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Functional Neurology[JOURNAL]

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A novel neurocognitive rehabilitation tool in the recovery of hemiplegic hand grip after stroke: a case report.

Paolucci T, Capobianco SV, Vinciguerra SM … +3 more , Cilli M, Villani C, Saraceni VM

Funct Neurol · 2019 · PMID 31172940

Stroke has significant physical, psychological and social consequences. Recent rehabilitation approaches suggest that cognitive exercises with dual-task (sensory-motor) exercises positively influence the recovery and fun... Stroke has significant physical, psychological and social consequences. Recent rehabilitation approaches suggest that cognitive exercises with dual-task (sensory-motor) exercises positively influence the recovery and function of the hemiplegic hand grip. The purpose of this study was to describe a rehabilitation protocol involving the use of a new neurocognitive tool called "UOVO" for hand grip recovery after stroke. A 58-year-old right-handed male patient in the chronic stage of stroke, presenting with left-sided hemiparesis and marked motor deficits at the level of the left hand and forearm, was treated with the UOVO, a new rehabilitation instrument based on the neurocognitive rehabilitation theory of Perfetti. The patient was evaluated at T0 (before treatment), T1 (after treatment) and T2 (2 months of follow-up). At T2, the patient showed improvements of motor functions, shoulder, elbow and wrist spasticity, motility and performance. This case report explores the possibility of improving traditional rehabilitation through a neurocognitive approach with a dual-task paradigm (including motor and somato-sensory stimulation), specifically one involving the use of an original rehabilitation aid named UOVO, which lends itself very well to exercises proposed through the use of motor imagery. The results were encouraging and showed improvements in hemiplegic hand grip function and recovery. However, further studies, in the form of randomized controlled trials, will be needed to further explore and confirm our results.

Effectiveness of intensive neurorehabilitation in obese subacute stroke patients.

Ciancarelli I, Tonin P, Garo ML … +1 more , Tozzi Ciancarelli MG

Funct Neurol · 2019 · PMID 31172939

The relationship between abdominal subcutaneous adipose tissue thickness (aSAT), body fat percentage (BFP), waist-to-hip ratio (WHR) and body mass index (BMI) and outcome measures of neurological deficit and functional r... The relationship between abdominal subcutaneous adipose tissue thickness (aSAT), body fat percentage (BFP), waist-to-hip ratio (WHR) and body mass index (BMI) and outcome measures of neurological deficit and functional recovery was evaluated in obese subacute stroke patients before and after neurorehabilitation. Decreased National Institutes of Health Stroke Scale (p = 0.0001) and modified Rankin Scale (mRS) (p= 0.002) scores, as well as increased Barthel Index (p= 0.0001) scores were detected after neurorehabilitation. Decreased BMI, aSAT, BFP and WHR observed after neurorehabilitation did not penalize the overall functional recovery as shown by correlations between the clinical measure scores and fat mass indices. The correlation observed after neurorehabilitation between BMI and mRS (rho = 0.4526, p < 0.05) suggests that a high BMI may compromise functional recovery. Monitoring of body fat mass indices may provide information aimed at improving the disability of obese stroke patients.

Augmentative and alternative communication improves quality of life in the early stages of amyotrophic lateral sclerosis.

Maresca G, Pranio F, Naro A … +8 more , De Luca R, Maggio MG, Scarcella I, De Domenico C, Bramanti P, Conti Nibali V, Portaro S, Calabrò RS

Funct Neurol · 2019 · PMID 31172938

This study aimed to evaluate the efficacy of low-tech augmentative and alternative communication (AAC) aids in improving quality of life (QoL) and mood disorders, as well as the psychosocial impact of assistive devices,... This study aimed to evaluate the efficacy of low-tech augmentative and alternative communication (AAC) aids in improving quality of life (QoL) and mood disorders, as well as the psychosocial impact of assistive devices, in 10 patients affected by amyotrophic lateral sclerosis (ALS) in the early stage of the disease, when speech difficulties appear. The AACtraining (AAC-T) study lasted around six months and comprised two phases of three months each: AAC-intervention (AAC-I) followed by AAC-familiarization (AAC-F). All the patients were assessed at the beginning (T0) and at the end (T1) of AAC-I, as well as at the end of AAC-F (T2). During the AAC-I phase, we applied a three-phase AAC intervention model to evaluate intelligibility of language, participation patterns, communication needs and adaptation to the AAC tools. All the patients showed a gradual and significant improvement, especially in acceptance of the AAC aids, mood and QoL. Moreover, a reduction of caregiver burden was noted. Our study has demonstrated the utility of the AAC aids also in the early stages of the disease in patients with ALS presenting with dysarthria. In our opinion, AAC-T may act as a bridge between the initial and later phases of the disease, when patients need to use high-tech aids, including an eye-tracking communication device. In conclusion, in this study we highlighted how early AAC-T in patients with ALS may be a valuable tool to demonstrate how specific strategies and low-technology aids can improve QoL of these patients and their caregivers, also decreasing stress and depression.

