Publications by authors named "Alfonso Giordano"
Objective: This study was undertaken to assess the effectiveness/tolerability of adjunctive cenobamate, variations in the load of concomitant antiseizure medications (ASMs) and predictors of clinical response in people with focal epilepsy.
Methods: This was a retrospective study at 21 centers participating in the Italian Expanded Access Program. Effectiveness outcomes included retention and responder rates (≥50% and 100% reduction in baseline seizure frequency).
Objective: There are few comparative data on the third-generation antiseizure medications (ASMs). We aimed to assess and compare the effectiveness of brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were compared as secondary objectives.
View Article and Find Full Text PDFBackground And Purpose: Although disabling fatigue is common in Parkinson disease (PD), available consensus-based diagnostic criteria have not yet been empirically validated. The aim of this study was to evaluate the clinimetric properties of the criteria.
Methods: A sample of outpatients with PD was evaluated for demographic, clinical, behavioral, and cognitive features.
Article Synopsis
- Psychological factors, specifically maladaptive metacognitive beliefs, may contribute to fatigue in Parkinson's disease, which had not been previously studied.
- A study involving 98 PD patients found that 21% experienced fatigue, with more significant fatigue linked to higher scores in metacognitive beliefs and poorer cognitive confidence.
- The research suggests that these maladaptive beliefs could trigger and sustain fatigue, indicating a need for future studies to explore potential interventions that could reduce fatigue by addressing these beliefs.
Introduction: Parkinson's disease (PD) patients in chronic levodopa treatment may experience motor and non-motor fluctuations, which may affect their quality of life. Safinamide is a new monoamine oxidase B inhibitor, also exerting a non-dopaminergic effect, recently approved as add-on therapy in fluctuating PD patients.
Methods: We performed a longitudinal prospective study in a cohort of 20 fluctuating PD patients, to test whether safinamide 50 mg may improve non-motor, cognitive, and behavioral symptoms over a 6-month treatment period.
Background: Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson's disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy.
Methods: We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson's Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure).
Background: Following the severe consequences of the COVID-19 outbreak, on March 9, 2020, the Italian government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. This resulted in a rapid and profound change of people's daily lives.
Objective: We assessed the psychological impact of the 40-day quarantine in a large cohort of patients with Parkinson's disease (PD) and caregivers.
Introduction: Following the severe consequences of the coronavirus disease 2019 (COVID-19) outbreak, on March 9th, 2020 the Italian Government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. Psychological distress represents the seizure-precipitating factor most often reported by patients with epilepsy. To date, no studies have analyzed the role played by the different dimensions of psychological distress quarantine-induced in patients with epilepsy.
View Article and Find Full Text PDFBackground: Anxiety symptoms are common in Parkinson's disease (PD). A link between anxiety and cognitive impairment in PD has been demonstrated.
Objectives: Using resting-state functional magnetic resonance imaging, we investigated intrinsic brain network connectivity correlates of anxiety symptoms in a cohort of drug-naive, cognitively unimpaired patients with PD.
Fatigue is a common and disabling nonmotor manifestation in patients with Parkinson's disease (PD), and the supplementary motor area (SMA) has been implicated in its pathophysiology. SMA is usually divided in its rostro-caudal axis, with the rostral (pre-) SMA playing a major role in motor planning, and the caudal (proper) SMA related to movement execution. To investigate brain functional connectivity of SMA subregions in de novo, drug-naïve PD patients affected by fatigue, 17 patients with fatigue, 18 without fatigue, and 16 matched healthy controls were recruited.
View Article and Find Full Text PDFBackground: Despite its clinical relevance, the pathophysiology of pain in Parkinson's disease (PD) is still largely unknown, and both central and peripheral mechanisms have been invoked.
Objectives: To investigate whether central pain processing is altered in "drug-naive" pain-free PD (dnPD) patients.
Methods: Using event-related functional MRI (fMRI), functional response to forearm heat stimulation (FHS) at two different intensities (41°C and 53°C) was investigated in 20 pain-free dnPD patients, compared with 18 healthy controls (HCs).
Background: Impulse control disorders can be triggered by dopamine replacement therapies in patients with PD. Using resting-state functional MRI, we investigated the intrinsic brain network connectivity at baseline in a cohort of drug-naive PD patients who successively developed impulse control disorders over a 36-month follow-up period compared with patients who did not.
Methods: Baseline 3-Tesla MRI images of 30 drug-naive PD patients and 20 matched healthy controls were analyzed.
Introduction: To investigate intrinsic neural networks connectivity changes in Parkinson's disease (PD) patients with and without impulse control disorders (ICD).
Methods: Fifteen patients with PD with ICD (ICD+), 15 patients with PD without ICD (ICD-) and 24 age and sex-matched healthy controls (HC) were enrolled in the study. To identify patients with and without ICD and/or punding, we used the Minnesota Impulsive Disorders Interview (MIDI) and a clinical interview based on diagnostic criteria for each symptom.
Introduction: Fatigue is a common problem in PD either in the early or later stage of the disease. Using resting-state functional MRI, we investigated the functional correlates of fatigue in a cohort of "drug-naïve" patients with PD.
Methods: MRI at 3Tesla was collected in 40 patients with PD, 20 with and 20 without fatigue, and 20 matched healthy controls.
Objective A prospective clinical imaging study has been conducted to investigate pain processing functional pathways during trigeminal heat stimulation (THS) in patients with migraine without aura experiencing ictal cutaneous allodynia (CA) (MwoA CA+). Methods Using whole-brain BOLD-fMRI, functional response to THS at three different intensities (41°, 51° and 53℃) was investigated interictally in 20 adult MwoA CA+ patients compared with 20 MwoA patients without ictal CA (MwoA CA-) and 20 healthy controls (HCs). Secondary analyses evaluated associations between BOLD signal change and clinical features of migraine.
View Article and Find Full Text PDFIntroduction: To investigate gray matter (GM) and cortical thickness (CTh) changes in patients with Parkinson's disease (PD) with and without Impulse Control Disorders (ICDs).
Methods: Fifteen patients with PD with ICDs (ICD+), 15 patients with PD without ICDs (ICD-) and 24 age and sex-matched healthy controls (HCs) were enrolled in the study. Patients were screened for ICDs by the Minnesota Impulsive Disorders Interview (MIDI) and underwent an extensive neuropsychological evaluation.
In the last decades a rapid evolution of structural advanced MRI techniques has occurred supporting the diagnosis of idiopathic Parkinson's disease, allowing us to further investigate the disease progression from nigral to extra-nigral degeneration and finally to detect pre-manifest Parkinson's disease. Diffusion-weighted imaging and diffusion tensor imaging represent advanced morphological approaches useful to detect changes in white matter integrity. These techniques, indeed, by measuring the translational displacement of water molecules in terms of fractional anisotropy and mean diffusivity, represent a powerful tool for the visualization of white matter changes, offering a unique window on brain structural connectivity.
View Article and Find Full Text PDFBackground: Transcutaneous supraorbital neurostimulation (tSNS) has been recently found superior to sham stimulation for episodic migraine prevention in a randomized trial. We evaluated both the safety and efficacy of a brief period of tSNS in a group of patients with migraine without aura (MwoA).
Methods: We enrolled 24 consecutive patients with MwoA experiencing a low frequency of attacks, which had never taken migraine preventive drugs in the course of their life.