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Parkinson Disease: HELP
Articles by Giovanni Abbruzzese
Based on 53 articles published since 2010
(Why 53 articles?)
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Between 2010 and 2020, G. Abbruzzese wrote the following 53 articles about Parkinson Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Relationships between gait and emotion in Parkinson's disease: A narrative review. 2018

Avanzino, Laura / Lagravinese, Giovanna / Abbruzzese, Giovanni / Pelosin, Elisa. ·Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino, IRCCS, Genoa, Italy. · Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy. · Ospedale Policlinico San Martino, IRCCS, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Unit, University of Genoa, Italy. · Ospedale Policlinico San Martino, IRCCS, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Unit, University of Genoa, Italy. Electronic address: elisapelosin@gmail.com. ·Gait Posture · Pubmed #30558947.

ABSTRACT: BACKGROUND: Disturbance of gait is a key feature of Parkinson's disease (PD) and has a negative impact on quality of life. Deficits in cognition and sensorimotor processing impair the ability of people with PD to walk quickly, efficiently and safely. Recent evidence suggests that emotional disturbances may also affect gait in PD. RESEARCH QUESTION: We explored if there were relationships between walking ability, emotion and cognitive impairment in people with PD. METHODS: The literature was firstly reviewed for unimpaired individuals. The recent experimental evidence for the influence of emotion on gait in people with PD was then explored. The contribution of affective disorders to continuous gait disorders was investigated, particularly for bradykinetic and hypokinetic gait. In addition, we investigated the influence of emotional processing on episodic gait disturbances, such as freezing of gait. Potential effects of pharmacological, surgical and physical therapy interventions were also considered. RESULTS: Emerging evidence showed that emotional disturbances arising from affective disorders such as anxiety and depression, in addition to cognitive impairment, could contribute to gait disorders in some people with PD. An analysis of the literature indicated mixed evidence that improvements in affective disorders induced by physical therapy, pharmacological management or surgery improve locomotion in PD. SIGNIFICANCE: When assessing and treating gait disorders in people with PD, it is important to take into the account non-motor symptoms such as anxiety, depression and cognitive impairment, in addition to the motor sequalae of this progressive neurological condition.

2 Review Pain in Parkinson's disease: facts and uncertainties. 2018

Antonini, A / Tinazzi, M / Abbruzzese, G / Berardelli, A / Chaudhuri, K R / Defazio, G / Ferreira, J / Martinez-Martin, P / Trenkwalder, C / Rascol, O. ·University of Padua, Padua. · University of Verona, Verona. · University of Genoa, Genoa. · University of Rome, Rome. · IRCCS NEUROMED, Isernia, Italy. · Kings College London, London, UK. · University of Cagliari, Cagliari, Italy. · Hospital de Santa Maria, Lisbon, Portugal. · National Center of Epidemiology and CIBERNED, Madrid, Spain. · University Medical Center Goettingen, Goettingen, Germany. · Université de Toulouse, Toulouse, France. ·Eur J Neurol · Pubmed #29520899.

ABSTRACT: Pain is one of the most common and troublesome non-motor symptoms of Parkinson's disease (PD). It can appear at any time during the disease and is often present before diagnosis. However, there is little or no consensus on its definition. An expert group of clinicians with relevant research experience met to review the existing evidence and to identify gaps in our understanding leading towards AUTHOR: 'understanding towards' has been changed to 'understanding leading towards'. Please check and confirm that this is appropriate an optimized therapy of pain in PD. Key findings from epidemiologic, neurophysiologic, neuroimaging and clinical studies are reviewed. In each case, the evidence base is limited by wide variations in the definitions of pain applied, study methodologies and populations evaluated. Disease-related and medical conditions trigger spontaneous pain in patients with PD, which is then abnormally processed and results in painful manifestations in specific body parts. Dopaminergic medications, such as rotigotine, as well as opiate analgesics, such as oxycodone, have shown positive results but future studies with more detailed pain characterization at inclusion are warranted.

3 Review Rehabilitation for Parkinson's disease: Current outlook and future challenges. 2016

Abbruzzese, Giovanni / Marchese, Roberta / Avanzino, Laura / Pelosin, Elisa. ·Centre for Parkinson's Disease, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy; Unit of Rehabilitation and Functional Recovery, IRCCS S. Martino Hospital-IST, Genoa, Italy. Electronic address: giabbr@unige.it. · Centre for Parkinson's Disease, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy; Unit of Rehabilitation and Functional Recovery, IRCCS S. Martino Hospital-IST, Genoa, Italy. · Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy. ·Parkinsonism Relat Disord · Pubmed #26360239.

ABSTRACT: Rehabilitation is considered as an adjuvant to pharmacological and surgical treatments for Parkinson's disease (PD) to maximize functional ability and minimize secondary complications. Originally, approaches were based on empirical experience, but growing evidence suggests that exercise-dependent plasticity constitutes the main mechanism underlying the effects of physiotherapy. Exercise increases synaptic strength and influences neurotransmission, thus potentiating functional circuitry in PD. In addition, exercise is a pivotal element of motor learning. PD patients retain a sufficient capacity of motor learning, though learning rates and performance are reduced in comparison to normal controls. Recent meta-analyses demonstrated that rehabilitation could induce short-lasting, but clinically important benefits, particularly for gait and balance. However, the interventions are largely heterogeneous (stretching, muscle strengthening, balance, postural exercises, occupational therapy, cueing, treadmill training), and there is still no consensus about the optimal approach. Innovative techniques have been recently proposed: virtual reality and exergaming, motor imagery and action observation, robot-assisted physiotherapy and non-conventional therapies (e.g.: dance, martial arts). The rehabilitative program for PD should be "goal-based" (targeted to practicing and learning specific activities in the core areas), but a number of practice variables (intensity, specificity, complexity) need to be identified and the program should tailored to the individual patients' characteristics.

4 Review Continuous intestinal infusion of levodopa/carbidopa in advanced Parkinson's disease: efficacy, safety and patient selection. 2012

Abbruzzese, Giovanni / Barone, Paolo / Bonuccelli, Ubaldo / Lopiano, Leonardo / Antonini, Angelo. ·Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Italy. ·Funct Neurol · Pubmed #23402675.

ABSTRACT: Long-term oral therapy with levodopa is associated with the development of motor fluctuations and dyskinesia in a large percentage of patients with Parkinson's disease (PD). Motor complications are associated with a number of non-motor symptoms and have a negative impact on disability and quality of life. There are three therapeutic options available for the management of patients at this advanced stage: high frequency deep brain stimulation, continuous subcutaneous infusion of apomorphine, and continuous intestinal infusion of levodopa/carbidopa. On the basis of published data and in consideration of the risk-benefit profile of current therapeutic strategies, we here propose an algorithm to help clinicians select the most suitable treatment option for patients with advanced PD.

