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1. Risk factors and significance of post-operative edema in Parkinson Disease patients submitted to deep brain stimulation. A ten-year case series

Author

Izzo, Alessandro, Bove, Francesco, D’Alessandris, Quintino Giorgio, Genovese, Danilo, Tufo, Tommaso, D’Ercole, Manuela, Pennisi, Giovanni, Figà, Federica, Obersnel, Marco, Perotti, Valerio, Fuggetta, Maria Filomena, Bentivoglio, Anna Rita, Calabresi, Paolo, Olivi, Alessandro, Piano, Carla, and Montano, Nicola

Published
2024
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2. Intraoperative microelectrode recording during asleep deep brain stimulation of subthalamic nucleus for Parkinson Disease. A case series with systematic review of the literature

Author

Izzo, Alessandro, Piano, Carla, D’Ercole, Manuela, D’Alessandris, Quintino Giorgio, Tufo, Tommaso, Fuggetta, Maria Filomena, Figà, Federica, Martinelli, Renata, Obersnel, Marco, Pambianco, Francesco, Bove, Francesco, Perotti, Valerio, Bentivoglio, Anna Rita, Olivi, Alessandro, and Montano, Nicola

Published
2024
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6. Intraoperative Local Field Potential Beta Power and Three-Dimensional Neuroimaging Mapping Predict Long-Term Clinical Response to Deep Brain Stimulation in Parkinson Disease: A Retrospective Study

Author

Altavista, Maria Concetta, Brusa, Livia, Ciavarro, Marco, Cortese, Francesca, D'Ercole, Manuela, De Pandis, Maria Francesca, Di Giuda, Daniela, Fabbrini, Giovanni, Izzo, Alessandro, Liperoti, Rosa, Marano, Giuseppe, Marano, Massimo, Orsini, Michela, Paradiso, Michele, Peppe, Antonella, Pierantozzi, Mariangela, Rocchi, Camilla, Suppa, Antonio, Vadalà, Rita, Vacca, Laura, Daniele, Antonio, di Biase, Lazzaro, Piano, Carla, Bove, Francesco, Ricci, Lorenzo, Caminiti, Maria Letizia, Stefani, Alessandro, Viselli, Fabio, Modugno, Nicola, Cerroni, Rocco, Calabresi, Paolo, Bentivoglio, Anna Rita, Tufo, Tommaso, and Di Lazzaro, Vincenzo

Published
2023
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9. Movement disorders following mechanical thrombectomy resulting in ischemic lesions of the basal ganglia: An emerging clinical entity

Author

Rigon, Leonardo, primary, Genovese, Danilo, additional, Piano, Carla, additional, Brunetti, Valerio, additional, Guglielmi, Valeria, additional, Cimmino, Angelo Tiziano, additional, Scala, Irene, additional, Citro, Salvatore, additional, Bentivoglio, Anna Rita, additional, Rollo, Eleonora, additional, Di Iorio, Riccardo, additional, Broccolini, Aldobrando, additional, Morosetti, Roberta, additional, Monforte, Mauro, additional, Frisullo, Giovanni, additional, Caliandro, Pietro, additional, Pedicelli, Alessandro, additional, Caricato, Anselmo, additional, Masone, Giovanna, additional, Calabresi, Paolo, additional, and Marca, Giacomo Della, additional

Published
2024
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10. Movement disorders following mechanical thrombectomy resulting in ischemic lesions of the basal ganglia: An emerging clinical entity

Author

Rigon, Leonardo, Genovese, Danilo, Piano, Carla, Brunetti, Valerio, Guglielmi, Valeria, Cimmino, Angelo Tiziano, Scala, Irene, Citro, Salvatore, Bentivoglio, Anna Rita, Rollo, Eleonora, Di Iorio, Riccardo, Broccolini, Aldobrando, Morosetti, Roberta, Monforte, Mauro, Frisullo, Giovanni, Caliandro, Pietro, Pedicelli, Alessandro, Caricato, Anselmo, Masone, Giovanna, Calabresi, Paolo, Della Marca, Giacomo, Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Caliandro, Pietro (ORCID:0000-0002-1190-4879), Pedicelli, Alessandro (ORCID:0000-0002-2558-8838), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Marca, Giacomo Della (ORCID:0000-0001-6914-799X), Rigon, Leonardo, Genovese, Danilo, Piano, Carla, Brunetti, Valerio, Guglielmi, Valeria, Cimmino, Angelo Tiziano, Scala, Irene, Citro, Salvatore, Bentivoglio, Anna Rita, Rollo, Eleonora, Di Iorio, Riccardo, Broccolini, Aldobrando, Morosetti, Roberta, Monforte, Mauro, Frisullo, Giovanni, Caliandro, Pietro, Pedicelli, Alessandro, Caricato, Anselmo, Masone, Giovanna, Calabresi, Paolo, Della Marca, Giacomo, Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Caliandro, Pietro (ORCID:0000-0002-1190-4879), Pedicelli, Alessandro (ORCID:0000-0002-2558-8838), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), and Marca, Giacomo Della (ORCID:0000-0001-6914-799X)

Abstract

Background and purposePost-stroke movement disorders (PMDs) following ischemic lesions of the basal ganglia (BG) are a known entity, but data regarding their incidence are lacking. Ischemic strokes secondary to proximal middle cerebral artery (MCA) occlusion treated with thrombectomy represent a model of selective damage to the BG. The aim of this study was to assess the prevalence and features of movement disorders after selective BG ischemia in patients with successfully reperfused acute ischemic stroke (AIS).MethodsWe enrolled 64 consecutive subjects with AIS due to proximal MCA occlusion treated with thrombectomy. Patients were clinically evaluated by a movement disorders specialist for PMDs onset at baseline, and after 6 and 12 months.ResultsNone of the patients showed an identifiable movement disorder in the subacute phase of the stroke. At 6 and 12 months, respectively, 7/25 (28%) and 7/13 (53.8%) evaluated patients developed PMDs. The clinical spectrum of PMDs encompassed parkinsonism, dystonia and chorea, either isolated or combined. In most patients, symptoms were contralateral to the lesion, although a subset of patients presented with bilateral involvement and prominent axial signs.ConclusionPost-stroke movement disorders are not uncommon in long-term follow-up of successfully reperfused AIS. Follow-up conducted by a multidisciplinary team is strongly advisable in patients with selective lesions of the BG after AIS, even if asymptomatic at discharge.

Published
2024

11. Effect of the COVID-19 pandemic and the lockdown measures on the local stroke network

Author

Brunetti, Valerio, Broccolini, Aldobrando, Caliandro, Pietro, Di Iorio, Riccardo, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Pilato, Fabio, Bellavia, Simone, Marotta, Jessica, Scala, Irene, Pedicelli, Alessandro, Pennisi, Mariano Alberto, Caricato, Anselmo, Roberti, Cinzia, Altavista, Maria Concetta, Valenza, Alessandro, Distefano, Marisa, Cecconi, Emanuela, Fanella, Martina, Roncacci, Sabina, Tasillo, Miriam, Calabresi, Paolo, Frisullo, Giovanni, and Marca, Giacomo Della

Published
2021
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20. Effects of deep brain stimulation of the subthalamic nucleus on patients with Parkinson's disease: a machine-learning voice analysis.

Author

Suppa, Antonio, Asci, Francesco, Costantini, Giovanni, Bove, Francesco, Piano, Carla, Pistoia, Francesca, Cerroni, Rocco, Brusa, Livia, Cesarini, Valerio, Pietracupa, Sara, Modugno, Nicola, Zampogna, Alessandro, Sucapane, Patrizia, Pierantozzi, Mariangela, Tufo, Tommaso, Pisani, Antonio, Peppe, Antonella, Stefani, Alessandro, Calabresi, Paolo, and Bentivoglio, Anna Rita

Subjects
SUBTHALAMIC nucleus, DEEP brain stimulation, VOICE analysis, PARKINSON'S disease, MACHINE learning, ARTIFICIAL intelligence
Abstract

Introduction: Deep brain stimulation of the subthalamic nucleus (STN-DBS) can exert relevant effects on the voice of patients with Parkinson's disease (PD). In this study, we used artificial intelligence to objectively analyze the voices of PD patients with STN-DBS. Materials and methods: In a cross-sectional study, we enrolled 108 controls and 101 patients with PD. The cohort of PD was divided into two groups: the first group included 50 patients with STN-DBS, and the second group included 51 patients receiving the bestmedical treatment. The voices were clinically evaluated using the Unified Parkinson's Disease Rating Scale part-III subitem for voice (UPDRS-III-v). We recorded and then analyzed voices using specific machine-learning algorithms. The likelihood ratio (LR) was also calculated as an objective measure for clinical-instrumental correlations. Results: Clinically, voice impairment was greater in STN-DBS patients than in those who received oral treatment. Using machine learning, we objectively and accurately distinguished between the voices of STN-DBS patients and those under oral treatments. We also found significant clinical-instrumental correlations since the greater the LRs, the higher the UPDRS-III-v scores. Discussion: STN-DBS deteriorates speech in patients with PD, as objectively demonstrated by machine-learning voice analysis. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Intraoperative Local Field Potential Beta Power and Three-Dimensional Neuroimaging Mapping Predict Long-Term Clinical Response to Deep Brain Stimulation in Parkinson Disease: A Retrospective Study

Author

di Biase, Lazzaro, primary, Piano, Carla, additional, Bove, Francesco, additional, Ricci, Lorenzo, additional, Caminiti, Maria Letizia, additional, Stefani, Alessandro, additional, Viselli, Fabio, additional, Modugno, Nicola, additional, Cerroni, Rocco, additional, Calabresi, Paolo, additional, Bentivoglio, Anna Rita, additional, Tufo, Tommaso, additional, Di Lazzaro, Vincenzo, additional, Altavista, Maria Concetta, additional, Brusa, Livia, additional, Ciavarro, Marco, additional, Cortese, Francesca, additional, D'Ercole, Manuela, additional, De Pandis, Maria Francesca, additional, Di Giuda, Daniela, additional, Fabbrini, Giovanni, additional, Izzo, Alessandro, additional, Liperoti, Rosa, additional, Marano, Giuseppe, additional, Marano, Massimo, additional, Orsini, Michela, additional, Paradiso, Michele, additional, Peppe, Antonella, additional, Pierantozzi, Mariangela, additional, Rocchi, Camilla, additional, Suppa, Antonio, additional, Vadalà, Rita, additional, Vacca, Laura, additional, and Daniele, Antonio, additional

