Publications by authors named "Angelo Antonini"

Background: Catechol-O-methyl transferase (COMT) inhibitors are routinely used to manage motor fluctuations in Parkinson's disease (PD). We assessed the effect of opicapone on motor symptom severity in levodopa-treated patients without motor complications.

Methods: This was a randomized, double-blind, 24-week, placebo-controlled study of opicapone 50 mg as adjunct to levodopa (NCT04978597).

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Background: Parkinson's disease (PD) is a neurodegenerative disorder affecting both sexes, but differences exist between male and female in clinical manifestations, functional impact of symptoms and hormonal influences. Therefore, representativeness of females in PD trials indirectly determines the external validity of the clinical research in this field.

Objective: To estimate the representativeness of female in infusion therapy trials for advanced PD.

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In this study, we compared the value of pathological alpha-synuclein (αSyn) seed amplification assay (SAA) in gastric and duodenal biopsies with skin biopsies in Parkinson disease (PD) patients with different disease duration. The accuracy of αSyn SAA was 87.7% in skin, 67.

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Background: Rapid eye movement (REM) sleep behavior disorder (RBD) may precede motor symptoms in Parkinson's disease (PD) by years. According to a recent hypothesis, premotor RBD (pRBD) is a marker of the PD body-first subtype, where synucleinopathy originates from the peripheral autonomic nervous system. Conversely, in the brain-first subtype, pathology would arise in the brain.

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Transient or persistent hypo-anosmia is common in SARS‑CoV‑2 infection but olfactory pathway late-term morphometric changes are still under investigation. We evaluated late olfactory bulb (OB) imaging changes and their correlates with the olfactory function in otherwise neurologically asymptomatic COVID-19 patients. Eighty-three subjects (mean-age 43 ± 14 yr; 54 females; time-interval infection/MRI: 129±68 d) were affected by asymptomatic to mild COVID-19 in 2020 and 25 healthy controls (mean-age 40 ± 13 yr; 9 females) underwent 3T-MRI and olfactory function evaluation through anamnestic questionnaire and Sniffin' Sticks.

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Parkinson disease (PD) is the fastest growing neurological disorder globally and poses substantial management challenges owing to progressive disability, emergence of levodopa-resistant symptoms, and treatment-related complications. In this Review, we examine the current state of research into PD therapies and outline future priorities for advancing our understanding and treatment of the disease. We identify two main research priorities for the coming years: first, slowing the progression of the disease through the integration of sensitive biomarkers and targeted biological therapies, and second, enhancing existing symptomatic treatments, encompassing surgical and infusion therapies, with the goal of postponing complications and improving long-term patient management.

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  • Identifying cognitive impairment in Parkinson's disease is complicated due to varied symptoms and incomplete criteria for diagnosis, with existing screening tools (MMSE and MoCA) lacking a unified approach.
  • The study analyzed data from 1,780 Parkinson's patients to establish effective cutoffs for MMSE and MoCA scores across different cognitive stages (normal, mild impairment, dementia).
  • A new decision tree model was created, suggesting specific MMSE and MoCA scores to accurately diagnose dementia and mild cognitive impairment, improving diagnostic precision and efficiency for clinicians.
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Background: Advances in analytical methods have recently paved the way to Alzheimer's disease (AD) biomarkers testing in blood along with the more established CSF testing. To ensure a forthcoming application of this low-invasive diagnostic that might allow to recognize early onset of dementia, appropriate pathological cut-points need to be defined.

Methods: In this cross-sectional study we measured blood and CSF neurofilament light chain (NFL), phosphorylated tau (pTau 181), Amyloid-β1-42 (AB 1-42) and Amyloid-β1-40 (AB 1-40) on a fully automated chemiluminescent platform (Lumipulse, Fujirebio) in 80 cognitively impaired patients and 55 cognitively unimpaired subjects.

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  • The study examines the prevalence of cerebrovascular and Alzheimer's disease co-pathologies in patients with dementia with Lewy bodies against various other cognitive states, including mild cognitive impairment and Alzheimer's disease.
  • A multi-cohort dataset of 4,549 participants was analyzed, revealing that 43% of dementia with Lewy bodies patients had a high load of white matter hyperintensities, indicating a significant difference compared to other groups.
  • Findings showed that white matter hyperintensities in dementia with Lewy bodies correlate with medial temporal atrophy, suggesting that the impact of these co-pathologies is particularly pronounced in this group compared to others.
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  • Family history of Parkinson's disease (PD) was examined in a study involving 2035 PD patients across 28 Italian centers, revealing that 21.9% had a family history of the disease.
  • Familial PD (fPD) patients experienced symptoms at an earlier age compared to sporadic PD (sPD) patients, although both groups showed similar prevalence of motor and nonmotor symptoms.
  • The findings suggest that fPD occurs more frequently than previously thought, highlighting the need for comprehensive family history taking to uncover potential disease patterns and risk factors.
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Background: The wearing-off phenomenon is a key driver of medication change for patients with Parkinson's disease (PD) treated with levodopa. Common first-line options include increasing the levodopa dose or adding a catechol-O-methyltransferase (COMT) inhibitor, but there are no trials comparing the efficacy of these approaches. We evaluated the effectiveness of adjunct opicapone versus an additional 100 mg levodopa dose in PD patients with early wearing-off using pooled data from 2 randomized studies.

