155 results on '"De Micco R"'
Search Results
2. Determination of Ambroxol Levels in Plasma and Cerebrospinal Fluid by Online Solid-Phase Extraction Coupled with Liquid Chromatography-Tandem Mass Spectrometry in GBA-Parkinson Disease Patients
- Author
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Franco, V., primary, Palmisani, M., additional, Colucci, F., additional, De Micco, R., additional, Aloisio, S., additional, Cazzaniga, F., additional, Cerri, S., additional, Cuconato, G., additional, Devigili, G., additional, Franciotta, D., additional, Eleopra, R., additional, Elia, A., additional, Garavaglia, B., additional, Andreasi, N. Golfrè, additional, Invernizzi, F., additional, Leta, V., additional, Moda, F., additional, Mitrotti, P., additional, Picascia, M., additional, Reale, C., additional, Romito, L., additional, Siciliano, M., additional, Stiuso, R., additional, Tessitore, A., additional, Valente, E.M., additional, Avenali, M., additional, and Cilia, R., additional
- Published
- 2024
- Full Text
- View/download PDF
3. Correction to: Gender differences in microRNA expression in levodopa‑naive PD patients
- Author
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Vallelunga, A., Iannitti, T., Somma, G., Russillo, M. C., Picillo, M., De Micco, R., Vacca, L., Cilia, R., Cicero, C. E., Zangaglia, R., Lazzeri, G., Galantucci, S., Radicati, F. G., De Rosa, A., Amboni, M., Scaglione, C., Tessitore, A., Stocchi, F., Eleopra, R., Nicoletti, A., Pacchetti, C., Di Fonzo, A., Volontè, M. A., Barone, P., and Pellecchia, M. T.
- Published
- 2023
- Full Text
- View/download PDF
4. Predictors of fatigue severity in early, de novo Parkinson disease patients: A 1-year longitudinal study
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Siciliano, M., Trojano, L., De Micco, R., Giordano, A., Russo, A., Tedeschi, G., Chiorri, C., and Tessitore, A.
- Published
- 2020
- Full Text
- View/download PDF
5. Fatigue in Parkinson's disease: Italian validation of the Parkinson Fatigue Scale and the Fatigue Severity Scale using a Rasch analysis approach
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Siciliano, M., Chiorri, C., De Micco, R., Russo, A., Tedeschi, G., Trojano, L., and Tessitore, A.
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- 2019
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- View/download PDF
6. Motor, behavioural, and cognitive correlates of fatigue in early, de novo Parkinson disease patients
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Siciliano, M., Trojano, L., De Micco, R., De Mase, A., Garramone, F., Russo, A., Tedeschi, G., and Tessitore, A.
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- 2017
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7. The Italian tremor Network (TITAN): rationale, design and preliminary findings
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Erro R, Pilotto A, Esposito M, Olivola E, Nicoletti A, Lazzeri G, Magistrelli L, Dallocchio C, Marchese R, Bologna M, Tessitore A, Misceo S, Gigante AF, Terranova C, Moschella V, di Biase L, Di Giacopo R, Morgante F, Valentino F, De Rosa A, Trinchillo A, Malaguti MC, Brusa L, Matinella A, Di Biasio F, Paparella G, De Micco R, Contaldi E, Modugno N, Di Fonzo A, Padovani A, Barone P, TITAN Study Group, Erro, R, Pilotto, A, Esposito, M, Olivola, E, Nicoletti, A, Lazzeri, G, Magistrelli, L, Dallocchio, C, Marchese, R, Bologna, M, Tessitore, A, Misceo, S, Gigante, Af, Terranova, C, Moschella, V, di Biase, L, Di Giacopo, R, Morgante, F, Valentino, F, De Rosa, A, Trinchillo, A, Malaguti, Mc, Brusa, L, Matinella, A, Di Biasio, F, Paparella, G, De Micco, R, Contaldi, E, Modugno, N, Di Fonzo, A, Padovani, A, Barone, P, and TITAN Study, Group
- Abstract
INTRODUCTION: The recently released classification has revised the nosology of tremor, defining essential tremor (ET) as a syndrome and fueling an enlightened debate about some newly conceptualized entities such as ET-plus. As a result, precise information of demographics, clinical features, and about the natural history of these conditions are lacking. METHODS: The ITAlian tremor Network (TITAN) is a multicenter data collection platform, the aim of which is to prospectively assess, according to a standardized protocol, the phenomenology and natural history of tremor syndromes. RESULTS: In the first year of activity, 679 patients have been recruited. The frequency of tremor syndromes varied from 32% of ET and 41% of ET-plus to less than 3% of rare forms, including focal tremors (2.30%), task-specific tremors (1.38%), isolated rest tremor (0.61%), and orthostatic tremor (0.61%). Patients with ET-plus were older and had a higher age at onset than ET, but a shorter disease duration, which might suggest that ET-plus is not a disease stage of ET. Familial aggregation of tremor and movement disorders was present in up to 60% of ET cases and in about 40% of patients with tremor combined with dystonia. The body site of tremor onset was different between tremor syndromes, with head tremor being most commonly, but not uniquely, associated with dystonia. CONCLUSIONS: The TITAN study is anticipated to provide clinically relevant prospective information about the clinical correlates of different tremor syndromes and their specific outcomes and might serve as a basis for future etiological, pathophysiological, and therapeutic research.
- Published
- 2022
8. Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson's disease patients: a prospective longitudinal study
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De Micco R, Satolli S, Siciliano M, De Mase A, Giordano A, Tedeschi G, Tessitore A., De Micco, R, Satolli, S, Siciliano, M, De Mase, A, Giordano, A, Tedeschi, G, and Tessitore, A.
- Published
- 2022
9. Correction to: The Italian tremor Network (TITAN): rationale, design and preliminary findings (Neurological Sciences, (2022), 10.1007/s10072-022-06104-w)
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Erro, R, Pilotto, A, Esposito, M, Olivola, E, Nicoletti, A, Lazzeri, G, Magistrelli, L, Dallocchio, C, Marchese, R, Bologna, M, Tessitore, A, Misceo, S, Gigante, Af, Terranova, C, Moschella, V, di Biase, L, Di Giacopo, R, Morgante, F, Valentino, F, De Rosa, A, Trinchillo, A, Malaguti, Mc, Brusa, L, Matinella, A, Di Biasio, F, Paparella, G, De Micco, R, Contaldi, E, Modugno, N, Di Fonzo, A, Padovani, A, and Barone, P
- Published
- 2022
10. Fading of brain network fingerprint in Parkinson’s disease predicts motor clinical impairment
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Troisi Lopez, E, primary, Minino, R, additional, Liparoti, M, additional, Polverino, A, additional, Romano, A, additional, De Micco, R, additional, Lucidi, F, additional, Tessitore, A, additional, Amico, E, additional, Sorrentino, G, additional, Jirsa, V, additional, and Sorrentino, P, additional
- Published
- 2022
- Full Text
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11. Correlates of psychological distress in epileptic patients during the COVID-19 outbreak
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Giordano A, Siciliano M, De Micco R, Sant'Elia V, Russo A, Tedeschi G, Tessitore A, Giordano, A, Siciliano, M, De Micco, R, Sant'Elia, V, Russo, A, Tedeschi, G, and Tessitore, A
- Published
- 2021
12. Correlates of Psychological Distress in Patients with Parkinson's Disease During the COVID-19 Outbreak
- Author
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De Micco R, Siciliano M, Sant'Elia V, Giordano A, Russo A, Tedeschi G, Tessitore A., De Micco, R, Siciliano, M, Sant'Elia, V, Giordano, A, Russo, A, Tedeschi, G, and Tessitore, A.
- Published
- 2020
13. Resting brain networks connectivity in patients with Parkinsonʼs disease and impulse control disorders: 254
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Tessitore, A., Santangelo, G., Vitale, C., Giordano, A., Amboni, M., De Micco, R., Esposito, F., Barone, P., and Tedeschi, G.
- Published
- 2014
14. Dopaminergic modulation of the resting-state sensori-motor network in drug-naive patients with Parkinson’s disease: EP3255
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De Micco, R., Tessitore, A., Giordano, A., Conforti, R., Pignataro, G., Annunziato, L., Esposito, F., and Tedeschi, G.
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- 2014
15. Extensive functional repertoire underpins complex behaviours: insights from Parkinson’s disease
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Michael Breakspear, Laura Mandolesi, Rosaria Rucco, Giuseppe Sorrentino, Arjan Hillebrand, Fabio Baselice, Leonardo L. Gollo, Alessandro Tessitore, De Micco R, and Pierpaolo Sorrentino
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0303 health sciences ,Parkinson's disease ,medicine.diagnostic_test ,Brain activity and meditation ,Repertoire ,Flexibility (personality) ,Magnetoencephalography ,Disease ,Biology ,medicine.disease ,03 medical and health sciences ,Neural activity ,0302 clinical medicine ,Basal ganglia ,medicine ,Neuroscience ,030217 neurology & neurosurgery ,030304 developmental biology - Abstract
Rapid reconfigurations of brain activity support efficient neuronal communication and flexible behaviour. Suboptimal brain dynamics impair this adaptability, possibly leading to functional deficiencies. We hypothesize that impaired flexibility in brain activity can lead to motor and cognitive symptoms of Parkinson’s disease (PD). To test this hypothesis, we studied the ‘functional repertoire’ – the number of distinct configurations of neural activity – using source-reconstructed magnetoencephalography in PD patients and controls. We found stereotyped brain dynamics and reduced flexibility in PD. The intensity of this reduction was proportional to symptoms severity, which can be explained by beta-band hyper-synchronization. Moreover, the basal ganglia were prominently involved in the abnormal patterns of brain activity. Our findings support the hypotheses that: symptoms in PD reflect impaired brain flexibility, this impairment preferentially involves the basal ganglia, and beta-band hypersynchronization is associated with reduced brain flexibility. These findings highlight the importance of extensive functional repertoires for behaviour and motor.
- Published
- 2019
16. Interictal cortical reorganization in episodic migraine without aura: an event-related fMRI study during parametric trigeminal nociceptive stimulation
- Author
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Tessitore, A., Russo, A., Esposito, F., Giordano, A., Taglialatela, G., De Micco, R., Cirillo, M., Conte, F., d’Onofrio, F., Cirillo, S., and Tedeschi, Gioacchino
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- 2011
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17. Editorial: Non-motor Symptoms in Primary Motor Neurological Disorders: From Molecular Pathways to Clinical and Therapeutic Implications
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Christidi, F. De Micco, R. Ehgoetz Martens, K.A. Moglia, C. Trojsi, F.
- Published
- 2019
18. Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis
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Balint, B, Killaspy, H, Marston, L, Barnes, T, Latorre, A, Joyce, E, Clarke, CS, De Micco, R, Edwards, MJ, Erro, R, Foltynie, T, Hunter, RM, Nolan, F, Schrag, A, Freemantle, N, Foreshaw, Y, Green, N, Bhatia, KP, and Martino, D
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antipsychotics ,Drug interactions and side effects ,clinical neurology ,Papers - Abstract
Background: Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed. Aims: To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses. Method: Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales. Results: Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia. Conclusions: The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia. Declaration of interest: None.
