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Biomedical subjects

A Moglia

Publications and source records attributed to A Moglia.

At least 19 recordsLinked to original sources

Electrically elicited short and long-latency responses of intrinsic hand muscles in hereditary ataxias. Effects of isometric and ballistic isotonic voluntary contractions.

Short- and long-latency responses (HR and LLR) from thenar muscles were studied in patients with Friedreich's ataxia and pure cerebellar ataxia with later onset by applying electrical stimuli on the median nerve at the wrist. HR and LLR were examined during two different voluntary activities of the opponens pollicis muscle: isometric ("hold") and isotonic ballistic ("move") conditions. A preliminary conventional study of motor and sensory conduction of the median nerve was also carried out. Patients with Friedreich's ataxia had reduced or absent HR and LLR. Furthermore, those who preserved both responses had prolonged HR-LLR interpeak latency. All patients with Friedreich's ataxia also showed peripheral nerve conduction abnormalities, mainly in sensory fibers. These data can be accounted for by the widespread degeneration of many neural structures in this disorder. No abnormalities in HR were observed in pure cerebellar ataxia with later onset, whereas LLR was grossly enlarged in most patients, notably during "move" condition. Since cerebellar structures (especially the cerebellar cortex) are the only ones involved in this disorder, the cerebellum may play a role in modulating LLR. In particular, this effect could be more evident in isotonic ballistic movements.

Adolescent

Neurophysiological markers of central and peripheral involvement of the nervous system in HIV-infection.

Peroneal motor and sural sensory conduction velocities (MNCVs/SNCVs), somatosensory evoked potentials to median nerve stimulation (MN-SEPs) and motor evoked potentials (MEPs) to transcranial stimulation were examined in 138 HIV-infected patients (in the different stages of the disease), 20 seronegative intravenous drug abusers (IVDAs), and 20 healthy subjects. Findings of peroneal MNCV slowing in patients ranged from 16% (asymptomatic HIV patients) to 63% (AIDS) and of sural SNCV slowing from 13% to 40%. Altered MN-SEPs ranged from 10% to 30%, and MEPs ranged from 44% to 72%, mostly due to a prolongation of the central motor conduction time (CMCT). All seronegative IVDAs showed patterns within the normal range. Electrophysiological techniques were helpful in demonstrating early and subclinical alterations in HIV patients.

Adult

Surface-EMG analysis of rectus femoris in patients with spastic hemiparesis undergoing rehabilitation treatment.

In the present study a surface-EMG investigation of the rectus femoris muscle was performed in patients with spastic hemiparesis before and after rehabilitation treatment. The EMG activity was detected during 50% of the maximum voluntary contraction by means of FFT automatic analysis; the mean power frequency (MPF) and the time-course of the frequencies of the surface-EMG signals showed significant changes after physiokinesitherapy. In hemiparetic patients a particular distribution of the frequencies of the surface-EMG signals towards the lowest values were observed. These findings could be related to the preferential atrophy of type II fibers which has been demonstrated in morphological studies. Furthermore the surface-EMG analysis after a period of rehabilitation treatment showed some significant modifications of MPF and time-course of the EMG signals. These changes corresponded to an improvement of the spasticity as evaluated by clinical rating-scale. This neurophysiological investigation seem to be a simple and reliable method for better evaluating some effects of the rehabilitation therapy.

Electromyography

Autoimmune myastenia gravis with thymoma following the spontaneous remission of stiff-man syndrome.

A patient who developed generalized autoimmune myasthenia gravis six years after the spontaneous remission of a stiff-man syndrome is described. He also suffered from chronic active hepatitis and had radiological evidence of a thymoma. He did not have diabetes mellitus. Besides anti-nicotinic acetylcholine receptor antibodies, anti-nuclear, anti-DNA, anti-mitochondrial and anti-skeletal muscle antibodies were found in his serum, while islet-cell antibodies were absent. Immunocytochemistry studies failed to demonstrate autoantibodies to GABA-ergic nerve terminals, although an aspecific neuronal immunostaining was observed. The clinical and immunological features of this case support the hypothesis of a dysimmune pathogenesis of SMS, also in cases not associated with autoimmunity to GABA-ergic nerve terminals. Furthermore, a relationship between thymoma and the neurological syndromes discussed could be considered.

