A partire da "Malombra" Fogazzaro sposta in ambito psicologico (e si direbbe proto-psic... more A partire da "Malombra" Fogazzaro sposta in ambito psicologico (e si direbbe proto-psicanalitico) le tematiche e i luoghi comuni di tanta letteratura gotica e spiritistica: non dall'oltremondo vengono i fanstasmi ma dalla psiche, dalla forza di impulsi non dominati dalla volont\ue0, dall'azione del sogno, dalla crisi della coscienza razionale. L'attenzione vivissima di Fogazzaro alla psicologia del profondo \ue8 confermata dal discorso "Per una nuova scienza", dove si propongono ricerche che saranno poi importanti per Pirandello. I romanzi della maturit\ue0 rappresentano un'estensione della tematica che in "Malombra" \ue8 collegata alla psicologia d'eccezione della protagonista. Impulsi, pensieri, sintomi inconsci nei successivi romanzi fogazzariani travolgono anche personaggi che vorrebbero aggrapparsi ostinatamente alla normalit\ue0, dando cos\uec all'autore la possibilit\ue0 di rappresentare con efficacia sia la dialettica tra...
La linguistica di Dante ha un valore non solo linguistico-letterario, ma teologico, sociale e pol... more La linguistica di Dante ha un valore non solo linguistico-letterario, ma teologico, sociale e politico, e contribuisce all'elaborazione dell'idea di italianit\ue0 come identit\ue0 composita e plurima
Fogazzaro elabora un realismo non razionalistico, che approfondisce il tema delle lacerazioni int... more Fogazzaro elabora un realismo non razionalistico, che approfondisce il tema delle lacerazioni interne ai gruppiu sociali, alle istituzioni familiari, all'individuo
Il rapporto tra scrittore e popolo compromesso dalla cultura aristocratica del secondo ottocento,... more Il rapporto tra scrittore e popolo compromesso dalla cultura aristocratica del secondo ottocento, viene trasformato in profondit\ue0 dalla guerra, determinando nuove condizioni non solo nella forma del contenuto ma in quella dell'espressione
La cultura italica va ricostruita al di l\ue0 del paradigma storico nazionale, nella sua diffusio... more La cultura italica va ricostruita al di l\ue0 del paradigma storico nazionale, nella sua diffusione al di fuori dei confini della penisola e nei suoi caratteri multiculturali e plurilinguistici. Le migrazioni devono essere affrontate non con pregiudizi etnici e sovranisti, ma con la consapevolezza che le politiche economiche e sociali non sono sufficienti se non vengono accompagnate da politiche culturali capaci di promuovere nel futuro quel medesimo dialogo dal quale la civilt\ue0 italica \ue8 nata e si \ue8 sviluppata nel passato
Background. Although physical exercise improves motor aspects of Parkinson’s disease (PD), it is ... more Background. Although physical exercise improves motor aspects of Parkinson’s disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression. Methods. Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson’s Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later. Results. Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were bet...
Resumo: Objetivo-O objetivo do presente estudo foi avaliar os desfechos do uso associado das técn... more Resumo: Objetivo-O objetivo do presente estudo foi avaliar os desfechos do uso associado das técnicas de Iso Stretching e pompage sobre a capacidade funcional, força muscular respiratória e a mobilidade torácica de indivíduos portadores de doença pulmonar obstrutiva crônica. Métodos-Trata se de um estudo piloto, onde participaram 10 indivíduos, randomizados em grupo tratado e grupo controle. Foram analisadas as variáveis espirométricas, antropométricas, força muscular respiratória e a capacidade funcional. Da amostra, cinco pacientes concluíram o tratamento de quatro semanas de intervenção com as técnicas de Iso Stretching e pompage. Resultados-Após a intervenção, houve aumento na força muscular inspiratória e expiratória para todos os indivíduos do grupo tratado, bem como, aumento na distância percorrida no TC6 e na expansibilidade torácica. Conclusão-um programa terapêutico baseado nas técnicas de Iso Stretching e pompage por quatro semanas, evidenciaram principalmente o aumento na força muscular respiratória, expansibilidade e distância percorrida no TC6. Descritores: Reabilitação, Modalidades de Fisioterapia, DPOC.