- Published
- 2018
19. Fatigue Severity Scale--Italian Version
- Author
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Siciliano, M., primary, Chiorri, C., additional, De Micco, R., additional, Russo, A., additional, Tedeschi, G., additional, Trojano, L., additional, and Tessitore, A., additional
- Published
- 2019
- Full Text
- View/download PDF
20. Parkinson Fatigue Scale--Italian Version
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Siciliano, M., primary, Chiorri, C., additional, De Micco, R., additional, Russo, A., additional, Tedeschi, G., additional, Trojano, L., additional, and Tessitore, A., additional
- Published
- 2019
- Full Text
- View/download PDF
21. Sensorimotor connectivity in Parkinson's disease: the role of functional neuroimaging
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TESSITORE, Alessandro, Giordano A, De Micco R, RUSSO, Antonio, TEDESCHI, Gioacchino, Tessitore, Alessandro, Giordano, A, De Micco, R, Russo, Antonio, and Tedeschi, Gioacchino
- Published
- 2014
22. OC.02.4: The Role of the Gastroenterologist in Advanced Parkinson’s Disease: Continuous Infusion of Levodopa-Carbidopa by PEG-J Tube
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Apicella, I., primary, De Mase, A., additional, Ormando, V.M., additional, De Micco, R., additional, Ferraro, F., additional, Tessitore, A., additional, Romano, M., additional, and Esposito, P., additional
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- 2017
- Full Text
- View/download PDF
23. Dopaminergic modulation of the resting-state sensori-motor network in drug-naive patients with Parkinson's disease
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De Micco R, TESSITORE, Alessandro, Paccone A, Giordano, A. Giordano A, Pignataro G, Annunziato L, Esposito F, TEDESCHI, Gioacchino, CONFORTI, Renata, De Micco, R, Tessitore, Alessandro, Paccone, A, Giordano, A., Giordano A, Conforti, Renata, Pignataro, G, Annunziato, L, Esposito, F, and Tedeschi, Gioacchino
- Published
- 2013
24. Continuous intra jejunal infusion of levodopa-carbidopa intestinal gel by jejunal extension tube placement through percutaneous endoscopic gastrostomy for patients with advanced Parkinson’s disease: a preliminary study.
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ZULLI, C., SICA, M., DE MICCO, R., DEL PRETE, A., AMATO, M. R., TESSITORE, A., FERRARO, F., and ESPOSITO, P.
- Abstract
OBJECTIVE: Levodopa is the gold standard in the pharmacological treatment of Parkinson’s disease (PD) and its oral administration is associated with the development of disabling motor and non-motor complications in advanced disease. Levodopa is rapidly metabolized and has a short plasma half-life thus requiring frequent, repeated dosing. Impaired gastric emptying is common in PD, and likely contributes to the unpredictable motor responses observed with orally-dosed levodopa. A new therapeutic protocol for patients with advanced PD include a carbidopa/levodopa combination using continuous, modulated enteral administration achieved inserting a Jejunal Extension Tube Placement through Percutaneous Endoscopic Gastrostomy (PEG-J). The aim of this work is to assess efficacy and safety of levodopa-carbidopa intestinal gel (LCIG) delivered continuously through an intrajejunal percutaneous tube (PEG-J). PATIENTS AND METHODS: We enrolled 11 adults with advanced PD and preserved sensitivity to L-dopa. For pre-procedural endoscopic evaluation each patient underwent a diagnostic esophagogastroduodenoscopy (EGD) 7 days before PEG-J placement to evaluate the presence of gastric anatomical or wall anomalies and the presence of oesophageal or gastric varices. Treatment with LCIG, consisting of a waterbased suspension containing micronized levodopa (20 mg/mL) and carbidopa (5 mg/mL) in methylcellulose (Duodopa
® ), was administered by continuous jejunal infusion for 12h/day using a portable pump (CADD-Legacy) by PEG-J. Clinical evaluations were performed at baseline (T0) before LCIG initiation, and after 3 (T3) and 6 (T6) months of therapy. The efficacy and safety out-comes were assessed by using the Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III and IV. RESULTS: Mean age of patients was 71.18 ± 5.4 SD at LCIG initiation. Out of the 11 patients, 2 (18%) dropped-out LCIG at T3. Patients showed statistically significant (p < 0.05) higher performances in activities of daily living and a statistically significant (p < 0.001) lower incidence and severity of motor fluctuations, as rating by UPDRS part IV, compared to their best oral therapy. During observational period, 5 patients experienced adverse events. Success rate for PEG-J placement was 100%. CONCLUSIONS: Our work shows that continuous intrajejunal infusion of LCIG ensures a reduction in motor Fluctuations compared to oral administration of levodopa-carbidopa in advanced PD. Based on our results and on the evidence emerging in the literature, this therapeutic approach should be the gold standard for therapy in these patients. [ABSTRACT FROM AUTHOR]- Published
- 2016
25. Continuous intra jejunal infusion of levodopa-carbidopa intestinal gel by jejunal extension tube placement through percutaneous endoscopic gastrostomy for patients with advanced Parkinson's disease: a preliminary study
- Author
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Claudio Zulli, Sica M, De Micco R, Del Prete A, Amato MR, Tessitore A, Ferraro F, Esposito P, Zulli, C, Sica, M, De Micco, R, DEL PRETE, Armando, Amato, M. R, Tessitore, Alessandro, Ferraro, Fausto, and Esposito, Pasquale
- Subjects
Antiparkinson Agents ,Gastrostomy ,Levodopa ,Drug Combinations ,Activities of Daily Living ,Carbidopa ,Humans ,Parkinson Disease ,Endoscopy, Gastrointestinal ,nervous system diseases - Abstract
Levodopa is the gold standard in the pharmacological treatment of Parkinson's disease (PD) and its oral administration is associated with the development of disabling motor and non-motor complications in advanced disease. Levodopa is rapidly metabolized and has a short plasma half-life thus requiring frequent, repeated dosing. Impaired gastric emptying is common in PD, and likely contributes to the unpredictable motor responses observed with orally-dosed levodopa. A new therapeutic protocol for patients with advanced PD include a carbidopa/levodopa combination using continuous, modulated enteral administration achieved inserting a Jejunal Extension Tube Placement through Percutaneous Endoscopic Gastrostomy (PEG-J). The aim of this work is to assess efficacy and safety of levodopa-carbidopa intestinal gel (LCIG) delivered continuously through an intrajejunal percutaneous tube (PEG-J).We enrolled 11 adults with advanced PD and preserved sensitivity to L-dopa. For pre-procedural endoscopic evaluation each patient underwent a diagnostic esophagogastroduodenoscopy (EGD) 7 days before PEG-J placement to evaluate the presence of gastric anatomical or wall anomalies and the presence of oesophageal or gastric varices. Treatment with LCIG, consisting of a water-based suspension containing micronized levodopa (20 mg/mL) and carbidopa (5 mg/mL) in methylcellulose (Duodopa®), was administered by continuous jejunal infusion for 12h/day using a portable pump (CADD-Legacy) by PEG-J. Clinical evaluations were performed at baseline (T0) before LCIG initiation, and after 3 (T3) and 6 (T6) months of therapy. The efficacy and safety outcomes were assessed by using the Unified Parkinson's Disease Rating Scale (UPDRS) parts II, III and IV.Mean age of patients was 71.18 ± 5.4 SD at LCIG initiation. Out of the 11 patients, 2 (18%) dropped-out LCIG at T3. Patients showed statistically significant (p0.05) higher performances in activities of daily living and a statistically significant (p0.001) lower incidence and severity of motor fluctuations, as rating by UPDRS part IV, compared to their best oral therapy. During observational period, 5 patients experienced adverse events. Success rate for PEG-J placement was 100%.Our work shows that continuous intrajejunal infusion of LCIG ensures a reduction in motor Fluctuations compared to oral administration of levodopa-carbidopa in advanced PD. Based on our results and on the evidence emerging in the literature, this therapeutic approach should be the gold standard for therapy in these patients.
26. Functional Connectomics and Disease Progression in Drug-Naïve Parkinson's Disease Patients
- Author
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Silvia Basaia, Gioacchino Tedeschi, Camilla Cividini, Massimo Filippi, Rosa De Micco, Mattia Siciliano, Federica Agosta, Alessandro Tessitore, De Micco, R., Agosta, F., Basaia, S., Siciliano, M., Cividini, C., Tedeschi, G., Filippi, M., Tessitore, A., De Micco, R, Agosta, F, Basaia, S, Siciliano, M, Cividini, C, Tedeschi, G, Filippi, M, De Micco, Rosa, Agosta, Federica, Basaia, Silvia, Siciliano, Mattia, Cividini, Camilla, Tedeschi, Gioacchino, Filippi, Massimo, and Tessitore, Alessandro
- Subjects
0301 basic medicine ,Connectomics ,Parkinson's disease ,Neural Pathway ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,Neural Pathways ,Basal ganglia ,medicine ,Humans ,drug-naïve ,medicine.diagnostic_test ,business.industry ,connectome ,functional connectivity ,Brain ,biomarkers ,Parkinson Disease ,medicine.disease ,Magnetic Resonance Imaging ,Functional imaging ,Drug-naïve ,030104 developmental biology ,Pharmaceutical Preparations ,Neurology ,Disease Progression ,Connectome ,biomarker ,Neurology (clinical) ,Functional magnetic resonance imaging ,business ,Neuroscience ,030217 neurology & neurosurgery ,Human ,medicine.drug - Abstract
Background Functional brain connectivity alterations may be detectable even before the occurrence of brain atrophy, indicating their potential as early markers of pathological processes. Objective We aimed to determine the whole-brain network topologic organization of the functional connectome in a large cohort of drug-naive Parkinson's disease (PD) patients using resting-state functional magnetic resonance imaging and to explore whether baseline connectivity changes may predict clinical progression. Methods One hundred and forty-seven drug-naive, cognitively unimpaired PD patients were enrolled in the study at baseline and compared to 38 age- and gender-matched controls. Non-hierarchical cluster analysis using motor and non-motor data was applied to stratify PD patients into two subtypes: 77 early/mild and 70 early/severe. Graph theory analysis and connectomics were used to assess global and local topological network properties and regional functional connectivity at baseline. Stepwise multivariate regression analysis investigated whether baseline functional imaging data were predictors of clinical progression over 2 years. Results At baseline, widespread functional connectivity abnormalities were detected in the basal ganglia, sensorimotor, frontal, and occipital networks in PD patients compared to controls. Decreased regional functional connectivity involving mostly striato-frontal, temporal, occipital, and limbic connections differentiated early/mild from early/severe PD patients. Connectivity changes were found to be independent predictors of cognitive progression at 2-year follow-up. Conclusions Our findings revealed that functional reorganization of the brain connectome occurs early in PD and underlies crucial involvement of striatal projections. Connectomic measures may be helpful to identify a specific PD patient subtype, characterized by severe motor and non-motor clinical burden as well as widespread functional connectivity abnormalities. © 2021 International Parkinson and Movement Disorder Society.
- Published
- 2021
27. Skin Biopsy May Help to Distinguish Multiple System Atrophy-Parkinsonism from Parkinson's Disease With Orthostatic Hypotension
- Author
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Gioacchino Tedeschi, Martina Magnani, Rossella Infante, Salvatore Bonvegna, Rosa De Micco, Giovanni Rizzo, Roberto Cilia, Vincenzo Donadio, Francesca Del Sorbo, Rocco Liguori, Alex Incensi, Grazia Devigili, Roberto Eleopra, Luca Vignatelli, Alessandro Tessitore, Corrado Zenesini, Donadio, V, Incensi, A, Rizzo, G, De Micco, R, Tessitore, A, Devigili, G, Del Sorbo, F, Bonvegna, S, Infante, R, Magnani, M, Zenesini, C, Vignatelli, L, Cilia, R, Eleopra, R, Tedeschi, G, Liguori, R., Donadio V., Incensi A., Rizzo G., De Micco R., Tessitore A., Devigili G., Del Sorbo F., Bonvegna S., Infante R., Magnani M., Zenesini C., Vignatelli L., Cilia R., Eleopra R., Tedeschi G., and Liguori R.