Published
2023
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22. Functional Movement Disorders during COVID-19: Psychological Distress, Affective Temperament and Emotional Dysregulation

Author

Janiri, Delfina, Petracca, Martina, Moccia, Lorenzo, Solito, Marcella, Lo Monaco, Maria Rita, Cerbarano, Maria Luana, Piano, Carla, Imbimbo, Isabella, Di Nicola, Marco, Simonetti, Alessio, Sani, Gabriele, Bentivoglio, Anna Rita, Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Di Nicola, Marco (ORCID:0000-0001-7457-0426), Sani, Gabriele (ORCID:0000-0002-9767-8752), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Janiri, Delfina, Petracca, Martina, Moccia, Lorenzo, Solito, Marcella, Lo Monaco, Maria Rita, Cerbarano, Maria Luana, Piano, Carla, Imbimbo, Isabella, Di Nicola, Marco, Simonetti, Alessio, Sani, Gabriele, Bentivoglio, Anna Rita, Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Di Nicola, Marco (ORCID:0000-0001-7457-0426), Sani, Gabriele (ORCID:0000-0002-9767-8752), and Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X)

Abstract

Background and objective: Functional movement disorders (FMD) represent a spectrum of psychosomatic symptoms particularly sensitive to stress. The COVID-19 pandemic has increased psychological distress worldwide and may have worsened FMD. The study aimed to confirm this hypothesis and to test whether in FMD there is a relationship between affective temperament, emotional dysregulation and psychological distress due to the pandemic. Methods: We recruited individuals with FMD, diagnosed them according to validated criteria and matched them with healthy controls (HC). Psychological distress and temperament were obtained using the Kessler-10 and the Temperament Evaluation of Memphis, Pisa and San Diego Autoquestionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation on the effect of temperament on psychological distress. Results: The sample consisted of 96 individuals. During the pandemic, 31.3% of the patients reported the need for urgent neurological care, and 40.6% reported a subjective worsening neurological condition. Patients with FMD presented with more psychological distress during the COVID-19 pandemic (F = 30.15, df = 1, p <= 0.001) than HC. They also reported more emotional dysregulation (F = 15.80, df = 1, p <= 0.001) and more cyclothymic traits (F = 14.84, df = 1, p <= 0.001). Cyclothymic temperament showed an indirect effect on COVID-19-related psychological distress, mediated by deficits in emotion regulation mechanisms (Bootstrapped LLCI = 0.41, ULCI = 2.41). Conclusion: Our results suggest that emotional dysregulation may represent a dimension mediating cyclotimic temperament response to the stressful effect of the pandemic and provide insight for developing intervention policies.

Published
2023

23. Intraoperative Local Field Potential Beta Power and Three-Dimensional Neuroimaging Mapping Predict Long-Term Clinical Response to Deep Brain Stimulation in Parkinson Disease: A Retrospective Study

Author

di Biase, Lazzaro, Piano, Carla, Bove, Francesco, Ricci, Lorenzo, Caminiti, Maria Letizia, Stefani, Alessandro, Viselli, Fabio, Modugno, Nicola, Cerroni, Rocco, Calabresi, Paolo, Bentivoglio, Anna Rita, Tufo, Tommaso, Di Lazzaro, Vincenzo, Calabresi, Paolo (ORCID:0000-0003-0326-5509), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), di Biase, Lazzaro, Piano, Carla, Bove, Francesco, Ricci, Lorenzo, Caminiti, Maria Letizia, Stefani, Alessandro, Viselli, Fabio, Modugno, Nicola, Cerroni, Rocco, Calabresi, Paolo, Bentivoglio, Anna Rita, Tufo, Tommaso, Di Lazzaro, Vincenzo, Calabresi, Paolo (ORCID:0000-0003-0326-5509), and Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X)

Abstract

Background: Directional deep brain stimulation (DBS) leads allow a fine-tuning control of the stimulation field, however, this new technology could increase the DBS programming time because of the higher number of the possible combinations used in directional DBS than in standard nondirectional electrodes. Neuroimaging leads localization techniques and local field potentials (LFPs) recorded from DBS electrodes implanted in basal ganglia are among the most studied biomarkers for DBS programing. Objective: This study aimed to evaluate whether intraoperative LFPs beta power and neuroimaging reconstructions correlate with contact selection in clinical programming of DBS in patients with Parkinson disease (PD). Materials and methods: In this retrospective study, routine intraoperative LFPs recorded from all contacts in the subthalamic nucleus (STN) of 14 patients with PD were analyzed to calculate the beta band power for each contact. Neuroimaging reconstruction obtained through Brainlab Elements Planning software detected contacts localized within the STN. Clinical DBS programming contact scheme data were collected after one year from the implant. Statistical analysis evaluated the diagnostic performance of LFPs beta band power and neuroimaging data for identification of the contacts selected with clinical programming. We evaluated whether the most effective contacts identified based on the clinical response after one year from implant were also those with the highest level of beta activity and localized within the STN in neuroimaging reconstruction. Results: LFPs beta power showed a sensitivity of 67%, a negative predictive value (NPV) of 84%, a diagnostic odds ratio (DOR) of 2.7 in predicting the most effective contacts as evaluated through the clinical response. Neuroimaging reconstructions showed a sensitivity of 62%, a NPV of 77%, a DOR of 1.20 for contact effectivity prediction. The combined use of the two methods showed a sensitivity of 87%, a NPV of 87%, a DOR o

Published
2023

24. Assessment of dopaminergic pathways in Huntington’s Disease: when, how, why? A (clinician-friendly) systematic review of the literature on PET and SPECT applications

Author

Triumbari, Elizabeth Katherine Anna, Pizzuto, Daniele Antonio, Bentivoglio, Anna Rita, Piano, Carla, Annunziata, Salvatore, Meduri, Guido Maria, and Di Giuda, Daniela

Abstract

Purpose: Positron Emission Tomography (PET) and Single Photon Emission Computerized Tomography (SPECT) allow the in-vivo evaluation of brain dopaminergic pathways’ integrity and functionality. A systematic review of published literature was performed to determine the usefulness of PET and SPECT for the assessment of dopaminergic pathways in patients with Huntington’s Disease (HD). Methods: PubMed/Medline databases were searched to identify studies responding to our aim. Included articles were appraised using the Quality Assessment of Diagnostic Accuracy Studies criteria. Evaluation and discussion of data was then designed to assist clinicians identifying when (during patients’ course of the disease), how (through PET or SPECT) and why (depending on the findings) it would be useful to perform a functional assessment of dopaminergic pathways in patients with manifest and pre-manifest HD. Results: Of 572 articles found, 33 were included in this systematic review, 6 among which evaluated the application of SPECT, and 27 the application of PET. Overall, there was an agreement in reporting dopaminergic system degeneration at both striatal and extra-striatal levels, often correlated with clinical and neuropsychological parameters. The non-linear progressive reduction of presynaptic dopamine transporter, vesicular monoamine transporter-2, or of post-synaptic dopamine receptors D1 and D2 was constantly described having a high potential of offering sensitive biomarkers of disease progression and response to disease-modifying interventions. Conclusions: Despite limited literature data, this systematic review revealed that SPECT and PET are useful to monitor different aspects of striatal and extra-striatal dopaminergic pathways degeneration during all stages of HD and may serve for response to disease-modifying interventions assessment.

Published
2024
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25. Functional Movement Disorders during COVID-19: Psychological Distress, Affective Temperament and Emotional Dysregulation

Author

Janiri, Delfina, primary, Petracca, Martina, additional, Moccia, Lorenzo, additional, Solito, Marcella, additional, Lo Monaco, Maria Rita, additional, Cerbarano, Maria Luana, additional, Piano, Carla, additional, Imbimbo, Isabella, additional, Di Nicola, Marco, additional, Simonetti, Alessio, additional, Sani, Gabriele, additional, and Bentivoglio, Anna Rita, additional

Published
2023
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28. Correction to: Beyond the CAG triplet number: exploring potential predictors of delayed age of onset in Huntington’s disease (Journal of Neurology, (2022), 269, 12, (6634-6640), 10.1007/s00415-022-11297-3)

Author

Di Tella, Sonia, Lo Monaco, Maria Rita, Petracca, Martina, Zinzi, P., Solito, Marcella, Piano, Carla, Calabresi, Paolo, Silveri, Maria Caterina, Bentivoglio, Anna Rita, Di Tella S. (ORCID:0000-0002-2248-5120), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Petracca M., Solito M., Piano C., Calabresi P. (ORCID:0000-0003-0326-5509), Silveri M. C. (ORCID:0000-0001-5012-0682), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Di Tella, Sonia, Lo Monaco, Maria Rita, Petracca, Martina, Zinzi, P., Solito, Marcella, Piano, Carla, Calabresi, Paolo, Silveri, Maria Caterina, Bentivoglio, Anna Rita, Di Tella S. (ORCID:0000-0002-2248-5120), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Petracca M., Solito M., Piano C., Calabresi P. (ORCID:0000-0003-0326-5509), Silveri M. C. (ORCID:0000-0001-5012-0682), and Bentivoglio A. R. (ORCID:0000-0002-9663-095X)

Abstract

Objective: Huntington's disease (HD) is a genetic neurodegenerative disease characterized by cognitive, motor, and psychiatric dysfunction. It is caused by an expansion of the trinucleotide repeat sequence cytosine-adenine-guanine (CAG) in the Huntingtin gene on chromosome 4. Onset typically occurs in the fourth or fifth decade, ranging from childhood to late adulthood. The CAG triplet number is generally inversely proportional to the age of onset (AOO), but the repeat number only accounts for ∼70% of the variability in AOO. Several studies demonstrated the impact of genetic modifiers on age of disease onset. In addition to genetics, we also explored the demographic, anamnestic, and socio-environmental factors that can affect AOO, to help us understand the non-genetic variability of age of onset in HD. Methods: We analyzed the retrospective data of the ENROLL-HD global registry study, particularly focusing on the continuum of ages, to include sociodemographic, genetic, and anamnestic psychobehavioral variables in a multivariate regression model aimed at identifying the potential predictors of age of motor onset (n = 5053). We ran the same regression model in the sample of subjects who had the same number of triplets (41 CAG, n = 593) and in the sample whose family history was absent/unknown (n = 630). Results: Patients with delayed onset more frequently have unknown/missing family history, are married or widowed, live in larger urbanized contexts and have a lower educational level. Individuals with earlier onset more frequently develop psychobehavioral symptoms. Conclusions: In the past, the HD gene was considered the epitome of genetic determinism. Our results are consistent with recent evidence that other factors might modulate its impact. These findings allow characterizing the determinants of AOO beyond the CAG expansions and provide valuable information for stratifying patients for future clinical trial designs.

