52 results on '"Basagni B"'
Search Results
2. Some evidence on Gerstmann's syndrome: A case study on a variant of the clinical disorder
- Author
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Basagni, B, Luzzatti, C, De Tanti, A, Bozzetti, F, Crisi, G, Pinardi, C, Errante, A, Fogassi, L, Basagni B., Luzzatti C., De Tanti A., Bozzetti F., Crisi G., Pinardi C., Errante A., Fogassi L., Basagni, B, Luzzatti, C, De Tanti, A, Bozzetti, F, Crisi, G, Pinardi, C, Errante, A, Fogassi, L, Basagni B., Luzzatti C., De Tanti A., Bozzetti F., Crisi G., Pinardi C., Errante A., and Fogassi L.
- Abstract
We describe the case of a bilingual patient with persistent symptoms largely, although not fully, consistent with those that are usually reported in Gerstmann's syndrome. Twenty months after a spontaneous primary intracranial hemorrhage, the patient was evaluated with a series of neuropsychological tasks and underwent an MRI investigation based on Diffusion Tensor Imaging probabilistic tractography. The patient suffered from dysgraphia (difficulty in the access to the graphemic representation of letter forms), autotopoagnosia (difficulties in locating body parts on verbal command), right–left confusion (difficulties in localizing right and left side of symmetrical body parts), and number processing/calculation impairments (predominant difficulties on transcoding tasks). Probabilistic tractography revealed a relatively spared superior longitudinal fasciculus and severe damage to the subcortical white matter connecting the angular gyrus with other parietal regions, such as the intraparietal sulcus and the supramarginal gyrus. Within the framework of the contemporary cognitive accounts of Gerstmann's syndrome, the case supports the assumption of an anatomical intraparietal disconnection more than a functional Grundstörung (core impairment).
- Published
- 2021
3. 'Less is more': validation with Rasch analysis of five short- forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs)
- Author
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Pellicciari, L, Piscitelli, D, Basagni, B, De Tanti, A, Algeri, L, Caselli, S, Ciurli, M, Conforti, J, Estraneo, A, Moretta, P, Gambini, M, Inzaghi, M, Lamberti, G, Mancuso, M, Rinaldesi, M, Sozzi, M, Abbruzzese, L, Zettin, M, La Porta, F, Ciurli, MP, Gambini, MG, Inzaghi, MG, Rinaldesi, ML, Pellicciari, L, Piscitelli, D, Basagni, B, De Tanti, A, Algeri, L, Caselli, S, Ciurli, M, Conforti, J, Estraneo, A, Moretta, P, Gambini, M, Inzaghi, M, Lamberti, G, Mancuso, M, Rinaldesi, M, Sozzi, M, Abbruzzese, L, Zettin, M, La Porta, F, Ciurli, MP, Gambini, MG, Inzaghi, MG, and Rinaldesi, ML
- Abstract
Background: Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). Objective: To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. Methods: BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. Results: The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. Conclusions: After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
- Published
- 2020
4. The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics
- Author
-
Basagni, B, Piscitelli, D, De Tanti, A, Pellicciari, L, Algeri, L, Caselli, S, Formisano, R, Conforti, J, Estraneo, A, Moretta, P, Gambini, M, Inzaghi, M, Lamberti, G, Mancuso, M, Quinquinio, C, Sozzi, M, Abbruzzese, L, Zettin, M, La Porta, F, Basagni, Benedetta, Piscitelli, Daniele, De Tanti, Antonio, Pellicciari, Leonardo, Algeri, Lorella, Caselli, Serena, Formisano, Rita, Conforti, Jessica, Estraneo, Anna, Moretta, Pasquale, Gambini, Maria Grazia, Inzaghi, Maria Grazia, Lamberti, Gianfranco, Mancuso, Mauro, Quinquinio, Cristina, Sozzi, Matteo, Abbruzzese, Laura, Zettin, Marina, La Porta, Fabio, Basagni, B, Piscitelli, D, De Tanti, A, Pellicciari, L, Algeri, L, Caselli, S, Formisano, R, Conforti, J, Estraneo, A, Moretta, P, Gambini, M, Inzaghi, M, Lamberti, G, Mancuso, M, Quinquinio, C, Sozzi, M, Abbruzzese, L, Zettin, M, La Porta, F, Basagni, Benedetta, Piscitelli, Daniele, De Tanti, Antonio, Pellicciari, Leonardo, Algeri, Lorella, Caselli, Serena, Formisano, Rita, Conforti, Jessica, Estraneo, Anna, Moretta, Pasquale, Gambini, Maria Grazia, Inzaghi, Maria Grazia, Lamberti, Gianfranco, Mancuso, Mauro, Quinquinio, Cristina, Sozzi, Matteo, Abbruzzese, Laura, Zettin, Marina, and La Porta, Fabio
- Abstract
Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods. Methods: Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA). Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062). Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
- Published
- 2020
5. VRT (verbal reasoning test): a new test for assessment of verbal reasoning. Test realization and Italian normative data from a multicentric study
- Author
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Basagni, B, Luzzatti, C, Navarrete, E, Caputo, M, Scrocco, G, Damora, A, Giunchi, L, Gemignani, P, Caiazzo, A, Gambini, M, Avesani, R, Mancuso, M, Trojano, L, de Tanti, A, de Tanti, A., LUZZATTI, CLAUDIO GIUSEPPE, DAMORA, ALESSIO, Basagni, B, Luzzatti, C, Navarrete, E, Caputo, M, Scrocco, G, Damora, A, Giunchi, L, Gemignani, P, Caiazzo, A, Gambini, M, Avesani, R, Mancuso, M, Trojano, L, de Tanti, A, de Tanti, A., LUZZATTI, CLAUDIO GIUSEPPE, and DAMORA, ALESSIO
- Abstract
Verbal reasoning is a complex, multicomponent function, which involves activation of functional processes and neural circuits distributed in both brain hemispheres. Thus, this ability is often impaired after brain injury. The aim of the present study is to describe the construction of a new verbal reasoning test (VRT) for patients with brain injury and to provide normative values in a sample of healthy Italian participants. Three hundred and eighty healthy Italian subjects (193 women and 187 men) of different ages (range 16–75 years) and educational level (primary school to postgraduate degree) underwent the VRT. VRT is composed of seven subtests, investigating seven different domains. Multiple linear regression analysis revealed a significant effect of age and education on the participants’ performance in terms of both VRT total score and all seven subtest scores. No gender effect was found. A correction grid for raw scores was built from the linear equation derived from the scores. Inferential cut-off scores were estimated using a non-parametric technique, and equivalent scores were computed. We also provided a grid for the correction of results by z scores
- Published
- 2017
6. Does word-frequency affect lexical selection in speech production?
- Author
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Navarrete, E., Basagni, B., Alario, François-Xavier, Costa, A., Laboratoire de psychologie cognitive (LPC), and Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)
- Subjects
[SCCO.PSYC]Cognitive science/Psychology ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
- Published
- 2006
7. Riabilitazione dei disturbi del comportamento conseguenti a lesioni cerebrali
- Author
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Mazzucchi A., Maietti, Alessandra, Basagni, B., Mazzucchi, A., Maietti A. (ORCID:0000-0002-9819-7037), Mazzucchi A., Maietti, Alessandra, Basagni, B., Mazzucchi, A., and Maietti A. (ORCID:0000-0002-9819-7037)
- Abstract
Un evento cerebrolesivo può determinare alterazioni del comportamento relazionale, della personalità e, più in generale, della condotta sociale. Variabili quali la sede e la vastità delle lesioni cerebrali, la personalità premorbosa, la presenza in anamnesi di eventuali disturbi psichiatrici, i disordini cognitivi associati e fattori ambientali possono contribuire allo sviluppo dei disordini comportamentali ed emozionali. L’insieme di questi fattori contribuisce alla grande variabilità delle alterazioni comportamentali e psicologiche in questa popolazione di pazienti, che spesso subiscono importanti limitazioni dell’attività e della partecipazione sociale. Le modificazioni del comportamento, infatti, rappresentano un ostacolo sia alla partecipazione ai programmi riabilitativi sia a un adeguato e soddisfacente reinserimento familiare, sociale, scolastico e lavorativo, essendo inficiata da questi disturbi soprattutto la qualità dei rapporti interpersonali. Negli ultimi decenni la pratica neuroriabilitativa ha focalizzato sempre di più l’attenzione sull’importanza di applicare programmi specifici e individualizzati per i disordini comportamentali conseguenti a una cerebrolesione. Oggi è possibile usufruire di diversi approcci che prevedono un armonico intersecarsi di interventi farmacologici e comportamentali, cognitivi e psicoterapeutici che accompagnano il paziente e la sua famiglia per tutto l’arco della presa in carico riabilitativa e nel follow-up. Nel presente capitolo, dopo una descrizione delle diverse possibili manifestazioni cliniche dei disordini comportamentali e dei loro correlati anatomo-funzionali, saranno descritti gli strumenti di valutazione, di inquadramento e di approfondimento, atti a individuare i fattori che contribuiscono al loro manifestarsi e al loro mantenersi nel tempo. Seguirà una descrizione delle principali metodiche per la riabilitazione dei disordini del comportamento e della evidenza della loro efficacia. L’ultimo paragrafo
- Published
- 2012
8. Some evidence on Gerstmann's syndrome: A case study on a variant of the clinical disorder
- Author
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Antonio De Tanti, Girolamo Crisi, Claudio Luzzatti, Benedetta Basagni, Francesca Bozzetti, Leonardo Fogassi, Chiara Pinardi, Antonino Errante, Basagni, B, Luzzatti, C, De Tanti, A, Bozzetti, F, Crisi, G, Pinardi, C, Errante, A, and Fogassi, L
- Subjects
medicine.medical_specialty ,Autotopoagnosia ,Gerstmann Syndrome ,Cognitive Neuroscience ,Acalculia ,Experimental and Cognitive Psychology ,Intraparietal sulcus ,Audiology ,M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA ,050105 experimental psychology ,Angular gyrus ,03 medical and health sciences ,Gerstmann's syndrome ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,Supramarginal gyrus ,Dysgraphia ,Parietal Lobe ,Developmental and Educational Psychology ,medicine ,Humans ,0501 psychology and cognitive sciences ,05 social sciences ,Superior longitudinal fasciculus ,Neuropsychology ,medicine.disease ,Magnetic Resonance Imaging ,Right-left confusion ,Diffusion Tensor Imaging ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery ,Diffusion MRI - Abstract
We describe the case of a bilingual patient with persistent symptoms largely, although not fully, consistent with those that are usually reported in Gerstmann’s syndrome. Twenty months after a spontaneous primary intracranial hemorrhage, the patient was evaluated with a series of neuropsychological tasks and underwent an MRI investigation based on Diffusion Tensor Imaging probabilistic tractography. The patient suffered from dysgraphia (difficulty in the access to the graphemic representation of letter forms), autotopoagnosia (difficulties in locating body parts on verbal command), right–left confusion (difficulties in localizing right and left side of symmetrical body parts), and number processing/calculation impairments (predominant difficulties on transcoding tasks). Probabilistic tractography revealed a relatively spared superior longitudinal fasciculus and severe damage to the subcortical white matter connecting the angular gyrus with other parietal regions, such as the intraparietal sulcus and the supramarginal gyrus. Within the framework of the contemporary cognitive accounts of Gerstmann’s syndrome, the case supports the assumption of an anatomical intraparietal disconnection more than a functional Grundstorung (core impairment).
