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Parkinson Disease: HELP
Articles by Paolo Barone
Based on 159 articles published since 2009
(Why 159 articles?)

Between 2009 and 2019, Paolo Barone wrote the following 159 articles about Parkinson Disease.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Review Prevalence and clinical aspects of mild cognitive impairment in Parkinson's disease: A meta-analysis. 2019

Baiano, Chiara / Barone, Paolo / Trojano, Luigi / Santangelo, Gabriella. ·Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. · Centre for Neurodegenerative Disease-CEMAND, University of Salerno, Salerno, Italy. ·Mov Disord · Pubmed #31743500.

ABSTRACT: Mild cognitive impairment associated with Parkinson's disease (PD) is a risk factor for the development of dementia. Despite the importance of early identification of mild cognitive impairment in PD, its prevalence and clinical correlates are still debated. The present meta-analysis provides a robust estimate of prevalence rate of mild cognitive impairment in PD according to the Movement Disorder Society clinical criteria and to explore the differences between PD patients with and without mild cognitive impairment in demographic, clinical, and neuropsychiatric features. A systematic literature search was performed up to April 2019 using PsycInfo (PROQUEST), PubMed, and Scopus. From 4706 titles and abstracts, 41 studies were selected (n = 7053 patients). Pooled mild cognitive impairment prevalence was 40% on a total sample of 7053 PD patients (95% confidence interval = 36-44; Q = 490.14, P < 0.0001; I

2 Review Detecting Mild Cognitive Deficits in Parkinson's Disease: Comparison of Neuropsychological Tests. 2018

Hoogland, Jeroen / van Wanrooij, Lennard L / Boel, Judith A / Goldman, Jennifer G / Stebbins, Glenn T / Dalrymple-Alford, John C / Marras, Connie / Adler, Charles H / Junque, Carme / Pedersen, Kenn F / Mollenhauer, Brit / Zabetian, Cyrus P / Eslinger, Paul J / Lewis, Simon J G / Wu, Ruey-Meei / Klein, Martin / Rodriguez-Oroz, Maria C / Cammisuli, Davide M / Barone, Paolo / Biundo, Roberta / de Bie, Rob M A / Schmand, Ben A / Tröster, Alexander I / Burn, David J / Litvan, Irene / Filoteo, J Vincent / Geurtsen, Gert J / Weintraub, Daniel / Anonymous2521562. ·Department of Neurology, Academic Medical Center Amsterdam, The Netherlands. · Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois, USA. · New Zealand Brain Research Institute, Brain Research New Zealand - Rangahau Roro Aotearoa, Christchurch, New Zealand. · Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. · Arizona Parkinson's Disease Consortium, Mayo Clinic Arizona, Scottsdale, Arizona, USA and Banner Sun Health Research Institute, Sun City, Arizona, USA. · Department of Medicine, Faculty of Medicine, IDIBAPS, University of Barcelona, Barcelona, Spain. · The Norwegian Centre for Movement Disorders, Department of Neurology, and Memory Clinic, Stavanger University Hospital, Stavanger, Norway. · Paracelsus-Elena-Klinik, Kassel, Germany, and University Medical Center Goettingen, Department of Neurology, Goettingen, Germany. · VA Puget Sound Health Care System and Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA. · Department of Neurology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA. · Brain & Mind Centre, The University of Sydney, Sydney, Australia. · Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. · Department of Medical Psychology, section Medical Neuropsychology, VU University Medical Center, Amsterdam, The Netherlands. · Department of Neurology, Hospital Donostia, Donostia, San Sebastian and Ikerbasque, Basque Foundation for Science, Bilbao, Spain. · Fifth Local Sanitary Unit, Hospital Psychology, Pisa, Italy and Department of Surgical, Medical, Molecular, and Critical Area Pathology, Pisa University School of Medicine, Pisa, Italy. · Center for Neurodegenerative Diseases (CEMAND) Neuroscience Section, Department of Medicine University of Salerno, Salerno, Italy. · San Camillo Hospital IRCCS, Venice, Italy. · Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands. · Department of Psychology, University of Amsterdam, The Netherlands. · Department of Clinical Neuropsychology and Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA. · Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. · Department of Neurosciences University of California San Diego, Parkinson and Other Movement Disorders Center, San Diego, California, USA. · Department of Psychiatry, University of California San Diego, and VA San Diego Healthcare System, San Diego, California, USA. · Departments of Psychiatry and Neurology, University of Pennsylvania School of Medicine, and Parkinson's Disease and Mental Illness Research, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. ·Mov Disord · Pubmed #30216541.

ABSTRACT: BACKGROUND: Numerous neuropsychological tests and test versions are used in Parkinson's disease research, but their relative capacity to detect mild cognitive deficits and their comparability across studies are unknown. The objective of this study was to identify neuropsychological tests that consistently detect cognitive decline in PD across studies. METHODS: Data from 30 normed neuropsychological tests across 20 international studies in up to 2908 nondemented PD patients were analyzed. A subset of 17 tests was administered to up to 1247 healthy controls. A 2-step meta-analytic approach using standardized scores compared performance in PD with normative data. RESULTS: Pooled estimates of the differences between PD and site-specific healthy controls identified significant cognitive deficits in PD patients on 14 test scores across 5 commonly assessed cognitive domains (attention or working memory, executive, language, memory, and visuospatial abilities), but healthy control performance was statistically above average on 7 of these tests. Analyses based on published norms only, as opposed to direct assessment of healthy controls, showed high between-study variability that could not be accounted for and led to inconclusive results. CONCLUSIONS: Normed neuropsychological tests across multiple cognitive domains consistently detect cognitive deficits in PD when compared with site-specific healthy control performance, but relative PD performance was significantly affected by the inclusion and type of healthy controls versus the use of published norms only. Additional research is needed to identify a cognitive battery that can be administered in multisite international studies and that is sensitive to cognitive decline, responsive to therapeutic interventions, and superior to individual cognitive tests. © 2018 International Parkinson and Movement Disorder Society.