Evaluation of the psychometric properties of the Barthel Index in an Italian ischemic stroke population in the acute phase: a cross-sectional study.

Galeoto G, Formica MC, Mercuri NB … +5 more , Santilli V, Berardi AC, Castiglia SF, Mollica R, Servadio A

Funct Neurol · 2019 · PMID 31172937

The objective of this study was to assess and validate the psychometric properties of the Italian culturally adapted Barthel Index (IcaBI) in a cohort of people with ischemic stroke. The validation process was conducted... The objective of this study was to assess and validate the psychometric properties of the Italian culturally adapted Barthel Index (IcaBI) in a cohort of people with ischemic stroke. The validation process was conducted in an Italian cohort of 99 stroke inpatients to whom the IcaBI was administered in order to test its structural validity, and inter-and intrarater reliability. The internal consistency (Cronbach's alpha) was 0.901. Factor analysis revealed a two-factor structure. The interclass correlation coefficient 3,1 (ICC) for intra-rater reliability was estimated at 0.987 (95% CI: 0.975-0.993), while the ICC for inter-rater reliability was 0.909 (95% CI: 0.852-0.948). This study demonstrates the psychometric properties of the IcaBI in an Italian stroke population, and therefore shows that the scale can be considered a valid and reliable assessment tool for measuring functional disability in Italian acute ischemic stroke survivors.

The role of Personal KinetiGraph™ fluctuator score in quantifying the progression of motor fluctuations in Parkinson's disease.

Tan EE, Hogg EJ, Tagliati M

Funct Neurol · 2019 · PMID 31172936

Motor fluctuations (MF) are important determinants of quality of life in Parkinson's disease (PD). To determine whether the Personal Kineti Graph (PKG), a wearable motion tracking device, can define MF progression, we co... Motor fluctuations (MF) are important determinants of quality of life in Parkinson's disease (PD). To determine whether the Personal Kineti Graph (PKG), a wearable motion tracking device, can define MF progression, we correlated PKG fluctuator scores (FS) with clinical motor fluctuator profiles in a case-control cohort study. 54 subjects completed a 6-day PKG trial and completed a standardized motor diary. We distinguished non-fluctuators (NF), early (EF), moderate (MF) and troublesome fluctuators (TF), based on Wearing Off Questionnaire and Movement Disorders Society-Unified Parkinson's Disease Rating Scale scores. PKG FS significantly differentiated EF and TF, as well as dyskinetic and non-dyskinetic subjects. Motor diaries could not distinguish the four study groups on the basis of average OFF time, while average time with dyskinesia distinguished NF and MF. In conclusion, PKG FS can distinguish EF from TF, as well as dyskinetic from non-dyskinetic patients, but cannot discriminate subtler MF. PKG may provide objective MF measures for routine PD management and clinical trials.

Hearing and cognitive impairment: a functional evaluation of associative brain areas in patients affected by Alzheimer's disease.

Chiaravalloti A, Fuccillo E, Martorana A … +4 more , Ricci M, Giacomini PG, Schillaci O, Di Girolamo S

Funct Neurol · 2019 · PMID 31172935

Auditory dysfunction observed in patients with cognitive diseases is probably due to the alteration of some brain areas involved in sound stimulus processing. The present study aimed to investigate differences in such pr... Auditory dysfunction observed in patients with cognitive diseases is probably due to the alteration of some brain areas involved in sound stimulus processing. The present study aimed to investigate differences in such processing and in connectivity of the primary auditory cortex in patients affected by Alzheimer's disease (AD) and in normal subjects. We examined 131 diagnosed AD patients and a control group (CG) of 36 normal subjects. After a complete clinical investigation, focused on hearing function, all subjects underwent a brain FDG PET/CT. AD subjects vs CG showed reduced glucose consumption in BA 6,7,8,39, whereas we did not find differences in the primary auditory cortex. In AD, connectivity analyses showed a positive correlation of the primary auditory cortex with BA 6,8,21,31,39,40,42 and a negative correlation with BA 19, cerebellum and basal ganglia. Our findings suggest that neurological evaluation of patients with hearing loss might allow earlier (preclinical) identification of those affected by cognitive impairment.

