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Rita Formisano

Publications and source records attributed to Rita Formisano.

15 recordsLinked to original sources
PubMed2007

Multimodal fMRI tractography in normal subjects and in clinically recovered traumatic brain injury patients.

In this study, we defined an operator-independent protocol for reconstructing the anatomical connections originating from fMRI activations in order to demonstrate that results obtained with this protocol are affected by alterations of functional activations. Seven healthy volunteers and two patients who sustained traumatic brain injury underwent an fMRI with a finger tapping task and a DTI scan. Cortical fMRI activations were used directly as seed mask for tractography for the reconstruction of individual motor pathways. On patients we observed a different motor network if compared to healthy subjects. However, when the activations of healthy subjects were used as seed masks for the tractography in patients, we observed for the patients a pattern of connectivity more similar to what was observed for healthy subjects. At the same time, when the activations of patients were used for the tractography on healthy subjects, we obtained patterns of connectivity similar to those obtained for patients. These results show the potential of the integration of fMRI and tractography for clarifying the mechanisms of cortical plasticity in the recovery of motor functions.

Adult↗
PubMed2006

Magnetic resonance imaging flow void changes after cerebrospinal fluid shunt in post-traumatic hydrocephalus: clinical correlations and outcome.

The assessment of the flow-void in the cerebral aqueduct of patients with post-traumatic hydrocephalus on magnetic resonance imaging (MRI) evaluation could concur the right diagnosis and have a prognostic value. We analysed prospectively 28 patients after a severe head injury (GCS<or=8), with radiological or clinical suspicion of post-traumatic hydrocephalus and a fast flow-void signal in the cerebral acqueduct on T2-weighted and proton density MRI. Twenty-two patients were shunted (n=19) or revised (n=3). Six patients were followed-up without surgery. Twenty out of 22 shunted patients (91%) showed variable reduction of the fast flow-void. Eighteen of the operated patients (82%) presented a significant clinical improvement at 6-month follow-up. All patients (n=2) who had no change of the fast flow-void after surgery did not clinically improve. The six non-shunted patients did not present any clinical or radiological improvement. In head-injured patients, fast flow-void in the cerebral aqueduct is diagnostic for post-traumatic hydrocephalus and its reduction after ventriculo-peritoneal shunt is correlated with a neurological improvement. In already shunted patients, a persistent fast flow-void is associated with a lack of or very slow clinical improvement and it should be considered indicative of under-drainage.

Adolescent↗
PubMed2006

Rehabilitation of attention in two patients with traumatic brain injury by means of 'attention process training'.

PRIMARY OBJECTIVE: This case study aims to evaluate the effectiveness of the Solhberg and Mateer's Attention Process Training (APT) using a comprehensive evaluation of various attentional processes. METHODS AND PROCEDURES: Two patients with severe traumatic brain injury were given the APT in a chronic phase. Attentional processes were evaluated at various stages before, during and after treatment, using the Testbatterie zur Aufmerksamkeitsprufung and the Test of everyday attention. MAIN OUTCOMES AND RESULTS: Both patients showed some degree of recovery, particularly in attentional tasks with a selective component. Lesser improvement was present in the case of tasks mapping on the intensity dimension of attention (alertness, vigilance). Training achievements were confirmed by the use of a functional scale evaluating attention, pointing to the generality of improvements. CONCLUSION: The results indicate selective training effects of APT on the attentional disturbances of TBI patients.

Adolescent↗
PubMed2005

Psychiatric disorders and pain location in unilateral migraineurs.

To explore the relationship between the side of pain during attacks and psychopathological features in strictly unilateral migraine, we recruited 35 patients affected by migraine with and/or without aura diagnosed according to the revised ICHD-II criteria. Seventeen patients had right side-locked pain (R-SUM), 11 had left side-locked (L-SUM) and 7 had side-shifting pain (SSM). Patients were administered the Hamilton Anxiety Scale, the State and Trait Anxiety Inventory-State Anxiety, the Beck Depression Inventory and the 20-item Toronto Alexithymia Scale. Statistical analyses showed that the L-SUM group was significantly more anxious and depressed than the other two groups of patients. Our preliminary data suggest that strictly left unilateral migraine is associated with more severe anxiety and depression. This finding appears to be consistent with studies that reported a higher degree of these disorders in patients with left cerebral hemispheric damage.

Adult↗
PubMed2005

Migraine disease: evolution and progression.

