Conference Presentations by Monica Ricci
Introduzione La carenza di Vitamina B12 è associata con vari disturbi ematologici, neurologici e ... more Introduzione La carenza di Vitamina B12 è associata con vari disturbi ematologici, neurologici e psichiatrici, fino a determinare quadri di demenza o psicosi. Livelli medio-bassi di vitamina B12 possono inficiare indirettamente le funzioni cognitive attraverso vari meccanismi eziopatogenici: aumento dell'omocisteina, neurotossicità diretta, danni alla sostanza bianca. Inoltre nei soggetti con ipovitaminosi B12 sono stati riscontrati effetti di riduzione della neurogenesi ippocampale attraverso delle lesioni microstrutturali delle aree CA4 e del Giro Dentato dell'ippocampo. Tuttavia, i risultati degli studi sul legame eziologico o di comorbidità tra ipovitaminosi B12 e deficit cognitivi, e sulla reversibilità dei deficit cognitivi dopo terapia suppletiva con cianocobalamina, sono ancora controversi. Le maggiori criticità emerse in questi studi riguardavano il ruolo di potenziali altri cofattori, come l'omocisteina, la carenza di altri folati, e la non univoca definizione delle soglie di cutoff della vitamina B12. Inoltre, solo pochi studi finora hanno investigato il quadro neuropsicologico dei pazienti con ipovitaminosi B12. Lo scopo di questo studio osservazionale neuropsicologico è di cercare di delineare maggiormente il profilo cognitivo e comportamentale dei pazienti con disturbi cognitivi e riscontro di ipovitaminosi B12.
Papers by Monica Ricci
Cortex, 2021
Craniopharyngiomas (CP's) are hypothalamic tumors often associated with psychological disorde... more Craniopharyngiomas (CP's) are hypothalamic tumors often associated with psychological disorders. Nevertheless, its diagnosis is still challenging when psychiatric disorders are not associated with any other neurological symptoms. This single-case study describes a patient with a history of bipolar disorder before a diagnosis of a large CP arising the sellar and suprasellar region was posed. At the time of the present study the patient showed emotional/behavioral disorders and Korsakoff-like amnesia, that completely recovered after surgical resection of the tumor. This is one of those few cases described in literature, who presented cognitive/behavioral disorders because the compression of the diencephalic structures due to CP mass effect. This case offers further evidence on the functional neuroanatomy of the hypothalamus and its pathways.
Acta Bio Medica : Atenei Parmensis, 2020
Two patients with post-coma reactivation deficiency who showed a “dramatic” response to rotigotin... more Two patients with post-coma reactivation deficiency who showed a “dramatic” response to rotigotine therapy are described. They had suffered from prolonged coma due to lesions in the mesencephalic ventral tegmental area. The authors believe that rotigotine effect in these cases could be due to restoration of dopaminergic transmission in medial frontal areas previously “de-afferented” from the lesions. Some comatous patients may experience a prolonged difficulty in recovering a normal state of consciousness. This phenomenon may be due to dysfunction of amynergic activating pathways connecting brainstem to the frontal cerebral cortex. In particular, dysfunction of dopaminergic pathways from the mesencephalon to the frontal cortical areas may be responsible for clinical pictures characterized by preserved alertness and total loss of interactions with the surrounding environment; the so called “waking coma” cases. (www.actabiomedica.it)
Journal of the Neurological Sciences, 2021
Results We found, during lockdown, a significant decrease in total ED attendances (4664) when com... more Results We found, during lockdown, a significant decrease in total ED attendances (4664) when compared to the matched control (10424) and to the pre-lockdown (9522) periods. Similarly, a reduction was detected for seizure attendances: 37 during lockdown and 63 and 44 respectively during the two other time periods. Interesting we found that more patients attended the ED with first seizures (p = 0.013), and a higher number of EEGs (p = 0.008) and CT brain scans (p = 0.018) were performed during lockdown; a trend favouring a more frequent transport to the ED by ambulance (p = 0.061) was also noted during lockdown period. Conclusions The pandemic had a relevant impact on how patients with seizures accessed the ED.