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Parkinson's disease ,Biopsy ,misfolded alpha-synuclein ,orthostatic hypotension ,03 medical and health sciences ,Orthostatic vital signs ,Hypotension, Orthostatic ,0302 clinical medicine ,Atrophy ,medicine ,Humans ,skin biopsy ,parkinsonism ,Denervation ,medicine.diagnostic_test ,business.industry ,Parkinsonism ,Parkinson Disease ,Multiple System Atrophy ,medicine.disease ,nervous system diseases ,030104 developmental biology ,nervous system ,Neurology ,Skin biopsy ,alpha-Synuclein ,Neurology (clinical) ,Differential diagnosis ,business ,030217 neurology & neurosurgery ,Immunostaining - Abstract
Background The differential diagnosis between multiple system atrophy parkinsonism type (MSA-P) and Parkinson's disease with orthostatic hypotension (PD+OH) is difficult because the 2 diseases have a similar clinical picture. The aim of this study is to distinguish MSA-P from PD+OH by immunostaining for abnormal phosphorylated α-synuclein at serine 129 (p-syn) in cutaneous nerves. Method We recruited 50 patients with parkinsonism and chronic orthostatic hypotension: 25 patients fulfilled the diagnostic criteria for MSA-P and 25 patients for PD+OH. The patients underwent a skin biopsy from the cervical area, thigh, and leg to analyze somatic and autonomic skin innervation and p-syn in skin nerves. Results Intraneural p-syn positivity was found in 72% of patients with MSA-P, mainly in distal skin sites. More important, p-syn deposits in MSA-P differed from PD+OH because they were mainly found in somatic fibers of subepidermal plexi, whereas scant autonomic fiber involvement was found in only 3 patients. All patients with PD+OH displayed widely distributed p-syn deposits in the autonomic skin fibers of proximal and distal skin sites, whereas somatic fibers were affected only slightly in 4 patients with PD+OH. Skin innervation mirrored p-syn deposits because somatic innervation was mainly reduced in MSA-P. Sympathetic innervation was damaged in PD+OH but fairly preserved in MSA-P. Conclusions The p-syn in cutaneous nerves allows the differentiation of MSA-P from PD+OH; MSA-P mainly shows somatic fiber involvement with relatively preserved autonomic innervation; and by contrast, PD+OH displays prevalent abnormal p-syn deposits and denervation in autonomic postganglionic nerves. © 2020 International Parkinson and Movement Disorder Society.
- Published
- 2020
28. Functional motor disorders associated with other neurological diseases: Beyond the boundaries of 'organic' neurology
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Alessandro Padovani, Alessandra Nicoletti, Angelo Pascarella, Giovanna Calandra-Buonaura, Fabrizio Stocchi, Orsola Gambini, Laura Bonanni, Marcello Esposito, Martina Petracca, Roberto Ceravolo, Sonia Mazzucchi, Sofia Cuoco, Angelo Antonini, Benedetta Demartini, Antonio Pisani, Andrea Pilotto, Elisabetta Zanolin, Roberto Eleopra, Alberto Albanese, Mario Coletti Moja, Luigi Romito, Michele Tinazzi, Elena Antelmi, Francesco Bono, Enrico Marcuzzo, Roberto Erro, Christian Geroin, Tommaso Ercoli, Mario Zappia, Nicola Modugno, Rosa De Micco, Gina Ferrazzano, Enrica Olivola, Francesca Morgante, Leonardo Lopiano, Carlo Dallocchio, Paolo Manganotti, Carla Arbasino, Tinazzi, Michele, Geroin, Christian, Erro, Roberto, Marcuzzo, Enrico, Cuoco, Sofia, Ceravolo, Roberto, Mazzucchi, Sonia, Pilotto, Andrea, Padovani, Alessandro, Romito, Luigi Michele, Eleopra, Roberto, Zappia, Mario, Nicoletti, Alessandra, Dallocchio, Carlo, Arbasino, Carla, Bono, Francesco, Pascarella, Angelo, Demartini, Benedetta, Gambini, Orsola, Modugno, Nicola, Olivola, Enrica, Bonanni, Laura, Antelmi, Elena, Zanolin, Elisabetta, Albanese, Alberto, Ferrazzano, Gina, de Micco, Rosa, Lopiano, Leonardo, Calandra-Buonaura, Giovanna, Petracca, Martina, Esposito, Marcello, Pisani, Antonio, Manganotti, Paolo, Stocchi, Fabrizio, Coletti Moja, Mario, Antonini, Angelo, Ercoli, Tommaso, Morgante, Francesca, Tinazzi, M., Geroin, C., Erro, R., Marcuzzo, E., Cuoco, S., Ceravolo, R., Mazzucchi, S., Pilotto, A., Padovani, A., Romito, L. M., Eleopra, R., Zappia, M., Nicoletti, A., Dallocchio, C., Arbasino, C., Bono, F., Pascarella, A., Demartini, B., Gambini, O., Modugno, N., Olivola, E., Bonanni, L., Antelmi, E., Zanolin, E., Albanese, A., Ferrazzano, G., de Micco, R., Lopiano, L., Calandra-Buonaura, G., Petracca, M., Esposito, M., Pisani, A., Manganotti, P., Stocchi, F., Coletti Moja, M., Antonini, A., Ercoli, T., Morgante, F., and Tinazzi M, Geroin C, Erro R, Marcuzzo E, Cuoco S, Ceravolo R, Mazzucchi S, Pilotto A, Padovani A, Romito LM, Eleopra R, Zappia M, Nicoletti A, Dallocchio C, Arbasino C, Bono F, Pascarella A, Demartini B, Gambini O, Modugno N, Olivola E, Bonanni L, Antelmi E, Zanolin E, Albanese A, Ferrazzano G, de Micco R, Lopiano L, Calandra Buonaura Giovanna, Petracca M, Esposito M, Pisani A, Manganotti P, Stocchi F, Coletti Moja M, Antonini A, Ercoli T, Morgante F.
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Pediatrics ,medicine.medical_specialty ,Neurology ,functional neurological disorders ,organic ,Motor Disorders ,functional dystonia ,functional tremor ,functional weakness ,neurological diseases ,functional weakne ,Disease ,Logistic regression ,03 medical and health sciences ,Humans ,Tremor ,Depressive Disorder, Major ,Movement Disorders ,0302 clinical medicine ,functional neurological disorder ,medicine ,030212 general & internal medicine ,neurological disease ,Depressive Disorder ,business.industry ,Parkinsonism ,Major ,Functional weakness ,Odds ratio ,medicine.disease ,Settore MED/26 - NEUROLOGIA ,Migraine ,Observational study ,Neurology (clinical) ,dystonia ,business ,030217 neurology & neurosurgery - Abstract
Background and purpose\ud The aims of this study were to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases (“comorbid FMDs”), and to compare comorbid FMDs with FMDs not overlapping with other neurological diseases (“pure FMDs”).\ud \ud Methods\ud For this multicenter observational study, we enrolled outpatients with a definite FMD diagnosis attending 25 tertiary movement disorder centers in Italy. Each patient with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Group comparisons (comorbid FMDs vs. pure FMDs) were performed in order to compare demographic and clinical variables. Logistic regression models were created to estimate the adjusted odds ratios (95% confidence intervals) of comorbid FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables).\ud \ud Results\ud Out of 410 FMDs, 21.7% of patients (n = 89) had comorbid FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%), FMDs appeared after the diagnosis of a neurological disease. Patients with comorbid FMDs were older, and more frequently had tremor, non‐neurological comorbidities, paroxysmal non‐epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid FMDs was more likely associated with longer time lag until the final diagnosis of FMD, presence of tremor and non‐neurological comorbidities.\ud \ud Conclusions\ud Our findings highlight the need for prompt diagnosis of FMDs, given the relatively high frequency of associated neurological and non‐neurological diseases.
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- 2020
29. Brain Networks and Cognitive Impairment in Parkinson's Disease
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Giuseppe Sorrentino, Marianna Liparoti, Carmine Granata, Pierpaolo Sorrentino, Emahnuel Troisi Lopez, Anna Lardone, Laura Mandolesi, Alessandro Tessitore, Rosaria Rucco, Rosa De Micco, Rucco, R, Lardone, A, Liparoti, M, Troisi Lopez, E, De Micco, R, Tessitore, A, Granata, C, Mandolesi, L, Sorrentino, G, Sorrentino, P., Rucco, Rosaria, Lardone, Anna, Liparoti, Marianna, Lopez, Emahnuel Troisi, De Micco, Rosa, Tessitore, Alessandro, Granata, Carmine, Mandolesi, Laura, Sorrentino, Giuseppe, and Sorrentino, Pierpaolo
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cognition ,magnetoencephalography ,graph theory ,brain networks topology ,Lateralization of brain function ,Lingual gyrus ,Inferior temporal gyrus ,Humans ,Medicine ,Cognitive Dysfunction ,functional connectivity ,synchrony ,Cognitive decline ,Brain Mapping ,Fusiform gyrus ,medicine.diagnostic_test ,business.industry ,Postcentral gyrus ,General Neuroscience ,Brain ,Montreal Cognitive Assessment ,Parkinson Disease ,Magnetoencephalography ,Magnetic Resonance Imaging ,business ,Neuroscience ,Human - Abstract
Aim: The aim of the present study is to investigate the relationship between both functional connectivity and brain networks with cognitive decline, in patients with Parkinson's disease (PD). Introduction: PD phenotype is not limited to motor impairment but, rather, a wide range of non-motor disturbances can occur, with cognitive impairment being one of the most common. However, how the large-scale organization of brain activity differs in cognitively impaired patients, as opposed to cognitively preserved ones, remains poorly understood. Methods: Starting from source-reconstructed resting-state magnetoencephalography data, we applied the phase linearity measurement (PLM) to estimate functional connectivity, globally and between brain areas, in PD patients with and without cognitive impairment (respectively PD-CI and PD-NC), as compared with healthy subjects (HS). Further, using graph analysis, we characterized the alterations in brain network topology and related these, as well as the functional connectivity, to cognitive performance. Results: We found reduced global and nodal PLM in several temporal (fusiform gyrus, Heschl's gyrus, and inferior temporal gyrus), parietal (postcentral gyrus), and occipital (lingual gyrus) areas within the left hemisphere, in the gamma band, in PD-CI patients, as compared with PD-NC and HS. With regard to the global topological features, PD-CI patients, as compared with HS and PD-NC patients, showed differences in multi-frequencies bands (delta, alpha, gamma) in the Leaf fraction, Tree hierarchy (Th) (both higher in PD-CI), and Diameter (lower in PD-CI). Finally, we found statistically significant correlations between the Montreal Cognitive Assessment test and both the Diameter in delta band and the Th in the alpha band. Conclusion: Our work points to specific large-scale rearrangements that occur selectively in cognitively compromised PD patients and are correlated to cognitive impairment. Impact statement In this article, we want to test the hypothesis that the cognitive decline observed in Parkinson's disease (PD) patients may be related to specific changes of both functional connectivity and brain network topology. Specifically, starting from magnetoencephalography signals and by applying the phase linearity measurement (PLM), a connectivity metric that measures the synchronization between brain regions, we were able to highlight differences in the global and nodal PLM values in PD patients with cognitive impairment as compared with both cognitively unimpaired patients and healthy subjects. Further, using graph analysis, we analyzed alterations in brain network topology that were related to cognitive functioning.