- Published
- 2021
9. The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics
- Author
-
Anna Estraneo, Laura Abbruzzese, Pasquale Moretta, Lorella Algeri, Daniele Piscitelli, Jessica Conforti, Leonardo Pellicciari, Serena Caselli, Rita Formisano, Gianfranco Lamberti, Benedetta Basagni, Marina Zettin, Maria Grazia Gambini, Fabio La Porta, Maria Grazia Inzaghi, Cristina Quinquinio, Antonio De Tanti, Mauro Mancuso, Matteo Sozzi, Basagni, B, Piscitelli, D, De Tanti, A, Pellicciari, L, Algeri, L, Caselli, S, Formisano, R, Conforti, J, Estraneo, A, Moretta, P, Gambini, M, Inzaghi, M, Lamberti, G, Mancuso, M, Quinquinio, C, Sozzi, M, Abbruzzese, L, Zettin, M, and La Porta, F
- Subjects
030506 rehabilitation ,Psychometrics ,medicine.medical_treatment ,Neuroscience (miscellaneous) ,Behavioral Symptom ,Personality Assessment ,Trust ,Classical test theory ,03 medical and health sciences ,0302 clinical medicine ,Brain Injurie ,Surveys and Questionnaires ,Developmental and Educational Psychology ,medicine ,Humans ,Acquired brain injury ,Rehabilitation ,Rasch model ,Construct validity ,Reproducibility of Results ,medicine.disease ,Confirmatory factor analysis ,Brain Injuries ,Behavioral Symptoms ,Outcome Assessment (Health care) ,Cross-Sectional Studies ,Italy ,Neurology (clinical) ,Personality Assessment Inventory ,0305 other medical science ,Psychology ,030217 neurology & neurosurgery ,Psychometric ,Clinical psychology ,Personality - Abstract
Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods. Methods: Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA). Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062). Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
- Published
- 2020
10. VRT (verbal reasoning test): a new test for assessment of verbal reasoning. Test realization and Italian normative data from a multicentric study
- Author
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Annarita Caiazzo, Luigi Trojano, Paola Gemignani, Gessica Scrocco, Eduardo Navarrete, Laura Giunchi, Mauro Mancuso, Maria Grazia Gambini, Benedetta Basagni, Renato Avesani, Claudio Luzzatti, Alessio Damora, Antonio De Tanti, Marina Caputo, Basagni, B, Luzzatti, C, Navarrete, E, Caputo, M, Scrocco, G, Damora, A, Giunchi, L, Gemignani, P, Caiazzo, A, Gambini, M, Avesani, R, Mancuso, M, Trojano, L, de Tanti, A, Basagni, Benedetta, Luzzatti, Claudio, Navarrete, Eduardo, Caputo, Marina, Scrocco, Gessica, Damora, Alessio, Giunchi, Laura, Gemignani, Paola, Caiazzo, Annarita, Gambini, Maria Grazia, Avesani, Renato, Mancuso, Mauro, Trojano, Luigi, and de Tanti, Antonio
- Subjects
Male ,Pilot Projects ,Audiology ,Developmental psychology ,Thinking ,0302 clinical medicine ,Reference Values ,Italian normative data ,Raw score ,Brain injury ,05 social sciences ,Linear model ,Age Factors ,General Medicine ,Middle Aged ,Verbal reasoning ,Test (assessment) ,Assessment ,Adolescent ,Adult ,Aged ,Brain Injuries ,Educational Status ,Female ,Humans ,Italy ,Linear Models ,Speech ,Young Adult ,Psychological Tests ,Speech Perception ,2708 ,Neurology (clinical) ,Psychiatry and Mental Health ,Psychology ,medicine.medical_specialty ,Speech perception ,Dermatology ,Standard score ,M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA ,050105 experimental psychology ,03 medical and health sciences ,Neuropsychology ,medicine ,0501 psychology and cognitive sciences ,Psychological testing ,Normative ,030217 neurology & neurosurgery - Abstract
Verbal reasoning is a complex, multicomponent function, which involves activation of functional processes and neural circuits distributed in both brain hemispheres. Thus, this ability is often impaired after brain injury. The aim of the present study is to describe the construction of a new verbal reasoning test (VRT) for patients with brain injury and to provide normative values in a sample of healthy Italian participants. Three hundred and eighty healthy Italian subjects (193 women and 187 men) of different ages (range 16–75 years) and educational level (primary school to postgraduate degree) underwent the VRT. VRT is composed of seven subtests, investigating seven different domains. Multiple linear regression analysis revealed a significant effect of age and education on the participants’ performance in terms of both VRT total score and all seven subtest scores. No gender effect was found. A correction grid for raw scores was built from the linear equation derived from the scores. Inferential cut-off scores were estimated using a non-parametric technique, and equivalent scores were computed. We also provided a grid for the correction of results by z scores.
- Published
- 2017
11. Cognitive profile in a young woman with Susac syndrome: a case report.
- Author
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Basagni B, Abbruzzese L, Radicchi G, Damora A, Salti G, Malentacchi GM, Caputo N, Zoccolotti P, Scarselli C, and Mancuso M
- Subjects
- Humans, Female, Adult, Cognitive Dysfunction etiology, Cognitive Dysfunction diagnosis, Cognitive Dysfunction physiopathology, Neuropsychological Tests, Executive Function physiology, Susac Syndrome diagnosis, Susac Syndrome complications
- Abstract
Susac syndrome is a rare immune-mediated endotheliopathy affecting the microvasculature. It presents three main symptoms: encephalopathy, branch retinal artery occlusions, and hearing loss . Here we present a new case report focusing on the evolution of the cognitive profile. The patient underwent two neuropsychological examinations. The first, one month after the onset of the symptomatology, highlighted a prevalent involvement of verbal executive functions. The second, conducted six months later, revealed a global improvement in most previously deficient areas, although with the persistence of a difficulty in cognitive estimation. . This case illustrates the importance of a comprehensive analysis of patients with Susac syndrome to appreciate the whole range of cognitive deficits and reliably evaluate symptom evolution.
- Published
- 2024
- Full Text
- View/download PDF
12. Modulation of Corticospinal Excitability during Action Observation in Patients with Disorders of Consciousness.
- Author
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Mancuso M, Mencarelli L, Abbruzzese L, Basagni B, Zoccolotti P, Scarselli C, Capitani S, Neri F, Santarnecchi E, and Rossi S
- Abstract
Brain imaging studies have recently provided some evidence in favor of covert cognitive processes that are ongoing in patients with disorders of consciousness (DoC) (e.g., a minimally conscious state and vegetative state/unresponsive wakefulness syndrome) when engaged in passive sensory stimulation or active tasks such as motor imagery. In this exploratory study, we used transcranial magnetic stimulation (TMS) of the motor cortex to assess modulations of corticospinal excitability induced by action observation in eleven patients with DoC. Action observation is known to facilitate corticospinal excitability in healthy subjects, unveiling how the observer's motor system maps others' actions onto her/his motor repertoire. Additional stimuli were non-biological motion and acoustic startle stimuli, considering that sudden and loud acoustic stimulation is known to lower corticospinal excitability in healthy subjects. The results indicate that some form of motor resonance is spared in a subset of patients with DoC, with some significant difference between biological and non-biological motion stimuli. However, there was no covariation between corticospinal excitability and the type of DoC diagnosis (i.e., whether diagnosed with VS/UWS or MCS). Similarly, no covariation was detected with clinical changes between admission and discharge in clinical outcome measures. Both motor resonance and the difference between the resonance with biological/non-biological motion discrimination correlated with the amplitude of the N20 somatosensory evoked potentials, following the stimulation of the median nerve at the wrist (i.e., the temporal marker signaling the activation of the contralateral primary somatosensory cortex). Moreover, the startle-evoking stimulus produced an anomalous increase in corticospinal excitability, suggesting a functional dissociation between cortical and subcortical circuits in patients with DoC. Further work is needed to better comprehend the conditions in which corticospinal facilitation occurs and whether and how they may relate to individual clinical parameters.
