196,248 research outputs found
Study of functional cortical connectivity in patients affected by drug resistant epilepsy treated with vagal nerve stimulation.
No full textObjectives
To explore functional brain connectivity [namely Phase Lag Index (PLI), Clustering Coefficient (Cw) and Characteristic path length (Lw)] in patients affected by drug-resistant epilepsy (DRE) treated with vagal nerve stimulation (VNS) by means of high density EEG.
Materials
Seven patients (3 females, 4 males, 27-63 y) waiting for VNS implantation, with drug-resistant epilepsy, non-eligible for epilepsy surgery, good compliance to electroencephalographic (EEG) recordings and no psychiatric comorbidity were selected for this study.
Method
Patients underwent VNS surgery; scalp signals were recorded using a 64 channel EEG system and was performed before and 1 year (12-14 months) after the VNS surgery. Signals were acquired during a 40 min eyes-closed resting state, at a distance from seizures or post-ictal state. For each subject ten artifact-free epochs using average reference were selected for analysis, analyzed separately in four bands (alfa: 8-12 Hz; beta: 12-30 Hz; theta: 3-8 Hz; delta: 0,5-3 Hz) and exported. Phase Lag Index (PLI), Clustering Coefficient (Cw) and Characteristic path length (Lw) were derived using Brain-wave software. Cw and Lw value computed for every patient in every frequency band before and after VNS substitution were compared using Student's t-test. Each EEG was compared to the same patientâ€TMs recording performed before VNS surgery.
Results
Every band shows an upward trend for clustering coefficient and a downward trend for characteristic path length after the substitution with the exception of theta band which shows an opposite trend. Ratio between Cw or Lw value after and before VNS surgery wasnâ€TMt statistically significant for any of the rhythms examined (p value 0,0721 - 0,9287).
Discussion
The peculiar trend observed in theta band is a marker of reduced synchronization. Previous studies demonstrated that VNS induce gamma band desynchronization in temporal lobe drug-resistant epilepsy. Theta band is related to encoding of new information and episodic memory; hippocampal theta band closely correlates with Long-Term Potentiation process and neuronal plasticity. Therefore, the peculiar trend of theta band could be related (if confirmed by larger studies) to hippocampal neuronal plasticity.
Conclusions
This preliminary study paves the way for various hypotheses on the effects of VNS on neuronal plasticity.
It will be necessary to expand the study to a larger number of patients before first VNS implant in
order to value functional connectivity before and after VNS
Efficacy and safety of the 5-Hydroxytryptophan on Depression and Apathy in Idiopathic Parkinson's disease
No full textPicoAgri. Realization of a Low-cost, Remote Sensing Environment for Monitoring Agricultural Fields Through Small Satellites and Drones
No full textIn this paper, we analyze the accomplishment of a study for a low cost system, named PicoAgri, to monitor the status of agricultural fields. We here deal with the small detection system we are developing representing the first element to build the final PicoAgri concept: a system consisting of two elements, an array of small satellites coupled to drones. The array of CubeSat small satellites will provide data for an initial multispectral analysis with a resolution at ground of 30 m; when required a well localized area will be explored employing suitable drones capable of analyzing the territory with a resolution at least two orders of magnitude higher
Impatto su qualità della vita, tono dell’umore e deficit cognitivi della terapia VNS nell'epilessia farmacoresistente
No full textUso del Cannabidiolo in un paziente con multiple comorbidità
No full textRazionale e Obiettivi. Il cannabidiolo, i cui effetti antiepilettici sono ipotizzati da diversi anni, è approvato dal 2018 e 2019 da FDA ed EMA ed è efficace per il controllo delle crisi nei pazienti affetti da sindrome di Dravet, Sindrome Lennox-Gastaut e Sclerosi Tuberosa Complessa. Il suo meccanismo d’azione non è totalmente noto ma il suo metabolismo porta ad interagire con diversi farmaci antiepilettici, in particolare il Clobazam.1 Gli effetti avversi più comuni sono danno epatocellulare, sedazione, ideazione suicidaria, ipersensibilità.2
Metodi. Presentiamo il caso di un paziente di 27 anni affetto da Sindrome di Lennox-Gastaut (LGS); in anamnesi atresia tricuspidale con ventricolo unico, arresto cardiaco prolungato durante intervento cardiochirurgico alla nascita, deficit cognitivo, epatopatia. Presenta crisi polimorfe, toniche, atoniche con caduta, assenze atipiche resistenti a numerosi trials farmacologici (totale 90 crisi/mese); EEG caratteristico per LGS. In terapia: Carbamazepina, Clobazam. È stato introdotto gradualmente Cannabidiolo e, giunti a 12,5 mg/kg/die, è stato gradualmente ridotto il Clobazam. In considerazione della nota epatopatia, è stato effettuato uno stretto monitoraggio degli indici di funzionalità epatica ed ecografico in collaborazione con lo specialista epatologo.
Risultati. L’introduzione del cannabidiolo ha portato ad una riduzione del 45% della frequenza delle crisi; non sono stati registrati effetti avversi epatici né comportamentali.
Conclusioni. L’associazione di cannabidiolo e clobazam porta ad un aumentato effetto antiepilettico a costo tuttavia di aumentato rischio di effetti avversi3 che va attentamente valutato e monitorizzato nel singolo paziente. Uno stretto monitoraggio clinico e laboratoristico permette, tuttavia, l’utilizzo del Cannabidiolo anche in pazienti con diverse comorbidità
Treatment of Benign Essential Blepharospasm With Finasteride: A Case Report
No full textAbstract: We report the case of a 75-year-old man with a 35-year history of benign essential blepharospasm, which was poorly responsive to botulinum toxin. The patient had also developed Parkinson disease over the past 2 years. After his condition was diagnosed as benign prostatic hypertrophy, he started finasteride (FIN, 5 mg/d) treatment. During the following month, he experienced a significant attenuation of the severity of his dystonic symptoms; this improvement remained stable for the course of the therapy, with no notable adverse effect and no alterations of the symptoms of Parkinson disease. Discontinuation of FIN led to an abrupt exacerbation of symptoms, which was promptly reversed by resumption of the therapy. This case highlights the possibility that FIN may represent a useful therapeutic option in the treatment of certain clusters of benign essential blepharospasm
Efficacy and Safety of the 5-Hydroxytryptophan on REM Sleep Behavior Disorder in Parkinson's Disease
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