Visual-spatial training in patients with sub-acute stroke without neglect: a randomized, single-blind controlled trial.

Tramontano M, Dell'Uomo D, Cinnera AM … +6 more , Luciani C, Di Lorenzo C, Marcotulli M, Vona F, Mercuro A, Abbruzzese S

Funct Neurol · 2019 · PMID 31172934

Many people who have suffered a stroke will experience sensorimotor impairments that disrupt their performance of motor skills, including balance and gait. Furthermore, stroke-induced brain damage can Result in visual di... Many people who have suffered a stroke will experience sensorimotor impairments that disrupt their performance of motor skills, including balance and gait. Furthermore, stroke-induced brain damage can Result in visual disorders that may significantly impact performance of normal daily activities. The primary aim of this study was to investigate the effects, on balance, of visual-spatial training as an add-on intervention to conventional neurorehabilitation in patients with subacute stroke without neglect; secondarily, it aimed to assess the effects of this training on activities of daily living. Thirty inpatients (17 M, age: 57.3±12.9 years) with a diagnosis of subacute stroke (< 180 days) were enrolled in this study and randomized into two groups: the visual-spatial training group and a control group. All patients were evaluated, using the Tinetti Balance and Gait Scale (TBG), the Berg Balance Scale, computerized posturography, and the Barthel Index (BI), both before (T0) and after (T1) four weeks of training sessions. In addition to conventional neurorehabilitation, each group performed a total of twelve 20-minute rehabilitation sessions (3 times/week for 4 weeks). Significant TIME x GROUP interactions were recorded in the experimental group with respect to the control group for the TBG score [F (1,18) =15.59; p = 0.0004] and BI score [F (1,28) =6.35; p = 0.01]. Both groups recorded non-significant improvements on the instrumental postural assessment. These data suggest that visualspatial training as an add-on intervention to conventional neurorehabilitation could be an effective complementary strategy to improve balance and activities of daily living.

Robots for stroke rehabilitation: not all that glitters is gold.

Morone G

Funct Neurol · 2019 · PMID 31172933

Abstract loading — click title to view on PubMed.

The dawn of algometry: Paolo Mantegazza's research on pain.

Cani V

Funct Neurol · 2018 · PMID 30663972

By the 1860s, Paolo Mantegazza was a professor of general pathology at the University of Pavia, where he had graduated in medicine in 1854. There, he founded Italy's first laboratory of experimental pathology and did his... By the 1860s, Paolo Mantegazza was a professor of general pathology at the University of Pavia, where he had graduated in medicine in 1854. There, he founded Italy's first laboratory of experimental pathology and did his first research on pain, the subject of various communications presented to the Istituto Lombardo in Milan. In 1880, Mantegazza published Physiology of Pain, one of the several "physiologies" (of pleasure, of love, of hatred, of woman) that he wrote during his career. In this book, a testament to his scientific versatility, experimental observations supplemented his insights into hygienism and anthropology. This research on pain also led to a dispute between Mantegazza and Cesare Lombroso, which was the start of the two scientists' estrangement.

Cross-cultural adaptation and validation in the Italian population of the wolf motor function test in patients with stroke.

Berardi A, Dhrami L, Tofani M … +3 more , Valente D, Sansoni J, Galeoto G

Funct Neurol · 2018 · PMID 30663971

Motor impairments of the upper extremities affect approximately 60% of stroke patients. Rehabilitation is extremely important and can make it possible to identify which manual function is causing difficulty for the patie... Motor impairments of the upper extremities affect approximately 60% of stroke patients. Rehabilitation is extremely important and can make it possible to identify which manual function is causing difficulty for the patient and hindering daily activities. The Wolf Motor Function Test (WMFT) was recently highly recommended as one of several outcome measures that assess limitations of activities with a high level of psychometrics and clinical utility. The objective of this study was to translate and culturally adapt the WMFT for the Italian population (WMFT-IT) and examine its reliability and validity in Italian post-stroke adults with chronic hemiplegia or hemiparesis. The original scale was translated into Italian and culturally adapted in accordance with international guidelines. Its internal consistency and stability were examined using the Cronbach's alpha (α) coefficient and the intra-class correlation coefficient (ICC), respectively. Its concurrent validity was evaluated using the Pearson's correlation coefficient to compare the instrument with the Italian version of the Jebsen-Taylor Hand Function Test and the Disabilities of the Arm, Shoulder and Hand outcome measure. All WMFT-IT items were either identical or similar in meaning to the items in the original version. The WMFT-IT was administered to 24 subjects. Cronbach's α was 0.91 and 0.98 for the time and performance subscales respectively, and the ICC for test-retest reliability was 0.99. Pearson's correlation coefficients of the time subscale and the performance subscale both showed significant positive correlations (p <0.01). The WMFT-IT was found to be reliable and a valid outcome measure for assessing function and quality of movement of the upper extremities in post-stroke adults in the Italian population.