- Published
- 2024
- Full Text
- View/download PDF
13. Psychological Distress in Patients Who Needed Invasive versus Non-Invasive Ventilation Following SARS-CoV-2 Viral Infection.
- Author
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Abbruzzese L, Basagni B, Damora A, Salti G, Martinelli G, Gambarelli C, Maietti A, Scarselli C, Carlucci L, Zoccolotti P, and Mancuso M
- Abstract
The COVID-19 pandemic has affected the mental health of those who survived the illness but underwent long treatment and hospitalization. Much research has highlighted signs of emotional distress in those who experienced intensive care, and the procedures implemented to fight the infection. The present study investigated the effects of the illness experience in 40 subjects admitted to a rehabilitation unit after discharge from intensive care by focusing on the possibility of differences in emotional well-being depending on the type of ventilation. The results of the administration of psychological scales for anxiety, depression, and post-traumatic stress disorder showed that many subjects experienced some form of emotional distress. There were no differences between patients who underwent invasive ventilation and those who did not.
- Published
- 2024
- Full Text
- View/download PDF
14. Trunk Control Test as a Main Predictor of the Modified Barthel Index Score at Discharge From Intensive Post-acute Stroke Rehabilitation: Results From a Multicenter Italian Study.
- Author
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Pellicciari L, Basagni B, Paperini A, Campagnini S, Sodero A, Hakiki B, Castagnoli C, Politi AM, Avila L, Barilli M, Romano E, Pancani S, Mannini A, Sensoli F, Salvadori E, Poggesi A, Grippo A, Macchi C, Baccini M, Carrozza MC, and Cecchi F
- Subjects
- Adult, Humans, Patient Discharge, Retrospective Studies, Disability Evaluation, Italy, Stroke Rehabilitation methods, Pressure Ulcer etiology, Stroke
- Abstract
Objectives: To verify whether trunk control test (TCT) upon admission to intensive inpatient post-stroke rehabilitation, combined with other confounding variables, is independently associated with discharge mBI., Design: Multicentric retrospective observational cohort study., Setting: Two Italian inpatient rehabilitation units., Participants: A total of 220 post-stroke adult patients, within 30 days from the acute event, were consecutively enrolled., Interventions: Not applicable., Main Outcome Measure: The outcome measure considered was the modified Barthel Index (mBI), one of the most widely recommended tools for assessing stroke rehabilitation functional outcomes., Results: All variables collected at admission and significantly associated with mBI at discharge in the univariate analysis (TCT, mBI at admission, pre-stroke modified Rankin Scale [mRS], sex, age, communication ability, time from the event, Cumulative Illness Rating Scale, bladder catheter, and pressure ulcers) entered the multivariate analysis. TCT, mBI at admission, premorbid disability (mRS), communication ability and pressure ulcers (P<.001) independently predicted discharge mBI (adjusted R
2 =68.5%). Concerning the role of TCT, the model with all covariates and without TCT presented an R2 of 65.1%. On the other side, the model with the TCT only presented an R2 of 53.1%. Finally, with the inclusion of both TCT and all covariates, the model showed an R2 increase up to 68.5%., Conclusions: TCT, with other features suggesting functional/clinical complexity, collected upon admission to post-acute intensive inpatient stroke rehabilitation, independently predicted discharge mBI., (Copyright © 2023 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
- Full Text
- View/download PDF
15. Predicting the functional outcome of intensive inpatient rehabilitation after stroke: results from the RIPS Study.
- Author
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Sodero A, Campagnini S, Paperini A, Castagnoli C, Hochleitner I, Politi AM, Bardi D, Basagni B, Barretta T, Guolo E, Tramonti C, Pancani S, Hakiki B, Grippo A, Mannini A, Nacmias B, Baccini M, Macchi C, and Cecchi F
- Subjects
- Humans, Female, Aged, 80 and over, Activities of Daily Living, Inpatients, Treatment Outcome, Patient Discharge, Recovery of Function, Stroke, Stroke Rehabilitation methods
- Abstract
Background: The complexity of stroke sequelae, the heterogeneity of outcome measures and rehabilitation pathways, and the lack of extensively validated prediction models represent a challenge in predicting stroke rehabilitation outcomes., Aim: To prospectively investigate a multidimensional set of variables collected at admission to inpatient post-stroke rehabilitation as potential predictors of the functional level at discharge., Design: Multicentric prospective observational study., Setting: Patients were enrolled in four Intensive Rehabilitation Units (IRUs)., Population: Patients were consecutively recruited in the period December 2019-December 2020 with the following inclusion criteria: aged 18+, with ischemic/haemorrhagic stroke, and undergoing inpatient rehabilitation within 30 days from stroke., Methods: This is a multicentric prospective observational study. The rehabilitation pathway was reproducible and evidence-based. The functional outcome was disability in activities of daily living, measured by the modified Barthel Index (mBI) at discharge. Potential multidimensional predictors, assessed at admission, included demographics, event description, clinical assessment, functional and cognitive profile, and psycho-social domains. The variables statistically associated with the outcome in the univariate analysis were fed into a multivariable model using multiple linear regression., Results: A total of 220 patients were included (median [IQR] age: 80 [15], 112 women, 175 ischemic). Median mBI was 26 (43) at admission and 62.5 (52) at discharge. In the multivariable analysis younger age, along with better functioning, fewer comorbidities, higher cognitive abilities, reduced stroke severity, and higher motor functions at admission, remained independently associated with higher discharge mBI. The final model allowed a reliable prediction of discharge functional outcome (adjusted R
2 =77.2%)., Conclusions: The model presented in this study, based on easily collectable, reliable admission variables, could help clinicians and researchers to predict the discharge scores of the global functional outcome for persons enrolled in an evidence-based inpatient stroke rehabilitation program., Clinical Rehabilitation Impact: A reliable outcome prediction derived from standardized assessment measures and validated treatment protocols could guide clinicians in the management of patients in the subacute phase of stroke and help improve the planning of the rehabilitation individualized project.- Published
- 2024
- Full Text
- View/download PDF
16. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study.
- Author
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Basagni B, Malloggi S, Polito C, Pellicciari L, Campagnini S, Pancani S, Mannini A, Gemignani P, Salvadori E, Marignani S, Giovannelli F, Viggiano MP, Hakiki B, Grippo A, Macchi C, and Cecchi F
- Abstract
A domain-specific perspective to cognitive functioning in stroke patients may predict their cognitive recovery over time and target stroke rehabilitation intervention. However, data about domain-specific cognitive impairment after stroke are still scarce. This study prospectively investigated the domain-specific pattern of cognitive impairments, using the classification proposed by the Montreal Cognitive Assessment (MoCA), in a cohort of 49 stroke patients at admission (T0), discharge (T1), and six-month follow-up (T2) from subacute intensive rehabilitation. The predictive value of T0 cognitive domains cognitive impairment at T1 and T2 was also investigated. Patients' cognitive functioning at T0, T1, and T2 was assessed through the MoCA domains for executive functioning, attention, language, visuospatial, orientation, and memory. Different evolutionary trends of cognitive domain impairments emerged across time-points. Patients' impairments in all domains decreased from T0 to T1. Attention and executive impairments decreased from T0 to T2 (42.9% and 26.5% to 10.2% and 18.4%, respectively). Conversely, altered visuospatial, language, and orientation increased between T1 and T2 (16.3%, 36.7%, and 40.8%, respectively). Additionally, patients' global cognitive functioning at T1 was predicted by the language and executive domains in a subacute phase ( p = 0.031 and p = 0.001, respectively), while in the long term, only attention ( p = 0.043) and executive ( p = 0.019) domains intervened. Overall, these results confirm the importance of a domain-specific approach to target cognitive recovery across time in stroke patients.