3 Review Merging Clinical and Imaging Biomarkers to Tackle Parkinson's Disease. 2017

Picillo, Marina / Barone, Paolo / Pellecchia, Maria Teresa. ·Neuroscience Section Department of Medicine and Surgery Center for Neurodegenerative Diseases (CMAND) University of Salerno Salerno Italy. ·Mov Disord Clin Pract · Pubmed #30363377.

ABSTRACT: Background: In Parkinson's disease, biomarkers represent tools that are potentially suitable for either clinical or research settings and are useful in predicting onset, confirming diagnosis, detecting progression, and evaluating response to potential disease-modifying treatments. The range of available biomarkers in Parkinson's disease is fast expanding and includes an increasing amount of laboratory, clinical, and imaging data. Indeed, the latter 2 represent the cornerstones of the diagnostic criteria for Parkinson's disease recently proposed by the International Parkinson and Movement Disorders Society Task Force on the definition of Parkinson's disease. Methods and Results: In this review, we describe current knowledge and emerging findings on clinical (with emphasis on nonmotor symptoms) and imaging biomarkers for Parkinson's disease, with a focus on prodromal, diagnostic, and middle/advanced phases. Conclusion: An increasing body of evidence suggests that merging clinical and imaging biomarkers through disease stages may be the best, fastest track to tackle Parkinson's disease.

4 Review Quality of Life and Nonmotor Symptoms in Parkinson's Disease. 2017

Barone, Paolo / Erro, Roberto / Picillo, Marina. ·Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, University of Salerno, Salerno, Italy. Electronic address: pbarone@unisa.it. · Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, University of Salerno, Salerno, Italy; University College London, Institute of Neurology, London, United Kingdom. · Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, University of Salerno, Salerno, Italy. ·Int Rev Neurobiol · Pubmed #28802930.

ABSTRACT: Health-related quality of life (HRQoL) is defined as "the perception and evaluation by patients themselves of the impact caused on their lives by the disease and its consequences." HRQoL is conceptualized as a combination of physical, psychological, and social well-being in the context of a particular disease. Following earlier studies revolving on the impact of the classic motor symptoms of Parkinson's disease on HRQoL, mounting evidence have been produced that nonmotor symptoms (NMS) significantly and independently contribute to worse HRQoL. This holds particularly true for such NMS such as neuropsychiatric disturbances, cognitive impairment, and fatigue, the burden of which might well exceed the effects of the motor symptoms. Nonetheless, there is very sparse evidence on how to manage these NMS and whether targeting NMS would in fact lead to an improvement of HRQoL, which calls for the need of future trials with NMS as primary outcomes.

5 Review The relationship between Impulse Control Disorders and cognitive dysfunctions in Parkinson's Disease: A meta-analysis. 2017

Santangelo, Gabriella / Raimo, Simona / Barone, Paolo. ·Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. Electronic address: gabriella.santangelo@unina2.it. · Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy. · Department of Medicine, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Italy. ·Neurosci Biobehav Rev · Pubmed #28242338.

ABSTRACT: Impulse Control Disorders (ICD) are associated with impairment in cognitive flexibility and cortical inhibition. In Parkinson's Disease (PD) the relationship between ICD and cognitive dysfunctions is still unclear: some studies found different cognitive profiles between Parkinsonians with and without ICD, whereas others did not. Moreover, findings from studies on ICD in PD are conflicting on which cognitive function is altered. A meta-analysis of 34 studies was performed to shed light on relationship between ICD and cognitive dysfunctions and to reveal the cognitive function compromised in Parkinsonians with ICD. Data were analysed in global cognitive functioning, memory, executive functions, attention/working memory, language, and visuospatial functions. Significant relationship between ICD and dysfunction of abstraction ability/concept formation, set-shifting, visuospatial/constructional abilities and decision-making was found. These findings suggested that people affected by PD with specific frontal dysfunctions are more vulnerable to develop ICD when they take antiparkinsonian drug. Evaluation of specific cognitive functions in routine clinical practice might help to detect those people with PD susceptible to ICD before treating them with antiparkinsonian drugs.

6 Review Walking on four limbs: A systematic review of Nordic Walking in Parkinson disease. 2017

Bombieri, Federica / Schena, Federico / Pellegrini, Barbara / Barone, Paolo / Tinazzi, Michele / Erro, Roberto. ·Department of Neuroscience, Biomedicine and Movement Sciences, Università di Verona, Verona, Italy. · Department of Neuroscience, Biomedicine and Movement Sciences, Università di Verona, Verona, Italy; CeRiSM (Research Centre of Mountain Sport and Health), University of Verona, Rovereto, Italy. · Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, Italy. · Department of Neuroscience, Biomedicine and Movement Sciences, Università di Verona, Verona, Italy. Electronic address: michele.tinazzi@univr.it. · Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, Italy; Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom. ·Parkinsonism Relat Disord · Pubmed #28202374.