Published
2022

29. Spinal cord stimulation may improve gait and cognition in hereditary spastic paraplegia with mental retardation: a case report

Author

Tufo, Tommaso, Ciavarro, Marco, Di Giuda, Daniela, Piccininni, Chiara, Piano, Carla, Daniele, Antonio, Di Giuda, Daniela (ORCID:0000-0002-5758-3986), Daniele, Antonio (ORCID:0000-0003-1641-5852), Tufo, Tommaso, Ciavarro, Marco, Di Giuda, Daniela, Piccininni, Chiara, Piano, Carla, Daniele, Antonio, Di Giuda, Daniela (ORCID:0000-0002-5758-3986), and Daniele, Antonio (ORCID:0000-0003-1641-5852)

Abstract

Background Hereditary spastic paraplegia (HSP) include various sporadic and hereditary neurodegenerative disorders, characterized by progressive spasticity and weakness of lower limbs, possibly associated to additional features. Case presentation We report a male HPS patient in his 40 s, showing mental retardation associated with language impairment, dysarthria, and increased urinary frequency. Three months after treatment with electric chronic high-frequency cervical spinal cord stimulation (HF-SCS), he showed an amelioration of motor symptoms (lower limbs spasticity and gait), dysarthria, cognitive functioning (language and constructive praxic abilities), and urinary symptoms (decreased urinary frequency). Single-photon emission computed tomography (SPECT) showed a postoperative increase of cerebral perfusion in right frontal cortex and temporal cortex bilaterally. Conclusion In our patient, HF-SCS might have induced an activation of ascending neural pathways, resulting in changes in activity in various cortical areas (including sensory-motor cortical areas), which may give rise to a modulation of activity in spared descending motor pathways and in neural networks involved in cognitive functions, including language. Although further studies in patients with HPS are needed to clarify whether HF-SCS can be a suitable treatment option in HSP, our observation suggests that HF-SCS, a minimally invasive neurosurgical procedure, might induce beneficial effects of on various symptoms of such orphan disease.

Published
2022

32. Effect of lockdown on the management of ischemic stroke: an Italian experience from a COVID hospital

Author

Frisullo, Giovanni, Brunetti, V., Di Iorio, Riccardo, Broccolini, Aldobrando, Caliandro, Pietro, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Pilato, Fabio, Calabresi, Paolo, Della Marca, Giacomo, De Belvis, A. G., Angioletti, C., Scala, Irene, Marotta, J., Bellavia, Simone, Reale, Giovanni, Pennisi, Mariano Alberto, Franceschi, Francesco, Caricato, Anselmo, Pedicelli, Alessandro, D'Argento, Francesco, Valente, I., Lozupone, Emilio, and Alexandre, Andrea

Subjects
Male, Neurology, medicine.medical_treatment, Covid, Brain Ischemia, Cohort Studies, 0302 clinical medicine, 80 and over, Medicine, Viral, 030212 general & internal medicine, Hub-and-spoke, Stroke, Neuroradiology, Aged, 80 and over, Disease Management, General Medicine, Thrombolysis, Middle Aged, Hospitalization, Settore MED/26 - NEUROLOGIA, Psychiatry and Mental health, Italy, Quarantine, Female, Neurosurgery, Coronavirus Infections, Cohort study, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Clinical Neurology, Dermatology, 03 medical and health sciences, Betacoronavirus, Lockdown, Humans, Pandemics, Aged, business.industry, SARS-CoV-2, COVID-19, Pneumonia, medicine.disease, Emergency medicine, Ischemic stroke, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objective To evaluate the impact of the lockdown measures, consequent to the outbreak of COVID-19 pandemic, on the quality of pre-hospital and in-hospital care of patients with acute ischemic stroke. Methods This is an observational cohort study. Data sources were the clinical reports of patients admitted during the first month of lockdown and discharged with a confirmed diagnosis of stroke or TIA. Data were collected in the interval ranging from March 11th to April 11th 2020. As controls, we evaluated the clinical reports of patients with stroke or TIA admitted in the same period of 2019. Results The clinical reports of patients eligible for the study were 52 in 2020 (71.6 ± 12.2 years) and 41 in 2019 (73.7 ± 13.1 years). During the lockdown, we observed a significant increase in onset-to-door time (median = 387 vs 161 min, p = 0.001), a significant reduction of the total number of thrombolysis (7 vs 13, p = 0.033), a non-significant increase of thrombectomy (15 vs 9, p = 0.451), and a significant increase in door-to-groin time (median = 120 vs 93 min, p = 0.048). No relevant difference was observed between 2019 and 2020 in the total number of patients admitted. Conclusions Due to the COVID-19 pandemic and lockdown measures, the stroke care pathway changed, involving both pre-hospital and in-hospital performances.

