Publications by authors named "Carmela Zuco"

4 Publications

  • Page 1 of 1

Epileptic seizures of suspected autoimmune origin: a multicentre retrospective study.

J Neurol Neurosurg Psychiatry 2020 Nov 28;91(11):1145-1153. Epub 2020 Aug 28.

Department of Neuroscience, Biomedicine and Movement Sciences, Section of Neurology, University of Verona, Verona, Italy

Objective: To analyse autoantibody status in a well-defined European multicentre cohort of patients with epilepsy of unknown aetiology and to validate the recently proposed Antibody Prevalence in Epilepsy (APE2) and Response to ImmunoTherapy in Epilepsy (RITE2) scores.

Methods: We retrospectively collected clinical and paraclinical data of 92 patients referred to the Neurology Units of Verona and Salzburg between January 2014 and July 2019 with new-onset epilepsy, status epilepticus or chronic epilepsy of unknown aetiology. Fixed and live cell-based assays, tissue-based assays, immunoblot, and live rat hippocampal cell cultures were performed in paired serum/cerebrospinal fluid (CSF) to detect antineuronal and antiglial antibodies. The APE2 and RITE2 scores were then calculated and compared with clinical and laboratory data.

Results: Autoantibodies were detected in 29/92 patients (31.5%), with multiple positivity observed in 6/29 cases. The APE2 score (median 5, range 1-15) significantly correlated with antibody positivity (p=0.014), especially for the presence of neuropsychiatric symptoms (p<0.01), movement disorders (p<0.01), dysautonomia (p=0.03), faciobrachial dyskinesias (p=0.03) and cancer history (p<0.01). Status epilepticus was significantly more frequent in antibody-negative patients (p<0.01). Among the items of the RITE2 score, early initiation of immunotherapy correlated with a good treatment response (p=0.001), whereas a cancer history was significantly more common among non-responders (p<0.01). Persistence of neuropsychiatric symptoms and seizures correlated with antiepileptic maintenance after at least 1 year.

Conclusions: This is the first study that independently validates the APE2 and RITE2 scores and includes the largest cohort of patients whose paired serum and CSF samples have been tested for autoantibodies possibly associated with autoimmune epilepsy.
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http://dx.doi.org/10.1136/jnnp-2020-323841DOI Listing
November 2020

Increased NK Cell Count in Multiple Sclerosis Patients Treated With Dimethyl Fumarate: A 2-Year Longitudinal Study.

Front Immunol 2019 19;10:1666. Epub 2019 Jul 19.

Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Dimethyl fumarate (DMF) is a disease-modifying drug for relapsing-remitting multiple sclerosis. Among others, DMF impedes immune activation by shifting the balance between inflammatory and regulatory cell types and by inducing apoptosis-triggered lymphopenia. Although the decrease in lymphocyte count is an early effect of the drug in several patients, the long-term impact on lymphocyte subsets is largely unknown. We performed a 2-years observational study on total lymphocyte count and subsets thereof by flow cytometry of peripheral blood of 38 multiple sclerosis patients in treatment with DMF. Data were collected at the beginning and after 3, 6, 12, and 24 months of therapy. Total lymphocyte count decreased in relation to time of exposure to DMF. Mean absolute B cell count decreased by 34.1% ( < 0.001) within the first 3 months of therapy and then remained stable over time. Mean absolute CD3 T cells count decrement reached 47.5% after 12 months of treatment ( < 0.001). NK cells count showed a heterogeneous trend, increasing by 85.9% ( < 0.001) after 2 years of treatment. CD4 T cells and CD8 T cells substantially decreased, with a significant increase of CD4/CD8 ratio during the first year of therapy. NK cells showed a heterogeneous behavior during DMF treatment with a significant increase over time. Since NK cells may also have a regulatory effect on immune system modulation, their increase during DMF treatment might play a role in the efficacy and safety of the drug.
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http://dx.doi.org/10.3389/fimmu.2019.01666DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658905PMC
October 2020

Transcranial sonographic findings in Wilson disease.

J Ultrasound Med 2010 Jul;29(7):1143-5

Department of Neurological Sciences, University of Rome La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.

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http://dx.doi.org/10.7863/jum.2010.29.7.1143DOI Listing
July 2010