Publications by authors named "Laura Pilati"

11 Publications

  • Page 1 of 1

Twenty-four hour blood pressure profile in idiopathic REM sleep behaviour disorder.

Sleep 2021 Sep 23. Epub 2021 Sep 23.

Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy.

Study Objectives: To determine whether autonomic dysfunction in idiopathic REM sleep behaviour disorder (iRBD) affects circadian blood pressure (BP) profile.

Methods: 21 iRBD (mean age 68.8±6.4, mean age at onset 62.2±9.3), 21 drug-free de novo Parkinson's disease (PD) subjects and 21 control subjects (HCs), comparable for age and sex, underwent 24-hour ambulatory BP monitoring. A prospective follow-up study was performed to evaluate the occurrence of neurodegenerative disorders in the iRBD cohort.

Results: In the iRBD group, night-time systolic BP (SBP) was higher (124.0±20.0, p=.026), nocturnal BP decrease lower (4.0±8.7% for SBP and 8.7±8.0% for DBP, p=.001), and non-dipping status more frequent (71.4% for systolic and 52.4% for diastolic BP; p=.001 and p=.01 respectively) than in the HCs. Reverse dipping of SBP was found in 23.8% (p=.048) of the iRBD subjects. Non-dipping status was not associated with differences in gender, age, disease duration, age at disease onset, UPDRS score, presence of antihypertensive therapy or polysomnographic measures. Patients with PD showed daytime and night-time BP profiles comparable to those observed in iRBD. A sub-group analysis considering only the subjects without antihypertensive therapy (12 iRBD, 12 PD) showed results superimposable on those of the whole iRBD and PD groups.Longitudinal follow up (mean 5.1±1.9 years) showed no differences in BP profile at baseline between converters (n=6) and non-converters.

Conclusions: 24-hour BP control was impaired in iRBD. This impairment, similar to patterns observed in de novo PD, consisted of reduced amplitude of nocturnal dipping and increased frequency of non-dipping status. These findings could have implications for cardiovascular morbidity and mortality in iRBD.
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http://dx.doi.org/10.1093/sleep/zsab239DOI Listing
September 2021

Neurophysiological evaluation of visual function in iRBD: potential role in stratifying RBD conversion risk.

Sleep Med 2021 08 15;84:26-31. Epub 2021 May 15.

Neurology and Stroke Unit, ASST Sette Laghi Ospedale di Circolo, Varese; DMC University of Insubria, Varese, Italy.

Study Objectives: To evaluate neurophysiological alterations of visual function in idiopathic REM sleep Behavior Disorder (iRBD) both as markers and predictors of neurodegenerative disorders.

Methods: In a longitudinal follow-up study of 46 consecutive iRBD patients (follow-up duration 8.4 ± 3.4 years), the baseline parameters in luminance-contrast pattern (VEPp), red-green color (VEPc) and motion-onset (VEPm) Visual Evoked Potentials in iRBD were compared to early (ePD) and advanced (aPD) Parkinson's Disease subjects. Parameters of latency and amplitude of iRBD converters to neurodegenerative disease were compared with those of the non-converters.

Results: The VEP P100 mean latency values for both eyes and for both stimulation checks (30' and 15') were significantly longer in all the three groups of patients as compared to controls; moreover latencies were longer in aPD than in the iRBD group who did not differ from the ePD group. The same held true when we analyzed the number of abnormal subjects belonging to each diagnostic group with a higher number of abnormal subjects in the aPD group compared to both the ePD and in iRBD groups. Chromatic and motion potentials were not different from controls and did not differ in the 3 diagnostic groups. The iRBD subjects who converted to a neurodegenerative disorder showed longer P100 latencies and a higher occurrence of VEPp abnormalities than those who did not convert. Again chromatic and motion VEPs were not different depending on conversion.

Conclusions: In iRBD patients the detection of an abnormal VEPp should be considered as a red flag for possible synnucleinopathy, eventually contributing in stratifying the risk of phenoconversion.
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http://dx.doi.org/10.1016/j.sleep.2021.05.006DOI Listing
August 2021

Medication overuse and drug addiction: a narrative review from addiction perspective.

J Headache Pain 2021 Apr 28;22(1):32. Epub 2021 Apr 28.

Regional Headache Referral Center, Sant'Andrea Hospital, Via di Grottarossa 1039, 00189, Rome, Italy.

Chronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache caused by overuse of analgesics or other medications such as triptans to abort acute migraine attacks. The worsening of headache symptoms associated with medication overuse (MO) generally ameliorates following interruption of regular medication use, although the primary headache symptoms remain unaffected. MO patients may also develop certain behaviors such as ritualized drug administration, psychological drug attachment, and withdrawal symptoms that have been suggested to correlate with drug addiction. Although several reviews have been performed on this topic, to the authors best knowledge none of them have examined this topic from the addiction point of view. Therefore, we aimed to identify features in MO and drug addiction that may correlate. We initiate the review by introducing the classes of analgesics and medications that can cause MOH and those with high risk to produce MO. We further compare differences between sensitization resulting from MO and from drug addiction, the neuronal pathways that may be involved, and the genetic susceptibility that may overlap between the two conditions. Finally, ICHD recommendations to treat MOH will be provided herein.
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http://dx.doi.org/10.1186/s10194-021-01224-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080402PMC
April 2021

Migraine and Sport in a Physically Active Population of Students: Results of a Cross-Sectional Study.

Headache 2020 Nov 7;60(10):2330-2339. Epub 2020 Nov 7.

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy.

Objective: In this study, we explored the relationship between migraine and sport in a physically active population of students, analyzing the risk of migraine among sporty students.

Background: The relationship between sport and migraine is controversial; moreover, several studies report on sport as a migraine trigger, but there is evidence that physical activity could have a relevant role in migraine prevention.

Methods: A cross-sectional survey was conducted using the validated ID-migraine questionnaire including specific demo-anthropometric (gender, age, weight, height) and sports variables on a potentially active student population of the University of Palermo. Evaluation in putative migraine subjects of clinical features and disability was explored through the administration of the Italian version of the Migraine Disability Assessment Scale. Statistical analyses were performed using univariate and logistic regression analyses.

Results: Three hundred and ninety-three out of 520 students (210 F, mean age: 23.5 ± 0.7 years; 183 M; mean age: 20.5 ± 0.7 years) participated in this study. Migraine screened positive in 102 subjects (26.0%) and its prevalence was significantly higher among females (P < .001). An increased risk of migraine was found in females, and a protective effect of sport on the risk of migraine among females, but not among males.

Conclusions: The role of exercise in migraine is still unclear. This study supports a protective role of sport in migraine reporting a protective effect in females. Further studies are needed to deepen the association between sport and migraine.
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http://dx.doi.org/10.1111/head.14015DOI Listing
November 2020

Transcranial random noise stimulation over the primary motor cortex in PD-MCI patients: a crossover, randomized, sham-controlled study.

J Neural Transm (Vienna) 2020 12 23;127(12):1589-1597. Epub 2020 Sep 23.

Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy.

Mild cognitive impairment (MCI) is a very common non-motor feature of Parkinson's disease (PD) and the non-amnestic single-domain is the most frequent subtype. Transcranial random noise stimulation (tRNS) is a non-invasive technique, which is capable of enhancing cortical excitability. As the main contributor to voluntary movement control, the primary motor cortex (M1) has been recently reported to be involved in higher cognitive functioning. The aim of this study is to evaluate the effects of tRNS applied over M1 in PD-MCI patients in cognitive and motor tasks. Ten PD-MCI patients, diagnosed according to the Movement Disorder Society, Level II criteria for MCI, underwent active (real) and placebo (sham) tRNS single sessions, at least 1 week apart. Patients underwent cognitive (Digit Span Forward and Backward, Digit Symbol, Visual Search, Letter Fluency, Stroop Test) and motor assessments (Unified Parkinson's Disease Rating Scale [UPDRS-ME], specific timed trials for bradykinesia, 10-m walk and Timed up and go tests) before and after each session. A significant improvement in motor ability (UPDRS-ME and lateralized scores, ps from 0.049 to 0.003) was observed after real versus sham tRNS. On the contrary, no significant differences were found in other motor tasks and cognitive assessment both after real and sham stimulations. These results confirm that tRNS is a safe and effective tool for improving motor functioning in PD-MCI. Future studies using a multisession tRNS applied over multitargeted brain areas (i.e., dorsolateral prefrontal cortex and M1) are required to clarify the role of tRNS regarding rehabilitative intervention in PD.
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http://dx.doi.org/10.1007/s00702-020-02255-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666273PMC
December 2020

A Comprehensive Analysis of Wheat Resistance to Rhopalosiphum padi (Hemiptera: Aphididae) in Brazilian Wheat Cultivars.

J Econ Entomol 2020 06;113(3):1493-1503

Plant Genetics and Molecular Biology Laboratory, Graduate Program in Agronomy, Universidade Estadual do Centro-Oeste, UNICENTRO, Guarapuava, PR, Brazil.

