: We included patients with histopathological diagnosis of IDH-wildtype GBM, presurgical MRI and survival data. For each patient, we recorded clinical-prognostic variables. GBM core and edema were segmented and normalized to a standard space. Pre-existing functional connectivity-based atlases were used to define network parcellations: 17 GMNs and 12 WMNs were considered in particular. We computed the percentage of lesion overlap with GMNs and WMNs, both for core and edema. Differences between overlap percentages were assessed through descriptive statistics, ANOVA, post-hoc tests, Pearson's correlation tests and canonical correlations. Multiple linear and non-linear regression tests were employed to explore relationships with OS., Results: 99 patients were included (70 males, mean age 62 years). The most involved GMNs included ventral somatomotor, salient ventral attention and default-mode networks; the most involved WMNs were ventral frontoparietal tracts, deep frontal white matter, and superior longitudinal fasciculus system. Superior longitudinal fasciculus system and dorsal frontoparietal tracts were significantly more included in the edema ( p < 0.001). 5 main patterns of GBM core distribution across functional networks were found, while edema localization was less classifiable. ANOVA showed significant differences between mean overlap percentages, separately for GMNs and WMNs ( p -values<0.0001). Core-N12 overlap predicts higher OS, although its inclusion does not increase the explained OS variance., Discussion and Conclusion: Both GBM core and edema preferentially overlap with specific GMNs and WMNs, especially associative networks, and GBM core follows five main distribution patterns. Some inter-related GMNs and WMNs were co-lesioned by GBM, suggesting that GBM distribution is not independent of the brain's structural and functional organization. Although the involvement of ventral frontoparietal tracts (N12) seems to have some role in predicting survival, network-topology information is overall scarcely informative about OS. fMRI-based approaches may more effectively demonstrate the effects of GBM on brain networks and survival., 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, (Copyright © 2023 Sansone, Pini, Salvalaggio, Gaiola, Volpin, Baro, Padovan, Anglani, Facchini, Chioffi, Zagonel, D’Avella, Denaro, Lombardi and Corbetta.)
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- 2023
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19. Assessment of structural disconnections in gliomas: comparison of indirect and direct approaches.
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Silvestri E, Villani U, Moretto M, Colpo M, Salvalaggio A, Anglani M, Castellaro M, Facchini S, Monai E, D'Avella D, Della Puppa A, Cecchin D, Corbetta M, and Bertoldo A
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- Adult, Humans, Brain Mapping methods, Brain diagnostic imaging, Brain pathology, Glioma diagnostic imaging, Glioma pathology, Brain Neoplasms diagnostic imaging, Brain Neoplasms pathology, White Matter diagnostic imaging, White Matter pathology
- Abstract
Gliomas are amongst the most common primary brain tumours in adults and are often associated with poor prognosis. Understanding the extent of white matter (WM) which is affected outside the tumoral lesion may be of paramount importance to explain cognitive deficits and the clinical progression of the disease. To this end, we explored both direct (i.e., tractography based) and indirect (i.e., atlas-based) approaches to quantifying WM structural disconnections in a cohort of 44 high- and low-grade glioma patients. While these methodologies have recently gained popularity in the context of stroke and other pathologies, to our knowledge, this is the first time they are applied in patients with brain tumours. More specifically, in this work, we present a quantitative comparison of the disconnection maps provided by the two methodologies by applying well-known metrics of spatial similarity, extension, and correlation. Given the important role the oedematous tissue plays in the physiopathology of tumours, we performed these analyses both by including and excluding it in the definition of the tumoral lesion. This was done to investigate possible differences determined by this choice. We found that direct and indirect approaches offer two distinct pictures of structural disconnections in patients affected by brain gliomas, presenting key differences in several regions of the brain. Following the outcomes of our analysis, we eventually discuss the strengths and pitfalls of these two approaches when applied in this critical field., (© 2022. The Author(s).)
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- 2022
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20. Case Report: Para-infectious cranial nerve palsy after bacterial meningitis.
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Zanotelli G, Bresciani L, Anglani M, Miscioscia A, Rinaldi F, and Puthenparampil M
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- Female, Humans, Adult, Oligoclonal Bands, Ceftriaxone, Gadolinium, Diplopia, Leukocytosis, Contrast Media, Prednisolone, Paralysis, Immunoglobulin G, Anti-Bacterial Agents, Cranial Nerve Diseases diagnosis, Cranial Nerve Diseases drug therapy, Cranial Nerve Diseases etiology, Meningitis, Bacterial complications, Meningitis, Bacterial diagnosis, Meningitis, Bacterial drug therapy
- Abstract
A 27-year-old woman was admitted to our hospital for fever, associated with headache, nausea, and vomiting, and she rapidly developed mild left facial nerve palsy and diplopia. Neurological examination revealed mild meningitis associated with bilateral VI cranial nerve palsy and mild left facial palsy. As central nervous system (CNS) infection was suspected, a diagnostic lumbar puncture was performed, which revealed 1,677 cells/μl, 70% of which were polymorphonuclear leukocytes. Moreover, multiplex PCR immunoassay was positive for Neisseria meningitidis , supporting the diagnosis of bacterial meningitis. Finally, IgG oligoclonal bands (IgGOB) were absent in serum and cerebrospinal fluid (CSF). Therefore, ceftriaxone antibiotic therapy was started, and in the following days, the patient's signs and symptoms improved, with complete remission of diplopia and meningeal signs within a week. On the contrary, left facial nerve palsy progressively worsened into a severe bilateral deficit. A second lumbar puncture was therefore performed: the CSF analysis revealed a remarkable decrease of pleocytosis with a qualitative modification (only lymphocytes), and oligoclonal IgG bands were present. A new brain MRI was performed, showing a bilateral gadolinium enhancement of the intrameatal VII and VIII cranial nerves bilaterally. Due to suspicion of para-infectious etiology, the patient was treated with oral steroid (prednisolone 1 mg/kg/day), with a progressive and complete regression of the symptoms. We suggest that in this case, after a pathogen-driven immunological response (characterized by relevant CSF mixed pleocytosis and no evidence of IgGOB), a para-infectious adaptive immunity-driven reaction (with mild lymphocyte pleocytosis and pattern III IgGOB) against VII and VIII cranial nerves started. Indeed, steroid administration caused a rapid and complete restoration of cranial nerve function., 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., (Copyright © 2022 Zanotelli, Bresciani, Anglani, Miscioscia, Rinaldi and Puthenparampil.)