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- 2022
30. Development and Validation of Automated <scp>Magnetic Resonance</scp> Parkinsonism Index 2.0 to Distinguish <scp>Progressive Supranuclear Palsy‐Parkinsonism</scp> From <scp>Parkinson's Disease</scp>
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Andrea Quattrone, Maria G. Bianco, Angelo Antonini, David E. Vaillancourt, Klaus Seppi, Roberto Ceravolo, Antonio P. Strafella, Gioacchino Tedeschi, Alessandro Tessitore, Roberto Cilia, Maurizio Morelli, Salvatore Nigro, Basilio Vescio, Pier Paolo Arcuri, Rosa De Micco, Mario Cirillo, Luca Weis, Eleonora Fiorenzato, Roberta Biundo, Roxana G. Burciu, Florian Krismer, Nikolaus R. McFarland, Christoph Mueller, Elke R. Gizewski, Mirco Cosottini, Eleonora Del Prete, Sonia Mazzucchi, Aldo Quattrone, Quattrone, A., Bianco, M. G., Antonini, A., Vaillancourt, D. E., Seppi, K., Ceravolo, R., Strafella, A. P., Tedeschi, G., Tessitore, A., Cilia, R., Morelli, M., Nigro, S., Vescio, B., Arcuri, P. P., De Micco, R., Cirillo, M., Weis, L., Fiorenzato, E., Biundo, R., Burciu, R. G., Krismer, F., Mcfarland, N. R., Mueller, C., Gizewski, E. R., Cosottini, M., Del Prete, E., and Mazzucchi, S.
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Magnetic Resonance Spectroscopy ,Parkinson's disease ,Magnetic Resonance Parkinsonism Index 2.0 ,Parkinson Disease ,automated MRI biomarker ,progressive supranuclear palsy-parkinsonism ,Magnetic Resonance Imaging ,eye diseases ,Diagnosis, Differential ,Parkinsonian Disorders ,Neurology ,Humans ,Paralysis ,Supranuclear Palsy, Progressive ,Neurology (clinical) - Abstract
Background: Differentiating progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) is clinically challenging. Objective: This study aimed to develop an automated Magnetic Resonance Parkinsonism Index 2.0 (MRPI 2.0) algorithm to distinguish PSP-P from PD and to validate its diagnostic performance in two large independent cohorts. Methods: We enrolled 676 participants: a training cohort (n=346; 43 PSP-P, 194 PD, and 109 control subjects) from our center and an independent testing cohort (n=330; 62 PSP-P, 171 PD, and 97 control subjects) from an international research group. We developed a new in-house algorithm for MRPI 2.0 calculation and assessed its performance in distinguishing PSP-P from PD and control subjects in both cohorts using receiver operating characteristic curves. Results: The automated MRPI 2.0 showed excellent performance in differentiating patients with PSP-P from patients with PD and control subjects both in the training cohort (area under the receiver operating characteristic curve [AUC]=0.93 [95% confidence interval, 0.89–0.98] and AUC=0.97 [0.93–1.00], respectively) and in the international testing cohort (PSP-P versus PD, AUC=0.92 [0.87–0.97]; PSP-P versus controls, AUC=0.94 [0.90–0.98]), suggesting the generalizability of the results. The automated MRPI 2.0 also accurately distinguished between PSP-P and PD in the early stage of the diseases (AUC=0.91 [0.84–0.97]). A strong correlation (r=0.91, P < 0.001) was found between automated and manual MRPI 2.0 values. Conclusions: Our study provides an automated, validated, and generalizable magnetic resonance biomarker to distinguish PSP-P from PD. The use of the automated MRPI 2.0 algorithm rather than manual measurements could be important to standardize measures in patients with PSP-P across centers, with a positive impact on multicenter studies and clinical trials involving patients from different geographic regions. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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- 2022
31. Rhythm-specific modulation of the sensorimotor network in drug-naive patients with Parkinson's disease by levodopa
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Gioacchino Tedeschi, Rosita De Micco, Antonella Paccone, Renta Conforti, Giuseppe Pignataro, Fabrizio Esposito, Alessandro Tessitore, Alfonso Giordano, Lucio Annunziato, Cognitive Neuroscience, RS: FPN CN 1, Esposito, F, Tessitore, A, Giordano, A, De Micco, R, Paccone, A, Conforti, R, Pignataro, Giuseppe, Annunziato, Lucio, Tedeschi, G., Tessitore, Alessandro, DE MICCO, R, Conforti, Renata, Pignataro, G, Annunziato, L, and Tedeschi, Gioacchino
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Male ,Levodopa ,Parkinson's disease ,EXTERNALLY TRIGGERED MOVEMENTS ,Rest ,resting-state functional magnetic resonance imaging ,POSITRON EMISSION TOMOGRAPHY ,sensorimotor network ,Antiparkinson Agents ,Neural Pathway ,Double-Blind Method ,Neural Pathways ,medicine ,Humans ,levodopa ,IMAGE-ANALYSIS ,MOTOR CORTEX ,Aged ,RESTING-STATE NETWORKS ,medicine.diagnostic_test ,Supplementary motor area ,INDEPENDENT COMPONENT ANALYSIS ,motor function ,Brain ,Magnetic resonance imaging ,Human brain ,FUNCTIONAL CONNECTIVITY ,Middle Aged ,medicine.disease ,HUMAN BRAIN ,Magnetic Resonance Imaging ,nervous system diseases ,Parkinson disease ,Drug-naïve ,medicine.anatomical_structure ,Antiparkinson Agent ,FMRI ,CEREBRAL-BLOOD-FLOW ,Female ,Neurology (clinical) ,Psychology ,Functional magnetic resonance imaging ,Neuroscience ,Human ,medicine.drug ,Motor cortex - Abstract
Brain activity during rest is characterized by slow (0.01–0.1 Hz) fluctuations of blood oxygenation level-dependent functional magnetic resonance imaging signals. These fluctuations are organized as functional connectivity networks called resting-state networks, anatomically corresponding to specific neuronal circuits. As Parkinson’s disease is mainly characterized by a dysfunction of the sensorimotor pathways, which can be influenced by levodopa administration, the present study investigated the functional connectivity changes within the sensorimotor resting-state network in drug-naı¨ve patients with Parkinson’s disease after acute levodopa administration. Using a double-blind placebo-controlled design, resting-state functional magnetic resonance imaging was carried out in 20 drug-naı¨ve patients with Parkinson’s disease, immediately before and 60 min after, oral administration of either levodopa or placebo. Control resting-state functional magnetic resonance imaging data were recorded in 18 age- and sex-matched healthy volunteers. Independent component analysis was performed to extract resting-state network maps and associated time-course spectral features. At the anatomical level, levodopa enhanced the sensorimotor network functional connectivity in the supplementary motor area, a region where drug-naı¨ve patients with Parkinson’s disease exhibited reduced signal fluctuations compared with untreated patients. At the spectral frequency level, levodopa stimulated these fluctuations in a selective frequency band of the sensorimotor network. The reported effects induced by levodopa on sensorimotor network topological and spectral features confirm that the sensorimotor system is a target of acute levodopa administration in drug-naı¨ve patients with Parkinson’s disease. Moreover, while the regional changes in supplementary motor area reflect the functional improvement in motor function, the rhythm-specific modulation induced by the dopamine precursor discloses a novel aspect of pharmacological stimulation in Parkinson’s disease, adding further insight to the comprehension of levodopa action
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- 2013
32. Distinctive Handwriting Signs in Early Parkinson’s Disease
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Rosa Senatore, Angelo Marcelli, Rosa De Micco, Alessandro Tessitore, Hans-Leo Teulings, Senatore, R., Marcelli, A., De Micco, R., Tessitore, A., and Teulings, H. -L.
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Fluid Flow and Transfer Processes ,handwriting analysi ,diagnostic protocol ,Process Chemistry and Technology ,Parkinson's disease ,General Engineering ,General Materials Science ,Instrumentation ,Computer Science Applications - Abstract
Featured Application This work identifies a set of distinctive signs in handwriting movement performed by patients in the early stage of PD. The analysis here performed can be used for the design of a diagnostic protocol, comprising specific handwriting motor tasks. The analysis of specific features, depending on the task examined, could provide clinicians with a useful tool for supporting the early clinical diagnosis of the disease. Background: The analysis of handwriting movements to quantify motor and cognitive impairments in neurodegenerative diseases is increasingly attracting interest. Non-invasive and quick-to-administer tools using handwriting movement analysis can be used in early screening of Parkinson's disease (PD) and maybe in the diagnosis of other neurodegenerative disease. Theaim of this work is to identify the distinctive signs characterizing handwriting in the early stage of PD, in order to provide a diagnostic tool for the early detection of the disease. Compared to previous studies, here, we analyzed handwriting movements of patients on which the disease affects the contralateral side with respect to the one used for writing. Methods: We collected and analyzed a set of handwriting samples by PD patients and healthy subjects. Participants were asked to follow a novel protocol, containing handwriting patterns of various levels of complexity, using both familiar and unfamiliar movements. Results: We found that the signs characterizing the early stage of PD differ from those appearing in later stages. Our work provides evidence that early detection of PD, even when the disease affects mainly the contralateral side with respect to the one used for writing, could be achieved by analyzing specific features measured during the execution of specific handwriting tasks. Eventually, we found that patients' performance benefits from the execution of handwriting in specific conditions. Conclusions: The analysis provides the guidelines for the design of a diagnostic tool for the early detection of PD and some suggestions for reducing motor impairments in PD patients.
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- 2022
33. Functional Connectivity Signatures of Parkinson’s Disease
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Rosa De Micco, Mario Cirillo, Alessandro Tessitore, Tessitore, A., Cirillo, M., and De Micco, R.
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0301 basic medicine ,Parkinson's disease ,Review ,Disease ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Neural Pathways ,Humans ,Medicine ,Functional MRI ,Brain Mapping ,Neural correlates of consciousness ,medicine.diagnostic_test ,business.industry ,Functional connectivity ,resting-state networks ,Brain ,imaging ,biomarkers ,Parkinson Disease ,medicine.disease ,Magnetic Resonance Imaging ,Clinical trial ,030104 developmental biology ,Disease Progression ,Parkinson’s disease ,biomarker ,Narrative review ,Neurology (clinical) ,business ,Functional magnetic resonance imaging ,Neuroscience ,030217 neurology & neurosurgery ,Clinical progression - Abstract
Resting-state functional magnetic resonance imaging (RS-fMRI) studies have been extensively applied to analyze the pathophysiology of neurodegenerative disorders such as Parkinson’s disease (PD). In the present narrative review, we attempt to summarize the most recent RS-fMRI findings highlighting the role of brain networks re-organization and adaptation in the course of PD. We also discuss limitations and potential definition of early functional connectivity signatures to track and predict future PD progression. Understanding the neural correlates and potential predisposing factors of clinical progression and complication will be crucial to guide novel clinical trials and to foster preventive strategies.
