Publications by authors named "Conforto A"

Background: Perivascular Spaces (PVS) are a marker of cerebral small vessel disease (CSVD) that are visible on brain imaging. Larger PVS has been associated with poor quality of life and cognitive impairment post-stroke. However, the association between PVS and post-stroke sensorimotor outcomes has not been investigated.

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  • * Researchers analyzed MRI scans from 501 stroke patients to assess regional brain-PAD and lesion loads, discovering that larger stroke lesions correlate with older brain-PAD in the affected areas and younger brain-PAD in the opposite hemisphere.
  • * The findings highlight that the severity of stroke damage is linked to poorer motor function, with machine learning models identifying specific brain regions and lesion characteristics as key predictors of motor outcomes.
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  • The article has a Digital Object Identifier (DOI) that allows it to be easily found online.
  • The DOI number given is 10.3389/fneur.2023.1251581.
  • This correction is important for making sure the information in the article is accurate.
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  • Chronic motor impairments are a significant disability after stroke, traditionally linked to damage in specific motor system structures like the corticospinal tract.
  • This study employs a data-driven approach to analyze chronic motor outcomes in 789 stroke patients, comparing the effectiveness of theory-based biomarkers against new data-driven biomarkers derived from clinical imaging data.
  • Results indicate that data-driven biomarkers, especially regional structural disconnection measures, show a stronger correlation with motor outcomes than traditional theory-based measures, while combining demographic factors further enhanced predictive accuracy.
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Objective: This study aimed at assessing the alterations in upper limb motor impairment and connectivity between motor areas following the post-stroke delivery of cathodal transcranial direct current stimulation sessions.

Methods: Modifications in the Fugl-Meyer Assessment scores, connectivity between the primary motor cortex of the unaffected and affected hemispheres, and between the primary motor and premotor cortices of the unaffected hemisphere were compared prior to and following six sessions of cathodal transcranial direct current stimulation application in 13 patients (active = 6; sham = 7); this modality targets the primary motor cortex of the unaffected hemisphere early after a stroke.

Results: Clinically relevant distinctions in Fugl-Meyer Assessment scores (≥9 points) were observed more frequently in the Sham Group than in the Active Group.

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Background And Objectives: Motor outcomes after stroke relate to corticospinal tract (CST) damage. The brain leverages surviving neural pathways to compensate for CST damage and mediate motor recovery. Thus, concurrent age-related damage from white matter hyperintensities (WMHs) might affect neurologic capacity for recovery after CST injury.

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Background: Decompressive neurosurgery is recommended for patients with cerebral venous thrombosis (CVT) who have large parenchymal lesions and impending brain herniation. This recommendation is based on limited evidence. We report long-term outcomes of patients with CVT treated by decompressive neurosurgery in an international cohort.

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With the pandemic, there has been a global reduction in influenza virus circulation, with WHO reporting, during 2021/22 season, laboratory testing positivity rate for influenza of less than 3%. Influenza surveillance systems anticipated a peak of influenza cases in the Northern Hemisphere during 2022/2023 season and the Italian Ministry of Health recommended the routinary co-administration of influenza with bivalent COVID-19 vaccines for the 2022/2023 season. At the Vaccination Hub of the University Hospital (UH) of Palermo, more than 700 subjects received influenza and COVID-19 booster doses in co-administration, during the 2021/2022 season.

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  • The text outlines the challenges of conducting research on cerebral venous thrombosis (CVT) due to its rarity, emphasizing the need for a prioritized international research agenda to enhance prevention, diagnosis, and treatment for better patient outcomes.
  • The agenda was developed during a summit in June 2023, involving 45 participants from 15 countries, including clinical researchers, former CVT patients, and representatives from funding organizations, focused on key research themes.
  • It categorizes essential research questions into themes like epidemiology, diagnosis, medical treatment, and more, aiming to inspire future research, foster collaboration, and help secure funding to address these critical questions in CVT.
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Motor outcomes after stroke relate to corticospinal tract (CST) damage. Concurrent damage from white matter hyperintensities (WMHs) might impact neurological capacity for recovery after CST injury. Here, we evaluated if WMHs modulate the relationship between CST damage and post-stroke motor impairment outcome.

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  • Current guidelines suggest treating cerebral venous thrombosis (CVT) with vitamin K antagonists (VKAs) for 3-12 months, but direct oral anticoagulants (DOACs) like dabigatran are becoming popular due to promising results in smaller studies.
  • The DOAC-CVT study is an international, observational trial aiming to compare the effectiveness and safety of DOACs and VKAs in preventing recurrent blood clots after CVT, involving at least 500 patients over three years.
  • The study's primary goal is to evaluate the rates of recurrent venous thrombotic events and major bleeding within six months, providing real-world insights into treatment options for CVT.
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Introduction: There is little data on the role of endovascular treatment (EVT) of cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT). Here, we describe clinical characteristics and outcomes of CVST-VITT patients who were treated with EVT.