Is there a correlation between urological and cardiovascular dysfunction in Parkinson's disease?

Brusa L, Rocchi C, Ponzo V … +3 more , Stanzione P, Finazzi E, Attanasio A

Funct Neurol · 2018 · PMID 30663970

It is well established that non-motor symptoms are a core feature of Parkinson's disease (PD). A dysregulation of the autonomic nervous system seems to be present in PD, supporting the coexistence of urological and cardi... It is well established that non-motor symptoms are a core feature of Parkinson's disease (PD). A dysregulation of the autonomic nervous system seems to be present in PD, supporting the coexistence of urological and cardiovascular non-motor features. We evaluated whether bladder dysfunctions in patients with PD are linked to blood pressure dysregulation. Twenty-eight mild PD patients, previously submitted to a urodynamic evaluation, underwent 24-hour ambulatory blood pressure and heart rate monitoring to allow assessment of their circadian blood pressure profile; the occurrence of postprandial hypotension and orthostatic hypotension was also investigated. No significant differences in blood pressure control were detected between bladder hyperreflexic and normoreflexic subjects. Our findings support different origins of urological and cardiovascular impairments in PD.

TIA patients with higher ABCD3-I scores are prone to a higher incidence of intracranial stenosis, unstable carotid plaques and multiple-vessel involvement.

Yu Q, Miao W, Han J

Funct Neurol · 2018 · PMID 30663969

The ABCD3-I criteria have proved to be effective for use in regular clinical practice to assist in transient ischemic attack (TIA) risk stratification and treatment. In this prospective study we aimed to explore the rela... The ABCD3-I criteria have proved to be effective for use in regular clinical practice to assist in transient ischemic attack (TIA) risk stratification and treatment. In this prospective study we aimed to explore the relationships between risk stratification and arterial stenosis location, carotid plaque morphology and vessel involvement in 90 TIA patients, stratifying risk by ABCD3-I scores. Clinical variables such as total cholesterol, triglyceride, low-density lipoprotein cholesterol, glycosylated hemoglobin, homocysteine and high-sensitive C-reactive protein levels were recorded. The endpoint was subsequent stroke at seven-day follow-up. Ninety patients were divided into three risk groups on the basis of their ABCD3-I scores. The results revealed that patients with higher ABCD3-I scores showed a higher occurrence of intracranial stenosis (P < 0.05), less organized carotid plaques (P < 0.05) and multiple-vessel involvement (P < 0.05).

Is bupropion useful in the treatment of post-stroke thalamic apathy? A case report and considerations.

Aragona B, De Luca R, Piccolo A … +5 more , Le Cause M, Destro M, Casella C, Filoni S, Calabrò RS

Funct Neurol · 2018 · PMID 30663968

Post-stroke apathy is considered to be one of the clinical consequences of lesions affecting the structures of the prefrontal cortex, basal ganglia, thalamus and limbic system. However, there is no current consensus on t... Post-stroke apathy is considered to be one of the clinical consequences of lesions affecting the structures of the prefrontal cortex, basal ganglia, thalamus and limbic system. However, there is no current consensus on the treatment of post-stroke apathy, which mainly depends on the underlying etiology and comorbidities. A 62-year-old man, affected by hemorrhagic stroke in the left thalamus, presented with mood depression, anhedonia, hyporexia and marked apathy. The patient underwent clinical evaluation before and after receiving two different pharmacological therapies: escitalopram and bupropion. Only after treatment with the latter drug did the patient show changes: high motivation and willingness to pursue activities, greater interest in the external environment and social life activities, and an overall reduction of apathy. On the basis of our observations in this case, we hypothesize that the thalamic lesion resulted in disconnection of the fronto-striatal-thalamic circuits, and that loss of the dopaminergic striatal innervation caused the patient's apathetic state. The resolution of the apathetic disorder may be attributable to the action of the dopaminergic drug bupropion on the mesocortical pathway.

Automated mechanical peripheral stimulation and postural control in subjects with Parkinson's disease and freezing of gait: a randomized controlled trial.

