P2-235 ABNORMALITIES OF RESTING STATE ELECTROENCEPHALOGRAPHIC RHYTHM IN PATIENTS WITH DEMENTIA DU... more P2-235 ABNORMALITIES OF RESTING STATE ELECTROENCEPHALOGRAPHIC RHYTHM IN PATIENTS WITH DEMENTIA DUE TO ALZHEIMER’S, PARKINSON’S AND LEWY BODY DISEASES Claudio Del Percio, Roberta Lizio, Susanna Lopez, Andrea Soricelli, Flavio Nobili, Dag Aarsland, Francesco Orzi, Franco Giubilei, Raffaele Ferri, Laura Bonanni, Fabrizio Stocchi, Peter Fuhr, Ute Gschwandtner, Gerhard Ransmayr, Heinrich Garn, Francesca De Pandis, Giovanni B. Frisoni, Carlo de Lena, Bahar G€untekin, Erol Başar, G€orsev Yener, Claudio Babiloni, IRCSS SDN Naples, Naples, Italy; Department of Physiology and Pharmacology, University of Rome, Rome, Italy; Sapienza University of Rome, Rome, Italy; University of Naples Parthenope, Naples, Italy; IRCCS SDN, Naples, Italy; University of Genoa, Italy, Genoa, Italy; King’s College London, London, United Kingdom; University of Rome “La Sapienza”, Rome, Italy; S. Andrea Hospital, Sapienza University of Rome, Rome, Italy; OASI Troina, Troina, Italy; Universit a degli Studi G. d’Annunzio Chieti e Pescara, Chieti, Italy; IRCSS Pisana, Roma, Italy; Universit€atsspital Basel, Basel, Switzerland; Johannes Kepler University Linz, Linz, Austria; AITAustrian Institute of Technology GmbH,Wien, Austria; Hospital San Raffaele of Cassino, Cassino, Italy; Memory Clinic and LANVIE Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland; Laboratory of Alzheimer’s Neuroimaging and Epidemiology LANE, IRCCS Institute The Saint John of God Clinical Research Centre, Brescia, Italy; Istanbul Medipol University, Istanbul, Turkey; Dokuz Eyl€ul University, Izmir, Izmir, Turkey; Dokuz Eyl€ul University, Izmir, Turkey. Contact e-mail: claudio. [email protected]
The round table discussion started with a brief history of the conceptual development of the matu... more The round table discussion started with a brief history of the conceptual development of the maturation phenomenon and its experimental support provided by Professor Igor Matzo. Professor Bazan then gave his impressions. He stated that it is enlightening to picture cell-signaling transduction as leading to different phases in cell death, activation, propagation, execution and final process. He felt that there is more to be learned about the messengers and receptor-mediated mechanisms that trigger the transcription and activation of genes encoding neurotrophic factors. Another area of interest to Professor Bazan involved the identification of mediators which allow communication between glial and neuronal cells. Some of these messengers are inflammatory mediators and the list would also include glutamate and several other diffuseable messengers. It is becoming apparent that the inflammatory response has a neuronal component such that neuronal inflammatory signaling occurs in addition to the well-recognized contribution of microvasculature and inflammatory cells to inflammation. Professor Bazan also suggested that the way signaling dysfunction affects the fate of neurons will probably be a widely studied question. Mitochondria are very important in the final stages of cell death and should be addressed along with synaptic signaling dysfunction and uncoupling of oxidative phosphorylation.