Background. Exercise may decrease the risk of Parkinson’s disease (PD) in humans and reduce PD sy... more Background. Exercise may decrease the risk of Parkinson’s disease (PD) in humans and reduce PD symptoms in animal models. The beneficial effects have been linked to increased levels of neurotrophic factors. Objective. We examined whether intensive rehabilitation treatment reduces motor disability in patients in the early stages of PD and increases brain-derived neurotrophic factor (BDNF) serum levels. Methods. Thirty participants in the early stages of PD treated with rasagiline were randomly assigned to 3 hours of rehabilitation treatment that included aerobic exercise for 28 days (Group 1) or to not therapy (control; Group 2). BDNF serum levels were assessed at time T0 (baseline, before treatment), T1 (10 days), T2 (20 days), and T3 (28 days). At T0 and T3, we assessed the Unified Parkinson’s Disease Rating Scale (UPDRS) III in both groups, as well as the UPDRS II and total, Berg Balance Scale, and 6-minute walking test only in Group 1. Results. BDNF levels significantly increased...
The hallmark of amnesia is poor explicit long-term memory along with normal short-term memory. It... more The hallmark of amnesia is poor explicit long-term memory along with normal short-term memory. It is often stated that information encountered by amnesic patients is forgotten within 1 minute of presentation. However, previous work has not distinguished between forgetting as a function of time versus the interfering material occupying that time. We show that there is a marked benefit of reduced interference in amnesic patients with mild cognitive impairment (MCI), a condition that is characterised by anterograde amnesia in the absence of other neuropsychological deficits and carries an increased risk for Alzheimer's disease. The result suggests that long-term memory is encoded in these patients to a greater extent than had been realised but that their memory is highly vulnerable to interference.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressi... more Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive and simultaneous degeneration of upper and lower motor neurons. The pathological process associated to ALS, albeit more pronounced in the motor/premotor cortices and along the corticospinal tracts (CST), does not spare extra-motor brain gray (GM) and white (WM) matter structures. However, it remains unclear whether such extra-motor cerebral abnormalities occur with mildly disabling disease, and how irreversible tissue loss and intrinsic tissue damage are interrelated. To this end, we used an optimized version of voxel-based morphometry (VBM) analysis to investigate the patterns of regional GM density changes and to quantify GM and WM diffusivity alterations of the entire brain from mildly disabled patients with ALS. A high-resolution T1-weighted 3D magnetization-prepared rapid acquisition gradient echo and a pulsed gradient spin-echo single shot echo-planar sequence of the brain were acquired from 25 mildly disabled patients with ALS and 18 matched healthy controls. An analysis of covariance was used to compare volumetry and diffusivity measurements between patients and controls. Compared with controls, ALS patients had significant clusters of locally reduced GM density (P < 0.001) in the right premotor cortex, left inferior frontal gyrus (IFG), and superior temporal gyrus (STG), bilaterally. In ALS patients contrasted to controls, we also found significant clusters of locally increased MD (P < 0.001) in the splenium of the corpus callosum and in the WM adjacent to the IFG, STG, and middle temporal gyrus (MTG) of the right hemisphere, and in the WM adjacent to the MTG and lingual gyrus in the left hemisphere. Compared with controls, ALS patients also had significant clusters of locally decreased FA values (P < 0.001) in the CST in the midbrain and corpus callosum, bilaterally. This study supports the notion that ALS is a multisystem disorder and suggests that extra-motor involvement may be an early feature of the disease.