- Published
- 2024
- Full Text
- View/download PDF
17. Development of a generic version of the multiple errands test for severe acquired brain injuries.
- Author
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Basagni B, Bosetti S, Cantelli S, Ermon S, Rovere F, Navarrete E, De Tanti A, and Saviola D
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- Adult, Humans, Reproducibility of Results, Executive Function, Brain Injuries complications, Brain Injuries diagnosis, Neurological Rehabilitation
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Background: Impairment of executive functions is a frequent and disabling consequence of brain injury. In 1991, Shallice and Burgess elaborated the Multiple Errand Test (MET) to assess everyday troubles associated with this impairment., Objective: Our first aim was to create a generic version of MET (MET-G) readily adaptable to different settings and for retesting. The second aim was to validate the revised version to detect executive impairment in individuals with severe ABI., Methods: An inter-professional team of experts in neurorehabilitation created a revised version of MET. Twenty-one patients with sABI (severe Acquired Brain Injury) and a control group of 20 neurologically healthy subjects, took part in the testing of MET-G., Results: MET-G clearly distinguished people with sABI from healthy controls based on Total error score, task completion, and rule breaking. The test showed good inter-rater reliability and internal consistency., Conclusions: The new, generic version of MET was able to differentiate adults with sABI from controls and proved to be a good tool for evaluating executive functions in these patients in daily-life contexts. Indications on how to adapt the test to different contexts and different scoring modalities are provided.
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- 2024
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18. Italian translation and transcultural validation of an assessment tool for community ambulation in stroke survivors: the modified Functional Walking Categories (mFWC).
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Barbato C, Antonucci L, Pellicciari L, Castagnoli C, Hochleitner I, Paperini A, Pancani S, Verdesca S, Basagni B, Macchi C, and Cecchi F
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- Humans, Reproducibility of Results, Psychometrics methods, Walking, Italy, Survivors, Surveys and Questionnaires, Quality of Life, Stroke diagnosis
- Abstract
Background: Community ambulation ability is one of the most important functional loss after stroke. The assessment of the level of community walking plays an important role in the multidimensional bio-psycho-social approach, to improve quality of life and social participation of stroke survivors. The modified Functional Walking Categories (mFWC) is a worldwide widely used tool to assess community ambulation in stroke survivors, but no Italian version is yet available., Objective: To cross-culturally adapt the mFWC into Italian and to assess its validity and reliability., Methods: According to the international guidelines, a multistep translation and cultural adaptation were conducted and revised by a committee of experts. Patients admitted to intensive inpatient rehabilitation with a sub-acute stroke were recruited. Inter- and intra-rater reliability and construct validity were studied., Results: Sixty patients with sub-acute stroke were prospectively enrolled in this study. Findings showed almost perfect intra- and inter-rater reliability (k = 1.000 [95% CI 1.000-1.000] and k = 0.984 [95% CI 0.955-1.000], respectively). The construct validity of the scale was satisfactory, as 100.0% a-priori hypotheses were met., Conclusions: The Italian mFWC offers a valid tool for measuring community ambulation in stroke patients. Our work provides a validated and a cross-cultural adapted Italian version of the mFWC to accurately measure community ambulation both in clinical and research settings in Italy.
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- 2023
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19. Can you please find my upper limb? Somatoparaphrenia without personal neglect: a new case report.
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Mancuso M, Basagni B, Bolognini N, Vallar G, and Damora A
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- 2023
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20. Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity.
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Hochleitner I, Pellicciari L, Castagnoli C, Paperini A, Politi AM, Campagnini S, Pancani S, Basagni B, Gerli F, Carrozza MC, Macchi C, Alt Murphy M, and Cecchi F
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- Male, Humans, Female, Reproducibility of Results, Upper Extremity, Lower Extremity, Stroke, Stroke Rehabilitation methods
- Abstract
Purpose: To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke., Materials and Methods: The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement., Results: The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE., Conclusions: The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes.Implications for rehabilitationThe FMA is the gold standard for assessing stroke patients' sensorimotor impairment worldwide.The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke.The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations.
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- 2023
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21. Persistent dysexecutive syndrome after pneumococcal meningitis complicated by recurrent ischemic strokes: A case report.
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Abbruzzese L, Martinelli G, Salti G, Basagni B, Damora A, Scarselli C, Peppoloni G, Podgorska A, Rosso G, Bacci M, Alfano AR, and Mancuso M
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Background: Meningitis is a possible complication of pneumococcal infection concerning acute otitis media and sinusitis. It might compromise cognitive function, both for the infection itself and the vascular events that sometimes follow the acute phase., Case Summary: Here we describe the case of a 32-year-old female patient admitted to the emergency room due to extensive pneumococcal meningitis as a consequence of sinus outbreak. She presented with extensive laminar ischemic damage in the acute phase, resulting in severe cognitive and behavioural impairment. Four years of follow-up, through neuropsychological assessments and neuroradiological investigations, demonstrated the presence of subsequent vascular events, 3 months and 2 years after onset., Conclusion: The case is discussed in light of scientific knowledge of the long-term outcomes of this pathology in order to potentially improve diagnosis and promote better outcomes., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2023
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22. Correction to: Cognitive and psychological outcomes and follow‑up in severely affected COVID‑19 survivors admitted to a rehabilitation hospital.
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De Tanti A, Conforti J, Bruni S, De Gaetano K, Cappalli A, Basagni B, Bertoni D, and Saviola D
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- 2023
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23. Cognitive and psychological outcomes and follow-up in severely affected COVID-19 survivors admitted to a rehabilitation hospital.
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De Tanti A, Conforti J, Bruni S, De Gaetano K, Cappalli A, Basagni B, Bertoni D, and Saviola D
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- Humans, SARS-CoV-2, Quality of Life, Follow-Up Studies, Intensive Care Units, Survivors psychology, Hospitals, COVID-19
- Abstract
Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents the most recent severe pandemic resulting in coronavirus disease 2019 (COVID-19). COVID-19 can damage the central nervous system, requiring admission to intensive care units (ICU) and aggressive treatments (long-term ventilatory assistance and sedation) to stabilize vitals. Most post-COVID-19 patients experience cognitive impairments and mood or stress disorders. We aimed to study the frequency of cognitive deficits in COVID-19 survivors, the relationship between clinical factors in the acute phase and cognitive outcomes, affective states, and quality of life. We explored cognitive reserve (CR) role, as a post-COVID-19 resilience factor., Methods: Twenty-nine COVID-19 inpatients were assessed using a neuropsychological battery, mood scales, quality of life, and social integration questionnaires. Twenty-five were retained through telephone follow-up to monitor cognitive sequelae, affective states, and reintegration levels roughly 8 months after hospital discharge. We administered the Cognitive Reserve Index questionnaire., Results: We found most patients display no cognitive deficits. When they did, multi-domain impairment occurred most frequently, especially involving executive functions. Results revealed a significant correlation between depression levels and the interval between ICU admission and tracheal tube removal. We found increased levels of depression and anxiety at follow-up, a significant relationship between resuming daily life activities, high CR, and executive functions., Conclusions: These findings suggest the importance of psychological support in the long term and the modulating role of cognitive reserve in quality of life after infection., (© 2023. Fondazione Società Italiana di Neurologia.)
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- 2023
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24. Acquired neurogenic foreign accent syndrome (ANFAS) as the sole outcome of the fibrinolysis procedure in a patient with acute stroke aphasia: a case study.
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Basagni B, Abbruzzese L, Priftis K, Damora A, and Mancuso M
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- Humans, Fibrinolysis, Stroke complications, Aphasia etiology
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- 2023
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25. Correlates of participation six months after stroke in an Italian population: results from the RIPS (Post-Stroke Intensive Rehabilitation) Study.
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Castagnoli C, Pancani S, Barretta T, Pellicciari L, Campagnini S, Basagni B, Gucci C, Sodero A, Guolo E, Hakiki B, Grippo A, Mannini A, Macchi C, and Cecchi F
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- Male, Adult, Humans, Aged, Female, Activities of Daily Living psychology, Prospective Studies, Stroke Rehabilitation, Stroke, Cognitive Dysfunction
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Background: Stroke survivors report physical, cognitive, and psychological impairments, with a consequent limitation of participation. Participation is the most context-related dimension of functioning, but the literature on participation in Italian stroke patients is scant., Aim: This study aimed to describe the recovery of participation six months after stroke with a validated Italian version of the Frenchay Activity Index (FAI) and to investigate potential correlates with higher participation scores., Design: The study is a prospective observational study., Setting: The cohort of patients was enrolled in four intensive inpatient rehabilitation units of IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy., Population: Adults addressing postacute intensive inpatient rehabilitation after an ischemic or hemorrhagic stroke occurred within 30 days from recruitment were prospectively enrolled., Methods: Data were collected at admission to intensive inpatient rehabilitation, and a six-month follow-up. The primary outcome was participation, measured by a validated Italian version of the FAI; only patients whose data included both anamnestic FAI and FAI at six months follow-up were included in this analysis. The data were analyzed by univariate and multivariate linear regressions., Results: A cohort of 105 patients (median age 78 years [interquartile range, IQR=21]; 46.7% males) with completed FAI at follow-up were included in this study. The sample reported a FAI median score of 28 (IQR=8) at admission (referred to the participation in the 3-6 months before the stroke) and 13 (IQR=20) at follow-up. All items were significantly affected, with the exception of reading and making trips. The multivariate regression for all patients with good participation before the stroke (N.=101), showed that 6 months after the stroke a higher FAI Score was independently associated with better functioning in activities of daily living (modified Barthel Index) (B=0.133; P=0.015), and absence of cognitive impairment (B=4.755; P=0.027); a lower stroke severity in the postacute phase (NIHSS B=-0.832; P=0.001) and a higher prestroke FAI Score (B=0.410; P=0.028) were also independently related to follow-up FAI Score., Conclusions: In our cohort of patients addressing postacute stroke rehabilitation, prestroke participation levels were on average good, while they were severely reduced six months after stroke for all the considered items except reading and making trips. Higher FAI at follow-up was independently associated with a higher functional level and no cognitive impairment at follow-up, with lower stroke severity in the postacute phase, as well as a higher anamnestic participation score., Clinical Rehabilitation Impact: Our results suggest that investigating prestroke participation may be highly relevant to predict, and possibly address, participation recovery after stroke.
