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Biomedical subjects

Giuseppe Cazzato

Publications and source records attributed to Giuseppe Cazzato.

At least 19 recordsLinked to original sources
PubMed2004

MMP-9 microsatellite polymorphism and multiple sclerosis.

A polymorphism (PM) in the microsatellite of the promoter region of matrix metalloproteinase 9 (MMP-9), modulating its expression, could play a role in susceptibility to multiple sclerosis (MS). MMP-9 PM was determined in 95 patients with MS (MS Group) and 95 age- and sex-matched controls (Control Group). Comparison of allelic frequencies showed that a higher number of CA repeats characterized the MS group (P<0.0001) and prevalence of carriers of > or =22 CA repeats was higher in the MS than in the Control Group (OR 3.4, 95% CI: 1.7-6.8, P<0.0001). An earlier age at disease onset was a characteristic of patients with >22 CA repeats (33+/-10 vs. 28+/-10, P=0.027). No differences were found in the main MRI parameters.

Adolescent↗
PubMed2004

Gabapentin as a drug therapy of intractable hiccup because of vascular lesion: a three-year follow up.

BACKGROUND: Persistent and intractable hiccups indicate multiple neurologic and extraneurologic disorders. Chronic hiccup is not so rare in patients suffering from stroke: its impact on quality of life and on rehabilitation management is substantial, and it may be closely related to aspiration pneumonia, respiratory arrest and nutritional depletion. REVIEW SUMMARY: Intractable hiccups can be associated with potentially fatal consequences and safe management may require inpatient rehabilitation. It has been suggested that hiccups could be a form of myoclonus, caused by repeated and abnormal activity of the solitary inspiratory nucleus. Because of this cause we decided to treat intractable hiccups in patients with ischemic lesions of the medulla with a short course of gabapentin. CONCLUSIONS: The results were promising, with the immediate disappearance of the hiccups, and the complete absence of side effects. The 36-months follow up was favorable to all the patients, who, after 6 days of treatment remain asymptomatic.

Acetates↗
PubMed2004

Rivastigmine in vascular dementia.

Patients with vascular dementia (VaD) show cholinergic deficits that may result in characteristic clinical syndromes for different subtypes of the condition. Subcortical VaD is characterised by executive dysfunction and behavioural problems, reflecting deterioration of the frontal lobe. Based on limited open-labelled controlled studies of rivastigmine in VaD, this article aims to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the typical symptoms of subcortical VaD. Long-term rivastigmine treatment is safe and effective. Improvements in domains that characterise subcortical VaD were observed, indicating that rivastigmine may have provided targeted treatment in areas of the brain that are particularly affected in this patient population. A large, double-blind study of rivastigmine in patients with VaD is clearly warranted.

Acetylcholinesterase↗
PubMed2003

A longitudinal study of quality of life and side effects in patients with multiple sclerosis treated with interferon beta-1a.

In a 12-month follow-up study, we evaluated 27 patients (18 F and 9 M) with relapsing-remitting (RR) multiple sclerosis (MS), who had started treatment with interferon beta-1a (IFNbeta-1a) (Avonex), 30 microg i.m. once weekly, 6-18 months (median 10 months) before study entry. Quality of life (QOL), disability, independence, cognitive performances, symptoms of depression and anxiety, and fatigue were assessed at baseline, 6 months and 12 months. The frequency and severity of the side effects of treatment, at hours 0-12, 13-48 and 49-168 after the injection, were self-reported weekly in a structured questionnaire. QOL did not change significantly during the follow-up. The percentage of patients who reported side effects after the injection of IFNbeta-1a remained constant during the 52 weeks. The mean number of side effects increased significantly from the 6th to the 12th month. The general linear model analysis of variance disclosed significant changes over time for almost all side effects, but we did not find any correlation between QOL and number of side effects. In conclusion, 1-year treatment with IFNbeta-1a did not significantly change patient's QOL. Disability progression correlated with patient's QOL. Side effects, which were mild, did not diminish over time, did not induce treatment discontinuation and did not interfere with QOL.

Activities of Daily Living↗
PubMed2003

Sexual dysfunction in multiple sclerosis: a MRI, neurophysiological and urodynamic study.