5 Review Selegiline: a reappraisal of its role in Parkinson disease. 2012

Fabbrini, Giovanni / Abbruzzese, Giovanni / Marconi, Stefano / Zappia, Mario. ·Department of Neurology and Psychiatry and IRCSS Neuromed Institute, "Sapienza" University of Rome, Rome, Italy. ·Clin Neuropharmacol · Pubmed #22592509.

ABSTRACT: Selegiline at the doses used in Parkinson disease is a selective irreversible monoamine oxidase type B inhibitor, which potentiates dopaminergic function in the brain, and is used as monotherapy in early Parkinson disease or in combination with levodopa in more advanced disease. A renewed interest in monoamine oxidase type B inhibitors in the treatment of Parkinson disease has emerged after recent clinical trials of agents in this class. The use of selegiline monotherapy in early Parkinson disease is supported by the results of a large well-controlled trial in 800 patients (DATATOP) and several other studies, which demonstrated a symptomatic benefit, a reduction in disability, and a delay in the need to start levodopa therapy. Administered with levodopa in studies of up to 5 years' duration in patients with more advanced disease, selegiline improved disease-related disability, reduced the end-of-dose motor fluctuations, and also led to a reduction of the dose and dose frequency of levodopa required.Selegiline was the first drug to be investigated as a possible neuroprotective agent in patients with Parkinson disease, based on preclinical studies indicating protection of dopaminergic neurons from damage. The results of the extensive body of clinical trials, including delayed and lower levodopa requirements, may indeed suggest that selegiline, in addition to conferring symptomatic benefit, may have other effects on disease progression. Selegiline is well tolerated, and initial fears of increased mortality with the drug have not been borne out by subsequent robust meta-analyses.

6 Review Role of pramipexole in the management of Parkinson's disease. 2010

Antonini, Angelo / Barone, Paolo / Ceravolo, Roberto / Fabbrini, Giovanni / Tinazzi, Michele / Abbruzzese, Giovanni. ·Department for Parkinson Disease, IRCCS San Camillo, Venice, Italy. angelo3000@yahoo.com ·CNS Drugs · Pubmed #20839895.

ABSTRACT: The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson's disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect on non-motor symptoms such as depression, and its safety and tolerability profile. Studies have shown that pramipexole is effective as monotherapy in early Parkinson's disease and as adjunctive therapy in advanced disease. Trials further suggest that the benefits of pramipexole may extend beyond the relief of motor symptoms (akinesia, rigidity and tremor at rest) to the amelioration of depressive symptoms in Parkinson's disease. Pramipexole is generally well tolerated; however, compared with levodopa treatment, pramipexole is associated with a higher rate of some dopaminergic adverse effects.

7 Clinical Trial Whole body and cardiac metaiodobenzylguanidine kinetics in Parkinson disease and multiple system atrophy: implications for the diagnostic role of imaging. 2010

Marini, Cecilia / Bandettini di Poggio, Monica / Pomposelli, Elena / Marchese, Roberta / Nobili, Flavio / Morbelli, Silvia D / Villa, Giuseppe / Abbruzzese, Giovanni / Sambuceti, Gianmario. ·CNR institute of Bioimages and Molecular Physiology, Milan, Section of Genoa, Italy. Cecilia.Marini@unige.it ·Clin Nucl Med · Pubmed #20395701.

ABSTRACT: PURPOSE OF THE REPORT: This study investigates whether combined analysis of I-123 metaiodobenzylguanidine (MIBG) kinetics in the heart and in the whole body can improve the accuracy of differential diagnosis between idiopathic Parkinson disease (PD) and a Parkinson variant of multiple system atrophy (MSA-P). MATERIALS AND METHODS: A total of 30 patients with clinical suspicion of PD (n = 16) or MSA-P (n = 14) underwent MIBG whole-body planar imaging. Final diagnosis was confirmed at follow-up. Images were collected 30 minutes and 4 hours after tracer injection. Myocardial uptake was evaluated by measuring heart/mediastinum (H/M) ratio and the percent fraction of the injected dose retained by the heart (calculated by whole-body counts). Tracer washout was measured from both the heart and the whole body. RESULTS: H/M ratio was lower in PD than in MSA-P at early imaging (1.32 +/- 0.21 vs. 1.81 +/- 0.46, respectively, P < 0.01), although a large overlap in individual data was observed. By contrast, % of injected dose taken up by the heart documented a large difference between PD and MSA-P (0.97% +/- 0.51% vs. 1.91% +/- 0.66% of the dose, P < 0.01), and a very small overlap in individual values. There was no difference in the heart washout between the 2 Groups (31% +/- 13% vs. 32% +/- 15%, P = 0.9), while tracer loss from the whole body was higher in PD than in MSA-P (29% +/- 12% vs. 19% +/- 10%, P < 0.01). CONCLUSIONS: PD and its correlated global postganglionic dysfunction alter MIBG kinetics in the heart and in the whole body. Image analysis accounting for tracer kinetics in the whole body may improve the diagnostic accuracy of this test in patients with suspected PD or MSA-P.

8 Article The TANDEM investigation: efficacy and tolerability of levodopa-carbidopa intestinal gel in (LCIG) advanced Parkinson's disease patients. 2020

Antonini, Angelo / Abbruzzese, Giovanni / Berardelli, Alfredo / Modugno, Nicola / Stroppa, Italo / Tamma, Filippo / Sensi, Mariachiara / Mancini, Francesca / Cossu, Giovanni / Stefani, Alessandro / Tambasco, Nicola / Tessitore, Alessandro / Fabbrini, Giovanni / Pontieri, Francesco E / Solla, Paolo / Bentivoglio, Anna Rita / Comi, Cristoforo / Minafra, Brigida / Riboldazzi, Giulio / Melchionda, Donato / Martino, Tommaso / Lopiano, Leonardo. ·Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy. angelo3000@yahoo.com. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy. · Department of Human Neurosciences, Sapienza University of Rome, IRCCS Neuromed, Rome, Italy. · Parkinson Centre, IRCCS Neuromed, Pozzilli, Italy. · U.O. Dipartimentale di Endoscopia Digestiva Operativa e D'Urgenza, Policlinico Tor Vergata, Rome, Italy. · Neurology Unit, Miulli Hospital, Acquaviva delle Fonti, BA, Italy. · Neurology Unit, Hospital Sant'Anna, Cona, Ferrara, Italy. · UO Neurologia e Stroke Unit e Laboratorio Neuroscienze, Istituto Auxologico San Luca, Milan, Italy. · SC Neurologia e Stroke Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy. · UOSD Parkinson, Fondazione Policlinico Tor Vergata, Rome, Italy. · Neurology Department, Perugia General Hospital, University of Perugia, Perugia, Italy. · Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania, "Luigi Vanvitelli", Caserta, Italy. · Department NESMOS, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy. · Neurology Unit, Policlinico Universitario Monserrato, Cagliari, Italy. · Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy. · Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. · Neurology Unit, Parkinson's Disease and Movement Disorders Centre, University of Piemonte Orientale, Novara, Italy. · Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Foundation, Pavia, Italy. · Neurology Unit, Parkinson's Disease and Movement Disorders Centre, ASST dei Sette Laghi, Varese, Italy. · S.C. Neurology, Neuroscience Department, A.O.U. Ospedali Riuniti, University of Foggia, Foggia, Italy. · Department of Neuroscience "Rita Levi-Montalcini", University of Torino, Turin, Italy. ·J Neural Transm (Vienna) · Pubmed #32212015.