The present manuscript investigates in two animal species by using two different experimental mod... more The present manuscript investigates in two animal species by using two different experimental models of middle cerebral artery occlusion (permanent and transient), the neuroprotective effects of the dopamine receptor agonist apomorphine. These effects were evaluated by measuring the infarct volume and by counting muscle strength at different time points following the ischemic insult. Apomorphine at the dose of 3 mg/Kg when adminsitered at two hours following the occlusion of the middle cerebral artery was able to reduce significantly the infarct volume in the cortex of mice and the ischemic volume of the basal ganglia perfused by the perforant branches of the middle cerebral artery in the rat. In this latter case the behavioral evaluation (i.e. muscle strength) was preserved most effectively in the contralateral side at 24 and 72 hours. The present findings contribute to foster the concept that DA agonists might be useful in the treatment of cerebral ischemia. At the same time the behavioral improvement induced by DA administration following basal ganglia ischemia may be interpreted as the effects of an authentic disease modifying effect rather than a simple symtomatic relief due to a potential loss of DA containing axons in the basal ganglia. These data add on previous evidence showing analogous effects induced by the DA precursor L-DOPA. Apart from providing an evidence of a neuroprotective effect induced by increased DA stimulation the present data call for further studies aimed at comparing the effects of apomorphine with other DA agonists. In fact the quinoline moiety of apomorphine was claimed to protect neurons from a variety of insults independently from a DA agonist activity. The induction of protein clearing pathways appears to be potentially relevant for these effects.
Development of enhanced tolerance to ischemic injury has been demonstrated when lethal ischemia i... more Development of enhanced tolerance to ischemic injury has been demonstrated when lethal ischemia is preceded by sublethal ischemic exposure. This study demonstrates a transneuronal induction of tolerance in distant areas, unaffected by primary ischemia, but connected by neuronal circuitry. In Model I, the induction of spreading depression in the cerebral cortex of the rat preceded 10-min cardiac arrest cerebral ischemia by 3 days. In Model II, the middle cerebral artery (MCA) occlusion for 2h in rats was followed 3 days later by 10-min clamping of both common carotid arteries, with simultaneous lowering of mean arterial blood pressure to 50 mm Hg. In Model III, 5-min bilateral occlusion of common carotid arteries in gerbils was preceded 3 days earlier by 35-min occlusion of the left common carotid artery in ischemiasensitive animals. Our observations in Models I and II revealed a marked bilateral preservation of CA1 pyramidal neurons. Gerbils in Model III showed, on the side of the 35-min occlusion, numerous infarcted regions, including hippocampus, whereas the contralateral hippocampus revealed a marked preservation of CA1 neurons. It is assumed that CA1 pyramidal cell protection is transneuronally transmitted via the entorhinal cortex and is associated with early activation of c-fos expression in both hippocampi.
Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for prima... more Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for primary headaches. However, evidence-based data about the effect of combining shiatsu and pharmacological treatments are still not available. Therefore, we tested the efficacy and safety of combining shiatsu and amitriptyline to treat refractory primary headaches in a single-blind, randomized, pilot study. Subjects with a diagnosis of primary headache and who experienced lack of response to C2 different prophylactic drugs were randomized in a 1:1:1 ratio to receive shiatsu plus amitriptyline, shiatsu alone, or amitriptyline alone for 3 months. Primary endpoint was the proportion of patients experiencing C50%-reduction in headache days. Secondary endpoints were days with headache per month, visual analogue scale, and number of pain killers taken per month. After randomization, 37 subjects were allocated to shiatsu plus amitriptyline (n = 11), shiatsu alone (n = 13), and amitriptyline alone (n = 13). Randomization ensured well-balanced demographic and clinical characteristics at baseline. Although all the three groups improved in terms of headache frequency, visual analogue scale score, and number of pain killers (p \ 0.05), there was no between-group difference in primary endpoint (p = ns). Shiatsu (alone or in combination) was superior to amitriptyline in reducing the number of pain killers taken per month (p \ 0.05). Seven (19%) subjects reported adverse events, all attributable to amitriptyline, while no side effects were related with shiatsu treatment. Shiatsu is a safe and potentially useful alternative approach for refractory headache. However, there is no evidence of an additive or synergistic effect of combining shiatsu and amitriptyline. These findings are only preliminary and should be interpreted cautiously due to the small sample size of the population included in our study.
h i g h l i g h t s • dTMS can improve treatment-resistant chronic migraine (CM). • Bilateral DLP... more h i g h l i g h t s • dTMS can improve treatment-resistant chronic migraine (CM). • Bilateral DLPFC dTMS reduced attack frequency, drug overuse, and depressive symptoms. • dTMS is safe and effective in treatment-resistant CM, with or without depression.