We investigated whether conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) f... more We investigated whether conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) features of the corticospinal tract (CST) contribute to the prediction of the long-term clinical evolution in patients with amyotrophic lateral sclerosis (ALS). Brain conventional and DT MRI were obtained from 18 healthy subjects and 24 patients with sporadic ALS. Mean diffusivity (MD) and fractional anisotropy (FA) of the CST were obtained. Patients were scanned at baseline, then entered a longitudinal clinical follow-up. The ALS Functional Rating scale (ALSFRS) progression rate during follow-up was estimated. Patients were followed up prospectively for a median period of 3.4 years. Two patients were lost at follow-up and eight died during the observation period. The mean ALSFRS progression rate was 0.7/month (range = 0.0–2.0/month). At baseline, ALS patients showed significantly increased MD and decreased FA of the CST compared with controls. CST FA was associated with ALSFRS progression rate. ALSFRS deterioration rate and CST FA were independent predictors of survival in ALS patients. Survival at year 3 was 42% in patients with CST FA ≤ 0.56 compared with 90% in patients with CST FA &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.56. This study shows that more severe CST DT MRI abnormalities predict a poorer long-term clinical outcome in ALS patients. DT MRI of the brain has the potential to offer in vivo markers of disease severity.
Our objective was to investigate grey matter (GM) contraction in patients with amyotrophic latera... more Our objective was to investigate grey matter (GM) contraction in patients with amyotrophic lateral sclerosis (ALS) using tensor based morphometry (TBM). Using a 1.5 Tesla scanner, T1-weighted MRI scans were obtained at baseline and at follow-up (mean interval, 9 months) from 16 ALS and 10 controls. Standard TBM procedures in Statistical Parametric Mapping (SPM2) were used for image processing and statistical analyses. The frontotemporal cortex and basal ganglia were considered areas of interest, based on pathological studies. Eight patients showed rapid clinical progression of ALS during the follow-up period. Compared to controls, all ALS patients showed progression of GM atrophy in left premotor cortex and right basal ganglia. Patients with rapidly progressing ALS showed GM atrophy changes in a larger motor corticalsubcortical area and in extramotor frontal regions compared to both controls and to non-rapidly progressing cases. Thus, TBM detected longitudinal atrophy changes in the motor network in ALS occurring over less than one year. The faster the clinical progression, the greater was the GM loss in motor and prefrontal areas. Further advances in tracking longitudinal changes in cortical and subcortical regions in ALS may provide an objective marker for monitoring disease progression, and the disease-modifying effect of potential treatments.
A potential role for macroautophagy dysfunction in the pathogenesis of amyotrophic lateral sclero... more A potential role for macroautophagy dysfunction in the pathogenesis of amyotrophic lateral sclerosis (ALS) was hypothesized after the demonstration that selected markers are up-regulated in post mortem samples obtained from both patients and animal models of disease. We hypothesized that a putative dysfunction of this catabolic pathway could be operative also in peripheral blood mononuclear cells (PBMC) obtained from ALS patients, since these cells represent an accessible model for studying molecular pathogenesis events in neuropsychiatric disorders. Beclin-1 and LC3II immunoreactivity were assessed in PBMC from 15 ALS patients and 15 controls by Western blot analysis. The expression of Atg12 mRNA was also assessed by real-time PCR. No significant difference was observed for all these parameters between patients and controls, although PBMC displayed a clear macroautophagy induction following exposure to rapamycin and lithium. Finally, we excluded a putative interference of riluzole demonstrating that LC3II immunoreactivity did not change in riluzole-treated SH-SY5Y neuroblastoma cells. In conclusion, the results of our pilot study do not support the idea of a systemic macroautophagic dysfunction in ALS, although they confirm that PBMC are a suitable peripheral marker for monitoring the effects of drugs interfering with this catabolic pathway.
BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST da... more BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS. MATERIALS AND METHODS: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, Ն20) and 20 healthy controls. The mean disease progression rate was 0.62 (range ϭ 0.08-2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi). RESULTS: Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally (P values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls (P ϭ .04). CST FA significantly correlated with the rate of disease progression (right CST: r ϭ Ϫ0.50, P ϭ .02; left CST: r ϭ Ϫ0.41, P ϭ .05). CONCLUSIONS: Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS. ABBREVIATIONS: ALS ϭ amyotrophic lateral sclerosis; ALSFRS ϭ ALS Functional Rating Scale; axial D ϭ axial diffusivity; CST ϭ corticospinal tract; DE ϭ dual-echo; DTI ϭ diffusion tensor imaging; FA ϭ fractional anisotropy; FTD ϭ frontotemporal dementia; MD ϭ mean diffusivity; radial D ϭ radial diffusivity; WM ϭ white matter
Amyotrophic lateral sclerosis & frontotemporal degeneration, Feb 24, 2017
To assess the association between amyotrophic lateral sclerosis (ALS) and previous traumatic even... more To assess the association between amyotrophic lateral sclerosis (ALS) and previous traumatic events, age of trauma, and site of injury. A population-based case-control study was performed in five European countries (Italy, Ireland, France, United Kingdom, Serbia). Newly diagnosed ALS patients and matched controls were interviewed to collect relevant demographic factors and exposures. Key clinical features at diagnosis were collected in ALS patients. Trauma was any accidental event causing an injury. Injuries were dated and classified according to cause, severity, type, site, and complications. All exposures were censored five years before symptoms onset. Risks were computed as odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariate conditional logistic regression models. Five hundred and seventy-five ALS patients and 1150 controls were interviewed. Disabling traumatic events predominated in the cases (OR 1.54 (95% CI 1.24-1.92)) and maintained significa...
La letteratura e il teatro sono stati frequentemente accusati di immoralit\ue0. La civilt\ue0 bor... more La letteratura e il teatro sono stati frequentemente accusati di immoralit\ue0. La civilt\ue0 borghese ha spostato l'accusa dal piano religioso a quello laico, collegandola allo spreco del tempo e al suo impiego in attivit\ue0 non produttive. Proprio in questo contesto prende rilievo l'immoralismo etico della modernit\ue0, come categoria insieme estetica e ideologica
Et défendez au fer d'outrager la nature. [...] Mais les ciseaux cruels... Prévenez ce forfait, Ny... more Et défendez au fer d'outrager la nature. [...] Mais les ciseaux cruels... Prévenez ce forfait, Nymphes des bois, courez. �ue dis-je? c'en est fait. L'acier a retranché leur cime verdoyante. Je n'entends plus au loin, sur leur tête ondoyante, Le rapide aquilon légèrement courir, Frémir dans leurs rameaux, s'éloigner, et mourir. Froids, monotones, morts, du fer qui les mutile Ils semblent avoir pris la raideur immobile. Vous donc, dans vos tableaux amis du mouvement, À vos arbres laissez leur doux balancement. �u'en mobiles objets la perspective abonde: Faites courir, tomber et rejaillir cette onde. […] Donnent le mouvement, la vie aux paysages. 2
A partire da "Malombra" Fogazzaro sposta in ambito psicologico (e si direbbe proto-psic... more A partire da "Malombra" Fogazzaro sposta in ambito psicologico (e si direbbe proto-psicanalitico) le tematiche e i luoghi comuni di tanta letteratura gotica e spiritistica: non dall'oltremondo vengono i fanstasmi ma dalla psiche, dalla forza di impulsi non dominati dalla volont\ue0, dall'azione del sogno, dalla crisi della coscienza razionale. L'attenzione vivissima di Fogazzaro alla psicologia del profondo \ue8 confermata dal discorso "Per una nuova scienza", dove si propongono ricerche che saranno poi importanti per Pirandello. I romanzi della maturit\ue0 rappresentano un'estensione della tematica che in "Malombra" \ue8 collegata alla psicologia d'eccezione della protagonista. Impulsi, pensieri, sintomi inconsci nei successivi romanzi fogazzariani travolgono anche personaggi che vorrebbero aggrapparsi ostinatamente alla normalit\ue0, dando cos\uec all'autore la possibilit\ue0 di rappresentare con efficacia sia la dialettica tra...
