Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Parkinson Disease: HELP
Articles by Giovanni Abbruzzese
Based on 56 articles published since 2008
||||

Between 2008 and 2019, G. Abbruzzese wrote the following 56 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 Review The rationale for motor learning in Parkinson's disease. 2009

Abbruzzese, G / Trompetto, C / Marinelli, L. ·Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy. giabbr@unige.it ·Eur J Phys Rehabil Med · Pubmed #19377414.

ABSTRACT: Parkinson's disease (PD) is a chronic progressive disorder mainly affecting the motor system. PD is only partially controlled by symptomatic dopaminergic treatment. Therefore, motor rehabilitation can be used in PD to reduce complications and to train patients in the use of compensatory movement strategies. Rehabilitative practice is largely dependent on the efficiency of motor learning, i.e. the acquisition of new abilities or the adaptation of pre-existing ones. Although patients with PD are able to improve their motor performance through practice, the amount and persistence of clinical benefit are uncertain. Both ''implicit'' (procedural) and ''explicit'' (declarative) features of motor learning have been extensively investigated in patients with PD using neuropsychological testing, serial reaction time paradigms, and analysis of reaching movements. Evidence from these studies suggests an early impairment of ''explicit'' learning in PD, while ''implicit'' learning is relatively preserved. The consolidation of learned motor tasks is defective in PD and the mechanisms of motor learning seem to be independent from dopamine-replacement therapy. The knowledge of motor learning in PD is critical in designing more effective rehabilitative protocols.

8 Review Optimising levodopa therapy. 2008

Abbruzzese, Giovanni. ·Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Via De Toni 5, Genoa, Italy. giabbr@csita.unige.it ·Neurol Sci · Pubmed #19381767.

ABSTRACT: Levodopa is still recognised to be the "gold standard" symptomatic treatment for Parkinson's disease. After 4-5 years however, its clinical efficacy declines and patients may experience the so-called "long-term levodopa syndrome", which represents the clinical counterpart of the changes of pharmacodynamic response to the drug. Long duration response (LDR) is substituted by the short duration response (SDR), which is responsible for the fluctuations of the clinical response. Strategies aimed at maintaining the clinical benefits for as long as possible and postponing the occurrence of motor complications as late as possible have been at the centre of scientific debates in recent years. We are still far from optimal use of the drug in the different stages or the disease, both regarding mode of administration and dose adjustment to individual needs.

9 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.

10 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.

11 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.

12 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.

13 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.

14 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.

15 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.

16 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.

17 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.

18 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.

19 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.

20 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.

21 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.

22 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 / Anonymous4560846. ·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.

23 Article A randomized clinical trial to evaluate the effects of rasagiline on depressive symptoms in non-demented Parkinson's disease patients. 2015

Barone, P / Santangelo, G / Morgante, L / Onofrj, M / Meco, G / Abbruzzese, G / Bonuccelli, U / Cossu, G / Pezzoli, G / Stanzione, P / Lopiano, L / Antonini, A / Tinazzi, M. ·University of Salerno, Baronissi, Italy. · Second University of Naples, Caserta, Italy. · University of Messina, Messina, Italy. · University of Chieti-Pescara, Chieti, Italy. · 'Sapienza' University of Rome, Rome, Italy. · University of Genoa, Genoa, Italy. · University of Pisa, Pisa, Italy. · AO Brotzu, Cagliari, Italy. · Parkinson Institute, Milan, Italy. · IRCCS Fondazione S Lucia, Rome, Italy. · University of Torino, Torino, Italy. · IRCCS Ospedale San Camillo, Venice, Italy. · University of Verona, Verona, Italy. ·Eur J Neurol · Pubmed #25962410.

ABSTRACT: BACKGROUND AND PURPOSE: Depressed mood is a common psychiatric problem associated with Parkinson's disease (PD), and studies have suggested a benefit of rasagiline treatment. METHODS: ACCORDO (see the ) was a 12-week, double-blind, placebo-controlled trial to evaluate the effects of rasagiline 1 mg/day on depressive symptoms and cognition in non-demented PD patients with depressive symptoms. The primary efficacy variable was the change from baseline to week 12 in depressive symptoms measured by the Beck Depression Inventory (BDI-IA) total score. Secondary outcomes included change from baseline to week 12 in cognitive function as assessed by a comprehensive neuropsychological battery; Parkinson's disease quality of life questionnaire (PDQ-39) scores; Apathy Scale scores; and Unified Parkinson's Disease Rating Scale (UPDRS) subscores. RESULTS: One hundred and twenty-three patients were randomized. At week 12 there was no significant difference between groups for the reduction in total BDI-IA score (primary efficacy variable). However, analysis at week 4 did show a significant difference in favour of rasagiline (marginal means difference ± SE: rasagiline -5.46 ± 0.73 vs. placebo -3.22 ± 0.67; P = 0.026). There were no significant differences between groups on any cognitive test. Rasagiline significantly improved UPDRS Parts I (P = 0.03) and II (P = 0.003) scores versus placebo at week 12. Post hoc analyses showed the statistical superiority of rasagiline versus placebo in the UPDRS Part I depression item (P = 0.04) and PDQ-39 mobility (P = 0.007) and cognition domains (P = 0.026). CONCLUSIONS: Treatment with rasagiline did not have significant effects versus placebo on depressive symptoms or cognition in PD patients with moderate depressive symptoms. Although limited by lack of correction for multiple comparisons, post hoc analyses signalled some improvement in patient-rated cognitive and depression outcomes.

