Publications by authors named "Mattioli P"

Objective: The aim of this study was to describe the clinical features of contactin-associated protein-like 2 (CASPR2)-IgG-associated seizures.

Methods: Nine patients were retrospectively collected from two epilepsy centers. For each patient we obtained a full clinical, neurophysiological, and MRI study along with detection of antineuronal autoantibodies from serum and CSF.

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Background: Magnetic resonance imaging (MRI) has recently enabled to identify four distinct Alzheimer's disease (AD) subtypes: hippocampal sparing (HpSp), typical AD (tAD), limbic predominant (Lp), and minimal atrophy (MinAtr). To date, however, the natural history of these subtypes, especially regarding the presence of subjects switching to other MRI patterns and their clinical and biological differences, remains poorly understood.

Objective: To investigate the clinical and biological underpinnings of longitudinal atrophy pattern progression in AD.

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Article Synopsis
  • REM Sleep Behavior Disorder (RBD) is linked to an increased risk of developing neurodegenerative diseases like Parkinson's and dementia, prompting a study of autonomic dysfunction in RBD patients.* -
  • The study used advanced methods to analyze sleep patterns and heart rate variability, revealing that RBD patients generally experience lower heart rate variability and are more likely to transition to lighter sleep stages.* -
  • Although RBD patients suffer from fragmented sleep and autonomic issues, those with Parkinson's displayed better sleep continuity, potentially due to relief from their PD symptoms during sleep.*
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The phenoconversion trajectory from idiopathic/isolated Rapid eye movement (REM) sleep behavior disorder (iRBD) towards either Parkinson's Disease (PD) or Dementia with Lewy Bodies (DLB) is currently uncertain. We investigated the capability of baseline brain [F]FDG-PET in differentiating between iRBD patients eventually phenoconverting to PD or DLB, by deriving the denovoPDRBD-related pattern (denovoPDRBD-RP) from 32 de novo PD patients; and the denovoDLBRBD-RP from 30 de novo DLB patients, both with evidence of RBD at diagnosis. To explore [F]FDG-PET phenoconversion trajectories prediction power, we applied these two patterns on a group of 115 iRBD patients followed longitudinally.

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  • - The transition from pediatric to adult care for epilepsy is complex and involves multiple stakeholders, essential for providing high-quality care and preventing negative outcomes in young patients.
  • - The study aimed to address the challenges and needs in this transition process from the perspective of adult neurologists through a survey assessing their views on the issue.
  • - Results indicate that adult neurologists find the transition challenging and recommend a collaborative approach between child and adult neurologists, along with better training in childhood epilepsy.
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  • A new tool called the International RBD Severity Scale (IRBD-SSS) was developed to assess the severity of REM Sleep Behavior Disorder (RBD) symptoms in patients and their bedpartners at home.
  • The scale includes two versions (one for patients and one for bedpartners) that evaluate vocalizations, body movements, injury, and dream content.
  • Results showed strong acceptability and good psychometric properties for both versions, indicating that IRBD-SSS is effective for testing RBD severity in clinical settings.
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Background: High-grade glioma (HGG) patients post-radiotherapy often face challenges distinguishing true tumor progression (TTP) from pseudoprogression (PsP). This study evaluates the effectiveness of systemic inflammatory markers and volume of enhancing tissue on post-contrast T1 weighted (T1WCE) MRI images for this differentiation within the first six months after treatment.

Material And Methods: We conducted a retrospective analysis on a cohort of HGG patients from 2015 to 2021, categorized per WHO 2016 and 2021 criteria.

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Background: Cognitive reserve (CR) is an expression of brain resilience in response to damage. Education, occupational experience and leisure activities are thought to increase CR and have beneficial effects on global cognition and cognitive decline in Parkinson's disease (PD). We aimed to disclose brain metabolic and dopaminergic correlates of CR in de-novo PD patients.

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  • Apathy unawareness in mild cognitive impairment (MCI) is linked to differences between caregiver and patient assessments, potentially predicting progression to Alzheimer's dementia.
  • Researchers studied 28 MCI patients, using the Apathy Evaluation Scale to gauge apathy levels from both perspectives, and analyzed brain activity via PET scans.
  • Findings revealed that greater discrepancies in assessments correlated with lower metabolism in specific brain regions, indicating that apathy unawareness is tied to early limbic system disruptions rather than traditional pathways associated with apathy.
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While research interest in the relationship between sleep and epilepsy is growing, it primarily centres on the effects of non-rapid eye movement (NREM) sleep in favouring seizures. Nonetheless, a noteworthy aspect is the observation that, in the lives of patients with epilepsy, REM sleep represents the moment with the least epileptic activity and the lowest probability of having a seizure. Studies demonstrate a suppressive effect of phasic REM sleep on interictal epileptiform discharges, potentially offering insights into epilepsy localisation and management.

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Background: REM Sleep Behavior Disorder (RBD) is characterized by absence of physiological muscle atonia during REM sleep (REM sleep without atonia, RWA). Nigro-striatal dopaminergic impairment is a feature of Parkinson disease (PD) and can be identified in prodromal stages as well, such as idiopathic RBD (iRBD). Aims of this study are to explore the efficacy of an automatic RWA quantification in identifying RBD patients and the correlation between RWA and nigro-striatal dopaminergic function.