We studied 31 patients with relapsing-remitting (RR) multiple sclerosis (MS) in which we performed an urodynamic study, the pudendal cortical evoked potentials, the tibial cortical evoked potentials and the cranial and cervical spinal cord magnetic resonance imaging (MRI). We calculated the T(1) and T(2) lesion load (LL) and brain parenchymal fraction (BPF) of whole brain, frontal lobes, pons and cervical spinal cord. We also estimated the cross-sectional area at C(2) level. Spearman's rank correlation analysis showed a relationship between symptoms of sexual dysfunction and age (r=0.73, p<0.0001), cognitive performances (r=-0.63, p<0.0001), level of independence (r=-0.63, p<0.0001), disability (r=0.56, p<0.001), symptoms of anxiety (r=0.55, p<0.001) and depression (r=0.50, p<0.005), disease duration (r=0.42, p<0.02) and parenchymal atrophy in the pons (r=-0.38, p=0.031). Sexual dysfunction was not correlated with any other MRI measure, urodynamic patterns or cortical evoked potentials. In multiple regression analysis, sexual dysfunction was predicted only by T(1) lesion load of the pons. In conclusion, we confirmed previous correlations of sexual dysfunction with various clinical variables and demonstrated an association between sexual dysfunction and destructive lesions in the pons, as detected by MRI, in patients with relapsing-remitting multiple sclerosis.

Adult↗
PubMed2003

HLA genotypes and disease severity assessed by magnetic resonance imaging findings in patients with multiple sclerosis.

The objective of the study was to examine the relationship between HLA genotypes and disease severity as measured by brain MRI quantitative markers of demyelinating and destructive pathology in patients with multiple sclerosis (MS). We studied 100 patients with MS and 122 age, sex-, ethnic- and residence-matched controls. The DNA extraction and the genomic typing (A, B, DRB1 and DQB1 loci) were obtained with sequence-specific oligonucleotide method, using a commercially available reversible line blot assay (INNO-LIPA). All patients underwent a 1.5 tesla MRI examination of the brain. Disease severity was assessed by clinical (Expanded Disability Status Scale (EDSS)) and MRI (T2- and T1-lesion load (LL) and brain parenchymal fraction (BPF)) outcome measures. HLA-DQB1* 02 (OR 19.9, 95% C. I. 16.2-24.3, uncorrected (uncorr)- p<0.00001, corr-p<0.0006), -DQB1*03 (OR 16.8, 95% C. I. 13.6-20.5, uncorr-p<0.00001, corrp< 0.0006), -DRB1*15 (OR 4.6, 95% C. I. 3.7-5.6, uncorr-p= 0.0001, corr-p=0.006), and -DRB1*03 (OR 3.9, 95% C. I. 3.2-4.8, uncorr-p=0.0001, corr-p= 0.006) alleles were associated with MS. T2-, T1-LL, BPF and EDSS were not significantly different according to the carrier status of these HLA alleles. No differences were found in the ratios of disease severity/disease duration according to the HLA carrier status. Multiple regression analysis showed that a higher T2-LL was associated with the presence of DRB1*04 (uncorr-R2=0.15, p=0.006 and corr-R2=0.11, p=0.025) and B7 alleles (uncorr-R2=0.08, p=0.02 and corr-R2=0.07, p=0.018), T1-LL was associated with B7 (uncorr-R2=0.30, p<0.0001 and corr-R2=0.27, p=0.0001) and DRB1*12 (uncorr-R2=0.25, p<0.0001 and corr-R2=0.21, p=0.0002) alleles, whereas the BPF was predicted only by the presence of DRB1*12 allele (uncorr-R2=0.24, p=0.002 and corr-R2=0.20, p=0.004). The study findings suggest that some HLA alleles may predict the destructive pathological processes visible on MRI. Since the size of the sample studied is relatively small, further studies are needed to draw any firm conclusion about genotype/phenotype correlation in patients with MS.

Adult↗
PubMed2003

Neuropsychological changes after subthalamic nucleus stimulation: a 12 month follow-up in nine patients with Parkinson's disease.

Deep brain stimulation of the subthalamic nucleus has been recognized as one of the most promising techniques to decrease 'off' motor symptoms and motor fluctuations, allowing a reduction of drug therapy and limiting side effects of drug therapy. However, there is still open debate on the possible consequences of chronic subthalamic stimulation on general cognitive performance. A general amelioration of cognitive performance, in particular of executive functions has been reported but results are not homogeneous. We studied nine patients with Parkinson's Disease for 12 months following surgery for deep stimulation, studying their cognitive performances, paying particular attention to linguistic tests and selective alternating words production. Our results may be consistent with a slowing of cognitive activity, with a reduction of quantitative production, but with an increase in control of linguistic production, which is more precise and definite. We discuss the possible significance of these results, fully aware that only nine patients were involved, and that the potential for generalization is seriously limited, with a particular overview on the frontal-subthalamic pathway, which in our opinion is responsible for the results we observed.

