Functional neurology最新文献

{"title":"Electrodiagnostic and nerve ultrasonographic features in upper limb spasticity: an observational study.","authors":"A Picelli, S Tamburin, G Berto, E Chemello, Marialuisa Gandolfi, Leopold Saltuari, Andreas Waldner, Nicola Smania","doi":"10.11138/fneur/2017.32.3.119","DOIUrl":"10.11138/fneur/2017.32.3.119","url":null,"abstract":"<p><p>To better understand the effects of spasticity on peripheral nerves, we evaluated the electrodiagnostic and nerve ultrasonographic features of the median and ulnar nerves in adults with upper limb spasticity. Twenty chronic stroke patients with spastic hemiparesis underwent nerve conduction study and nerve ultrasonography of the median and ulnar nerves at both upper limbs. Affected versus unaffected upper limb comparisons showed significant differences in the median and ulnar nerve distal motor latencies, compound muscle action potentials and F-wave minimal latencies. Furthermore, we observed a significantly greater median nerve crosssectional area at the elbow of the affected upper limb compared with the unaffected one. Our findings confirmed electrodiagnostic asymmetries and nerve ultrasonographic abnormalities in the affected versus the unaffected upper limb after stroke. Slight changes in lower motor neuron activity and spasticity might contribute to these alterations.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726346/pdf/119-122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative, functional MRI and neurophysiological markers in a case of Gerstmann-Sträussler-Scheinker syndrome.","authors":"Silvia Marino,&nbsp;Rosa Morabito,&nbsp;S De Salvo,&nbsp;L Bonanno,&nbsp;A Bramanti,&nbsp;P Pollicino,&nbsp;R Giorgianni,&nbsp;Placido Bramanti","doi":"10.11138/fneur/2017.32.3.153","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.3.153","url":null,"abstract":"<p><p>Gerstmann-Sträussler-Scheinker syndrome (GSS) is an inherited autosomal dominant prion disease, caused by a codon 102 proline to leucine substitution (P102L) in the prion protein gene (PRNP). We describe the case of a 40-year-old male, affected by a slowly progressive gait disturbance, leg weakness and cognitive impairment. Genomic DNA revealed a point mutation of PRNP at codon 102, resulting in P102L, and the diagnosis of GSS was confirmed. Somatosensory evoked potentials showed alterations of principal parameters, particularly in the right upper and lower limbs. Laser-evoked potentials were indicative of nociceptive system impairment, especially in the right upper and lower limbs. Conventional magnetic resonance imaging (MRI) revealed marked atrophy of the vermis and cerebellar hemispheres and mild atrophy of the middle cerebellar peduncles and brainstem, as confirmed by a brain volume automatic analysis. Resting-state functional MRI showed increased functional connectivity in the bilateral visual cortex, and decreased functional connectivity in the bilateral frontal pole and supramarginal and precentral gyrus. Albeit limited to a single case, this is the first study to assess structural and functional connectivity in GSS using a multimodal approach.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"153-158"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.3.153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35617125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nociceptive blink reflex habituation biofeedback in migraine.","authors":"M de Tommaso,&nbsp;M Delussi","doi":"10.11138/fneur/2017.32.3.123","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.3.123","url":null,"abstract":"<p><p>Reduced habituation of the nociceptive blink reflex (NBR) is considered a trait marker for genetic predisposition to migraine. In this open-label randomized controlled study, we aimed to test the efficacy of a biofeedback training based on learning of habituation of the NBR (NBR biofeedback) compared with pharmacological (topiramate) treatment and NBR biofeedback plus topiramate treatment in a cohort of migraine without aura patients eligible for prophylaxis. Thirty-three migraine patients were randomly assigned to three months of treatment with: 1) NBR biofeedback, 2) NBR biofeedback plus topiramate 50 mg (b.i.d.), or 3) topiramate 50 mg (b.i.d.). Frequency of headache and disability changes were the main study outcomes. Anxiety, depression, sleep, fatigue, quality of life, allodynia and pericranial tenderness were also evaluated. NBR biofeedback reduced the R2 area, without improving R2 habituation. However, it reduced the frequency of headache and disability, similarly to the combined treatment and topiramate alone. Reduced habituation of the NBR is a stable neurophysiological pattern, scarcely modifiable by learning procedures. Training methods able to act on stress-related responses may modulate cortical mechanisms inducing migraine onset and trigeminal activation under stressful trigger factors.