Citing this paper Please note that where the full-text provided on King's Research Portal is ... more Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
Background: Several lines of evidence support the involvement of the lectin pathway of complement... more Background: Several lines of evidence support the involvement of the lectin pathway of complement (LP) in the pathogenesis of acute ischemic stroke. The aim of this multicenter observational study was to assess the prognostic value of different circulating LP initiators in acute stroke. Methods: Plasma levels of the LP initiators ficolin-1,-2, and-3 and mannose-binding lectin (MBL) were measured in 80 stroke patients at 6 h only and in 85 patients at 48 h and later. Sixty-one age-and sex-matched healthy individuals served as controls. Stroke severity was measured on admission using the National Institutes of Health Stroke Scale (NIHSS). The outcome was measured at 90 days by the modified Rankin Scale (mRS). Results: Ficolin-1 was decreased in patients compared with controls measured at 6 h (median 0.13 vs 0.33 μg/ml, respectively, p < 0.0001). At 48 h, ficolin-1 was significantly higher (0.45 μg/ml, p < 0.0001) compared to the 6 h samples and to controls. Likewise, ficolin-2 was decreased at 6 h (2.70 vs 4.40 μg/ml, p < 0.0001) but not at 48 h. Ficolin-3 was decreased both at 6 and 48 h (17.3 and 18.23 vs 21.5 μg/ml, p < 0.001 and <0.05, respectively). For MBL no difference was detected between patients and controls or within patients at the different time points. In multivariate analysis, early ficolin-1 was independently associated with unfavorable mRS outcome (adjusted odds ratio (OR): 2.21, confidence interval (CI) 95 % 1.11-4.39, p = 0.023). Early ficolin-1 improved the discriminating ability of an outcome model including NIHSS and age (area under the curve (AUC) 0.95, CI 95 % 0.90-0.99, p = 0.0001). Conclusions: The ficolins are consumed within 6 h after stroke implicating activation of the LP. Early ficolin-1 is selectively related to 3-month unfavorable outcome.
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature, Jul 14, 2012
BACKGROUND: The Mannose-binding lectin (MBL) pathway of complement plays a pivotal role in the pa... more BACKGROUND: The Mannose-binding lectin (MBL) pathway of complement plays a pivotal role in the pathogenesis of ischemia/reperfusion (I/R) injury after experimental ischemic stroke. As comparable data in human ischemic stroke are limited, we investigated in more detail the association of MBL deficiency with infarction volume and functional outcome in a large cohort of patients receiving intravenous thrombolysis or conservative treatment. METHODOLOGY/PRINCIPAL FINDINGS: In a post hoc analysis of a prospective cohort study, admission MBL concentrations were determined in 353 consecutive patients with an acute ischemic stroke of whom 287 and 66 patients received conservative and thrombolytic treatment, respectively. Stroke severity, infarction volume, and functional outcome were studied in relation to MBL concentrations at presentation to the emergency department. MBL levels on admission were not influenced by the time from symptom onset to presentation (p = 0.53). In the conservative treatment group patients with mild strokes at presentation, small infarction volumes or favorable outcomes after three months demonstrated 1.5 to 2.6-fold lower median MBL levels (p = 0.025, p = 0.0027 and p = 0.046, respectively) compared to patients with more severe strokes. Moreover, MBL deficient patients (>100 ng/ml) were subject to a considerably decreased risk of an unfavorable outcome three months after ischemic stroke (adjusted odds ratio 0.38, p>0.05) and showed smaller lesion volumes (mean size 0.6 vs. 18.4 ml, p = 0.0025). In contrast, no association of MBL concentration with infarction volume or functional outcome was found in the thrombolysis group. However, the small sample size limits the significance of this observation. CONCLUSIONS: MBL deficiency is associated with smaller cerebral infarcts and favorable outcome in patients receiving conservative treatment. Our data suggest an important role of the lectin pathway in the pathophysiology of cerebral I/R injury and might pave the way for new therapeutic interventions
