Papers by Immacolata Magnano
Obiettivi Didattici: Illustrare gli aspetti RM della CAA-IR, sottotipo della CAA con sintomatolog... more Obiettivi Didattici: Illustrare gli aspetti RM della CAA-IR, sottotipo della CAA con sintomatologia e terapie specifiche. Introduzione: La diagnosi di CAA diviene probabile in anziani normotesi con clinica indicativa ed evidenza RM di multipli depositi emosiderinici parenchimali. Nei Pazienti con genotipo APOE ?4-?4 è più frequente lo sviluppo di alterazioni infiammatorie. Riportiamo i reperti diagnostici RM in un caso di un uomo che ha mostrato successivamente netto miglioramento dopo terapia steroidea. Tecnica d'esame e/o riscontri all'imaging: Uomo di 81 aa, con crisi epilettica generalizzata e sindrome cognitiva frontale; proteinoracchia in assenza di cellule o di positività del liquor a microrganismi (JCV compreso). La RM mostrava aree di iperintensità in T2 ed ipointensità in T1 della s. bianca periventricolare-sottocorticale degli emisferi cerebrali, a distribuzione asimmetrica, di aspetto digitato con estensione alla giunzione s. bianca-s. grigia, in parte con effett...
Vestibular-evoked myogenic potentials (VEMPs) Vestibulo-masseteric reflex (VMR) Acoustic-masseter... more Vestibular-evoked myogenic potentials (VEMPs) Vestibulo-masseteric reflex (VMR) Acoustic-masseteric reflex (AMR) Vestibulo-collic reflex (VCR) Trigemino-collic reflex (TCR) Multiple sclerosis h i g h l i g h t s Vestibular and trigeminal reflexes showed a sensitivity similar to that of evoked potentials and revealed a brainstem dysfunction in patients with multiple sclerosis without associated clinical or MRI findings. The combined use of these brainstem reflexes and evoked potentials proved to be significantly superior to clinical and MRI assessments, in the first few years after onset. Brainstem reflexes can effectively complement standard neurophysiological tests in early detection of clinically and radiologically silent lesions.
Deficits of language comprehension in non-demented patients with Parkinson's disease (PD) hav... more Deficits of language comprehension in non-demented patients with Parkinson's disease (PD) have been observed. These alterations concern verbal fluency, the semantic domain and the cognitive-linguistic flexibility. An involvement of the nucleus candatus in linguistic comprehension has been hypothesized. The event-related potentials (ERPs) represent an electrophysiological tool for studying the global cognitive state (P300) and linguistic functions of semantic and syntactic postlexical integration (N400 and P600, respectively). To evaluate language comprehension in patients with PD by means of ERPs and neuropsychological evaluation and to compare these results with those obtained in a case of restless legs syndrome (RLS) secondary to ischemic stroke in the basal ganglia region.
Describe RM features of primary epidural NHL and illustrate the most important differential crite... more Describe RM features of primary epidural NHL and illustrate the most important differential criteria from extra-dural tumours.
We have previously shown in patients with relapsing-remitting Multiple Sclerosis (MS) that: i) th... more We have previously shown in patients with relapsing-remitting Multiple Sclerosis (MS) that: i) the vestibulomasseteric (VMR), acousticmasseteric (AMR), trigeminocollic (TCR) and vestibulocollic (VCR) reflexes are able to spot brainstem (BS) dysfunctions undetected by clinical and MRI examinations; ii) the combined use of these Brainstem Reflexes (BSRs) with multimodal Evoked Potentials (EPs) is more valuable than each single test in the early years after onset. Our aim was to document BS changes over time by BSRs, EPs, MRI and BS signs/symptoms (CLIN) before and after at least one year follow up, in MS.
Journal of Neurology, Neurosurgery & Psychiatry, 2003
Objective: (1) To assess cognitive function and cerebral magnetic resonance imaging (MRI) involve... more Objective: (1) To assess cognitive function and cerebral magnetic resonance imaging (MRI) involvement in relapsing-remitting multiple sclerosis; (2) to monitor disease evolution, cognitive dysfunction, and cerebral lesion burden over time (mean 8.5 year follow up period); (3) to study the relation between clinical, neuropsychological, and MRI data. On follow up assessment, visual and auditory oddball event related potentials (ERPs) were recorded as psychophysiological evaluation of cognitive status. Correlations between neuropsychological, MRI, and ERP data were also analysed. Methods: Neuropsychological study assessed verbal and non-verbal IQ, deterioration index (DI) from WAIS subtests, conceptual reasoning, attention, verbal and visuospatial short-term and long term memory. MRI assessment detected presence of demyelinating lesions by using a semiquantitative method as well as cortical and subcortical atrophy over time.