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- 2019
34. Flexible brain dynamics underpins complex behaviours as observed in Parkinson’s disease
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Leonardo L Gollo, Rosaria Rucco, Laura Mandolesi, Giuseppe Sorrentino, Rosa De Micco, Michael Breakspear, Pierpaolo Sorrentino, Arjan Hillebrand, Fabio Baselice, Alessandro Tessitore, Neurology, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Systems & Network Neuroscience, Sorrentino, Pierpaolo, Rucco, Rosaria, Baselice, Fabio, De Micco, Rosa, Tessitore, Alessandro, Hillebrand, Arjan, Mandolesi, Laura, Breakspear, Michael, Gollo, Leonardo L, Sorrentino, Giuseppe, Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli Studi di Napoli 'Parthenope' = University of Naples (PARTHENOPE), QIMR Berghofer Medical Research Institute, Sorrentino, P, Rucco, R, Baselice, F, De Micco, R, Tessitore, A, Hillebrand, A, Mandolesi, L, Breakspear, M, Gollo, Ll, and Sorrentino, G
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Male ,0301 basic medicine ,Parkinson's disease ,Brain activity and meditation ,Science ,Neuroimaging ,Disease ,Article ,Basal Ganglia ,03 medical and health sciences ,0302 clinical medicine ,Neuronal communication ,Basal ganglia ,medicine ,Humans ,Multidisciplinary ,Cognitive Symptoms ,medicine.diagnostic_test ,business.industry ,[SCCO.NEUR]Cognitive science/Neuroscience ,Brain ,Case-Control Studies ,Female ,Magnetic Resonance Imaging ,Magnetoencephalography ,Middle Aged ,Parkinson Disease ,Patient Acuity ,Flexibility (personality) ,medicine.disease ,030104 developmental biology ,Neurology ,Medicine ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Rapid reconfigurations of brain activity support efficient neuronal communication and flexible behaviour. Suboptimal brain dynamics is associated to impaired adaptability, possibly leading to functional deficiencies. We hypothesize that impaired flexibility in brain activity can lead to motor and cognitive symptoms of Parkinson’s disease (PD). To test this hypothesis, we studied the ‘functional repertoire’—the number of distinct configurations of neural activity—using source-reconstructed magnetoencephalography in PD patients and controls. We found stereotyped brain dynamics and reduced flexibility in PD. The intensity of this reduction was proportional to symptoms severity, which can be explained by beta-band hyper-synchronization. Moreover, the basal ganglia were prominently involved in the abnormal patterns of brain activity. Our findings support the hypotheses that: symptoms in PD relate to impaired brain flexibility, this impairment preferentially involves the basal ganglia, and beta-band hypersynchronization is associated with reduced brain flexibility. These findings highlight the importance of extensive functional repertoires for correct behaviour.
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- 2021
35. Correlates of the discrepancy between objective and subjective cognitive functioning in non-demented patients with Parkinson's disease
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Mattia Siciliano, Alfonso Giordano, Antonio Russo, Carlo Chiorri, Gioacchino Tedeschi, Rosa De Micco, L. Trojano, Luca Passamonti, Valeria Sant'Elia, Alessandro Tessitore, Passamonti, Luca [0000-0002-7937-0615], Apollo - University of Cambridge Repository, Siciliano, M., Trojano, L., De Micco, R., Sant'Elia, V., Giordano, A., Russo, A., Passamonti, L., Tedeschi, G., Chiorri, C., and Tessitore, A.
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Parkinson's disease ,Neuropsychological Tests ,Logistic regression ,050105 experimental psychology ,03 medical and health sciences ,0302 clinical medicine ,Cognition ,Cognitive impairment ,Depression ,Fatigue ,Mild cognitive impairment ,Subjective cognitive decline ,Rating scale ,medicine ,Humans ,0501 psychology and cognitive sciences ,Cognitive Dysfunction ,Cognitive skill ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Original Communication ,business.industry ,05 social sciences ,Beck Depression Inventory ,Montreal Cognitive Assessment ,Parkinson Disease ,medicine.disease ,Neurology ,Neurology (clinical) ,business ,Cognition Disorders ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p p p p Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting.
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- 2021
36. Advanced visual network and cerebellar hyperresponsiveness to trigeminal nociception in migraine with aura
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Antonio Russo, Alessandro Tessitore, Francesca Trojsi, Marcello Silvestro, Federica Di Nardo, Rosa De Micco, Gioacchino Tedeschi, Teresa Del Santo, Fabrizio Esposito, Russo, A., Tessitore, A., Silvestro, M., Di Nardo, F., Trojsi, F., Del Santo, T., De Micco, R., Esposito, F., and Tedeschi, G.
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Male ,Nociception ,Cerebellum ,Aura ,Migraine with Aura ,lcsh:Medicine ,Trigeminal Nuclei ,Lingual gyrus ,Random Allocation ,0302 clinical medicine ,Thalamus ,Neural Pathways ,Visual Pathway ,030212 general & internal medicine ,Prospective Studies ,CHEPS ,Pain Measurement ,Visual Cortex ,fMRI ,Migraine, fMRI, Aura, CHEPS, Cerebellum ,General Medicine ,Middle Aged ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Female ,medicine.symptom ,Human ,Research Article ,Adult ,Inferior frontal gyrus ,Pain ,Neural Pathway ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Visual Pathways ,Thalamu ,Migraine ,Sensory gating ,business.industry ,lcsh:R ,Medial frontal gyrus ,medicine.disease ,Migraine with aura ,Prospective Studie ,Anesthesiology and Pain Medicine ,nervous system ,Neurology (clinical) ,Nerve Net ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Background Despite the growing body of advanced studies investigating the neuronal correlates of pain processing in patients with migraine without aura (MwoA), only few similar studies have been conducted in patients with migraine with aura (MwA). Therefore, we aimed to explore the functional brain response to trigeminal noxious heat stimulation in patients with MwA. Methods Seventeen patients with MwA and 15 age- and sex-matched healthy controls (HC) underwent whole-brain blood oxygen level–dependent (BOLD) fMRI during trigeminal noxious heat stimulation. To examine the specificity of any observed differences between patients with MwA and HC, the functional response of neural pathways to trigeminal noxious heat stimulation in patients with MwA was compared with 18 patients with MwoA. Secondary analyses investigated the correlations between BOLD signal changes and clinical parameters of migraine severity. Results We observed a robust cortical and subcortical pattern of BOLD response to trigeminal noxious heat stimulation across all participants. Patients with MwA showed a significantly increased activity in higher cortical areas known to be part of a distributed network involved in advanced visual processing, including lingual gyrus, inferior parietal lobule, inferior frontal gyrus and medial frontal gyrus. Moreover, a significantly greater cerebellar activation was observed in patients with MwA when compared with both patients with MwA and HC. Interestingly, no correlations were found between migraine severity parameters and magnitude of BOLD response in patients with MwA. Conclusion Our findings, characterized by abnormal visual pathway response to trigeminal noxious heat stimulation, support the role of a functional integration between visual and trigeminal pain networks in the pathophysiological mechanisms underlying migraine with aura. Moreover, they expand the concept of “neurolimbic-pain network” as a model of MwoA including both limbic dysfunction and cortical dys-excitability. Indeed, we suggest a model of “neurolimbic-visual-pain network” in MwA patients, characterized by dysfunctional correlations between pain-modulating circuits not only with the cortical limbic areas but with advanced visual areas as well. Furthermore, the abnormal cerebellar response to trigeminal noxious heat stimulation may suggest a dysfunctional cerebellar inhibitory control on thalamic sensory gating, impinging on the advanced visual processing cortical areas in patients with MwA. Electronic supplementary material The online version of this article (10.1186/s10194-019-1002-3) contains supplementary material, which is available to authorized users.
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- 2019
37. The psychological correlates of fatigue in Parkinson's disease: Contribution of maladaptive metacognitive beliefs
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Mattia Siciliano, L. Trojano, Alessandro Tessitore, Rosa De Micco, Luca Passamonti, Valeria Sant'Elia, Gioacchino Tedeschi, Carlo Chiorri, Alfonso Giordano, Antonio Russo, Siciliano, M., De Micco, R., Trojano, L., Sant'Elia, V., Giordano, A., Russo, A., Passamonti, L., Tedeschi, G., Chiorri, C., and Tessitore, A.
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Male ,Nonmotor symptom ,Future studies ,Parkinson's disease ,Metacognitive belief ,Culture ,Metacognition ,Disease ,Adaptation, Psychological ,Fatigue ,Metacognitions ,Metacognitive beliefs ,Nonmotor symptoms ,Humans ,Medicine ,Association (psychology) ,Aged ,business.industry ,Parkinson Disease ,Cognition ,Middle Aged ,medicine.disease ,Self Concept ,Psychological correlates ,Neurology ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,Multivariate statistical ,business ,Clinical psychology - Abstract
Introduction: Psychological factors can underlie fatigue in neurological disorders, but its relationship to fatigue in Parkinson's disease (PD) has not been explored. We assessed the association between maladaptive metacognitive beliefs and presence of fatigue in PD. Methods: Ninety-eight consecutive outpatients with PD (61% male; median age: 66.50 years) were assessed in terms of demographic, clinical, medication treatment, cognitive, or behavioural characteristics including metacognitive beliefs (Metacognitions Questionnaire-30 or MCQ). Fatigue was ascertained by PD-related diagnostic criteria. Univariate statistical approach (Mann-Whitney and Pearson chi-square tests) was used to compare PD patients with (f-PD) or without (nf-PD) fatigue in terms of demographic, clinical, medication treatment, cognitive, behavioural, and metacognitive measures. Results: Twenty-one PD patients (21%) displayed fatigue. The f-PD group scored higher on the MCQ-total score, MCQ-Cognitive Confidence subscale, and all behavioral measures (ps < 0.01) relative to nf-PD. They also had a more advanced Hoehn and Yahr stage and Unified Parkinson's Disease Rating Scale-III score. Conclusion: Maladaptive metacognitive beliefs such as the lack of cognitive confidence may play a key role to trigger and maintain fatigue in PD. Future studies, using a multivariate statistical approach, are needed to confirm these preliminary findings in a larger sample of patients with fatigue and to assess if modification of such metacognitive beliefs has the potential to ameliorate fatigue in PD.
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- 2021
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38. Functional motor phenotypes: to lump or to split?
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Laura Bonanni, Roberto Ceravolo, Mario Zappia, Sofia Cuoco, Enrico Marcuzzo, Giovanna Calandra-Buonaura, Alberto Albanese, Martina Petracca, Gina Ferrazzano, Francesco Bono, Alessandra Nicoletti, Benedetta Demartini, Rosa De Micco, Nicola Modugno, Enrica Olivola, Roberto Eleopra, Carlo Dallocchio, Paolo Manganotti, Antonio Pisani, Lucia Tesolin, Alessandro Padovani, Christian Geroin, Carla Arbasino, Luigi Romito, Leonardo Lopiano, Sonia Mazzucchi, Francesca Morgante, Elisabetta Zanolin, Francesco Teatini, Andrea Pilotto, Tommaso Ercoli, Michele Tinazzi, Marcello Esposito, Roberto Erro, Orsola Gambini, Giuseppe Magro, Tinazzi, Michele, Geroin, Christian, Marcuzzo, Enrico, Cuoco, Sofia, Ceravolo, Roberto, Mazzucchi, Sonia, Pilotto, Andrea, Padovani, Alessandro, Romito, Luigi Michele, Eleopra, Roberto, Zappia, Mario, Nicoletti, Alessandra, Dallocchio, Carlo, Arbasino, Carla, Bono, Francesco, Magro, Giuseppe, Demartini, Benedetta, Gambini, Orsola, Modugno, Nicola, Olivola, Enrica, Bonanni, Laura, Zanolin, Elisabetta, Albanese, Alberto, Ferrazzano, Gina, De Micco, Rosa, Lopiano, Leonardo, Calandra-Buonaura, Giovanna, Petracca, Martina, Esposito, Marcello, Pisani, Antonio, Manganotti, Paolo, Tesolin, Lucia, Teatini, Francesco, Ercoli, Tommaso, Morgante, Francesca, Erro, Roberto, Tinazzi M., Geroin C., Marcuzzo E., Cuoco S., Ceravolo R., Mazzucchi S., Pilotto A., Padovani A., Romito L.M., Eleopra R., Zappia M., Nicoletti A., Dallocchio C., Arbasino C., Bono F., Magro G., Demartini B., Gambini O., Modugno N., Olivola E., Bonanni L., Zanolin E., Albanese A., Ferrazzano G., De Micco R., Lopiano L., Calandra Buonaura G., Petracca M., Esposito M., Pisani A., Manganotti P., Tesolin L., Teatini F., Ercoli T., Morgante F., and Erro R.