ABSTRACT: The TANDEM investigation was carried out in 17 Italian Movement Disorder centers on behalf of a joint initiative of neurologist members of the Italian Academy for Parkinson's disease and Movement Disorders (LIMPE-DISMOV Academy) and gastroenterologist members of the Italian Society of Digestive Endoscopy (SIED) to evaluate the efficacy and tolerability of levodopa-carbidopa intestinal gel (LCIG) in patients with advanced Parkinson's disease (PD) in routine medical care. Motor scores in "ON" and OFF" state (UPDRS-III), complications of therapy (UPDRS-IV), activities of daily living, sleep disorders and quality of life were evaluated at baseline and at two follow-up assessments (FUV1 and FUV2) within the initial 12-month LCIG treatment. In 159 patients (55% males) with a mean age of 69.1 ± 6.6 years and a diagnosis of PD since 13.6 ± 5.5 years, the UPDRS-III total score (in "OFF") decreased from baseline (45.8 ± 13.2) to FUV1 (41.0 ± 17.4; p < 0.001) and FUV2 (40.5 ± 15.5; p < 0.001), the UPDRS-IV total score decreased from baseline (8.8 ± 2.9) to FUV1 (5.1 ± 3.4; p < 0.001) and FUV2 (5.5 ± 3.2; p < 0.001). The percentage of patients exhibiting freezing, dystonia, gait/walking disturbances, falls, pain and sleep disorders was significantly reduced. Twenty-eight device complications were reported and 11 (6.9%) patients prematurely terminated the study. LCIG after 12-month treatment led to sustained improvement of time spent in "OFF", complications of therapy, PD-associated symptoms and sleep disorders. LCIG tolerability was consistent with the established safety profile of LCIG.

9 Article Haptic perception of verticality correlates with postural and balance deficits in patients with Parkinson's disease. 2019

Mori, Laura / Putzolu, Martina / Bonassi, Gaia / Galeoto, Giovanni / Mezzarobba, Susanna / Trompetto, Carlo / Avanzino, Laura / Marchese, Roberta / Abbruzzese, Giovanni / Pelosin, Elisa. ·Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy; Ospedale Policlinico San Martino, IRCSS, Genova, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy. · Department of Public Health and Infection Disease, Sapienza University of Rome, Rome, Italy. · Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy. · Ospedale Policlinico San Martino, IRCSS, Genova, Italy; Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy; Ospedale Policlinico San Martino, IRCSS, Genova, Italy. Electronic address: giabbr@unige.it. ·Parkinsonism Relat Disord · Pubmed #31279636.

ABSTRACT: INTRODUCTION: Perception of verticality is fundamental for postural stability that is often impaired in patients with Parkinson's disease (PD). Haptic perception of verticality has not been fully investigated in PD. The aim of the study was to assess subjective haptic vertical (SHV) in PD patients in relation to postural and balance impairments. METHODS: 39 PD patients (mean age 72.87 ± 5.78) and 28 gender and age-matched healthy elderly (ELD, mean age 69.16 ± 13.89) were enrolled. The Pull test and the Activities-specific Balance Confidence (ABC) were used for evaluating balance performance, whereas measurement of posture was performed using the Physical Analyzer System RESULTS: SHV data showed that PD subjects had a greater deviation from the objective vertical than controls (p < 0.001). Significant differences in balance performance (ABC and Pull test) and postural alignment were found between PD and ELD. Only in PD participants, SHV deviations significantly correlated with the lateral inclination of the trunk (r = 0.618, p < 0.001), pull test (r = 0.519; p = 0.001) and ABC (r = 0.471, p = 0.002) scores. CONCLUSIONS: The perception of verticality, driven by multimodal sensory integration, is defective in PD subjects. Deficits in SHV correlated with postural alignment and balance performances, independently from age, disease severity or cognitive decline. Our findings support that PD pathology is associated with a decline in haptic perception suggesting that perception per se might have a causal role in postural and balance deficits.

10 Article Associations between daily-living physical activity and laboratory-based assessments of motor severity in patients with falls and Parkinson's disease. 2019

Galperin, Irina / Hillel, Inbar / Del Din, Silvia / Bekkers, Esther M J / Nieuwboer, Alice / Abbruzzese, Giovanni / Avanzino, Laura / Nieuwhof, Freek / Bloem, Bastiaan R / Rochester, Lynn / Della Croce, Ugo / Cereatti, Andrea / Giladi, Nir / Mirelman, Anat / Hausdorff, Jeffrey M. ·Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel. · Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. · Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Italy; IRCCS San Martino Teaching Hospital, Genoa, Italy. · IRCCS San Martino Teaching Hospital, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genova, Italy. · Donders Institute for Brain, Cognition and Behaviour; Radboudumc, Department of Neurology, Nijmegen, the Netherlands; Radboud university Medical Center, Departments of Geriatric Medicine, Neurology and Parkinson's Disease Center Nijmegen (ParC), Nijmegen, the Netherlands. · Donders Institute for Brain, Cognition and Behaviour; Radboudumc, Department of Neurology, Nijmegen, the Netherlands. · Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK; The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK. · Department of Biomedical Sciences, Bioengineering unit, University of Sassari, Sassari (SS), Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari (SS), Italy. · Department of Biomedical Sciences, Bioengineering unit, University of Sassari, Sassari (SS), Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari (SS), Italy; Department of Electronics and Telecommunications, Politecnico di Torino, Torino (TO), Italy. · Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Department of Neurology and Neurosurgery, Sackler School of Medicine, Tel Aviv University, Israel. · Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA. Electronic address: jhausdor@tlvmc.gov.il. ·Parkinsonism Relat Disord · Pubmed #30718220.