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- 2022
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21. Impaired cognitive control in patients with brain tumors.
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Tarantino V, Visalli A, Facchini S, Rossato C, Bertoldo A, Silvestri E, Cecchin D, Capizzi M, Anglani M, Baro V, Denaro L, Della Puppa A, D'Avella D, Corbetta M, and Vallesi A
- Subjects
- Brain Mapping, Cognition physiology, Humans, Prefrontal Cortex physiology, Reaction Time physiology, Brain Neoplasms complications, Brain Neoplasms diagnostic imaging, Cognitive Dysfunction
- Abstract
Though the assessment of cognitive functions is proven to be a reliable prognostic indicator in patients with brain tumors, some of these functions, such as cognitive control, are still rarely investigated. The objective of this study was to examine proactive and reactive control functions in patients with focal brain tumors and to identify lesioned brain areas more at "risk" for developing impairment of these functions. To this end, a group of twenty-two patients, candidate to surgery, were tested with an AX-CPT task and a Stroop task, along with a clinical neuropsychological assessment, and their performance was compared to that of a well-matched healthy control group. Although overall accuracy and response times were similar for patients and control groups, the patient group failed more on the BX trials of the AX-CPT task and on the incongruent trials of the Stroop task, specifically. Behavioral results were associated with the damaged brain areas, mostly distributed in right frontal regions, by means of a lesion-symptom mapping multivariate approach. This analysis showed that a white matter cluster in the right prefrontal area was associated with lower d'-context values on the AX-CPT, which reflected the fact that these patients rely more on later information (reactive processes) to respond to unexpected and conflicting stimuli, than on earlier contextual cues (proactive processes). Taken together, these results suggest that patients with brain tumors present an imbalance between proactive and reactive control strategies in high interfering conditions, in association with right prefrontal white matter lesions., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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22. Brain Stem Glucose Hypermetabolism in Amyotrophic Lateral Sclerosis/Frontotemporal Dementia and Shortened Survival: An 18 F-FDG PET/MRI Study.
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Zanovello M, Sorarù G, Campi C, Anglani M, Spimpolo A, Berti S, Bussè C, Mozzetta S, Cagnin A, and Cecchin D
- Subjects
- Brain Stem, Fluorodeoxyglucose F18, Glucose, Humans, Magnetic Resonance Imaging, Positron Emission Tomography Computed Tomography, Prospective Studies, Tomography, X-Ray Computed, Amyotrophic Lateral Sclerosis diagnostic imaging, Frontotemporal Dementia diagnostic imaging
- Abstract
A few
18 F-FDG PET/CT studies have revealed the presence of brain hypermetabolism in the brain stem and cervical spinal cord of patients within the amyotrophic lateral sclerosis/frontotemporal dementia (ALS/FTD) continuum. We aimed to investigate this finding through a hybrid PET/MRI system, allowing a more precise depiction of the spatial pattern of metabolic changes in the brain stem and cervical spinal cord. Methods: Twenty-eight patients with a diagnosis of ALS or a diagnosis of the behavioral variant of FTD plus motoneuron disease, as well as 13 control subjects, underwent18 F-FDG PET/MRI. Mean normalized18 F-FDG uptake in the midbrain/pons, medulla oblongata, and cervical spinal cord as defined on the individual's MRI scans were compared between groups. Furthermore, the associations between regional18 F-FDG uptake and clinical and demographic characteristics-including gene mutation, type of onset (bulbar, spinal, dementia), and clinical characteristics-were investigated. Results: A significant ( P < 0.005) increment in glucose metabolism in the midbrain/pons and medulla oblongata was found in ALS/FTD patients (spinal-ALS and FTD-motor neuron disease subgroups) in comparison to controls. No relevant associations between clinical and metabolic features were reported, although medulla oblongata hypermetabolism was associated with shortened survival ( P < 0.001). Conclusion: Increased glucose metabolism in the brain stem might be due to neuroinflammation, one of the key steps in the pathogenic cascade that leads to neurodegeneration in ALS/FTD.18 F-FDG PET/MRI could be a valuable tool to assess glial changes in the ALS/FTD spectrum and could serve as a prognostic biomarker. Large prospective initiatives would likely shed more light on the promising application of PET/MRI in this setting., (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2022
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23. Widespread cortical functional disconnection in gliomas: an individual network mapping approach.
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Silvestri E, Moretto M, Facchini S, Castellaro M, Anglani M, Monai E, D'Avella D, Della Puppa A, Cecchin D, Bertoldo A, and Corbetta M
- Abstract
Assessment of impaired/preserved cortical regions in brain tumours is typically performed via intraoperative direct brain stimulation of eloquent areas or task-based functional MRI. One main limitation is that they overlook distal brain regions or networks that could be functionally impaired by the tumour. This study aims (i) to investigate the impact of brain tumours on the cortical synchronization of brain networks measured with resting-state functional magnetic resonance imaging (resting-state networks) both near the lesion and remotely and (ii) to test whether potential changes in resting-state networks correlate with cognitive status. The sample included 24 glioma patients (mean age: 58.1 ± 16.4 years) with different pathological staging. We developed a new method for single subject localization of resting-state networks abnormalities. First, we derived the spatial pattern of the main resting-state networks by means of the group-guided independent component analysis. This was informed by a high-resolution resting-state networks template derived from an independent sample of healthy controls. Second, we developed a spatial similarity index to measure differences in network topography and strength between healthy controls and individual brain tumour patients. Next, we investigated the spatial relationship between altered networks and tumour location. Finally, multivariate analyses related cognitive scores across multiple cognitive domains (attention, language, memory, decision making) with patterns of multi-network abnormality. We found that brain gliomas cause broad alterations of resting-state networks topography that occurred mainly in structurally normal regions outside the tumour and oedema region. Cortical regions near the tumour often showed normal synchronization. Finally, multi-network abnormalities predicted attention deficits. Overall, we present a novel method for the functional localization of resting-state networks abnormalities in individual glioma patients. These abnormalities partially explain cognitive disabilities and shall be carefully navigated during surgery., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.)