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"123-130"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726347/pdf/123-130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Italian regulations on pathways of care for patients in a vegetative or minimally conscious state.","authors":"D Sattin, L De Torres, G Dolce, Francesco Arcuri, Anna Estraneo, V Cardinale, R Piperno, E Zavatta, Rita Formisano, Mariagrazia D'Ippolito, C Vassallo, B Dessi, G Lamberti, E Antoniono, C Lanzillotti, J Navarro, P Bramanti, Silvia Marino, M Zampolini, F Scarponi, R Avesani, L Salvi, S Ferro, L Mazza, P Fogar, S Feller, F De Nigris, A Martinuzzi, M Buffoni, A Pessina, P Corsico, M Leonardi","doi":"10.11138/fneur/2017.32.3.159","DOIUrl":"10.11138/fneur/2017.32.3.159","url":null,"abstract":"<p><p>Different rehabilitation models for persons diagnosed with disorders of consciousness have been proposed in Europe during the last decade. In Italy, the Ministry of Health has defined a national healthcare model, although, to date, there is a lack of information on how this has been implemented at regional level. The INCARICO project collected information on different regional regulations, analysing ethical aspects and mapping care facilities (numbers of beds and medical units) in eleven regional territories. The researchers found a total of 106 laws; differences emerged both between regions and versus the national model, showing that patients with the same diagnosis may follow different pathways of care. An ongoing cultural shift from a treatment-oriented medical approach towards a care-oriented integrated biopsychosocial approach was found in all the welfare and healthcare systems analysed. Future studies are needed to explore the relationship between healthcare systems and the quality of services provided.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"159-163"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726352/pdf/159-163.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35617124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pisa syndrome in Parkinson's disease: electromyographic quantification of paraspinal and non-paraspinal muscle activity.","authors":"C Geroin,&nbsp;G Squintani,&nbsp;A Morini,&nbsp;F Donato,&nbsp;Nicola Smania,&nbsp;Maria Giovanna Gandolfi,&nbsp;S Tamburin,&nbsp;Alfonso Fasano,&nbsp;Michele Tinazzi","doi":"10.11138/fneur/2017.32.3.143","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.3.143","url":null,"abstract":"<p><p>Patients with Parkinson's disease (PD) and Pisa syndrome (PS) may present tonic dystonic or compensatory (i.e. acting against gravity) hyperactivity in the paraspinal and non-paraspinal muscles. Electromyographic (EMG) activity was measured in nine patients with PD and PS, three with PD without PS, and five healthy controls. Fine-wire intramuscular electrodes were inserted bilaterally into the iliocostalis lumborum (ICL), iliocostalis thoracis (ICT), gluteus medius (GM), and external oblique (EO) muscles. The root mean square (RMS) of the EMG signal was calculated and normalized for each muscle. In stance condition, side-to-side muscle activity comparisons showed a higher RMS only for the contralateral ICL in PD patients with PS (p=0.028). Moreover, with increasing degrees of lateral flexion, the activity of the EO and the ICL muscles progressively increased and decreased, respectively. The present data suggest that contralateral paraspinal muscle activity plays a crucial compensatory role and can be dysfunctional in PD patients with PS.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"143-151"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.3.143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking dementias.","authors":"E Sinforiani, Matteo Cotta Ramusino, Alfredo Costa","doi":"10.11138/fneur/2017.32.3.117","DOIUrl":"10.11138/fneur/2017.32.3.117","url":null,"abstract":"","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"117-118"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726345/pdf/117-118.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery from vegetative state of patients with a severe brain injury: a 4-year real-practice prospective cohort study.","authors":"Alessio Baricich,&nbsp;A de Sire,&nbsp;E Antoniono,&nbsp;F Gozzerino,&nbsp;G Lamberti,&nbsp;C Cisari,&nbsp;M Invernizzi","doi":"10.11138/fneur/2017.32.3.131","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.3.131","url":null,"abstract":"<p><p>Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU). The aim of the study was to assess their recovery in order to identify variables that might increase the probability of a VS patient transitioning to MCS. Rehabilitation treatment included passive joint mobilisation and helping/placing patients into an upright sitting position on a tilt table. All the patients underwent a specific assessment protocol every month to identify any emergence, however late, from the VS. Over a 4-year period, 194 patients suffering sequelae of a severe brain injury, consecutively seen, had an initial Glasgow Coma Scale score ≤ 8. Of these, 63 (32.5%) were in a VS, 84 (43.3%) in a MCS, and 47 (24.2%) in a coma; of the 63 patients admitted in a VS, 49 (57.1% males and 42.9% females, mean age 25.34 ± 19.12 years) were transferred to a specialist VSU and put on a slow-to-recover brain injury programme. Ten of these 49 patients were still in a VS after 36 months; of these 10, 3 recovered consciousness, transitioning to a MCS, 2 died, and 5 remained in a VS during the last 12 months of the observation. Univariate analysis identified male sex, youth, a shorter time from onset of the VS, diffuse brain injury, and the presence of status epilepticus as variables increasing the likelihood of transition to a MCS. Long-term monitoring of patients with chronic disorders of consciousness should be adequately implemented in order to optimise their access to rehabilitation services.