Clinical Neurophysiology, 2013
Question: Brainstem (BS) functions are conventionally studied by multimodal evoked potential (EP)... more Question: Brainstem (BS) functions are conventionally studied by multimodal evoked potential (EP) recordings, MRI and clinical examination (CLIN). In Multiple Sclerosis (MS), increasing evidence accounts for a BS involvement, often undetected by standard testing. Recently, brainstem reflexes (BSRs) have drawn attention in evaluating BS dysfunction in MS especially the vestibulocollic (VCR) and vestibuloocular reflexes. In contrast, the vestibulomasseteric (VMR), acousticmasseteric (AMR) and trigeminocollic (TCR) reflexes have never been studied systematically in MS. Aims: to investigate whether the diagnostic sensitivity of CLIN, EPs and MRI can be improved adding the assessment of VMR, AMR, TCR and VCR either as single reflexes or in a 4-BSR battery.
Clinical Neurophysiology, 2014
Vestibular-evoked myogenic potentials (VEMPs) Vestibulo-masseteric reflex (VMR) Acoustic-masseter... more Vestibular-evoked myogenic potentials (VEMPs) Vestibulo-masseteric reflex (VMR) Acoustic-masseteric reflex (AMR) Vestibulo-collic reflex (VCR) Trigemino-collic reflex (TCR) Multiple sclerosis h i g h l i g h t s Vestibular and trigeminal reflexes showed a sensitivity similar to that of evoked potentials and revealed a brainstem dysfunction in patients with multiple sclerosis without associated clinical or MRI findings. The combined use of these brainstem reflexes and evoked potentials proved to be significantly superior to clinical and MRI assessments, in the first few years after onset. Brainstem reflexes can effectively complement standard neurophysiological tests in early detection of clinically and radiologically silent lesions.
Electroencephalography and Clinical Neurophysiology, 1995
6SP patients and cryptogenic in 12. Clinical manifestation and outcome of ical, lesional and bioc... more 6SP patients and cryptogenic in 12. Clinical manifestation and outcome of ical, lesional and biochemical studies, including pharmacological manipu-PFE were different in the various patients: versive or adversive seizures lation. The rationale of these investigations deals with the role that this (6 patients); partial complex seizures (4 patients); sudden fainting (5 neurotransmitter plays in many crucial physiological activities. Moreover, patients); rarely occurring nocturnal grand mal seizures (3 patients);
Clinical Neurophysiology, 2002
Objectives: To investigate the relationship between amyotrophic lateral sclerosis (ALS) and cogni... more Objectives: To investigate the relationship between amyotrophic lateral sclerosis (ALS) and cognitive function by means of oddball event-related potentials (ERPs) and to determine the usefulness of this methodology in the cognitive status assessment of physically disabled patients.
Neurological Sciences, 2002
To evaluate possible cause-effect relationships between hyperostosis frontalis interna and cognit... more To evaluate possible cause-effect relationships between hyperostosis frontalis interna and cognitive dysfunction, we performed a neurophysiological (event-related potentials, ERPs) and neuropsychological study in a case of Morgagni-Stewart-Morel (MSM) syndrome associated with frontal lobe compression. Neuropsychological evaluation evidenced selective impairment of executive function. Visual and auditory oddball ERPs revealed delayed P300 latency and reduced auditory P300 amplitude with multi-peaked morphology. ERP abnormalities and cognitive dysfunction could be due to the frontal bone-cortex conflict documented by neuroradiological investigations.
Neuroscience Letters, 2005
Long-standing overt ventriculomegaly in adults (LOVA) is a clinical entity characterized by chron... more Long-standing overt ventriculomegaly in adults (LOVA) is a clinical entity characterized by chronic hydrocephalus with infant onset, slow evolution and clinical disturbances during adulthood. Few cases are reported in literature describing the evident contrast between the severity of hydrocephalus and the relatively spared neurological functioning and cognitive aspects. The authors describe a 59-year-old man with congenital hydrocephalus complaining of persistent gait impairment. Neurological examination showed a mild paraparesis, severe higher cortical function impairment but relatively sparing of daily living activity. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a very remarkable ventriculomegaly compressing the brain cortex but sparing the cerebellum and the brainstem. Brain Single Photon Emission Computer Tomography (SPECT) showed a prevalent cerebellar perfusion as well. Neuropsychological testing was consistent with severe cognitive deterioration and attention disorders. Language and praxis functions seemed to be preserved. Auditory oddball ERPs (P300) showed morphological abnormalities especially of late components. This case report demonstrates in vivo the level of adaptation to which human brain can reach under chronic mechanic stress conditions. The striking poor cerebral parenchyma representation and the relatively spared language and praxic abilities account for a functional reorganization of residual structures due to the neural plasticity.