ABSTRACT: Nordic Walking is a relatively high intensity activity that is becoming increasingly popular. It involves marching using poles adapted from cross-country skiing poles in order to activate upper body muscles that would not be used during normal walking. Several studies have been performed using this technique in Parkinson disease patients with contradictory results. Thus, we reviewed here all studies using this technique in Parkinson disease patients and further performed a meta-analysis of RCTs where Nordic Walking was evaluated against standard medical care or other types of physical exercise. Nine studies including four RCTs were reviewed for a total of 127 patients who were assigned to the Nordic Walking program. The majority of studies reported beneficial effects of Nordic Walking on either motor or non-motor variables, but many limitations were observed that hamper drawing definitive conclusions and it is largely unclear whether the benefits persist over time. It would appear that little baseline disability is the strongest predictor of response. The meta-analysis of the 4 RCTs yielded a statistically significant reduction of the UPDRS-3 score, but its value of less than 1 point does not appear to be clinically meaningful. Well-designed, large RCTs should be performed both against standard medical care and other types of physical exercise to definitively address whether Nordic Walking can be beneficial in PD.

7 Review Personality in Parkinson's disease: Clinical, behavioural and cognitive correlates. 2017

Santangelo, Gabriella / Piscopo, Fausta / Barone, Paolo / Vitale, Carmine. ·Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy; Institute of Diagnosis and Health, Hermitage-Capodimonte, Naples, Italy. · Institute of Diagnosis and Health, Hermitage-Capodimonte, Naples, Italy; Neurodegenerative Diseases Centre, Department of Medicine and Surgery, University of Salerno, Italy. · Institute of Diagnosis and Health, Hermitage-Capodimonte, Naples, Italy; Department of Motor Sciences and Health, University "Parthenope", Naples, Italy. Electronic address: cavit69@hotmail.com. ·J Neurol Sci · Pubmed #28087060.

ABSTRACT: Affective disorders and personality changes have long been considered pre-motor aspects of Parkinson's disease (PD). Many authors have used the term "premorbid personality" to define distinctive features of PD patients' personality characterized by reduced exploration of new environmental stimuli or potential reward sources ("novelty seeking") and avoidance behaviour ("harm avoidance") present before motor features. The functional correlates underlying the personality changes described in PD, implicate dysfunction of meso-cortico-limbic and striatal circuits. As disease progresses, the imbalance of neurotransmitter systems secondary to degenerative processes, along with dopamine replacement therapy, can produce a reversal of behaviours and an increase in reward seeking, laying the foundations for the emergence of the impulse control disorders. Personality disorders can be interpreted, therefore, as the result of individual susceptibility arising from intrinsic degenerative processes and individual personality features, in combination with extrinsic factors such as lifestyle, PD motor dysfunction and drug treatment. For a better understanding of personality disorders observed in PD and their relationship with the prodromal stage of the disease, prospective clinical studies are needed that correlate different personality profiles with other disease progression markers. Here, we review previous studies investigating the clinical, cognitive and behavioural correlates of personality traits in PD patients.

8 Review The relevance of gender in Parkinson's disease: a review. 2017

Picillo, Marina / Nicoletti, Alessandra / Fetoni, Vincenza / Garavaglia, Barbara / Barone, Paolo / Pellecchia, Maria Teresa. ·Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, 84131, Italy. picillo.marina@gmail.com. · Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy. · Neurologia Fatebenefratelli-ASST Fatebenefratelli Sacco, Milan, Italy. · Molecular Neurogenetics Unit, IRCCS Foundation Neurological Institute "Carlo Besta", Milan, Italy. · Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, 84131, Italy. ·J Neurol · Pubmed #28054129.

ABSTRACT: Since the official and systematic inclusion of sex and gender in biomedical research, gender differences have been acknowledged as important determinants of both the susceptibility to develop neurodegenerative diseases in general population and the clinical and therapeutic management of neurodegenerative patients. In this review, we gathered the available evidence on gender differences in Parkinson's disease (PD) regarding clinical phenotype (including motor and non-motor symptoms), biomarkers, genetics and therapeutic management (including pharmacological and surgical treatment). Finally, we will briefly discuss the role of estrogens in determining such differences. Several data demonstrate that PD in women starts with a more benign phenotype, likely due to the effect of estrogens. However, as the disease progresses, women are at higher risk of developing highly disabling treatment-related complications, such as motor and non-motor fluctuations as well as dyskinesia, compared with men. In addition, women have lower chances of receiving effective treatment for PD as deep brain stimulation. Taken together these findings challenge the definition of a more benign phenotype in women. Still, much work needs to be done to better understand the interaction between gender, genetics and environmental factors in determining the PD risk and clinical features. Improving our understanding in this field may result in implementation of strategies to identify prodromal PD and speed efforts to discern new directions for disease tailored treatment and management.

9 Review Toward the premotor diagnosis of Parkinson's disease: Suggestions from a modelling study. 2015

Erro, Roberto / Barone, Paolo. ·Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom. · Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy. · University of Salerno Center for Neurodegenerative Disease-CEMAND, Salerno, Italy. ·Mov Disord · Pubmed #26575210.