ABSTRACT: INTRODUCTION: Recent work suggests that wearables can augment conventional measures of Parkinson's disease (PD). We evaluated the relationship between conventional measures of disease and motor severity (e.g., MDS-UPDRS part III), laboratory-based measures of gait and balance, and daily-living physical activity measures in patients with PD. METHODS: Data from 125 patients (age: 71.7 ± 6.5 years, Hoehn and Yahr: 1-3, 60.5% men) were analyzed. The MDS-UPDRS-part III was used as the gold standard of motor symptom severity. Gait and balance were quantified in the laboratory. Daily-living gait and physical activity metrics were extracted from an accelerometer worn on the lower back for 7 days. RESULTS: In multivariate analyses, daily-living physical activity and gait metrics, laboratory-based balance, demographics and subject characteristics together explained 46% of the variance in MDS-UPDRS-part III scores. Daily-living measures accounted for 62% of the explained variance, laboratory measures 30%, and demographics and subject characteristics 7% of the explained variance. Conversely, demographics and subject characteristics, laboratory-based measures of gait symmetry, and motor symptom severity together explained less than 30% of the variance in total daily-living physical activity. MDS-UPDRS-part III scores accounted for 13% of the explained variance, i.e., <4% of all the variance in total daily-living activity. CONCLUSIONS: Our findings suggest that conventional measures of motor symptom severity do not strongly reflect daily-living activity and that daily-living measures apparently provide important information that is not captured in a conventional one-time, laboratory assessment of gait, balance or the MDS-UPDRS. To provide a more complete evaluation, wearable devices should be considered.

11 Article Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson's Disease. 2018

Pelosin, Elisa / Barella, Roberta / Bet, Cristina / Magioncalda, Elisabetta / Putzolu, Martina / Di Biasio, Francesca / Cerulli, Cecilia / Casaleggio, Mauro / Abbruzzese, Giovanni / Avanzino, Laura. ·Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy. · Azienda Sanitaria Locale 3 Genovese, S.C. Riabilitazione Territoriale N.O. Polo Riabilitativo Levante, Genoa, Italy. · Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy. ·Neural Plast · Pubmed #29977280.

ABSTRACT: Freezing of gait (FoG) is among the most disabling symptoms of Parkinson's disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

12 Article Postural Stabilization Strategies to Motor Contagion Induced by Action Observation Are Impaired in Parkinson's Disease. 2018

Pelosin, Elisa / Bisio, Ambra / Pozzo, Thierry / Lagravinese, Giovanna / Crisafulli, Oscar / Marchese, Roberta / Abbruzzese, Giovanni / Avanzino, Laura. ·Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy. · Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Genoa, Italy. · Department of Experimental Medicine, Section of Human Physiology, Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy. · INSERM-U1093, CAPS, Campus Universitaire, UBFC, Dijon, France. · Istituto Italiano di Tecnologia, Centro di Neurofisiologia Traslazionale, Ferrara, Italy. ·Front Neurol · Pubmed #29545771.

ABSTRACT: Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects' body sway. Parkinson's disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation. In this study, an action observation paradigm for assessing postural reaction to motor contagion in PD subjects and healthy older adults was used. Postural stability changes were measured during the observation of a static stimulus (control condition) and during a point-light display of a gymnast balancing on a rope (biological stimulus). Our results showed that, during the observation of the biological stimulus, sway area and antero-posterior and medio-lateral displacements of center of pressure significantly increased only in PD participants, whereas correct stabilization reactions were present in elderly subjects. These results demonstrate that PD leads to a decreased capacity to control automatic imitative tendencies induced by motor contagion. This behavior could be the consequence either of an inability to inhibit automatic imitative tendencies or of the cognitive load requested by the task. Whatever the case, the issue about the ability to inhibit automatic imitative tendencies could be crucial for PD patients since it might increase falls risk and injuries.

13 Article Gait initiation is influenced by emotion processing in Parkinson's disease patients with freezing. 2018

Lagravinese, Giovanna / Pelosin, Elisa / Bonassi, Gaia / Carbone, Federico / Abbruzzese, Giovanni / Avanzino, Laura. ·Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genova, Genova, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy. · Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Genova, Italy. ·Mov Disord · Pubmed #29392774.

ABSTRACT: BACKGROUND: Freezing of gait is a symptom that affects more than 50% of Parkinson's disease (PD) patients and increasing evidence suggests that nonmotor systems (i.e., limbic system) are involved in its underlying mechanisms. OBJECTIVE: The objective of this study was to investigate whether gait initiation characteristics are influenced by emotional stimuli in patients with PD, with or without freezing of gait. METHODS: A total of 44 participants, divided into 3 groups (15 PD patients with and 15 PD patients without freezing of gait and 14 controls), stood on a sensorized mat and were asked to take a step forward in response to a pleasant image and a step backward in response to an unpleasant one (congruent task, low cognitive load) or to take a step backward in response to a pleasant image and a step forward in response to an unpleasant one (incongruent task, high cognitive load). Reaction time, step size, anticipatory postural adjustments, and sway path were measured. RESULTS: In PD with freezing of gait, the reaction time was longer and the step size was shorter than in the other groups when they took a step forward in response to an unpleasant image (incongruent task). Changes in reaction time performance in response to unpleasant images remained significant after having adjusted for executive dysfunction and positively correlated with the "frequency" of freezing episodes. CONCLUSIONS: This study demonstrates that gait initiation was influenced by the emotional valence of visual stimuli in addition to the cognitive load of the task suggesting that the limbic system may be involved in freezing of gait. © 2018 International Parkinson and Movement Disorder Society.

14 Article Factors influencing psychological well-being in patients with Parkinson's disease. 2017

Nicoletti, Alessandra / Mostile, Giovanni / Stocchi, Fabrizio / Abbruzzese, Giovanni / Ceravolo, Roberto / Cortelli, Pietro / D'Amelio, Marco / De Pandis, Maria F / Fabbrini, Giovanni / Pacchetti, Claudio / Pezzoli, Gianni / Tessitore, Alessandro / Canesi, Margherita / Zappia, Mario. ·Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy. · Institute of Neurology, IRCCS San Raffaele Pisana, Rome, Italy. · Centre for Parkinson's Disease and Movement Disorders, DINOGMI, University of Genoa, Genoa, Italy. · Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. · IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy. · DIBINEM, Alma Mater Studiorum, University of Bologna, Bologna, Italy. · Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy. · Department of Neurorehabilitation, Parkinson Operative Unit, San Raffaele Institute, Cassino (FR), Italy. · Department of Neurology and Psychiatry, and IRCSS Neuromed, La Sapienza University of Rome, Rome, Italy. · Parkinson's Disease and Movement Disorders Unit, IRCCS Neurological National Institute C. Mondino, Pavia, Italy. · Parkinson Institute, ASST G. Pini-CTO, Milan, Italy. · Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy. ·PLoS One · Pubmed #29244834.

ABSTRACT: BACKGROUND: Both motor and non-motor symptoms could contribute to significant deterioration of psychological well-being in patients with Parkinson's disease (PD). However, its assessment has been only indirectly evaluated using tools based on health-related quality of life (HRQoL), such as the PDQ-39 scale. OBJECTIVES: To evaluate psychological well-being in PD using a specific tool of assessment, the Psychological Well-being Scale (PWS), and its clinical correlates. METHODS: This article reports data of patients' perception of health state, as measured by means of the PWS, from an epidemiological, cross-sectional study conducted in Italian PD patients (FORTE Study). We tested possible relationship between well-being and clinical characteristics including fatigue, depression, sleep disruption and HRQoL. RESULTS: 272 patients completed the PWS questionnaire. Significant and clinically-relevant correlations were found between PWS total score and Parkinson's Fatigue Scale, Beck Depression Inventory, UPDRS Section I, PD Sleep Scale and PDQ-39 for HRQoL scores. Only clinically negligible correlations were found between PWS and motor scores. CONCLUSIONS: Non-motor symptoms have a significant impact on psychological well-being in PD patients.