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Psychogenic movement disorder ,medicine.medical_specialty ,Weakness ,Neurology ,03 medical and health sciences ,0302 clinical medicine ,Acute onset ,Physical medicine and rehabilitation ,Functional dystonia ,Functional neurological disorders ,Functional tremor ,Functional weakness ,Non-motor features ,Psychogenic movement disorders ,Tremor ,medicine ,Humans ,Gait disorders ,Sensory symptoms ,Neuroradiology ,Dystonia ,Original Communication ,Movement Disorders ,business.industry ,Phenotype ,Dystonic Disorders ,Dystonic Disorder ,Functional weakne ,medicine.disease ,030227 psychiatry ,Neurology (clinical) ,medicine.symptom ,Functional neurological disorder ,business ,Non-motor feature ,030217 neurology & neurosurgery ,Human - Abstract
Introduction Functional motor disorders (FMDs) are usually categorized according to the predominant phenomenology; however, it is unclear whether this phenotypic classification mirrors the underlying pathophysiologic mechanisms. Objective To compare the characteristics of patients with different FMDs phenotypes and without co-morbid neurological disorders, aiming to answer the question of whether they represent different expressions of the same disorder or reflect distinct entities. Methods Consecutive outpatients with a clinically definite diagnosis of FMDs were included in the Italian registry of functional motor disorders (IRFMD), a multicenter data collection platform gathering several clinical and demographic variables. To the aim of the current work, data of patients with isolated FMDs were extracted. Results A total of 176 patients were included: 58 with weakness, 40 with tremor, 38 with dystonia, 23 with jerks/facial FMDs, and 17 with gait disorders. Patients with tremor and gait disorders were older than the others. Patients with functional weakness had more commonly an acute onset (87.9%) than patients with tremor and gait disorders, a shorter time lag from symptoms onset and FMDs diagnosis (2.9 ± 3.5 years) than patients with dystonia, and had more frequently associated functional sensory symptoms (51.7%) than patients with tremor, dystonia and gait disorders. Patients with dystonia complained more often of associated pain (47.4%) than patients with tremor. No other differences were noted between groups in terms of other variables including associated functional neurological symptoms, psychiatric comorbidities, and predisposing or precipitating factors. Conclusions Our data support the evidence of a large overlap between FMD phenotypes.
- Published
- 2021
39. Supplementary motor area functional connectivity in 'drug-naïve' Parkinson's disease patients with fatigue
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Rosa De Micco, Federica Di Nardo, Mattia Siciliano, Alfonso Giordano, Alessandro Tessitore, Antonio Russo, Antonio De Mase, Mario Cirillo, Gioacchino Tedeschi, Luigi Trojano, Giuseppina Caiazzo, Siciliano, M., De Micco, R., Giordano, A., Di Nardo, F., Russo, A., Caiazzo, G., De Mase, A., Cirillo, M., Tedeschi, G., Trojano, L., and Tessitore, A.
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0301 basic medicine ,Nonmotor symptom ,medicine.medical_specialty ,Parkinson's disease ,Neurology ,computer.software_genre ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Voxel ,Neuromodulation ,medicine ,Humans ,Parkinson ,Biological Psychiatry ,Fatigue ,Brain Mapping ,Supplementary motor area ,business.industry ,Functional connectivity ,Motor Cortex ,Parkinson Disease ,medicine.disease ,SMA ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,Drug-naïve ,030104 developmental biology ,medicine.anatomical_structure ,Pharmaceutical Preparations ,De novo ,Neurology (clinical) ,business ,computer ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Fatigue is a common and disabling nonmotor manifestation in patients with Parkinson’s disease (PD), and the supplementary motor area (SMA) has been implicated in its pathophysiology. SMA is usually divided in its rostro-caudal axis, with the rostral (pre-) SMA playing a major role in motor planning, and the caudal (proper) SMA related to movement execution. To investigate brain functional connectivity of SMA subregions in de novo, drug-naïve PD patients affected by fatigue, 17patients with fatigue, 18 without fatigue, and 16 matched healthy controls were recruited. All the participants were not depressed and did not suffer from daytime sleepiness. Parkinson Fatigue Scale (PFS) was used for fatigue screening (cut-off > 3.3 points) and severity rating. Seed-based resting-state functional MRI was used to compare the functional connectivity from bilateral SMA subregions to the whole brain. Voxel-based morphometry analysis was employed to test whether functional connectivity results were related to brain structural differences. PD-related fatigue was associated with an increased connectivity between the left pre-SMA and the left postcentral gyrus as well as a decreased connectivity between the left SMA proper and the left middle frontal gyrus (ps < 0.01). These patterns of functional connectivity were tightly correlated with PFS scores (Pearson’s rs < 0.01). No structural brain changes were observed. In early PD, altered functional connectivity of both SMA subregions might play a crucial role in fatigue pathophysiology. These results offer new insights into the mechanisms responsible for fatigue in PD, suggesting possible targets for neuromodulation strategies oriented to modulate the SMA activity.
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- 2020
40. Subjective memory decline in Parkinson's disease patients with and without fatigue
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Rosa De Micco, Antonio Russo, Alessandro Tessitore, Gioacchino Tedeschi, Mattia Siciliano, Luigi Trojano, Siciliano, M., Trojano, L., De Micco, R., Russo, A., Tedeschi, G., and Tessitore, A.
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0301 basic medicine ,Male ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Disease ,Logistic regression ,Severity of Illness Index ,03 medical and health sciences ,Diagnostic Self Evaluation ,0302 clinical medicine ,Physical medicine and rehabilitation ,Rating scale ,Memory ,Medicine ,Humans ,Effects of sleep deprivation on cognitive performance ,Fatigue ,Aged ,Memory Disorders ,Subjective memory complaints ,medicine.diagnostic_test ,business.industry ,Cognition ,Parkinson Disease ,Neuropsychological test ,Middle Aged ,medicine.disease ,030104 developmental biology ,Neurology ,Subjective cognitive decline ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,Cognition Disorders ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Introduction: Previous studies on Parkinson's disease (PD) have shown that memory complaints and fatigue co-occur since premotor stages of disease, but whether Subjective Memory Decline (SMD, defined as memory complaints with normal objective cognitive performance) and fatigue were associated in PD has not been explored yet. Methods: One-hundred PD patients underwent measures of memory complaints (Multifactorial Memory Questionnaire, MMQ), neuropsychological test (Parkinson's Disease-Cognitive Rating Scale), and assessment of behavioural symptoms. Fatigue was diagnosed according to current diagnostic criteria. Mann-Whitney test or Pearson chi-square test were used to compare fatigued and nonfatigued patients for prevalence of SMD and for demographic, clinical, and behavioural features, memory complaint, and objective cognitive measures. The confounding effect of sample's features on results was controlled by logistic regression and Quade's rank analysis. Results: Twenty-three patients were diagnosed as fatigued whereas 15 patients met SMD criteria. Fatigued patients showed higher levodopa equivalent daily dose and more marked behavioural symptoms than nonfatigued patients (ps < 0.01). The prevalence of SMD was higher in fatigued patients than in those nonfatigued (35% vs 9%, p < 0.01). After controlling for confounds, the patients with fatigue had an odds ratio for SMD 5.97 [CI 95%, 1.18–30.03] times higher and presented significantly lower scores on Contentment subscales of MMQ (p < 0.01) than those without fatigue. Conclusion: Fatigue in PD is associated with SMD mainly characterized by less contentment with one's own memory ability. These findings suggest possible shared pathogenic mechanisms underlying these two nonmotor manifestations and foster to identify potential phenotypes of patients requiring multistrategic therapeutic approaches.
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- 2020
41. Predictors of fatigue severity in early, de novo Parkinson disease patients: A 1-year longitudinal study
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Mattia Siciliano, G. Tedeschi, Alessandro Tessitore, Antonio Russo, R. De Micco, Alfonso Giordano, Carlo Chiorri, L. Trojano, Siciliano, M., Trojano, L., De Micco, R., Giordano, A., Russo, A., Tedeschi, G., Chiorri, C., and Tessitore, A.
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0301 basic medicine ,Male ,Longitudinal study ,medicine.medical_specialty ,de novo ,Nonmotor symptom ,Nonmotor symptoms ,Sleepiness ,Apathy ,Excessive daytime sleepiness ,Disease ,Severity of Illness Index ,Fatigue ,Prospective study ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Longitudinal Studies ,Prospective cohort study ,Aged ,business.industry ,Epworth Sleepiness Scale ,Neuropsychology ,Beck Depression Inventory ,Parkinson Disease ,Middle Aged ,Prognosis ,030104 developmental biology ,Neurology ,Disease Progression ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction: Fatigue is one of the most common and disabling nonmotor symptom in Parkinson's disease (PD). The aim of the present study was to investigate the 1-year course of fatigue in a consecutive sample of de novo drug-naïve patients with PD, and at systematically searching for baseline motor and nonmotor predictors associated with fatigue severity over time. Methods: Fifty-five consecutive de novo PD patients (age: 64.71 ± 7.74 years) underwent a comprehensive examination, including Parkinson Fatigue Scale, Epworth Sleepiness Scale, Parkinson's Disease Sleep Scale, Beck Depression Inventory, Parkinson's Anxiety Scale, Apathy Evaluation Scale, and an extensive neuropsychological evaluation. Bivariate and multiple regression analyses were performed to identify baseline predictors independently related to fatigue severity at 1-year follow-up. Results: Prevalence rate of fatigue (defined by PFS cut-off) increased from 22% at baseline to 38% at 1-year follow-up. A similar increase in prevalence was observed for excessive daytime sleepiness, and apathy. Among patients with fatigue at baseline, 91% had fatigue at follow-up too (i.e., persistent fatigue). Multivariate regression analysis identified fatigue (p < 0.01), daytime sleepiness (p < 0.01), and emotional apathy (p < 0.01) as the main baseline variables significantly predicting fatigue severity at 1-year follow-up. Conclusion: In early PD, fatigue increases and persists over time, and its severity is related to higher baseline levels of fatigue, excessive daytime sleepiness, and emotional apathy. These results warrant to monitor fatigue since the early stage of disease, and suggest that treating excessive daytime sleepiness and emotional apathy might prevent its worsening.
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- 2020
42. Connectivity Correlates of Anxiety Symptoms in Drug-Naive Parkinson's Disease Patients
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Alfonso Giordano, Alessandro Tessitore, Gioacchino Tedeschi, Giuseppina Caiazzo, Rosa De Micco, Fabrizio Esposito, Federica Di Nardo, Mattia Siciliano, Sara Satolli, Antonio Russo, De Micco, R., Satolli, S., Siciliano, M., Di Nardo, F., Caiazzo, G., Russo, A., Giordano, A., Esposito, F., Tedeschi, G., and Tessitore, A.
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0301 basic medicine ,medicine.medical_specialty ,Parkinson's disease ,drug naive ,Disease ,Audiology ,03 medical and health sciences ,0302 clinical medicine ,anxiety ,magnetic resonance imaging ,resting-state networks ,Neural Pathways ,medicine ,Humans ,Brain Mapping ,medicine.diagnostic_test ,business.industry ,Neuropsychology ,Brain ,Cognition ,Magnetic resonance imaging ,Parkinson Disease ,medicine.disease ,Drug-naïve ,030104 developmental biology ,Neurology ,Pharmaceutical Preparations ,Anxiety ,Neurology (clinical) ,medicine.symptom ,Functional magnetic resonance imaging ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background Anxiety symptoms are common in Parkinson's disease (PD). A link between anxiety and cognitive impairment in PD has been demonstrated. Objectives Using resting-state functional magnetic resonance imaging, we investigated intrinsic brain network connectivity correlates of anxiety symptoms in a cohort of drug-naive, cognitively unimpaired patients with PD. Methods The intrinsic functional brain connectivity of 25 drug-naive, cognitively unimpaired PD patients with anxiety, 25 without anxiety, and 20 matched healthy controls was compared. All patients underwent a detailed behavioral and neuropsychological evaluation. Anxiety presence and severity were assessed using the Parkinson's Disease Anxiety Scale. Single-subject and group-level independent component analyses were used to investigate functional connectivity differences within and between the major resting-state networks. Results Decreased connectivity within the default-mode and sensorimotor networks (SMN), increased connectivity within the executive-control network (ECN), and divergent connectivity measures within salience and frontoparietal networks (SN and FPN) were detected in PD patients with anxiety compared with those without anxiety. Moreover, patients with anxiety showed a disrupted inter-network connectivity between SN and SMN, ECN, and FPN. Anxiety severity was correlated with functional abnormalities within these networks. Conclusions Our findings demonstrated that an abnormal intrinsic connectivity within and between the most reported large-scale networks may represent a potential neural correlate of anxiety symptoms in drug-naive PD patients even in the absence of clinically relevant cognitive impairment. We hypothesize that these specific cognitive and limbic network architecture changes may represent a potential biomarker of treatment response in clinical trials. © 2020 International Parkinson and Movement Disorder Society.