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- 2022
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24. Magnetic Resonance Imaging Correlates of Immune Microenvironment in Glioblastoma.
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Salvalaggio A, Silvestri E, Sansone G, Pinton L, Magri S, Briani C, Anglani M, Lombardi G, Zagonel V, Della Puppa A, Mandruzzato S, Corbetta M, and Bertoldo A
- Abstract
Background: Glioblastoma (GBM) is the most commonly occurring primary malignant brain tumor, and it carries a dismal prognosis. Focusing on the tumor microenvironment may provide new insights into pathogenesis, but no clinical tools are available to do this. We hypothesized that the infiltration of different leukocyte populations in the tumoral and peritumoral brain tissues may be measured by magnetic resonance imaging (MRI)., Methods: Pre-operative MRI was combined with immune phenotyping of intraoperative tumor tissue based on flow cytometry of myeloid cell populations that are associated with immune suppression, namely, microglia and bone marrow-derived macrophages (BMDM). These cell populations were measured from the central and marginal areas of the lesion identified intraoperatively with 5-aminolevulinic acid-guided surgery. MRI features (volume, mean and standard deviation of signal intensity, and fractality) were derived from all MR sequences (T1w, Gd+ T1w, T2w, FLAIR) and ADC MR maps and from different tumor areas (contrast- and non-contrast-enhancing tumor, necrosis, and edema). The principal components of MRI features were correlated with different myeloid cell populations by Pearson's correlation., Results: We analyzed 126 samples from 62 GBM patients. The ratio between BMDM and microglia decreases significantly from the central core to the periphery. Several MRI-derived principal components were significantly correlated (p <0.05, r range: [-0.29, -0.41]) with the BMDM/microglia ratio collected in the central part of the tumor., Conclusions: We report a significant correlation between structural MRI clinical imaging and the ratio of recruited vs. resident macrophages with different immunomodulatory activities. MRI features may represent a novel tool for investigating the microenvironment of GBM., 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., (Copyright © 2022 Salvalaggio, Silvestri, Sansone, Pinton, Magri, Briani, Anglani, Lombardi, Zagonel, Della Puppa, Mandruzzato, Corbetta and Bertoldo.)
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- 2022
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25. Imaging features of rhinocerebral mucormycosis: from onset to vascular complications.
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Mazzai L, Anglani M, Giraudo C, Martucci M, Cester G, and Causin F
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- Brain Diseases complications, Brain Ischemia etiology, Cavernous Sinus Thrombosis etiology, Cerebral Hemorrhage etiology, Diagnosis, Differential, Humans, Intracranial Aneurysm etiology, Mucormycosis complications, Orbital Diseases complications, Orbital Diseases diagnostic imaging, Orbital Diseases parasitology, Sinusitis complications, Brain Diseases diagnostic imaging, Brain Diseases parasitology, Magnetic Resonance Imaging, Mucormycosis diagnostic imaging, Neuroimaging, Sinusitis diagnostic imaging, Sinusitis parasitology, Tomography, X-Ray Computed
- Abstract
Rhinocerebral mucormycosis (RCM) may result in severe intracranial ischemic and hemorrhagic lesions. Both computed tomography (CT) and magnetic resonance imaging (MRI) play an essential role in the diagnosis of RCM, but whereas CT is better for assessing bone erosion, MRI is superior in evaluating soft tissue, intraorbital extension, and in assessing intracranial and vascular invasion. Specific CT and MRI techniques, such as CT angiography or enhanced MR angiography, and more advanced MRI sequences such as gadolinium-3D Black Blood imaging, contribute to the assessment of the extension of vascular invasion.In this pictorial review, we describe specific CT and MRI signs of RCM, mainly focusing on its life-threatening complications due to vascular involvement.
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- 2022
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26. Diffusion-based microstructure models in brain tumours: Fitting in presence of a model-microstructure mismatch.
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Villani U, Silvestri E, Castellaro M, Schiavi S, Anglani M, Facchini S, Monai E, D'Avella D, Della Puppa A, Cecchin D, Corbetta M, and Bertoldo A
- Subjects
- Brain diagnostic imaging, Diffusion Tensor Imaging methods, Humans, Reproducibility of Results, Tumor Microenvironment, Brain Neoplasms diagnostic imaging, Diffusion Magnetic Resonance Imaging methods
- Abstract
Diffusion-based biophysical models have been used in several recent works to study the microenvironment of brain tumours. While the pathophysiological interpretation of the parameters of these models remains unclear, their use as signal representations may yield useful biomarkers for monitoring the treatment and the progression of this complex and heterogeneous disease. Up to now, however, no study was devoted to assessing the mathematical stability of these approaches in cancerous brain regions. To this end, we analyzed in 11 brain tumour patients the fitting results of two microstructure models (Neurite Orientation Dispersion and Density Imaging and the Spherical Mean Technique) and of a signal representation (Diffusion Kurtosis Imaging) to compare the reliability of their parameter estimates in the healthy brain and in the tumoral lesion. The framework of our between-tissue analysis included the computation of 1) the residual sum of squares as a goodness-of-fit measure 2) the standard deviation of the models' derived metrics and 3) models' sensitivity functions to analyze the suitability of the employed protocol for parameter estimation in the different microenvironments. Our results revealed no issues concerning the fitting of the models in the tumoral lesion, with similar goodness of fit and parameter precisions occurring in normal appearing and pathological tissues. Lastly, with the aim of highlight possible biomarkers, in our analysis we briefly discuss the correlation between the metrics of the three techniques, identifying groups of indices which are significantly collinear in all tissues and thus provide no additional information when jointly used in data-driven analyses., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2022
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27. Hand-compression pressure cooker: an innovative variation of an existing technique with two example cases.