ABSTRACT: -- No abstract --

10 Review Recruitment strategies and patient selection in clinical trials for Parkinson's disease: Going viral and keeping science and ethics at the highest standards. 2015

Picillo, Marina / Kou, Nancy / Barone, Paolo / Fasano, Alfonso. ·Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, ON, Canada; Centre for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno, Salerno, Italy. · Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, ON, Canada. · Centre for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno, Salerno, Italy. · Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, ON, Canada. Electronic address: alfonso.fasano@gmail.com. ·Parkinsonism Relat Disord · Pubmed #26228079.

ABSTRACT: INTRODUCTION: Enrollment of an adequate number of suitable candidates is a critical component of good quality randomized controlled trials (RCTs). Parkinson's disease (PD) is a highly heterogeneous disease and recruiting a large and homogeneous sample of patients is often challenging. Further, PD patients are often elderly, cognitively impaired and disabled, thus requiring the assistance from their caregivers for participation in RCTs. Only a limited number of studies have explored the effectiveness of recruitment strategies and PD patient selection in clinical trials. We aim to review the four crucial recruitment components of RCTs (i.e. infrastructure, nature of the research, recruiter characteristics and participant characteristics) with particular implications in PD, and to explore strategies to improve recruitment and patient selection in RCTs in PD. CONCLUSION: Movement disorders centers have a key role in managing recruitment and patient selection in RCTs in PD. Key recommendations within the infrastructure component are to improve trust and communication between patient and participant, and to consider the diversity, perceived disadvantages, and health care accessibility of the participants. Further, study designs that involve participant's opinions and considers placebo and lessebo effects are highly recommended for the nature of the research component of RCTs. Finally, a team-based approach with recruiters and participants that establishes relationships between researchers and the community and addresses ethical considerations are encouraged as part of the recruiters and participants components. Finally, we envisage a greater usage of internet-based strategies for clinical trials recruitment in PD with the goal of 'going viral' with the recruitment.

11 Review Cognitive contributions to gait and falls: evidence and implications. 2013

Amboni, Marianna / Barone, Paolo / Hausdorff, Jeffrey M. ·Isituto di Diagnosi e Cura Hermitage-Capodimonte, Naples, Italy; Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy. ·Mov Disord · Pubmed #24132840.

ABSTRACT: Dementia and gait impairments often coexist in older adults and patients with neurodegenerative disease. Both conditions represent independent risk factors for falls. The relationship between cognitive function and gait has recently received increasing attention. Gait is no longer considered merely automated motor activity but rather an activity that requires executive function and attention as well as judgment of external and internal cues. In this review, we intend to: (1) summarize and synthesize the experimental, neuropsychological, and neuroimaging evidence that supports the role played by cognition in the control of gait; and (2) briefly discuss the implications deriving from the interplay between cognition and gait. In recent years, the dual task paradigm has been widely used as an experimental method to explore the interplay between gait and cognition. Several neuropsychological investigations have also demonstrated that walking relies on the use of several cognitive domains, including executive-attentional function, visuospatial abilities, and even memory resources. A number of morphological and functional neuroimaging studies have offered additional evidence supporting the relationship between gait and cognitive resources. Based on the findings from 3 lines of studies, it appears that a growing body of evidence indicates a pivotal role of cognition in gait control and fall prevention. The interplay between higher-order neural function and gait has a number of clinical implications, ranging from integrated assessment tools to possible innovative lines of interventions, including cognitive therapy for falls prevention on one hand and walking program for reducing dementia risk on the other.

12 Review Pathological gambling in Parkinson's disease. A comprehensive review. 2013

Santangelo, Gabriella / Barone, Paolo / Trojano, Luigi / Vitale, Carmine. ·Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Caserta, Italy. gabriella.santangelo@unina2.it ·Parkinsonism Relat Disord · Pubmed #23490464.

ABSTRACT: Pathological gambling (PG) and other Impulse Control Disorders (ICDs), such as hypersexuality, compulsive eating and buying, are often reported in Parkinson's disease (PD). The prevalence of PG is 2.2%-7% in treated PD patients, which is higher than the background population rate. As other non motor symptoms in PD, PG is frequently under-reported by patients and caregivers and may be under-recognized by the treating physicians. Factors associated with PG include male sex, younger age or younger age at PD onset, personal or family history of substance abuse or ICD, a personality profile characterized by impulsiveness, and treatment with dopamine agonists (DA) more than with levodopa (l-dopa). The DA effect seems to be a class effect and not specific for any DA. Neurofunctional studies suggest that medication-induced downregulation of frontostriatal connections and upregulation of striatum might combine to induce impulsive behavior. A dysfunction of fronto-subcortical circuits in PD patients with PG is also supported by neuropsychological findings of impaired executive control and monitoring abilities. Management of ICDs in PD is complex, and until now only discontinuation and/or tapering of DA treatment seem to be an effective management strategy for ICDs in PD. There is no empirical evidence supporting the use of psychiatric drugs for PG such as antipsychotics and antidepressants. Data regarding the effect of deep brain stimulation (DBS), particularly of subthalamic nucleus, on PG and ICDs in PD are still limited and sometimes conflicting since improvement of PG or new onset of PG after surgery have been reported.

13 Review Apathy in Parkinson's disease: diagnosis, neuropsychological correlates, pathophysiology and treatment. 2013

Santangelo, Gabriella / Trojano, Luigi / Barone, Paolo / Errico, Domenico / Grossi, Dario / Vitale, Carmine. ·Department of Psychology, Second University of Naples, Caserta, Italy Istituto di Diagnosi e Cura "Hermitage Capodimonte", Naples, Italy. ·Behav Neurol · Pubmed #23242365.