La linguistica di Dante ha un valore non solo linguistico-letterario, ma teologico, sociale e pol... more La linguistica di Dante ha un valore non solo linguistico-letterario, ma teologico, sociale e politico, e contribuisce all'elaborazione dell'idea di italianit\ue0 come identit\ue0 composita e plurima
Fogazzaro elabora un realismo non razionalistico, che approfondisce il tema delle lacerazioni int... more Fogazzaro elabora un realismo non razionalistico, che approfondisce il tema delle lacerazioni interne ai gruppiu sociali, alle istituzioni familiari, all'individuo
Il rapporto tra scrittore e popolo compromesso dalla cultura aristocratica del secondo ottocento,... more Il rapporto tra scrittore e popolo compromesso dalla cultura aristocratica del secondo ottocento, viene trasformato in profondit\ue0 dalla guerra, determinando nuove condizioni non solo nella forma del contenuto ma in quella dell'espressione
La cultura italica va ricostruita al di l\ue0 del paradigma storico nazionale, nella sua diffusio... more La cultura italica va ricostruita al di l\ue0 del paradigma storico nazionale, nella sua diffusione al di fuori dei confini della penisola e nei suoi caratteri multiculturali e plurilinguistici. Le migrazioni devono essere affrontate non con pregiudizi etnici e sovranisti, ma con la consapevolezza che le politiche economiche e sociali non sono sufficienti se non vengono accompagnate da politiche culturali capaci di promuovere nel futuro quel medesimo dialogo dal quale la civilt\ue0 italica \ue8 nata e si \ue8 sviluppata nel passato
Background. Although physical exercise improves motor aspects of Parkinson’s disease (PD), it is ... more Background. Although physical exercise improves motor aspects of Parkinson’s disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression. Methods. Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson’s Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later. Results. Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were bet...
Resumo: Objetivo-O objetivo do presente estudo foi avaliar os desfechos do uso associado das técn... more Resumo: Objetivo-O objetivo do presente estudo foi avaliar os desfechos do uso associado das técnicas de Iso Stretching e pompage sobre a capacidade funcional, força muscular respiratória e a mobilidade torácica de indivíduos portadores de doença pulmonar obstrutiva crônica. Métodos-Trata se de um estudo piloto, onde participaram 10 indivíduos, randomizados em grupo tratado e grupo controle. Foram analisadas as variáveis espirométricas, antropométricas, força muscular respiratória e a capacidade funcional. Da amostra, cinco pacientes concluíram o tratamento de quatro semanas de intervenção com as técnicas de Iso Stretching e pompage. Resultados-Após a intervenção, houve aumento na força muscular inspiratória e expiratória para todos os indivíduos do grupo tratado, bem como, aumento na distância percorrida no TC6 e na expansibilidade torácica. Conclusão-um programa terapêutico baseado nas técnicas de Iso Stretching e pompage por quatro semanas, evidenciaram principalmente o aumento na força muscular respiratória, expansibilidade e distância percorrida no TC6. Descritores: Reabilitação, Modalidades de Fisioterapia, DPOC.
Background. Exercise may decrease the risk of Parkinson’s disease (PD) in humans and reduce PD sy... more Background. Exercise may decrease the risk of Parkinson’s disease (PD) in humans and reduce PD symptoms in animal models. The beneficial effects have been linked to increased levels of neurotrophic factors. Objective. We examined whether intensive rehabilitation treatment reduces motor disability in patients in the early stages of PD and increases brain-derived neurotrophic factor (BDNF) serum levels. Methods. Thirty participants in the early stages of PD treated with rasagiline were randomly assigned to 3 hours of rehabilitation treatment that included aerobic exercise for 28 days (Group 1) or to not therapy (control; Group 2). BDNF serum levels were assessed at time T0 (baseline, before treatment), T1 (10 days), T2 (20 days), and T3 (28 days). At T0 and T3, we assessed the Unified Parkinson’s Disease Rating Scale (UPDRS) III in both groups, as well as the UPDRS II and total, Berg Balance Scale, and 6-minute walking test only in Group 1. Results. BDNF levels significantly increased...