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Colasurdo M, Gabrieli JD, Cester G, Simonato D, Anglani M, and Causin F
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- Humans, Treatment Outcome, Arteriovenous Fistula therapy, Arteriovenous Malformations, Embolization, Therapeutic
- Abstract
The pressure cooker technique was originally ideated to obtain wedge-flow conditions during arteriovenous malformation or arteriovenous fistula embolisation. The anti-reflux plug created with coils or glue around the tip of a detachable microcatheter enables a continuous injection with a more in-depth penetration. Here we describe two illustrative cases performed with a variation of the technique that we describe as the hand-compression pressure cooker technique.
- Published
- 2021
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28. Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome.
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Baro V, Moiraghi A, Carlucci V, Paun L, Anglani M, Ermani M, Saladino A, Chioffi F, d'Avella D, Landi A, Bartoli A, DiMeco F, Schaller K, Denaro L, and Tessitore E
- Abstract
Background: Radiological parameters predicting the postoperative neurological outcome after resection of a spinal meningioma (SM) are poorly studied, with controversial results., Methods: Observational multicenter cohort (2011-2018) of adult patients undergoing surgery for resection of SM. Tumor-canal volume ratio (TCR), the areas related to the cord and tumor occupancy at maximum compression, the presence of dural tail, calcifications, signs of myelopathy, and postoperative cord expansion were compared with the modified McCormick scale (mMCS) preoperative and at follow-up., Results: In the cohort ( n = 90 patients), cord and tumor occupancy as well as cord compression and tumor volume showed a correlation with preoperative mMCS ( p < 0.05, R -0.23; p < 0.001, R 0.35; p < 0.005, R -0.29; p < 0.001, R 0.42). Cord occupancy had a strong correlation with cord compression ( p < 0.001, R 0.72). Tumor occupancy and TCR were correlated with relative outcome at follow-up ( p < 0.005 R 0.3; p < 0.005 R 0.29). No correlation was found between cord re-expansion and clinical outcome at follow-up. Finally, a correlation was shown between preoperative signs of cord myelopathy and mMCS ( p < 0.05 R 0.21) at follow-up., Conclusions: Larger tumors showed lower preoperative functional status and a worse clinical outcome. Moreover, preoperative T2 cord signal changes are correlated with a poorer outcome.
- Published
- 2021
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29. The contribution of beta-amyloid to dementia in Lewy body diseases: a 1-year follow-up study.
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Biundo R, Weis L, Fiorenzato E, Pistonesi F, Cagnin A, Bertoldo A, Anglani M, Cecchin D, and Antonini A
- Abstract
Dementia in Lewy Body Diseases (Parkinson's disease and dementia with Lewy Bodies) affects progression of disabilities, quality of life and well-being. Understanding its pathogenetic mechanisms is critical to properly implement disease-modifying strategies. It has been hypothesized that synuclein- and amyloid-pathology act synergistically aggravating cognitive decline in elderly patients but their precise contribution to dementia is debated. In this study, we aimed at exploring if presence of amyloid deposits influences clinical, cognitive and neuroanatomical correlates of mental decline in a cohort of 40 Parkinson's disease patients with normal cognition ( n = 5), mild cognitive impairment ( n = 22), and dementia ( n = 13) as well as in Dementia with Lewy Bodies ( n = 10). Patients underwent simultaneous 3 T PET/MRI with [
18 F]-flutemetamol and were assessed with an extensive baseline motor and neuropsychological examination, which allowed level II diagnosis of mild cognitive impairment and dementia. The role of amyloid positivity on each cognitive domain, and on the rate of conversion to dementia at 1-year follow-up was explored. A Kaplan Meier and the Log Rank (Mantel-Cox) test were used to assess the pairwise differences in time-to-develop dementia in Parkinson's disease patients with and without significant amyloidosis. Furthermore, the presence of an Alzheimer's dementia-like morphological pattern was evaluated using visual and automated assessment of T1 -weighted and T2 -weighted MRI images. We observed similar percentage of amyloid deposits in Parkinson's disease dementia and dementia with Lewy Bodies cohorts (50% in each group) with an overall prevalence of 34% of significant amyloid depositions in Lewy Body Diseases. PET amyloid positivity was associated with worse global cognition (Montreal Cognitive Assessment and Mini Mental State Examination), executive and language difficulties. At 12-month follow-up, amyloid positive Parkinson's disease patients were more likely to have become demented than those without amyloidosis. Moreover, there was no difference in the presence of an Alzheimer's disease-like atrophy pattern and in vascular load (at Fazekas scale) between Lewy Body Diseases with and without significant amyloid deposits. Our findings suggest that in Lewy Body Diseases, amyloid deposition enhances cognitive deficits, particularly attention-executive and language dysfunctions. However, the large number of patients without significant amyloid deposits among our cognitively impaired patients indicates that synuclein pathology itself plays a critical role in the development of dementia in Lewy Body Diseases., (© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain.)- Published
- 2021
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30. Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area.
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Baro V, Caliri S, Sartori L, Facchini S, Guarrera B, Zangrossi P, Anglani M, Denaro L, d'Avella D, Ferreri F, and Landi A
- Abstract
Awake surgery and intraoperative neuromonitoring represent the gold standard for surgery of lesion located in language-eloquent areas of the dominant hemisphere, enabling the maximal safe resection while preserving language function. Nevertheless, this functional mapping is invasive; it can be executed only during surgery and in selected patients. Moreover, the number of neuro-oncological bilingual patients is constantly growing, and performing awake surgery in this group of patients can be difficult. In this scenario, the application of accurate, repeatable and non-invasive preoperative mapping procedures is needed, in order to define the anatomical distribution of both languages. Repetitive navigated transcranial magnetic stimulation (rnTMS) associated with functional subcortical fiber tracking (nTMS-based DTI-FT) represents a promising and comprehensive mapping tool to display language pathway and function reorganization in neurosurgical patients. Herein we report a case of a bilingual patient affected by brain tumor in the left temporal lobe, who underwent rnTMS mapping for both languages (Romanian and Italian), disclosing the true eloquence of the anterior part of the lesion in both tests. After surgery, language abilities were intact at follow-up in both languages. This case represents a preliminary application of nTMS-based DTI-FT in neurosurgery for brain tumor in eloquent areas in a bilingual patient.
