Publications by authors named "Capellari S"

Background: The diagnostic and prognostic performance of the novel fluid biomarkers brain-derived tau (BD-tau) and phospho-tau217 (p-tau217) in Creutzfeldt-Jakob disease (CJD) is not defined.

Methods: We measured cerebrospinal fluid (CSF) and plasma BD-tau, p-tau217, p-tau181, total tau (t-tau), neurofilament light (NfL), and 14-3-3 in 100 CJD patients, 100 with non-prion rapidly progressive dementia (np-RPD), 92 with mild cognitive impairment due to Alzheimer's disease (AD-MCI), and 55 healthy controls (HC).

Results: Plasma BD-tau performed comparably to plasma t-tau but had lower performance than CSF t-tau (p < 0.

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Background And Purpose: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by pervasive personality and behavioural disturbances with severe impact on patients and caregivers. In current clinical practice, treatment is based on nonpharmacological and pharmacological approaches. Unfortunately, trial-based evidence supporting symptomatic pharmacological treatment for the behavioural disturbances in FTD is scarce despite the significant burden this poses on the patients and caregivers.

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Background: The term rapidly progressive dementia (RPD) with Lewy bodies (rpDLB) is used for DLB patients who develop a rapidly progressive neurological syndrome and have reduced survival. Here, we characterise the clinical, neuropathological, and molecular characteristics of a large rpDLB neuropathological series.

Methods: We included all RPD patients with a disease duration < 4 years submitted to our prion disease referral centre between 2003 and 2022 who showed Lewy body pathology (LBP) in limbic or neocortical stages as primary neuropathological diagnosis, had no systemic condition justifying the rapid deterioration and were previously neurologically unimpaired.

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The advent of computerized medical recording systems in healthcare facilities has made data retrieval tasks easier, compared to manual recording. Nevertheless, the potential of the information contained within medical records remains largely untapped, mostly due to the time and effort required to extract data from unstructured documents. Natural Language Processing (NLP) represents a promising solution to this challenge, as it enables the use of automated text-mining tools for clinical practitioners.

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Article Synopsis
  • Human prion diseases are unusual brain illnesses that can spread and cause quick changes in memory and thinking.
  • The study looked at a specific type called sporadic Creutzfeldt-Jakob disease (sCJD), examining data from over 3,700 cases to understand how long the disease lasts and at what age it starts.
  • Researchers found important genetic clues on chromosome 20 that can help understand how long people live with this disease, especially one specific genetic change that seems to have a big effect on survival time.
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Background: Currently, the impact of drug therapies on neurodegenerative conditions is limited. Therefore, there is a strong clinical interest in non-pharmacological interventions aimed at preserving functionality, delaying disease progression, reducing disability, and improving quality of life for both patients and their caregivers. This longitudinal multicenter Randomized Controlled Trial (RCT) applies three innovative cognitive telerehabilitation (TR) methods to evaluate their impact on brain functional connectivity reconfigurations and on the overall level of cognitive and everyday functions.

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Background: This work aimed to study the Village Test (VT) in a group of patients with Alzheimer's disease (AD) and compare the results with those of a group of patients with mild cognitive impairment (MCI) and controls.

Methods: A total of 50 patients with AD, 28 patients with MCI, and 38 controls were evaluated. All participants underwent the VT and an extensive neuropsychological evaluation.

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  • Plasma glial fibrillary acidic protein (pl-GFAP) levels were significantly higher in sporadic Creutzfeldt-Jakob disease (sCJD) patients compared to those with non-prion rapidly progressive dementia (np-RPD) and healthy controls, showing potential as a diagnostic marker.
  • Despite its diagnostic promise, pl-GFAP's ability to indicate prognosis in sCJD patients was limited compared to established biomarkers like 14-3-3 and tau proteins.
  • Overall, pl-GFAP may be useful for detecting neuroinflammation in sCJD noninvasively, but it won't replace existing neurodegeneration biomarkers for monitoring disease progression.
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  • The study investigates how sulcal morphometry, which looks at the shape and structure of brain folds, can help predict whether patients with mild cognitive impairment (MCI) will progress to Alzheimer's disease (AD).
  • Using MRI scans, researchers analyzed brain data from patients with AD, those with MCI, and healthy controls, particularly focusing on certain sulci (brain grooves).
  • Results showed that changes in the width of specific sulci, especially in the temporo-occipital and frontal regions, were significant indicators for differentiating between patients who would convert to AD and those who would not, along with correlations to cognitive performance.
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Objectives: The effect of preanalytical and analytical factors on the α-synuclein (α-syn) seed amplification assay's (SAA) performance has not been fully explored. Similarly, there is limited knowledge about the most suitable assay protocol and kinetic parameters for misfolded α-syn seed quantification.