Rhopalosiphum padi L. is one of the predominant aphids affecting wheat crops worldwide. Therefore, the identification of resistant genotypes and the understanding of molecular response mechanisms involved in wheat resistance to this aphid may contribute to the development of new breeding strategies. In this study, we evaluated the resistance of 15 wheat cultivars to R. padi and performed morpho-histological and gene expression analyses of two wheat cultivars (BRS Timbaúva, resistant and Embrapa 16, susceptible) challenged and unchallenged by R. padi. The main findings of our work are as follows: 1) most Brazilian wheat cultivars recently released are resistant to R. padi; 2) Green leaf volatiles are probably involved in the resistance of the BRS Timbaúva cultivar to the aphid; 3) trichomes were more abundant and larger in the resistant cultivar; 4) the internal morphology did not show differences between cultivars; 5) the lipoxygenase-encoding gene was downregulated in the susceptible cultivar and basal expression remained level in the resistant cultivar; and 6) the expression of resistance-related proteins was induced in the resistant but not in the susceptible cultivar. Lipoxygenase is the first enzyme in the octadecanoic pathway, a well-known route for the synthesis of signaling molecules involved in the activation of plant defense. The overall analyses suggest that the key steps in BRS Timbaúva resistance to R. padi may be presence or absence of green leaf volatiles decreasing the aphid preference and the action of nonglandular trichome as a physical barrier, which allows continuous lipoxygenase-encoding gene expression.
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http://dx.doi.org/10.1093/jee/toaa059DOI Listing
June 2020

Incidence of Mild Cognitive Impairment and Dementia in Parkinson's Disease: The Parkinson's Disease Cognitive Impairment Study.

Front Aging Neurosci 2019 8;11:21. Epub 2019 Feb 8.

Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.

Cognitive impairment in Parkinson's disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients. PD patients from a large hospital-based cohort who underwent at least two comprehensive neuropsychological evaluations were retrospectively enrolled in the study. PD-MCI and PDD were diagnosed according to the Movement Disorder Society criteria. Incidence rates of PD-MCI and PDD were estimated. Clinical and demographic factors predicting PD-MCI and dementia were evaluated using Cox proportional hazard model. Out of 139 enrolled PD patients, 84 were classified with normal cognition (PD-NC), while 55 (39.6%) fulfilled the diagnosis of PD-MCI at baseline. At follow-up (mean follow-up 23.5 ± 10.3 months) 28 (33.3%) of the 84 PD-NC at baseline developed MCI and 4 (4.8%) converted to PDD. The incidence rate of PD-MCI was 184.0/1000 pyar (95% CI 124.7-262.3). At multivariate analysis a negative association between education and MCI development at follow-up was observed (HR 0.37, 95% CI 0.15-0.89; = 0.03). The incidence rate of dementia was 24.3/1000 pyar (95% CI 7.7-58.5). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD, giving an incidence rate of 123.5/1000 pyar (95% CI 70.3-202.2). A five time increased risk of PDD was found in PD patients with MCI at baseline (RR 5.09, 95% CI 1.60-21.4). Our study supports the relevant role of PD-MCI in predicting PDD and underlines the importance of education in reducing the risk of cognitive impairment.
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http://dx.doi.org/10.3389/fnagi.2019.00021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376919PMC
February 2019

Wernicke-Korsakoff syndrome complicated by subacute beriberi neuropathy in an alcoholic patient.

Clin Neurol Neurosurg 2018 01 8;164:1-4. Epub 2017 Nov 8.

Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy. Electronic address:

Thiamine (vitamin B1) deficiency is a common condition in alcohol abusers, which can lead to damage of both the peripheral and the central nervous systems. Here we describe the case of an alcoholic patient who presented with acute onset of ataxia, severe weakness of the four limbs, and hypoesthesia and dysesthesia of the distal portion of the upper and lower extremities. The clinical picture also included mental confusion and amnesia. A diagnosis of Wernicke-Korsakoff syndrome was made based on clinical symptoms and brain RMI findings. Electromyography and electroneurography revealed signs of subacute axonal sensory-motor polyneuropathy that were compatible with a rare acute presentation of beriberi. Patient immediately received parenteral thiamine administration, which resulted in rapid clinical amelioration of ataxia and confusion and also in a significant improvement of motor and sensory deficits. The association between Wernicke-Korsakoff syndrome and acute axonal polyneuropathy is a very rare condition that could make less recognizable the clinical picture of a thiamine deficiency. However, the diagnosis of thiamine deficiency should be suspected in every alcoholic patient presenting with acute onset symptoms of central and/or peripheral nervous system involvement. This because the immediate replacement treatment can be life-saving and reverse the clinical symptoms.
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http://dx.doi.org/10.1016/j.clineuro.2017.11.006DOI Listing
January 2018
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