- Published
- 2021
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31. Von Hippel-Lindau disease and multispecialist team.
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Pavesi G, Feletti A, Ferrara AM, Anglani M, Scarpa B, Schiavi F, Boaretto F, Zovato S, Taschin E, Gardi M, Zanoletti E, Piermarocchi S, Murgia A, and Opocher G
- Subjects
- Humans, von Hippel-Lindau Disease diagnosis
- Published
- 2021
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32. Retrospective Analysis of a Modified Organizational Model to Guarantee CT Workflow during the COVID-19 Outbreak in the Tertiary Hospital of Padova, Italy.
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Cester G, Giraudo C, Causin F, Boemo DG, Anglani M, Capizzi A, Carretta G, Cattelan A, Cecchin D, Cianci V, Crisanti A, De Conti G, Donato D, Flor L, Gabrieli JD, Munari M, Navalesi P, Ponzoni A, Scapellato ML, Tiberio I, Vianello A, and Stramare R
- Abstract
At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) outbreak in Italy, the cluster of Vò Euganeo was managed by the University Hospital of Padova. The Department of Diagnostic Imaging (DDI) conceived an organizational approach based on three different pathways for low-risk, high-risk, and confirmed Coronavirus Disease 19 (COVID-19) patients to accomplish three main targets: guarantee a safe pathway for non-COVID-19 patients, ensure health personnel safety, and maintain an efficient workload. Thus, an additional pathway was created with the aid of a trailer-mounted Computed Tomography (CT) scanner devoted to positive patients. We evaluated the performance of our approach from February 21 through April 12 in terms of workload (e.g., number of CT examinations) and safety (COVID-19-positive healthcare workers). There was an average of 72.2 and 17.8 COVID-19 patients per day in wards and the Intensive Care Unit (ICU), respectively. A total of 176 high-risk and positive patients were examined. High Resolution Computed Tomography (HRCT) was one of the most common exams, and 24 pulmonary embolism scans were performed. No in-hospital transmission occurred in the DDI neither among patients nor among health personnel. The weekly number of in-patient CT examinations decreased by 27.4%, and the surgical procedures decreased by 29.5%. Patient screening and dedicated diagnostic pathways allowed the maintenance of high standards of care while working in safety.
- Published
- 2020
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33. Multishell Diffusion MRI-Based Tractography of the Facial Nerve in Vestibular Schwannoma.
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Castellaro M, Moretto M, Baro V, Brigadoi S, Zanoletti E, Anglani M, Denaro L, Dell'Acqua R, Landi A, Causin F, d'Avella D, and Bertoldo A
- Subjects
- Algorithms, Female, Humans, Male, Middle Aged, Neurosurgical Procedures methods, Diffusion Tensor Imaging methods, Facial Nerve diagnostic imaging, Image Interpretation, Computer-Assisted methods, Neuroma, Acoustic surgery, Surgery, Computer-Assisted methods
- Abstract
Background and Purpose: Tractography of the facial nerve based on single-shell diffusion MR imaging is thought to be helpful before surgery for resection of vestibular schwannoma. However, this paradigm can be vitiated by the isotropic diffusion of the CSF, the convoluted path of the facial nerve, and its crossing with other bundles. Here we propose a multishell diffusion MR imaging acquisition scheme combined with probabilistic tractography that has the potential to provide a presurgical facial nerve reconstruction uncontaminated by such effects., Materials and Methods: Five patients scheduled for vestibular schwannoma resection underwent multishell diffusion MR imaging (b-values = 0, 300, 1000, 2000 s/mm
2 ). Facial nerve tractography was performed with a probabilistic algorithm and anatomic seeds located in the brain stem, cerebellopontine cistern, and internal auditory canal. A single-shell diffusion MR imaging (b-value = 0, 1000 s/mm2 ) subset was extrapolated from the multishell diffusion MR imaging data. The quality of the facial nerve reconstruction based on both multishell diffusion MR imaging and single-shell diffusion MR imaging sequences was assessed against intraoperative videos recorded during the operation., Results: Single-shell diffusion MR imaging-based tractography was characterized by failures in facial nerve tracking (2/5 cases) and inaccurate facial nerve reconstructions displaying false-positives and partial volume effects. In contrast, multishell diffusion MR imaging-based tractography provided accurate facial nerve reconstructions (4/5 cases), even in the presence of ostensibly complex patterns., Conclusions: In comparison with single-shell diffusion MR imaging, the combination of multishell diffusion MR imaging-based tractography and probabilistic algorithms is a more valuable aid for surgeons before vestibular schwannoma resection, providing more accurate facial nerve reconstructions, which may ultimately improve the postsurgical patient's outcome., (© 2020 by American Journal of Neuroradiology.)- Published
- 2020
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34. The rolling cyst: migrating intraventricular neurocysticercosis-a case-based update.