Published
2020

36. Clinical and genetic characteristics of late-onset Huntington's disease

Author

Oosterloo, Mayke, Bijlsma, Emilia K., van Kuijk, Sander MJ., Minkels, Floor, de Die-Smulders, Christine EM., Bachoud-Lévi, Anne-Catherine, Bentivoglio, Anna-Rita, Biunno, Ida, Bonelli, Raphael M., Bronzova, Juliana, Burgunder, Jean-Marc, Dunnett, Stephen B., Ferreira, Joaquim J., Frich, Jan, Giuliano, Joe, Handley, Olivia J., Heiberg, Arvid, Illarioshkin, Sergey, Illmann, Torsten, Klempir, Jiri, Landwehrmeyer, G. Bernhard, Levey, Jamie, Mclean, Tim, Nielsen, Jørgen E., Koivisto, Susana Pro, Päivärinta, Markku, Pålhagen, Sven, Quarrell, Oliver, Ramos-Arroyo, Maria, Roos, Raymund A. C., Saft, Carsten, Sebastián, Ana Rojo, Tabrizi, Sarah J., Vandenberghe, Wim, Verellen-Dumoulin, Christine, Uhrova, Tereza, Wahlström+, Jan, Zaremba, Jacek (formerly Rödig, Verena, Baake, Barth, Katrin, Garde, Monica Bascuñana, Becanovic, Kristina, Bernard, Tomáš, Betz, Sabrina, Bos, Reineke, Come, Adrien, Guedes, Leonor Correia, Callaghan, Jenny, Capodarca, Selene, Charpentier, Sébastien, Vieira da Silva, Wildson, Di Renzo, Martina, Ecker, Daniel, Finisterra, Ana Maria, Fullam, Ruth, Genoves, Camille, Gilling, Mette, Horta, Andrea, Hvalstedt, Carina, Held, Christine, Hussain, Hasina, Koppers, Kerstin, Lamanna, Claudia, Laurà, Matilde, Descals, Asunción Martínez, Martinez-Horta, Saul, Mestre, Tiago, Minster, Sara, Monza, Daniela, Münkel, Kristina, Mütze, Lisanne, Oehmen, Martin, Padieu, Helene, Paterski, Laurent, Peppa, Nadia, Rindal, Beate, Rogers, Dawn, Røren (formerly Heinonen), Niini, Salgueiro, Ana, Šašinková, Pavla, Seliverstov, Yury, Taylor, Catherine, Timewell, Erika, Townhill, Jenny, Cubillo, Patricia Trigo, van Walsem, Marleen R., Witjes-Ané, Marie-Noelle, Witkowski, Grzegorz, Wright, Abigail, Yudina, Elizaveta, Zielonka, Daniel, Zielonka, Eugeniusz, Zinzi, Paola, Hecht, Karen, Herranhof, Brigitte, Holl (formerly Hödl), Anna, Kapfhammer, Hans-Peter, Koppitz, Michael, Lilek, Sabine, Magnet, Markus, Müller, Nicole, Otti, Daniela, Painold, Annamaria, Reisinger, Karin, Scheibl, Monika, Schöggl, Helmut, Ullah, Jasmin, Braunwarth, Eva-Maria, Brugger, Florian, Buratti, Lisa, Hametner, Eva-Maria, Hepperger, Caroline, Holas, Christiane, Hotter, Anna, Hussl, Anna, Larcher, Barbara, Mahlknecht, Philipp, Müller, Christoph, Pinter, Bernadette, Poewe, Werner, Reiter, Eva-Magdalena, Seppi, Klaus, Sprenger, Fabienne, Wenning, Gregor, Ladurner, Gunther, Lilek, Stefan, Sinadinosa, Daniela, Staffen, Wolfgang, Walleczek, Anna Maria, Linder, Christoph, Pirker, Walter, Liessens, Dirk, Calmeyn, Godelinde, Somers, Nele, Delvaux, Isabelle, Boogaerts, Andrea, Flamez, Anja, de Raedt, Sylvie, Alaerts, Nick, Slama, Hichem, Supiot, Frédéric, Constant, Eric, Gillardin, Anne-Françoise, Léonard, Marie-Claude, van de Wyngaerde, Françoise, Dupuis, Michel, Minet, Cécile, Ribaï, Pascale, Van Paemel, Dominique, van Reijen, Dimphna, Weckx, Petra, Kaiserova, Michaela, Šenkárová, Zuzana, Bezdíček, Ondřej, Klempíř, Jiří, Klempířová, Olga, Majerová-Ibarburu, Veronika, Nikolai, Tomáš, Roth, Jan, Stárková, Irena, Madsen, Louise Hasselstrøm, Møller, Anette Torvin, Hjermind, Lena, Jacobsen, Oda, Larsen, Ida Unmack, Lindquist, Suzanne, Nielsen, Jørgen, Regeur, Lisbeth, Roos, Peter, Stockholm, Jette, Vangsted-Hansen, Christina, Vinther-Jensen, Tua, Lolk, Annette, Lundsgaard, Marianne, Wermuth, Lene, Andersson, Christian, Nyberg, Clara, Sundblom, Jimmy, Peippo, Maarit, Sipponen, Marjatta, Bruun, Anu, Hartikainen, Paivi, Mäkipää, Seija, Ollokainen, Mari, Åman, Jaana, Kärppä, Mikko, Ignatius, Jaakko, Jääskeläinen, Outi, Kajula, Outi, Moilanen, Jukka, Mustonen, Aki, Santala, Maire, Eklund, Pia, Hiivola, Heli, Hyppönen, Hannele, Martikainen, Kirsti, Ojala, Marjut, Tähkäpää, Sirkku, Tuuha, Katri, Allain, Philippe, Bonneau, Dominique, Bost, Marie, Gohier, Bénédicte, Guérid, Marie-Anne, Olivier, Audrey, Prouzet, Julie, Prundean, Adriana, Scherer-Gagou, Clarisse, Verny, Christophe, Babiloni, Blandine, Bled, Déborah, Debruxelles, Sabrina, Duché, Charlotte, Fraisse, Sonia, Goizet, Cyril, Jameau, Laetitia, Lafoucrière, Danielle, Spampinato, Umberto, Couttier, Julien, Debilly, Bérengère, Delaigue, Christine, Derost, Philippe, Durif, Franck, Germain, Véronique, Legendre, Perrine, Loiseau, Sylvie, Marques, Ana, Ulla, Miguel, Vidal, Tiphaine, Badei, Farideh, Boissé, Marie-Françoise, Boudali, Lotfi, Cleret de Langavant, Laurent, Lemoine, Laurie, Morgado, Graca, Youssov, Katia, Annic, Agnès, Barthélémy, Recka, De Bruycker, Christelle, Cabaret, Maryline, Carette, Anne-Sophie, Carrière, Nicolas, Decorte, Eric, Defebvre, Luc, Delliaux, Marie, Delval, Arnaud, Depelchin, Alizé, Destee, Alain, Dewulf-Pasz, Nelly, Dondaine, Thibaut, Dugauquier, Florence, Dujardin, Kathy, Hopes, Lucie, Krystkowiak, Pierre, Lemaire, Marie-Hélène, Manouvrier, Sylvie, Mutez, Eugénie, Peter, Mireille, Plomhause, Lucie, Sablonnière, Bernard, Simonin, Clémence, Tard, Céline, Thibault-Tanchou, Stéphanie, Vuillaume, Isabelle, Bellonet, Marcellin, Blin, Stéphanie, Chen, Simone, Masmoudi, Kamel, Morin, Gilles, Roussel, Martine, Tir, Mélissa, Schüler, Béatrice, Wannepain, Sandrine, Zouitina, Yassine, Azulay, Jean-Philippe, Delfini, Marie, Eusebio, Alexandre, Fluchere, Frédérique, Guenam, Aicha, Mundler, Laura, Nguyen, Karine, Benaich, Sandra, Brice, Alexis, Boster, Sarah, Charles, Perrine, Durr, Alexandra, Ewenczyk, Claire, Francisque, Hélène, Jauffret, Céline, Justo, Damian, Kassar, Abdulrahman, Klebe, Stephan, Lesne, Fabien, Milani, Paolo, Monin, Marie-Lorraine, Monnier, Tiffany, Roze, Emmanuel, Tataru, Alina, Tchikviladzé, Maya, Bioux, Sandrine, Bliaux, Evangeline, Girard, Carole, Guyant-Maréchal, Lucie, Hannequin, Didier, Hannier, Véronique, Jourdain, Séverine, Maltête, David, Pouliquen, Dorothée, Anheim, Mathieu, Barun, Nadia, Lagha-Boukbiza, Ouhaid, Longato, Nadine, Marcel, Christophe, Phillipps, Clélie, Rudolf, Gabrielle, Steinmetz, Gisèle, Tranchant, Christine, Wagner, Caroline, Zimmermann, Marie-Agathe, Blondeau, Leily, Calvas, Fabienne, Cheriet, Samia, Delabaere, Helène, Demonet, Jean-François, Marquine, Laurent, Pariente, Jérémie, Pierre, Michèle, Pomies, Elsa, Rolland, Sandrine, Souyris, Corinne, Kosinski, Christoph Michael, Milkereit, Eva, Probst, Daniela, Reetz, Kathrin, Sass, Christian, Schiefer, Johannes, Schlangen, Christiane, Werner, Cornelius J., Beuth, Markus, Gelderblom, Harald, Priller, Josef, Prüß, Harald, Spruth, Eike, Thiel, Silvia, Andrich, Jürgen, Ellrichmann, Gisa, Herrmann, Lennard, Hoffmann, Rainer, Kaminski, Barbara, Kraus, Peter, Stamm, Christiane, Ganos, Christos, Stubbe, Lars, Tadic, Vera, Tübing, Jennifer, Lange, Herwig, Bosredon, Cecile, Hunger, Ulrike, Löhle, Matthias, Maass, Antonia, Ossig, Christiana, Schmidt, Simone, Storch, Alexander, Wolz, Annett, Wolz, Martin, Kohl, Zacharias, Kozay, Christina, Winkler, Jürgen, Bergmann, Ulrike, Böringer, Regina, Capetian, Philipp, Kammel, Gerit, Lambeck, Johann, Mächtel, Miriam, Meier, Simone, Rijntjes, Michel, Zucker, Birgit, Boelmans, Kai, Goerendt, Ines, Heinicke, Walburgis, Hidding, Ute, Lewerenz, Jan, Münchau, Alexander, Orth, Michael, Schmalfeld, Jenny, Zittel, Simone, Diercks, Gabriele, Dressler, Dirk, Francis, Flverly, Gayde-Stephan, Sabine, Gorzolla, Heike, Kramer, Bianca, Minschke, Rebecca, Schrader, Christoph, Tacik, Pawel, Ribbat+, Michael, Longinus, Bernhard, Möller, Carsten, Bürk, Katrin, Lüsebrink, Antje, Mühlau, Mark, Peinemann, Alexander, Städtler, Michael, Weindl, Adolf, Winkelmann, Juliane, Ziegler, Cornelia, Bechtel, Natalie, Beckmann, Heike, Bohlen, Stefan, Göpfert, Nicole, Hölzner, Eva, Reilmann, Ralf, Rohm, Stefanie, Rumpf, Silke, Schepers, Sigrun, Weber, Nathalia, Bachmeier, Michael, Dose, Matthias, Hofstetter, Nina, Marquard, Ralf, Mühlbäck, Alzbeta, Buck, Andrea, Connemann, Julia, Geitner, Carolin, Kesse, Andrea, Landwehrmeyer, Bernhard, Lezius, Franziska, Nepper, Solveig, Niess, Anke, Schneider, Ariane, Schwenk, Daniela, Süssmuth, Sigurd, Trautmann, Sonja, Vogel, Melanie, Weydt, Patrick, Musacchio, Thomas, Leypold, Christine, Nöth, Kerstin, Cormio, Claudia, Difruscolo, Olimpia, Franco, Giovanni, Nuzzi, Angela, Sciruicchio, Vittorio, Serpino, Claudia, de Tommaso, Marina, Calandra-Buonaura, Giovanna, Capellari, Sabina, Cortelli, Pietro, Gallassi, Roberto, Poda, Roberto, Scaglione, Cesa, Agosti, Chiara, Barlati, Sergio, Compostella, Silvia, Marchina, Eleonora, Padovani, Alessando, Figorilli, Michela, Marrosu, Francesco, Muroni, Antonella, Piras, Valeria, Vacca, Melisa, Bertini, Elisabetta, Bartoli, Caterina, Fortunato, Fernanda, Ghelli, Elena, Ginestroni, Andrea, Mechi, Claudia, Paganini, Marco, Piacentini, Silvia, Pradella, Silvia, Romoli, Anna Maria, Sorbi, Sandro, Abbruzzese, Giovanni, Bandettini di Poggio, Monica, Ferrandes, Giovanna, Mandich, Paola, Marchese, Roberta, Di Maria, Emilio, Tamburini, Tiziano, Albanese, Alberto, Castagliuolo, Simona, Castaldo, Anna, Di Donato, Stefano, Di Bella, Daniela, Gellera, Cinzia, Genitrini, Silvia, Mariotti, Caterina, Nanetti, Lorenzo, Panzeri, Marta, Paridi, Dominga, Soliveri, Paola, Spagnolo, Francesca, Taroni, Franco, Tomasello, Chiara, De Michele, Giuseppe, Di Maio, Luigi, Rinaldi, Carlo, Massarelli, Marco, Peluso, Silvio, Roca, Alessandro, Russo, Cinzia Valeria, Salvatore, Elena, Sorrentino, Pierpaolo, Tucci, Tecla, Cannella, Milena, Codella, Valentina, De Gregorio, Francesca, De Nicola, Annunziata, Elifani, Francesca, Esposito, Chiara, Martino, Tiziana, Mazzante, Irene, Petrollini, Martina, Simonelli, Maria, Vezza, Maurizio, Squitieri, Ferdinando, D'Alessio, Barbara, Lovo, Francesca, Bentivoglio, Anna Rita, Bove, Francesco, Catalli, Claudio, Di Giacopo, Raffaella, Fasano, Alfonso, Frontali, Marina, Guidubaldi, Arianna, Ialongo, Tamara, Jacopini, Gioia, Loria, Giovanna, Modoni, Anna, Petracca, Martina, Piano, Carla, Chiara, Piccininni, Quaranta, Davide, Romano, Silvia, Soleti, Francesco, Solito, Marcella, Spadaro, Maria, Torlizzi, Flavia, Coarelli, Giulia, Ferraldeschi, Michela, Ristori, Giovanni, van Hout, Monique S. E., van Vugt, Jeroen P. P., Marit de Weert, A., Verhoeven, Marloes, Dekker, Meike, Klooster, Jesper, Leenders, Nico, van Oostrom, Joost, Kremer, Berry, Baake, Verena, van den Bogaard, Simon J. A., Dumas, Eve M., t Hart, Ellen P., Hogenboom, Marye, Jacobs, Milou, Jurgens, Caroline, Kampstra, Anne, Schoonderbeek, Anne, Witjes-Ané, Marie-Noëlle, Duits, Annelien, Waber, Mirella, Verstappen, Carla, Blinkenberg, Ellen