Publications by authors named "Bianca Napolitano"

12 Publications

  • Page 1 of 1

Early and phasic cortical metabolic changes in vestibular neuritis onset.

PLoS One 2013 7;8(3):e57596. Epub 2013 Mar 7.

Department of Medical Science and Translational Medicine, Tor Vergata University, Rome, Italy.

Functional brain activation studies described the presence of separate cortical areas responsible for central processing of peripheral vestibular information and reported their activation and interactions with other sensory modalities and the changes of this network associated to strategic peripheral or central vestibular lesions. It is already known that cortical changes induced by acute unilateral vestibular failure (UVF) are various and undergo variations over time, revealing different cortical involved areas at the onset and recovery from symptoms. The present study aimed at reporting the earliest change in cortical metabolic activity during a paradigmatic form of UVF such as vestibular neuritis (VN), that is, a purely peripheral lesion of the vestibular system, that offers the opportunity to study the cortical response to altered vestibular processing. This research reports [(18)F]fluorodeoxyglucose positron emission tomography brain scan data concerning the early cortical metabolic activity associated to symptoms onset in a group of eight patients suffering from VN. VN patients' cortical metabolic activity during the first two days from symptoms onset was compared to that recorded one month later and to a control healthy group. Beside the known cortical response in the sensorimotor network associated to vestibular deafferentation, we show for the first time the involvement of Entorhinal (BAs 28, 34) and Temporal (BA 38) cortices in early phases of symptomatology onset. We interpret these findings as the cortical counterparts of the attempt to reorient oneself in space counteracting the vertigo symptom (Bas 28, 34) and of the emotional response to the new pathologic condition (BA 38) respectively. These interpretations were further supported by changes in patients' subjective ratings in balance, anxiety, and depersonalization/derealization scores when tested at illness onset and one month later. The present findings contribute in expanding knowledge about early, fast-changing, and complex cortical responses to pathological vestibular unbalanced processing.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057596PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591410PMC
September 2013

P6 acupressure effectiveness on acute vertiginous patients: a double blind randomized study.

J Altern Complement Med 2012 Dec 5;18(12):1121-6. Epub 2012 Sep 5.

Institute of Otorhinolaryngology, Tor Vergata University, Rome, Italy.

Objectives: The purpose of this study was to evaluate the effectiveness of P6 acupressure on vertigo and neurovegetative symptoms, its possible interference with vestibular-ocular reflex (VOR), and its clinical usefulness during acute vertigo.

Materials And Methods: Two hundred and four patients, either affected by acute vertigo (n=124) or undergoing labyrinth stimulation (n=80), were randomly divided in two homogeneous groups: an experimental group A and a placebo group B. Each patient rated severity of vertigo and neurovegetative symptoms on a visuo-analogue scale ranging from 0 to 10, before and after bilateral placement of a P6 device. The latter was placed on the P6 acupressure point (appropriate placement) in Group A patients or on the dorsal part of the carpus (inappropriate placement) in the Group B patients. Furthermore, qualitative and quantitative nystagmus parameters were collected via recorded video-oculoscopy and electronystagmography.

Results: Eighty-five percent of Group A patients reported improvement of symptoms, which was significant for neurovegetative symptoms, but not for vertigo. In contrast, only 11% of the Group B patients reported improvement. VOR analysis did not show any significant variation of qualitative and quantitative nystagmus variables.

Conclusions: This study demonstrated that the P6 device is effective in improving neurovegetative symptoms in patients affected by spontaneous and provoked vertigo, without any interference with VOR. Given the low cost and lack of side-effects of the P6 device, its routine application is suggested for acute vertigo and during labyrinth stimulation.
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http://dx.doi.org/10.1089/acm.2011.0384DOI Listing
December 2012

Connexin 26 (GJB2) mutations as a cause of the KID syndrome with hearing loss.

Biochem Biophys Res Commun 2010 Apr 20;395(1):25-30. Epub 2010 Mar 20.