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Baro V, Anglani M, Martinolli F, Landi A, d'Avella D, and Denaro L
- Subjects
- Adolescent, Female, Humans, Cysts, Hydrocephalus diagnostic imaging, Hydrocephalus etiology, Hydrocephalus surgery, Neurocysticercosis diagnostic imaging, Neurocysticercosis surgery
- Abstract
Background: Neurocysticercosis is the most frequent parasitic disease of the central nervous system, and its incidence in the developed countries is increasing due to immigration and travels from endemic areas. The intraventricular location has been found to involve up to 61.3% of the patients; moreover, only 22 cases of migrating intraventricular cyst have been reported so far. Despite the rarity of the condition in western countries, its occurrence generates some concerns and the aim of this paper is to update the information concerning pathogenesis, clinical presentation, diagnosis and management of this entity., Methods and Results: All the pertinent literature was analysed, focused on the cases of migrating intraventricular neurocysticercosis and its peculiar features. An illustrative case regarding a 14-year-old girl is also presented., Conclusions: Migrating intraventricular neurocysticercosis is a pathognomonic entity usually presenting with hydrocephalus, and its treatment is mainly surgical, preferring an endoscopic approach. When the resection of the intraventricular cyst is not performed, an accurate follow-up is mandatory to detect clinical changes due to a recurrent hydrocephalus or to the effect of the dying cyst on the surrounding area. In case of permanent shunt placement, the cysticidal and steroid treatment is recommended to reduce the risk of shunt failure.
- Published
- 2020
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35. Selective Cerebellar Atrophy Associates with Depression and Fatigue in the Early Phases of Relapse-Onset Multiple Sclerosis.
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Lazzarotto A, Margoni M, Franciotta S, Zywicki S, Riccardi A, Poggiali D, Anglani M, and Gallo P
- Subjects
- Adolescent, Adult, Atrophy pathology, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Young Adult, Cerebellum pathology, Depression etiology, Fatigue etiology, Multiple Sclerosis, Relapsing-Remitting complications, Multiple Sclerosis, Relapsing-Remitting pathology
- Abstract
Cerebellar dysfunctions have been associated to depressive disorders and cognitive impairment in neurodegenerative diseases. The objective is to analyze the associations between cerebellar atrophy, depression, and fatigue in the early phases of relapse-onset multiple sclerosis (RRMS). Sixty-one RRMS patients and 50 healthy controls (HC) were enrolled and clinically evaluated by means of expanded disability status scale (EDSS), Rao's brief repeatable battery of neuropsychological tests (BRB-NT), Delis-Kaplan executive function system sorting test, beck depression inventory II (BDI-II), and fatigue severity scale (FSS). The relationships between MRI variables and clinical scores were assessed. Depressed RRMS (dRRMS) had significantly lower Vermis Crus I volume compared with not depressed RRMS (ndRRMS) (p = 0.009). Vermis Crus I volume was lower in dRRMS suffering from fatigue than in ndRRMS without fatigue (p = 0.01). The hierarchical regression models which included demographic and clinical data (age, sex, and disease duration, FSS or BDI-II) and cerebellar volumes disclosed that cerebellar lobule right V atrophy explained an increase of 4% of the variability in FSS (p = 0.25) and Vermis Crus I atrophy explained an increase of 6% of variability in BDI-II (p = 0.049). Since clinical onset, atrophy of specific cerebellar lobules associates with important clinical aspects of RRMS. Cerebellar pathology may be one of the determinants of fatigue and depression that contribute to worsen disability in RRMS.
- Published
- 2020
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36. Immunomodulatory drugs in plasma cell diseases: everything has its price.
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Berno T, Riva M, Fedrigo M, Naso A, Anglani M, Briani C, and Adami F
- Subjects
- Drug Costs, Pharmaceutical Preparations, Plasma Cells
- Published
- 2020
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37. Focal left prefrontal lesions and cognitive impairment: A multivariate lesion-symptom mapping approach.
- Author
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Arbula S, Ambrosini E, Della Puppa A, De Pellegrin S, Anglani M, Denaro L, Piccione F, D'Avella D, Semenza C, Corbetta M, and Vallesi A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Multivariate Analysis, Principal Component Analysis, Severity of Illness Index, Young Adult, Brain Neoplasms complications, Brain Neoplasms pathology, Brain Neoplasms physiopathology, Cognitive Dysfunction etiology, Cognitive Dysfunction pathology, Cognitive Dysfunction physiopathology, Nerve Net pathology, Nerve Net physiopathology, Prefrontal Cortex pathology, Prefrontal Cortex physiopathology
- Abstract
Despite network studies of the human brain have brought consistent evidence of brain regions with diverse functional roles, the neuropsychological approach has mainly focused on the functional specialization of individual brain regions. Relatively few neuropsychological studies try to understand whether the severity of cognitive impairment across multiple cognitive abilities can be related to focal brain injuries. Here we approached this issue by applying a latent variable modeling of the severity of cognitive impairment in brain tumor patients, followed by multivariate lesion-symptom methods identifying brain regions critically involved in multiple cognitive abilities. We observed that lesions in confined left lateral prefrontal areas including the inferior frontal junction produced the most severe cognitive deficits, above and beyond tumor histology. Our findings support the recently suggested integrated albeit modular view of brain functional organization, according to which specific brain regions are highly involved across different sub-networks and subserve a vast range of cognitive abilities. Defining such brain regions is relevant not only theoretically but also clinically, since it may facilitate tailored tumor resections and improve cognitive surgical outcomes., (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Published
- 2020
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38. 18 F-Fluorodeoxyglucose Positron Emission Tomography-Magnetic Resonance Monitoring of Brain Metabolic Changes in a Case of Arteriovenous Malformation-Related Steal Phenomenon Symptoms.
