Publications by authors named "Giulia Paparella"

Background: In the international landscape, assistive technologies are often integrated into programs to support elderly individuals with dementia and/or multiple disabilities (Lancioni et al., 2021). However, there is a need to extend these interventions to primary/secondary prevention of such conditions in the elderly population at higher risk.

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Essential tremor (ET) is characterized by upper limbs action tremor, sometimes extending to other body parts. However, ET can present with additional neurological features known as "soft signs." These signs of uncertain clinical significance are not sufficient to suggest an alternative neurological diagnosis, and include, among others, questionable dystonia and subtle voluntary movement alterations, i.

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Background: Plasma neurofilament light chain (NFL) has been measured as a biomarker of neuronal damage in various neurological disorders. Elevated tau and β-amyloid levels have been found in patients with fibromyalgia (FM). The aim of the present study was to compare plasma neurofilament levels in fibromyalgia patients with normal controls and to investigate the correlation with clinical features and cognitive tests.

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Article Synopsis
  • SARS-CoV-2 infection has negatively affected public health, leading to new or worsened neurological symptoms in some individuals, particularly in those with essential tremor (ET).
  • A study examined the effects of SARS-CoV-2 infection on 36 ET patients, finding that 44% of those who contracted the virus reported a subjective worsening of their tremor after infection.
  • The analysis showed that while clinical data indicated a decline in tremor for infected patients, kinematic measurements remained stable, suggesting that long COVID might intensify the impact of tremor on daily life for those affected.
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Article Synopsis
  • * A specific case is presented of a 53-year-old male who experienced progressive myoclonus-ataxia and was found to have a new genetic variant (c.3835G > A) in the CACNA1G gene.
  • * The study suggests that this novel variant may affect calcium channel activity and emphasizes the significance of genetic testing for understanding myoclonus-ataxia disorders.
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Compensatory mechanisms in Parkinson's disease are defined as the changes that the brain uses to adapt to neurodegeneration and progressive dopamine reduction. Motor compensation in early Parkinson's disease could, in part, be responsible for a unilateral onset of clinical motor signs despite the presence of bilateral nigrostriatal degeneration. Although several mechanisms have been proposed for compensatory adaptations in Parkinson's disease, the underlying pathophysiology is unclear.

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Over the past three decades, substantial advancements have occurred in non-invasive brain stimulation (NIBS). These developments encompass various non-invasive techniques aimed at modulating brain function. Among the most widely utilized methods today are transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES), which include direct- or alternating-current transcranial stimulation (tDCS/tACS).

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Migraine is the fourth most common cause of disability in women and the eighth most common cause in men. Central sensitization phenomena predispose to chronic migraine and are generally more pronounced in women. The aim of this retrospective observational study was to look for sex differences in a population of migraine subjects attending a tertiary headache center, focusing on symptoms of central sensitization such as allodynia and pericranial tenderness.

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Introduction: Essential tremor (ET) and Parkinson's disease (PD) are the most common causes of tremor and the most prevalent movement disorders, with overlapping clinical features that can lead to diagnostic challenges, especially in the early stages.

Areas Covered: In the present paper, the authors review the clinical and experimental studies and emphasized the major aspects to differentiate between ET and PD, with particular attention to cardinal phenomenological features of these two conditions. Ancillary and experimental techniques, including neurophysiology, neuroimaging, fluid biomarker evaluation, and innovative methods, are also discussed for their role in differential diagnosis between ET and PD.

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Substantial evidence highlights the role of the cerebellum in the pathophysiology of tremor in essential tremor (ET), although its potential involvement in altered movement execution in this condition remains unclear. This study aims to explore potential correlations between the cerebellum and basal ganglia functional connectivity and voluntary movement execution abnormalities in ET, objectively assessed with kinematic techniques. A total of 20 patients diagnosed with ET and 18 healthy subjects were enrolled in this study.

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Essential tremor (ET) is a heterogeneous disorder characterized by bilateral upper limbs action tremor and, possibly, neurological signs of uncertain significance, including voluntary movement abnormalities and cognitive disturbances, i.e., the so-called 'soft' signs configuring the ET-plus definition.

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Background: Subtle parkinsonian signs, i.e., rest tremor and bradykinesia, are considered soft signs for defining essential tremor (ET) plus.

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Background: Tremor disorders have various genetic causes.