15 Article Impulse control disorders in advanced Parkinson's disease with dyskinesia: The ALTHEA study. 2017

Biundo, Roberta / Weis, Luca / Abbruzzese, Giovanni / Calandra-Buonaura, Giovanna / Cortelli, Pietro / Jori, Maria Cristina / Lopiano, Leonardo / Marconi, Roberto / Matinella, Angela / Morgante, Francesca / Nicoletti, Alessandra / Tamburini, Tiziano / Tinazzi, Michele / Zappia, Mario / Vorovenci, Ruxandra Julia / Antonini, Angelo. ·Parkinson and Movement Disorders Unit, IRCCS Hospital San Camillo, Venice, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa Genoa, Italy. · Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy. · I.R.C.C.S. Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy. · Mediolanum Cardio Research, Milano, Italy. · Department of Neuroscience "Rita Levi Montalcini", University of Turin, Torino, Italy. · Unità Operativa Complessa di Neurologia, Ospedale Misericordia, Grosseto, Italy. · Department of Neurological, Neuropsychological, Morphological and Motor Sciences, University of Verona, Italy. · Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy. · Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy. · SC Neurologia - Ospedale S. Corona - ASL2 Savonese. · Department of Neuroscience, Biomedicine and Motor Sciences, University of Verona, Italy. · Clinica Neurologica I Policlinico Universitario, Catania, Italy. · University of Medicine and Pharmacy "Victor Babes"; County Hospital, Department of Neurology, Timisoara, Romania. · Department of Neuroscience (DNS), University of Padua, Padua, Italy. ·Mov Disord · Pubmed #28960475.

ABSTRACT: BACKGROUND: Impulse control disorders and dyskinesia are common and disabling complications of dopaminergic treatment in Parkinson's disease. They may coexist and are possibly related. The objectives of this study were to assess the frequency and severity of impulse control disorders in Parkinson's disease patients with dyskinesia. METHODS: The ALTHEA study enrolled 251 Parkinson's disease patients with various degrees of dyskinesia severity from 11 movement disorders centers in Italy. Each patient underwent a comprehensive assessment including Unified Dyskinesia Rating Scale and the Questionnaire for Impulsive Compulsive Disorders in Parkinson Disease-Rating Scale. RESULTS: There was an overall 55% frequency of impulse control disorder and related behaviors (36% were clinically significant). The positive patients were younger at disease diagnosis and onset and had higher Unified Dyskinesia Rating Scale historical and total score (P = 0.001 and P = 0.02, respectively, vs negative). There was an increased frequency of clinically significant impulse control disorders in patients with severe dyskinesia (P = 0.013), a positive correlation between the questionnaire total score and dopamine agonist dose (P = 0.018), and a trend with levodopa dose. CONCLUSIONS: More than half of Parkinson's disease patients with dyskinesia have impulse control disorders and related behaviors, which are frequently clinically significant. Dopaminergic therapy total dose is associated with their severity. Clinicians should carefully assess patients with maladaptive behaviors and dyskinesia because they do not properly evaluate their motor and nonmotor status. © 2017 International Parkinson and Movement Disorder Society.

16 Article Learning "How to Learn": Super Declarative Motor Learning Is Impaired in Parkinson's Disease. 2017

Marinelli, Lucio / Trompetto, Carlo / Canneva, Stefania / Mori, Laura / Nobili, Flavio / Fattapposta, Francesco / Currà, Antonio / Abbruzzese, Giovanni / Ghilardi, Maria Felice. ·Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy. · Ospedale Policlinico San Martino, Genova, Italy. · Neurology Unit, Policlinico Umberto I, Department of Neurology and Psichiatry, Sapienza University of Rome, Rome, Italy. · Academic Neurology Unit, A. Fiorini Hospital, Terracina (LT), Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy. · Department of Physiology, Pharmacology & Neuroscience, CUNY School of Medicine, New York, NY, USA. ·Neural Plast · Pubmed #28828186.

ABSTRACT: Learning new information is crucial in daily activities and occurs continuously during a subject's lifetime. Retention of learned material is required for later recall and reuse, although learning capacity is limited and interference between consecutively learned information may occur. Learning processes are impaired in Parkinson's disease (PD); however, little is known about the processes related to retention and interference. The aim of this study is to investigate the retention and anterograde interference using a declarative sequence learning task in drug-naive patients in the disease's early stages. Eleven patients with PD and eleven age-matched controls learned a visuomotor sequence, SEQ1, during Day1; the following day, retention of SEQ1 was assessed and, immediately after, a new sequence of comparable complexity, SEQ2, was learned. The comparison of the learning rates of SEQ1 on Day1 and SEQ2 on Day2 assessed the anterograde interference of SEQ1 on SEQ2. We found that SEQ1 performance improved in both patients and controls on Day2. Surprisingly, controls learned SEQ2 better than SEQ1, suggesting the absence of anterograde interference and the occurrence of learning optimization, a process that we defined as "learning how to learn." Patients with PD lacked such improvement, suggesting defective performance optimization processes.

17 Article The Parkinson's Disease-Cognitive Rating Scale (PD-CRS): normative values from 268 healthy Italian individuals. 2017

Santangelo, Gabriella / Lagravinese, Giovanna / Battini, Valeria / Chiorri, Carlo / Siciliano, Mattia / Abbruzzese, Giovanni / Vitale, Carmine / Barone, Paolo. ·Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. gabriella.santangelo@unina2.it. · Istituto di Diagnosi e Cura (IDC) "Hermitage Capodimonte", Naples, Italy. gabriella.santangelo@unina2.it. · Department of Experimental Medicine, University of Genoa, Genoa, Italy. · Department of Educational Sciences, University of Genoa, Genoa, Italy. · Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy. · Istituto di Diagnosi e Cura (IDC) "Hermitage Capodimonte", Naples, Italy. · Department of Motor Sciences and Wellness, University Parthenope, Naples, Italy. · Department of Medicine and Surgery, Neuroscience Section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Salerno, Italy. ·Neurol Sci · Pubmed #28224328.