Journal of the Neurological Sciences, 2021
Journal of the Neurological Sciences, 2021
International Journal of Language & Communication Disorders, 2020
Background: Despite initial underreporting of language dysfunctions in corticobasal syndrome (CBS... more Background: Despite initial underreporting of language dysfunctions in corticobasal syndrome (CBS), aphasia is now recognized as a frequent feature of this disease. Aphasia in CBS seems clinically overlying to a nonfluent/agrammatic primary progressive aphasia (nfaPPA), which is also a clinical phenotype associated with corticobasal degeneration (CBD) pathology. However, the clinical features of aphasia in CBS still remain poorly delineated, resulting in misjudgements in the differential diagnosis from a PPA presentation of the disease. Aims: To investigate the language disorders of this syndrome, also through a systematic examination of recoding skills (reading, written spelling and repetition) and articulatory disturbances, which have been rarely examined in previous studies. Methods & Procedures: We present a clinical and neuropsychological descriptive study of the language impairments in a case series of 12 aphasic patients with a clinical diagnosis of CBS. Language assessment was conducted by means of the Esame NeuroPsicologico dell'Afasia, a comprehensive Italian battery for language functions, the Token Test, and the Apraxia of Speech Rating Scale. Outcomes & Results: The language profile of the patients showed a severe expressive language disorder, characterized by non-fluent speech, apraxia of speech (AoS) with predominant stuttering-like dysfluencies, spatial/apraxic agraphia, lack of word-finding and defective sentence repetition. Severe limb apraxia, visual-spatial deficit and alien hand syndrome were also present. Neuroimaging showed bilateral left asymmetric atrophies and hypometabolism in the frontal premotor, parietal posterior and temporal areas. Conclusions & Implications: These findings suggest that aphasia in CBS might present as a 'mixed PPA', instead of an nfaPPA as previously stated, showing a combination of features of the nfa and logopenic variants of the PPA, associated with AoS, stuttering and agraphia, which might be additional important cognitive markers for the clinical diagnosis of CBS and discriminating features of an nfaPPA presentation of a CBD. These results might also suggest specific intervention areas in the rehabilitation of patients with CBS.
Epilepsy & Behavior, 2018
Disturbed sleep can negatively affect overnight memory retention as well as new learning the subs... more Disturbed sleep can negatively affect overnight memory retention as well as new learning the subsequent day. In healthy participants, positive associations between memory performance and sleep characteristics (e.g., time spent in slow-wave sleep [SWS]) have been detected. In a previous study, we found that SWS was much reduced in patients with focal seizures, but when correlations between memory complaints and various sleep characteristics were considered, the only significant relationship was with the time to onset of rapid eye movement (REM) sleep (i.e., REM latency). In this study, we investigated the relationships between sleep, epilepsy, and objective memory performance variables. Twenty-five patients with focal seizures had their memory tested while undergoing a two-day ambulatory electroencephalography (EEG). The sleep variables of interest were the percentage of time spent in SWS (%SWS) and REM latency. Epilepsy variables included the presence of (1) seizures, (2) interictal epileptiform discharges, and/or (3) hippocampal lesions as well as site of seizure origin (temporal vs extratemporal). Overnight retention (of autobiographical events, a story, and a complex geometric figure) and the ability to learn a word list on day 2 were the measures of memory. A significant positive correlation was found between word-list learning and %SWS during the previous night. A significant negative correlation was observed between REM latency and overnight retention of autobiographical events. Overnight retention scores for the story and geometric figure were not related to sleep characteristics but were negatively affected by the presence of epileptiform activity. Story retention was also worse for temporal lobe epilepsy (TLE) than for patients with extratemporal epilepsy (ETE). Those with hippocampal lesions were more impaired than those without lesions on word-list learning, autobiographical events' retention, and story retention. When multiple contributing factors were entered into regression analyses, %SWS was found to be the best predictor of subsequent word-list learning, whereas the presence of a hippocampal lesion was the best predictor of overnight retention of autobiographical events and a story. These findings provide further evidence of the ways in which particular sleep characteristics are associated with memory and suggest that treatment of sleep disturbances in patients with epilepsy might be helpful for improving their performance.
Neurological Sciences, 2015
The Addenbrooke&a... more The Addenbrooke's Cognitive Examination Revised (ACE-R) is a brief cognitive screening instrument also proposed to detect mild cognitive impairment, a high-risk condition for Alzheimer's disease and other forms of dementia. In this study, we report normative data on the ACE-R-Italian version, collected on a sample of 264 Italian healthy subjects aging between 60 and 93 years, and with a formal education from 1 to 19 years. The global normal cognition was established in accordance with the Italian version of the Mini-Mental State Examination score and with exclusion criteria derived by a consensus process. Linear regression analysis was performed to evaluate the effect of age, gender, and education on the ACE-R total performance score. We provide correction grids to adjust raw scores and equivalent scores with cut-off value to allow comparison between ACE-R performance and others neuropsychological test scores that can be administered to the same subject.
Diet and Nutrition in Dementia and Cognitive Decline, 2015
ABSTRACT
Neuropsychologia, 2015
Accelerated long term forgetting (ALF), whereby information is rapidly lost over days or weeks ha... more Accelerated long term forgetting (ALF), whereby information is rapidly lost over days or weeks has been noted in patients with epileptic conditions. The present study sought to determine which clinical factors underlie such consolidation failure for recent autobiographical experiences in patients with focal epilepsy. We enrolled 21 patients with temporal lobe epilepsy (TLE), with and without hippocampal lesions (TLE(þ) ¼12; TLE(À) ¼9, respectively), 11 patients with extratemporal epilepsy (ETE) and 29 controls (NC). Recall and recognition were tested at different delays (i.e., 30 min, 24 h and 4 days). During the study interval, most of the patients underwent concurrent ambulatory EEG monitoring. Analyses of variance indicated Group  Delay interval interactions for recall. The TLE(þ) group showed significant decline in recall by 24 h delay. On recognition Group by Delay interval was not detected but main effect for Group revealed that the ETE group demonstrated ALF on recognition questions over the interval between 24 h and 4 days. Regression analyses confirmed that a hippocampal lesion was particularly disruptive to consolidation over the first 24 h, and that seizures were associated with memory decline over longer delays. Our findings show that the retention of autobiographical experiences involves multiple mechanisms, which operate over different timeframes.