The hallmark of amnesia is poor explicit long-term memory along with normal short-term memory. It... more The hallmark of amnesia is poor explicit long-term memory along with normal short-term memory. It is often stated that information encountered by amnesic patients is forgotten within 1 minute of presentation. However, previous work has not distinguished between forgetting as a function of time versus the interfering material occupying that time. We show that there is a marked benefit of reduced interference in amnesic patients with mild cognitive impairment (MCI), a condition that is characterised by anterograde amnesia in the absence of other neuropsychological deficits and carries an increased risk for Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. The result suggests that long-term memory is encoded in these patients to a greater extent than had been realised but that their memory is highly vulnerable to interference.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressi... more Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive and simultaneous degeneration of upper and lower motor neurons. The pathological process associated to ALS, albeit more pronounced in the motor/premotor cortices and along the corticospinal tracts (CST), does not spare extra-motor brain gray (GM) and white (WM) matter structures. However, it remains unclear whether such extra-motor cerebral abnormalities occur with mildly disabling disease, and how irreversible tissue loss and intrinsic tissue damage are interrelated. To this end, we used an optimized version of voxel-based morphometry (VBM) analysis to investigate the patterns of regional GM density changes and to quantify GM and WM diffusivity alterations of the entire brain from mildly disabled patients with ALS. A high-resolution T1-weighted 3D magnetization-prepared rapid acquisition gradient echo and a pulsed gradient spin-echo single shot echo-planar sequence of the brain were acquired from 25 mildly disabled patients with ALS and 18 matched healthy controls. An analysis of covariance was used to compare volumetry and diffusivity measurements between patients and controls. Compared with controls, ALS patients had significant clusters of locally reduced GM density (P < 0.001) in the right premotor cortex, left inferior frontal gyrus (IFG), and superior temporal gyrus (STG), bilaterally. In ALS patients contrasted to controls, we also found significant clusters of locally increased MD (P < 0.001) in the splenium of the corpus callosum and in the WM adjacent to the IFG, STG, and middle temporal gyrus (MTG) of the right hemisphere, and in the WM adjacent to the MTG and lingual gyrus in the left hemisphere. Compared with controls, ALS patients also had significant clusters of locally decreased FA values (P < 0.001) in the CST in the midbrain and corpus callosum, bilaterally. This study supports the notion that ALS is a multisystem disorder and suggests that extra-motor involvement may be an early feature of the disease.
We investigated whether conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) f... more We investigated whether conventional and diffusion tensor (DT) magnetic resonance imaging (MRI) features of the corticospinal tract (CST) contribute to the prediction of the long-term clinical evolution in patients with amyotrophic lateral sclerosis (ALS). Brain conventional and DT MRI were obtained from 18 healthy subjects and 24 patients with sporadic ALS. Mean diffusivity (MD) and fractional anisotropy (FA) of the CST were obtained. Patients were scanned at baseline, then entered a longitudinal clinical follow-up. The ALS Functional Rating scale (ALSFRS) progression rate during follow-up was estimated. Patients were followed up prospectively for a median period of 3.4 years. Two patients were lost at follow-up and eight died during the observation period. The mean ALSFRS progression rate was 0.7/month (range = 0.0–2.0/month). At baseline, ALS patients showed significantly increased MD and decreased FA of the CST compared with controls. CST FA was associated with ALSFRS progression rate. ALSFRS deterioration rate and CST FA were independent predictors of survival in ALS patients. Survival at year 3 was 42% in patients with CST FA ≤ 0.56 compared with 90% in patients with CST FA &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.56. This study shows that more severe CST DT MRI abnormalities predict a poorer long-term clinical outcome in ALS patients. DT MRI of the brain has the potential to offer in vivo markers of disease severity.
Our objective was to investigate grey matter (GM) contraction in patients with amyotrophic latera... more Our objective was to investigate grey matter (GM) contraction in patients with amyotrophic lateral sclerosis (ALS) using tensor based morphometry (TBM). Using a 1.5 Tesla scanner, T1-weighted MRI scans were obtained at baseline and at follow-up (mean interval, 9 months) from 16 ALS and 10 controls. Standard TBM procedures in Statistical Parametric Mapping (SPM2) were used for image processing and statistical analyses. The frontotemporal cortex and basal ganglia were considered areas of interest, based on pathological studies. Eight patients showed rapid clinical progression of ALS during the follow-up period. Compared to controls, all ALS patients showed progression of GM atrophy in left premotor cortex and right basal ganglia. Patients with rapidly progressing ALS showed GM atrophy changes in a larger motor corticalsubcortical area and in extramotor frontal regions compared to both controls and to non-rapidly progressing cases. Thus, TBM detected longitudinal atrophy changes in the motor network in ALS occurring over less than one year. The faster the clinical progression, the greater was the GM loss in motor and prefrontal areas. Further advances in tracking longitudinal changes in cortical and subcortical regions in ALS may provide an objective marker for monitoring disease progression, and the disease-modifying effect of potential treatments.