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- 2023
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26. Factors influencing trunk control recovery after intensive rehabilitation in post-stroke patients: a multicentre prospective study.
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Pellicciari L, Sodero A, Campagnini S, Guolo E, Basagni B, Castagnoli C, Hochleitner I, Paperini A, Gnetti B, Avila L, Romano E, Grippo A, Hakiki B, Carrozza MC, Mannini A, Macchi C, and Cecchi F
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- Humans, Prospective Studies, Recovery of Function, Hospitalization, Stroke complications, Stroke Rehabilitation
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Background: Trunk control plays a crucial role in the stroke rehabilitation, but it is unclear which factors could influence the trunk control after an intensive rehabilitation treatment., Objectives: To study which demographic, clinical and functional variables could predict the recovery of trunk control after intensive post-stroke inpatient rehabilitation., Methods: Subjects with acute, first-ever stroke were enrolled and clinical and data were collected at admission and discharge. The primary outcome was considered the trunk control measured by the Trunk Control Test (TCT). The data were analyzed by a univariate and multivariate logistic regressions., Results: Two hundred forty-one post-stroke patients were included. All baseline variables significantly associated to TCT at discharge in the univariate analysis (i.e. gender, NIHSS neglect item at admission, presence of several complexity markers, TCT total score at admission, NIHSS total score, pre-stroke modified Rankin Scale, Fugl-Meyer Assessment motor and sensitivity score) were entered in the multivariate analysis. The multivariate regression showed that age ( p = .003), admission NIHSS total score ( p = .001), admission TCT total score ( p < .001) and presence of depression ( p = .027) independently influenced the TCT total score at discharge ( R
2 = 61.2%)., Conclusions: Age, admission neurological impairment (NIHSS total score), trunk control at the admission (TCT total score), and presence of depression independently influenced the TCT at discharge. These factors should be carefully assessed at the baseline to plan a tailoring rehabilitation treatment achieving the best trunk control performance at discharge.- Published
- 2023
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27. Cognition in COVID-19 infected patients undergoing invasive ventilation: results from a multicenter retrospective study.
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Basagni B, Abbruzzese L, Damora A, Conforti J, Saviola D, De Tanti A, Podgorska A, Biagioni C, Bacci M, Gambarelli C, Strologo F, Maietti A, and Mancuso M
- Abstract
A growing number of scientific contributions suggest that COVID-19 infection can lead to impairment of cognition, mainly in executive functions and memory domains, even in the absence of frank neurological pathologies.The primary objective of this retrospective study is to evaluate the frequency and type of inefficiencies in a selection of cognitive tests administered to a sample of subjects who, following infection, required invasive assisted ventilation and were admitted to rehabilitation wards for the treatment of functional impairment.Fifty-seven subjects were enrolled. The recruited patients undergone an assessment of verbal and visuospatial memory and executive functions, upon entry into the rehabilitation department, after discharge from intensive care. The following tests were administered: Rey Auditory Verbal Learning Test (AVLT) (immediate and delayed recall), Rey-Osterrieth Complex Figure Test (ROCFT) (copy and delayed recall), Stroop Color-Word Test, and Trail Making Test (TMT, A and B).Deficient scores, in beyond 25% of subjects, were found in the copy of the ROCFT (32.1% of subjects), and in the delayed recall of ROCFT (27.2%). Between 10 and 20% of patients presented an abnormal result in delayed recall of AVLT (16.07%), and Stroop Test (time, 15.6%, error, 11.5%). Less than 10% of the sample had abnormal performances on TMT (A, 3.5%, and B, 9.4%), and in AVLT immediate recall (8.9%). Correlations of the performances with age, sex, and education were also found.This paper highlights the high incidence of abnormal cognitive performances in this specific subpopulation of patients with COVID-19 infection.
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- 2023
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28. Long term effects of severe acquired brain injury: A follow-up investigation on the role of cognitive reserve on cognitive outcomes.
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Basagni B, Di Rosa E, Bertoni D, Mondini S, and De Tanti A
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In a recent study we showed that Cognitive Reserve (CR) did not significantly predict the neuropsychological outcomes of patients with severe Acquired Brain Injury (sABI), after a rehabilitation program. The present study aims to extend the previous results by assessing the role of CR on long-term neuropsychological outcomes of a subgroup ( N = 27) of that same population. Patients took part in a telephone interview, where Tele-Global Examination Mental State (Tele-GEMS) and Glasgow Outcome Scale Extended (GOS-E) were administered. A linear regression model was conducted considering Tele-GEMS and GOS-E as dependent variables, while the scores on Cognitive Reserve Index questionnaire (CRIq), Disability Rating Scale (DRS), and Level of Cognitive Functioning (LCF), administered at discharge, were considered as predictors. Results show that higher levels of CR and LCF, significantly predicted cognitive performance 4 years later. However, in the same follow-up, CR did not predict functional outcome, which was only predicted by lower disability scores at discharge. Thus, even if CR seems not showing an effect on cognitive efficiency when tested after the first rehabilitation intervention, current results show that CR has significant effects on long-term cognitive outcomes.
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- 2023
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29. Cognitive Profile in Patients Admitted to Intensive Rehabilitation after Stroke Is Associated with the Recovery of Dysphagia: Preliminary Results from the RIPS (Intensive Post-Stroke Rehabilitation) Study.
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Basagni B, Marignani S, Pancani S, Mannini A, Hakiki B, Grippo A, Macchi C, and Cecchi F
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- Humans, Patient Discharge, Cognition, Stroke Rehabilitation, Deglutition Disorders diagnosis, Deglutition Disorders etiology, Stroke complications, Stroke diagnosis
- Abstract
Dysphagia represents one of the most frequent symptoms in the post-acute stroke population. Swallowing impairment and cognitive deficits can often co-occur. This study aims to investigate the relationship between cognitive impairment and the recovery of dysphagia in patients attending specific rehabilitation. Patients admitted to intensive rehabilitation units were administered the Functional Oral Intake Scale (FOIS) and Montreal Cognitive Screening Test (MoCA); when screening positive for dysphagia, they entered a rehabilitation program. Their FOIS score at discharge was the primary outcome measure. In the multivariate analysis, younger age (B = - 0.077, p = 0.017), higher MoCA (B = 0.191, p = 0.002), and higher FOIS (B = 1.251, p = 0.032) at admission were associated with higher FOIS at discharge. When executive function (EF) replaced the MoCA total score in the model, younger age (B = - 0.134, p = 0.001), higher admission EF (B = 1.451, p < 0.001), and FOIS (B = 1.348, p = 0.035) were associated with higher FOIS at discharge. Our results confirm the hypothesis that a better cognitive profile upon admission is associated with a higher probability of dysphagia recovery at discharge. EF seems to have a crucial role in dysphagia recovery. These results highlight the importance of considering the cognitive profile when assessing and treating dysphagia after stroke and of using screening tests that include executive functions., Competing Interests: The authors declare that they have no relevant or material financial interests that relate to the research described in this article., (Thieme. All rights reserved.)
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- 2023
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30. Extra-Linguistic Cognitive Functions Involved in the Token Test: Results from a Cohort of Non-Aphasic Stroke Patients with Right Hemisphere Lesion.
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Basagni B, Pancani S, Pellicciari L, Gemignani P, Salvadori E, Marignani S, Grippo A, Hakiki B, Mannini A, Bardi D, Pellegrini I, Viggiano MP, Giovannelli F, Macchi C, and Cecchi F
- Abstract
Background: The Token Test (TT) is widely used to examine comprehension disorders in aphasic patients, but abilities other than language may affect a patient's performance. This study aims to explore the correlation between the TT subtest performances and the performances in extra-linguistic cognitive areas in a cohort of patients from the Intensive Rehabilitation Post-Stroke (RIPS) study with a first, right hemisphere stroke and without aphasia, prospectively enrolled at admission to intensive inpatient post-acute rehabilitation., Methods: The patients were administered the TT (50-item version), the forward and backward digit span (DST), and the Montreal Cognitive Assessment (MoCA). Spearman's partial correlations adjusted by age were used to evaluate the association between the number of errors in the TT and the other tests' corrected scores., Results: Of the 37 patients enrolled in this study, 29.7% made 3-11 errors on the TT, 27.0% more than 11 errors, mostly in parts IV and V. The forward and backward digit span scores showed correlations with errors in part V of the TT (r = -0.408, p = 0.013; r = -0.307, p = 0.027). The errors in part IV of the TT presented a correlation with a forward digit span too (r = -0.394, p = 0.017). With respect to MoCA domains, executive functioning, and orientation were related to the TT part V errors (r = -0.468, p = 0.007; r = -0.499, p = 0.003). The orientation also correlated with the TT part III (r = -0.504, p = 0.002)., Conclusion: Our findings show that the TT performances in patients with right hemisphere stroke and without aphasia are related to impairments in auditory-verbal span/auditory working memory mostly for TT scores on subpart V as measured by the DST and to executive function and orientation, as measured by the MoCA subtests.
