Publications by authors named "Frazzini V"

Volitional respiratory manoeuvres such as sniffing and apnoea play a key role in the active olfactory exploration of the environment. Their impairment by neurodegenerative processes could thus impair olfactory abilities with the ensuing impact on quality of life. Functional brain imaging studies have identified brain networks engaged in sniffing and voluntary apnoea, comprising the primary motor and somatosensory cortices, the insula, the anterior cingulate cortex and the amygdala.

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Background: Mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE/HS) is the most common cause of drug-resistant focal seizures and surgical resection is the primary treatment option, with seizure-free rates ranging from 60 to 80%. However, data on postsurgical seizure outcomes in patients ≥ 50 years of age are limited. This study aimed to assess the efficacy and safety of surgery in this age group compared to younger patients.

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This pilot study presents a retrospective analysis of 10 asymptomatic patients with a positive calcium score who received a series of intravenous calcium ethylenediaminetetraacetic acid (EDTA) chelations. Current standards for cardiovascular risk stratification include assessments of cholesterol, blood pressure, blood sugar, lifestyle, obesity, and family history. Despite addressing traditional risk factors, myocardial infarctions and cerebrovascular accidents remain the leading causes of death and disability worldwide.

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Computational models and in vivo studies in rodents suggest that the emergence of gamma activity (40-140 Hz) during memory encoding and retrieval is coupled to opposed-phase states of the underlying hippocampal theta rhythm (4-9 Hz). However, direct evidence for whether human hippocampal gamma-modulated oscillatory activity in memory processes is coupled to opposed-phase states of the ongoing theta rhythm remains elusive. Here, we recorded local field potentials (LFPs) directly from the hippocampus of 10 patients with epilepsy, using depth electrodes.

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Article Synopsis
  • The study focuses on predicting seizure risk by identifying preictal states that indicate a higher likelihood of seizures occurring.
  • Researchers explored using daily intracranial EEG connectivity during controlled periods of vigilance to differentiate between interictal (no seizure) and preictal (risk of seizure within 24 hours) states.
  • Findings showed that theta band connectivity yielded successful predictions in 80% of patients, suggesting potential for mobile EEG or implanted devices for more accessible monitoring.
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  • Periventricular nodular heterotopia (PNH) is a brain development disorder linked to drug-resistant epilepsy, with ongoing debate about how ectopic neurons contribute to seizures.
  • The study reports the first human recordings of activity from these heterotopic neurons, identifying three types of interictal patterns: Periodic Discharges PLUS Fast activity (PD+F), Sporadic discharges PLUS Fast activity (SD+F), and epileptic spikes (ES).
  • The presence of SD+F was exclusive to nodules involved in seizures, indicating a connection to seizure generation, while the other patterns (PD+F and ES) were found in all nodules, suggesting that PNH nodules are highly epileptogenic and
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  • A study investigated mortality risk factors in older COVID-19 patients with preexisting neuropsychiatric conditions, using a sample of 191 inpatients aged 70 and above.
  • The majority of these patients had prior neuropsychiatric comorbidities, and many showed new neuropsychiatric symptoms, with a notable mortality rate of 19.4% within 40 days.
  • Key risk factors for increased mortality included having a history of brain tumors or Parkinsonism, impaired consciousness, lower daily activity scores, and specific blood markers (neutrophil-to-lymphocyte ratio and thrombocytopenia).
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Objective: Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures but are not due to underlying epileptic activity and in some cases coexist alongside epilepsy. We described the clinical characteristics of patients with PNES as reported in the literature from the outbreak of the COVID-19 pandemic. We evaluated differences between patients with a diagnosis made immediately before the pandemic (pPNES) and those newly diagnosed during it (nPNES).

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Temporal lobe epilepsy (TLE) is the most common type of focal epilepsy. First descriptions of TLE date back in time and detailed portraits of epileptic seizures of temporal origin can be found in early medical reports as well as in the works of various artists and dramatists. Depending on the seizure onset zone, several subtypes of TLE have been identified, each one associated with peculiar ictal semiology.

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Objective: The temporal lobe plays a central role in the regulation of the "Central Autonomic Network" and cardiovascular functions. The blockade of glutamatergic pathways in the temporal lobe affects cardio-autonomic control. Perampanel (PER) is a non-competitive agonist of the AMPA receptor.

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Background: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder caused by a somatic mutation in the GNAQ gene, leading to capillary venous malformations with neurological, ocular, and cutaneous abnormalities. Descriptions of adult and elderly patients with SWS are scarce compared to those of neonates or children.

Methods: We reviewed clinical, neuro-radiological and electroencephalographical findings of adult patients diagnosed with SWS, treated in our tertiary center for rare epilepsies.

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Purpose: Human neuronal activity, recorded in vivo from microelectrodes, may offer valuable insights into physiological mechanisms underlying human cognition and pathophysiological mechanisms of brain diseases, in particular epilepsy. Continuous and long-term recordings are necessary to monitor non predictable pathological and physiological activities like seizures or sleep. Because of their high impedance, microelectrodes are more sensitive to noise than macroelectrodes.

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Focal neuronal lipofuscinosis (FNL) is an uncommon epileptic disorder related to an excess of lipofuscin accumulation within dysmorphic-appearing neurons (DANs), whose epileptogenic mechanisms are still poorly understood. It shares some clinical and neuroimaging similarities with focal cortical dysplasia of type IIb (FCDIIb), but it represents a different pathological entity. Here, we identified two patients with FNL among a 10-year cohort of 323 patients who underwent neurosurgery for a focal pharmacoresistant epilepsy.