Patients And Methods: We report data from an international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 6 March 2023.

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Chronic motor impairments are a leading cause of disability after stroke. Previous studies have predicted motor outcomes based on the degree of damage to predefined structures in the motor system, such as the corticospinal tract. However, such theory-based approaches may not take full advantage of the information contained in clinical imaging data.

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The study of an Ischemic stroke infarction allows verifying how the lesion produces alterations in the neuronal networks resulting in cognitive deficits. It also allows the verification of adaptive and maladaptive cerebral reorganization related to the injury. In our previous fMRI study, we found that patients without ischemic vascular lesions in left inferior frontal gyrus showed an efficient compensation mechanism during the associative encoding of face name pairs, by the increased activation of ventrolateral and dorsolateral areas of contralesional hemisphere associated with better memory performance.

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Background: Integrity of the corticospinal tract (CST) is an important biomarker for upper limb motor function following stroke. However, when structurally compromised, other tracts may become relevant for compensation or recovery of function.

Methods: We used the ENIGMA Stroke Recovery data set, a multicenter, retrospective, and cross-sectional collection of patients with upper limb impairment during the chronic phase of stroke to test the relevance of tracts in individuals with less and more severe (laterality index of CST fractional anisotropy ≥0.

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  • A study investigated sex differences in cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT), revealing that 77% of the patients were women.
  • Women presented with more severe symptoms, such as coma and lower platelet counts, and more women underwent endovascular treatment compared to men.
  • Despite these differences in presentation and treatment, the overall clinical outcomes, including complications and in-hospital mortality, were similar for both sexes.
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Background And Purpose: Several risk factors of symptomatic intracerebral hemorrhage (SICH) following intravenous thrombolysis for acute ischaemic stroke have been established. However, potential predictors of good functional outcome post-SICH have been less studied.

Methods: Patient data registered in the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) from 2005 to 2021 were used.

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  • Adenovirus-based COVID-19 vaccines are widely used in low- and middle-income countries (LMICs), but cases of vaccine-induced cerebral venous sinus thrombosis (CVST) are rarely reported.
  • A study of 228 CVST cases showed 63 from LMICs, with 51% meeting vaccine-induced immune thrombotic thrombocytopenia (VITT) criteria, compared to 62% from high-income countries (HICs).
  • Although clinical manifestations were similar, in-hospital mortality was significantly lower in LMICs (23%) compared to HICs (43%), suggesting different outcomes despite similar treatment approaches.
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Background: The coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis ≥50% in the carotid or vertebrobasilar territories (Group) and a control group (Group).

Methods: In this cross-sectional study, Group included two subgroups: Group, with stenoses in either cervical intracranial arteries, and Group, with stenoses in at least one cervical and one intracranial artery.

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Rotavirus (RV) is among the most common vaccine-preventable diseases in children under five years of age. Despite the severity of rotavirus pathology in early childhood, rotavirus vaccination for children admitted to the neonatal intensive care unit (NICU), who are often born preterm and with various previous illnesses, is not performed. This multicenter, 3-year project aims to evaluate the safety of RV vaccine administration within the six main neonatal intensive care units of the Sicilian Region to preterm infants.

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Objective: The purpose of this study was to investigate the details of minor complications of carotid artery stenting in a developing country.

Methods: This was a retrospective, single-center study conducted on the target group consisting of 65 symptomatic patients who underwent carotid artery stenting. We assessed technical success rate, periprocedural complication within 30 days (hypotension, bradycardia, acute kidney injury, vasospasm, a transient ischemic attack, stroke, myocardial infarction, and death), and the differences between groups with and without complications.

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Background And Objectives: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance.

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Objectives: Central neuropathic pain (CNP) is associated with altered corticomotor excitability (CE), which can potentially provide insights into its mechanisms. The objective of this study is to describe the CE changes that are specifically related to CNP.

Methods: We evaluated CNP associated with brain injury after stroke or spinal cord injury (SCI) due to neuromyelitis optica through a battery of CE measurements and comprehensive pain, neurological, functional, and quality of life assessments.

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  • The study aims to understand how different types of central nervous system injuries can affect the way central neuropathic pain (CNP) presents in patients.
  • Researchers compared pain profiles between patients with central post-stroke pain (CPSP) and those with spinal cord injury pain (CPSCI), observing significant differences in pain scores and sensory responses.
  • The results indicate that the location of the brain or spinal cord injury may influence pain sensations and thresholds, suggesting that tailored treatment strategies could be developed based on these differences in CNP profiles.
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