Publications by authors named "Signoriello E"

Background: Characterizing Cladribine tablets prescription pattern in daily clinical practice is crucial for optimizing multiple sclerosis (MS) treatment.

Objectives: To describe efficacy, safety profile and new disease-modifying therapy (DMT) prescriptions following Cladribine treatment.

Design: Independent retrospective cohort study in patients followed at six Italian MS centres.

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Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by demyelination in the central nervous system (CNS), affecting individuals globally. The pathological mechanisms underlying MS remain unclear, but current evidence suggests that inflammation and immune dysfunction play a critical role in the pathogenesis of MS disease. Adipose tissue (AT) is a dynamic multifunctional organ involved in various immune diseases, including MS, due to its endocrine function and the secretion of adipokines, which can influence inflammation and immune responses.

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  • The study investigates the effects of discontinuing dimethyl fumarate (DMF) during early pregnancy in women with multiple sclerosis (MS), analyzing 137 pregnancies from Italian MS Centers.
  • Results show that disease activity typically decreases during pregnancy but increases postpartum; higher relapse rates before conception correlate with faster relapses after giving birth.
  • Importantly, DMF exposure during early pregnancy did not negatively affect fetal outcomes, suggesting it is safe for the pregnancy context.
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Background: Pediatric-onset Multiple Sclerosis (POMS) patients show more inflammatory disease compared with adult-onset MS. However, highly effective treatments are limited with only fingolimod being approved in Italy and natalizumab prescribed as off-label treatment.

Objectives: to compare the efficacy of natalizumab versus fingolimod in POMS.

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Introduction: Multiple sclerosis (MS) is a chronic neurodegenerative disease that leads to impaired cognitive function and accumulation of disability, with significant socioeconomic burden. Serious unmet need in the context of managing MS has given rise to ongoing research efforts, leading to the launch of new drugs planned for the near future, and subsequent concerns about the sustainability of healthcare systems. This study assessed the changes in the Italian MS market and their impact on the expenditures of the Italian National Healthcare Service between 2023 and 2028.

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Background: The mental representation of the body (or body representation, BR) derives from the processing of multiple sensory and motor inputs and plays a crucial role in guiding our actions and in how we perceive our body. Fundamental inputs for BR construction come also from the interoceptive systems which refer to the whole bidirectional processes between the brain and the body. People with Multiple sclerosis (MS) show an abnormal multisensory integration which may compromise BR and interoception integrity.

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Background: in the early stages of Multiple Sclerosis (MS), initiating high-efficacy disease-modifying therapy (HE DMTs) may represent an optimal strategy for delaying neurological damage and long-term disease progression, especially in highly active MS patients (HAMS). Natalizumab (NAT) and Ocrelizumab (OCR) are recognized as HE DMTs with significant anti-inflammatory effects. This study investigates NEDA-3 achievement in treatment-naïve HAMS patients receiving NAT or OCR over three years.

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Background: The management of Multiple Sclerosis (MS) has undergone transformative evolution with the introduction of high-efficacy disease-modifying therapies (DMTs), specifically anti-CD20 monoclonal antibodies, such as ocrelizumab (OCR) and ofatumumab (OFA).

Materials And Methods: This is an independent retrospective cohort study in Relapsing MS (RMS) patients followed at eight Italian MS centers who initiated treatment with OCR or OFA in the participating centers and with at least 12 months on therapy. A generalized linear regression model inverse probability of treatment weight (IPTW) PS-adjusted was performed to evaluate the relationship between annualized relapse rate (ARR) and treatment groups.

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Background And Objectives: The role of B cells in the pathogenic events leading to relapsing multiple sclerosis (R-MS) has only been recently elucidated. A pivotal step in defining this role has been provided by therapeutic efficacy of anti-CD20 monoclonal antibodies. Indeed, treatment with anti-CD20 can also alter number and function of other immune cells not directly expressing CD20 on their cell surface, whose activities can contribute to unknown aspects influencing therapeutic efficacy.

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  • Cladribine is an oral treatment for relapsing multiple sclerosis (RMS) and researchers are studying how pregnancy affects disease activity in women who had been treated with it.
  • A study involved 48 women with relapsing-remitting MS, comparing those who became pregnant after cladribine treatment to those who did not, assessing their disease activity over a mean follow-up of 3.53 years.
  • Results indicated no significant differences in disease activity or disability progression between the pregnant and non-pregnant groups, suggesting pregnancy does not affect the disease in women treated with cladribine; more extensive studies are needed for confirmation.
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  • * A study involving 204 patients who completed two years of cladribine treatment found that 75.4% did not start new treatments in the year following therapy, and there was a significant reduction in relapse rates after treatment.
  • * The results suggest that cladribine is effective in lowering relapse rates and has a favorable safety profile, with lymphopenia being the main side effect; however, further larger studies are needed to confirm its long
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  • Maternal COVID-19 is linked to worse outcomes for mothers, but its effects on pregnant women with multiple sclerosis (MS) had not been thoroughly examined prior to this study.
  • This multicenter study focused on pregnant women with MS who contracted COVID-19, assessing their maternal and fetal health outcomes compared to a control group.
  • Findings revealed that while COVID-19 increased the risk of maternal complications, it did not significantly affect rates of spontaneous abortion or fetal malformations.
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Mild cognitive impairment (MCI) is a transitional clinical stage prior to dementia. Patients with amnestic MCI have a high risk of progression toward Alzheimer's disease. Both amnestic mild cognitive impairment and sporadic Alzheimer's disease are multifactorial disorders consequential from a multifaceted cross-talk among molecular and biological processes.