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- 2022
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31. Design and implementation of a Stroke Rehabilitation Registry for the systematic assessment of processes and outcomes and the development of data-driven prediction models: The STRATEGY study protocol.
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Chiavilli M, Campagnini S, Baretta T, Castagnoli C, Paperini A, Politi AM, Pellicciari L, Baccini M, Basagni B, Marignani S, Bardi D, Sodero A, Lombardi G, Guolo E, Navarro JS, Galeri S, Montesano A, Falco L, Rovaris MG, Carrozza MC, Macchi C, Mannini A, and Cecchi F
- Abstract
Background: Stroke represents the second preventable cause of death after cardiovascular disease and the third global cause of disability. In countries where national registries of the clinical quality of stroke care have been established, the publication and sharing of the collected data have led to an improvement in the quality of care and survival of patients. However, information on rehabilitation processes and outcomes is often lacking, and predictors of functional outcomes remain poorly explored. This paper describes a multicenter study protocol to implement a Stroke rehabilitation Registry, mainly based on a multidimensional assessment proposed by the Italian Society of Physical and Rehabilitation Medicine (PMIC2020), in a pilot Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation, to provide a systematic assessment of processes and outcomes and develop data-driven prediction models of functional outcomes., Methods: All patients with a diagnosis of ischemic or haemorrhagic stroke confirmed by clinical assessment, admitted to intensive rehabilitation units within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled. Measures will be taken at admission (T0), at discharge (T1), and at follow-up, 3 months (T2) and 6 months (T3) after the stroke. Assessment variables include anamnestic data, clinical and nursing complexity information and measures of body structures and function, activity and participation (PMIC2020), rehabilitation interventions, adverse events and discharge data. The modified Barthel Index will be our primary outcome. In addition to classical biostatistical analysis, learning algorithms will be cross-validated to achieve data-driven prognosis prediction models., Conclusions: This study will test the feasibility of a stroke rehabilitation registry in the Italian health context and provide a systematic assessment of processes and outcomes for quality assessment and benchmarking. By the development of data-driven prediction models in stroke rehabilitation, this study will pave the way for the development of decision support tools for patient-oriented therapy planning and rehabilitation outcomes maximization., Clinical Tial Registration: The registration on ClinicalTrials.gov is ongoing and under review. The identification number will be provided when the review process will be completed., 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 Chiavilli, Campagnini, Baretta, Castagnoli, Paperini, Politi, Pellicciari, Baccini, Basagni, Marignani, Bardi, Sodero, Lombardi, Guolo, Navarro, Galeri, Montesano, Falco, Rovaris, Carrozza, Macchi, Mannini and Cecchi.)
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- 2022
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32. Cross-validation of predictive models for functional recovery after post-stroke rehabilitation.
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Campagnini S, Liuzzi P, Mannini A, Basagni B, Macchi C, Carrozza MC, and Cecchi F
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- Humans, Machine Learning, Recovery of Function, Support Vector Machine, Stroke, Stroke Rehabilitation
- Abstract
Background: Rehabilitation treatments and services are essential for the recovery of post-stroke patients' functions; however, the increasing number of available therapies and the lack of consensus among outcome measures compromises the possibility to determine an appropriate level of evidence. Machine learning techniques for prognostic applications offer accurate and interpretable predictions, supporting the clinical decision for personalised treatment. The aim of this study is to develop and cross-validate predictive models for the functional prognosis of patients, highlighting the contributions of each predictor., Methods: A dataset of 278 post-stroke patients was used for the prediction of the class transition, obtained from the modified Barthel Index. Four classification algorithms were cross-validated and compared. On the best performing model on the validation set, an analysis of predictors contribution was conducted., Results: The Random Forest obtained the best overall results on the accuracy (76.2%), balanced accuracy (74.3%), sensitivity (0.80), and specificity (0.68). The combination of all the classification results on the test set, by weighted voting, reached 80.2% accuracy. The predictors analysis applied on the Support Vector Machine, showed that a good trunk control and communication level, and the absence of bedsores retain the major contribution in the prediction of a good functional outcome., Conclusions: Despite a more comprehensive assessment of the patients is needed, this work paves the way for the implementation of solutions for clinical decision support in the rehabilitation of post-stroke patients. Indeed, offering good prognostic accuracies for class transition and patient-wise view of the predictors contributions, it might help in a personalised optimisation of the patients' rehabilitation path., (© 2022. The Author(s).)
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- 2022
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33. Italian translation and cross-cultural validation of an assessment tool for participation in stroke survivors: the Frenchay Activities Index.
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Antonucci L, Barbato C, Pellicciari L, Paperini A, Hochleitner I, Castagnoli C, Verdesca S, Lucidi G, Marignani S, Pancani S, Basagni B, Macchi C, and Cecchi F
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- Cross-Cultural Comparison, Humans, Psychometrics methods, Reproducibility of Results, Surveys and Questionnaires, Survivors, Translations, Stroke, Stroke Rehabilitation methods
- Abstract
Purpose: Participation needs to be assessed objectively, to state accurate rehabilitation objectives. The Frenchay Activities Index (FAI) is a widely used tool to measure participation in stroke patients. To date, no cross-culturally validated Italian version of FAI is available. This study provides a translation and cross-cultural adaptation of FAI into Italian, assessing its validity and reliability in sub-acute stroke patients., Methods: According to international guidelines, a multistep translation and cultural adaptation protocol of forward and backward translations was conducted by qualified linguists and independent native English translators and revised by a healthcare committee. Patients admitted to intensive inpatient rehabilitation after stroke were recruited. Structural validity, reliability (internal consistency, inter- and intra-rater reliability and measurement error), and construct validity were studied., Results: One hundred and seventy-three patients were included in this study. No significant observations in terms of comprehensibility and conceptual equivalence of the FAI Italian version emerged. The exploratory factorial analysis revealed the presence of two subscales (i.e., domestic chores and work/leisure). The internal consistency resulted good for the first and second subscale (α = 0.821 and 0.716, respectively). Intra- and inter-reliability showed an ICC > 0.90 for both subscales. SEM = 5.75% and 2.33% and MDC = 15.85% and 6.48% were found for the first and second subscale, respectively. Construct validity of first subscale was satisfactory, as 100.0% a priori hypotheses were met, while for the second subscale it was moderate, as 66.6% a priori hypotheses were respected., Conclusion: FAI-I provides a tool for professionals to measure participation in Italian stroke patients in health and social care settings., (© 2022. Fondazione Società Italiana di Neurologia.)
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- 2022
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34. Cognitive reserve index and functional and cognitive outcomes in severe acquired brain injury: A pilot study.
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Bertoni D, Petraglia F, Basagni B, Pedrazzi G, De Gaetano K, Costantino C, and De Tanti A
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- Humans, Neuropsychological Tests, Pilot Projects, Retrospective Studies, Brain Injuries complications, Cognitive Reserve
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Background: Many variables affect outcome after brain injury. Cognitive reserve (CR) is a subjective factor that reflects a set of personal characteristics and that differentiates individuals. It may influence an individual's capacity to react to brain injury., Objective: To study the effects of cognitive reserve on functional and cognitive outcome at the end of rehabilitation, in patients with severe acquired brain injury (sABI), by means of the Cognitive Reserve Index questionnaire (CRIq)., Methods: We report a retrospective study of a continuous series of sABI patients on first admission to a rehabilitation center. Disability and cognitive outcomes were recorded., Results: In the 94 patients enrolled, the assessments after rehabilitation showed a significant gain measured with the disability Rating Scale for patients with a higher CR (CRIq≥ 85). A significant negative correlation was found: between CRIq scores and the interval elapsing before first access to neuropsychological assessment, between CRIq scores, especially level of education, and tests that measure the same domain (attention)., Conclusions: Improvements in overall and cognitive disability emerged, but CR did not seem to substantially influence outcome in this sample of patients. This result may be partly due to the clinical severity of the population studied and the sample's dimension, although quantitatively representative of the population.
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- 2022
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35. Amnesia of Uncertain Etiology in an Adolescent during COVID-19 Pandemic: A Case Report.
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Basagni B, Martelli S, Mazzucchi A, and Cecchi F
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Sudden retrograde memory loss, in the absence of neurological causes, is usually referred to as a dissociative symptom. Dissociative amnesia, defined in the DSM-V as an inability to remember important autobiographical experiences, usually of a traumatic or stressful nature, is however a controversial phenomenon. Few cases with this pattern are described in the scientific literature and still fewer regarding adolescents. The objective of this study was to describe the case of an unexplained sudden memory loss that only partially fits with the criteria for dissociative amnesia, in a juvenile patient aged 16 years, which occurred during the COVID-19 lockdown. After the exclusion of any organic disturbances, 10 days after the clinical onset, a series of psychometric (neuropsychological and psychodiagnostics) tests were administered to the patient. Recent distress associated with COVID-19 lockdown was reported, while no previous significant distress or psychiatric history emerged during the clinical interview, conducted with the patient and parents. Severe disturbances in remote memory tests were registered, while no impairments in cognitive or anterograde amnestic functions were found or personality disorders. The disturbance was diagnosed as "amnesia of uncertain etiology.", Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2022 by S. Karger AG, Basel.)