Biochemistry Laboratory, IDI-IRCCS, C/O Department of Experimental Medicine and Biochemical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy.

KID syndrome (MIM 148210) is an ectodermal dysplasia characterized by the occurrence of localized erythematous scaly skin lesions, keratitis and severe bilateral sensorineural deafness. KID syndrome is inherited as an autosomic dominant disease, due to mutations in the gene encoding gap junction protein GJB2 (connexin 26, Cx26). Cx26 is a component of gap junction channels in the epidermis and in the stria vascularis of the cochlea. These channels play a role in the coordinated exchange of molecules and ions occurring in a wide spectrum of cellular activities. In this paper we describe two patients with Cx26 mutations cause cell death by the alteration of protein trafficking, membrane localization and probably interfering with intracellular ion concentrations. We discuss the pathogenesis of both the hearing and skin phenotypes.
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http://dx.doi.org/10.1016/j.bbrc.2010.03.098DOI Listing
April 2010

Cerebral plasticity in acute vestibular deficit.

Eur Arch Otorhinolaryngol 2009 Oct 18;266(10):1547-51. Epub 2009 Mar 18.

Department of Otolaryngology, University of Rome Tor Vergata, Policlinico Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy.

The aim of this study was to analyze the effect of acute vestibular deficit on the cerebral cortex and its correlation with clinical signs and symptoms. Eight right-handed patients affected by vestibular neuritis, a purely peripheral vestibular lesion, underwent two brain single photon emission computed tomography (SPECT) in 1 month. The first SPECT analysis revealed reduced blood flow in the temporal frontal area of the right hemisphere in seven of eight patients, independent of the right/left location of the lesion. The alteration was present always in the right, non-dominant hemisphere and was reversible in some patients 1 month after the onset, together with attenuation of signs and symptoms. It may be hypothesized that the transient reduction of cortical blood flow and subsequently of cortical activity in the non-dominant hemisphere, also the expression of cerebral plasticity, may serve as a defense mechanism aimed to attenuate the vertigo symptom.
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http://dx.doi.org/10.1007/s00405-009-0953-4DOI Listing
October 2009

Dual-energy X-ray absorptiometry analysis of body composition in patients affected by OSAS.

Eur Arch Otorhinolaryngol 2009 Aug 4;266(8):1285-90. Epub 2008 Nov 4.

Department of Otolaryngology, University of Rome "Tor Vergata", Italy.

Obstructive sleep apnoea syndrome (OSAS) is a disorder characterized by recurrent episodes of apnoea. This study evaluates the body composition in OSAS patients compared to normal weight, pre-obese and obese subjects. Body composition has been measured by dual-energy X-ray absorptiometry in the whole body and in three different body regions. Abdominal region revealed no significant differences in fat mass percentage between patients and controls and no correlation between fat mass percentage and severity of OSAS. At the level of oral region, OSAS patients showed a significant decrease of fat free mass compared to control groups. At the level of neck region, OSAS patients showed a significant increase of fat mass compared to control groups and a significant correlation between the neck fat mass percentage and severity of OSAS. Regional fat distribution constitutes a risk factor for OSAS and a prognostic factor for severity of OSAS.
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http://dx.doi.org/10.1007/s00405-008-0844-0DOI Listing
August 2009

Voice disorders and posturography: variables to define the success of rehabilitative treatment.

J Voice 2009 Jan 5;23(1):71-5. Epub 2007 Nov 5.

Department of Otolaryngology, University of Rome Tor Vergata, Roma, Italy.