Økland, Hauge, Erik, Tyvoll, Hilde, Aaserud, Olaf, Aanonsen, Nils Olaf, Bjørgo, Kathrine, Borgerød, Nancy, Dramstad, Elisabeth, Fannemel, Madeleine, Frich, Jan C., Gørvell, Per F., Haggag, Kathrine, Johannessen, Cecilie Haggag, Retterstøl, Lars, Røsby, Oddveig, Rummel, Jutta, Sikiric, Alma, Stokke, Bodil, van Walsem, Marleen, Wehus, Ragnhild, Arntsen, Vibeke, Bjørnevoll, Inga, Sando, Sigrid Botne, Haug, Marte Gjøl, Størseth, Hanna Haugan, Østern, Rune, Paulsen, Julie, Dziadkiewicz, Artur, Konkel, Agnieszka, Narożańska, Ewa, Nowak, Malgorzata, Robowski, Piotr, Sitek, Emilia, Slawek, Jaroslaw, Soltan, Witold, Szinwelski, Michal, Arkuszewski, Michał, Błaszczyk, Magdalena, Boczarska-Jedynak, Magdalena, Ciach-Wysocka, Ewelina, Gorzkowska, Agnieszka, Jasińska-Myga, Barbara, Kaczmarczyk, Aleksandra, Kłodowska – Duda, Gabriela, Opala, Grzegorz, Rudzińska, Monika, Stompel, Daniel, Banaszkiewicz, Krzysztof, Boćwińska, Dorota, Bojakowska-Jaremek, Kamila, Dec, Małgorzata, Grabska, Natalia, Krawczyk, Malgorzata, Kubowicz, Ewelina, Malec-Litwinowicz, Michalina, Stenwak, Agata, Szczudlik, Andrzej, Szczygieł, Elżbieta, Wójcik, Magdalena, Wasielewska, Anna, Anna Bryl, Jacek Anioła, Ciesielska, Anna, Klimberg, Aneta, Marcinkowski, Jerzy, Samara, Husam, Sempołowicz, Justyna, Wiśniewski, Bartłomiej, Gogol (formerly Kalbarczyk), Anna, Janik, Piotr, Jamrozik, Zygmunt, Kaminska, Anna, Kwiecinski+, Hubert, Antczak, Jakub, Jachinska, Katarzyna, Krysa, Wioletta, Rakowicz, Maryla, Rola, Rafal, Ryglewicz, Danuta, Sienkiewicz-Jarosz, Halina, Stępniak, Iwona, Sułek, Anna, Zaremba, Jacek, Zdzienicka, Elzbieta, Ziora-Jakutowicz, Karolina, Januário, Cristina, Júlio, Filipa, Almeida, Manuel, Calado, Ana, Dias, Margarida, Morgado, Joana, Semedo, Cristina, Coelho, Miguel, Magalhães, Andreia, Mendes, Tiago, Neutel, Dulce, Rodrigues, Filipe, Valadas, Anabela, Costa, Cristina, Cardoso, Helena, Santos, Mariana, Cação, Gonçalo, Cavaco, Sara, Damásio, Joana, Fernandes, Joana, Gonçalves, Alexandra, Loureiro, Rui, Moreira, Inês, Magalhães, Marina, Salgado, Paula, Andrade, Carlos, Costa, Andreia, Garrett, Carolina, Gago, Miguel, Guimarães, Joana, Massano, João, Meireles, Joana, Monteiro, Ana, Khasanova, Diana, Zalyalova, Zuleykha, Klyushnikov, Sergey, Sidorova, Olga, Smirnov, Oleg, Antonova, Victoria, Kopishinskaya, Svetlana, Korotysh, Maria, Magzhanov, Rim, Saifullina, Elena, Kurbatov, Sergey, Solis, Pilar, Herrera, Carmen Durán, Moreno, Patrocinio Garcia, Bas, Jordi, Busquets, Núria, Calopa, Matilde, Classen, Serge Jaumà, Dedichá, Nadia Rodríguez, Buongiorno, María Teresa, María, Andrés de la Cerda Santa, Muñoz, Esteban, Santacruz, Pilar, Barbera, Miquel Aguilar, Pardo, Sonia Arribas, Guia, Dolors Badenes, Calzado, Noemi, Hernanz, Laura Casas, Tartari Díaz-Zorita, Juan Pablo, Catena, Judit López, Ferrer, Pilar Quiléz, Carruesco, Gemma Tome, Robert, Misericordia Floriach, Viladrich, Cèlia Mareca, Roca, Elvira, Ruiz Idiago, Jesús Miguel, Riballo, Antonio Villa, Campolongo, Antonia, Fernandez de Bobadilla, Ramon, Bojarsky, Jaime Kulisevsky, Pagonabarraga, Javier, Perez, Jesus Perez, Ribosa, Roser, Villa, Carolina, Acera Gil, Maria Angeles, Corrales, Koldo Berganzo, Gomez Esteban, Juan Carlos, González, Amaia, Merino, Beatriz Tijero, Cubo, Esther, Polo, Cecilia Gil, Mariscal, Natividad, Sánchez, Jesús, Romero, Sandra Gutierrez, Arbelo, José Matías, Malo de Molina, Rocío, Martín, Idaira, Periañez, Juan Manuel, Udaeta, Beatriz, Alonso-Frech, Fernando, Loarte, María del Valle, Barrero, Francisco, Morales, Blas, Frades, Belén, Villanueva, Marina Ávila, Zea Sevilla, Maria Ascension, Fenollar, María del Mar, García-Ramos García, Rocío, Villanueva, Clara, Bascuñana, Mónica, Ventura, Marta Fatás, Caldentey, Juan García, Ribas, Guillermo García, García de Yébenes, Justo, López-Sendón Moreno, José Luis, Barral, Verónica Mañanes, Feliz, Cici, García Ruíz, Pedro José, García, Ana, López, Rosa Guerrero, Bárcenas, Antonio Herranz, Martínez-Descals, Asunción, Pueyo, Angel Martínez, Martin, Veronica Puertas, Martínez, Noelia Rodríguez, Montojo, Teresa, Sainz Artiga, María José, Sánchez, Vicenta, Alarcón, María Dolores, Almagro, Carmen Antúnez, Diéguez, Esther, Fortuna, Lorenza, Legaz, Agustina, Manzanares, Salvadora, Muñoz, Juan Marín, Antequera Torres, María Martirio, Perea, Fuensanta Noguera, Vivancos, Laura, González, Sonia, Guisasola, Luis Menéndez, Prieto, Marta Para, Ribacoba, René, Salvador, Carlos, Lozano, Pablo Sánchez, Ramirez, Inés Legarda, Benito, Dolors Moragues, Arques, Penelope Navas, Lopera, Monica Rodriguez, Pastor, Barbara Vives, Gaston, Itziar, Garcia-Amigot, Fermin, Martinez-Jaurrieta, Maria Dolores, Ramos-Arroyo, Maria Antonia, Adarmes, Astrid, Bernal-Escudero, Maravilla, Carrillo, Fátima, Jesús, Silvia, Mir, Pablo, Vargas-González, Laura, Hermoso, Fátima Damas, García Moreno, José Manuel, Jaramillo, Javier Abril, Lucena, Carolina Mendez, Pacheco Cortegana, Eva María, Peña, José Chacón, Redondo, Luis, Sánchez, Violeta Sánchez, Fernandez, Cristina Melgar, Romero Lemos, María Dolores, Mata, Maite Paredes, Casado, Rocío Villagrán, Bosca, Maria, Burguera, Juan Andres, Brugada, Francisco Castera, Millán Salvador, Jose Maria, Vilaplana, Carmen Peiró, Solís, Pilar, Figuerola, Begoña Jeweinat, Palanca, Paloma Millan, Diago, Elena Bellosta, López del Val, Javier, Martinez, Laura Martinez, López, Elena, Høsterey-Ugander, Ulrika, Fredlund, Gunnel, Constantinescu, Radu, Lewin, Kajsa, Neleborn-Lingefjärd, Liselotte, Berglund, Maria, Berglund, Peter, Linnsand, Petra, Petersén, Åsa, Reimer, Jan, Widner, Håkan, Esmaeilzadeh, Mouna, Tedroff, Joakim, Winnberg, Elisabeth, Benaminov, Stanislav, Björnsson, Elisabeth, Merrick, Daniel, Paucar, Martin, Svenningsson, Per, Wallden, Tina, Berglund, Måns, Loutfi, Ghada, Olofsson, Carina, Stattin, Eva-Lena, Westman, Laila, Wikström, Birgitta, Ekwall, Camilla, Göller, Marie-Lousie, Johansson, Anders, Niemelä, Valter, Nyholm, Dag, Wiklund, Leif, Koehli, Jessica, Stebler, Yanik, Kaelin, Alain, Romero, Irene, Schüpbach, Michael, Zaugg, Sabine Weber, Esposito, Federica, Good, Jean-Marc, Paus, Karin, Vingerhoets, Francois, Wider+, Christian, Jung, Hans H., Petersen, Jens A., Ligon-Auer, Maria, Mihaylova, Violeta, Downie, Lorna, Jack, Roisin, Matheson, Kirsty, Miedzybrodzka, Zosia, Rae, Daniela, Simpson, Sheila A., Summers, Fiona, Ure, Alexandra, Vaughan, Vivien, Harrower, Timothy, Vernon, Nathan, Akhtar, Shahbana, Crooks, Jenny, Curtis, Adrienne, de Souza (Keylock), Jenny, Piedad, John, Rickards, Hugh, Wright, Jan, Haig-Brown, Diane, Craven, Janet, Pallett, Andrew, Simpson, Steve, Weekes, Rebecca, Coulthard, Elizabeth, Gethin, Louise, Hayward, Beverley, Sieradzan, Kasia, Barker, Roger A., O'Keefe, Deidre, Gerrtiz (nee Di Pietro), Anna, Fisher, Kate, Goodman, Anna, Hill, Susan, Mason, Sarah, Swain, Rachel, Guzman, Natalie Valle, Busse, Monica, Butcher, Cynthia, Dunnett, Stephen, Clenaghan, Catherine, Hunt, Sarah, Jones, Lesley, Jones, Una, Khalil, Hanan, Owen, Michael, Price, Kathleen, Rosser, Anne, Goudie, David, Buchanan, Lindsay, Mcfadyen, Paula, Tonner, Alison, Taylor, Anne-Marie, Edwards, Maureen, Carrie, Ho, Mcgill, Marie, Porteous, Mary, Pearson, Pauline, Irvine, Sarah, Brockie, Peter, Foster, Jillian, Johns, Nicola, Mckenzie, Sue, Rothery, Jean, Thomas, Gareth, Yates, Shona, Neumann, Christian, Patterson, Kirsten, Thomson, David, Deith, Catherine, Ireland, Jane, Ritchie, Stuart, Brown, Pauline, Burrows, Liz, Fletcher, Amy, Harding, Alison, Harrison, Kaye, Laver, Fiona, Silva, Mark, Thomson, Aileen, Chu, Carol, Evans, Carole, Gallentree, Deena, Hamer, Stephanie, Kraus, Alison, Markova, Ivana, Raman, Ashok, Rowett, Liz, Andrew, Alyson, Frost, Julie, Noad, Rupert, Cosgrove, Jeremy, Gallantree, Deena, Hobson, Emma, Jamieson, Stuart, Longthorpe, Mandy, Musgrave, Hannah, Peacy, Caroline, Toscano, Jean, Wild, Sue, Yardumian, Pam, Clayton, Carole, Dipple, Heather, Freire-Patino, Dawn, Hallam, Caroline, Middleton, Julia, Alusi, Sundus, Davies, Rhys, Foy, Kevin, Gerrans, Emily, Pate, Louise, Anjum, Uruj, Coebergh, Jan, Eddy, Charlotte, Lahiri, Nayana, Mcentagart, Meriel, Patton, Michael, Peterson, Maria, Rose, Sarah, Andrews, Thomasin, Dougherty, Andrew, Golding, Charlotte, Kavalier, Fred, Laing, Hana, Lashwood, Alison, Robertson, Dene, Ruddy, Deborah, Santhouse, Alastair, Whaite, Anna, Gosling (nee Brown), Stefanie, Bruno, Stefania, Chu, Elvina, Doherty, Karen, Haider, Salman, Hensman, Davina, Lewis, Monica, Novak, Marianne, Patel, Aakta, Robertson, Nicola, Rosser, Elisabeth, Tabrizi, Sarah, Taylor, Rachel, Warner, Thomas, Wild, Edward, Ackermann, Oda, Duport, Sophie, Scott, Adrienne, Stoy, Nicholas, Vaughn, Jenny, Arran, Natalie, Bek, Judith, Craufurd, David, Hare, Marianne, Howard, Liz, Huson, Susan, Johnson, Liz, Jones, Mary, Krishnamoorthy, Ashok, Murphy, Helen, Oughton, Emma, Partington-Jones, Lucy, Sollom, Andrea, Snowden, Julie, Stopford, Cheryl, Thompson, Jennifer, Trender-Gerhard, Iris, Verstraelen (formerly Ritchie), Nichola, Westmoreland, Leann, Cass, Ginette, Davidson, Lynn, Davison, Jill, Fullerton, Neil, Holmes, Katrina, Komati, Suresh, Mcdonnell, Sharon, Mohammed, Zeid, Morgan, Karen, Savage, Lois, Singh, Baldev, Wood, Josh, Knight, Caroline, O'Neill, Mari, Purkayastha, Debasish Das, Nemeth, Andrea H., Siuda, Gill, Valentine, Ruth, Dixon, Kathryn, Armstrong, Richard, Harrison, David, Hughes, Max, Large, Sandra, Donovan, John O., Palmer, Amy, Parkinson, Andrew, Soltysiak, Beverley, Timings, Leanne, Williams, Josh, Burn, John, Bailey, Wendy, Coleman, Caroline, Majeed, Tahir, Verstraelen (Ritchie), Nicola, Barrett, Wendy, Aileen, Ho, Bandmann, Oliver, Bradbury, Alyson, Fairtlough, Helen, Fillingham, Kay, Foustanos, Isabella, Gill, Paul, Kazoka, Mbombe, O'Donovan, Kirsty, Nevitt, Louise, Taylor, Cat, Tidswell, Katherine, Kipps, Christopher, Mackinnon, Lesley, Agarwal, Veena, Hayward, Elaine, Gunner, Kerry, Harris, Kayla, Anderson, Mary, Heywood, Melanie, Keys, Liane, Smalley, Sarah, El-Nimr, George, Duffell, Allison, Wood, Sue, Kennedy (nee Smith), Karen, Gowers, Lesley, Powell, Kingsley, Bethwaite, Pamela, Edwards, Rachel, Fuller, Kathleen, Phillips, Michelle, Tan, Louis, Lau, Puay Ngoh, Pica, Emmanuel, Roos, Raymund AC., Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, Klinische Genetica, MUMC+: DA KG Polikliniek (9), and RS: GROW - R4 - Reproductive and Perinatal Medicine