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- 2022
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36. Progressive Unspecified Motor Speech Disorder: A Longitudinal Single Case Study of an Older Subject.
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Basagni B, Martelli S, Ruffini L, Mazzucchi A, and Cecchi F
- Abstract
Introduction: In a few cases, neurodegenerative diseases debut with a speech disorder whose differential diagnosis can be difficult., Case Report: We describe the case of a right-handed woman with a progressive speech impairment, which debuted when she was 80 years old. We report the results of neurological, neuropsychological, and imaging assessments with positron emission tomography (PET) over a period of nine years. Metabolic PET with 18F-FDG was performed at the age of 81 and repeated two years later due to the worsening of symptoms; amyloid PET with 18F-flutemetamol was performed at the age of 86. All PET results were quantitatively analyzed. A speech impairment remained the isolated neurological symptom for a long time, together with a mood disorder. Early FDG-PET showed hypometabolism in the left superior and inferior frontal areas, in the left superior temporal area, and in the right superior frontal area. Two years later, the hypometabolic area was more extensive. Amyloid PET was qualitatively and quantitatively normal. Nine years after the first symptoms, the speech production progressively worsened until complete anarthria, in association with writing impairment onset and signs of behavioral impairments. No signs of motor involvement were found., Conclusions: A progressive articulatory disorder without an evolution of motor disorders may be a distinct neurological degenerative entity, mainly affecting speech production for very a long time and with a specific early metabolic pattern in brain FDG-PET in the language production area. Monitoring patients with FDG-PET could predict the disease evolution years before a clinical deterioration.
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- 2022
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37. Critical issue on the extinction and inattention subtest of NIHSS scale: an analysis on post-acute stroke patients attending inpatient rehabilitation.
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Basagni B, Hakiki B, Campagnini S, Salvadori E, Grippo A, Paperini A, Castagnoli C, Hochleitner I, Politi AM, Gemignani P, Mosca IE, Franceschini A, Bonotti EB, Sodero A, Mannini A, Pellicciari L, Poggesi A, Macchi C, Carrozza MC, and Cecchi F
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- Cognition, Humans, Inpatients, Registries, Severity of Illness Index, Stroke complications, Stroke diagnosis, Stroke Rehabilitation
- Abstract
Objectives: This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed., Methods: We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients., Results: Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 72.9% and a moderate agreement level (Cohen's kappa = 0.404). Furthermore, a decrease in NIHSS accuracy detecting neglect (61.1%) was observed in patients with pathological scores in NIHSS visual field item., Conclusions: Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment., Trial Registration: This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627 . The name of the registry is "Development of a National Protocol for Stroke Rehabilitation in a Multicenter Italian Institution" and the date of the registration is the 30th May 2019., (© 2021. The Author(s).)
- Published
- 2021
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38. Some evidence on Gerstmann's syndrome: A case study on a variant of the clinical disorder.
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Basagni B, Luzzatti C, De Tanti A, Bozzetti F, Crisi G, Pinardi C, Errante A, and Fogassi L
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- Diffusion Tensor Imaging, Humans, Magnetic Resonance Imaging, Parietal Lobe diagnostic imaging, Gerstmann Syndrome diagnostic imaging
- Abstract
We describe the case of a bilingual patient with persistent symptoms largely, although not fully, consistent with those that are usually reported in Gerstmann's syndrome. Twenty months after a spontaneous primary intracranial hemorrhage, the patient was evaluated with a series of neuropsychological tasks and underwent an MRI investigation based on Diffusion Tensor Imaging probabilistic tractography. The patient suffered from dysgraphia (difficulty in the access to the graphemic representation of letter forms), autotopoagnosia (difficulties in locating body parts on verbal command), right-left confusion (difficulties in localizing right and left side of symmetrical body parts), and number processing/calculation impairments (predominant difficulties on transcoding tasks). Probabilistic tractography revealed a relatively spared superior longitudinal fasciculus and severe damage to the subcortical white matter connecting the angular gyrus with other parietal regions, such as the intraparietal sulcus and the supramarginal gyrus. Within the framework of the contemporary cognitive accounts of Gerstmann's syndrome, the case supports the assumption of an anatomical intraparietal disconnection more than a functional Grundstörung (core impairment)., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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39. 'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs).
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Pellicciari L, Piscitelli D, Basagni B, De Tanti A, Algeri L, Caselli S, Ciurli MP, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Rinaldesi ML, Sozzi M, Abbruzzese L, Zettin M, and La Porta F
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- Humans, Personality, Psychometrics, Reproducibility of Results, Surveys and Questionnaires, Brain Injuries, Trust
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Background: Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs)., Objective: To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements., Methods: BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model., Results: The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p -values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements., Conclusions: After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
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- 2020
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40. The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics.
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Basagni B, Piscitelli D, De Tanti A, Pellicciari L, Algeri L, Caselli S, Formisano R, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Quinquinio C, Sozzi M, Abbruzzese L, Zettin M, and La Porta F
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- Cross-Sectional Studies, Humans, Italy, Personality, Psychometrics, Reproducibility of Results, Surveys and Questionnaires, Brain Injuries, Trust
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Objective : To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods. Methods : Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA). Results : Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062). Conclusion : Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
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- 2020
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41. Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study.
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Errante A, Saviola D, Fasano F, Basagni B, Alinovi S, Bosetti S, Chiari M, Minardi R, Pinardi C, Crisi G, Fogassi L, and De Tanti A
- Abstract
Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activities, has been demonstrated. Here, we describe the application of an intensive multi-professional rehabilitation program carried out on a young female patient, with exceptionally late recovery of consciousness, specifically, after 7 years of vegetative state due to severe brain hemorrhage. Neuropsychological and functional assessment was conducted before and after the end of the rehabilitation program. In addition, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI)-based probabilistic tractography were performed. Two follow-up neuropsychological and functional assessments were also conducted 6 and 29 months after the conclusion of the program. Functional results showed an improvement, maintained over time, in walking with assistance, cognitive efficiency, visual acuity and visual field, dysarthria, and execution of activities of daily living. Moreover, functional and structural magnetic resonance imaging (MRI) data documented the existence of preserved neural networks involved in sensory, motor, and linguistic tasks, which in all likelihood support the recovery process. This report suggests the possibility of undertaking an intensive rehabilitation program in patients who remain for long periods in altered states of consciousness, in spite of early negative prognosis., Competing Interests: Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2019
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42. Rehabilitation of unilateral spatial neglect: A combined behavioral and fMRI single-case study.
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Basagni B, Errante A, Pinardi C, De Gaetano K, Crisi G, De Tanti A, and Fogassi L
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- Humans, Male, Middle Aged, Neuropsychological Tests, Perceptual Disorders diagnostic imaging, Perceptual Disorders etiology, Perceptual Disorders psychology, Quality of Life psychology, Stroke complications, Attention physiology, Brain diagnostic imaging, Functional Laterality physiology, Magnetic Resonance Imaging, Perceptual Disorders rehabilitation
- Abstract
Objective: Symptoms of visuospatial neglect occur frequently after unilateral brain damage. Neglect hampers general rehabilitation progress and is associated with reduced quality of life. Some of the rehabilitation programs developed to treat neglect have demonstrated behavioral improvements. However, only a few of them have addressed specifically the anatomo-functional correlates associated behavioral improvement., Method: Here we describe the case of a patient (GV) with a severe left neglect disorder as a consequence of a right hemisphere stroke. Eighteen weeks after the onset, he underwent a 10-week intensive neuropsychological rehabilitation program. Functional MRI (fMRI) during execution of a covert attention task, and a broad neuropsychological assessment were conducted before and after the training., Results: The results show a significant improvement of the performance in neglect tasks after the rehabilitation program, although the remission of symptoms was not complete. fMRI data showed that the behavioral improvement was accompanied by an increase of activity in the dorsal premotor cortex and middle frontal gyrus bilaterally. Other activations were present only in the contralesional left hemisphere, including supplementary motor area and superior temporal gyrus., Conclusions: The implications of the results are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
- Published
- 2019
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43. A New Standardization of the Bells Test: An Italian Multi-Center Normative Study.
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Mancuso M, Damora A, Abbruzzese L, Navarrete E, Basagni B, Galardi G, Caputo M, Bartalini B, Bartolo M, Zucchella C, Carboncini MC, Dei S, Zoccolotti P, Antonucci G, and De Tanti A
- Abstract
Objective: The Bells Test is a cancelation task that is widely used for the diagnosis of unilateral spatial neglect (USN). With the aim of fostering more reliable use of this instrument, we set out to develop new norms adjusted for the possible influence of age, gender and education. We worked on the original version of the test. Methods: Normative data were collected from 401 healthy participants aged between 20 and 80 years. Individual factors that could affect performance (i.e., gender, age, and years of education) were considered. We computed several indices on the Bells Test including an asymmetry score, an accuracy score and execution time. Multiple regression analyses (for time measures) and generalized linear models (for accuracy measures) were used to check for the influence of individual predictors of performance on the Bells Test. Results: Data indicated a significant influence of age on the accuracy score and execution time variables and a marginally significant effect of education on the accuracy score variable. Wherever appropriate, cut-offs are provided for the three dependent scores on the Bells Test corrected for age and education. Conclusion: Based on a large normative sample, the present study provides new normative data on the Bells Test, which could lead to its reliable use in the diagnosis of USN.
