ABSTRACT A basic property of REM sleep is that is not a uniform stage. Two kinds of variations ar... more ABSTRACT A basic property of REM sleep is that is not a uniform stage. Two kinds of variations are particularly significant. First, a remarkable amount of literature, based on polygraphic signals, fMRI images, and psychophysiological data, has shown that "phasic" epochs, presenting distinct oculomotor activity, should be distinguished from "tonic" epochs. Second, recent litarature has provided interesting data about slow eye movements (SEMs), which are present during REM sleep in addition to rapid eye movements (REMs), although, according to Rechtshaffen and Kales (1968), during REM sleep SEMs "do not approach the abundance magnitude, and pendular pattern of the slow eye movements during stage 1".
Aim of this study is to examine caregiver burden and family functioning in different neurological... more Aim of this study is to examine caregiver burden and family functioning in different neurological conditions. Forty-two primary caregivers of patients with Amyotrophic Lateral Sclerosis (ALS), Alzheimer's Disease and other dementia (AD), Parkinson's Disease (PD), Acquired Brain Injuries (ABI) and Multiple Sclerosis (MS) were administered scales for the evaluation of caregiver burden (CBI) and family functioning (FACES IV). Caregiver burden was overall high, with caregivers of patients with ALS and ABI having exceeded the CBI cut-off score for possible burn-out. The average scores of caregivers of patients with AD or other dementia and PD were close to the cut-off score, whereas those of caregivers of patients with MS were significantly lower than the others. Family cohesion, family satisfaction and the quality of family communication were associated with reduced levels of caregiver burden, whereas disengagement was associated with a higher burden. The data from the present study confirm that caregiver burden is a relevant issue in the context of neurological diseases, especially for those causing higher degrees of impairment. Significant correlations with family functioning emerged as well, highlighting the importance of studying and treating caregiver burden within the context of family relations.
Preterm children have an increased risk of neurodevelopmental impairments which include psychomot... more Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and be...
diabetes and deafness (n 5 10), chronic progressive external ophthalmoplegia (n 5 6), and in subj... more diabetes and deafness (n 5 10), chronic progressive external ophthalmoplegia (n 5 6), and in subjects with atypical clinical presentations (n 5 4). Six patients of our cohort (20%) had a history of intestinal pseudo-obstruction (6 pedigrees, 3 men; mean age, 37 years; range, 16–65; mean body mass index [BMI], 16; range, 13–18). Differently from what was reported by Ng et al, all patients manifested MELAS syndrome and only 1 patient developed intestinal pseudo-obstruction concomitantly with an acute stroke-like episode (SLE). Moreover, we, too, observed 1 patient who developed a severe gastrointestinal dysmotility episode 14 years before his first SLE. Radiological investigations on 5 patients showed a concomitant dilation of small and large bowels in 3 patients and an isolated distension of large bowel in 2 patients. One patient had clinical evidence of urinary retention during an acute presentation of intestinal pseudoobstruction. Three patients died concomitantly with the severe gastrointestinal event: 2 of aspiration pneumonia and sepsis and 1 of aspiration pneumonia and cardiorespiratory failure. All patients with a history of intestinal pseudo-obstruction had at least an SLE. These data confirm that SLE and BMI are strong predictors of the development of intestinal pseudo-obstruction. Interestingly, the 3 patients of our cohort who died concurrently with this severe gastrointestinal episode presented a severe cortical atrophy and dementia, and we speculate that these clinical and radiological conditions increase risk of death during an intestinal pseudo-obstruction episode probably attributed to the inability to protect their own airways. We suggest to extend the gastrointestinal screening to all patients with mitochondrial diseases. In fact, also in our experience, severe gastrointestinal events are associated in other primary mitochondrial DNA and nuclear mutations (eg, a TWINKLE-related mitochondrial disease and a patient with mutation in the COX3 gene). Finally, we fully agree with Ng et al to avoid surgical intervention for this clinical condition and to begin an adequate medical treatment as early as possible.
Modulation of frontal midline theta (fmθ) is observed during error commission, but little is know... more Modulation of frontal midline theta (fmθ) is observed during error commission, but little is known about the role of theta oscillations in correcting motor behaviours. We investigate EEG activity of healthy partipants executing a reaching task under variable degrees of prism-induced visuo-motor distortion and visual occlusion of the initial arm trajectory. This task introduces directional errors of different magnitudes. The discrepancy between predicted and actual movement directions (i.e. the error), at the time when visual feedback (hand appearance) became available, elicits a signal that triggers on-line movement correction. Analysis were performed on 25 EEG channels. For each participant, the median value of the angular error of all reaching trials was used to partition the EEG epochs into high- and low-error conditions. We computed event-related spectral perturbations (ERSP) time-locked either to visual feedback or to the onset of movement correction. ERSP time-locked to the on...
2015 International Workshop on Computational Intelligence for Multimedia Understanding (IWCIM), 2015
A method is described for the automatic and quantitative analysis of changes in polysomnographic ... more A method is described for the automatic and quantitative analysis of changes in polysomnographic signals during REM sleep. The implementation of the procedures has been motivated by the remarkable psychophysiological and clinical significance not only of REM sleep per se, but also of its microstructure, given by state variations at frequencies slower than 1 Hz. These procedures provide a segmentation of REM sleep into sub-stages and allow the calculation of quantitative parameters connected with the microstructural properties of REM sleep.