BackgroundParkinson’s disease (PD) is the second‐most common neurodegenerative disorder that affe... more BackgroundParkinson’s disease (PD) is the second‐most common neurodegenerative disorder that affects 2–3% of the population ≥ 65 years of age and may belong to cognitive deficits and dementia in 50% of cases. Disease with Lewy Bodies (DLB) is emerging as another important cause of dementia in pathological aging. PD and DLB are both due to intra‐neuronal Lewy bodies and are characterized not only by motor dysfunctions but also by cognitive and/or psychiatric symptoms. An open issue is the extent to which these diseases are distinct entities. In this respect, here we compared cortical sources of resting state eyes‐closed electroencephalographic (rsEEG) rhythms in PD and DLB patients having visual hallucinations.MethodClinical and rsEEG rhythms in demographic matched PD (N = 93), DLB (N = 46), Alzheimer’s disease dementia (AD, N= 70) and healthy elderly (Nold, N = 60) subjects were available from an international archive. Pathological groups were matched for cognitive status. Individua...
h i g h l i g h t s Patients with prodromal-overt dementia with Lewy bodies (DLB) and visual hall... more h i g h l i g h t s Patients with prodromal-overt dementia with Lewy bodies (DLB) and visual hallucinations show highest parietal delta rhythms. DLB patients with the greatest cognitive deficits show highest posterior alpha rhythms. EEG rhythms are related to clinical manifestations in DLB patients.
P2-235 ABNORMALITIES OF RESTING STATE ELECTROENCEPHALOGRAPHIC RHYTHM IN PATIENTS WITH DEMENTIA DU... more P2-235 ABNORMALITIES OF RESTING STATE ELECTROENCEPHALOGRAPHIC RHYTHM IN PATIENTS WITH DEMENTIA DUE TO ALZHEIMER’S, PARKINSON’S AND LEWY BODY DISEASES Claudio Del Percio, Roberta Lizio, Susanna Lopez, Andrea Soricelli, Flavio Nobili, Dag Aarsland, Francesco Orzi, Franco Giubilei, Raffaele Ferri, Laura Bonanni, Fabrizio Stocchi, Peter Fuhr, Ute Gschwandtner, Gerhard Ransmayr, Heinrich Garn, Francesca De Pandis, Giovanni B. Frisoni, Carlo de Lena, Bahar G€untekin, Erol Başar, G€orsev Yener, Claudio Babiloni, IRCSS SDN Naples, Naples, Italy; Department of Physiology and Pharmacology, University of Rome, Rome, Italy; Sapienza University of Rome, Rome, Italy; University of Naples Parthenope, Naples, Italy; IRCCS SDN, Naples, Italy; University of Genoa, Italy, Genoa, Italy; King’s College London, London, United Kingdom; University of Rome “La Sapienza”, Rome, Italy; S. Andrea Hospital, Sapienza University of Rome, Rome, Italy; OASI Troina, Troina, Italy; Universit a degli Studi G. d’Annunzio Chieti e Pescara, Chieti, Italy; IRCSS Pisana, Roma, Italy; Universit€atsspital Basel, Basel, Switzerland; Johannes Kepler University Linz, Linz, Austria; AITAustrian Institute of Technology GmbH,Wien, Austria; Hospital San Raffaele of Cassino, Cassino, Italy; Memory Clinic and LANVIE Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland; Laboratory of Alzheimer’s Neuroimaging and Epidemiology LANE, IRCCS Institute The Saint John of God Clinical Research Centre, Brescia, Italy; Istanbul Medipol University, Istanbul, Turkey; Dokuz Eyl€ul University, Izmir, Izmir, Turkey; Dokuz Eyl€ul University, Izmir, Turkey. Contact e-mail: claudio. [email protected]
The round table discussion started with a brief history of the conceptual development of the matu... more The round table discussion started with a brief history of the conceptual development of the maturation phenomenon and its experimental support provided by Professor Igor Matzo. Professor Bazan then gave his impressions. He stated that it is enlightening to picture cell-signaling transduction as leading to different phases in cell death, activation, propagation, execution and final process. He felt that there is more to be learned about the messengers and receptor-mediated mechanisms that trigger the transcription and activation of genes encoding neurotrophic factors. Another area of interest to Professor Bazan