- Author
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Anglani M, Cecchin D, Cester G, Simonato D, Baracchini C, Della Puppa A, and Causin F
- Subjects
- Adult, Embolization, Therapeutic, Female, Fluorodeoxyglucose F18, Humans, Intracranial Arteriovenous Malformations metabolism, Intracranial Arteriovenous Malformations therapy, Magnetic Resonance Imaging, Positron-Emission Tomography, Subclavian Steal Syndrome metabolism, Tomography, X-Ray Computed, Treatment Outcome, Intracranial Arteriovenous Malformations diagnostic imaging, Subclavian Steal Syndrome diagnostic imaging
- Abstract
Background: Unruptured brain arteriovenous malformations (AVMs) represent a complex disease in young healthy adults. Most often AVMs are clinically silent but also can display a neurologic syndrome due to hypoperfusion/hypometabolism in perilesional brain tissue called steal phenomenon., Case Description: A 34-year-old woman was admitted to a secondary neurologic center complaining of a right hemiparesis and secondarily generalized seizures. Computed tomography scan and magnetic resonance imaging of the brain showed a left prerolandic AVM without signs of acute or previous bleedings. Digital subtraction angiography confirmed a left juxta-central AVM, with a diffuse pattern, fed by hypertrophic rolandic branches from the left middle cerebral artery. An
18 F-fluorodeoxyglucose positron emission tomography-magnetic resonance imaging scan was performed 3 days after the critical episode. A significant hypometabolism in parenchymal regions ipsilaterally to the AVM was detected. Two embolization sessions were performed by means of N-butyl cyanoacrylate glue. At the end of the second procedure, a decrease of the shunt-flow and AVM size was observed. Six months later,18 F-fluorodeoxyglucose positron emission tomography-magnetic resonance imaging scan showed persistent hypometabolism located in the AVM area, with a significant improvement of the cortical hemispheric hypometabolism. The patient was asymptomatic and was sent to stereotactic radiosurgery to complete the treatment., Conclusions: In clinical practice, irritative symptoms in patients with unruptured AVMs could lead to erroneous evaluations. In case of fluctuating clinical syndromes, like our case, establishing that symptoms are related to a steal phenomenon is usually difficult., (Copyright © 2019 Elsevier Inc. All rights reserved.)- Published
- 2019
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39. Preoperative Prediction of Facial Nerve in Patients with Vestibular Schwannomas: The Role of Diffusion Tensor Imaging-A Systematic Review.
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Baro V, Landi A, Brigadoi S, Castellaro M, Moretto M, Anglani M, Ermani M, Causin F, Zanoletti E, Denaro L, Bertoldo A, and d'Avella D
- Subjects
- Facial Nerve surgery, Humans, Neuroma, Acoustic surgery, Predictive Value of Tests, Diffusion Tensor Imaging methods, Facial Nerve diagnostic imaging, Intraoperative Neurophysiological Monitoring methods, Neuroma, Acoustic diagnostic imaging, Preoperative Care methods
- Abstract
In vestibular schwannoma surgery, the preservation of facial and cochlear nerves is of paramount concern regarding to their effect on patients' quality of life. The rate of nerve function preservation has increased with advancements in surgical technique and neuroimaging and the introduction of intraoperative neuromonitoring. The preoperative depiction of anatomical issues between the nerves and tumor could help in surgical planning. Many studies investigating advanced imaging for cranial nerves detection, in particular diffusion tensor imaging, have been reported in the past decade. A systematic review of the reported data evaluating preoperative facial nerve fiber tracking, followed by intraoperative verification, was conducted. Seventeen studies with 223 patients (mean age, 47.5 years; range 17-77; male/female ratio 1:1.4) met our inclusion criteria. Preoperative facial nerve fiber tracking was obtained for 214 patients (96%), and subsequent intraoperative verification revealed a correct prediction for 187 cases (85.5%). The results from the present review have confirmed that preoperative fiber tracking for facial nerve identification during large vestibular schwannoma surgery is valuable and reliable. However, the included studies were not comparable in terms of images, acquisitions, or postprocessing elaboration. Larger series and homogenous magnetic resonance imaging parameters are required to strengthen these findings., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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40. NEDA-3 status including cortical lesions in the comparative evaluation of natalizumab versus fingolimod efficacy in multiple sclerosis.
- Author
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Puthenparampil M, Cazzola C, Zywicki S, Federle L, Stropparo E, Anglani M, Rinaldi F, Perini P, and Gallo P
- Abstract
Background: Cortical lesions (CLs) are typical of multiple sclerosis (MS) and have been recently incorporated in MS diagnostic criteria. Thus, the 'no evidence of disease activity' (NEDA) definition should now include CLs. The aim of this study was to evaluate the NEDA3 + CL status in natalizumab- or fingolimod-treated relapsing remitting MS (RMS) patients., Methods: Natalizumab- or fingolimod-treated RMS patients were enrolled in a 2-year longitudinal study based on clinical and magnetic resonance imaging (MRI) evaluations performed respectively biannually and annually. CLs were detected by double inversion recovery. The NEDA3 + CL condition was evaluated at baseline (T0) and at the end of the first (T1) and second (T2) year., Results: Of the 137 RMS patients included in the study, 86 were propensity-matched. At T2, the annualized relapse rate was lower on natalizumab ( p = 0.021), but the effect on white matter lesions ( p = 0.29) and the proportion of NEDA-3 patients ( p = 0.14) were similar in the two treatment arms. At T2, 11.6% natalizumab- and 62.8% fingolimod-treated patients had new CLs ( p < 0.001) and a higher proportion of natalizumab-treated patients (55.8% versus 11.6%, p < 0.001) achieved the NEDA3 + CL status (hazard ratio 5.2, p < 0.001)., Conclusion: The incorporation of CLs in the NEDA-3 definition highlighted the higher efficacy of natalizumab versus fingolimod in suppressing disease activity in RMS patients., Competing Interests: Conflict of interest statement: MP reports grants and personal fees from Novartis, grants and personal fees from Almirall, grants and personal fees from Biogen Idec, grants and personal fees from Sanofi Genzyme, grants from Teva, outside the submitted work. CC, ES and MA have nothing to disclose. SZ reports grants from Sanofi Genzyme, grants from Almirall, outside the submitted work. FR serves as an advisory board member of Biogen Idec and Sanofi Genzyme and has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, Teva and Bayer Schering Pharma. PP has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, and Bayer Schering Pharma and has been consultant for Merck Serono, Biogen Idec and Teva. PG reports grants and personal fees from Novartis, grants and personal fees from Almirall, grants and personal fees from Biogen Idec, grants and personal fees from Sanofi Genzyme, grants and personal fees from Teva, grants and personal fees from Merck Serono, grants from University of Padova, grants from the Italian Ministry of Public Health, grants from the Veneto Region of Italy, and grants from the Italian Association for Multiple Sclerosis, outside the submitted work.