24 Article Prevalence and associated features of self-reported freezing of gait in Parkinson disease: The DEEP FOG study. 2015

Amboni, M / Stocchi, F / Abbruzzese, G / Morgante, L / Onofrj, M / Ruggieri, S / Tinazzi, M / Zappia, M / Attar, M / Colombo, D / Simoni, L / Ori, A / Barone, P / Antonini, A / Anonymous6580827. ·IDC Hermitage-Capodimonte - Napoli, Italy; Department of Medicine and Surgery, University of Salerno, Salerno, Italy. Electronic address: marianna.amboni@libero.it. · Department of Neurology, Institute of Research and Medical Care, IRCCS San Raffaele, Rome, Italy. Electronic address: fabrizio.stocchi@tin.it. · Department of Neurosciences, University of Genoa, Genoa, Italy. Electronic address: giabbr@unige.it. · Department of Neurosciences University of Messina, Messina, Italy. Electronic address: morgante@unime.it. · CeSI-Centro Studi Invecchiamento Fondazione Università Gabriele D'Annunzio, Chieti, Italy. Electronic address: onofrj@unich.it. · Neurologia Istituto Mediterraneo Neuromed, Isernia, Italy. Electronic address: stefano.ruggieri@uniroma1.it. · U.O. Neurologia Ospedale Civile Maggiore, Borgo Trento, Verona, Italy. Electronic address: michele.tinazzi@ospedaleuniverona.it. · Clinica Neurologica I Policlinico Universitario, Catania, Italy. Electronic address: m.zappia@unict.it. · Novartis Pharma Italia, Medical Department, Origgio, Italy. Electronic address: mahmood.attar@novartis.com. · Novartis Pharma Italia, Medical Department, Origgio, Italy. Electronic address: delia.colombo@novartis.com. · Medidata srl, Modena, Italy. Electronic address: l.simoni@medidata.it. · Medidata srl, Modena, Italy. Electronic address: a.ori@medidata.it. · Department of Medicine and Surgery, University of Salerno, Salerno, Italy. Electronic address: pbarone@unisa.it. · Department for Parkinson's Disease, IRCCS San Camillo, Venice, Italy. Electronic address: angelo3000@yahoo.com. ·Parkinsonism Relat Disord · Pubmed #25899545.

ABSTRACT: Freezing of Gait (FOG) is a common and disabling symptom in patients with Parkinson disease (PD). The relationship between FOG and dopaminergic medication is complex. The aim of the present study was to estimate the prevalence of self-reported FOG, its associated clinical features, and its relationship with wearing-off in a wide PD population. This is an observational multicenter study of 634 consecutive non-demented PD patients. Patients were identified either as freezers or non-freezers based on item-3 of the Freezing of Gait-Questionnaire. FOG was then classified as on, off and onoff freezing based on its relationship with wearing-off. Patients were assessed with Unified Parkinson's Disease Rating Scale, Hoehn and Yahr scale, 8-item Parkinson's disease Questionnaire, Mini-Mental State Examination. Data from 593 patients were analyzed, 325 (54.3%) were freezers of whom 200 (61.6%) experienced FOG only during off state (off-freezers), 6 (1.8%) only during on state and 119 (36.6%) either in on and off states or independently of dopaminergic response-related symptoms (onoff-freezers). Overall, freezers vs non-freezers had longer disease duration, more advanced disease and greater disability. Moreover, freezers more frequently reported wearing-off and experienced worse quality of life. Onoff-freezers vs off-freezers were older, more severely disabled, less likely to experience wearing-off, treated with lower levodopa equivalent daily dose and with poorer cognitive performance. Self-reported FOG is mainly recognizable in advanced PD and is associated with more disability and worse quality of life. Onoff-FOG may represent the result of under-treatment or rather interpretable as a distinct clinical entity.

25 Article Brain (18)F-DOPA PET and cognition in de novo Parkinson's disease. 2015

Picco, Agnese / Morbelli, Silvia / Piccardo, Arnoldo / Arnaldi, Dario / Girtler, Nicola / Brugnolo, Andrea / Bossert, Irene / Marinelli, Lucio / Castaldi, Antonio / De Carli, Fabrizio / Campus, Claudio / Abbruzzese, Giovanni / Nobili, Flavio. ·Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Largo P Daneo, 3, 16132, Genoa, Italy. ·Eur J Nucl Med Mol Imaging · Pubmed #25820675.

ABSTRACT: PURPOSE: The role of mesocortical dopaminergic pathways in the cognitive function of patients with early Parkinson's disease (PD) needs to be further clarified. METHODS: The study groups comprised 15 drug-naive patients with de novo PD and 10 patients with essential tremor (controls) who underwent (18)F-DOPA PET (static acquisition, normalization on mean cerebellar counts) and an extended neuropsychological test battery. Factor analysis with varimax rotation was applied to the neuropsychological test scores, to yield five factors from 16 original scores, which explained 82 % of the total variance. Correlations between cognitive factors and (18)F-DOPA uptake were assessed with SPM8, taking age and gender as nuisance variables. RESULTS: (18)F-DOPA uptake was significantly lower in PD patients than in controls in the bilateral striatum, mainly in the more affected (right) hemisphere, and in a small right temporal region. Significant positive correlations were found only in PD patients between the executive factor and (18)F-DOPA uptake in the bilateral anterior cingulate cortex (ACC) and the middle frontal gyrus, between the verbal fluency factor and (18)F-DOPA uptake in left BA 46 and the bilateral striatum, and between the visuospatial factor and (18)F-DOPA uptake in the left ACC and bilateral striatum. No correlations were found between (18)F-DOPA uptake and either the verbal memory factor or the abstraction-working memory factor. CONCLUSION: These data clarify the role of the mesocortical dopaminergic pathways in cognitive function in early PD, highlighting the medial frontal lobe, anterior cingulate, and left BA 46 as the main sites of cortical correlation with executive and language functions.

Next