Subjects
Male, HD, 0301 basic medicine, Pediatrics, Neurology, Huntingtin Protein/genetics, FEATURES, Disease, Neuropsychological Tests, 0302 clinical medicine, Cognitive Dysfunction/psychology, Medicine, Family history, Postural Balance, Huntington Disease/genetics, Huntingtin Protein, education.field_of_study, Chorea/physiopathology, Huntington's disease, Sensation Disorders/physiopathology, Middle Aged, Dystonia, Settore MED/26 - NEUROLOGIA, Huntington Disease, neurodegenerative disorders, Sensation Disorders, Disease Progression, Female, medicine.symptom, Adult, medicine.medical_specialty, Population, Age of onset, Late-onset Huntington's disease, Geriatrics and Gerontology, Neurology (clinical), 03 medical and health sciences, AGE, Chorea, Humans, Cognitive Dysfunction, education, Dystonia/physiopathology, Gait Disorders, Neurologic/physiopathology, Gait Disorders, Neurologic, business.industry, medicine.disease, Gait, 030104 developmental biology, Trinucleotide Repeat Expansion, business, 030217 neurology & neurosurgery, Balance problems
Abstract

Background: The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P

Published
2019

37. Subacute onset dystonia in a woman affected by Parkinson's disease following SARS-COV-2 infection

Author

Lo Monaco, Maria Rita, Bentivoglio, Anna Rita, Fusco, Domenico, Calabresi, Paolo, Piano, Carla, Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Lo Monaco, Maria Rita, Bentivoglio, Anna Rita, Fusco, Domenico, Calabresi, Paolo, Piano, Carla, Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), and Calabresi, Paolo (ORCID:0000-0003-0326-5509)

Abstract

N/A

Published
2021

38. Heart Rate Variability during wake and sleep in Huntington's Disease patients. An observational, cross-sectional, cohort study

Author

Marotta, Jessica, Piano, Carla, Brunetti, Valerio, Genovese, Danilo, Bentivoglio, Anna Rita, Calabresi, Paolo, Cortelli, P., Della Marca, Giacomo, Marotta J., Piano C., Brunetti V., Genovese D., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Calabresi P. (ORCID:0000-0003-0326-5509), Della Marca G. (ORCID:0000-0001-6914-799X), Marotta, Jessica, Piano, Carla, Brunetti, Valerio, Genovese, Danilo, Bentivoglio, Anna Rita, Calabresi, Paolo, Cortelli, P., Della Marca, Giacomo, Marotta J., Piano C., Brunetti V., Genovese D., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Calabresi P. (ORCID:0000-0003-0326-5509), and Della Marca G. (ORCID:0000-0001-6914-799X)

Abstract

Introduction Autonomic dysfunction has been reported as one of non-motor manifestations of both pre-symptomatic and manifest Huntington's Disease (HD). The aim of our study was to evaluate heart rate variability (HRV) during wake and sleep in a cohort of patients with manifest HD. Methods Thirty consecutive patients with manifest HD were enrolled, 14 men and 16 women, mean age 57.3±12.2 years. All patients underwent full-night attended video-polysomnography. HRV was analyzed during wake, NREM and REM sleep, in time and frequency domain. Results were compared with a control group of healthy volunteers matched for age and sex. Results During wake HD patients presented significantly higher mean heart rate than controls (72.4±9.6 vs 58.1±7.3 bpm; p<0.001). During NREM sleep, HD patients showed higher mean heart rate (65.6±11.1 vs 48.8±4.6 bpm; p<0.001) and greater Low Frequency (LF) component of HRV (52.9±22.6 vs 35.5±17.3 n.u.; p=0.004). During REM sleep, we observed lower standard deviation of the R-R interval (SDNN) in HD subjects (3.4±2.2 vs 3.7±1.3 ms; p=0.015). Conclusion Our results showed that HD patients have higher heart rate than controls, during wake and NREM, but not during REM sleep. Among HRV variability parameters, the most relevant difference regarded the LF component, which reflects, at least partially, the ortho-sympathetic output. Our results confirm the involvement of autonomic nervous system in HD and demonstrate that it is evident during both wake and sleep.

Published
2021

39. Effect of the COVID-19 pandemic and the lockdown measures on the local stroke network

Author

Brunetti, V., Broccolini, Aldobrando, Caliandro, Pietro, Di Iorio, Riccardo, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Pilato, Fabio, Bellavia, Simone, Marotta, J., Scala, Irene, Pedicelli, Alessandro, Pennisi, Mariano Alberto, Caricato, Anselmo, Roberti, Claudia, Altavista, M. C., Valenza, Alessandro, Distefano, Maria Grazia, Cecconi, E., Fanella, M., Roncacci, S., Tasillo, M., Calabresi, Paolo, Frisullo, Giovanni, Marca, G. D., Broccolini A. (ORCID:0000-0001-8295-9271), Caliandro P. (ORCID:0000-0002-1190-4879), Di Iorio R., Monforte M., Morosetti R., Piano C., Pilato F. (ORCID:0000-0002-7248-3916), Bellavia S., Scala I., Pedicelli A. (ORCID:0000-0002-2558-8838), Pennisi M. A. (ORCID:0000-0001-8761-5144), Caricato A. (ORCID:0000-0001-5929-120X), Roberti C., Valenza A., Distefano M., Calabresi P. (ORCID:0000-0003-0326-5509), Frisullo G., Brunetti, V., Broccolini, Aldobrando, Caliandro, Pietro, Di Iorio, Riccardo, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Pilato, Fabio, Bellavia, Simone, Marotta, J., Scala, Irene, Pedicelli, Alessandro, Pennisi, Mariano Alberto, Caricato, Anselmo, Roberti, Claudia, Altavista, M. C., Valenza, Alessandro, Distefano, Maria Grazia, Cecconi, E., Fanella, M., Roncacci, S., Tasillo, M., Calabresi, Paolo, Frisullo, Giovanni, Marca, G. D., Broccolini A. (ORCID:0000-0001-8295-9271), Caliandro P. (ORCID:0000-0002-1190-4879), Di Iorio R., Monforte M., Morosetti R., Piano C., Pilato F. (ORCID:0000-0002-7248-3916), Bellavia S., Scala I., Pedicelli A. (ORCID:0000-0002-2558-8838), Pennisi M. A. (ORCID:0000-0001-8761-5144), Caricato A. (ORCID:0000-0001-5929-120X), Roberti C., Valenza A., Distefano M., Calabresi P. (ORCID:0000-0003-0326-5509), and Frisullo G.