Case Report: A 60-year-old female with a family history of tremor presented a combined tremor syndrome, transient episodes of loss of contact and speech disturbances, as well as distal painful symptoms. Genetic screening revealed a novel heterozygous missense variant in the KCNQ2 gene.

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In the field of neuroscience, brain-computer interfaces (BCIs) are used to connect the human brain with external devices, providing insights into the neural mechanisms underlying cognitive processes, including aesthetic perception. Non-invasive BCIs, such as EEG and fNIRS, are critical for studying central nervous system activity and understanding how individuals with cognitive deficits process and respond to aesthetic stimuli. This study assessed twenty participants who were divided into control and impaired aging (AI) groups based on MMSE scores.

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Article Synopsis
  • Tremor disorders often get misdiagnosed, and this study compares three types: pure Essential Tremor (ET), ET with soft dystonic signs (ET + DS), and tremor with dystonia (TwD).
  • Researchers analyzed 383 patients, finding significant differences in demographics and tremor onset sites among the groups, along with varying symptoms and responsiveness to treatment.
  • The findings suggest overlaps between pure ET and TwD, indicating a need for better diagnostic tools, with ET + DS showing characteristics from both groups, highlighting a complexity within these syndromes.
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Blinking is a motor act characterized by the sequential closing and opening of the eyelids, which is achieved through the reciprocal activation of the orbicularis oculi and levator palpebrae superioris muscles. This stereotyped movement can be triggered reflexively, occur spontaneously, or voluntarily initiated. During each type of blinking, the neural control of the antagonistic interaction between the orbicularis oculi and levator palpebrae superioris muscles is governed by partially overlapping circuits distributed across cortical, subcortical, and brainstem structures.

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In patients with Parkinson's disease, the connectivity between the two primary motor cortices may be altered. However, the correlation between asymmetries of abnormal interhemispheric connections and bradykinesia features has not been investigated. Furthermore, the potential effects of dopaminergic medications on this issue remain largely unclear.

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Objective: To evaluate the effects of cerebellar transcranial alternating current stimulation (tACS) delivered at cerebellar-resonant frequencies, i.e., theta (θ) and gamma (γ), on upper limb motor performance and cerebellum-primary motor cortex (M1) connectivity, as assessed by cerebellar-brain inhibition (CBI), in healthy subjects.

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Background: Opicapone (OPC) is a third-generation, selective peripheral COMT inhibitor that improves peripheral L-DOPA bioavailability and reduces OFF time and end-of-dose motor fluctuations in Parkinson's disease (PD) patients.

Objectives: In this study, we objectively assessed the effects of adding OPC to L-DOPA on bradykinesia in PD through kinematic analysis of finger movements.

Methods: We enrolled 20 treated patients with PD and motor fluctuations.

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Article Synopsis
  • Cortical myoclonus is caused by abnormal neuron signals in the sensorimotor cortex, and researchers believe that a lack of inhibitory control from the cerebellum may be a key factor.
  • The study applied a specific brain stimulation technique to the cerebellum of both patients with cortical myoclonus and healthy controls to test its effects on brain activity in the sensorimotor cortex.
  • Results showed that while healthy participants were unaffected, patients experienced increased brain signal responses, with some indications of worsened myoclonus symptoms, particularly in those with larger sensory response potentials.
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Background: While migraine is markedly prevalent in women, gender-related phenotype differences were rarely assessed. For this reason, we investigated, through a multicenter observational cross-sectional study, based on an online questionnaire, gender-related differences in stress factors, emotions, and pain perception in migraine patients and controls and their impact on migraine severity.

Methods: The study was designed as an online questionnaire.

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Introduction: In this research, our primary objective was to explore the correlation between basal ganglia dopaminergic neurotransmission, assessed using 123I-FP-CIT (DAT-SPECT), and finger movements abnormalities in patients with essential tremor (ET) and Parkinson's disease (PD).

Methods: We enrolled 16 patients with ET, 17 with PD, and 18 healthy controls (HC). Each participant underwent comprehensive clinical evaluations, kinematic assessments of finger tapping.

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Introduction: Tremor is the most common movement disorder. Although clinical examination plays a significant role in evaluating patients with tremor, laboratory tests are useful to classify tremors according to the recent two-axis approach proposed by the International Parkinson and Movement Disorders Society.

Methods: In the present review, we will discuss the usefulness and applicability of the various diagnostic methods in classifying and diagnosing tremors.

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