Hsp60 and AChR cross-reactivity in myasthenia gravis: An update.
Disfunzioni sessuali, farmaci antiepilettici e profilo ormonale sierico negli uomini affetti da epilessia
Razionale ed obiettivi: Le disfunzioni sessuali sono un problema relativamente comune nei pazienti di sesso maschile affetti da epilessia, la cui.prevalenza varia dal 38-71%. La loro eziologia non è conosciuta e potrebbe essere multifattoriale; possono essere implicati nella loro genesi sia l’epilessia che l’utilizzo di farmaci antiepilettici (FAE). L’assunzione di farmaci per la terapia dell’epilessia può essere all’origine della presenza di DS e di alterazioni ormonali e riproduttive in questa popolazione di pazienti. Lo scopo dello studio è valutare l’incidenza delle DS negli uomini con epilessia, valutando il tipo di epilessia, la frequenza delle crisi, il tipo di FAE utilizzato, il pro…
Natalizumab therapy of relapsing-remitting multiple sclerosis: an evaluation of the safety profile and a comparison of efficacy with interferon beta therapy
Ruolo delle heat shock proteins nella patogenesi della miastenia gravis
Myasthenia Gravis (MG) is an autoimmune disorder of the neuromuscolar junction mediated by specific antibodies to the nicotinic acetylcholine receptors. Several clinical and experimental studies have confirmed that the HSPs are involved in the process of regulation of some autoimmune disorders such as arthritis, diabetes, atherosclerosis and multiple sclerosis. The involvement of HSPs within different autoimmune disorders allows to hypothesize their presence in the pathogenesis of the MG, i.e. as suggested by the existence of a cross-reactivity among the antigenic epitopes of Hsp60 and AChR. Moreover, since a cross-reactivity between human and bacterial epitopes of Hsp60 has also been descr…
Lifestyle factors and multiple sclerosis: a case control study
Validation Study of Italian Version of Inventory for DéJà vu Experiences Assessment (I-IDEA): A Screening Tool to Detect DéJà vu Phenomenon in Italian Healthy Individuals
The Inventory Déjà Vu Experiences Assessment (IDEA) is the only screening instrument proposed to evaluate Déjà vu (DV) experience. Here we intended to validate the Italian version of IDEA (I-IDEA) and at the same time to investigate the incidence and subjective qualities of DV phenomenon in Italian healthy adult individuals on basis of an Italian multicentre observational study. In this study we report normative data on the I-IDEA, collected on a sample of 542 Italian healthy subjects aging between 18 to 70 years (average age 40, range 18-70) with a formal educational from 1-19 years. From September 2013 to March 2016 were recruited 542 healthy vo…
Antiepileptic Drugs, Sexual Functions and Serum Hormonal Profile in Males with Epilepsy
Sexual dysfunctions are a common problem in epileptic men. Etiology is multifactorial involving both epilepsy and antiepileptic drugs. Purpose of this study was to evaluate incidence of sexual dysfunctions in epileptic men, assessing epilepsy, antiepileptic drugs, serum hormonal profile, psychiatric disorders.
MDMA Administration and Heat Shock Proteins Response: Foreseeing a Molecular Link
Molecular and cellular mechanisms of MDMA-induced toxicity have been extensively studied in a number of experimental models. Nevertheless, only few studies investigated the involvement of HSPs ("molecular chaperones") in MDMA organs toxicity. In the present minireview we highlight this subject analysing the results of these studies conducted especially on brain tissue. Despite of it seems obvious that HSPs overexpression is a protective reaction against MDMA treatment, the molecular mechanisms for exerting their action are far to be undiscovered. At the same time, we need of comprehensive studies concerning the whole range of Hsps/chaperones expressions in all organs after acute and chronic…
Taravana: documentation of bubbles by computerized tomography.