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- 2019
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44. Safe return to driving following severe acquired brain injury: role of a short neuropsychological assessment.
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Saviola D, De Tanti A, Conforti J, Posteraro L, Manfredini A, Bagattini C, and Basagni B
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- Adult, Attention, Automobile Driver Examination, Cognition, Executive Function, Female, Humans, Male, Psychomotor Performance, Automobile Driving psychology, Brain Injuries physiopathology, Neuropsychological Tests
- Abstract
Background: Driving is a complex ability requiring a broad range of motor, cognitive-behavioral and visual skills that may be impaired after severe acquired brain injury (sABI). Resumption of driving is perceived as a major need by patients, being closely linked to personal autonomy, work and social activities., Aim: The objective of this study was to identify a short battery of neuropsychological tests with predictive value with regard to safe return to driving after sABI., Design: Observational study., Setting: Outpatient of a rehabilitation center for sABI., Population: A continuous series of 127 patients with stable sABI, well-reintegrated at a family and social level, dismissed since at least one year from the end of their intensive rehabilitation, enrolled between 2006 and 2014., Methods: Patients underwent an extensive battery of neuropsychological tests (pencil and paper and specific PC programs), aimed at assessing cognitive functions, in performance and verbal tasks. The results were analyzed in relation to their on-road performance during the driving test conducted by the office of the Italian Government Authority (success or failure of the test)., Results: No correlations were found between demographic data, etiology, driving experience, verbal competence and the decision of the competent authority. Significant correlation was found between attention, executive functions, overall visual-spatial exploration and driving performance., Conclusions: Both "pencil and paper" and computerized tests in the cognitive domains of attentive functions, and those involving performance with visual-spatial material, are significantly correlated with the driving test outcome, even if there is not enough evidence of the relative value of off-road compared to direct on-road tests., Clinical Rehabilitation Impact: We propose a small neuropsychological battery of tests with normative data for Italian population, predictive with respect to the ability to drive safely. We recommend to use it as first screening before submitting patients to more demanding and risky on-road driving tests.
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- 2018
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45. The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test.
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Basagni B, De Tanti A, Damora A, Abbruzzese L, Varalta V, Antonucci G, Bickerton WL, Smania N, and Mancuso M
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- Acute Disease, Adult, Aged, Aged, 80 and over, Brain Ischemia complications, Brain Ischemia diagnosis, Brain Ischemia psychology, Cerebral Hemorrhage complications, Cerebral Hemorrhage diagnosis, Cerebral Hemorrhage psychology, Chronic Disease, Female, Functional Laterality, Humans, Male, Middle Aged, Perceptual Disorders etiology, Retrospective Studies, Stroke complications, Stroke diagnosis, Stroke psychology, Stroke Rehabilitation methods, Neuropsychological Tests, Perceptual Disorders diagnosis
- Abstract
Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.
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- 2017
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46. VRT (verbal reasoning test): a new test for assessment of verbal reasoning. Test realization and Italian normative data from a multicentric study.
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Basagni B, Luzzatti C, Navarrete E, Caputo M, Scrocco G, Damora A, Giunchi L, Gemignani P, Caiazzo A, Gambini MG, Avesani R, Mancuso M, Trojano L, and De Tanti A
- Subjects
- Adolescent, Adult, Age Factors, Aged, Brain Injuries diagnosis, Brain Injuries psychology, Educational Status, Female, Humans, Italy, Linear Models, Male, Middle Aged, Pilot Projects, Reference Values, Speech, Young Adult, Psychological Tests, Speech Perception, Thinking
- Abstract
Verbal reasoning is a complex, multicomponent function, which involves activation of functional processes and neural circuits distributed in both brain hemispheres. Thus, this ability is often impaired after brain injury. The aim of the present study is to describe the construction of a new verbal reasoning test (VRT) for patients with brain injury and to provide normative values in a sample of healthy Italian participants. Three hundred and eighty healthy Italian subjects (193 women and 187 men) of different ages (range 16-75 years) and educational level (primary school to postgraduate degree) underwent the VRT. VRT is composed of seven subtests, investigating seven different domains. Multiple linear regression analysis revealed a significant effect of age and education on the participants' performance in terms of both VRT total score and all seven subtest scores. No gender effect was found. A correction grid for raw scores was built from the linear equation derived from the scores. Inferential cut-off scores were estimated using a non-parametric technique, and equivalent scores were computed. We also provided a grid for the correction of results by z scores.
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- 2017
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47. Recovery of consciousness after 7 years in vegetative state of non-traumatic origin: A single case study.
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De Tanti A, Saviola D, Basagni B, Cavatorta S, Chiari M, Casalino S, De Bernardi D, and Galvani R
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- Adolescent, Disability Evaluation, Female, Humans, Prognosis, Young Adult, Intracranial Arteriovenous Malformations complications, Persistent Vegetative State etiology, Recovery of Function
- Abstract
Primary Objective: To report consistent recovery of consciousness to a state of severe disability in a young patient after 7 years in vegetative state due to severe acquired brain injury, with reflections on protraction of intensive care and expert follow-up for the purpose of intercepting possible, albeit infrequent, cases of late recovery of consciousness., Research Design: Single case study Methods: This study describes the 9-year history of a healthy 15-year-old who suffered cerebellar haemorrhage due to rupture of an arteriovenous malformation, followed by a brief period of coma then protracted vegetative state; late stabilization of general condition with resolution of neurosurgical complications. Clinical monitoring employed scales for structured assessment of severe disability and disorders of consciousness., Results: The transition from vegetative state to full consciousness occurred over a period of ~ 3 months, 7 years after onset. In the subsequent 2 years the patient has shown slow but progressive overall improvement in a framework of severe residual motor and cognitive disability., Conclusions: Cases of recovery of consciousness after periods of vegetative state exceeding 1 year are rare, but remind one that a negative prognosis decided too early may be a self-fulfilling forecast.
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- 2016
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48. Long-term cognitive sequelae in a case of Wernicke's encephalopathy after allogeneic stem cell transplantation.
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Giovannelli F, Basagni B, Potenza L, Foschi V, and De Tanti A
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- Adult, Humans, Leukemia, Myeloid etiology, Longitudinal Studies, Male, Neuropsychological Tests, Postoperative Complications physiopathology, Transplantation, Homologous, Cognition Disorders etiology, Stem Cell Transplantation adverse effects, Wernicke Encephalopathy complications, Wernicke Encephalopathy surgery
- Abstract
We describe the case of a non-alcoholic patient with chronic myeloid leukemia who developed iatrogenic Wernicke's encephalopathy (WE) following stem cell transplantation. Four years after the WE acute event, the patient's cognitive profile was mainly characterized by moderate memory impairment, and functional and daily-living difficulties. Our report sustains the hypothesis that a iatrogenic form of WE may produce long-term cognitive sequelae even when thiamine therapy is administered in the acute phase until the resolution of the neurological signs.
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- 2016
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49. The Italian version of the Brain Injury Rehabilitation Trust (BIRT) personality questionnaires: five new measures of personality change after acquired brain injury.
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Basagni B, Navarrete E, Bertoni D, Cattran C, Mapelli D, Oddy M, and De Tanti A
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- Acebutolol, Adult, Brain Injuries rehabilitation, Female, Humans, Male, Middle Aged, Translations, Young Adult, Brain Injuries diagnosis, Brain Injuries psychology, Language, Personality Tests
- Abstract
The aim of this study was to describe the translation and adaptation of the BIRT personality questionnaires for the Italian population. This included the replication of validity testing and the collection of normative data. Following translation and adaptation according to cross-cultural guidelines, the questionnaires were administered as a pre-test to a sample of 20 healthy subjects and then to 10 patients. The questionnaires were then administered to 120 healthy subjects equally distributed by sex, education, and age, to collect normative data from an Italian population. The questionnaires were easily administered to both healthy subjects and patients. Statistical analysis on normative data was conducted to find the mean value for each questionnaire. This study lays the foundations for using a new instrument to assess behavioral changes after acquired brain injury on the Italian population.
- Published
- 2015
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50. Impaired reading not due to visual field loss in a patient with a right-hemipsheric lesion.
- Author
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Basagni B, Patané I, Ferrari V, and Bruno N
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- Aged, Dyslexia, Acquired etiology, Humans, Male, Neuropsychological Tests, Dyslexia, Acquired diagnosis, Hemianopsia etiology, Intracranial Hemorrhages complications, Reading, Visual Fields physiology
- Abstract
We describe a right-handed patient (M.B.), who developed left hemianopsia and a severe reading impairment after right occipital-parietal hemorrhage. The pattern of his reading deficit was very similar to that of pure alexia (alexia-without-agraphia): extremely slow reading times with frequent grapheme substitutions and omissions. A test of letter reading while controlling for saccadic eye movements and hemifield of presentation ruled out hemianoptic alexia. Although there have already been reports of reading impairments in right handers following right- hemispheric lesions, ours is, to the best of our knowledge, the first where visual field loss can be definitely excluded as the main cause. Based on a standard neuropsychological assessment and on additional behavioral tests, we argue that M.B.'s difficulties are unlikely to be due to right-hemisphere dominance for language. After considering several candidate explanations, we suggest that M.B.'s symptoms may be related to an impairment in attentional processes related to reading.
- Published
- 2014
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