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Bellaria-Igea Marina, Italy

Marucci G.,University of Bologna | Farnedi A.,University of Bologna | Giulioni M.,Bellaria Hospital
Neurological Sciences | Year: 2012

Reelin is a glycoprotein that acts as a stop signal for neuronal migration during brain ontogenesis. It plays an important role in the remodeling of the hippocampal formation and in stabilizing cortical architecture. We studied immunohistochemically 30 cases of focal cortical dysplasia (FCD) type IIIa to verify whether Reelin could represent the pathogenetic link between HS and cortical dyslamination in the setting of FCD type IIIa. Our results suggest that a subset of FCD type IIIa (namely abnormal cortical layering associated with MTS and GCD type 2) exists in which loss of Reelin appears to be the common pathogenetic basis. On the contrary in the other cases the presence of a common pathogenetic link remains to be demonstrated. © The Author(s) 2011.

Coello A.F.,Hospital Universitario Of Bellvitge | Moritz-Gasser S.,Montpellier University | Moritz-Gasser S.,French Institute of Health and Medical Research | Martino J.,Hospital Universitario Marques Of Valdecilla | And 4 more authors.
Journal of Neurosurgery | Year: 2013

Intraoperative electrical brain mapping is currently the most reliable method to identify eloquent cortical and subcortical structures at the individual level and to optimize the extent of resection of intrinsic brain tumors. The technique allows the preservation of quality of life, not only allowing avoidance of severe neurological deficits but also facilitating preservation of high neurocognitive functions. To accomplish this goal, however, it is crucial to optimize the selection of appropriate intraoperative tasks, given the limited intrasurgical awake time frame. In this review, the authors' aim was to propose specific parameters that could be used to build a personalized protocol for each patient. They have focused on lesion location and relationships with functional networks to guide selection of intrasurgical tasks in an effort to increase reproducibility among neurooncological centers.

Guidi J.,University of Bologna | Rafanelli C.,University of Bologna | Roncuzzi R.,Bellaria Hospital | Sirri L.,University of Bologna | And 2 more authors.
General Hospital Psychiatry | Year: 2013

Objective: We compared the provisional Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for Somatic Symptom Disorders (SSD) and an alternative classification based on the Diagnostic Criteria for Psychosomatic Research (DCPR) as to prevalence and associations with dimensional measures of psychological distress and functioning in a population of medical patients. Method: Seventy consecutive outpatients with congestive heart failure were administered an ad hoc structured clinical interview for the identification of DSM-5 SSD, the section concerning hypochondriasis of the Structured Clinical Interview for DSM-IV, the Structured Interview for DCPR and Paykel's Clinical Interview for Depression. Subjects also completed the Symptom Questionnaire and the Psychosocial Index. Global assessment of functioning was performed with the DSM-IV Axis V. Results: A diagnosis within DSM-5 SSD was found in 13 patients (18.5%): 61.5% of them were diagnosed with the Psychological Factors Affecting Medical Condition category. Twenty-nine patients (41.4%) were classified according to the DCPR-based proposal: illness denial, demoralization and irritable mood were the most frequent specifiers. The DCPR-based classification showed a greater number of significant associations with dimensional measures of psychological distress, global functioning and stress. Conclusion: Compared to DSM-5 SSD, the DCPR-based proposal was more sensitive in detecting psychological factors relevant to illness course and provided a better characterization of such factors. The DCPR-based proposal was also superior in identifying patients with increased psychological distress and poor psychosocial functioning. © 2013 Elsevier Inc.

Rafanelli C.,University of Bologna | Offidani E.,University of Bologna | Gostoli S.,University of Bologna | Roncuzzi R.,Bellaria Hospital
Psychiatry Research | Year: 2012

The evidence linking essential systemic arterial hypertension (SAH) with psychological characteristics remains equivocal. The aims of this study were to assess clinical and subclinical distress, psychosocial aspects and psychological well-being in treated hypertensive patients and to evaluate the psychosocial variables associated with higher levels of blood pressure according to guidelines for hypertension management. A consecutive series of 125 hypertensive patients were evaluated using both self- and observer-rated reliable measures. Generalized anxiety disorder, minor depression, demoralization and alexithymia were the most frequent diagnoses. Cluster analysis revealed an association of three distinct symptomatological groups such as the Anxiety-Depression, the Alexithymia and the Somatization groups, with different levels of hypertension. In particular, patients with moderate to severe hypertension were more frequently in the Anxiety-Depression and the Alexithymia groups, whereas the Somatization cluster has been shown to be associated with isolated systolic hypertension. The results provide new insight into the psychosocial characteristics among patients with different levels of SAH according to recent guidelines of the management of hypertension. They also outline the need to monitor the clinical course of hypertensive patients characterized by these specific clinical and subclinical psychological conditions. © 2012 Elsevier Ireland Ltd.

Weller M.,University of Zurich | Stupp R.,University of Lausanne | Reifenberger G.,Heinrich Heine University Dusseldorf | Brandes A.A.,Bellaria Hospital | And 3 more authors.
Nature Reviews Neurology | Year: 2010

The DNA repair enzyme O6-methylguanine-DNA methyltransferase (MGMT) antagonizes the genotoxic effects of alkylating agents. MGMT promoter methylation is the key mechanism of MGMT gene silencing and predicts a favorable outcome in patients with glioblastoma who are exposed to alkylating agent chemotherapy. This biomarker is on the verge of entering clinical decision-making and is currently used to stratify or even select glioblastoma patients for clinical trials. In other subtypes of glioma, such as anaplastic gliomas, the relevance of MGMT promoter methylation might extend beyond the prediction of chemosensitivity, and could reflect a distinct molecular profile. Here, we review the most commonly used assays for evaluation of MGMT status, outline the prerequisites for standardized tests, and evaluate reasons for difficulties in reproducibility. We critically discuss the prognostic and predictive value of MGMT silencing, reviewing trials in which patients with different types of glioma were treated with various chemotherapy schedules, either upfront or at recurrence. Standardization of MGMT testing requires comparison of different technologies across laboratories and prospectively validated cut-off values for prognostic or predictive effects. Moreover, future clinical trials will need to determine, for each subtype of glioma, the degree to which MGMT promoter methylation is predictive or prognostic, and whether testing should become routine clinical practice. © 2010 Macmillan Publishers Limited. All rights reserved.

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