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"131-136"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.3.131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnea syndrome in Parkinson's disease and other parkinsonisms.","authors":"F Crosta, Giovambattista Desideri, Carmine Marini","doi":"10.11138/fneur/2017.32.3.137","DOIUrl":"10.11138/fneur/2017.32.3.137","url":null,"abstract":"<p><p>An association of obstructive sleep apnea syndrome (OSAS) and other sleep-disordered breathing (SDB) with Parkinson's disease (PD) has been reported in some small studies. In the present study we investigated the occurrence of SDB in a large consecutive outpatient series. This is a case-control study in subjects attending a neurological clinic where all patients were screened for SDB by means of sleep-wake history, Epworth Sleepiness Scale, and full-night polysomnography, when indicated. 3194 patients were recruited. Of these, 194 were affected by PD and 77 by other parkinsonisms. Snoring, excessive daytime sleepiness and OSAS were more common in patients with PD or parkinsonisms (40.59, 5.9, and 4.06%) than in controls (35.58, 2.19, and 2.09%). Our study suggests an increased frequency of OSAS and other SDB in PD and parkinsonisms. Early detection and management of these disorders may have a substantial impact on quality of life and survival in these patients.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 3","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.3.137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35459870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity of multi-shell NODDI to multiple sclerosis white matter changes: a pilot study.","authors":"Torben Schneider,&nbsp;W Brownlee,&nbsp;H Zhang,&nbsp;Olga Ciccarelli,&nbsp;David H Miller,&nbsp;Claudia Gandini Wheeler-Kingshott","doi":"10.11138/fneur/2017.32.2.097","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.2.097","url":null,"abstract":"<p><p>Diffusion tensor imaging (DTI) is sensitive to white matter (WM) damage in multiple sclerosis (MS), not only in focal lesions but also in the normal-appearing WM (NAWM). However, DTI indices can also be affected by natural spatial variation in WM, as seen in crossing and dispersing white matter fibers. Neurite orientation dispersion and density imaging (NODDI) is an advanced diffusion-weighted imaging technique that provides distinct indices of fiber density and dispersion. We performed NODDI of lesion tissue and NAWM in five MS patients and five controls, comparing the technique with traditional DTI. Both DTI and NODDI identified tissue damage in NAWM and in lesions. NODDI was able to detect additional changes and it provided better contrast in MS-NAWM microstructure, because it distinguished orientation dispersion and fiber density better than DTI. We showed that NODDI is viable in MS patients and that it offers, compared with DTI parameters, improved sensitivity and possibly greater specificity to microstructure features such as neurite orientation.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 2","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.2.097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35141375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebellar transcranial static magnetic field stimulation transiently reduces cerebellar brain inhibition.","authors":"Akiyoshi Matsugi,&nbsp;Y Okada","doi":"10.11138/fneur/2017.32.2.077","DOIUrl":"https://doi.org/10.11138/fneur/2017.32.2.077","url":null,"abstract":"<p><p>The aim of this study was to investigate whether transcranial static magnetic field stimulation (tSMS) delivered using a compact cylindrical NdFeB magnet over the cerebellum modulates the excitability of the cerebellum and contralateral primary motor cortex, as measured using cerebellar brain inhibition (CBI), motor evoked potentials (MEPs), and resting motor threshold (rMT). These parameters were measured before tSMS or sham stimulation and immediately, 5 minutes and 10 minutes after stimulation. There were no significant changes in CBI, MEPs or rMT over time in the sham stimulation condition, and no changes in MEPs or rMT in the tSMS condition. However, CBI was significantly decreased immediately after tSMS as compared to that before and 5 minutes after tSMS. Our results suggest that tSMS delivered to the cerebellar hemisphere transiently reduces cerebellar inhibitory output but does not affect the excitability of the contralateral motor cortex.</p>","PeriodicalId":12560,"journal":{"name":"Functional neurology","volume":"32 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.11138/fneur/2017.32.2.077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35142923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}