ABSTRACT: Apathy has been defined as lack of motivation. It has been traditionally considered as a symptom of psychiatric disorders, such as major depression and schizophrenia, but more recently it has been recognized as a specific neuropsychiatric syndrome associated with neurodegenerative such as Parkinson's disease (PD). As a consequence the reported prevalence of apathy in PD ranges from 13.9% to 70%; the mean prevalence is 35%. Prevalence of "pure apathy" (i.e., of apathy without comorbid depression and dementia) seems to be substantially lower, from 3 to 47.9%. High levels of apathy in PD are associated with decreased daily function, specific cognitive deficits and increased stress for families. Although neuroimaging studies do not provide a unique anatomic pattern, several data suggest that the ventromedial prefrontal cortex and the basal ganglia connected through frontal-subcortical circuits, are particularly involved in the genesis of apathy. At present, there are no approved medications for the treatment of apathy in and no proof of efficacy exists for any drug in current use. Further studies and innovative pharmacologic approaches are thus needed to ameliorate our understanding and treatment of apathy in PD.

14 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.

15 Review Identifying prodromal Parkinson's disease: pre-motor disorders in Parkinson's disease. 2012

Postuma, Ronald B / Aarsland, Dag / Barone, Paolo / Burn, David J / Hawkes, Christopher H / Oertel, Wolfgang / Ziemssen, Tjalf. ·Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada. ronald.postuma@mcgill.ca ·Mov Disord · Pubmed #22508280.

ABSTRACT: Increasing recognition that Parkinson's disease (PD) may start outside of the substantia nigra has led to a rapidly expanding effort to define prodromal stages of PD, before motor signs permit classical diagnosis. Many of these efforts center around the identification of clinical non-motor symptoms and signs of disease. There is now direct evidence that olfaction, rapid eye movement (REM) sleep behavior disorder (RBD), constipation, and depression can be present in prodromal PD. In addition, there is suggestive evidence that visual changes, other autonomic symptoms, and subtle cognitive changes may also be present at prodromal stages. A critical issue in utility of these prodromal markers will be assessment of sensitivity, specificity, and positive and negative predictive values. Although these have yet to be fully defined, olfactory deficits, some visual changes, and autonomic symptoms occur in the majority of PD patients at diagnosis, suggesting good potential sensitivity. However, with the exception of RBD and perhaps some specific autonomic measures, specificity, and positive predictive value of these markers may be insufficient to be used alone as identifiers of prodromal disease. The evidence for the utility of olfaction, RBD, autonomic markers, visual changes, mood disorders, and cognitive loss as markers of prodromal PD and the potential sensitivity and specificity of these markers are summarized.

16 Review Cognitive impairment in nondemented Parkinson's disease. 2011

Barone, Paolo / Aarsland, Dag / Burn, David / Emre, Murat / Kulisevsky, Jaime / Weintraub, Daniel. ·Department of Neurological Sciences, University Federico II-ICD Hermitage, Capodimonte, Naples, Italy. barone@unina.it ·Mov Disord · Pubmed #22170275.

ABSTRACT: A substantial percentage of patients with newly diagnosed Parkinson's disease without dementia are reported to be affected by cognitive impairment (CI). In practice, however, CI is underrecognized, as the signs may not be apparent in early-stage disease and many routine assessment tools lack the sensitivity to detect subtle cognitive dysfunction. Patients with PD and mild CI (MCI) may have a higher risk of developing dementia than cognitively intact PD patients; however, it is not currently known which patients with CI are at increased risk of developing dementia. This review summarizes current knowledge about CI in nondemented PD; it discusses the structural and functional changes associated with CI and addresses areas of unmet needs. We focus on questions that should be addressed in future studies to achieve consensus on its characteristics and definition, pathophysiology, epidemiology, diagnosis and assessment, and treatment and management.

17 Review Effects of cholinesterase inhibitors in Parkinson's disease dementia: a review of clinical data. 2011

van Laar, Teus / De Deyn, Peter Paul / Aarsland, Dag / Barone, Paolo / Galvin, James E. ·Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. t.van.laar@neuro.umcg.n ·CNS Neurosci Ther · Pubmed #21951368.

ABSTRACT: AIMS: Cognitive impairment and dementia are common features of Parkinson's disease (PD). Patients with Parkinson's disease dementia (PDD) often have significant cholinergic defects, which may be treated with cholinesterase inhibitors (ChEIs). The objective of this review was to consider available efficacy, tolerability, and safety data from studies of ChEIs in PDD. DISCUSSIONS: A literature search resulted in the identification of 20 relevant publications. Of these, the treatment of PD patients with rivastigmine, donepezil, or galantamine was the focus of six, eleven, and two studies respectively, while one study reported use of both tacrine and donepezil. The majority of studies were small (<40 patients), with the exception of two large randomized controlled trials (RCTs) that are the main focus of this review. In the smaller studies, treatment benefits were reported on a range of outcome measures, though results were extremely variable. While the full results of a large RCT of donepezil in patients with PDD are not yet available, significant treatment differences were reported on the CIBIC-plus at the highest treatment dose. A trend toward improvement was also observed in treated patients on the ADAS-cog. The second large RCT found significant improvements in rivastigmine-treated patients compared with placebo on both the ADAS-cog (P < 0.001) and the ADCS-CGIC (P < 0.007), as well as on all secondary efficacy outcomes. Consequently, rivastigmine is now widely approved for the symptomatic treatment of mild to moderate PDD. CONCLUSIONS: Taken together, these studies suggest that ChEIs are efficacious in the treatment of PDD.