Abstract

Introduction: The COVID-19 outbreak highly impacted the acute ischemic stroke care management. The primary end point of the study was to evaluate the impact of the COVID-19 outbreak and the following lockdown measures on our hub-and-spoke network; the secondary end point was to evaluate if the impact of the COVID-19 outbreak was different in hub-and-spoke centers. Methods: This was a retrospective multicenter observational study conducted at the Stroke Units of Policlinico Gemelli, Ospedale San Filippo Neri, Ospedale di Belcolle, and Ospedale San Camillo de Lellis. We collected clinical reports of all consecutive patients admitted with diagnosis of acute ischemic stroke or transient ischemic attack (TIA) during the phase 1 of the lockdown period (11 March 2020–4 May 2020). As controls, we used all consecutive patients admitted for acute ischemic stroke or TIA in the same period of the previous year. Results: A total of 156 and 142 clinical reports were collected in 2019 and 2020, respectively. During the COVID-19 outbreak, we observed a reduction of number of thrombolysis, a reduction of the length of hospitalization, and an increase of pneumonia. Regarding performance indicators, we observed an increase in onset-to-door time and in door-to-groin time. We did not observe any statistically significant interaction between year (2019 vs 2020) and facility of admission (hub vs spoke) on all variables analyzed. Discussion: Our observational study, involving hub-and-spoke stroke network of a wide regional area, indicates that the COVID-19 outbreak impacted on the acute stroke management. This impact was equally observed in hub as well as in spoke centers.

Published
2021

40. Extradural Motor Cortex Stimulation in Parkinson's Disease: Long-Term Clinical Outcome.

Author

Piano, Carla, Bove, Francesco, Mulas, D, Di Stasio, Enrico, Fasano, Alfonso, Bentivoglio, Anna Rita, Daniele, Antonio, Cioni, Beatrice, Calabresi, Paolo, Tufo, Tommaso, Piano C, Bove F, Di Stasio E (ORCID:0000-0003-1047-4261), Fasano A, Bentivoglio AR (ORCID:0000-0002-9663-095X), Daniele A (ORCID:0000-0003-1641-5852), Cioni B (ORCID:0000-0002-6830-6204), Calabresi P (ORCID:0000-0003-0326-5509), Tufo T, Piano, Carla, Bove, Francesco, Mulas, D, Di Stasio, Enrico, Fasano, Alfonso, Bentivoglio, Anna Rita, Daniele, Antonio, Cioni, Beatrice, Calabresi, Paolo, Tufo, Tommaso, Piano C, Bove F, Di Stasio E (ORCID:0000-0003-1047-4261), Fasano A, Bentivoglio AR (ORCID:0000-0002-9663-095X), Daniele A (ORCID:0000-0003-1641-5852), Cioni B (ORCID:0000-0002-6830-6204), Calabresi P (ORCID:0000-0003-0326-5509), and Tufo T

Abstract

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

Published
2021

43. An Italian Neurology Outpatient Clinic Facing SARS-CoV-2 Pandemic: Data From 2,167 Patients

Author

Piano, Carla, Di Stasio, Enrico, Primiano, Guido Alessandro, Janiri, Delfina, Luigetti, Marco, Frisullo, Giovanni, Vollono, Catello, Lucchini, Matteo, Brunetti, Valerio, Monforte, Mauro, Guglielmi, Valeria, Della Marca, Giacomo, Evoli Stampanoni-B, Amelia, Marra, Camillo, Mirabella, Massimiliano, Quaranta, Davide, Ricci, Enzo, Servidei, Serenella, Silvestri, Gabriella, Bellavia, Simone, Bortolani, Sara, Bove, Francesco, Di Iorio, Riccardo, Di Paolantonio, Andrea, Genovese, Danilo, Ialongo, Tamara, Lo Monaco, Maria Rita, Marotta, Jessica, Patanella, Agata Katia, Perna, Alessia, Petracca, Martina, Presicce, Giorgia, Riso, Vittorio, Rollo, Eleonora, Romano, Angela, Romozzi, Marina, Sancricca, Cristina, Scala, Irene, Spagni, Gregorio, Solito, Marcella, Tricoli, Luca, Zinzi, Paola, Calabresi, Paolo, Bentivoglio, Anna Rita, Di Stasio, Enrico (ORCID:0000-0003-1047-4261), Primiano, Guido, Luigetti, Marco (ORCID:0000-0001-7539-505X), Lucchini, Matteo (ORCID:0000-0002-0447-2297), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Evoli, Amelia (ORCID:0000-0003-0282-8787), Marra, Camillo (ORCID:0000-0003-3994-4044), Mirabella, Massimiliano (ORCID:0000-0002-7783-114X), Ricci, Enzo (ORCID:0000-0003-3092-3597), Servidei, Serenella (ORCID:0000-0001-8478-2799), Silvestri, Gabriella (ORCID:0000-0002-1950-1468), Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Piano, Carla, Di Stasio, Enrico, Primiano, Guido Alessandro, Janiri, Delfina, Luigetti, Marco, Frisullo, Giovanni, Vollono, Catello, Lucchini, Matteo, Brunetti, Valerio, Monforte, Mauro, Guglielmi, Valeria, Della Marca, Giacomo, Evoli Stampanoni-B, Amelia, Marra, Camillo, Mirabella, Massimiliano, Quaranta, Davide, Ricci, Enzo, Servidei, Serenella, Silvestri, Gabriella, Bellavia, Simone, Bortolani, Sara, Bove, Francesco, Di Iorio, Riccardo, Di Paolantonio, Andrea, Genovese, Danilo, Ialongo, Tamara, Lo Monaco, Maria Rita, Marotta, Jessica, Patanella, Agata Katia, Perna, Alessia, Petracca, Martina, Presicce, Giorgia, Riso, Vittorio, Rollo, Eleonora, Romano, Angela, Romozzi, Marina, Sancricca, Cristina, Scala, Irene, Spagni, Gregorio, Solito, Marcella, Tricoli, Luca, Zinzi, Paola, Calabresi, Paolo, Bentivoglio, Anna Rita, Di Stasio, Enrico (ORCID:0000-0003-1047-4261), Primiano, Guido, Luigetti, Marco (ORCID:0000-0001-7539-505X), Lucchini, Matteo (ORCID:0000-0002-0447-2297), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Evoli, Amelia (ORCID:0000-0003-0282-8787), Marra, Camillo (ORCID:0000-0003-3994-4044), Mirabella, Massimiliano (ORCID:0000-0002-7783-114X), Ricci, Enzo (ORCID:0000-0003-3092-3597), Servidei, Serenella (ORCID:0000-0001-8478-2799), Silvestri, Gabriella (ORCID:0000-0002-1950-1468), Lo Monaco, Maria Rita (ORCID:0000-0002-1457-7981), Calabresi, Paolo (ORCID:0000-0003-0326-5509), and Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X)

Abstract

Objective:Neurological sequelae of SARS-CoV-2 infection have already been reported, but there is insufficient data about the impact of the pandemic on the management of the patients with chronic neurological diseases. We aim to analyze the effect of COVID-19 pandemic and social restriction rules on these fragile patients. Methods:Patients with chronic neurologic diseases routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for symptoms suggestive of SARS-CoV-2 infection in the pandemic period, consequences of social restrictions, and neurological disease features, concomitant medical conditions, current medical and disease-specific treatments. Data source: a dedicated telephone survey designed to encompass questions on COVID-19 symptoms and on pandemic effects in chronic neurologic conditions. Results:Overall, 2,167 individuals were analyzed: 63 patients reported contact with COVID-19 positive cases, 41 performed the swab, and 2 symptomatic patients tested positive for COVID-19 (0.09%). One hundred fifty-eight individuals (7%) needed urgent neurological care, deferred due to the pandemic; 641 patients (30%) suspended hospital treatments, physiotherapy or other support interventions; 405 individuals (19%) reported a subjective worsening of neurological symptoms. Conclusions:In our population, the presence of neurological chronic diseases did not increase the prevalence of COVID-19 infection. Nevertheless, the burden of neurological disorders has been worsened by the lockdown.

Published
2020

44. Effects of COVID-19 Lockdown on Movement Disorders Patients With Deep Brain Stimulation: A Multicenter Survey

Author

Piano, Carla, Bove, Francesco, Tufo, Tommaso, Imbimbo, Isabella, Genovese, Danilo, Stefani, Alessio, Marano, M., Peppe, A., Brusa, L., Cerroni, R., Motolese, F., Di Stasio, Enrico, Mazza, Marianna, Daniele, Antonio, Olivi, Alessandro, Calabresi, Paolo, Bentivoglio, Anna Rita, Piano C., Bove F., Tufo T., Imbimbo I., Genovese D., Stefani A., Di Stasio E. (ORCID:0000-0003-1047-4261), Mazza M., Daniele A. (ORCID:0000-0003-1641-5852), Olivi A. (ORCID:0000-0002-4489-7564), Calabresi P. (ORCID:0000-0003-0326-5509), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Piano, Carla, Bove, Francesco, Tufo, Tommaso, Imbimbo, Isabella, Genovese, Danilo, Stefani, Alessio, Marano, M., Peppe, A., Brusa, L., Cerroni, R., Motolese, F., Di Stasio, Enrico, Mazza, Marianna, Daniele, Antonio, Olivi, Alessandro, Calabresi, Paolo, Bentivoglio, Anna Rita, Piano C., Bove F., Tufo T., Imbimbo I., Genovese D., Stefani A., Di Stasio E. (ORCID:0000-0003-1047-4261), Mazza M., Daniele A. (ORCID:0000-0003-1641-5852), Olivi A. (ORCID:0000-0002-4489-7564), Calabresi P. (ORCID:0000-0003-0326-5509), and Bentivoglio A. R. (ORCID:0000-0002-9663-095X)

Abstract

Background: The containment measures taken by Italian government authorities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic caused the interruption of neurological activities of outpatient clinics. Vulnerable patients, as Parkinson's disease (PD) and dystonic patients with deep brain stimulation (DBS), may have an increased risk of chronic stress related to social restriction measures and may show a potential worsening of motor and psychiatric symptoms. Methods: This cross-sectional multicenter study was carried out during the SARS-CoV-2 pandemic and was based on a structured survey administered during a telephone call. The questionnaire was designed to gather motor and/or psychiatric effects of the lockdown and coronavirus disease 2019 (COVID-19) epidemiologic information in PD and dystonic patients with a functioning DBS implant. Results: One hundred four patients were included in the study, 90 affected by PD and 14 by dystonia. Forty-nine patients reported a subjective perception of worsening of global neurological symptoms (motor and/or psychiatric) related to the containment measures. In the multivariate analysis, having problems with the DBS device was the only independent predictor of motor worsening [odds ratio (OR) = 3.10 (1.22–7.91), p = 0.018]. Independent predictors of psychiatric worsening were instrumental activities of daily living (IADL) score [OR = 0.78 (0.64–0.95), p = 0.012] and problems with DBS [OR = 5.69 (1.95–16.62), p = 0.001]. Only one patient underwent nasopharyngeal swabs, both negative, and no patient received a diagnosis of COVID-19. Conclusions: Lockdown restriction measures were associated with subjective worsening of motor and psychiatric symptoms in PD and dystonic patients treated with DBS, and they may have exacerbated the burden of neurological disease and increased the chronic stress related to the DBS management.

