Cognitive, behavioural, and functional assessment is crucial in longitudinal studies of neurodegenerative dementias (NDD). Central issues, such as the definition of the study population (asymptomatic, at risk, or individuals with... more
Cognitive, behavioural, and functional assessment is crucial in longitudinal studies of neurodegenerative dementias (NDD). Central issues, such as the definition of the study population (asymptomatic, at risk, or individuals with dementia), the detection of change/decline, and the assessment of relevant outcomes depend on quantitative measures of cognitive, behavioural, and functional status.Currently, we are far from having available reliable protocols and tools for the assessment of dementias in Europe. The main problems are the heterogeneity of the tools used across different European countries, the lack of standardisation of administration and scoring methods across centres, and the limited information available about the psychometric properties of many tests currently in widespread use. This situation makes it hard to compare results across studies carried out in different centres, thus hampering research progress, in particular towards the contribution to a "big data"...
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Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic... more
Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke. Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks. Twenty sessions of standard therapy were performed by both groups. In the other 20 sessions the subjects enrolled in the i-Walker-Group (iWG) performed with the i-Walker and the Control-Group patients (CG) performed the same amount of conventional walking oriented therapy. Clinical and instrumented gait assessments were made pre- and post-treatment. The follow-up observation consisted of recording the number of faller...
Research Interests: Robotics, Biomedical Engineering, Rehabilitation, Treatment Outcome, Stroke rehabilitation, and 15 moreExercise therapy, Medicine, Physical Medicine and Rehabilitation, Physical Therapy, Gait, Stroke, Humans, Female, Male, Aged, Middle Aged, Postural Balance, Robotics in Medicine, Neurosciences, and Gait Training
Dendritic cells (DCs) are major orchestrators of immune responses and inflammation. They are migratory cells, which may play a role in Alzheimer's disease (AD), as suggested by prior in vitro studies. With the intent to investigate... more
Dendritic cells (DCs) are major orchestrators of immune responses and inflammation. They are migratory cells, which may play a role in Alzheimer's disease (AD), as suggested by prior in vitro studies. With the intent to investigate the clinical relevance of DC modifications in vivo, the present study was aimed to evaluate the levels of blood DCs in AD patients, in relation to the progression of the disease, the severity of its symptoms, and the treatment with acetylcholinesterase inhibitors (AChEIs), a class of drugs used to improve cognitive functioning in people with dementia. The two main subpopulations of immature blood DCs, namely myeloid (mDCs) and plasmacytoid (pDCs) cells, were evaluated by flow cytometry analysis in 106 AD patients, in comparison with the same cells from 65 individuals with mild cognitive impairment (MCI) and 73 healthy control subjects (HC). The relationship between blood DC levels and symptom severity was also assessed in AD patients, and their blood ...
Research Interests: Immunology, Depression, Dementia, Medicine, Dendritic Cells, and 15 moreItaly, Humans, Female, Disease, Neuroinflammation, Male, Clinical Sciences, Aged, Disease Progression, Myeloid Cells, Alzheimer Disease, Neurosciences, Psychiatric Status Rating Scales, Neuropsychological Tests, and Cognitive dysfunction
Increasing evidence suggests that motor rehabilitation may delay Parkinson's disease (PD) progression. Moreover, parallel treatments in animals up-regulate brain-derived neurotrophic factor (BDNF). Thus, we investigated the effect of... more
Increasing evidence suggests that motor rehabilitation may delay Parkinson's disease (PD) progression. Moreover, parallel treatments in animals up-regulate brain-derived neurotrophic factor (BDNF). Thus, we investigated the effect of a motor rehabilitation protocol on PD symptoms and BDNF serum levels. Motor rehabilitation training consisted of a cycle of 20 days/month of physiotherapy divided in 3 daily sessions. Clinical data were collected at the beginning, at the end, and at 90 days follow-up. BDNF serum levels were detected by ELISA at 0, 7, 14, 21, 30, and 90 days. The follow-up period had a duration of 60 days (T30-T90). The results showed that at the end of the treatment (day 30), an improvement in extrapyramidal signs (UPDRS III; UPDRS III - Gait and Balance items), motor (6 Minute Walking Test), and daily living activities (UPDRS II; PDQ-39) was observed. BDNF levels were increased at day 7 as compared with baseline. After that, no changes in BDNF were observed during ...
