Papers by Antonio Carolei
Diagnostics
Moving from the central role of the thalamus in the integration of inner and external stimuli and... more Moving from the central role of the thalamus in the integration of inner and external stimuli and in the implementation of a stress-related response, the objective of the present study was to investigate the presence of any MRI structural and volumetric changes of the thalamic structures in earthquake witnesses. Forty-one subjects were included, namely 18 university students belonging to the experimental earthquake-exposed group (8 males and 10 females, mean age 24.5 ± 1.8 years) and a control group of 23 students not living in any earthquake-affected areas at the time of the earthquake (14 males and 9 females, mean age 23.7 ± 2.0 years). Instrumental MRI evaluation was performed using a 3-Tesla scanner, by acquiring a three-dimensional fast spoiled gradient-echo (FSPGR) sequence for volumetric analysis and an EPI (echoplanar imaging) sequence to extract fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values. As compared to the control one, the experimental group...
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Brain and Heart Dynamics, 2019
Recently, there has been a growing emphasis on better understanding how the brain-heart axis work... more Recently, there has been a growing emphasis on better understanding how the brain-heart axis works and in which way the brain may influence cardiac performances both in physiological and in pathological conditions. A new research field, named as neurocardiology, investigates the whole spectrum of cardiac syndromes, which arise as a result of a widespread or a strategic brain injury in the absence of a real ischemic heart disease. Disorders of consciousness, such as coma, vegetative state and minimally conscious state, have been recently reported to be associated with multiple medical comorbidities, also including cardiovascular manifestations like arrhythmias, arterial hypertension, and conditions of myocardial stunning. There is growing evidence that such clinical events are the consequence of an autonomic imbalance within the autonomic
Brain Sciences, 2021
Background: Patients who are in a coma, a vegetative state or a minimally conscious state present... more Background: Patients who are in a coma, a vegetative state or a minimally conscious state present a clinical challenge for neurological assessment, which is a prerequisite for establishing a prognosis and planning management. Several scales have been developed to evaluate these patients. The Wessex Head Injury Matrix is a comprehensive tool but is currently available only in the French and English languages. The aim of this study was to translate and evaluate the reliability of the Italian version of the scale. Methods: The original scale was translated according to a standard protocol: three separate translations were made, and a selected version was back-translated to check for any errors in order to obtain the most accurate Italian translation. A final back translation of the agreed version was made as a further check. The final version was then administered blind to a consecutive series of patients with severe acquired brain injury by two examiners. Inter-rater and test-retest r...
Brain Sciences, 2016
The experience of pain in disorders of consciousness is still debated. Neuroimaging studies, usin... more The experience of pain in disorders of consciousness is still debated. Neuroimaging studies, using functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), multichannel electroencephalography (EEG) and laser-evoked potentials, suggest that the perception of pain increases with the level of consciousness. Brain activation in response to noxious stimuli has been observed in patients with unresponsive wakefulness syndrome (UWS), which is also referred to as a vegetative state (VS), as well as those in a minimally conscious state (MCS). However, all of these techniques suggest that pain-related brain activation patterns of patients in MCS more closely resemble those of healthy subjects. This is further supported by fMRI findings showing a much greater functional connectivity within the structures of the so-called pain matrix in MCS as compared to UWS/VS patients. Nonetheless, when interpreting the results, a distinction is necessary between autonomic responses to potentially harmful stimuli and conscious experience of the unpleasantness of pain. Even more so if we consider that the degree of residual functioning and cortical connectivity necessary for the somatosensory, affective and cognitive-evaluative components of pain processing are not yet clear. Although procedurally challenging, the particular value of the aforementioned techniques in the assessment of pain in disorders of consciousness has been clearly demonstrated. The study of pain-related brain activation and functioning can contribute to a better understanding of the networks underlying pain perception while addressing clinical and ethical questions concerning patient care. Further development of technology and methods should aim to increase the availability of neuroimaging, objective assessment of functional connectivity and analysis at the level of individual cases as well as group comparisons. This will enable neuroimaging to truly become a clinical tool to reliably investigate pain in severely brain-injured patients as well as an asset for research.