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- 2020
43. Validation of the Italian version of the PSP Quality of Life questionnaire
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Francesca Di Biasio, Alessandra Nicoletti, Alessandro Padovani, Anna Vera Milner, Mario Zappia, Nicola Modugno, Brigida Minafra, Luca Magistrelli, Marina Picillo, Sebastiano Galantucci, Enrica Olivola, Paolo Barone, Fabio Bruschi, Roberta Marchese, Rosa De Micco, Maurizio Zibetti, Sofia Cuoco, Nicola Biagio Mercuri, Roberta Zangaglia, Maria Cristina Rizzetti, Alessio Di Fonzo, Immacolata Carotenuto, Francesco Paolo Bonifacio, Maria Chiara Malaguti, Giulia Lazzeri, Daniela Frosini, Andrea Pilotto, Marianna Amboni, Giulia Franco, Eleonora Del Prete, Alessandro Tessitore, Tommaso Schirinzi, Margherita Fabbri, Alessandro Stefani, Francesca Elifani, Barbara Borroni, Anna De Rosa, Maria Antonietta Volontè, Roberto Ceravolo, Marika Falla, Cristina Rascunà, Roberto Erro, Gabriella Santangelo, Picillo, Marina, Cuoco, Sofia, Amboni, Marianna, Bonifacio, Francesco Paolo, Bruschi, Fabio, Carotenuto, Immacolata, De Micco, Rosa, De Rosa, Anna, Del Prete, Eleonora, Di Biasio, Francesca, Elifani, Francesca, Erro, Roberto, Fabbri, Margherita, Falla, Marika, Franco, Giulia, Frosini, Daniela, Galantucci, Sebastiano, Lazzeri, Giulia, Magistrelli, Luca, Malaguti, Maria Chiara, Milner, Anna Vera, Minafra, Brigida, Olivola, Enrica, Pilotto, Andrea, Rascunà, Cristina, Rizzetti, Maria Cristina, Schirinzi, Tommaso, Borroni, Barbara, Ceravolo, Roberto, Di Fonzo, Alessio, Marchese, Roberta, Mercuri, Nicola B, Modugno, Nicola, Nicoletti, Alessandra, Padovani, Alessandro, Santangelo, Gabriella, Stefani, Alessandro, Tessitore, Alessandro, Volontè, Maria Antonietta, Zangaglia, Roberta, Zappia, Mario, Zibetti, Maurizio, Barone, Paolo, Picillo, M., Cuoco, S., Amboni, M., Bonifacio, F. P., Bruschi, F., Carotenuto, I., De Micco, R., De Rosa, A., Del Prete, E., Di Biasio, F., Elifani, F., Erro, R., Fabbri, M., Falla, M., Franco, G., Frosini, D., Galantucci, S., Lazzeri, G., Magistrelli, L., Malaguti, M. C., Milner, A. V., Minafra, B., Olivola, E., Pilotto, A., Rascuna, C., Rizzetti, M. C., Schirinzi, T., Borroni, B., Ceravolo, R., Di Fonzo, A., Marchese, R., Mercuri, N. B., Modugno, N., Nicoletti, A., Padovani, A., Santangelo, G., Stefani, A., Tessitore, A., Volonte, M. A., Zangaglia, R., Zappia, M., Zibetti, M., and Barone, P.
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Male ,medicine.medical_specialty ,Neurology ,Movement disorders ,Psychometrics ,Psychological intervention ,Dermatology ,Disease ,Parkinsonism ,Settore MED/26 ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,Progressive supranuclear palsy ,Quality of life ,Cronbach's alpha ,Progressive ,80 and over ,Medicine ,Supranuclear Palsy ,Humans ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,business.industry ,Reproducibility of Results ,General Medicine ,medicine.disease ,Female ,Italy ,Self Report ,Supranuclear Palsy, Progressive ,Quality of Life ,humanities ,eye diseases ,Clinical trial ,Psychiatry and Mental health ,Convergent validity ,Physical therapy ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background: Progressive supranuclear palsy (PSP) is a rare rapidly progressive, neurodegenerative disease characterized by falls and ocular movement disturbances. The use of health-related quality of life (HR-QoL) measures allows assessing changes in health status induced by therapeutic interventions or disease progress in neurodegenerative diseases. The PSP-QoL is a 45-item, self-administered questionnaire designed to evaluate HR-QoL in PSP. Methods and Results: Here, the PSP-QoL was translated into Italian and validated in 190 PSP (96 women and 94 men; mean age ± standard deviation, 72 ± 6.5; mean disease duration, 4.2 ± 2.3) patients diagnosed according to the Movement Disorder Society criteria and recruited in 16 third level movement disorders centers participating in the Neurecanet project. The mean PSP-QoL total score was 77.8 ± 37 (physical subscore, 46.5 ± 18.7; mental subscore, 33.6 ± 19.2). The internal consistency was high (Cronbach’s alpha = 0.954); corrected item-total correlation was > 0.40 for the majority of items. The significant and moderate correlation of the PSP-QoL with other HR-QoL measures as well as with motor and disability assessments indicated adequate convergent validity of the scale. Gender and geographic location presented a significant impact on the PSP-QoL in our sample with women and patients from the South of Italy scoring higher than their counterparts. Conclusion: In conclusion, the Italian version of the PSP-QoL is an easy, reliable and valid tool for assessment of HR-QoL in PSP.
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- 2019
44. Sex‐related pattern of intrinsic brain connectivity in drug‐naïve Parkinson's disease patients
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Mattia Siciliano, Giuseppina Caiazzo, Antonio Russo, Mario Cirillo, Gioacchino Tedeschi, Fabrizio Esposito, Rosa De Micco, Federica Di Nardo, Alessandro Tessitore, De Micco, R., Esposito, F., di Nardo, F., Caiazzo, G., Siciliano, M., Russo, A., Cirillo, M., Tedeschi, G., and Tessitore, A.
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0301 basic medicine ,Oncology ,Male ,medicine.medical_specialty ,Parkinson's disease ,Dopamine ,Correlation ,03 medical and health sciences ,resting-state connectivity ,Neural Pathway ,0302 clinical medicine ,Sex Factors ,Internal medicine ,Neural Pathways ,Basal ganglia ,gender ,Humans ,Medicine ,Premovement neuronal activity ,Attention ,Spectral composition ,drug-naïve ,Aged ,Brain Mapping ,business.industry ,Brain ,Sex related ,Parkinson Disease ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Drug-naïve ,030104 developmental biology ,medicine.anatomical_structure ,Neurology ,Dopaminergic pathways ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug ,MRI ,Human - Abstract
Background: Sex difference is related to specific clinical features in PD patients over the disease course. Objectives: To investigate the potential sex-difference effect on the spontaneous neuronal activity within the most reported resting-state networks in early untreated PD patients and its correlation with baseline and longitudinal clinical features. Methods: Fifty-six drug-naïve PD patients (30/26 male/female) and 30 (15/15 male/female) matched controls were enrolled in the study. Topological and spectral resting-state functional MRI features of the sensorimotor, dorsal and ventral attention, frontoparietal, and default-mode networks were analyzed for possible sex-difference effects in both PD patients and controls groups. Additionally, a region-of-interest analysis was performed to test for a sex effect on basal ganglia connectivity. Multivariate ordinal regression was used to investigate whether connectivity findings at baseline were predictors of motor impairment over a 2-year follow-up period. Results: Compared to female PD patients and controls, male PD patients showed an abnormal spectral composition of the sensorimotor and dorsal attention networks in the slow-5 band. The region-of-interest analysis showed an increased connectivity within the basal ganglia in female PD patients compared to males. Functional sensorimotor connectivity changes at baseline showed to be an independent predictor of disease severity at 2-year follow-up. Conclusions: Our findings revealed the presence of a disease-related, sex-specific cortical and subcortical connectivity pattern within the sensorimotor network, in the early stage of PD. We hypothesize that these findings may be related to the presence of different sex-specific nigrostriatal dopaminergic pathways and might predict PD progression. © 2019 International Parkinson and Movement Disorder Society.
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- 2019
45. Fatigue in Parkinson's disease: Italian validation of the Parkinson Fatigue Scale and the Fatigue Severity Scale using a Rasch analysis approach
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G. Tedeschi, Mattia Siciliano, Alessandro Tessitore, Luigi Trojano, Carlo Chiorri, Antonio Russo, R. De Micco, Siciliano, M., Chiorri, C., De Micco, R., Russo, A., Tedeschi, G., Trojano, L., and Tessitore, A.
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0301 basic medicine ,Male ,Fatigue, Fatigue Severity Scale, Italian version, Parkinson Fatigue Scale, Parkinson's disease, Rasch analysis ,Parkinson's disease ,Scale (ratio) ,Concurrent validity ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Parkinson Fatigue Scale ,Italian version ,Surveys and Questionnaires ,medicine ,Fatigue Severity Scale ,Humans ,Reliability (statistics) ,Fatigue ,Aged ,Rasch model ,business.industry ,Reproducibility of Results ,Rasch analysis ,Parkinson Disease ,Gold standard (test) ,Middle Aged ,Translating ,medicine.disease ,Differential item functioning ,030104 developmental biology ,Neurology ,Italy ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Introduction The Fatigue Severity Scale (FSS-9) and the Parkinson Fatigue Scale (PFS-16) are commonly used for assessing fatigue in Parkinson's disease (PD). Here we validated the Italian version of these scales, assessed their psychometric properties by Rasch analysis, and computed their optimal cut-off scores using clinical diagnosis of PD-related fatigue as the gold standard. Methods PD patients (n = 167) completed the Italian versions of FSS-9 and PFS-16. Each item of PFS-16 was scored both on a 5-point (PFS-16polytomous) and on a 2-point scale (PFS-16dichotomous). Results All scales showed an adequate overall Rasch model fit, high reliability, and good discriminant, convergent, and concurrent validity, but were less accurate in measuring very high and very low fatigue levels. No evidence of differential item functioning with respect to age, sex, and severity of parkinsonian symptoms was found. Some items of FSS-9 (item 1), PFS-16polytomous (items 1 and 13), and PFS-16dichotomous (items 1, 8, and 13) showed misfit, possibly due to their content concerning sleep and motivation disorders. When FSS-9 and PFS-16polytomous’ responses were rescored on a 3-point scale, the discriminability across response categories improved. The optimal cut-off score in detecting clinically-diagnosed fatigue (observed in 20% of the sample) was 3.09 for PFS-16polytomous, 8.00 for PFS-16dichotomous, and 4.67 for FSS-9. Conclusions The Italian version of PFS-16 and FSS-9 showed sound psychometric properties and can be confidently used to quantify fatigue symptoms in PD, although clinical diagnosis of fatigue should rely on validated criteria. The PFS-16polytomous exhibited advantages with respect to PFS-16dichotomous.