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Article Synopsis
  • Status epilepticus (SE) is a serious condition characterized by prolonged seizures, requiring quick diagnosis for effective treatment to avoid neurological damage.
  • In this study, researchers evaluated biomarkers like Neuron Specific Enolase (NSE), S100-beta protein (S100B), and progranulin in a large group of patients to improve SE diagnosis.
  • Results showed that serum S100B levels have good accuracy in detecting SE, suggesting it should be included in clinical assessments alongside other diagnostic methods.
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Autonomic status epilepticus (Aut SE) is a condition characterized by ongoing focal autonomic seizure lasting for >30 min. Aut SE can show a variety of clinical manifestations including vomiting, nausea, changes in heart rate, piloerection, pupillary abnormalities, and visual abnormalities. Although Aut SE is a common finding in childhood in the context of Panayiotopoulos syndrome, few reports have described this condition during adulthood.

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Introduction: Temporal lobe epilepsy (TLE) is the most frequent focal epilepsy in adulthood. Catamenial C1-type TLE, is characterized by a cyclic seizure exacerbation during the menstrual phase. The heart rate variability (HRV) analysis assesses cardiac autonomic control and may represent a biomarker for Sudden Unexpected Death in Epilepsy (SUDEP).

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Objective: To assess the relation between coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy.

Methods: Cross-sectional analysis of data collected in the SAVE study, which included patients with drug-resistant focal epilepsy during long-term EEG monitoring. Patients in whom both coffee consumption and data about seizure frequency, including focal to bilateral tonic-clonic seizures (FBTCS), were available were selected.

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Objective: To highlight specific characteristics of seizure semiology and EEG features associated with different subtypes of autoimmune encephalitis (AE).

Methods: We systematically reviewed the seizure semiology and all the EEG recordings from patients with AE managed in a tertiary referral centre for epilepsy and a neuro-intensive care unit. Each characteristic across the different subtypes of AE was compared by post hoc analysis.

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Purpose: Accurate segmentation of brain resection cavities (RCs) aids in postoperative analysis and determining follow-up treatment. Convolutional neural networks (CNNs) are the state-of-the-art image segmentation technique, but require large annotated datasets for training. Annotation of 3D medical images is time-consuming, requires highly trained raters and may suffer from high inter-rater variability.

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Agitation is a behavioral syndrome characterized by increased, often undirected, motor activity, restlessness, aggressiveness, and emotional distress. According to several observations, agitation prevalence ranges from 30 to 50% in Alzheimer's disease, 30% in dementia with Lewy bodies, 40% in frontotemporal dementia, and 40% in vascular dementia (VaD). With an overall prevalence of about 30%, agitation is the third most common neuropsychiatric symptoms (NPS) in dementia, after apathy and depression, and it is even more frequent (80%) in residents of nursing homes.

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Article Synopsis
  • The study aimed to compare video-EEG monitoring with standard polysomnography for sleep scoring in an Epileptology Unit, evaluating their effectiveness across 22 patients.
  • Experts manually scored sleep based on specific guidelines and analyzed various sleep parameters, such as sleep cycles, efficiency, and sleep latencies, using statistical methods to assess agreement between the two methods.
  • The results indicated a high level of agreement for most parameters between video-EEG and polysomnography, suggesting that video-EEG is a viable alternative for studying sleep architecture in epilepsy patients.
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The understanding of the excitotoxic processes associated with a severe status epilepticus (SE) is of major importance. Changes of brain cholesterol homeostasis is an emerging candidate for excitotoxicity. We conducted an overall analysis of the cholesterol homeostasis both (i) in fluids and tissues from patients with SE: blood (n = 63, n = 87 controls), CSF (n = 32, n = 60 controls), and post-mortem brain tissues (n = 8, n = 8 controls) and (ii) in a mouse model of SE induced by an intrahippocampal injection of kainic acid.

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Article Synopsis
  • COVID-19 may lead to central nervous system issues, such as encephalopathy, prompting the need for comprehensive monitoring to understand these impacts better and improve patient care.* -
  • A study at Pitié-Salpêtrière Hospital analyzed clinical, laboratory, and MRI data along with EEG results from 78 patients hospitalized with severe COVID-19, focusing on encephalopathy-related features.* -
  • The results showed that a significant number of patients exhibited abnormal EEG patterns and MRI changes, indicating potential brain damage linked to COVID-19, emphasizing the need for critical neurological assessments in these patients.*
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Brain aging and aging-related neurodegenerative disorders are posing a significant challenge for health systems worldwide. To date, most of the therapeutic efforts aimed at counteracting dementiarelated behavioral and cognitive impairment have been focused on addressing putative determinants of the disease, such as β-amyloid or tau. In contrast, relatively little attention has been paid to pharmacological interventions aimed at restoring or promoting the synaptic plasticity of the aging brain.

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The temporal lobe, a critical hub for cognition, also plays a central role in the regulation of autonomic cardiovascular functions. Lesions in this area are usually associated with abnormalities in the regulation of heart rate (HR) and blood pressure (BP). The analysis of the heart rate variability (HRV) is useful to evaluate the cardiac parasympathetic nervous system activity.

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