Research Interests: Psychology, Rehabilitation, Medicine, Physical Medicine and Rehabilitation, Teaching, and 13 moreActivities of Daily Living, Gait, Humans, Female, Male, Medical Physiology, Aged, Middle Aged, Parkinson´s Disease, Parkinson Disease, Motor activity, Brain-derived neurotrophic factor (BDNF), and Pharmacology and pharmaceutical sciences
We investigated the role of the dopamine system [i.e., subcortical-medial prefrontal cortex (mPFC) network] in dreaming, by studying patients with Parkinson's Disease (PD) as a model of altered dopaminergic transmission. Subcortical... more
We investigated the role of the dopamine system [i.e., subcortical-medial prefrontal cortex (mPFC) network] in dreaming, by studying patients with Parkinson's Disease (PD) as a model of altered dopaminergic transmission. Subcortical volumes and cortical thickness were extracted by 3T-MR images of 27 PD patients and 27 age-matched controls, who were asked to fill out a dream diary upon morning awakening for one week. PD patients do not substantially differ from healthy controls with respect to the sleep, dream, and neuroanatomical measures. Multivariate correlational analyses in PD patients show that dopamine agonist dosage is associated to qualitatively impoverished dreams, as expressed by lower bizarreness and lower emotional load values. Visual vividness (VV) of their dream reports positively correlates with volumes of both the amygdalae and with thickness of the left mPFC. Emotional load also positively correlates with hippocampal volume. Beside the replication of our previou...
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Approach and avoidance are two basic behavioral aptitudes of humans whose correct balance is critical for successful adaptation to the environment. As the expression of approach and avoidance tendencies may differ significantly between... more
Approach and avoidance are two basic behavioral aptitudes of humans whose correct balance is critical for successful adaptation to the environment. As the expression of approach and avoidance tendencies may differ significantly between healthy individuals, different psychobiological factors have been posited to account for such variability. In this regard, two main issues are still open that refers to (i) the role played by dopamine neurotransmission; and (ii) the possible influence of cognitive characteristics, particularly executive functioning. The aim of the present paper was to highlight the contribution of research on Parkinson's disease (PD) to our understanding of the above issues. In particular, we here reviewed PD literature to clarify whether neurobiological and neuropsychological modifications due to PD are associated to changes in approach-avoidance related personality features. Available data indicate that PD patients may show and approach-avoidance imbalance as do...
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A fully adapted behavior requires maximum efficiency to inhibit processes in the motor domain. Although a number of cortical and subcortical brain regions have been implicated, converging evidence suggests that activation of right... more
A fully adapted behavior requires maximum efficiency to inhibit processes in the motor domain. Although a number of cortical and subcortical brain regions have been implicated, converging evidence suggests that activation of right inferior frontal gyrus (r-IFG) and right presupplementary motor area (r-preSMA) is crucial for successful response inhibition. However, it is still unknown how these prefrontal areas convey the necessary signal to the primary motor cortex (M1), the cortical site where the final motor plan eventually has to be inhibited or executed. On the basis of the widely accepted view that brain oscillations are fundamental for communication between neuronal network elements, one would predict that the transmission of these inhibitory signals within the prefrontal-central networks (i.e., r-IFG/M1 and/or r-preSMA/M1) is realized in rapid, periodic bursts coinciding with oscillatory brain activity at a distinct frequency. However, the dynamics of corticocortical effectiv...
Research Interests: Neuroscience, Transcranial Magnetic Stimulation, Biology, Electroencephalography, Medicine, and 15 morePrefrontal Cortex, Biological Sciences, Humans, Movement, Female, Male, Young Adult, Motor Cortex, Synaptic Transmission, Adult, Primary Motor Cortex, Beta Rhythm, photic stimulation, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Cognition, Magnetic Resonance Imaging, Forecasting, Mild Cognitive Impairment, Cognitive reserve, and 15 moreMedicine, Brain, Humans, Female, Disease, Male, Clinical Sciences, Aged, Middle Aged, Longitudinal Studies, Atrophy, Disease Progression, Alzheimer Disease, Cohort Studies, and Nerve degeneration
Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and... more
Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and provide benefits in cognitive functions, by supposedly resolving a “hypoperfusion” condition. Methods. In this study we sought to test whether resolution of a carotid stenosis is followed by measurable changes in cognitive functions in 22 subjects with “asymptomatic” stenosis. Results. A main finding of the study was the statistically significant pre-post difference observed in the performance of phonological verbal fluency and Rey’s 15-word immediate recall. Remarkably, there was a significant interaction between phonological verbal fluency performance and side of the carotid intervention, as the improvement in the verbal performance, a typical “lateralized” skill, was associated with resolution of the left carotid stenosis. Conclusion. The results refle...