Methods: We studied the effect of centrifugation, repeated freeze-thaw cycles (up to seven), delayed freezing, detergent addition, and blood contamination on the performance of the cerebrospinal fluid (CSF) α-syn SAA real-time quaking-induced conversion (RT-QuIC).

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Introduction: High repeat expansion (HRE) alleles in have been linked to both amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD); ranges for intermediate allelic expansions have not been defined yet, and clinical interpretation of molecular data lacks a defined genotype-phenotype association. In this study, we provide results from a large multicenter epidemiological study reporting the distribution of repeats in healthy elderly from the Italian population.

Methods: A total of 967 samples were collected from neurologically evaluated healthy individuals over 70 years of age in the 13 institutes participating in the RIN (IRCCS Network of Neuroscience and Neurorehabilitation) based in Italy.

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Background: Increased prevalence of cardiovascular autonomic failure might play a key role on Parkinson's disease (PD) progression of glucocerebrosidase gene (GBA)-mutated patients, determining a malignant phenotype of disease in these patients.

Objective: To objectively characterize, for the first time, the cardiovascular autonomic profile of GBA-mutated patients compared to idiopathic PD patients by means of cardiovascular reflex tests (CRTs).

Methods: This is a case-control (1 : 2) study on PD patients belonging to well-characterized prospective cohorts.

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The development of in vitro seed amplification assays (SAA) detecting misfolded alpha-synuclein (αSyn) in cerebrospinal fluid (CSF) and other tissues has provided a pathology-specific biomarker for Lewy body disease (LBD). However, αSyn SAA diagnostic performance in early pathological stages or low Lewy body (LB) pathology load has only been assessed in small cohorts. Moreover, the relationship between SAA kinetic parameters, the number of αSyn brain seeds and the LB pathology burden assessed by immunohistochemistry has never been systematically investigated.

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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with a complex genetic architecture, showing monogenic, oligogenic, and polygenic inheritance. In this study, we describe the case of a 71 years-old man diagnosed with ALS with atypical clinical features consisting in progressive ocular ptosis and sensorineural deafness. Genetic analyses revealed two heterozygous variants, in the (OMIM*147450) and the (OMIM*604834) genes respectively, and furthermore mitochondrial DNA (mtDNA) sequencing identified the homoplasmic m.

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Multiple myeloma (MM) cells from 1 out of 20 patient expressed high basal levels of membrane B-cell maturation antigen (BCMA, TNFRSF17, CD269), which was not upregulated by gamma-secretase inhibitor, suggesting a defective BCMA shedding by gamma-secretase. Genetic analyses of the patient's bone marrow DNA showed no mutations within the BCMA coding region, but rather partial deletion of PSEN1 and amplification of PSEN2, which encode alternative catalytic units of gamma-secretase. Altogether the data suggest that pt#12 MM cells express high and dysregulated BCMA with no shedding, due to genetic alterations of one or more gamma-secretase subunits.