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We present the case of a 48-year-old-woman with apparently isolated central nervous system Erdheim-Chester disease characterized by brainstem involvement. Erdheim-Chester disease is extremely rare and multisystem impairment should always be sought in the suspicion of such pathology.

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Background: The COVID-19 pandemic has underlined the need to evaluate cognitive profile via videoconferencing (teleneuropsychology, TeleNP) as a suitable alternative to face-to-face assessment (F-F).

Objective: To evaluate the feasibility and the reliability of Rao's Brief Repeatable Battery of Neuropsychological Tests (R-BRB) remote administration in people with multiple sclerosis (PwMS).

Methods: Sixty PwMS underwent R-BRB in two conditions: F-F and TeleNP, 1 month apart.

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Multiple sclerosis (MS) is the most common disabling neurological disease characterized by chronic inflammation and neuronal cell viability impairment. Based on previous studies reporting that adiponectin exhibits neuroprotective effects in some models of neurodegenerative diseases, we analyzed the effects of AdipoRon treatment, alone or in combination with the cerebrospinal fluid of patients with MS (MS-CSF), to verify whether this adipokine acts on the basal neuronal cellular processes. To this aim, SH-SY5Y and U-87 cells (models of neuronal and glial cells, respectively) were exposed to MS-CSF alone or in co-treatment with AdipoRon.

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Introduction: The diagnosis of the progression phase of Multiple Sclerosis (MS) is still retrospective and based on the objectivation of clinical disability accumulation.

Objectives: To assess whether the Patient Reported Outcomes Measures (PROMs) scores predict the occurrence of disease progression within three years of follow-up.

Methods: Observational prospective multicenter study.

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Background And Purpose: Although two doses of COVID-19 vaccine elicited a protective humoral response in most persons with multiple sclerosis (pwMS), a significant group of them treated with immunosuppressive disease-modifying therapies (DMTs) showed less efficient responses.

Methods: This prospective multicenter observational study evaluates differences in immune response after a third vaccine dose in pwMS.

Results: Four hundred seventy-three pwMS were analyzed.

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Background: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is the most widely used screening tool for cognitive impairment in Multiple Sclerosis (MS). However, the administration and scoring procedures of the paper version are time consuming and prone to errors. Aim of our study was to develop a tablet version of BICAMS (iBICAMS), and to assess its reliability compared to the paper version.

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Background And Objectives: alemtuzumab is a monoclonal anti-CD52 antibody acting on B and T cells in highly active multiple sclerosis (MS). We analyzed changes in lymphocyte subsets after alemtuzumab administration in relation to disease activity and autoimmune adverse events.

Methods: lymphocyte subset counts were assessed longitudinally using linear mixed models.

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Background: Therapeutic plasmapheresis (TP) is an extracorporeal therapy that allows the removal of pathogens from plasma. The role of TP in immuno-mediated diseases and toxic conditions has been of interest for decades.

Summary: We reviewed the recent literature on the application and the optimal choice of TP technique ranging from plasma exchange, double filtration plasmapheresis, rheopheresis, immunoadsorptions, plasma adsorption perfusion and lipidoapheresis.

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Two structurally connected brain regions are more likely to interact, with the lengths of the structural bundles, their widths, myelination, and the topology of the structural connectome influencing the timing of the interactions. We introduce an approach for measuring functional delays across the whole brain in humans (of either sex) using magneto/electroencephalography (MEG/EEG) and integrating them with the structural bundles. The resulting topochronic map of the functional delays/velocities shows that larger bundles have faster velocities.

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Article Synopsis
  • The study aims to evaluate the risk of multiple sclerosis (MS) reactivation during and after pregnancy in women treated with natalizumab (NTZ), comparing those who continued treatment (LONG_EXP) with those who interrupted it before or shortly after conception (NO_EXP, SHORT_EXP).
  • Results showed that women who continued NTZ during pregnancy had a significantly lower annualized relapse rate and fewer gadolinium-enhancing lesions than those who interrupted treatment.
  • Newborns' health outcomes were similar across the groups, with no significant differences in weight, length, or head circumference, although there was a slight incidence of anemia in the LONG_EXP group.
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In the COVID-19 pandemic era, safety concerns have been raised regarding the risk of severe infection following administration of ocrelizumab (OCR), a B-cell-depleting therapy. We enrolled all relapsing remitting multiple sclerosis (RRMS) patients who received maintenance doses of OCR from January 2020 to June 2021. Data were extracted in December 2021.

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Nociplastic pain has been introduced by the IASP as a third category of pain, distinct from nociceptive and neuropathic pain. Pathogenetically, it is considered to be a continuum of these two types of pain after becoming chronic. Repetitive peripheral painful stimulation causes a central sensitization with hypersensitivity of the corresponding spinal metamer or brain region.

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