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Research Interests: Cognitive Science, Neuroimaging, Cognition, Magnetic Resonance Imaging, Diffusion Tensor Imaging, and 15 moreMedicine, Prefrontal Cortex, Diffusion MRI, Brain Mapping, Insight, Humans, Female, Male, Awareness, Metacognitive, Middle Aged, Adult, Fractional Anisotropy, Neurosciences, and Neuropsychological Tests
Research Interests: Neuroscience, Cognitive Science, Magnetic Resonance Imaging, MRI, Medicine, and 15 moreLanguage disorders, Humans, Cerebral Cortex, Comprehension, Magnetic Resonance, Clinical Sciences, Atrophy, Brain Structure, Neurosciences, Gray Matter, Left Ventricle, Cognition disorders, Narrative Language, Magnetic resonance image, and Medical and Health Sciences
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Research Interests: Neuroscience, Cognitive Science, Computer Science, Deep Brain Stimulation, Neurorehabilitation, and 15 moreCognition, Medicine, Emotions, Learning, Biological Sciences, Humans, Cerebellum, Animals, Neuroimage, Neuronal Plasticity, Neuroenhancement, Neurosciences, Motor activity, Medical and Health Sciences, and Electric stimulation
Research Interests: Genetics, Computer Science, Magnetic Resonance Imaging, Adolescent, Medicine, and 15 moreNeuroimmunology, Humans, Cerebral Cortex, Haplotypes, Female, Neuroimage, Male, Aged, Middle Aged, Adult, Genetic variation, Cortical Thickness, Haplotype, Medical and Health Sciences, and Genetic predisposition to disease
Research Interests: Neuroscience, Neurology, Immunology, Magnetic Resonance Imaging, Biology, and 15 moreAdolescent, Medicine, Neuroprotection, Humans, Female, Neuroinflammation, Male, Clinical Sciences, Middle Aged, Adult, Neurosciences, Frontal Lobe, Enzyme Linked Immunosorbent Assay, Transforming Growth Factor, and Statistics as Topic
This study investigates the differential contribution of gray matter (GM) atrophy and deafferentation through white matter (WM) damage in the clinical progression of Alzheimer's disease (AD). Thirty‐one patients with probable AD, 23... more
This study investigates the differential contribution of gray matter (GM) atrophy and deafferentation through white matter (WM) damage in the clinical progression of Alzheimer's disease (AD). Thirty‐one patients with probable AD, 23 with amnestic mild cognitive impairment (a‐MCI), and 14 healthy subjects underwent MRI scanning at 3T. Voxel‐based morphometry was used to assess regional GM atrophy in AD and a‐MCI patients. Diffusion tensor‐MRI tractography was used to reconstruct the cingulum bilaterally, and to quantify, voxel‐by‐voxel, its fractional anisotropy (FA) and mean diffusivity (MD) (measures of microscopic WM integrity). Atrophy of the cinguli was also assessed by means of jacobian determinants (JD) of local transformations. In AD patients, four clusters of reduced GM were found nearby the cinguli, in the posterior (PCC) and anterior cingulate cortex, and in the hippocampal/parahippocampal areas. Widespread areas of reduced FA and increased MD were found in the cinguli...
Research Interests: Cognitive Science, Dementia, Magnetic Resonance Imaging, Diffusion Tensor Imaging, Mild Cognitive Impairment, and 15 moreMedicine, Diffusion MRI, Humans, Female, Male, Human Brain, Aged, Middle Aged, Atrophy, Cingulum, Fractional Anisotropy, Disease Progression, Human Brain Mapping, Alzheimer Disease, and Fornix
Research Interests: Cognitive Science, Cognition, Magnetic Resonance Imaging, Attention, Medicine, and 15 moreFMRI, Electrocardiography, Autonomic Nervous System, Brain Mapping, Brain, Humans, Insula, Blood Pressure, Functional Magnetic Resonance Imaging, Brainstem, Male, Heart rate, Human Brain, Adult, and Human Brain Mapping
Microstructural analyses by MRI brain scans and by DTI analysis of MR images were used to investigate the possible relationship between deep gray matter structures (amygdala and hippocampus) and dreaming in healthy subjects. Thirty‐four... more
Microstructural analyses by MRI brain scans and by DTI analysis of MR images were used to investigate the possible relationship between deep gray matter structures (amygdala and hippocampus) and dreaming in healthy subjects. Thirty‐four subjects ranging in age 20s to 70s underwent to a MRI protocol for the assessment of volume and mean diffusivity (MD) in the amygdala and hippocampus and were asked to fill out a dream diary via audiotape recording upon morning awakening for two weeks. Multiple regression analyses evaluated the relationships between anatomical measures and quantitative and qualitative measures of the reported dreams. The main result points to a dissociation between some quantitative and qualitative aspects of dream reports. While the mean number of dreams recalled per day did not show any significant relationship with the neuroanatomical measures, significant associations with some qualitative features of the recalled dreams (emotional load, bizarreness, and vividnes...