ABSTRACT: The Parkinson's Disease-Cognitive Rating Scale (PD-CRS) is a cognitive screening battery that includes subtests to assess cortical and subcortical functions. It is a valid screening tool for mild cognitive impairment (MCI) in Parkinson's disease (PD) and is recommended for diagnosing PD-MCI-Level I. Until now, no study has provided population-based norms for the Italian population. The aim of the present study was to collect normative values in a sample of Italian healthy subjects. Two hundred and sixty-eight (125 men) participants of different ages (age range 30-79 years) and educational levels (from primary school to university) underwent the PD-CRS. Regression-based norming was used to explore the influence of demographic variables (age, education level, and gender) on PD-CRS total score, frontal-subcortical and instrumental-cortical sub-scores, and score achieved on each task of the PD-CRS. Multiple linear regression analysis revealed that age and education significantly predicted the total score, the two sub-scores and the score on each task of the PD-CRS. No significant effect of gender was found. From the derived linear equations, a correction grid for raw scores was developed. Inferential cut-off scores, estimated using a non-parametric technique, were 71.25 for PD-CRS total score and 46.25 and 20.17 for frontal-subcortical and instrumental-cortical sub-score, respectively. Since the use of adjusted scores is more informative when they are standardized, we have converted adjusted scores into equivalent scores. The present study provides normative data for the PD-CRS, being useful and recommended by Movement Disorders Society task force to identify PD-MCI-Level I, at several stages of the disease.

18 Article Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson's disease: a randomized controlled pilot study. 2017

Volpe, Daniele / Giantin, Maria Giulia / Manuela, Pilleri / Filippetto, Consuelo / Pelosin, Elisa / Abbruzzese, Giovanni / Antonini, Angelo. ·1 Department of Physical Medicine and Rehabilitation, Casa di Cura "Villa Margherita", Vicenza, Italy. · 2 Parkinson's Centre, IRCCS S. Camillo, Lido Alberoni, Venice, Italy. · 3 Department of Physical Medicine and Rehabilitation, Montebelluna, Italy. · 4 Department of Neuroscience, University of Genova, Genova, Italy. ·Clin Rehabil · Pubmed #27512099.

ABSTRACT: OBJECTIVE: To compare the efficacy of two physiotherapy protocols (water-based vs. non-water-based) on postural deformities of patients with Parkinson's disease. DESIGN: A single blind, randomized controlled pilot study. SETTING: Inpatient (Rehabilitative Department). PARTICIPANTS: A total of 30 patients with idiopathic Parkinson's disease. INTERVENTIONS: Participants were randomly assigned to one of two eight-week treatment groups: Water-based ( n = 15) or non-water-based physiotherapy exercises ( n = 15). OUTCOME MEASURES: Changes in the degree of cervical and dorsal flexion and in the angle of lateral inclination of the trunk (evaluated by means of a posturographic system) were used as primary outcomes. Unified Parkinson Disease Rating Scale section III, Time Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence, Falls Efficacy Scale and the Parkinson's disease quality of life questionnaire (39 items) were the secondary outcomes. All outcomes were assessed at baseline, at the end of training and eight weeks after treatment. Patients were always tested at the time of their optimal antiparkinsonian medication ('on' phase). RESULTS: After the treatment, only Parkinson's disease subjects randomized to water-based treatment showed a significant improvement of trunk posture with a significant reduction of cervical flexion (water-based group: -65.2°; non-water-based group: +1.7°) and dorsal flexion (water-based group: -22.5°; non-water-based group: -6.5°) and lateral inclination of the trunk (water-based group: -2.3°; non-water-based group: +0.3°). Both groups presented significant improvements in the secondary clinical outcomes without between-group differences. CONCLUSION: Our results show that water-based physiotherapy was effective for improving postural deformities in patients with Parkinson's disease.

19 Article Treadmill training frequency influences walking improvement in subjects with Parkinson's disease: a randomized pilot study. 2017

Pelosin, Elisa / Avanzino, Laura / Barella, Roberta / Bet, Cristina / Magioncalda, Elisabetta / Trompetto, Carlo / Ruggeri, Piero / Casaleggio, Mauro / Abbruzzese, Giovanni. ·Department of Neurosciences (DINOGMI), University of Genoa, Genoa, Italy. · Section of Human Physiology, Department of Experimental Medicine, Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy. · Azienda Sanitaria Locale 3 Genovese - S.C. Riabilitazione Territoriale N.O. Polo Riabilitativo Levante, Genoa, Italy. · Department of Neurosciences (DINOGMI), University of Genoa, Genoa, Italy - giabbr@unige.it. ·Eur J Phys Rehabil Med · Pubmed #27434611.

ABSTRACT: BACKGROUND: Treadmill training (TT) has been indicated as a potential therapeutic tool for improving balance and gait in patients with Parkinson's disease (PD). However, the lack of evidences about the best modality of intervention (e.g.: number of sessions) and the lack of reliable follow-up measures, made difficult to hand down these results into the clinical practice. AIM: The aim of this study was to compare the efficacy of 3 different modalities of TT program on gait performance in PD patients. DESIGN: A randomized, single-blind pilot study. SETTING: Outpatients clinic, Department of Neuroscience, University of Genoa. POPULATION: Thirty patients (out of 42 screened) with PD were randomized. METHODS: Participants underwent the same TT program (ten sessions, 45 minute each) but with a different frequency throughout a week: 1) low-frequency (LF) group: 2-times a week; 2) intermediate-frequency (IF) group: 3-times a week; and 3) high-frequency (HF) group: 5-times a week. Patients were evaluated by Timed Up and Go (TUG) test, 10-meter walking test (10M-WT), Berg Balance Scale (BBS), Falls Efficacy Scale (FES) and falls diary before TT, immediately after the training was stopped, and 2 and 4 months later. RESULTS: At baseline, no significant differences were found among groups. Immediately after the end of the TT, TUG Test, 10 MWT, FES and falls diary scores significantly improved in the LF and IF groups, whereas they did not change in the HF group. Improvements were sustained for up 2-months in the IF and LF groups. At 4-months evaluation, outcome measures were either comparable or sometimes even better than at baseline in the LF and IF groups, whereas in the HF group, 10M-WT and FES score worsened. CONCLUSIONS: According to the results of this study, we might postulate that the frequency of TT influences short and long-lasting effects on walking performance and falls. CLINICAL REHABILITATION IMPACT: The present study confirms that TT is effective in improving gait disturbances and reducing falls risk in patients with PD. The short- and long-lasting effects induced by TT on walking performance are specifically affected by the frequency of training, possibly in relationship to learning mechanisms and fatigue.

20 Article An objective measure combining physical and cognitive fatigability: Correlation with subjective fatigue in Parkinson's disease. 2016

Martino, Davide / Tamburini, Tiziano / Zis, Panagiotis / Rosoklija, Gavril / Abbruzzese, Giovanni / Ray-Chaudhuri, Kallol / Pelosin, Elisa / Avanzino, Laura. ·International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK; Queen Elizabeth Hospital, Woolwich, Lewisham & Greenwich NHS Trust, London, UK. Electronic address: davidemartino@nhs.net. · Department of Neuroscience (DiNOGMI), University of Genoa, Genoa, Italy. · International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK. · International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London, UK. · Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy. · Department of Neuroscience (DiNOGMI), University of Genoa, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy. ·Parkinsonism Relat Disord · Pubmed #27600158.