18 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.

19 Review Dopamine receptor agonists and depression in Parkinson's disease. 2009

Picillo, Marina / Rocco, Mariangela / Barone, Paolo. ·Department of Neurological Sciences, University of Naples Federico II, Naples, Italy. ·Parkinsonism Relat Disord · Pubmed #20123564.

ABSTRACT: Depression is one of the most common non-motor symptoms in Parkinson's disease (PD). It is associated with a more rapid progression of physical symptoms, greater decline in cognitive skills, and a poorer quality of life. Despite the high prevalence of depression and antidepressant use in PD, validated guidelines for the treatment of PD-associated depression (dPD) are lacking. Several methodological limitations have been recognized in the available studies examining the treatment of dPD. Some studies support a relevant role of the catecholaminergic systems in the pathogenesis of dPD. In open-label studies, the dopamine receptor agonists pramipexole and pergolide have shown antidepressant effects in PD patients. A placebo-controlled study of pramipexole in dPD is ongoing. The combined results of data from animal models and evidence in human studies support the strategy of dopaminergic stimulation as a treatment of depression. Treatment strategies for depressive symptoms in PD should include optimization of dopaminergic treatment prior to the addition of classic antidepressant drugs, thus reducing the risk of side-effects associated with multi-drug therapies.

20 Clinical Trial Effects of Safinamide on Pain in Fluctuating Parkinson's Disease Patients: A Post-Hoc Analysis. 2017

Cattaneo, Carlo / Barone, Paolo / Bonizzoni, Erminio / Sardina, Marco. ·Medical Department, Zambon SpA, Bresso (MI), Italy. · Centre for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno, Baronissi (SA), Italy. · Department of Clinical Science and Community, Section of Medical Statistics and Biometry "GA Maccacaro", University of Milan, Milan, Italy. · R&D Department, Zambon SpA, Bresso (MI), Italy. ·J Parkinsons Dis · Pubmed #27802242.

ABSTRACT: BACKGROUND: Pain, a frequent non-motor symptom in Parkinson's Disease (PD), significantly impacts on quality of life. Safinamide is a new drug with dopaminergic and non-dopaminergic properties, approved in Europe as adjunct therapy to levodopa for the treatment of fluctuating PD patients. Results from two 24-month, double-blind, placebo-controlled studies demonstrated that safinamide has positive effects on both motor functions and quality of life in PD patients. OBJECTIVE: To investigate the effects of safinamide on pain management in PD patients with motor fluctuations using pooled data from studies 016 and SETTLE. METHODS: This post-hoc analysis evaluated the reduction of concomitant pain treatments and the changes in the scores of the items related to pain of the Parkinson's Disease Quality of Life Questionnaire (PDQ-39). A path analysis was performed in order to examine direct and indirect associations between safinamide and PDQ-39 pain-related items assessed after 6-months of treatment. RESULTS: The percentage of patients with no pain treatments at the end of the trials was significantly lower in the safinamide group compared to the placebo group. Safinamide 100 mg/day significantly reduced on average the individual use of pain treatments by ≈24% and significantly improved two out of three PDQ-39 pain-related items of the "Bodily discomfort" domain.Path analysis showed that the direct effect of safinamide on pain accounted for about 80% of the total effect. CONCLUSIONS: These results suggest that safinamide may have a positive effect on pain, one of the most underestimated non-motor symptoms. Prospective studies are warranted to investigate this potential benefit.

21 Clinical Trial Efficacy, safety, and tolerability of overnight switching from immediate- to once daily extended-release pramipexole in early Parkinson's disease. 2010

Rascol, Olivier / Barone, Paolo / Hauser, Robert A / Mizuno, Yoshikuni / Poewe, Werner / Schapira, Anthony H V / Salin, Laurence / Sohr, Mandy / Debieuvre, Catherine / Anonymous5680666. ·Departments of Clinical Pharmacology and Neurosciences, Toulouse University Hospital, INSERM CIC9302-UMR825 Toulouse, France. rascol@cict.fr ·Mov Disord · Pubmed #20669265.

ABSTRACT: The aim of this article is to test the feasibility, in early Parkinson's disease (PD), of an overnight switch from immediate-release (IR) pramipexole to a new once-daily extended-release (ER) formulation. Nonfluctuating patients on pramipexole IR three-times daily, alone or with levodopa, for early PD were randomly switched overnight to double-blind IR three-times daily (N = 52) or ER once-daily (N = 104) at initially unchanged daily dosage. Successful switching (defined as no worsening >15% of baseline UPDRS II+III score and no drug-related adverse event withdrawal) was assessed at 9 weeks, after optional dosage adjustments (primary endpoint), and at 4 weeks, before adjustment. Other secondary endpoints included adjusted mean changes from baseline in UPDRS scores and proportion of responders based on Clinical or Patient Global Impression (CGI/PGI). Absolute difference between percentage of successful switch to ER versus IR was tested for ER noninferiority, defined as a 95% confidence-interval lower bound not exceeding -15%. At 9 weeks, 84.5% of the ER group had been successfully switched, versus 94.2% for IR. Noninferiority was not demonstrated, with a difference of -9.76% (95% CI: [-18.81%, +1.66%]). At 4 weeks, 81.6% of the ER group had been successfully switched, versus 92.3% for IR, a difference of -10.75% (95% CI: [-20.51%, +1.48%]). UPDRS changes and CGI/PGI analyses showed no differences between the groups. Both formulations were safe and well tolerated. Pramipexole ER was not equivalent to IR, but the difference was marginal. The fact that >80% of the patients successfully switched overnight at unchanged dosage shows that this practice was feasible in most patients.