Aged↗
PubMed2003

Frontotemporal dementia: paroxetine as a possible treatment of behavior symptoms. A randomized, controlled, open 14-month study.

Frontotemporal dementia (FTD) represents an important cause for degenerative disruption and is increasingly recognized as an important cause (up to 25%) of degenerative dementia among late-middle-age individuals. The serotoninergic system is tightly bound to frontal circuits, whose degeneration subserves FTD. Patients aged 64-68 years, with a diagnosis of FTD, were randomized to receive paroxetine up to 20 mg/day (n = 8) or piracetam up to 1,200 mg/day (n = 8). At 14 months, the patients treated with paroxetine showed significant improvements in behavioral symptoms, reflected by a reduction of caregiver stress. Side effects were easily tolerable, and there was no dropout. The results are presented with an overview of the literature on the topic.

Aged↗
PubMed2003

Gabapentin for the treatment of behavioural alterations in dementia: preliminary 15-month investigation.

BACKGROUND: Although the core feature of dementia is progressive cognitive disruption, non-cognitive behavioural problems are expressed in most patients with dementia during the course of their illness. While psychotropic drugs are frequently used to control behavioural symptoms, comorbidities, which are very common in the geriatric population, could often limit their use. Gabapentin may be a potential treatment in such situations. METHODS: In this open, baseline comparison study 20 patients with probable Alzheimer's disease with behavioural alterations and serious comorbidities (paralytic ileus, open-angle glaucoma, ischaemic cardiopathy, hepatic failure or severe prostatic hyperplasia) received gabapentin for 15 months. Patients were allowed to continue any previous therapy for concurrent diseases. However, concomitant antipsychotic or benzodiazepine intake was not permitted. RESULTS: Gabapentin appeared to be efficacious and well tolerated in this patient population, and did not appear to interact with other drugs. General benefit is reflected by a reduction of caregiver stress. No patients withdrew before the end of the study and no serious adverse events were reported. CONCLUSION: The results of this study in patients with probable Alzheimer's disease with behavioural alterations and serious comorbidities indicate that gabapentin provides significant and sustained efficacy in terms of behaviour, with associated reductions in caregiver burden. The results of an ongoing larger, randomised, double-blind study of gabapentin are keenly awaited and may help to provide a safer and more efficacious treatment option for this group of patients.

Acetates↗
PubMed2003

Writing errors by normal subjects.

Writing is a complex process requiring visual memory, attention, phonological and semantic operations, and motor performance. For that reason, it can easily be disturbed by interfering with attention, memory, by interfering subvocalization, and so on. With 16 female third-year students (23.4 +/- 0.8 yr.) from the University of Trieste, we investigated the production of errors in three experimental conditions (control, articulatory suppression, and tapping). In the articulatory suppression condition, the participants produced significantly more linguistic impairments (such as agrammatism, unrelated substitutions, sentence omissions, and semantically deviant sentences), which are similar to linguistic impairments found in aphasia. On the tapping condition there were more perseverations, deletions, and substitutions of both letters and words. These data suggest that writing is not an automatic skill. Only after many years of experience and practice of processing information (through cortical to subcortical channels) can writing be considered an automatic skill. Limited experimental conditions can disrupt the writing system of normal subjects, probably interfering with the cortical to subcortical loops, and link normality to pathology.

Adult↗
PubMed2003

[Clinical surveillance of patients with multiple sclerosis].

Clinical management of people with multiple sclerosis (MS) is based not only on the control of side-effects of disease-modifying drugs but also on the recognition and treatment of disease exacerbations, on the evaluation of disease progression and on the management of the wide range of MS symptoms. A multidisciplinary approach is essential to achieve the best results and improve the quality of life of MS patients.

Acute Disease↗
PubMed2002

Rivastigmine in subcortical vascular dementia: an open 22-month study.