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- 2019
46. Validation of the Italian version of carers’ quality-of-life questionnaire for parkinsonism (PQoL Carer) in progressive supranuclear palsy
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Sofia Cuoco, Francesca Di Biasio, Alessio Di Fonzo, Alessandra Nicoletti, Antonino Bruno, Brigida Minafra, Roberta Zangaglia, Alessandro Stefani, Marika Falla, Cristina Rascunà, Roberto Erro, Leonardo Lopiano, Alessandro Padovani, Alessandro Tessitore, Anna Vera Milner, Fabio Bruschi, Maria Cristina Rizzetti, Mario Zappia, Daniela Frosini, Arianna Cappiello, Roberto Ceravolo, Sebastiano Galantucci, Rosa De Micco, Gabriella Santangelo, Enrica Olivola, Roberta Marchese, Tommaso Schirinzi, Andrea Pilotto, Giulia Franco, Nicola Modugno, Margherita Fabbri, Maria Chiara Malaguti, Giulia Lazzeri, Paolo Barone, Anna De Rosa, Maria Antonietta Volontè, Francesco Paolo Bonifacio, Marianna Amboni, Luca Magistrelli, Nicola Biagio Mercuri, Marina Picillo, Francesca Elifani, Barbara Borroni, Picillo, M., Cuoco, S., Amboni, M., Bonifacio, F. P., Bruno, A., Bruschi, F., Cappiello, A., De Micco, R., De Rosa, A., Di Biasio, F., Elifani, F., Erro, R., Fabbri, M., Falla, M., Franco, G., Frosini, D., Galantucci, S., Lazzeri, G., Magistrelli, L., Malaguti, M. C., Milner, A. V., Minafra, B., Olivola, E., Pilotto, A., Rascuna, C., Rizzetti, M. C., Schirinzi, T., Borroni, B., Ceravolo, R., Di Fonzo, A., Lopiano, L., Marchese, R., Mercuri, N. B., Modugno, N., Nicoletti, A., Padovani, A., Santangelo, G., Stefani, A., Tessitore, A., Volonte, M. A., Zangaglia, R., Zappia, M., and Barone, P.
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Quality of life ,Adult ,Male ,medicine.medical_specialty ,Neurology ,Movement disorders ,Psychometrics ,Dermatology ,Progressive supranuclear palsy ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,Cronbach's alpha ,Parkinsonian Disorders ,Progressive ,Surveys and Questionnaires ,medicine ,Humans ,Supranuclear Palsy ,030212 general & internal medicine ,Aged ,Caregiver ,Carer ,business.industry ,Parkinsonism ,Discriminant validity ,General Medicine ,Middle Aged ,Translating ,medicine.disease ,eye diseases ,humanities ,Clinical trial ,Psychiatry and Mental health ,Convergent validity ,Caregivers ,Italy ,Physical therapy ,Female ,Neurology (clinical) ,Supranuclear Palsy, Progressive ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Quality of Life - Abstract
Progressive supranuclear palsy (PSP) is a rare, rapidly progressive, neurodegenerative disease characterized by falls and ocular movement disturbances. Caring for a partner or relative who suffers from PSP entails a strenuous and demanding task, usually lasting for years that affects carers’ everyday life routines and emotional and social well-being. The 26-item Parkinsonism Carers QoL (PQoL Carer) is a self-administered, concise instrument evaluating the quality of life of caregivers of patients with atypical parkinsonism (both PSP and multiple system atrophy). Here, the PQoL Carer was translated into Italian and validated in 162 carers of PSP patients (54.3% women; mean age (standard deviation), 62.4 (15.4)) diagnosed according to the Movement Disorder Society criteria and recruited in 16 third-level movement disorders centers participating in the Neurecanet project. The mean PQoL total score was 40.66 ± 19.46. The internal consistency was excellent (Cronbach’s alpha = 0.941); corrected item-total correlation was > 0.40 for all the items. A correlation with other health-related quality of life measures as well as with behavioral assessments was shown suggesting adequate convergent validity of the scale. PQoL also correlated with patients’ severity of disease. The discriminant validity of the scale was evidenced by its capacity to differentiate between carers with varying levels of self-reported health (p < 0.001). In conclusion, the Italian version of the PQoL Carer is an easy, consistent, and valid tool for the assessment of the quality of life in carers of PSP patients.
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- 2019
47. Impulse Control Behaviors in Parkinson's Disease: Drugs or Disease? Contribution From Imaging Studies
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Rosa De Micco, Antonio Russo, Gioacchino Tedeschi, Alessandro Tessitore, De Micco, R., Russo, A., Tedeschi, G., and Tessitore, A.
- Subjects
0301 basic medicine ,Parkinson's disease ,Impulse control behavior ,Mini Review ,Disease ,lcsh:RC346-429 ,impulse control behaviors ,03 medical and health sciences ,Reward system ,0302 clinical medicine ,Neuroimaging ,medicine ,lcsh:Neurology. Diseases of the nervous system ,Neural correlates of consciousness ,Dopaminergic ,Neuropsychology ,medicine.disease ,Pathophysiology ,030104 developmental biology ,PET ,Neurology ,reward system ,Neurology (clinical) ,Neuroscience ,030217 neurology & neurosurgery ,MRI - Abstract
Impulse control behaviors (ICB) are recognized as non-motor complications of dopaminergic medications in patients with Parkinson's disease (PD). Compelling evidence suggests that ICB are not merely due to the PD-related pathology itself. Several risk factors have been identified, either demographic, clinical, genetic or neuropsychological. Neuroimaging studies have yielded controversial results regarding ICB correlates in PD and still it is not clear whether they can be triggered by the PD biology or the dopaminergic treatment stimulation. We provided an overview of the imaging studies that offered the most relevant insights into the debate about the role of drugs and disease in ICB pathophysiology. Understanding neural correlates and potential predisposing factors of these severe neuropsychiatric symptoms will be crucial to guide clinical practice and to foster preventive strategies.
- Published
- 2018
48. Structural MRI in Idiopathic Parkinson's Disease
- Author
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Alessandro Tessitore, Antonio Russo, Rosa De Micco, Marios Politis, De Micco, R., Russo, A., and Tessitore, A.
- Subjects
0301 basic medicine ,Parkinson's disease ,Neuroimaging ,Idiopathic parkinson's disease ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Gray Matter ,Modalities ,medicine.diagnostic_test ,business.industry ,Brain morphometry ,Neurodegeneration ,Magnetic resonance imaging ,Parkinson Disease ,medicine.disease ,Magnetic Resonance Imaging ,030104 developmental biology ,medicine.anatomical_structure ,business ,Neuroscience ,030217 neurology & neurosurgery ,MRI ,Human - Abstract
Among modern neuroimaging modalities, magnetic resonance imaging (MRI) is a widely available, non-invasive, and cost-effective method to detect structural and functional abnormalities related to neurodegenerative disorders. In the last decades, MRI have been widely implemented to support PD diagnosis as well as to provide further insights into motor and non-motor symptoms pathophysiology, complications and treatment-related effects. Different aspects of the brain morphology and function may be derived from a single scan, by applying different analytic approaches. Biomarkers of neurodegeneration as well as tissue microstructural changes may be extracted from structural MRI techniques. In this chapter, we analyze the role of structural imaging to differentiate PD patients from controls and to define neural substrates of motor and non-motor PD symptoms. Evidence collected in the premotor PD phase will be also critically discussed. White matter as well as gray matter integrity imaging studies has been reviewed, aiming to highlight points of strength and limits to their potential application in clinical settings.
- Published
- 2018
49. Motor, behavioural, and cognitive correlates of fatigue in early, de novo Parkinson disease patients
- Author
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Federica Garramone, Luigi Trojano, Antonio Russo, A. De Mase, Mattia Siciliano, R. De Micco, G. Tedeschi, Alessandro Tessitore, Siciliano, M., Trojano, L., De Micco, R., De Mase, A., Garramone, F., Russo, A., Tedeschi, G., and Tessitore, A.
- Subjects
0301 basic medicine ,Male ,Sleep Wake Disorders ,medicine.medical_specialty ,Apathy ,Anxiety ,Non-motor symptom ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Motor symptom ,medicine ,Prevalence ,Humans ,Cognitive Dysfunction ,Psychiatry ,Fatigue ,Aged ,Working memory ,Epworth Sleepiness Scale ,Neuropsychology ,Beck Depression Inventory ,Mild cognitive impairment ,Parkinson Disease ,Middle Aged ,Executive functions ,030104 developmental biology ,Neurology ,PD ,Female ,Neurology (clinical) ,Behavioural ,Geriatrics and Gerontology ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Introduction Fatigue is one of the most common and disabling non-motor symptoms in Parkinson's disease (PD). The objective of this study was to determine prevalence and motor, behavioural, and cognitive correlates of distressing fatigue in early, de novo PD patients. Methods Eighty-one consecutive de novo PD patients (64% men; mean age 65.73 ± 8.26 years) underwent a comprehensive examination, including Parkinson's disease Fatigue Scale (PFS), Epworth Sleepiness Scale (ESS), Parkinson's Disease Sleep Scale (PDSS), Beck Depression Inventory (BDI), Parkinson's Anxiety Scale (PAS), and Apathy Evaluation Scale (AES). Moreover, all patients underwent a detailed neuropsychological evaluation exploring attention and working memory, executive functions, memory, visuospatial abilities and language. Score of patients with or without distressing fatigue (defined as a PFS score ≥ 8) were compared by Student's t-test or Pearson's chi-square test. Logistic regression analyses were performed to search for motor and non-motor features independently associated with presence of distressing fatigue. Results Twelve (15%) patients presented distressing fatigue. Logistic regression identified sleepiness (p = 0.04), “episodic anxiety” subscale of PAS (p = 0.005), and “cognitive apathy” subscale of AES (p = 0.017) as the main factors associated with distressing fatigue. No significant association was found between diagnosis of Mild Cognitive Impairment and distressing fatigue (p = 0.745). Conclusion In a sample of consecutive de novo PD patients, distressing fatigue is associated with episodic anxiety, cognitive apathy and sleepiness, but not with cognitive impairment. Our findings suggest possible shared pathogenic mechanisms underlying these non-motor symptoms and foster development of early combined therapeutic approaches.
- Published
- 2017
50. A transient third cranial nerve palsy as presenting sign of spontaneous intracranial hypotension
- Author
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Alfonso Giordano, Antonio Russo, G. Bussone, Alessandro Tessitore, Mario Cirillo, Gioacchino Tedeschi, Rosa De Micco, Russo, Antonio, Tessitore, Alessandro, Cirillo, Mario, Giordano, A, DE MICCO, R, Bussone, G, and Tedeschi, Gioacchino
- Subjects
Male ,medicine.medical_specialty ,Neurology ,Clinical Neurology ,Intracranial Hypotension ,Cranial nerve palsy ,Nerve palsy ,Third cranial nerve palsy ,Young Adult ,medicine ,Oculomotor Nerve Diseases ,Spontaneous Intracranial Hypotension ,Humans ,Abducens nerve ,Epidural blood patch ,business.industry ,Brief Report ,Persistent headache ,General Medicine ,Surgery ,Radiography ,Anesthesiology and Pain Medicine ,Anesthesia ,Neurology (clinical) ,business ,MRI - Abstract
Spontaneous intracranial hypotension is an uncommon cause of sudden and persistent headache: associated symptoms are common, among which there are cranial nerve palsies, especially of the abducens nerve. We report a case of a 21-year-old man with a transient and isolated third nerve palsy due to spontaneous intracranial hypotension. To our knowledge, there are only few reports in the literature of such association.
- Published
- 2011
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