ABSTRACT A basic property of REM sleep is that is not a uniform stage. Two kinds of variations ar... more ABSTRACT A basic property of REM sleep is that is not a uniform stage. Two kinds of variations are particularly significant. First, a remarkable amount of literature, based on polygraphic signals, fMRI images, and psychophysiological data, has shown that "phasic" epochs, presenting distinct oculomotor activity, should be distinguished from "tonic" epochs. Second, recent litarature has provided interesting data about slow eye movements (SEMs), which are present during REM sleep in addition to rapid eye movements (REMs), although, according to Rechtshaffen and Kales (1968), during REM sleep SEMs "do not approach the abundance magnitude, and pendular pattern of the slow eye movements during stage 1".
Aim of this study is to examine caregiver burden and family functioning in different neurological... more Aim of this study is to examine caregiver burden and family functioning in different neurological conditions. Forty-two primary caregivers of patients with Amyotrophic Lateral Sclerosis (ALS), Alzheimer's Disease and other dementia (AD), Parkinson's Disease (PD), Acquired Brain Injuries (ABI) and Multiple Sclerosis (MS) were administered scales for the evaluation of caregiver burden (CBI) and family functioning (FACES IV). Caregiver burden was overall high, with caregivers of patients with ALS and ABI having exceeded the CBI cut-off score for possible burn-out. The average scores of caregivers of patients with AD or other dementia and PD were close to the cut-off score, whereas those of caregivers of patients with MS were significantly lower than the others. Family cohesion, family satisfaction and the quality of family communication were associated with reduced levels of caregiver burden, whereas disengagement was associated with a higher burden. The data from the present study confirm that caregiver burden is a relevant issue in the context of neurological diseases, especially for those causing higher degrees of impairment. Significant correlations with family functioning emerged as well, highlighting the importance of studying and treating caregiver burden within the context of family relations.
Preterm children have an increased risk of neurodevelopmental impairments which include psychomot... more Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and be...
diabetes and deafness (n 5 10), chronic progressive external ophthalmoplegia (n 5 6), and in subj... more diabetes and deafness (n 5 10), chronic progressive external ophthalmoplegia (n 5 6), and in subjects with atypical clinical presentations (n 5 4). Six patients of our cohort (20%) had a history of intestinal pseudo-obstruction (6 pedigrees, 3 men; mean age, 37 years; range, 16–65; mean body mass index [BMI], 16; range, 13–18). Differently from what was reported by Ng et al, all patients manifested MELAS syndrome and only 1 patient developed intestinal pseudo-obstruction concomitantly with an acute stroke-like episode (SLE). Moreover, we, too, observed 1 patient who developed a severe gastrointestinal dysmotility episode 14 years before his first SLE. Radiological investigations on 5 patients showed a concomitant dilation of small and large bowels in 3 patients and an isolated distension of large bowel in 2 patients. One patient had clinical evidence of urinary retention during an acute presentation of intestinal pseudoobstruction. Three patients died concomitantly with the severe gastrointestinal event: 2 of aspiration pneumonia and sepsis and 1 of aspiration pneumonia and cardiorespiratory failure. All patients with a history of intestinal pseudo-obstruction had at least an SLE. These data confirm that SLE and BMI are strong predictors of the development of intestinal pseudo-obstruction. Interestingly, the 3 patients of our cohort who died concurrently with this severe gastrointestinal episode presented a severe cortical atrophy and dementia, and we speculate that these clinical and radiological conditions increase risk of death during an intestinal pseudo-obstruction episode probably attributed to the inability to protect their own airways. We suggest to extend the gastrointestinal screening to all patients with mitochondrial diseases. In fact, also in our experience, severe gastrointestinal events are associated in other primary mitochondrial DNA and nuclear mutations (eg, a TWINKLE-related mitochondrial disease and a patient with mutation in the COX3 gene). Finally, we fully agree with Ng et al to avoid surgical intervention for this clinical condition and to begin an adequate medical treatment as early as possible.
Modulation of frontal midline theta (fmθ) is observed during error commission, but little is know... more Modulation of frontal midline theta (fmθ) is observed during error commission, but little is known about the role of theta oscillations in correcting motor behaviours. We investigate EEG activity of healthy partipants executing a reaching task under variable degrees of prism-induced visuo-motor distortion and visual occlusion of the initial arm trajectory. This task introduces directional errors of different magnitudes. The discrepancy between predicted and actual movement directions (i.e. the error), at the time when visual feedback (hand appearance) became available, elicits a signal that triggers on-line movement correction. Analysis were performed on 25 EEG channels. For each participant, the median value of the angular error of all reaching trials was used to partition the EEG epochs into high- and low-error conditions. We computed event-related spectral perturbations (ERSP) time-locked either to visual feedback or to the onset of movement correction. ERSP time-locked to the on...
2015 International Workshop on Computational Intelligence for Multimedia Understanding (IWCIM), 2015
A method is described for the automatic and quantitative analysis of changes in polysomnographic ... more A method is described for the automatic and quantitative analysis of changes in polysomnographic signals during REM sleep. The implementation of the procedures has been motivated by the remarkable psychophysiological and clinical significance not only of REM sleep per se, but also of its microstructure, given by state variations at frequencies slower than 1 Hz. These procedures provide a segmentation of REM sleep into sub-stages and allow the calculation of quantitative parameters connected with the microstructural properties of REM sleep.
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Papers by Luca Bonfiglio