22 Article Parkinsonism in diseases predominantly presenting with dystonia. 2019

Di Fonzo, Alessio / Franco, Giulia / Barone, Paolo / Erro, Roberto. ·Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. · Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy. ·Int Rev Neurobiol · Pubmed #31779818.

ABSTRACT: If the presence of dystonia is a well-recognized phenomenon in disorders predominantly presenting with parkinsonism, including sporadic Parkinson Disease, the term dystonia-parkinsonism usually refers to rare conditions, often genetic, in which the severity of dystonia usually equates that of parkinsonism. At variance with parkinsonian syndromes with additional dystonia, the conditions reviewed in this chapter have usually their onset in childhood and their diagnostic work-up is different. In fact, the phenotype is not usually specific of the underlying defect and additional investigations are therefore required. Here, we review the diseases predominantly presenting with dystonia where parkinsonism can develop, according to their main pathophysiological mechanism including disorders of dopamine biosynthesis, neurotransmitter transporter disorders, disorder of metal metabolism (i.e., iron, copper and manganese) and other inherited dystonia-parkinsonism conditions.

23 Article Using gait analysis' parameters to classify Parkinsonism: A data mining approach. 2019

Ricciardi, Carlo / Amboni, Marianna / De Santis, Chiara / Improta, Giovanni / Volpe, Giampiero / Iuppariello, Luigi / Ricciardelli, Gianluca / D'Addio, Giovanni / Vitale, Carmine / Barone, Paolo / Cesarelli, Mario / Anonymous1071482 / Anonymous1081482. ·Department of Advanced Biomedical Sciences, University Hospital of Naples 'Federico II', Via S. Pansini, 5, Naples 80131, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Via bagni vecchi, 1, Telese Terme (BN), Italy. · Center for Neurodegenerative Diseases, Department of Medicine and Surgery, University of Salerno, Via San Leonardo, Salerno 84131, Italy; Istituto di Diagnosi e Cura Hermitage-Capodimonte, Naples, Italy. · Center for Neurodegenerative Diseases, Department of Medicine and Surgery, University of Salerno, Via San Leonardo, Salerno 84131, Italy. · Department of Public Health, University Hospital of Naples 'Federico II', Via S. Pansini, 5, Naples 80131, Italy. · Azienda Ospedaliera Universitaria OO.RR. San Giovanni di Dio Ruggi d'Aragona - Scuola Medica Salernitana, Via San Leonardo, Salerno 84131, Italy. · Department of Electrical Engineering and Information Technology, University of Naples 'Federico II', Via Claudio, 21, Naples, Italy; Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy. · Istituti Clinici Scientifici Maugeri IRCCS, Via bagni vecchi, 1, Telese Terme (BN), Italy. · Department of Motor Sciences and Wellness, University of Naples Parthenope, Via Ammiraglio Ferdinando Acton, 38, Naples 80133, Italy. · Istituti Clinici Scientifici Maugeri IRCCS, Via bagni vecchi, 1, Telese Terme (BN), Italy; Department of Electrical Engineering and Information Technology, University of Naples 'Federico II', Via Claudio, 21, Naples, Italy. Electronic address: cesarell@unina.it. ·Comput Methods Programs Biomed · Pubmed #31445485.

ABSTRACT: INTRODUCTION: Parkinson's disease (PD) is the second most common neurodegenerative disorder in the world, while Progressive Supranuclear Palsy (PSP) is an atypical Parkinsonism resembling PD, especially in early stage. Assumed that gait dysfunctions represent a major motor symptom for both pathologies, gait analysis can provide clinicians with subclinical information reflecting subtle differences between these diseases. In this scenario, data mining can be exploited in order to differentiate PD patients at different stages of the disease course and PSP using all the variables acquired through gait analysis. METHODS: A cohort of 46 subjects (divided into three groups) affected by PD patients at different stages and PSP patients was acquired through gait analysis and spatial and temporal parameters were analysed. Synthetic Minority Over-sampling Technique was used to balance our imbalanced dataset and cross-validation was applied to provide different training and testing sets. Then, Random Forests and Gradient Boosted Trees were implemented. RESULTS: Accuracy, error, precision, recall, specificity and sensitivity were computed for each group and for both algorithms, including 16 features. Random Forests obtained the highest accuracy (86.4%) but also specificity and sensitivity were particularly high, overcoming the 90% for PSP group. CONCLUSION: The novelty of the study is the use of a data mining approach on the spatial and temporal parameters of gait analysis in order to classify patients affected by typical (PD) and atypical Parkinsonism (PSP) based on gait patterns. This application would be helpful for clinicians to distinguish PSP from PD at early stage, when the differential diagnosis is particularly challenging.