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Article Synopsis
  • Rapidly progressive dementias (RPDs) are neurological disorders that lead to quick cognitive decline, and the role of blood-based biomarkers in diagnosing Alzheimer's disease (AD) in these cases is still being investigated.
  • Researchers analyzed levels of plasma brain-derived tau (BD-tau) and phosphorylated tau (p-tau181) in three groups: controls, AD patients, and RPD patients (including those with Creutzfeldt-Jakob disease).
  • The study found that plasma BD-tau can effectively differentiate AD from RPD and controls, while p-tau181 levels are notably higher in AD but not in RPD, indicating that these biomarkers can help in distinguishing between these forms of dementia.*
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  • Recent studies show that plasma GFAP levels are elevated in ALS patients compared to healthy controls, indicating a potential link between GFAP and ALS pathology.
  • In a larger study with 156 ALS patients, higher plasma GFAP levels were associated with cognitive decline and differentiated patients with Alzheimer's disease pathology (ALS-AD) from those without.
  • Plasma GFAP proved to be a more accurate biomarker for identifying Alzheimer’s co-pathology in ALS patients than other biomarkers like p-tau181 and neurofilament light chain protein.
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Background And Objective: Early-onset Parkinson's disease (EOPD) commonly recognizes a genetic basis; thus, patients with EOPD are often addressed to diagnostic testing based on next-generation sequencing (NGS) of PD-associated multigene panels. However, NGS interpretation can be challenging in a diagnostic setting, and few studies have addressed this issue so far.

Methods: We retrospectively collected data from 648 patients with PD with age at onset younger than 55 years who underwent NGS of a minimal shared panel of 15 PD-related genes, as well as PD-multiplex ligation-dependent probe amplification in eight Italian diagnostic laboratories.

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Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare extranodal lymphoma that is characterized by the selective growth of neoplastic cells in blood vessels, representing a potentially treatable cause of rapidly progressive dementia (RPD). Given its diverse clinical and instrumental presentation, it is often misdiagnosed with more common RPD causes, for example, Creutzfeldt-Jakob disease (CJD) or vascular dementia.

Methods: This study presents the clinical and histopathological characteristics of four IVLBCL cases that we diagnosed post-mortem over 20 years among over 600 brain samples received as suspected CJD cases at our prion disease reference center.

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Article Synopsis
  • Background
  • : The study investigates the levels of synaptic markers (SNAP-25 and neurogranin) in the cerebrospinal fluid of patients with Creutzfeldt-Jakob disease (CJD) compared to those with non-prion rapidly progressive dementia, highlighting their potential as diagnostic and prognostic biomarkers.
  • Methods
  • : Researchers analyzed CSF samples from 220 CJD patients and 213 non-prion dementia patients to measure various biomarkers and assessed their diagnostic accuracy and survival associations using advanced statistical techniques.
  • Results
  • : SNAP-25 showed significantly higher levels in CJD compared to non-prion dementia, with better diagnostic accuracy than other biomarkers; it also correlated with survival rates
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Article Synopsis
  • Beta-synuclein is identified as a potential biomarker for detecting synaptic damage, particularly in conditions like sporadic Creutzfeldt-Jakob disease.
  • In a study comparing 150 cases of sporadic Creutzfeldt-Jakob disease to 106 cases of other rapidly progressive dementias, beta-synuclein showed superior diagnostic accuracy in cerebrospinal fluid and blood.
  • Its performance in cerebrospinal fluid (AUC 0.95) and plasma (AUC 0.91) was better than other biomarkers like protein 14-3-3 and total tau, suggesting beta-synuclein could be a breakthrough in diagnosing this disease.
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  • Human prion diseases are complex, rapidly progressing neurodegenerative disorders caused by misfolded prion proteins, with various forms arising from genetic and environmental factors.
  • The review highlights potential therapeutic approaches that mainly focus on targeting the prion protein to inhibit misfolding or enhance its removal, noting the most encouraging strategies include passive immunization and gene therapy.
  • Significant challenges remain in conducting effective clinical trials due to the rarity of the diseases, their diverse forms, and the need to identify patients early before severe brain damage occurs, making prevention and delay of disease onset in high-risk individuals a primary goal.
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Objective: In Alzheimer's disease (AD), the presence of circadian dysfunction is well-known and may occur early in the disease course. The melanopsin retinal ganglion cell (mRGC) system may play a relevant role in contributing to circadian dysfunction. In this study, we aimed at evaluating, through a multimodal approach, the mRGC system in AD at an early stage of disease.

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  • * Plasma p-tau181 levels are significantly associated with lower motor neuron dysfunction and the progression of ALS over time, making it a potential prognostic marker for the disease.
  • * The study suggests that the elevated p-tau181 in ALS may originate from peripheral sources and poses questions about its role in Alzheimer's pathology screening, warranting further exploration.
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