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The 5-2-1 criteria was developed to facilitate the identification and referral of patients with Parkinson's Disease (PD) inadequately controlled by oral medications. The criterion was not developed to screen patients with PD for device-aided therapy eligibility. The robust design and validation of the 5-2-1 criteria minimizes over or inappropriate referrals, and supports physicians in the timely identification of patients with PD who may warrant further evaluation for treatment optimization.

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In Parkinson's disease, neuroinflammation is a double-edged sword; when inflammation occurs it can have harmful effects, despite its important role in battling infections and healing tissue. Once triggered by microglia, astrocytes acquire a reactive state and shift from supporting the survival of neurons to causing their destruction. Activated microglia and Proteinase-activated receptor-2 (PAR2) are key points in the regulation of neuroinflammation.

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Background: Gastrointestinal dysfunction has emerged as a prominent early feature of Parkinson's Disease, shedding new light on the pivotal role of the enteric nervous system in its pathophysiology. However, the role of immune-cell clusters and inflammatory and glial markers in the gut pathogenetic process needs further elucidation.

Objectives: We aimed to study duodenum tissue samples to characterize PD's enteric nervous system pathology further.

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  • Parkinson's disease (PD) is a complex disorder influenced by genetic factors, with this study focusing on a cohort from Northeastern Italy to explore its genetic basis and clinical characteristics.
  • Using a next-generation sequencing (NGS) panel, researchers identified 133 genetic variants in 218 PD patients, diagnosing monogenic PD in 20% of them, primarily linked to mutations in the GBA1, LRRK2, and PRKN genes.
  • The findings suggest that certain clinical criteria, like early age of onset, can reliably predict positive genetic test outcomes, which helps in managing patient care and opens avenues for future therapies targeting specific genetic causes of the disease.
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The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson's disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively.

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Objective: This study was undertaken to investigate the effects of dietary caffeine intake on striatal dopamine function and clinical symptoms in Parkinson disease in a cross-sectional and longitudinal setting.

Methods: One hundred sixty-three early Parkinson disease patients and 40 healthy controls were investigated with [I]FP-CIT single photon emission computed tomography, and striatal dopamine transporter binding was evaluated in association with the level of daily coffee consumption and clinical measures. After a median interval of 6.

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  • Deep brain stimulation (STN-DBS) is a treatment for people with advanced Parkinson's disease that helps with movement problems, but results can be different for each person.
  • Researchers studied the brain scans of 49 Parkinson's patients to see if certain brain measurements could predict how well they would do in areas not just related to movement after treatment.
  • They found that while losing brain volume in some areas like the frontal cortex linked to worse motor outcomes, it didn't really help predict non-motor issues, meaning it might not be super helpful for choosing which patients should get the treatment.
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Background: Parkinson's disease is a progressive neurodegenerative disorder mainly distinguished by sporadic etiology, although a genetic component is also well established. Variants in the LRRK2 gene are associated with both familiar and sporadic disease. We have previously shown that PAK6 and 14-3-3γ protein interact with and regulate the activity of LRRK2.

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Background: Zonisamide (ZNS) has shown some efficacy in motor symptoms of PD; however, more evidence is lacking, and its effects on nonmotor symptoms (NMSs) and quality of life (QoL) remain to be investigated. This randomized double-blinded placebo-controlled crossover study investigated the effect of ZNS on motor and NMS symptoms and QoL in advanced PD.

Methods: PD patients with Hoehn and Yahr stage ≥ 2 ("On" state) and at least 2 h off time daily were randomized to groups: ZNS 25 mg, ZNS 50 mg and placebo.

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Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia - MCI, or consequent to Parkinson's disease - PD-MCI).

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A key distinguishing factor between mild cognitive impairment (MCI) and dementia in Parkinson's disease (PD) lies in the notable decrease in functioning due to cognitive impairment. The Parkinson's Disease-Cognitive Functional Rating Scale (PD-CRFS) was developed to assess functional limitations caused by cognitive impairment, while reducing the influence of motor impairment. The aim of this multicenter study was to (i) validate the Italian version of the PD-CFRS in PD, (ii) determine optimal cut-off scores for detecting MCI and dementia in PD, (iii) compare its performances with the most established functional assessment tool (IADL).

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