Clinical Neurophysiology, 2011
Electroencephalography and Clinical Neurophysiology, 1996
International Journal of Psychophysiology, 1998
Italian Journal of Neurological Sciences, 1997
Bladder dysfunctions are often observed in patients with multiple sclerosis (MS). In order to eva... more Bladder dysfunctions are often observed in patients with multiple sclerosis (MS). In order to evaluate their sensitivity in detecting abnormalities in bladder central control pathways, pudendal nerve somatosensory evoked potentials (pSEPs) were recorded in 16 patients with clinically probable MS: six were affected by retention or urge incontinence, and ten were asymptomatic. Conventional visual, auditory and somatosensory evoked potentials were also recorded, and all of the patients underwent a urodynamic examination. Prolonged latency or the absence of pSEP cortical responses was found in eight of the ten asymptomatic patients, and in all of the symptomatic cases (87.5%). The urodynamic evaluation revealed abnormalities in 12 patients (75%). Our findings seem to indicate an early and frequent involvement of bladder control pathways in MS patients, as well as a high rate of subclinical disorders. I pazienti affetti da sclerosi multipla (SM) frequentemente presentano turbe della minzione. Al fin di valutare la sensibilità dei potenziali evocati somatosensoriali del nervo pudendo (pPES) nell'identificazione di una compromissione delle vie centrali di controllo della minzione, abbiamo registrato i pPES in 16 pazienti affetti da SM probabile. In tutti i pazienti è stato eseguito inoltre uno studio urodinamico e sono stati registrati i potenziali evocati visivo, uditivo e somatosensoriale dei nervi mediano e tibiale. Anomalie del PES del nervo pudendo sono state riscontrate nei 6 pazienti con disturbi della minzione e in 8 dei 10 pazienti asintomatici (87,5%). In 12 di essi (75% dei casi) sono state riscontrate anomalie del profilo urodinamico suscettibili di trattamento. Le nostre osservazioni sembrano deporre per un frequente e precoce coinvolgimento delle vie di controllo della minzione nei pazienti affetti da SM e per un'elevata frequenza di anomalie subcliniche.
Electroencephalography and Clinical Neurophysiology, 1995
proximal motor point of the tibialis anterior muscle was stimulated through continuous trains of ... more proximal motor point of the tibialis anterior muscle was stimulated through continuous trains of stimuli (3.5 Hz, 2-5 mA, 100 ysec duration) for 40 sec. Subjects lay supine with lower limbs extended with the tibio-tarsal joint positioned at llO", to assure an optimal length of muscle fibers along their length-tension curve. Spectra1 media1 frequency (MDF) and average muscle fiber conduction velocity (CV) were measured. Evaluation variables were (1) the initial values and (2) the linear term (fatigue index, FI) of the quadratic regression equation (y = ax' + bx + c) fitting (n = 96 in al1 cases) those variables over time. Initial CV values were lower (P < 0.001) in ischemic (3.95 f 0.6 m/sec) as compared with the healthy limbs (4.54 + 0.7 m/sec), the latter being comparable with values obtained in the controls 4.58 f 0.66 m/sec). MDF behaved similarly (ischemic limbs: 67.4 + 16.18 Hz vs. healthy limbs: 77.75 + 17 Hz, P < 0.005; controls: 95.06 f 17.19 Hz, NS vs. healthy limbs). 122. Neuromuscular transmission impairment and multiple sclerosis. -1.
Journal of The Neurological Sciences, 2006
Cognitive impairment in multiple sclerosis (MS) has received considerable interest over the last ... more Cognitive impairment in multiple sclerosis (MS) has received considerable interest over the last decades. Heterogeneous patterns of cognitive dysfunction have been reported in literature in relation to the subtype of the disease and the severity of specific cognitive domains affected. Event related potentials (ERPs), especially P300, have been employed to evaluate the cognitive decline in MS and neurophysiological findings agree with data obtained by neuropsychological testing. The objectivity, the reliability and the easy administration are the main features of ERP technique but more specific attention and memory tasks are needed to enhance the clinical value of the methodology. Moreover, ERP recording has the advantage of being feasible even in severe disabled patients. Finally, longitudinal ERP studies are required to investigate the natural course of cognitive dysfunction in MS, to estimate the prognostic value of subclinical defects in different clinical form of the disease and to evaluate clinical benefits of therapeutic and rehabilitative interventions.
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Papers by Immacolata Magnano