involved the identification of mediators which allow communication between glial and neuronal cells. Some of these messengers are inflammatory mediators and the list would also include glutamate and several other diffuseable messengers. It is becoming apparent that the inflammatory response has a neuronal component such that neuronal inflammatory signaling occurs in addition to the well-recognized contribution of microvasculature and inflammatory cells to inflammation. Professor Bazan also suggested that the way signaling dysfunction affects the fate of neurons will probably be a widely studied question. Mitochondria are very important in the final stages of cell death and should be addressed along with synaptic signaling dysfunction and uncoupling of oxidative phosphorylation.
The present manuscript investigates in two animal species by using two different experimental mod... more The present manuscript investigates in two animal species by using two different experimental models of middle cerebral artery occlusion (permanent and transient), the neuroprotective effects of the dopamine receptor agonist apomorphine. These effects were evaluated by measuring the infarct volume and by counting muscle strength at different time points following the ischemic insult. Apomorphine at the dose of 3 mg/Kg when adminsitered at two hours following the occlusion of the middle cerebral artery was able to reduce significantly the infarct volume in the cortex of mice and the ischemic volume of the basal ganglia perfused by the perforant branches of the middle cerebral artery in the rat. In this latter case the behavioral evaluation (i.e. muscle strength) was preserved most effectively in the contralateral side at 24 and 72 hours. The present findings contribute to foster the concept that DA agonists might be useful in the treatment of cerebral ischemia. At the same time the behavioral improvement induced by DA administration following basal ganglia ischemia may be interpreted as the effects of an authentic disease modifying effect rather than a simple symtomatic relief due to a potential loss of DA containing axons in the basal ganglia. These data add on previous evidence showing analogous effects induced by the DA precursor L-DOPA. Apart from providing an evidence of a neuroprotective effect induced by increased DA stimulation the present data call for further studies aimed at comparing the effects of apomorphine with other DA agonists. In fact the quinoline moiety of apomorphine was claimed to protect neurons from a variety of insults independently from a DA agonist activity. The induction of protein clearing pathways appears to be potentially relevant for these effects.
Development of enhanced tolerance to ischemic injury has been demonstrated when lethal ischemia i... more Development of enhanced tolerance to ischemic injury has been demonstrated when lethal ischemia is preceded by sublethal ischemic exposure. This study demonstrates a transneuronal induction of tolerance in distant areas, unaffected by primary ischemia, but connected by neuronal circuitry. In Model I, the induction of spreading depression in the cerebral cortex of the rat preceded 10-min cardiac arrest cerebral ischemia by 3 days. In Model II, the middle cerebral artery (MCA) occlusion for 2h in rats was followed 3 days later by 10-min clamping of both common carotid arteries, with simultaneous lowering of mean arterial blood pressure to 50 mm Hg. In Model III, 5-min bilateral occlusion of common carotid arteries in gerbils was preceded 3 days earlier by 35-min occlusion of the left common carotid artery in ischemiasensitive animals. Our observations in Models I and II revealed a marked bilateral preservation of CA1 pyramidal neurons. Gerbils in Model III showed, on the side of the 35-min occlusion, numerous infarcted regions, including hippocampus, whereas the contralateral hippocampus revealed a marked preservation of CA1 neurons. It is assumed that CA1 pyramidal cell protection is transneuronally transmitted via the entorhinal cortex and is associated with early activation of c-fos expression in both hippocampi.
Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for prima... more Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for primary headaches. However, evidence-based data about the effect of combining shiatsu and pharmacological treatments are still not available. Therefore, we tested the efficacy and safety of combining shiatsu and amitriptyline to treat refractory primary headaches in a single-blind, randomized, pilot study. Subjects with a diagnosis of primary headache and who experienced lack of response to C2 different prophylactic drugs were randomized in a 1:1:1 ratio to receive shiatsu plus amitriptyline, shiatsu alone, or amitriptyline alone for 3 months. Primary endpoint was the proportion of patients experiencing C50%-reduction in headache days. Secondary endpoints were days with headache per month, visual analogue scale, and number of pain killers taken per month. After randomization, 37 subjects were allocated to shiatsu plus amitriptyline (n = 11), shiatsu alone (n = 13), and amitriptyline alone (n = 13). Randomization ensured well-balanced demographic and clinical characteristics at baseline. Although all the three groups improved in terms of headache frequency, visual analogue scale score, and number of pain killers (p \ 0.05), there was no between-group difference in primary endpoint (p = ns). Shiatsu (alone or in combination) was superior to amitriptyline in reducing the number of pain killers taken per month (p \ 0.05). Seven (19%) subjects reported adverse events, all attributable to amitriptyline, while no side effects were related with shiatsu treatment. Shiatsu is a safe and potentially useful alternative approach for refractory headache. However, there is no evidence of an additive or synergistic effect of combining shiatsu and amitriptyline. These findings are only preliminary and should be interpreted cautiously due to the small sample size of the population included in our study.
h i g h l i g h t s • dTMS can improve treatment-resistant chronic migraine (CM). • Bilateral DLP... more h i g h l i g h t s • dTMS can improve treatment-resistant chronic migraine (CM). • Bilateral DLPFC dTMS reduced attack frequency, drug overuse, and depressive symptoms. • dTMS is safe and effective in treatment-resistant CM, with or without depression.
Citing this paper Please note that where the full-text provided on King's Research Portal is ... more Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
Background: Several lines of evidence support the involvement of the lectin pathway of complement... more Background: Several lines of evidence support the involvement of the lectin pathway of complement (LP) in the pathogenesis of acute ischemic stroke. The aim of this multicenter observational study was to assess the prognostic value of different circulating LP initiators in acute stroke. Methods: Plasma levels of the LP initiators ficolin-1,-2, and-3 and mannose-binding lectin (MBL) were measured in 80 stroke patients at 6 h only and in 85 patients at 48 h and later. Sixty-one age-and sex-matched healthy individuals served as controls. Stroke severity was measured on admission using the National Institutes of Health Stroke Scale (NIHSS). The outcome was measured at 90 days by the modified Rankin Scale (mRS). Results: Ficolin-1 was decreased in patients compared with controls measured at 6 h (median 0.13 vs 0.33 μg/ml, respectively, p < 0.0001). At 48 h, ficolin-1 was significantly higher (0.45 μg/ml, p < 0.0001) compared to the 6 h samples and to controls. Likewise, ficolin-2 was decreased at 6 h (2.70 vs 4.40 μg/ml, p < 0.0001) but not at 48 h. Ficolin-3 was decreased both at 6 and 48 h (17.3 and 18.23 vs 21.5 μg/ml, p < 0.001 and <0.05, respectively). For MBL no difference was detected between patients and controls or within patients at the different time points. In multivariate analysis, early ficolin-1 was independently associated with unfavorable mRS outcome (adjusted odds ratio (OR): 2.21, confidence interval (CI) 95 % 1.11-4.39, p = 0.023). Early ficolin-1 improved the discriminating ability of an outcome model including NIHSS and age (area under the curve (AUC) 0.95, CI 95 % 0.90-0.99, p = 0.0001). Conclusions: The ficolins are consumed within 6 h after stroke implicating activation of the LP. Early ficolin-1 is selectively related to 3-month unfavorable outcome.