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The pathology of neuropsychological deficits in Parkinson's disease (PD) is incompletely defined. We investigated cortical thickness and neuropsychological performances in non-demented patients with PD and healthy controls.... more
The pathology of neuropsychological deficits in Parkinson's disease (PD) is incompletely defined. We investigated cortical thickness and neuropsychological performances in non-demented patients with PD and healthy controls. Patients showed significant cortical thinning in right middle temporal and left fusiform cortices. Verbal memory performance was related with left fusiform thinning. Cognitive and cortical changes in non-demented patients with PD are detectable and clearly related.
Research Interests: Neuropsychology, Dementia, Cognition, Magnetic Resonance Imaging, Medicine, and 15 moreHumans, Cerebral Cortex, Female, Male, Clinical Sciences, Aged, Middle Aged, Adult, Cognitive functions, Cortical Thickness, Pilot Projects, Neurosciences, Parkinson Disease, Cognition disorders, and Neuropsychological Tests
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Abstracts of the IX Congresso SindemItalian Association for the study of Dementia linked to the Italian Neurological Society (SIN)Firenze, Palazzo dei Congressi, Villa Vittoria March 13-15, 2014Comitato Scientifico: Vincenzo Bonavita,... more
Abstracts of the IX Congresso SindemItalian Association for the study of Dementia linked to the Italian Neurological Society (SIN)Firenze, Palazzo dei Congressi, Villa Vittoria March 13-15, 2014Comitato Scientifico: Vincenzo Bonavita, Alessandro Padovani, Amalia Bruni, Leonardo Pantoni, Carlo Caltagirone, Lucilla Parnetti, Francesca Clerici, Daniela Perani, Monica Di Luca, Sandro Sorbi, Gianluigi Forloni, Francesco Tagliavini, Giovanni Frisoni, Marilu Gorno Tempini, Claudio Mariani, Annalena Venneri, Massimo Musicco.
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The concept of brain, cognitive, and neural reserves has been introduced to account for the apparent discrepancies between neurological damage and clinical manifestations. However, these ideas are yet theoretical suggestions that are not... more
The concept of brain, cognitive, and neural reserves has been introduced to account for the apparent discrepancies between neurological damage and clinical manifestations. However, these ideas are yet theoretical suggestions that are not completely assimilated in the clinical routine. The mechanisms of the reserves have been extensively studied in neurodegenerative pathologies, in particular in Alzheimer's disease. Both human and animal studies addressed this topic by following two parallel pathways. The specific aim of the present review is to attempt to combine the suggestions derived from the two different research fields to deepen the knowledge about reserves. In fact, the achievement of a comprehensive theoretical framework on reserve mechanisms is an essential step to propose well-timed interventions tailored to the clinical characteristics of patients. The present review highlights the importance of addressing three main aspects: the definition of reserve proxy measures, ...
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Patients with amnestic mild cognitive impairment (aMCI) have higher probability to develop Alzheimer's disease (AD) than elderly controls. The detection of subtle changes in brain structure associated with disease progression and the... more
Patients with amnestic mild cognitive impairment (aMCI) have higher probability to develop Alzheimer's disease (AD) than elderly controls. The detection of subtle changes in brain structure associated with disease progression and the development of tools to identify patients at high risk for dementia in a short time is crucial. Here, we used probabilistic white matter (WM) tractography to explore microstructural alterations within the main association, limbic, and commissural pathways in aMCI patients who converted to AD after 1 year follow-up (MCIconverters) and those who remained stable (MCIstable). Both diffusion tensor imaging (DTI) and quantitative magnetization transfer (qMT) parameters have been considered for a comprehensive pathophysiological characterization of the WM damage. Overall, tract-specific parameters derived from qMT and DTI at baseline were able to differentiate aMCI patients who converted to AD from those who remained stable in time. In particular, the qMT ...