Journal of Clinical Neuroscience, 2013
Recently, a pattern referred to as accelerated long-term forgetting (ALF) has been described in p... more Recently, a pattern referred to as accelerated long-term forgetting (ALF) has been described in patients with epilepsy. In ALF, acquisition and retention over standard delayed recall intervals (up to 30 minutes) tend to be intact, but there is an abnormally rapid rate of forgetting over delays of days or weeks. ALF is associated with everyday memory complaints as well as impairments in autobiographical memory, but goes largely undetected by traditional neuropsychological measures. We consider here the characteristics of ALF and possible contributors to its underlying pathophysiology. Overall, a better understanding of this relatively newly recognised memory disorder should improve clinical treatment.
Dementia and Geriatric Cognitive Disorders, 2011
Aims: The main aims of the study were the translation and the subsequent validation in Italian of... more Aims: The main aims of the study were the translation and the subsequent validation in Italian of the Addenbrooke’s Cognitive Examination Revised (ACE-R), and the evaluation of its usefulness in discriminating cognitively normal subjects from patients with mild dementia in an elderly population. Methods: The ACE-R was translated and adapted into Italian. The Italian ACE-R was administered to a group of 179 elderly subjects (72 cognitively healthy and 107 subjects with mild dementia, mean age 75.4 ± 6.4 years). The group was stratified into two subsamples according to age, i.e. a young-old (<75 years) and an old-old (≧75 years) group, in order to evaluate the sensitivity and specificity of the test in detecting dementia in different age strata of elderly subjects. Results: The reliability of the Italian ACE-R was extremely good (α-coefficient = 0.85). Two different cutoffs were identified for young-old (cutoff 79; sensitivity 90% and specificity 80%) and old-old subjects (cutoff 6...
Archives of Gerontology and Geriatrics, 2009
DLB is considered the second most common cause of degenerative dementia after AD in elderly peopl... more DLB is considered the second most common cause of degenerative dementia after AD in elderly people (McKeith et al., 1996). Early differentiation between DLB and AD is essential to make the most of the therapies available for each disease. Previous studies designed to examine the cognitive profiles of DLB and AD in the early stages have shown that visuospatial abilities and attentive and executive functions are more severely impaired in patients with DLB than in those with AD, while the domain compromised most in early AD is the memory pattern (Guidi et al., 2006; Crowell et al., 2007; Metzler-Baddeley, 2007). Furthermore, personality disorders in these two diseases also differ in the early stages, with DLB patients displaying apathy, relinquished hobbies, purposeless hyperactivity and severe psychiatric symptoms more often than AD patients (Galvin et al., 2007). The neuropsychiatric disorders are less closely correlated with cognitive decline in DLB than in AD (Del Ser et al., 2000). However, few studies have compared neuropsychiatric disorders and functional abilities in the early stages of these two types of dementia and their influence on caregiver distress (McKeith et al., 2006; Stavitsky et al., 2006; Matsumoto et al., 2007). While distress in caregivers of AD subjects seems to be influenced more by behavioral than by psychological changes (Hart et al., 2003), there are no specific data on the causes of distress in caregivers of DLB subjects. The aim of our study was to assess neuropsychiatric disorders and functional abilities in two subject groups affected by DLB and AD in the same phase of cognitive decline and to analyze their influence on caregiver distress. 2. Methods 2.1. Patient groups Sixteen patients (10 males and 6 females; mean age AE S.D.: 74.7 AE 4.3 years, range 65-80) with a diagnosis of probable DLB (McKeith et al., 1996) and 12 patients (6 males and 6 females; mean age AE S.D.: 69.5 AE 4.9 years, range 60-70) with a diagnosis of probable AD according to the NINCDS-ADRDA criteria (McKhan Archives of Gerontology and Geriatrics 49 (2009) e101-e104
Archives of Clinical Neuropsychology
Objective The Rey Auditory Verbal Learning Test (RAVLT) is a widely used verbal memory measure th... more Objective The Rey Auditory Verbal Learning Test (RAVLT) is a widely used verbal memory measure that provides scores for different aspects of memory. It involves repeated auditory presentation and recall of a 15-item word list (List A) followed by presentation and recall of a distractor list (List B) and then un-cued immediate and delayed recalls (at 15 min and 1 week) of List A as well as recognition testing. Aims of this study are to provide Italian normative data for certain RAVLT Scores and Composite Indices to improve the diagnostic accuracy of the test in clinical settings and to provide further evidence on how RAVLT can differentiate different amnesia profiles due to focal lesions. Methods We enrolled 440 healthy participants and RAVLT Single Scores and Composite Indices have been analyzed by means of multiple regression to verify the influence of age, education, and gender. Results We computed the best linear models with RAVLT Single Scores and Composite Indices, as dependent...
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Conference Presentations by Monica Ricci
Papers by Monica Ricci