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Parkinson's disease (PD) is characterized by a progressive loss of dopaminergic neurons in the substantia nigra. Recent literature has proposed two subgroups of PD. The "body-first subtype" is associated with a prodrome of isolated REM-sleep Behavior Disorder (iRBD) and a relatively symmetric brain degeneration.

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Objective: To apply a machine learning analysis to clinical and presynaptic dopaminergic imaging data of patients with rapid eye movement (REM) sleep behavior disorder (RBD) to predict the development of Parkinson disease (PD) and dementia with Lewy bodies (DLB).

Methods: In this multicenter study of the International RBD study group, 173 patients (mean age 70.5 ± 6.

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Study Objectives: Isolated rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies and eventually phenoconverts to overt neurodegenerative diseases including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Associations of baseline resting-state electroencephalography (EEG) with phenoconversion have been reported. In this study, we aimed to develop machine learning models to predict phenoconversion time and subtype using baseline EEG features in patients with iRBD.

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In Dementia with Lewy bodies (DLB), rapid cognitive decline and seizures seldom complicate the typical clinical course. Nevertheless, concurrent, treatable conditions may be responsible. We report a case of DLB with superimposed anti-LGI1 encephalitis, emphasizing the importance of thorough diagnostic reasoning beyond the simplest explanation amid distinct clinical cues.

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Background: Neuronal pentraxin-2 (NPTX2), crucial for synaptic functioning, declines in cerebrospinal fluid (CSF) as cognition deteriorates. The variations of CSF NPTX2 across mild cognitive impairment (MCI) due to Alzheimer's disease (AD) and its association with brain metabolism remain elusive, albeit relevant for patient stratification and pathophysiological insights.

Methods: We retrospectively analyzed 49 MCI-AD patients grouped by time until dementia (EMCI, n = 34 progressing within 2 years; LMCI, n = 15 progressing later/stable at follow-up).

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Background: SOMI (Stages of Objective Memory Impairment) is a novel classification that identifies six stages of memory decline in Alzheimer's Disease (AD) using the Free and Cued Selective Reminding Test (FCSRT). However, the relationship between SOMI stages and brain metabolism remains unexplored. This study aims to investigate the metabolic correlates of SOMI stages using FDG-PET in Mild Cognitive Impairment due to AD (MCI-AD) and early AD patients.

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Idiopathic Rem sleep Behavior Disorder (iRBD) is a significant biomarker for the development of alpha-synucleinopathies, such as Parkinson's disease (PD) or Dementia with Lewy bodies (DLB). Methods to identify patterns in iRBD patients can help in the prediction of the future conversion to these diseases during the long prodromal phase when symptoms are non-specific. These methods are essential for disease management and clinical trial recruitment.

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Article Synopsis
  • Idiopathic REM sleep behavior disorder (iRBD) may indicate early stages of neurodegenerative diseases, making these patients critical for testing potential therapies.
  • The FARPRESTO study is focusing on iRBD patients to identify risk factors that predict progression to more severe conditions through clinical and imaging assessments.
  • In a study of 365 participants, 33.6% showed progression to overt synucleinopathy, with factors like older age, cognitive issues, and depression linked to increased risk.
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  • Isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) is a key early indicator of dementia with Lewy bodies (DLB) and Parkinson's disease (PD), allowing for the observation of cognitive decline prior to dementia onset.
  • A study with 754 iRBD participants utilized annual neuropsychological assessments to identify cognitive variables predictive of dementia, revealing that attention and executive function were particularly telling.
  • Findings indicate that cognitive decline starts as much as 10 years before the onset of noticeable dementia, with specific declines in attention, executive function, and verbal memory serving as important indicators.
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Background: A brain glucose metabolism pattern related to phenoconversion in patients with idiopathic/isolated REM sleep behaviour disorder (iRBDconvRP) was recently identified. However, the validation of the iRBDconvRP in an external, independent group of iRBD patients is needed to verify the reproducibility of such pattern, so to increase its importance in clinical and research settings. The aim of this work was to validate the iRBDconvRP in an independent group of iRBD patients.

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Background: Pisa syndrome (PS) is a trunk postural abnormality in Parkinson's disease (PD). Its pathophysiology is still debated: peripheral and central mechanisms have been hypothesized.

Objective: To investigate the role of nigrostriatal dopaminergic deafferentation and of brain metabolism impairment in the onset PS in PD patients.

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The neurodegenerative synucleinopathies, including Parkinson's disease and dementia with Lewy bodies, are characterized by a typically lengthy prodromal period of progressive subclinical motor and non-motor manifestations. Among these, idiopathic REM sleep behaviour disorder is a powerful early predictor of eventual phenoconversion, and therefore represents a critical opportunity to intervene with neuroprotective therapy. To inform the design of randomized trials, it is essential to study the natural progression of clinical markers during the prodromal stages of disease in order to establish optimal clinical end points.

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Purpose: A cut-off of -2 z-score for striatal or putaminal SBR has been to date arbitrarily used to define an abnormal DaT SPECT in patients with suspected neurodegenerative parkinsonism. We aimed to experimentally identify the most accurate z-score cut-offs for SBR of striatal and substriatal regions to independently discriminate PD and DLB, with respect to essential tremor (ET) and Alzheimer's disease (AD) respectively.

Methods: Two-hundred twenty-five patients undergoing DaT SPECT were enrolled (seventy-five de novo PD, eighty ET, fifty DLB, and twenty AD).

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