Migraine is a complex pathology and it should be regarded as a disease evolving during the lifetime along with other comorbid conditions. Migraine susceptibility may be unmasked by exogenous substances and the occurrence of migraine attacks may change following drugs given for therapeutical purposes. The evolution of migraine should be followed up because childhood migrainous manifestations may vary over the years and an earlier diagnosis may not apply later on.

Cardiovascular Diseases↗
PubMed2005

Late motor recovery is influenced by muscle tone changes after stroke.

OBJECTIVES: To evaluate the time course of motor recovery in a poststroke period ranging from 2 to 6 months and its correlation with both the severity of motor deficit and the muscle tone disturbances (flaccidity or spasticity) of the affected limbs. DESIGN: Prospective cohort study. SETTING: A comprehensive rehabilitation hospital. PARTICIPANTS: Forty consecutive stroke patients (21 men, 19 women) with first ischemic stroke who met the inclusion criteria. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Change in motor deficit as evaluated by the Adams Hemispheric Stroke Scale. RESULTS: Stepwise regression analysis indicated that the most significant factors influencing motor recovery were the time elapsed since stroke and muscle tone. CONCLUSIONS: Rehabilitation of stroke patients is more effective in the first months after the event rather than later, considering the significant correlation observed between motor recovery and time elapsed since stroke. Flaccid patients appear to need 3 months or more before reaching the final plateau, because motor recovery occurs later and/or proceeds more slowly, whereas outcomes for spastic patients with spasticity appears to occur in the first months after stroke.

Adult↗
PubMed2005

A preliminary investigation of road traffic accident rate after severe brain injury.

PRIMARY OBJECTIVE: to investigate the road traffic accident rate in patients who have resumed driving after severe brain injury. RESEARCH DESIGN: a retrospective study conducted by means of telephone interviews. METHODS AND PROCEDURES: The caregivers of 90 patients suffering from severe brain injury were included. All of the patients had sustained severe brain injury and prolonged coma, i.e. lasting for at least 48 hours. The caregivers were interviewed by means of a Questionnaire that investigated several aspects of driving competence after coma and the incidence of road traffic accidents. MAIN OUTCOMES AND RESULTS: All patient outcomes were evaluated by means of the Glasgow Outcome Scale (GOS). The 90 caregivers reported that 29 patients (32%) had resumed driving and that 11 of the 29 (38%) were subsequently involved in road traffic accidents. During the total duration of our patient population risk exposure, we found 11 cases in our study group, against the 4.7 expected cases calculated in the normal population. The relative risk of road traffic accidents in severe brain injury patients versus uninjured individuals was 2.3. CONCLUSIONS: Our preliminary data show that a subject who has suffered from severe brain injury and coma lasting for at least 48 hours has a statistically significant higher risk of being involved in a road traffic accident.

Accidents, Traffic↗
PubMed2005

Fast detection of diffuse axonal damage in severe traumatic brain injury: comparison of gradient-recalled echo and turbo proton echo-planar spectroscopic imaging MRI sequences.

BACKGROUND AND PURPOSE: Diffuse axonal injury (DAI) is a common type of primary neuronal injury in patients with severe traumatic brain injury (TBI), and is frequently accompanied by tissue tear hemorrhage. T2-weighted gradient-recalled echo (GRE) sequences are more sensitive than T2-weighted spin-echo images for detection of hemorrhage. The purpose of this study is to compare turbo Proton Echo Planar Spectroscopic Imaging (t-PEPSI), an extremely fast sequence, with GRE sequence in the detection of DAI. METHODS: Twenty-one patients (mean age 26.8 years) with severe TBI occurred at least 3 months earlier, underwent a brain MR Imaging study on a 1.5-T scanner. A qualitative evaluation of the t-PEPSI sequences was performed by identifying the optimal echo time and in-plane resolution. The number and size of DAI lesions, as well as the signal intensity contrast ratio (SI CR), were computed for each set of GRE and t-PEPSI images, and divided according to their anatomic location as lobar and/or deep brain. RESULTS: There was no significant difference between GRE and t-PEPSI sequences in the detection of the total number of DAI lesions (291 vs. 230, respectively). GRE sequence delineated a higher number of DAI in the temporal lobe compared to the t-PEPSI sequence (74 vs. 37, P < .004), while no differences were found for the other regions. The SI CR was significantly lower with the t-PEPSI than the GRE sequence (P < .00001). CONCLUSION: Owing to its very short scan time and high sensitivity to the hemorrhage foci, the t-PEPSI sequence may be used as an alternative to the GRE to assess brain DAI in severe TBI patients, especially if uncooperative and medically unstable.