ABSTRACT: BACKGROUND: Objective measures of physical and cognitive fatigability do not correlate with subjective Parkinson's disease (PD)-related fatigue. The relationship of subjective PD-related fatigue to tasks combining cognitive and motor effort has never been explored. METHODS: Forty-four right-handed, non-demented PD patients, 22 with (PD-F) and 22 without (PD-NF) fatigue, were tested using a sensor-engineered glove on their more affected hand. Patients performed sequential opposition finger movements following a metronome at 2 Hz for 5 min (cued task), and for another minute following a 2-min rest. The same task was repeated without sustained auditory cueing. Movement time (inter-tapping interval, ITI) and rate, touch duration, percentage of correct sequences and clinical measures (motor and fatigue severity, depression, sleep impairment and apathy) were analysed. RESULTS: In the cued task, motor performance worsened over time (significantly increased ITI and decreased movement rate on the third to fifth minute) in PD-F patients only. In the uncued task, motor performance deteriorated similarly in the two groups. PD-F and PD-NF patients differed in ITI and movement rate deterioration over time only in the cued task, independently from motor severity, depression and sleep impairment. The severity of subjective fatigue complaints significantly correlated with motor performance deterioration in the cued task. CONCLUSIONS: PD-related fatigue is associated with performance on an externally cued, attention-controlled motor task, but not with an uncued version of the same task. The finding supports a link between PD-related fatigue and attention-demanding motor tasks, proposing a model of inducible fatigue applicable to future clinical and neuroimaging research.

21 Article Mirror Visual Feedback to Improve Bradykinesia in Parkinson's Disease. 2016

Bonassi, Gaia / Pelosin, Elisa / Ogliastro, Carla / Cerulli, Cecilia / Abbruzzese, Giovanni / Avanzino, Laura. ·Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genova, 16132 Genova, Italy. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, 16132 Genova, Italy. ·Neural Plast · Pubmed #27563470.

ABSTRACT: Mirror visual feedback (MVF) therapy has been applied to improve upper limb function in stroke. When combined with motor training, MVF improves the performance of the trained and untrained hand by enhancing the excitability of both primary motor cortices (M1s). Bradykinesia is a typical feature of Parkinson's disease (PD), characterized by slowness in the execution of movement. This condition is often asymmetrical and possibly supported by a volitional hypoactivation of M1. MVF therapy could tentatively treat bradykinesia since the untrained hand, which benefits from the exercise, is generally more severely impaired in undertaking sequential movements. Aim of the study was to evaluate whether MVF therapy may improve bradykinesia of the more affected hand in PD patients. Twelve PD patients and twelve healthy controls performed for 10 minutes a finger sequence, receiving MVF of the more affected/nondominant hand. Before and after MVF training, participants performed a finger sequence at their spontaneous pace with both hands. M1 excitability was assessed in the trained and untrained hemispheres by means of transcranial magnetic stimulation. Movement speed increased after MVF training in either hand of both groups. MVF therapy enhanced cortical excitability of M1s in both groups. Our preliminary data support the use of MVF therapy to improve bradykinesia in PD patients.

22 Article Attentional Control of Gait and Falls: Is Cholinergic Dysfunction a Common Substrate in the Elderly and Parkinson's Disease? 2016

Pelosin, Elisa / Ogliastro, Carla / Lagravinese, Giovanna / Bonassi, Gaia / Mirelman, Anat / Hausdorff, Jeffrey M / Abbruzzese, Giovanni / Avanzino, Laura. ·Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa Genoa, Italy. · Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa Genoa, Italy. · Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical CenterTel Aviv, Israel; Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv UniversityTel Aviv, Israel. ·Front Aging Neurosci · Pubmed #27242515.

ABSTRACT: The aim of this study was to address whether deficits in the central cholinergic activity may contribute to the increased difficulty to allocate attention during gait in the elderly with heightened risk of falls. We recruited 50 participants with a history of two or more falls (33 patients with Parkinson's Disease and 17 older adults) and 14 non-fallers age-matched adults. Cholinergic activity was estimated by means of short latency afferent inhibition (SAI), a transcranial magnetic stimulation (TMS) technique that assesses an inhibitory circuit in the sensorimotor cortex and is regarded as a global marker of cholinergic function in the brain. Increased difficulty to allocate attention during gait was evaluated by measuring gait performance under single and dual-task conditions. Global cognition was also assessed. Results showed that SAI was reduced in patients with PD than in the older adults (fallers and non-fallers) and in older adults fallers with respect to non-fallers. Reduction in SAI indicates less inhibition i.e., less cholinergic activity. Gait speed was reduced in the dual task gait compared to normal gait only in our faller population and changes in gait speed under dual task significantly correlated with the mean value of SAI. This association remained significant after adjusting for cognitive status. These findings suggest that central cholinergic activity may be a predictor of change in gait characteristics under dual tasking in older adults and PD fallers independently of cognitive status.

23 Article Levodopa and neuropathy risk in patients with Parkinson disease: Effect of COMT inhibition. 2016

Cossu, Giovanni / Ceravolo, Roberto / Zibetti, Maurizio / Arca, Roberta / Ricchi, Valeria / Paribello, Alessandra / Murgia, Daniela / Merola, Aristide / Romagnolo, Alberto / Nicoletti, Valentina / Palermo, Giovanni / Mereu, Alessandra / Lopiano, Leonardo / Melis, Maurizio / Abbruzzese, Giovanni / Bonuccelli, Ubaldo. ·Neurology Unit, Azienda Ospedaliera Brotzu Cagliari, P.le Ricchi 1, 009134, Cagliari Italy. Electronic address: giovannicossu1@gmail.com. · Neurology Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, Ospedale S. Chiara Via Roma 67, 56126, Pisa, Italy. · Neurology Unit, University of Torino, Ospedale Molinette, C.so Bramante, 88, 10126, Torino, Italy. · Neurology Unit, Azienda Ospedaliera Brotzu Cagliari, P.le Ricchi 1, 009134, Cagliari Italy. · Department of Public Health University, Clinical and Molecular Medicine, University of Cagliari, 09042, Monserrato, Cagliari, Italy. · Department of Neurosciences, Ophthalmology & Genetics University of Genova, Via De Toni, 5, 16132, Genova, Italy. ·Parkinsonism Relat Disord · Pubmed #27129930.