Previous studies have investigated the relationship between muscular tension, body posture, and voice quality. The aim of this paper is to study the postural pattern during voice production in healthy subjects compared with patients affected by voice disorders and in the same patients before and after vocal treatment by means of static posturography. Classic posturographic variables and spectral frequency analysis of body sway have been measured. Posturographic values in patients before vocal treatment and controls were within normal ranges but not homogeneous. Body sway significantly decreased during voice production in patients after voice training. Spectral frequency analysis of body sway showed a significantly decreased body sway at middle frequencies on the anteroposterior (y) plane during voice production after voice training. Our results would suggest that in patients affected by voice disorders rehabilitative treatment may cause an improvement of the body proprioceptive scheme and this improvement might be useful to evaluate the proper (ongoing) treatment.
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http://dx.doi.org/10.1016/j.jvoice.2007.06.002DOI Listing
January 2009

Paroxysmal positional vertigo in skeet shooters and hunters.

Eur Arch Otorhinolaryngol 2007 Apr 23;264(4):381-3. Epub 2007 Jan 23.

Department of Otolaryngology, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy.

Paroxysmal positional vertigo (PPV) is a high prevalence vestibular end organ disorder due to the detachment of the utricular otoconia floating in the posterior or lateral semicircular canal. In the majority of cases the etiology of PPV is unknown and it may follow viral infections, vascular disorders and head trauma. This report presents six cases (out of 520 diagnoses of PPV) of PPV following repeated training sessions of skeet shooting or gun shooting during animal hunting. The transmission of impulsive and vibratory energy from the shoulder to the cervical spine and the subsequent minimal whiplash injury ipsilateral to the side where the gun is placed on the shoulder may be considered to be responsible of the otoconia detachment.
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http://dx.doi.org/10.1007/s00405-006-0198-4DOI Listing
April 2007

Recurrent paroxysmal positional vertigo related to oral contraceptive treatment.

Gynecol Endocrinol 2006 Jan;22(1):5-8

Department of Otolaryngology, University of Rome Tor Vergata, Rome, Italy.

Benign paroxysmal positional vertigo (BPPV) is a high-prevalence vestibular end-organ disorder caused by the detachment of utricular otoconia which float in the posterior or lateral semicircular canal. In the majority of cases the etiology of BPPV is unknown and it may follow viral infection, vascular disorders or head trauma. BPPV may be recurrent, with some authors demonstrating a correlation between recurrence and female gender. We report herein on ten cases (out of 289 diagnoses of BPPV) of recurrent idiopathic BPPV, occurring in healthy women receiving oral contraceptive treatment, which ceased after treatment suspension. It has been hypothesized that the impaired water and electrolyte balance, the variations of endolymphatic pH and the impairment of glucose or lipid metabolism induced by oral contraceptive treatment may cause otoconial degeneration and subsequent otoconia detachment and BPPV. The rarity of the finding (10/289) could account for the poor attention paid to the hormonal pathogenesis of BPPV.
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http://dx.doi.org/10.1080/09513590500441614DOI Listing
January 2006

Posturography frequency analysis of sound-evoked body sway in normal subjects.

Eur Arch Otorhinolaryngol 2006 Mar 1;263(3):248-52. Epub 2006 Feb 1.

Department Otolaryngology, University of Rome Tor Vergata, Rome, Italy.

Sound-evoked activation of the vestibular system has been suggested for a long time, and myogenic potentials have been recorded at the level of different muscular groups while a high intensity sound was applied. The aim of this study was to analyse sound-evoked postural responses in normal subjects and to correlate them with the activation of the vestibular system. Body sway was measured by posturography and elaborated through spectral frequency analysis in 40 healthy volunteers in the basal condition and after applying a sound stimulus monoaurally. Spectral frequency analysis results showed a significant increase, in presence of stimulus, of body sway at low and middle frequencies only on the lateral plane and in the closed-eyes condition. As it seems that these frequency ranges are mainly under vestibular control, our results suggest that sound activates specifically the vestibular system, and posturography during sound stimulation represents an alternative approach to assess vestibular function.
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http://dx.doi.org/10.1007/s00405-005-0965-7DOI Listing
March 2006

Indium111 pentetreotide single photon emission computed tomography (In111 pentetreotide SPECT): a new technique to evaluate somatostatin receptors in chordomas.

