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Gianesini S.,University of Ferrara | Menegatti E.,University of Ferrara | Mascoli F.,University of Ferrara | Salvi F.,IRCCS Neurosciences | And 2 more authors.
Phlebology | Year: 2014

Objectives: To evaluate the role of the omohyoid muscle anatomic variants as a possible reversible cause of internal jugular vein extrinsic compression. Method: We describe a chronic cerebro-spinal venous insufficiency patient, who presented a omohyoid muscle entrapment of the internal jugular vein, confirmed by both magnetic resonance venography and ultrasound investigation. A omohyoid muscle surgical transection together with a patch angioplasty was performed. Results: The surgical procedure led to both IJV flow restoration and neurological improvement. Conclusions: The omohyoid muscle compression on the internal jugular vein seems to be a possible cause of venous obstruction, but several anatomical and patho-physiological aspects need further investigations. Such picture might cause balloon venous angioplasty inefficacy and needs to be preoperatively considered. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Caltagirone C.,University of Rome Tor Vergata | Marchionni N.,University of Florence | Nappi G.,Mondino National Neurological Institute | Nappi G.,University of Rome La Sapienza | And 2 more authors.
Aging Clinical and Experimental Research | Year: 2012

Due to the progressive aging of the population and to the age-associated increase in its incidence, Alzheimer's disease (AD) will become in near future one of the major challenges that healthcare systems will have to face with in developed countries. Since the pathophysiological process of AD is thought to begin many years before the clinical diagnosis of dementia, in theory there is an opportunity for preventive therapeutic interventions. In recent years, there has been a growing interest, supported by a large number of experimental and epidemiological studies, in the beneficial effects of some natural compounds in preventing various age-related pathologic conditions, including brain aging and neurodegeneration. Homotaurine, a small aminosulfonate compound that is present in different species of marine red algae, has been shown, in both in vitro and in vivo models, to provide a relevant neuroprotective effect by its specific anti-amyloid activity and by its γ-aminobutyric acid type A receptor affinity. The therapeutic efficacy of homotaurine in AD has been investigated in a pivotal Phase III clinical study that did not reach its pre-defined primary endpoints. However, post-hoc analyses have shown positive and significant effects of homotaurine on secondary endpoints and subgroups of patients, including a reduction in hippocampal volume loss and lower decline in memory function in the overall cohort, as well as a reduction in global cognitive decline in APOE4 allele carriers, suggesting a disease-modifying effects. In this review, we will examine the pre-clinical and clinical evidence supporting the potential role of homotaurine as a promising candidate for both primary and secondary prevention of AD. ©2012, Editrice Kurtis.

Veggiotti P.,Mondino National Neurological Institute | Veggiotti P.,University of Pavia | Pera M.C.,University of Pavia | Olivotto S.,University of Pavia | De Giorgis V.,University of Pavia
Journal of Clinical Neurophysiology | Year: 2016

Summary: Electrical status epilepticus in sleep is an age-dependent syndrome with the characteristic pattern of continuous spike and waves during non-rapid eye movement sleep. Most children can present developmental deterioration. The demonstration of the EEG pattern has to rely on all night long EEG recordings. A comprehensive neuropsychologic evaluation with periodic reassessment should be performed. For the idiopathic forms of electrical status epilepticus in sleep, clobazam could be considered as the first-line therapy; in the other cases, corticosteroids, in particular intravenous methylprednisolone pulse therapy, remain the most effective and should be considered the therapy of choice. © 2016 by the American Clinical Neurophysiology Society.

Fuzzati-Armentero M.-T.,Mondino National Neurological Institute | Cerri S.,Mondino National Neurological Institute | Levandis G.,Mondino National Neurological Institute | Ambrosi G.,Mondino National Neurological Institute | And 10 more authors.
Journal of Neurochemistry | Year: 2015

The glutamate metabotropic receptor 5 (mGluR5) and the adenosine A2A receptor (A2AR) represent major non-dopaminergic therapeutic targets in Parkinson's disease (PD) to improve motor symptoms and slow down/revert disease progression. The 6-hydroxydopamine rat model of PD was used to determine/compare the neuroprotective and behavioral impacts of single and combined administration of one mGluR5 antagonist, 2-methyl-6-(phenylethynyl)pyridine (MPEP), and two A2AR antagonists, (E)-phosphoric acid mono-[3-[8-[2-(3-methoxyphenyl)vinyl]-7-methyl-2,6-dioxo-1-prop-2-ynyl-1,2,6,7-tetrahydropurin-3-yl]propyl] (MSX-3) and 8-ethoxy-9-ethyladenine (ANR 94). Chronic treatment with MPEP or MSX-3 alone, but not with ANR 94, reduced the toxin-induced loss of dopaminergic neurons in the substantia nigra pars compacta. Combining MSX-3 and MPEP further improved the neuroprotective effect of either antagonists. At the behavioral level, ANR 94 and MSX-3 given alone significantly potentiated l-DOPA-induced turning behavior. Combination of either A2AR antagonists with MPEP synergistically increased L-DOPA-induced turning. This effect was dose-dependent and required subthreshold drug concentration, which per se had no motor stimulating effect. Our findings suggest that co-treatment with A2AR and mGluR5 antagonists provides better therapeutic benefits than those produced by either drug alone. Our study sheds some light on the efficacy and advantages of combined non-dopaminergic PD treatment using low drug concentration and establishes the basis for in-depth studies to identify optimal doses at which these drugs reach highest efficacy. © 2015 International Society for Neurochemistry.

Viana M.,Mondino National Neurological Institute | Sances G.,Mondino National Neurological Institute | Ghiotto N.,Mondino National Neurological Institute | Guaschino E.,Mondino National Neurological Institute | And 5 more authors.
Cephalalgia | Year: 2016

Background Migraine attacks may present different features in different patients and also within the same patient. The percentage of patients reporting stereotyped attacks and those reporting attacks with different phenotypes has not been the object of specific investigations. Objective The objective of this article is to evaluate the percentage of migraine patients reporting the same characteristics, in terms of phenotype and response to symptomatic medications on three consecutive migraine attacks. Methods Thirty patients with migraine without aura prospectively recorded the features of three consecutive attacks in a headache diary. Characteristics recorded were: pain intensity, presence of nausea, vomiting, photophobia, phonophophia, osmophobia, allodynia, cranial autonomic symptoms (at least one), and premonitory symptoms. Patients were allowed to take frovatriptan as symptomatic medication, whose efficacy was evaluated as the two hours pain-free status. Results None of the patients presented identical characteristics on the three studied attacks. This was still the case if we reduced the number of variables evaluated from 11 to seven of the eight core features indicated by the ICHD. Considering just six variables: unilaterality and quality of pain, presence/absence of nausea, vomiting, photophobia and phonophobia, only two patients (6%) had identical features on three consecutive attacks. With respect to the response to frovatriptan, 39% of patients had the same response, either positive (i.e. pain free after two hours) or negative (i.e. not pain free after two hours) on three consecutive attacks. Conclusion Migraine attacks show a high variability not just among patients, but also within the same patient. Our data indicate that stereotypy of attacks is uncommon, and reinforces the underlying logic of the current operational classification system. © International Headache Society.

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