1,721,233 research outputs found
Dystonias
No full textDystonias are characterized by involuntary muscle contractions, twisting movements, abnormal postures, and often tremor in various body regions. However, in the last decade several studies have demonstrated that dystonias are also characterized by sensory abnormalities. While botulinum toxin is the gold standard therapy for focal dystonia, exactly how it improves this disorder is not entirely understood. Neurophysiological studies in animals and humans have clearly demonstrated that botulinum toxin improves dystonic motor manifestations by inducing chemodenervation, therefore weakening the injected muscles. In addition, neurophysiological and neuroimaging evidence also suggests that botulinum toxin modulates the activity of various neural structures in the CNS distant from the injected site, particularly cortical motor and sensory areas. Concordantly, recent studies have shown that in patients with focal dystonias botulinum toxin ameliorates sensory disturbances, including reduced spatial discrimination acuity and pain. Overall, these observations suggest that in these patients botulinum toxin-induced effects encompass complex mechanisms beyond chemodenervation of the injected muscles
Review of available data for the efficacy and effectiveness of nabiximols oromucosal spray (Sativex) in multiple sclerosis patients with moderate to severe spasticity
No full textBackground: Sativex (USAN: nabiximols) oromucosal spray is indicated for treatment of multiple sclerosis (MS) patients with moderate to severe spasticity and inadequate response to other antispasticity medications who demonstrate clinically significant improvement during an initial trial of therapy. This narrative review investigated the efficacy and effectiveness of nabiximols oromucosal spray for moderate to severe MS spasticity by examining spasticity 010 Numerical Rating Scale (NRS) data from interventional and observational studies which featured a 4-week trial period as per the European Union approved label. Summary: Across both study types, clinically relevant and statistically significant reductions in mean MS spasticity 0-10 NRS scores were measured soon after treatment start and were maintained in the mid to long term in treatment responders. Initial responder rates (≥ 20% NRS improvement from baseline at week 4) ranged from 47.6% to 81.4%, tending lower in the randomized clinical trials setting. Clinically relevant responder rates (≥ 30% NRS improvement from baseline at week 12) were similar between study types (range 3041%) except for one outlier (74% in an observational study). Two open studies reported treatment continuation for ≥ 18 months in approximately half of patients who initiated treatment. In most longer-term studies, symptomatic improvement in MS spasticity was maintained at mean daily dosages of about 67 sprays/day. Safety was consistent with the known profile of nabiximols. Key messages: Experimental and observational studies of nabiximols oromucosal spray recorded similar findings. About half to two-thirds of MS patients who begin treatment will perceive initial symptomatic relief of spasticity within the 4-week trial period. About 40% of patients who initiate treatment will reach the ≥ 30% NRS improvement threshold at 3 months, comprising the majority of patients who continue long-term treatment. A trial of therapy with nabiximols is useful to identify patients most likely to gain longer-term improvement in spasticity symptoms and discontinue those with insufficient benefit
Metodologie e sistemi informativi per la definizione e la gestione di interventi di recupero dell’edilizia storica del borgo La Martella a Matera
No full textThe use of ICT methodologies and tools is fundamental for the development of intervention strategies for building and urban recovery as well as for the enhancement of modern urban settlements, in particular those built in the immediate second post-war period of testimonial-historical value ; both for the construction of an appropriate knowledge of the current situation and as a support and aid to decisions in the definition, in particular, of the interventions on the building heritage of historical and testimonial value. The proposed intervention for the recovery of the historic building of the village La Martella in Matera, starting from a preliminary archive research, was developed through the construction of a geographical database in a GIS environment that allowed to organize the essential elements of knowledge and cataloging the different types of residential buildings and of the main existing public facilities, as well as their respective areas and relevant lots. The built information system provides a searchable, updatable and implementable database based on the objectives of protection, recovery and reuse of the historic buildings of the Borgo
CONOSCERE PER RICOSTRUIRE LA MEMORIA COLLETTIVA: L’ESPERIENZA DELL’UCCR MARCHE NELLA GESTIONE DELLE MACERIE DEI BENI CULTURALI NELLO SCENARIO POST-SISMA 2016
No full textThe vast Marche Region cultural heritage was deeply damaged by the 2016 seismic events. The MIBAC conducted a cataloguing campaign not only of the damage on the monuments but also of the rubbles derived from partial or total collapses of listed buildings. A widespread mapping of the rubble typology based on the architectural value and the construction material was performed for the first time. The aim of this contribution is to illustrate the new methodology developed by the UCCR-Marche for the post-earthquake management of the rubble intended as parts of a cultural asset from emergency to reconstruction. All this incessant activity that lasted more than two years saw the UCCR-Marche involved in the different phases from the rubble value acknowledgment to the selection up to their conservation. The flow of the vast amount of data was managed digitally through a geo-referenced DB by the UCCR and by the operators in charge in order to guarantee the geographical traceability of the rubble in the future. Now that the rubble of cultural heritage is being preserved it remains to be understood, case by case, how and if it should be reused to reconstruct the identity of wounded communities
UN "VUOTO URBANO" NELLA CITTA' DI REGGIO EMILIA RILIEVO E PROPOSTA DI RIUSO PER L'EX OSPEDALE PSICHIATRICO GIUDIZIARIO
Full text linkIl Patrimonio archeologico industriale e le trasformazioni del territorio: il caso dell'ex Fornace Dieci a Scauri (LT) tra conoscenza e restauro
No full textThe effect of L-dopa in Parkinson's disease as revealed by neurophysiological studies of motor and sensory functions
No full textNTRODUCTION:
This review will first discuss evidence of motor and sensory abnormalities as yielded by neurophysiological techniques in patients with PD. It will then go on to describe the effects of L-dopa replacement on motor and sensory abnormalities in PD as assessed by neurophysiological studies.
AREAS COVERED:
We analyzed papers in English using Pubmed with the following keywords: L-dopa, dopamine, bradykinesia, basal ganglia, kinematic analysis, TMS, motor cortex plasticity, motor cortex excitability, somatosensory discrimination threshold, pain Expert commentary: L-dopa improves the amplitude and speed of upper limb voluntary movements, but it does not restore abnormalities in the sequence effect or voluntary facial movements. L-dopa only partially normalizes changes in motor cortex excitability and plasticity and has also contrasting effects on the sensory system and on sensory-motor integration. The neurophysiological studies reviewed here show that PD is more than a hypo-dopaminergic disease, and non-dopaminergic mechanisms should also be considered
Bilateral spike-and-wave dicharges in a hemi-deafferented cortex
No full textWe studied a patient with a history of absence attacks in childhood in whom an absence status with bilateral spike-and-wave discharges developed after a top-of-the-basilar syndrome. Surprisingly, even though the ischemic lesion involved the left thalamus alone, spike-and-wave discharges were recorded from the two hemispheres. Three days after antiepileptic treatment (sodium valproate 500 mg 3 times a day) began, electroenceplalographic recordings and consciousness became normal. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
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