Adolescent↗
PubMed2004

Reaction and movement times in individuals with chronic traumatic brain injury with good motor recovery.

Reaction times and movement times were studied in 18 individuals with severe traumatic brain injury (TBI) and 36 matched normal controls. Reaction times depended on the type of task: in the case of simple visual stimuli (Alertness condition) they were similar in individuals with TBI and normal controls. In contrast, individuals with TBI were slower in a Go-no-go test. Regardless of task, movement times depended on movement length and were slower in individuals with TBI. These findings indicate the presence of a residual motor programming deficit in individuals with TBI even in the chronic stage and in the presence of good motor recovery, as assessed clinically.

Adolescent↗
PubMed2003

Chiari-associated exertional, cough, and sneeze headache responsive to medical therapy.

Benign exertional headache is coded as a separate entity within the International Headache Society's classification system, but the pathophysiological mechanisms underlying this clinical headache subtype are unknown and possibly are similar to those generating migraine. Coexistence of migraine and benign exertional headache in the same patient is not unusual, and antimigraine pharmacologic treatments are often effective in both headache types. Regardless, optimal management mandates that the clinician exclude any intracranial or systemic disease that could mimic "primary" exertional headache. The same holds for primary headaches induced by coughing or sneezing; congenital malformations or neoplasms, particularly within the posterior fossa, are not rare in these patients. The neurologic examination may not be sufficiently sensitive to detect the offending lesion. We describe a patient with migraine without aura and exertional secondary headache due to Chiari malformation type I whose headaches responded to treatment with propranolol and indomethacin.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.

OBJECTIVES: To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. BACKGROUND: Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. METHODS: Six CH sum-naïve patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. RESULTS: All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache. CONCLUSIONS: Physicians should recognize the possibility that treatment of CH with SQ sum may be associated with an increased frequency of headache attacks.

Adult↗
PubMedDate not supplied

Potentiation of ischemia-related behavioral alterations by electro-acupuncture in gerbils.

Gerbils subjected to global ischemia or sham-ischemia received electro-acupuncture (EA) or sham EA at points 26 Du (Renzhong) and 8 Du (Junsuo). All animals were then tested for motor activity in an open field, and for spontaneous alternation in a T maze. Results show that EA alone did not affect any behavioral parameter. Ischemia alone increased motor activity without significantly interfering with spontaneous alternation. EA in ischemic gerbils potentiated the increase of motor activity and elicited a decrease in spontaneous alternation. Thus, our data show an interaction between global ischemia and EA applied at specific acupoints which, however, consists of a potentiation rather than an alleviation of the behavioral alterations consecutive to the ischemic insult.

Analysis of Variance↗
PubMedDate not supplied

Hypnic headache responsive to indomethacin: second Italian case.

We report a case of hypnic headache (HH) fulfilling the criteria proposed by the revised IHS headache classification and rapidly responsive to indomethacin. The patient is a 70-year-old housewife who presented with a 7-year history of strictly nocturnal headache attacks. The headache occurred every night with a frequency of 1 to 2 attacks occurring between 03.00 and 04.00 a.m. Indomethacin was prescribed at a daily dose of 150 mg/day for 30 days and tapered down in 15 days. Pain did not occur thereafter and at follow up, nine months after discontinuation of the drug, the patient was still pain-free with no relapses. This is the second Italian HH patient responsive to indomethacin, indicating that indomethacin may be a useful alternative treatment in HH patients, and providing further evidence in favour of a common pathophysiological mechanism in HH and other indomethacin-responsive primary headaches.

Aged↗
PubMedDate not supplied

Prodromes and the early phase of the migraine attack: therapeutic relevance.

A migraine attack is a multiphasic event. In some patients the initial phase of the attack is characterized by the presence of "prodromes" or "premonitory symptoms" which are not recognized by the patient as part of the attack. Premonitory symptoms are defined as "symptoms preceding and forewarning of a migraine attack by 2-48 hours, occurring before the aura in migraine with aura and before the onset of pain in migraine without aura". Migraine premonitory symptoms should be differentiated from aura and symptoms of premenstrual syndrome. This differentiation, which is crucial to correct diagnosis, is based on two principal aspects, namely, the timing of these premonitory symptoms prior to the headache pain and their clinical characteristics. The neurotransmitters dopamine and serotonin are possibly involved in the development of premonitory symptoms, as demonstrated by experimental models and by the efficacy of migraine aborting and preventive treatments. Accurate recording of premonitory symptoms may contribute to efforts to design the best therapeutic approach in migraine patients.

Female↗