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature, Jul 14, 2012
BACKGROUND: The Mannose-binding lectin (MBL) pathway of complement plays a pivotal role in the pa... more BACKGROUND: The Mannose-binding lectin (MBL) pathway of complement plays a pivotal role in the pathogenesis of ischemia/reperfusion (I/R) injury after experimental ischemic stroke. As comparable data in human ischemic stroke are limited, we investigated in more detail the association of MBL deficiency with infarction volume and functional outcome in a large cohort of patients receiving intravenous thrombolysis or conservative treatment. METHODOLOGY/PRINCIPAL FINDINGS: In a post hoc analysis of a prospective cohort study, admission MBL concentrations were determined in 353 consecutive patients with an acute ischemic stroke of whom 287 and 66 patients received conservative and thrombolytic treatment, respectively. Stroke severity, infarction volume, and functional outcome were studied in relation to MBL concentrations at presentation to the emergency department. MBL levels on admission were not influenced by the time from symptom onset to presentation (p = 0.53). In the conservative treatment group patients with mild strokes at presentation, small infarction volumes or favorable outcomes after three months demonstrated 1.5 to 2.6-fold lower median MBL levels (p = 0.025, p = 0.0027 and p = 0.046, respectively) compared to patients with more severe strokes. Moreover, MBL deficient patients (>100 ng/ml) were subject to a considerably decreased risk of an unfavorable outcome three months after ischemic stroke (adjusted odds ratio 0.38, p>0.05) and showed smaller lesion volumes (mean size 0.6 vs. 18.4 ml, p = 0.0025). In contrast, no association of MBL concentration with infarction volume or functional outcome was found in the thrombolysis group. However, the small sample size limits the significance of this observation. CONCLUSIONS: MBL deficiency is associated with smaller cerebral infarcts and favorable outcome in patients receiving conservative treatment. Our data suggest an important role of the lectin pathway in the pathophysiology of cerebral I/R injury and might pave the way for new therapeutic interventions
BackgroundParkinson’s disease (PD) is the second‐most common neurodegenerative disorder that affe... more BackgroundParkinson’s disease (PD) is the second‐most common neurodegenerative disorder that affects 2–3% of the population ≥ 65 years of age and may belong to cognitive deficits and dementia in 50% of cases. Disease with Lewy Bodies (DLB) is emerging as another important cause of dementia in pathological aging. PD and DLB are both due to intra‐neuronal Lewy bodies and are characterized not only by motor dysfunctions but also by cognitive and/or psychiatric symptoms. An open issue is the extent to which these diseases are distinct entities. In this respect, here we compared cortical sources of resting state eyes‐closed electroencephalographic (rsEEG) rhythms in PD and DLB patients having visual hallucinations.MethodClinical and rsEEG rhythms in demographic matched PD (N = 93), DLB (N = 46), Alzheimer’s disease dementia (AD, N= 70) and healthy elderly (Nold, N = 60) subjects were available from an international archive. Pathological groups were matched for cognitive status. Individua...
h i g h l i g h t s Patients with prodromal-overt dementia with Lewy bodies (DLB) and visual hall... more h i g h l i g h t s Patients with prodromal-overt dementia with Lewy bodies (DLB) and visual hallucinations show highest parietal delta rhythms. DLB patients with the greatest cognitive deficits show highest posterior alpha rhythms. EEG rhythms are related to clinical manifestations in DLB patients.
Uploads
Papers by Francesco Orzi