ABSTRACT: OBJECTIVE: Our purpose was to determine whether the use of catechol-O-methyltransferase-inhibitors (ICOMT) can reduce the risk of developing levodopa (LD)-induced neuropathy in Parkinson's disease (PD) patients. METHODS: A multicentre study of 197 PD patients was performed. 144 were exposed to LD for more than three years (LELD group); 53 simultaneously assumed Entacapone for at least eighteen months (LELD_ICOMT group). RESULTS: The prevalence of neuropathy in LELD patients was 19.4% whereas it was 5.7% in LELD_ICOMT group with a significant difference (p = 0.025). In LELD_ICOMT cohort the daily LD dose and serum VB12 levels were significantly higher (p < 0.0001), the serum Hcy levels were significantly lower (p = 0.001) compared to LELD group. CONCLUSION: Our results suggest that ICOMT could have a protective effect on the development of LD-induced neuropathy. Their action probably occurs through the metabolic rebalancing of the one-carbon-pathway cycle and is independent of the PD duration and severity and the duration of LD intake.

24 Article Parkinson's Disease Sleep Scale 2: application in an Italian population. 2016

Arnaldi, Dario / Cordano, Christian / De Carli, Fabrizio / Accardo, Jennifer / Ferrara, Michela / Picco, Agnese / Tamburini, Tiziano / Brugnolo, Andrea / Abbruzzese, Giovanni / Nobili, Flavio. ·Clinical Neurology Unit, Department of Neuroscience (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Genoa, Italy. dario.arnaldi@gmail.com. · Clinical Neurology Unit, Department of Neuroscience (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Genoa, Italy. · Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy. · Neuro-rehabilitation Unit, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy. ·Neurol Sci · Pubmed #26520846.

ABSTRACT: Sleep disturbances and nocturnal disabilities are common in Parkinson's Disease (PD). The PD sleep scale, second version (PDSS-2), has been proposed as a helpful tool for measuring sleep disorders in PD. We aimed to validate the Italian version of the PDSS-2. One hundred and twenty-three consecutive PD outpatients (76 males) were evaluated by means of PDSS-2, Epworth Sleepiness Scale, Hamilton Depression Rating Scale, Parkinson's Disease Quality of Life Questionnaire (self-administered scales), Unified Parkinson's Disease Rating (motor section) and Hoehn and Yahr Scales, and Mini Mental State Examination. PDSS-2 internal consistency was satisfactory (Cronbach's α: 0.77) with significant item to total score correlation and high intra-class correlation coefficient for test-retest reliability (0.943). Total PDSS-2 score was correlated with the scores on all other clinical scales. The factor analysis identified five factors, related to five areas of nocturnal disturbances, similarly as the original PDSS-2. The five factors mainly reflected: (1) nocturnal movement-related problems, (2) quality of sleep, (3) dreaming distress, (4) fragmentation of sleep and (5) insomnia symptoms. The PDSS-2 scale has confirmed its usefulness in evaluating sleep problems in Italian PD patients.

25 Article Pisa syndrome in Parkinson disease: An observational multicenter Italian study. 2015

Tinazzi, Michele / Fasano, Alfonso / Geroin, Christian / Morgante, Francesca / Ceravolo, Roberto / Rossi, Simone / Thomas, Astrid / Fabbrini, Giovanni / Bentivoglio, Annarita / Tamma, Filippo / Cossu, Giovanni / Modugno, Nicola / Zappia, Mario / Volontè, Maria Antonietta / Dallocchio, Carlo / Abbruzzese, Giovanni / Pacchetti, Claudio / Marconi, Roberto / Defazio, Giovanni / Canesi, Margherita / Cannas, Antonino / Pisani, Antonio / Mirandola, Rina / Barone, Paolo / Vitale, Carmine / Anonymous4540846. ·From the Department of Neurological and Movement Sciences (M.T., C.G.) and Neuromotor and Cognitive Rehabilitation Research Centre (C.G.), University of Verona, Italy · Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.F.), Toronto Western Hospital and Division of Neurology, University of Toronto, Canada · Department of Clinical and Experimental Medicine (F.M.), University of Messina · Neurology Unit (R.C.), Department of Clinical and Experimental Medicine, University of Pisa · Department of Neurological and Neurosensorial Sciences (S.R.), Neurology and Neurophysiology Unit, University of Siena · Department of Neuroscience and Imaging (A.T.), University of Chieti-Pescara · Aging Research Center Ce.S.I. University Foundation (A.T.), Chieti Behavioural Neurology and Movement Disorders Unit · Department of Neurology and Psychiatry (G.F.), University of Rome Sapienza · IRCSS Neuromed Institute (G.F., N.M.), Pozzilli-Isernia · Department of Geriatrics, Neuroscience and Orthopedics (A.B.), Università Cattolica del Sacro Cuore, University Hospital Agostino Gemelli, Rome · Department of Neurology (F.T.), F. Miulli General Hospital, Acquaviva delle Fonti (BA) · Department of Neurology (G.C.), AOB Brotzu, Cagliari · Department G.F. Ingrassia (M.Z.), Area of Neurosciences, University of Catania · Neurological Department and INSPE-Institute of Experimental Neurology (M.A.V.), University Hospital San Raffaele, Milan · Division of Neurology (C.D.), Civil Hospital Voghera (PV) · Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (G.A.), University of Genova · U.O.C. Parkinson e Disordini del Movimento (C.P.), IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino, Pavia · Neurology Unit (R. Marconi), Ospedale Misericordia, Grosseto · Department of Basic Medical Sciences (G.D.), Neuroscience and Sense Organs, University of Bari Aldo Moro · Parkinson Institute (M.C.), Istituti Clinici di Perfe ·Neurology · Pubmed #26491088.

ABSTRACT: OBJECTIVE: To estimate the prevalence of Pisa syndrome (PS) in patients with Parkinson disease (PD) and to assess the association between PS and demographic and clinical variables. METHODS: In this multicenter cross-sectional study, consecutive outpatients with PD attending 21 movement disorders Italian tertiary centers were enrolled and underwent standardized clinical evaluation. PS was defined as trunk lateral deviation ≥10°. Patients with PD were compared according to the presence of PS for several demographic and clinical variables. RESULTS: Among 1,631 enrolled patients with PD, PS was detected in 143 patients (8.8%, 95% confidence interval 7.4%-10.3%). Patients with PS were older, had lower body mass index, longer disease duration, higher disease stages, and poorer quality of life. Falls were more frequent in the PS group as well as occurrence of "veering gait" (i.e., the progressive deviation toward one side when patient walked forward and backward with eyes closed). Patients with PS received higher daily levodopa equivalent daily dose and were more likely to be treated with combination of levodopa and dopamine agonists. Osteoporosis and arthrosis were significantly the most frequent associated medical conditions in patients with PS. Multiple explanatory variable logistic regression models confirmed the association of PS with the following variables: Hoehn and Yahr stage, ongoing combined treatment with levodopa and dopamine agonist, associated medical conditions, and presence of veering gait. CONCLUSIONS: Our results suggest that PS is a relatively frequent and often disabling complication in PD, especially in the advanced disease stages. The association is dependent on a number of potentially relevant demographic and clinical variables.

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