Validation study of Italian version of inventory for déjà vu experiences assessment (I-IDEA): A screening tool to detect déjà vu phenomenon in Italian healthy individuals
The Inventory Déjà Vu Experiences Assessment (IDEA) is the only screening instrument proposed to evaluate the Déjà vu (DV) experience. Here, we intended to validate the Italian version of IDEA (I-IDEA) and at the same time to investigate the incidence and subjective qualities of the DV phenomenon in healthy Italian adult individuals on basis of an Italian multicentre observational study. In this study, we report normative data on the I-IDEA, collected on a sample of 542 Italian healthy subjects aging between 18-70 years (average age: 40) with a formal educational from 1-19 years. From September 2013 to March 2016, we recruited 542 healthy volunteers from 10 outpatient neurological clinics i…
Social cognition dysfunctions in patients with epilepsy: Evidence from patients with temporal lobe and idiopathic generalized epilepsies
Abstract Background and aim Despite an extensive literature on cognitive impairments in focal and generalized epilepsy, only a few number of studies specifically explored social cognition disorders in epilepsy syndromes. The aim of our study was to investigate social cognition abilities in patients with temporal lobe epilepsy (TLE) and in patients with idiopathic generalized epilepsy (IGE). Materials and methods Thirty-nine patients (21 patients with TLE and 18 patients with IGE) and 21 matched healthy controls (HCs) were recruited. All subjects underwent a basic neuropsychological battery plus two experimental tasks evaluating emotion recognition from facial expression (Ekman-60-Faces test…
LACOSAMIDE: TERAPIA IN ADD ON NEL TRATTAMENTO DELL’EPILESSIA PARZIALE
Razionale ed obiettivi: La lacosamide è una nuova molecola con spiccata attività anticonvulsivante utilizzata nelle forme di epilessia ad esordio focale. Obiettivo del nostro studio è quello di valutare la tollerabilità, le interazioni farmacologiche e l’efficacia di questo nuovo farmaco usato in associazione ai vecchi ed ai nuovi farmaci antiepilettici. Pazienti e metodi: Abbiamo arruolato 30 pazienti afferenti al nostro Centro per la Diagnosi e la Cura dell’Epilessia dell’Università degli studi di Palermo affetti da epilessia parziale in bi-politerapia. L’età media dei pazienti era di 36,6 anni, l’età media di esordio della prima crisi di 15,9; 25 erano farmacoresistenti e 22 hanno presen…
The role of circulating and exosomal miRNAs as biomarkers of drug-resistant epilepsy
Epilepsy is estimated to affect about 65 million individuals worldwide, with up to 30 percent of drug-resistant patients who do not have remission despite appropriate therapy with antiepileptic drugs (AEDs). Therefore, it is important to distinguish drug-resistant epilepsy early in the course of disease to start a specific therapeutical approach as soon as possible. Recently circulating miRNAs have been proposed as promising biomarkers for different neurodegenerative disorders, including epilepsy. MiRNAs are a class of small non-coding RNA that regulate gene expression at a post-transcriptional level. The regulatory mechanisms controlling translation of mRNA transcripts represents to date a…
Lacosamide in patients with temporal lobe epilepsy: An observational multicentric open-label study.
Abstract Purpose The aim of this study was to evaluate the efficacy and tolerability of lacosamide (LCM) both as add-on therapy and monotherapy in patients with temporal lobe epilepsy (TLE) based on an observational, prospective, multicenter study. Methods We enrolled 100 patients (mean age: 43.4 ± 12.53 years, 57 females) with nonlesional TLE and TLE with hippocampal sclerosis (HS) that did not respond to the first drug and who were referred to epilepsy centers of the University of Catanzaro, University of Palermo, IRCSS Neuromed of Pozzilli, and Otto-von-Guericke University of Magdeburg. In this open-label, multicenter trial, patients were initiated on oral LCM as add-on therapy to first …
Do neurologists agree in diagnosing drug resistance in adults with focal epilepsy?