- Published
- 2018
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41. Postpartum headache: not only a spinal anesthesia "affaire".
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Bellamio M, Mainardi F, Anglani M, Barp M, and Maggioni F
- Subjects
- Adult, Brain Neoplasms complications, Brain Neoplasms diagnostic imaging, Brain Neoplasms surgery, Cesarean Section, Female, Humans, Magnetic Resonance Imaging, Meningioma complications, Meningioma diagnostic imaging, Meningioma surgery, Pregnancy, Tomography, X-Ray Computed, Post-Dural Puncture Headache diagnostic imaging, Post-Dural Puncture Headache therapy, Postpartum Period
- Published
- 2017
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42. Cluster headache: When to worry? Two case reports.
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Bellamio M, Anglani M, Mainardi F, Zanchin G, and Maggioni F
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- Adult, Aged, Brain Neoplasms complications, Cluster Headache etiology, Hemangioma, Cavernous complications, Humans, Male, Venous Thrombosis complications, Brain Neoplasms diagnostic imaging, Cluster Headache diagnostic imaging, Hemangioma, Cavernous diagnostic imaging, Venous Thrombosis diagnostic imaging
- Abstract
Background The clinical criteria for cluster headache (CH) are included in Chapter 3 of the International Classification of Headache Disorders, 3rd beta edition (ICHD-III). CH may sometimes be secondary to other pathologies. Case reports We report two patients in whom the clinical features of CH initially fulfilled the ICHD-III criteria, but who later presented some radical modifications in headache natural history as a result of a secondary pathology. The first case of CH was secondary to a pontine cavernous angioma and the second to a cerebral venous thrombosis. Conclusion We highlight the importance of clinical modifications of CH that could suggest clinical investigations should be performed or repeated to exclude a secondary pathology in a previously diagnosed cluster headache. Some of the pathological mechanisms of CH and brain lesions are discussed.
- Published
- 2017
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43. Von Hippel-Lindau disease: an evaluation of natural history and functional disability.
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Feletti A, Anglani M, Scarpa B, Schiavi F, Boaretto F, Zovato S, Taschin E, Gardi M, Zanoletti E, Piermarocchi S, Murgia A, Pavesi G, and Opocher G
- Subjects
- Disability Evaluation, Disease Progression, Female, Hemangioblastoma diagnosis, Humans, Male, Mutation genetics, Prospective Studies, Quality of Life, von Hippel-Lindau Disease diagnosis, Hemangioblastoma genetics, Hemangioblastoma surgery, von Hippel-Lindau Disease genetics, von Hippel-Lindau Disease surgery
- Abstract
Background: Although many studies have been published about specific lesions characterizing von Hippel-Lindau(VHL) disease, none have dealt with the natural history of the whole disease and the consequent disabilities. We aim to define the comprehensive natural history of VHL disease and to describe the functional disabilities and their impact upon patients' quality of life, thereby tailoring the follow-up schedule accordingly., Methods: We performed a prospective analysis on 128 VHL-affected patients beginning in 1996. For each affected organ, we defined intervals between the first and subsequent VHL-related manifestations and compared them with current VHL surveillance protocols. We looked for any association of the number of involved organs with age, sex, type of VHL gene mutation, and functional domain mutation. Ultimately, we assessed the organ-specific disabilities caused by VHL disease., Results: Hemangioblastomas show different patterns of progression depending on their location, whereas both renal cysts and carcinomas have similar progression rates. Surgery for pheochromocytoma and CNS hemangioblastoma is performed earlier than for pancreatic or renal cancer. The number of involved organs is associated with age but not with sex, type of VHL gene mutation, or functional domain mutation. A thorough analysis of functional disabilities showed that age is related to the first-appearing functional impairment, but it is not predictive of the final number of disabilities., Conclusions: Our study defines the disease progression and provides a comprehensive view of the syndrome over time. We analyzed for the first time the functional disability of VHL patients, assessing the progression for each function., (© The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2016
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44. Characterization of endolymphatic sac tumors and von Hippel-Lindau disease in the International Endolymphatic Sac Tumor Registry.
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Bausch B, Wellner U, Peyre M, Boedeker CC, Hes FJ, Anglani M, de Campos JM, Kanno H, Maher ER, Krauss T, Sansó G, Barontini M, Letizia C, Hader C, Schiavi F, Zanoletti E, Suárez C, Offergeld C, Malinoc A, Zschiedrich S, Glasker S, Bobin S, Sterkers O, Ba Huy PT, Giraud S, Links T, Eng C, Opocher G, Richard S, and Neumann HP
- Subjects
- Adolescent, Adult, Aged, Child, Female, Germ-Line Mutation, Humans, Male, Middle Aged, Registries, Von Hippel-Lindau Tumor Suppressor Protein genetics, Young Adult, Ear Neoplasms pathology, Endolymphatic Sac pathology, von Hippel-Lindau Disease complications
- Abstract
Background: Endolymphatic sac tumors (ELSTs) are, with a prevalence of up to 16%, a component of von Hippel-Lindau (VHL) disease. Data from international registries regarding heritable fraction and characteristics, germline VHL mutation frequency, and prevalence are lacking., Methods: Systematic registration of ELSTs from international centers of otorhinolaryngology and from multidisciplinary VHL centers' registries was performed. Molecular genetic analyses of the VHL gene were offered to all patients., Results: Our population-based registry comprised 93 patients with ELST and 1789 patients with VHL. The prevalence of VHL germline mutations in apparently sporadic ELSTs was 39%. The prevalence of ELSTs in patients with VHL was 3.6%. ELST was the initial manifestation in 32% of patients with VHL-ELST., Conclusion: Prevalence of ELST in VHL disease is much lower compared to the literature. VHL-associated ELSTs can be the first presentation of the syndrome and mimic sporadic tumors, thus emphasizing the need of molecular testing in all presentations of ELST. © 2015 Wiley Periodicals, Inc. Head Neck 38: 673-679, 2016., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2016
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