A potential role for macroautophagy dysfunction in the pathogenesis of amyotrophic lateral sclero... more A potential role for macroautophagy dysfunction in the pathogenesis of amyotrophic lateral sclerosis (ALS) was hypothesized after the demonstration that selected markers are up-regulated in post mortem samples obtained from both patients and animal models of disease. We hypothesized that a putative dysfunction of this catabolic pathway could be operative also in peripheral blood mononuclear cells (PBMC) obtained from ALS patients, since these cells represent an accessible model for studying molecular pathogenesis events in neuropsychiatric disorders. Beclin-1 and LC3II immunoreactivity were assessed in PBMC from 15 ALS patients and 15 controls by Western blot analysis. The expression of Atg12 mRNA was also assessed by real-time PCR. No significant difference was observed for all these parameters between patients and controls, although PBMC displayed a clear macroautophagy induction following exposure to rapamycin and lithium. Finally, we excluded a putative interference of riluzole demonstrating that LC3II immunoreactivity did not change in riluzole-treated SH-SY5Y neuroblastoma cells. In conclusion, the results of our pilot study do not support the idea of a systemic macroautophagic dysfunction in ALS, although they confirm that PBMC are a suitable peripheral marker for monitoring the effects of drugs interfering with this catabolic pathway.
BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST da... more BACKGROUND AND PURPOSE: Most DTI studies in ALS have been limited to the assessment of the CST damage. In this study, we used DTI tractography to investigate whether microstructural abnormalities occur in the major motor and extramotor WM tracts in mildly disabled patients with ALS. MATERIALS AND METHODS: Brain conventional MR imaging and DTI were performed in 24 patients with probable or definite ALS and mild disability (ALSFRS score, Ն20) and 20 healthy controls. The mean disease progression rate was 0.62 (range ϭ 0.08-2.50). DTI tractography was used to segment the CST, the corpus callosum, and the major WM association tracts (ie, cingulum, uncinate fasciculus, inferior fronto-occipital, inferior longitudinal, and superior longitudinal fasciculi). RESULTS: Compared with healthy controls, patients with ALS showed significantly decreased FA and significantly increased MD and radial D of the CST bilaterally (P values from .005 to .01). Patients with ALS also had a significantly increased axial D of the right uncinate fasciculus relative to controls (P ϭ .04). CST FA significantly correlated with the rate of disease progression (right CST: r ϭ Ϫ0.50, P ϭ .02; left CST: r ϭ Ϫ0.41, P ϭ .05). CONCLUSIONS: Patients with ALS and mild disability have preferential damage to the CST. The association of CST damage with the rate of disease progression suggests that DTI has the potential to provide in vivo markers of ALS evolution. The subtle involvement of the uncinate fasciculus may precede the appearance of behavioral symptoms in patients with ALS. ABBREVIATIONS: ALS ϭ amyotrophic lateral sclerosis; ALSFRS ϭ ALS Functional Rating Scale; axial D ϭ axial diffusivity; CST ϭ corticospinal tract; DE ϭ dual-echo; DTI ϭ diffusion tensor imaging; FA ϭ fractional anisotropy; FTD ϭ frontotemporal dementia; MD ϭ mean diffusivity; radial D ϭ radial diffusivity; WM ϭ white matter
Amyotrophic lateral sclerosis & frontotemporal degeneration, Feb 24, 2017
To assess the association between amyotrophic lateral sclerosis (ALS) and previous traumatic even... more To assess the association between amyotrophic lateral sclerosis (ALS) and previous traumatic events, age of trauma, and site of injury. A population-based case-control study was performed in five European countries (Italy, Ireland, France, United Kingdom, Serbia). Newly diagnosed ALS patients and matched controls were interviewed to collect relevant demographic factors and exposures. Key clinical features at diagnosis were collected in ALS patients. Trauma was any accidental event causing an injury. Injuries were dated and classified according to cause, severity, type, site, and complications. All exposures were censored five years before symptoms onset. Risks were computed as odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariate conditional logistic regression models. Five hundred and seventy-five ALS patients and 1150 controls were interviewed. Disabling traumatic events predominated in the cases (OR 1.54 (95% CI 1.24-1.92)) and maintained significa...