The Journal of Headache and Pain, 2015
Journal of Neurotrauma, 2015
Many evidence suggest that recognizing and sharing emotions with others require a first-hand expe... more Many evidence suggest that recognizing and sharing emotions with others require a first-hand experience of those emotions in our own body which, in turn, depends on the adequate perception of our own internal state (interoception) through preserved sensory pathways. Here we explored the contribution of interoception to first-hand emotional experiences and to the recognition of others' emotions. For this aim ten individuals with sensory deafferentation as a consequence of high spinal cord injury (SCI) (5 males and 5 females; mean age: 48±14.8 years) and twenty healthy subjects matched for age, sex and education were included in the study. Recognition of facial expressions and judgment of emotionally evocative scenes were investigated in both groups using the Ekman and Friesen set of Pictures of Facial Affect and the International Affective Picture System. A two-way mixed ANOVA and post-hoc comparisons were used to test differences among emotions and groups. As compared to healthy subjects, individuals with SCI, when asked to judge emotionally evocative scenes, had difficulties in judging their own emotional response to complex scenes eliciting fear and anger, while they were able to recognize the same emotions when conveyed by facial expressions. Our findings endorse a simulative view of emotional processing according to which the proper perception of our own internal state (interoception), through preserved sensory pathways, is crucial for first-hand experiences of the more primordial emotions such as fear and anger.
Comparative Biochemistry and Physiology Part C: Comparative Pharmacology, 1992
The dopaminergic receptors of Hydra have been studied by pharmacological and biochemical methods.... more The dopaminergic receptors of Hydra have been studied by pharmacological and biochemical methods. 2. Dl selective agonists, D2 selective agonists and DlLD2 mixed-action agonists inhibit the glutathioneinduced feeding response. 3. Dopaminergic blocking agents protract the glutathione action. regardless of their Dl or D2 selectivity. 4. A very long-lasting response is observed in 6-hydroxydopamine-treated specimens. 5. Hydra treatment with dopamine agonists (Dl, D2 or mixed-action) induces a significant rise in CAMP levels. 6. Pretreatment with blocking agents prevents both the enhancement of cyclic nucleotide levels and the inhibition of feeding response induced by dopaminergic agonists. regardless of their Dl or D2 selectivity.
Cephalalgia, 2002
The study is aimed to ascertain whether the Helicobacter pylori ( Hp) infection is responsible fo... more The study is aimed to ascertain whether the Helicobacter pylori ( Hp) infection is responsible for the vulnerability to oxidative stress observed in migraineurs. Hp sero-logical positivity was assessed by ELISA evaluation of specific IgA and IgG antibodies in 30 subjects (11 males and 19 females) suffering from migraine without aura during the headache-free period. The Hp infection was detected in 16.7% of migraineurs. Plasma accumulation of peroxidative substances (TBA-RS), an index of systemic oxidative status, was increased in migraineurs without Hp infection with respect to controls ( P< 0.001), while no significant differences of TBA-RS were found in migraineurs with or without Hp infection. Unmodified values of plasma nitrite/nitrate concentrations, expression of systemic nitric oxide (NO), were obtained in migraineurs in comparison to controls indicating that Hp infection does not modify the plasma oxidative status and the systemic NO bioavailability of migraineurs. In con...
