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The purpose of post-stroke rehabilitation consists in finding appropriate training to make patients become autonomous in their daily life activities by improving the ability to express properly their minds, recognize the ambient where they are and improve the mobility of their impaired limbs. In case of successful rehabilitation people could return to their normal activities while, if only partial recovery had occurred, they could be able to perform independently some basic activities at least. Even a partial success is a great improvement for patients, their families and even societies. In fact, if a smaller amount of people has to be assisted with intense and expensive 24-hours care, societies can fund money to other projects. We limit our analysis to motor rehabilitation procedures to improve patient performance in activities like reaching or grasping.

Stroke injury is one of the leading causes of motor impairment in the modern society. Recently Brain-Computer Interfaces (BCIs) have been used in the recovery of motor functions [1], [2]: indeed, the closed loop involving sensorimotor brain rhythms (SMR), assistive-robot training and proprioceptive feedback in an operant learning fashion might potentially be one of the most effective way to promote the neural plasticity of the damaged brain hemisphere and to restore motor abilities [3]. Thank to such a BCI treatment, one stroke patient learnt to control μ and lower β rhythms in his ipsilesional brain hemisphere and improved his upper limb control in a standard 2D reaching task.

Objectives. We based our study on 2 aspects: (i) the interest in the functional role of oscillatory brain activity in specific frequency bands and the coherence analysis between EEG traces; (ii) the increasing use of non-invasive stimulation of the human brain via transcranial direct current stimulation (tDCS). The aim of the study was to assess the potential effects of the combination of these two lines of research on a group of patients in vegetative state (VS). Materials. Five patients in VS and 5 age-matched healthy controls received anodal tDCS over the central (C3), parietal (P3), dorso-lateral prefrontal areas (DLPF), and a sham stimulation. tDCS was applied for 20 min at 200 microA. 19 channels-EEG was recorded before and after each stimulation session. Method. EEG was filtered between 0.5 and 30 Hz by elliptic filters. Fast Fourier Transformation was performed on 2 sec-epochs. For each stimulation site, coherence values were estimated within four frequency bands: Delta (0.5- 3.5 Hz), Theta (4-7.5 Hz), Alpha (8-12.5 Hz), and Beta (13-30 Hz). Each coherence map was proportionally thresholded, preserving 50% of the strongest coherence values, to produce a weighted adjacency matrix. The estimated functional connectivity patterns were characterized by means of two global network metrics derived from graph theory: modularity and global efficiency. Modularity measures how the network is organized into modules with high level clustering. Global efficiency measures how efficient the network is in exchanging information at the global level. For each frequency band and site of effective stimulation, we performed a repeated measure analysis of variance (RMANOVA) on each graph measure, using Stimulation (Effective vs. Sham) and tDCS (Pre vs. Post) as factors. Results. RM-ANOVA computed on modularity in the alpha frequency band revealed a significant interaction between the factors Stimulation and tDCS (p = .035) when applying tDCS on DLPF of healthy participants. Two paired t-tests revealed a significant increase of the network modularity (pre tDCS: .16 ± .007; post tDCS: .21 ± .014) when stimulating in DLPF (p = .009) compared to SHAM (p = .76). No significant effect was revealed on other frequency bands and stimulation site on both healthy participants and VS patients. Discussion. The tDCS-related modifications of the coherence in the alpha frequencies after DLPF stimulation could indicate that the alpha range is important to transmit information between cortical areas in healthy controls. The increased modularity suggests that the coherently synchronous alpha activities can occur within different modular brain areas and appear substantially independent of one another. This mechanism seems to be lack in VS patients. Conclusion. Our preliminary study revealed that tDCS but not sham stimulation elevates EEG alpha power and thus demonstrates the feasibility of tDCS to modulate specific oscillatory brain activity. tDCS could be considered a powerful tool for diagnosis/prognosis in altered state of consciousness.

Beta(2)-adrenoreceptor overexpression is beneficial against ischemia/reperfusion (I/R) injury. Whether beta-adrenoreceptors are involved in postconditioning (PostC) is unknown. We investigated whether nandrolone-decanoate (ND)-pretreatment can modulate (1) beta-adrenoreceptor expression and (2) post-ischemic cardiac function in response to I/R and PostC. Finally, we tested whether cardioprotection can be prevented by the inhibition of beta(2)-adrenoreceptors. Isolated rat hearts from ND pretreated (15 mg/kg/day i.m., for 14 days) and untreated-animals underwent 30-min ischemia and 120-min reperfusion. In subgroups, at the end of ischemia a PostC protocol (five cycles of 10-s reperfusion and 10-s ischemia) was applied and/or a beta(2)-adrenoreceptor blocker, ICI-118.551 (10 microM), was infused. Left ventricular pressure (LVP) was measured with an electromanometer, and infarct-size was evaluated using nitro-blue-tetrazolium staining. ND-pretreatment increased beta(2)-adrenoreceptor expression, but did not alter cardiac-weight, LVP and maximum rate of increase of LVP (dP/dt(max)). After I/R, infarct-size was smaller in ND-pretreatment than in untreated-animals. Infarct-size was also reduced by PostC, both in untreated and ND-pretreated animals. Contracture was less marked in ND-pretreated animals. PostC reduced contracture in both ND-pretreated and untreated hearts. Moreover, PostC improved post-ischemic recovery of developed LVP and dP/dt(max) much more in earts of ND-pretreated than untreated-animals. ICI-118.551 abolished ND protection and PostC-protection both in ND-pretreated and untreated hearts. Data show that two-weeks ND-pretreatment induces 1) an overexpression of beta(2)-ARs without cardiac hypertrophy and 2) improves the post-ischemic diastolic and systolic cardiac function. Intriguingly, ND-pretreatment potentiates the improvement of systolic function induced by postconditioning via beta(2)-adrenoreceptor activation.

The aim of this study was to underline, given the well-known incidence of beta thalassemia in Calabria, the possibility of establishing a prevention programme based on an increased awareness among the population using information and health education, genetic consultancy to identify high-risk subjects and prenatal diagnosis.Between January 1992 and December 1999, we analysed 181 high-risk couples for beta thalassemia using chorionic villi sampling (CVS) performed with an echoguided transcervical or transabdominal route. A steady rise was observed over the years in the number of couples asking for prenatal diagnosis, thus demonstrating that patients and doctors are increasingly aware of the importance of a correct prenatal diagnosis. The variability of molecular defects found and the number of complications linked to the technique used are underlined.Prenatal diagnosis revealed 46 fetuses with the disease (24.8%), 97 heterozygotes (53.2%) and 41 healthy fetuses (22%). Only one malformation was observed in the 41 healthy fetuses. The authors also report the incidence of complications linked to CVS. In overall terms, 2.2% of pregnancies ended in spontaneous abortions (4 cases) and 2.75% with preterm births (5 cases). These complications could not be correlated with gestational age at the time of biopsy or the number of attempts made to obtain an appropriate sample.

Thanks to the improvement of the techniques of assisted fecundation, of the obstetric management and of the fetal and neonatal monitoring now it's possible for a woman suffering from beta-thalassemia to have a child. Our purpose is to stress the importance to control the high maternal and fetal risk through the monitoring of several scales. The problems, connected with pregnancy of beta-thalassemic women are discussed, emphasizing the connection between pregnancy management and gestational and neonatal outcome. A variety of problems should be considered such as the informed consent about maternal and fetal risks, the problems caused by infectious agents or due to the use of some antiviral; the difficulties connected with heart and endocrine diseases are also discussed. Personal experience, from 1995 to 1999, on 4 beta-thalassemic pregnant women (three with the intermediate type and one with the major type) is reported.