Published
2020

45. Stroke and COVID19: Not only a large-vessel disease

Author

Frisullo, Giovanni, Bellavia, Simone, Scala, Irene, Piano, Carla, Morosetti, Roberta, Brunetti, V., Calabresi, Paolo, Della Marca, Giacomo, Frisullo G., Bellavia S., Scala I., Piano C., Morosetti R., Calabresi P. (ORCID:0000-0003-0326-5509), Della Marca G. (ORCID:0000-0001-6914-799X), Frisullo, Giovanni, Bellavia, Simone, Scala, Irene, Piano, Carla, Morosetti, Roberta, Brunetti, V., Calabresi, Paolo, Della Marca, Giacomo, Frisullo G., Bellavia S., Scala I., Piano C., Morosetti R., Calabresi P. (ORCID:0000-0003-0326-5509), and Della Marca G. (ORCID:0000-0001-6914-799X)

Abstract

Recent evidence has underlined the association between large-vessel stroke and COVID-19, probably due to a proinflammatory and prothrombotic microenvironment induced by SARS-CoV-2. Here, we report the case of a young fit woman affected by COVID-19 without any flu-like symptom, who suffered from speech disorder and left hemiparesis. Brain magnetic resonance evidenced two small acute brain infarctions in right perirolandic cortex without signs of previous ischemic lesions and hemorrhagic infarction. Diagnostic workup excluded cardiac embolic sources, acquired and inherited thrombophilia or autoimmune diseases. Two positive nasopharyngeal swab tests and high titers of serum specific IgA/IgM confirmed COVID-19 diagnosis. In our case stroke seems to be the only manifestation of SARS-COV-2 infection. Therefore the hypothesis of an underlying viral infection, as COVID-19, should be investigated in all the cases of small vessel cryptogenic stroke.

Published
2020

46. COVID-19 Pandemic and Psychiatric Symptoms: The Impact on Parkinson's Disease in the Elderly

Author

Janiri, Delfina, Petracca, Martina, Moccia, Lorenzo, Tricoli, Luca, Piano, Carla, Bove, Francesco, Imbimbo, Isabella, Simonetti, Alessio, Di Nicola, Marco, Sani, Gabriele, Calabresi, Paolo, Bentivoglio, Anna Rita, Di Nicola, Marco (ORCID:0000-0001-7457-0426), Sani, Gabriele (ORCID:0000-0002-9767-8752), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X), Janiri, Delfina, Petracca, Martina, Moccia, Lorenzo, Tricoli, Luca, Piano, Carla, Bove, Francesco, Imbimbo, Isabella, Simonetti, Alessio, Di Nicola, Marco, Sani, Gabriele, Calabresi, Paolo, Bentivoglio, Anna Rita, Di Nicola, Marco (ORCID:0000-0001-7457-0426), Sani, Gabriele (ORCID:0000-0002-9767-8752), Calabresi, Paolo (ORCID:0000-0003-0326-5509), and Bentivoglio, Anna Rita (ORCID:0000-0002-9663-095X)

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic represents a condition of increased vulnerability and frailty for elderly patients with Parkinson's disease (PD). Social isolation may worsen the burden of the disease and specifically exacerbate psychiatric symptoms, often comorbid with PD. This study aimed at identifying risk/protective factors associated with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak in a sample of individuals with PD aged 65 years or older. Methods: Patients with PD routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for subjective worsening of psychiatric symptoms through a dedicated telephone survey, after Italy COVID-19 lockdown. Patients' medical records were reviewed to collect sociodemographic and clinical data, including lifetime psychiatric symptoms and pharmacological treatment. Results: Overall, 134 individuals were assessed and 101 (75.4%) reported lifetime psychiatric symptoms. Among those, 23 (22.8%) presented with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak. In this group, the most frequent symptom was depression (82.6%), followed by insomnia (52.2%). Subjective worsening of neurological symptoms (Wald = 24.03, df = 1, p = 0.001) and lifetime irritability (Wald = 6.35, df = 1, p = 0.020), together with younger age (Wald = 5.06, df = 1, p = 0.038) and female sex (Wald = 9.07 df = 1, p = 0.007), resulted as specific risk factors for ingravescence of psychiatric presentation. Lifetime pre-existing delusions, having received antipsychotics, and not having received mood stabilizer were also associated with subjective worsening of psychiatric symptomatology due to the COVID-19 pandemic. Conclusions: Individuals with PD and lifetime history of psychiatric symptoms may be exposed to increased vulnerability to the stressful effect of COVID-19 outbreak. Interventions aimed at reducing irritability and mood instabili

Published
2020

47. Predicting factors of functional outcome in patients with acute ischemic stroke admitted to neuro-intensive care unit—A prospective cohort study

Author

Pilato, Fabio, Silva, S., Valente, I., Distefano, Maria Grazia, Broccolini, Aldobrando, Brunetti, V., Caliandro, Pietro, Marca, G. D., Di Iorio, Riccardo, Frisullo, Giovanni, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Calandrelli, Rosalinda, Capone, F., Alexandre, Andrea, Pedicelli, Alessandro, Colosimo, Cesare, Caricato, Anselmo, Pilato F. (ORCID:0000-0002-7248-3916), Distefano M., Broccolini A. (ORCID:0000-0001-8295-9271), Caliandro P. (ORCID:0000-0002-1190-4879), Di Iorio R., Frisullo G., Monforte M., Morosetti R., Piano C., Calandrelli R., Alexandre A., Pedicelli A. (ORCID:0000-0002-2558-8838), Colosimo C. (ORCID:0000-0003-3800-3648), Caricato A. (ORCID:0000-0001-5929-120X), Pilato, Fabio, Silva, S., Valente, I., Distefano, Maria Grazia, Broccolini, Aldobrando, Brunetti, V., Caliandro, Pietro, Marca, G. D., Di Iorio, Riccardo, Frisullo, Giovanni, Monforte, Mauro, Morosetti, Roberta, Piano, Carla, Calandrelli, Rosalinda, Capone, F., Alexandre, Andrea, Pedicelli, Alessandro, Colosimo, Cesare, Caricato, Anselmo, Pilato F. (ORCID:0000-0002-7248-3916), Distefano M., Broccolini A. (ORCID:0000-0001-8295-9271), Caliandro P. (ORCID:0000-0002-1190-4879), Di Iorio R., Frisullo G., Monforte M., Morosetti R., Piano C., Calandrelli R., Alexandre A., Pedicelli A. (ORCID:0000-0002-2558-8838), Colosimo C. (ORCID:0000-0003-3800-3648), and Caricato A. (ORCID:0000-0001-5929-120X)

Abstract

Although thrombectomy is beneficial for most stroke patients with large vessel occlusion (LVO), it has added new issues in acute management due to intensive care support. In this prospective cohort study, we described the patients admitted to our neuro-intensive care unit (NICU) after thrombectomy in order to assess factors linked to functional outcomes. The outcome was independency assessed for stroke patients consecutively admitted to NICU for an ischemic stroke due to LVO of the anterior cerebral circulation that underwent intra-arterial mechanical thrombectomy (IAMT), either in combination with intravenous thrombolysis (IVT) in eligible patients or alone in patients with contraindications for IVT. Overall, 158 patients were enrolled. IVT (odds ratio (OR), 3.78; 95% confidence interval (CI), 1.20–11.90; p = 0.023) and early naso-gastric tube removal (OR, 3.32; 95% CI, 1.04–10.59 p = 0.042) were associated with good outcomes, whereas a high baseline National Institutes of Health Stroke Scale (NIHSS) score (OR, 0.72 for each point of increase; 95% CI, 0.61–0.85; p < 0.001) was a predictor of poor outcomes at 3 months. Older age (OR, 0.95 for each year of increase; 95% CI, 0.92–0.99; p = 0.020) and hemorrhagic transformation (OR, 0.31; 95% CI, 0.11–0.84; p = 0.022) were predictors of poor outcomes after IAMT, whereas a modified Treatment in Cerebral Infarction (mTICI) score of 2b/3 was a predictor of good outcomes (OR, 7.86; 95% CI, 1.65–37.39; p = 0.010) at 6 months. Our results show that acute stroke patients with LVO who require NICU management soon after IAMT may show specific clinical factors influencing short-and long-term neurologic independency.

Published
2020

48. Frameless stereotaxy in subthalamic deep brain stimulation: 3-year clinical outcome

Author

Piano, Carla, Bove, Francesco, Mulas, D., Bentivoglio, Anna Rita, Cioni, Beatrice, Tufo, Tommaso, Piano C., Bove F., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Cioni B. (ORCID:0000-0002-6830-6204), Tufo T., Piano, Carla, Bove, Francesco, Mulas, D., Bentivoglio, Anna Rita, Cioni, Beatrice, Tufo, Tommaso, Piano C., Bove F., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Cioni B. (ORCID:0000-0002-6830-6204), and Tufo T.

Abstract

Background: In most centers, the surgery of deep brain stimulation (DBS) is performed using a stereotactic frame. Compared with frame-based technique, frameless stereotaxy reduces the duration of surgical procedure and patient’s discomfort, with lead placing accuracy equivalent after the learning curve. Although several studies have investigated the targeting accuracy of this technique, only a few studies reported clinical outcomes, with data of short-term follow-up. Objective: To assess clinical efficacy and safety of frameless bilateral subthalamic nucleus (STN) DBS in Parkinson’s disease (PD) patients at 1- and 3-year follow-up. Methods: Consecutive PD patients who underwent bilateral STN-DBS with a manual adjustable frameless system were included in the study. The data were collected retrospectively. Results: Eighteen PD patients underwent bilateral STN-DBS implant and were included in the study. All patients completed 1-year observation and ten of them completed 3-year observation. At 1-year follow-up, motor efficacy of STN stimulation in off-med condition was of 30.1% (P = 0.003) and at 3-year follow-up was of 36.3%, compared with off-stim condition at 3-year follow-up (P = 0.005). Dopaminergic drugs were significantly reduced by 31.2% 1 year after the intervention (P = 0.003) and 31.7% 3 years after the intervention (P = 0.04). No serious adverse events occurred during surgery. Conclusions: Frameless stereotaxy is an effective and safe technique for DBS surgery at 1- and 3-year follow-up, with great advantages for patients’ discomfort during surgery.

Published
2020

49. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)

Abstract

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

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