La letteratura e il teatro sono stati frequentemente accusati di immoralit\ue0. La civilt\ue0 bor... more La letteratura e il teatro sono stati frequentemente accusati di immoralit\ue0. La civilt\ue0 borghese ha spostato l'accusa dal piano religioso a quello laico, collegandola allo spreco del tempo e al suo impiego in attivit\ue0 non produttive. Proprio in questo contesto prende rilievo l'immoralismo etico della modernit\ue0, come categoria insieme estetica e ideologica
Et défendez au fer d'outrager la nature. [...] Mais les ciseaux cruels... Prévenez ce forfait, Ny... more Et défendez au fer d'outrager la nature. [...] Mais les ciseaux cruels... Prévenez ce forfait, Nymphes des bois, courez. �ue dis-je? c'en est fait. L'acier a retranché leur cime verdoyante. Je n'entends plus au loin, sur leur tête ondoyante, Le rapide aquilon légèrement courir, Frémir dans leurs rameaux, s'éloigner, et mourir. Froids, monotones, morts, du fer qui les mutile Ils semblent avoir pris la raideur immobile. Vous donc, dans vos tableaux amis du mouvement, À vos arbres laissez leur doux balancement. �u'en mobiles objets la perspective abonde: Faites courir, tomber et rejaillir cette onde. […] Donnent le mouvement, la vie aux paysages. 2
La donna illavoro il sogno e un hbro a p111 voc1, che esamma l'evoluzione e le problemanche, pass... more La donna illavoro il sogno e un hbro a p111 voc1, che esamma l'evoluzione e le problemanche, passate e present!, d1 due tra gli aspett1 piu tmportanu della vua e delle aspettattve del mondo femminile, ded1cando parttcolare attenzwne al Novecento. I dodici saggi che compongono 1l volume approfondiscono s1a 1 mutamenti progress1vt, nel nostro Paese, della legislazione sulle donne che lavorano, s1a alcum tra 1 piu nlevanti aspetti letterari e ps1cosoc1ah del lavoro femmimle nell'epoca delle industrie e della tecnologta S1 anahzza qumd1 tl sogno della donna, come esso ha permeate alcuni de1 protagomsti e degh scenan ch1ave della letteratura degli ultimi due secoli, per fimre con 1l sogno femminile nella stona dell'arte modema e 1l lavoro delle donne nello humour de1 mass med1a, dall'avvento della televiswne at giomi nostn.
G. Prezzolini, Vita intima (1903); Il linguaggio come causa d'errore (1904), Studi e capricci sui... more G. Prezzolini, Vita intima (1903); Il linguaggio come causa d'errore (1904), Studi e capricci sui mistici tedeschi (1912), introduzione e nota al testo di F. Finotti
Emma (Emilia Ferretti Viola, Milano, 1844 – Roma, 1929) è la celebre autrice di "Una fra tante", ... more Emma (Emilia Ferretti Viola, Milano, 1844 – Roma, 1929) è la celebre autrice di "Una fra tante", romanzo di forte coscienza sociale e di genere. "La messa a Psiche" è un racconto lungo altrettanto interessante per la tematica simbolista e proto-psicanalitica, dominata dal tema del sogno e della visione ad occhi aperti. Il naturalismo positivista si dissolve in un'atmosfera fluida che ricorda le sculture di Bistolfi, subito proposta da Vittorio Pica come sintomo di un rinnovamento post-verista.
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