Further to recent data indicating that patients with vascular dementia (VaD) show a cholinergic deficit, we aimed to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the symptoms of VaD. Patients aged 65-80, with a diagnosis of dementia and probable VaD, received rivastigmine 3-6 mg/day (n=8) or cardioaspirin (n=8) in an open study for 22 months. At 22 months, patients treated with rivastigmine showed significant improvements in executive function and behavioural symptoms (both p<0.05 vs. both baseline and control group), which were reflected in reduced caregiver stress (p<0.05 vs. baseline and controls). Baseline scores of global response, cognition, word fluency and activities of daily living were maintained in patients receiving rivastigmine, and there was no increase in benzodiazepine or neuroleptic intake. In contrast, the control group showed no improvements in any domain, and significant deterioration in global response and executive function (both p<0.05 vs. baseline and rivastigmine group). Side effects in both groups were tolerable and there were no study withdrawals. Long-term rivastigmine treatment appeared to be safe and effective in this patient population. In particular, improvements in domains particularly relevant to this condition were observed. These benefits may reflect the drug's dual inhibitory effects on the cholinergic system, and its particular activity in frontal areas of the brain. A large, double-blind study of rivastigmine in patients with VaD would be worthwhile.

Activities of Daily Living↗
PubMed2002

Ten-Point Clock Test: a correlation analysis with other neuropsychological tests in dementia.

BACKGROUND: Neuropsychology can be useful for differentiating patients with fronto-temporal dementia (FTD) from those with Alzheimer disease (AD) and those with Vascular Dementia (VaD). OBJECTIVES: The purpose of this study was twofold: to explore possible employment of the Ten-Point Clock Test in early identification of different types of cognitive distribution and to relate to its execution to other specific impairment, bound to the selected pathology. METHOD: We compared 30 patients with FLD, to a group of 30 probable-AD patients accordingly to the NINCDS-ADRDA criteria, and to a group of 30 probable VaD patients, according to the NINDS-AIREN criteria. RESULTS: AD group showed the worst results in Clock Drawing Test. On the contrary, FLD group did produce the worst performances in Proverb Interpretation Tasks. VaD worst performance was that of phonological fluency. Our data seem to demonstrate that in mild dementia, stated by the MMSE score (around 22) and confirmed by the data derived from the other neuropsychological evaluation, the Clock Drawing Test is quite sensitive to detect cognitive impairment, even if of different origins. CONCLUSIONS: Ten-Point Clock Test is a strong tool, in order to identify early forms of Alzheimer, and to help differential diagnosis when frontal or vascular dementia have been taken into account. More data will be necessary to give to this speculative interpretation, a neuroimaging and neuroanatomical support. However, this report may encourage the wider use of this parametric test, easily applicable and well accepted by the population in order to implement data concerning cognitive disruption.

Aged↗
PubMed2002

Reading errors in patients with cerebellar vermis lesions.

Dyslexia, both developmental and acquired, has been considered the result of cerebrocortical dysfunction, affecting the temporo-parieto-occipital brain regions. However, dyslexia may involve abnormalities of the magnocellular component of the visual system, leading to binocular instability or alterations of accommodation. To test the hypothesis of cerebellar involvement in the reading process -- justified by its emergent role in language and cognition -- we studied 10 patients with cerebellar vermis/paravermis lesions using reading tests and we compared the results with those produced by 10 normal volunteers. The data obtained demonstrate an increased number of reading mistakes in the patient group, resulting from a possible alteration of the diffuse connection system from the cerebellum to different cerebrocortical and subcortical structures. Acquired dyslexia due to cerebellar impairment may be due to oculomotor alteration or, more subtly, to the intimate cerebellar-encephalic projections, connecting the cerebellum to the attentive and alerting processes and to the language system. We discuss the data with an overview of literature.

Adult↗
PubMed2002

Complex cognitive disruption in motor neuron disease.

We describe 14 patients having been diagnosed as suffering from motor neuron disease (MND). These patients underwent a detailed and sequential neuropsychological evaluation, with particular care of neurolinguistic assessment. Their results have been compared to those obtained by a group of healthy volunteers. The most obvious disclosure was the finding of 4 cases of frontal dementia in the MND group. Apart from that, we demonstrated subtle though evident frontal disruption signs, evidenced by an alteration in language planning, language comprehension, morphosyntactic operations, planning, attention deficit, and abstract reasoning disturbances which got worse during the 15 months of follow-up in all the other subjects. We suggest that a specific and sensitive neurolinguistic and neuropsychological test battery could detect signs of disruption of cognition present even in the sporadic form of MND. We discuss the results with a review of the literature.

Aged↗