Central Nervous System Diseases

Abnormalities of central motor conduction in asymptomatic HIV-positive patients. Significance and prognostic value.

Percutaneous magnetic stimulation of the brain and spinal cord is a technique developed to demonstrate early and subclinical abnormalities in corticomotoneuron pathways. Central motor conduction time (CMCT) was evaluated in 58 HIV-seropositive patients neurologically asymptomatic (CDC groups II and III) and in two control groups. CMCT was abnormal in about 50% of HIV-seropositive patients. These electrophysiological abnormalities seem to have a negative prognostic value since about 64% of the patients with abnormal parameters seem to progress more rapidly to AIDS stages.

Acquired Immunodeficiency Syndrome

Neuropsychological and neurophysiological abnormalities in HIV-infection. Their relevance and predictive value.

A group of n. 86 HIV-pts. (CDC stages from II to IV) were cross-sectionally studied with neuropsychological and neurophysiological methods. The percentage of abnormalities detected even among pre-AIDS stages is very high (from 25 to 50% of the cases). Sensibility and specificity of the above investigations is discussed. Their possible predictive role (evolution to successive stages of asymptomatic pts. and development of CNS pathology) is also evaluated based on a medium-term clinical follow-up (18-24 months).

AIDS Dementia Complex

Peripheral nerve conduction velocity in normal infants and children.

Maximum motor conduction velocity of the median, ulnar and peroneal nerves and maximum sensory conduction velocity of the median nerve have been studied in 635 children, below 12 years of age, free from peripheral nervous system disease. The children fell into four age-group: from 0 to 1 year; from 1 to 3 years: from 3 to 6 years; from 6 to 12 years. No normal values were recorded for the sensory conduction velocity of the median nerve under the age of one year. The motor conduction velocity values significantly rise for the median and ulnar nerves up to 1 year, for the peroneal nerve up to 3 years. The sensory conduction velocity values of median nerve increase significantly up to 6 years.

Child

Electroencephalography in the early diagnosis of HIV-related subacute encephalitis: analysis of 185 patients.

Of subjects with asymptomatic HIV infection or Lymphoadenopathy Syndrome, 185 were studied by means of electroencephalography coupled with computerized spectral analysis and mapping (EEG-CSA). Abnormal EEGs were found in 30 of 118 (25.4%) patients with asymptomatic infection (CDC Group II) and in 20 of 67 (29.9%) patients with Lymphoadenopathy Syndrome (CDC Group III). The most common EEG abnormalities were represented by theta slowing on the frontal and fronto-temporal lobes and, in some cases, by delta slowing and paroxysmal sharp activity on the forebrain. Among 50 patients with abnormal EEGs, 16 showed some abnormalities on neuropsychological testing, whereas mild signs of cerebral atrophy were evident on CT scan in only 12 patients. These findings suggest that EEG-CSA could be a useful and sensitive method in the early detection and monitoring of HIV-related subacute encephalitis.

Acquired Immunodeficiency Syndrome

Steroid-responsive and dependent stiff-man syndrome: a clinical and electrophysiological study of two cases.

Two female patients with the typical clinical and electrophysiological features of the stiff-man syndrome, both responded to steroid treatment. ACTH infusion produced an immediate clinical relief of muscle contracture and cramps, with parallel marked reduction of the EMG pattern of continuous spontaneous activity in agonist and antagonist muscles. Apart from this effect, a more delayed response to oral prednisone was observed in both cases and steroid-dependence in one of them, who also exhibited instrumental and laboratory findings suggesting an inflammatory process. These data lead us to consider a possible dysimmune pathogenesis of some cases with the stiff-man syndrome.

Aged

Activity of oxiracetam in patients with organic brain syndrome: a neuropsychological study.

Oxiracetam is a new psychotropic drug that has been shown to positively affect processes both in animals and in patients with impaired brain function. The aim of this study was the evaluation of the effects of oxiracetam treatment on clinical symptoms in 43 patients with organic brain syndrome (OBS). After a 2-week washout period, patients were assigned to either oxiracetam or placebo, according to a randomized, double-blind, between-patients design. Both oxiracetam and placebo were orally given bid for 8 weeks; daily dose of oxiracetam was 2 X 800 mg. In OBS patients with a mild to moderate degree of cognitive impairment, oxiracetam showed to improve cognitive functions, logical performance, and attention. Other behavioral and functional parameters were also positively modified.

Aged