24 Article Toward more focused multimodal and multidisciplinary approaches for pain management in Parkinson's disease. 2019

Cuomo, Arturo / Crispo, Anna / Truini, Andrea / Natoli, Silvia / Zanetti, Orazio / Barone, Paolo / Cascella, Marco. ·Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy. · S.C. Epidemiologia e Biostatistica, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy. · Department of Human Neuroscience, University Sapienza, Rome, Italy. · Department of Clinical Science and Translational Medicine, Tor Vergata University of Rome, Rome, Italy. · U.O. Alzheimer, IRCCS Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy. · Center for Neurodegenerative Disease-CEMAND, University of Salerno, Fisciano, Italy. ·J Pain Res · Pubmed #31413618.

ABSTRACT: In Parkinson's disease (PD), pain represents a significant issue in terms of prevalence, clinical features, and treatment. Painful manifestations not strictly related to the disease are often amplified by the motor dysfunction. On the other hand, typical pain problems may specifically concern this vulnerable population. In turn, pain may have a deep impact on patients' health-related quality of life. However, pain treatment in PD remains an unmet need as only about half of patients with pain use analgesics and pain is often managed by simply increasing doses of PD medications. In this complex scenario, pain treatments should follow multimodal approaches through a careful combination of pharmacological agents with non-pharmacological strategies, depending on the type of pain and the clinical context. A multidisciplinary approach involving medical specialists from different disciplines could be a winning strategy to address the issue. This work is aimed to provide practical suggestions useful for different types of clinicians and care professionals for pain management in this vulnerable population.

25 Article Validation of the Italian version of the PSP Quality of Life questionnaire. 2019

Picillo, Marina / Cuoco, Sofia / Amboni, Marianna / Bonifacio, Francesco Paolo / Bruschi, Fabio / Carotenuto, Immacolata / De Micco, Rosa / De Rosa, Anna / Del Prete, Eleonora / Di Biasio, Francesca / Elifani, Francesca / Erro, Roberto / Fabbri, Margherita / Falla, Marika / Franco, Giulia / Frosini, Daniela / Galantucci, Sebastiano / Lazzeri, Giulia / Magistrelli, Luca / Malaguti, Maria Chiara / Milner, Anna Vera / Minafra, Brigida / Olivola, Enrica / Pilotto, Andrea / Rascunà, Cristina / Rizzetti, Maria Cristina / Schirinzi, Tommaso / Borroni, Barbara / Ceravolo, Roberto / Di Fonzo, Alessio / Marchese, Roberta / Mercuri, Nicola B / Modugno, Nicola / Nicoletti, Alessandra / Padovani, Alessandro / Santangelo, Gabriella / Stefani, Alessandro / Tessitore, Alessandro / Volontè, Maria Antonietta / Zangaglia, Roberta / Zappia, Mario / Zibetti, Maurizio / Barone, Paolo. ·Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Odontoiatry, University of Salerno, 84131, Salerno, Italy. · Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. · Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy. · Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy. · Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy. · IRCCS Policlinico San Martino, Genoa, Italy. · IRCCS Neuromed, Pozzilli, Italy. · Department of Neuroscience "Rita Levi Montalcini", University of Turin, via Cherasco 15, 10124, Torino, Italy. · Department of Neurology, General Hospital of Bolzano, Bolzano, Italy. · CIMec and CeRIN, University of Trento, Rovereto, Italy. · IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy. · Dipartimento Neurologico, IRCCS Ospedale San Raffaele, Milan, Italy. · Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. · PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, Italy. · UO Neurologia, Ospedale Santa Chiara Trento, Azienda provinciale per i servizi sanitari provincia autonoma di Trento, Trento, Italy. · Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. · Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy. · S. Isidoro Hospital - FERB Onlus, Trescore Balneario, Bergamo, Italy. · Centro Parkinson, Dip. Medicina dei Sistemi, Policlinico Tor Vergata, Rome, Italy. · Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy. · Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Odontoiatry, University of Salerno, 84131, Salerno, Italy. pbarone@unisa.it. ·Neurol Sci · Pubmed #31350659.

ABSTRACT: BACKGROUND: Progressive supranuclear palsy (PSP) is a rare rapidly progressive, neurodegenerative disease characterized by falls and ocular movement disturbances. The use of health-related quality of life (HR-QoL) measures allows assessing changes in health status induced by therapeutic interventions or disease progress in neurodegenerative diseases. The PSP-QoL is a 45-item, self-administered questionnaire designed to evaluate HR-QoL in PSP. METHODS AND RESULTS: Here, the PSP-QoL was translated into Italian and validated in 190 PSP (96 women and 94 men; mean age ± standard deviation, 72 ± 6.5; mean disease duration, 4.2 ± 2.3) patients diagnosed according to the Movement Disorder Society criteria and recruited in 16 third level movement disorders centers participating in the Neurecanet project. The mean PSP-QoL total score was 77.8 ± 37 (physical subscore, 46.5 ± 18.7; mental subscore, 33.6 ± 19.2). The internal consistency was high (Cronbach's alpha = 0.954); corrected item-total correlation was > 0.40 for the majority of items. The significant and moderate correlation of the PSP-QoL with other HR-QoL measures as well as with motor and disability assessments indicated adequate convergent validity of the scale. Gender and geographic location presented a significant impact on the PSP-QoL in our sample with women and patients from the South of Italy scoring higher than their counterparts. CONCLUSION: In conclusion, the Italian version of the PSP-QoL is an easy, reliable and valid tool for assessment of HR-QoL in PSP.