Stroke, 1983
CEREBRAL VASCULAR DISEASES in Italy have a mortality rate of 136/100,000/year, representing 15% o... more CEREBRAL VASCULAR DISEASES in Italy have a mortality rate of 136/100,000/year, representing 15% of all deaths: these data, registered in 1975, 1 do not differ from those of other countries. 23 Preventive treatment of patients at risk is a guideline to reduce incidence and mortality of such severe diseases. Patients with focal reversible cerebral ischemia (RIA) are considered those typically at risk of stroke and cerebrovascular death. 4-8 Since many strokes are not preceded by RIAs, these latter unfortunately do not identify all "risk patients": 4-9 however, the fact that these events are easily recognizable has served to direct much attention and research effort toward the prevention of ischemic phenomena in this special group of patients.' 0, " The natural history and aggravating factors of this disease are far from being clarified and very few data are available in Italy:' 2 this is preliminary to any study of therapeutic efficacy and to correctly planning protocols of health care delivery. Therefore, in 1975 the Italian National Research Council (I.N.R.C.) included the present study in the Special Project Preventive Medicine: Atherosclerosis, to be carried on in a six year period, 1977-1982.' 3 The goals of this research are: 1) to study the clinical, neuroradiological, neuropsychological and laboratory features of a consecutive population of patients with recent RIAs; 2) to record the modification of these data under close observation and treatment and to correlate the former to the incidence of new cardio-and cerebro-vascular events (new RIAs, strokes, myocardial infarction, death) for a subsequent period of four years. Clinical characteristics of the 462 patients form the object of this report. Participating Units This study (Organ Disease 2 (OD2) of the Special Project Preventive Medicine-Atherosclerosis of the I.N.R.C.) has been carried on in 12 Units (see Appendix): 1) Central biostatistical and epidemiological unit (Pisa); 2-3) Two neuroradiological consulting units (Padua and Rome); 4) One neuropsychological consulting unit (Modena); 5-12) Eight neurological or neurosurgical University
Cerebrovascular Diseases, 2011
Background: The optimal management of patients with cryptogenic ischemic stroke found to have a p... more Background: The optimal management of patients with cryptogenic ischemic stroke found to have a patent foramen ovale (PFO) at diagnostic workup remains unclear. The aims of this observational multicenter study were to evaluate: (1) the risk of recurrent cerebrovascular events in patients with cryptogenic minor ischemic stroke or transient ischemic attack (TIA) and PFO who either underwent percutaneous PFO closure
The journal of headache and pain, Jan 21, 2015
The journal of headache and pain, Jan 21, 2015
Journal of the American Heart Association
Internal and Emergency Medicine
Frontiers in psychology, 2018
Frontiers in neurology, 2018
Previous evidence suggests that hallucinations and delusions may be detected in patients with the... more Previous evidence suggests that hallucinations and delusions may be detected in patients with the most severe forms of motor disability including locked-in syndrome (LIS). However, such phenomena are rarely described in LIS and their presence may be underestimated as a result of the severe communication impairment experienced by the patients. In this study, we retrospectively reviewed the clinical history and the neuroimaging data of a cohort of patients with LIS in order to recognize the presence of hallucinations and delusions and to correlate it with the pontine damage and the presence of any cortical volumetric changes. Ten patients with LIS were included (5 men and 5 women, mean age 50.1 ± 14.6). According to the presence of indicators of symptoms, these patients were categorized as hallucinators ( = 5) or non-hallucinators ( = 5). MRI images of patients were analyzed using Freesurfer 6.0 software to evaluate volume differences between the two groups. Hallucinators showed a sel...
Frontiers in behavioral neuroscience, 2018
After a natural disaster like an earthquake about 15% of the population experience a post-traumat... more After a natural disaster like an earthquake about 15% of the population experience a post-traumatic stress disorder (PTSD). However, even those without a diagnosis of PTSD can suffer from disorders of the affective sphere, including anxiety, depression and alteration of emotion recognition. The objective of this study was to investigate the neuropsychological and emotional profile of students living in the earthquake-affected areas of L'Aquila, Italy. A group of students living in L'Aquila at the time of the 2009 earthquake was recruited, and compared to a control group of students not living in any earthquake-affected areas. Participants were assessed by means of the Beck Depression Inventory (BDI) scale, the State-Trait Anxiety Inventory (STAI), the Insomnia Severity Index (ISI), the Intolerance of Uncertainty Scale Short Form, the Uncertainty Response Scale (URS), the Anxiety Sensitivity Index 3 (ASI-3), and the Eysenck Personality Questionnaire-Revised Short Form (EPQ-RS...
Neurology, Jan 27, 2018
To examine factors contributing to the sex differences in functional outcomes and participation r... more To examine factors contributing to the sex differences in functional outcomes and participation restriction after stroke. Individual participant data on long-term functional outcome or participation restriction (i.e., handicap) were obtained from 11 stroke incidence studies (1993-2014). Multivariable log-binomial regression was used to estimate the female:male relative risk (RR) of poor functional outcome (modified Rankin Scale score >2 or Barthel Index score <20) at 1 year (10 studies, n = 4,852) and 5 years (7 studies, n = 2,226). Multivariable linear regression was used to compare the mean difference (MD) in participation restriction by use of the London Handicap Scale (range 0-100 with lower scores indicating poorer outcome) for women compared to men at 5 years (2 studies, n = 617). For each outcome, study-specific estimates adjusted for confounding factors (e.g., sociodemographics, stroke-related factors) were combined with the use of random-effects meta-analysis. In unad...
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Papers by Antonio Carolei