Objective: To evaluate interrater agreement in categorizing treatment outcomes and drug responsiveness status according to the International League Against Epilepsy (ILAE) definition of drug-resistant epilepsy. Methods: A total of 1053 adults with focal epilepsy considered by the investigators to meet ILAE criteria for drug resistance were enrolled consecutively at 43 centers and followed up prospectively for 18-34 months. Treatment outcomes for all antiepileptic drugs (AEDs) used up to enrollment (retrospective assessment), and on an AED newly introduced at enrollment, were categorized by individual investigators and by 2 rotating members of a 16-member expert panel (EP) that reviewed the …
Frequency of Mitoxantrone related heart involvement in patients affected by Multiple Sclerosis
Insight into epileptic and physiological déjà vu: from a multicentric cohort study
Background and purpose The presence of a continuum between physiological deja vu (DV) and epileptic DV is still not known as well as epidemiological data in the Italian population. The aim was to identify the epidemiological distribution of DV in Italy, and secondly to look for specific features of DV able to discriminate between epileptic and non-epileptic DV. Methods In all, 1000 individuals, 543 healthy controls (C) (313 women; age 40 ± 15 years) and 457 patients with epilepsy (E) (260 women; age 39 ± 14 years), were prospectively recruited from 10 outpatient neurological clinics throughout Italy. All populations were screened using the Italian Inventory for Deja Vu Experiences Assessmen…
Molecular chaperones and mirnas in epilepsy: Pathogenic implications and therapeutic prospects
Epilepsy is a pathologic condition with high prevalence and devastating consequences for the patient and its entourage. Means for accurate diagnosis of type, patient monitoring for predicting seizures and follow up, and efficacious treatment are desperately needed. To improve this adverse outcome, miRNAs and the chaperone system (CS) are promising targets to understand pathogenic mechanisms and for developing theranostics applications. miRNAs implicated in conditions known or suspected to favor seizures such as neuroinflammation, to promote epileptic tolerance and neuronal survival, to regulate seizures, and others showing variations in expression levels related to seizures are promising ca…
Role of heat shock proteins in the pathogenesis of myasthenia gravis.
Relation between Sexual Dysfunctions and Epilepsy, Type of Epilepsy, Type of Antiepileptic Drugs: A Prospective Study
Introduction The aim of this study was to evaluate the incidence of sexual dysfunctions in males with epilepsy, the type of epilepsy, the frequency of seizures, the type of antiepileptic drugs (AEDs), the serum hormonal profile and the presence of psychiatric comorbidity. Methods Sixty-one patients focused on type of epilepsy, frequency of seizures, AEDs, hormonal profile and presence of mood disorders. We excluded all patients with severe neurologic and psychiatric impairment and patient who were not able to fill questionnaires. Mean age was 31.2 years (range 18-50 years); 31 patients (50.8%) had an idiopathic generalised epilepsy and 30 (49.2%) a focal epilepsy; among them, latter 18 (60%…
Corrigendum to “Hsp60 and AChR cross-reactivity in myasthenia gravis: An update.” [J. Neurol. Sci. 292 (2010) 117–118]
Corrigendum to “Hsp60 and AChR cross-reactivity in myasthenia gravis: An update.” [J. Neurol. Sci. 292 (2010) 117–118] Francesco Cappello ⁎, Antonella Marino Gammazza, Leila Zummo, Everly Conway de Macario, Alberto J.L. Macario a Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy b University of Maryland, IMET, 701 East Pratt Street, 21202, Baltimore, MD, USA
Emotion recognition in temporal lobe epilepsy and idiopathic generalized epilepsy
Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)
Objective: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A. The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting. Methods: This was a subgroup analysis of patients with PSE included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). The BRIVAFI…
Excessive Daytime Sleepiness and Sleep Disorders in a Population of Patients with Epilepsy: a Case-Control Study
Background and purpose There are several primary causes for excessive daytime sleepiness (EDS) and sleep disorders in patients with epilepsy. Up to now, studies in the literature report conflicting data in terms of both prevalence and aetiology. The aim of our study was therefore to evaluate the prevalence of EDS and some sleep disorders in a population of patients with epilepsy treated with no more than two antiepileptic drugs (AEDs). We also investigated the role of the depression of mood as a variable that can negatively affect EDS. Methods We prospectively and consecutively recruited 99 patients with a diagnosis of epilepsy, sleep disorders and EDS, belonging to the Centre for Epilepsy …
Heart involvement in patients treated with mitoxantrone for multiple sclerosis
Guillain-Barré Syndrome
Background: Guillain–Barré syndrome is a rare disorder in which our body’s immune system attacks nerves determining weakness and tingling of extremities as first symptoms. It can also be associated to respiratory failure and require mechanical ventilation during hospitalization (up to 30% of patients). Nowadays patient’s hyper-reactive immune responses benefits from immunotherapies such as intravenous immunoglobulin (IVIg), therapeutic plasma exchange (TPE) and new biological drugs. Case Report: We report our experience with the case of a 64-year-old woman who presented a symmetric progressive flaccid paralysis after a week of mild cold symptoms. The respiratory and neurological symptoms wo…