J Laryngol Otol 2005 May;119(5):405-8

Department of Otorhinolaryngology, University Tor Vergata, Rome, Italy.

Chordomas are rare neoplasms originating along the neuraxis. Although they do not usually show cytological atypia, metastases have been reported in 30 per cent of cases. Survival rates in cases of skull base locations are low, and local recurrence is common after local excision. Radiation therapy is used in post-operative treatment and proton radiation therapy as the primary treatment. In the present paper we present the case of a 50-year-old Caucasian man affected by chordoma of the clivus, with liver and chest metastases, relapsed after several surgical local excisions, to discuss improvements in therapeutic and imaging techniques. Indium111 (In111) pentetreotide single photon emission computed tomography (SPECT) was employed to assess the presence of somatostatin receptors and to treat the tumour with radiolabelled Y90-DOTA-lanreotide. Imaging, performed 2 months afterwards, showed stable disease in the lungs but a local progression in the metastases, in comparison with pre-treatment uptake. These data suggest the usefulness of radiolabelled somatostatin analogues in the diagnosis and therapy of chordomas.
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http://dx.doi.org/10.1258/0022215053945886DOI Listing
May 2005

Paroxysmal positional vertigo as a complication of osteotome sinus floor elevation.

Eur Arch Otorhinolaryngol 2005 Aug 27;262(8):631-3. Epub 2005 Feb 27.

School of Dentistry, University of Rome Tor Vergata, Rome, Italy.

Paroxysmal positional vertigo (PPV) is a high prevalence, vestibular end organ disorder due to the detachment of the utricular otoconia floating in the posterior or lateral semicircular canal. Even though in the majority of cases the etiology of PPV is unknown, it may follow viral infection, vascular disorders and head trauma after different surgical procedures. The aim of this study was to investigate the correlation between PPV and the surgical trauma induced by the vibratory and percussive forces on the upper maxilla during the osteotome sinus floor elevation procedure. We performed a complete otoneurological examination on 146 patients affected by atrophic ridges before and after upper maxilla surgery. Four patients showed a PPV of the posterior semicircular canal controlateral to the implanted side 1 or 2 days after the surgical procedure, which promptly was solved with the Epley re-positioning maneuver. We hypothesize that the surgical trauma, and specifically the pressure exerted by the osteotomes, determines the detachment of the otoliths from the utricular macula while the patient head position, hyper-extended and tilted opposite to the side where the surgeon is working, favors the entry of these free-floating particles in the posterior semicircular canal of the implanted side. Although this disease is rather frequent in the normal population and it is a benign, self-limiting peripheral disorder, it should be considered by the oral surgeon as a possible complication of pre-prosthetic upper maxilla surgery, and the patient should be informed before undergoing surgery.
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http://dx.doi.org/10.1007/s00405-004-0879-9DOI Listing
August 2005

Vestibular compensation: analysis of postural re-arrangement as a control index for unilateral vestibular deficit.

Neuroreport 2003 May;14(7):1075-9

Department of Biopathology and Diagnostic Imaging, University of Rome Tor Vergata, Roma, Italy.

Patients with an acute unilateral vestibular lesion show an impaired balance control. The initial presentation is vertigo followed by postural instability; but with time, the global balance functions can be completely restored by a process called vestibular compensation. The aim of our study was to evaluate short and long-term variations of postural parameters in 20 patients affected by vestibular neuritis (VN), and to compare these patients to 20 normal individuals using computerized static posturography (CSP) along with patient feedback throughout the spectral frequency analysis. This analysis showed in patients with no residual dizziness a frequency shift of body sway from low to middle frequencies as a probable expression of the compensatory strategies used by the central nervous system. On the other hand, patients with persistence of postural instability did not show any frequency shift. Our results seem to provide an early index of a proper occurring compensation so that we can adjust therapeutic protocols according to each patient's functional modifications.
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http://dx.doi.org/10.1097/01.wnr.0000070827.57864.49DOI Listing
May 2003