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White matter abnormalities have been shown in the large deep fibers of Alzheimer's disease patients. However, the late myelinating superficial white matter comprised of intracortical myelin and short-range association fibers has not... more
White matter abnormalities have been shown in the large deep fibers of Alzheimer's disease patients. However, the late myelinating superficial white matter comprised of intracortical myelin and short-range association fibers has not received much attention. To investigate this area, we extracted a surface corresponding to the superficial white matter beneath the cortex and then applied a cortical pattern-matching approach which allowed us to register and subsequently sample diffusivity along thousands of points at the interface between the gray matter and white matter in 44 patients with Alzheimer's disease (Age: 71.02 ± 5.84, 16M/28F) and 47 healthy controls (Age 69.23 ± 4.45, 19M/28F). In patients we found an overall increase in the axial and radial diffusivity across most of the superficial white matter (P < 0.001) with increases in diffusivity of more than 20% in the bilateral parahippocampal regions and the temporal and frontal lobes. Furthermore, diffusivity correla...
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Research Interests: Neuroscience, Psychology, Long Term Potentiation, Transcranial Magnetic Stimulation, Neuropsychopharmacology, and 14 moreMedicine, Neuroplasticity, Humans, Female, Male, Neuronal Plasticity, Motor Cortex, Cholinesterase inhibitors, Aged, Cholinergic Systems, Alzheimer Disease, dopaminergic, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Psychology, Cognitive Psychology, Cognitive Science, Semantics, Transcranial Magnetic Stimulation, and 14 moreSemantic Memory, Medicine, Temporal Lobe, Humans, Female, Male, Reaction Time, Young Adult, Adult, Neuropsychologia, Neurosciences, Semantic Dementia, Amodal Perception, and Functional Laterality
Levodopa-induced dyskinesias are disabling motor complications of long-term dopamine replacement in patients with Parkinson's disease. In recent years, several alternative models have been proposed to explain the pathophysiological... more
Levodopa-induced dyskinesias are disabling motor complications of long-term dopamine replacement in patients with Parkinson's disease. In recent years, several alternative models have been proposed to explain the pathophysiological mechanisms underlying this hyperkinetic motor disorder. In particular, our group has shed new light on the role of the prefrontal cortex as a key site of interest, demonstrating that, among other areas, the inferior frontal cortex is particularly characterized by altered patterns of anatomical and functional changes. However, how neural activity varies depending on levodopa treatment in patients with dyskinesias and whether the reported prefrontal abnormalities may have a critical role in dyskinesias is debated. To answer these questions we performed independent functional magnetic resonance imaging and repetitive transcranial magnetic stimulation studies. In the first experiment we applied resting state functional magnetic resonance imaging on 12 pat...
Research Interests: Neuroscience, Psychology, Transcranial Magnetic Stimulation, Medicine, Prefrontal Cortex, and 12 moreBrain, Humans, Functional Magnetic Resonance Imaging, Female, Male, Levodopa, Aged, Middle Aged, Theta Rhythm, Neuropsychological Tests, Psychology and Cognitive Sciences, and Medical and Health Sciences
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The human brain is characterized by the lateralization of cognitive functions. Multiple lines of evidence suggest the deployment of visuospatial attention is controlled by a frontoparietal network, with a right hemisphere dominance. Among... more
The human brain is characterized by the lateralization of cognitive functions. Multiple lines of evidence suggest the deployment of visuospatial attention is controlled by a frontoparietal network, with a right hemisphere dominance. Among cortical areas included in the network, the right posterior parietal cortex (PPC) has been proposed to be a crucial node and has also been implicated on clinical grounds. Here, the authors provide an overview of the existent literature giving evidence to a functional asymmetry of the parietal cortices in directing visuospatial attention, focusing on those studies seeking to characterize the causal role of PPC, applying transcranial magnetic stimulation and its combination with imaging techniques, such as electroencephalography and fMRI. First, the role of PPC and how this region exerts its control over remote areas of both hemispheres is discussed. The second part discusses studies involving neglect patients shedding light on the complex interplay ...