Prusch JS, Kleiner AFR, Salazar AP … +4 more , Pinto C, Marchese RR, Galli M, Pagnussat AS

Funct Neurol · 2018 · PMID 30663967

Individuals with Parkinson's disease (PD) and freezing of gait (FOG) have impaired postural control. Recent studies using foot sensory stimulation delivered by means of automated mechanical peripheral stimulation (AMPS)... Individuals with Parkinson's disease (PD) and freezing of gait (FOG) have impaired postural control. Recent studies using foot sensory stimulation delivered by means of automated mechanical peripheral stimulation (AMPS) have demonstrated improvements of gait in individuals with PD. This study aimed to investigate the effects of AMPS on postural control in individuals with PD and FOG. Thirty-three subjects participated in this randomized controlled trial. Participants were allocated to two groups: AMPS and AMPS SHAM. Subjects underwent eight sessions of real (AMPS) or placebo AMPS (AMPS SHAM) once every three/four days. Postural control was assessed by means of posturography before the first and after the eighth session of treatment. We did not find positive effects of AMPS on center of pressure parameters. Thus, it seems that AMPS has no positive effect in terms of improving static postural control in individuals with PD and FOG.

From paper to informatics: the Post Soft Care-App, an easy-to-use and fast tool to help therapists identify unmet needs in stroke patients.

De Bartolo D, Morone G, Lupo A … +12 more , Aloise F, Baricich A, Di Francesco D, Calderone C, Cisari C, Verdecchia G, Sandrini G, Pistarini C, Antonucci G, Smania N, Paolucci S, Iosa M

Funct Neurol · 2018 · PMID 30663966

Even after rehabilitation, post stroke patients remain disabled. The Post Stroke Checklist (PSC) was developed to highlight unmet needs of community-dwelling stroke patients. The present study set out to validate Post So... Even after rehabilitation, post stroke patients remain disabled. The Post Stroke Checklist (PSC) was developed to highlight unmet needs of community-dwelling stroke patients. The present study set out to validate Post Soft Care-App, designed to administer the PSC using smartphones and tablets, in order to monitor unmet needs in chronic patients. Fifty-three patients and fifteen physiotherapists were enrolled. The therapists administered the PSC to patients using the app, and then completed a structured questionnaire on its usability and utility. The Post Soft Care-App highlighted the following unmet needs: increased spasticity (56.6%), reduced independence in activities of daily living (47.2%), reduced mobility (45.3%), absence of secondary prevention (45.3%). Therapists positively evaluated Post Soft Care-App as useful, practical, quick to complete (96.2%), and effective in helping improve communication with patients (75.5%). The Post Soft Care-App can be considered a valid assessment tool for helping therapists to monitor functional outcomes in chronic patients.

Multiple sclerosis and non-dystrophic myotonias: do they share a common pathophysiology?

Portaro S, Naro A, Russo M … +6 more , Bramanti P, Lauria P, D'Aleo G, La Rosa G, Bramanti A, Calabrò RS

Funct Neurol · 2018 · PMID 30663965

Some patients with multiple sclerosis (MS) complain of symptoms, such as myokymia, myotonia, spasms, and stiffness, which have been demonstrated to be due to a concurrent non-dystrophic myotonia, i.e. myotonia congenita... Some patients with multiple sclerosis (MS) complain of symptoms, such as myokymia, myotonia, spasms, and stiffness, which have been demonstrated to be due to a concurrent non-dystrophic myotonia, i.e. myotonia congenita or paramyotonia congenita. Beyond the known casual association between MS and non-dystrophic myotonia, a channelopathy representing a primary trait of MS rather than an epiphenomenon of demyelization (i.e., an acquired channelopathy) may exist. Indeed, the finding of MS patients with no genetic evidence of non-dystrophic myotonia but showing a clinical picture resembling this condition would support this hypothesis. Thirty patients with MS and no concurrent diagnosis of myotonia congenita or paramyotonia congenita were submitted to the Fournier protocol. Some of these MS patients presented abnormal muscle excitability with scarce myotonic discharges, but only a few of them had clinical features compatible with myotonia congenita or paramyotonia congenita syndromes. Even though the low number of recruited patients did not allow a robust statistical analysis, our data seemed to indicate the presence of an ion channel dysfunction that is independent of the acquired channelopathies and likely represents a common pathophysiological mechanism underlying a unique channelopathy simultaneously involving the peripheral and the central nervous system in individuals with MS. Confirming the presence of such a primary channelopathy in MS patients is of non-negligible importance, since dysfunction of ion channels may represent a suitable therapeutic target in MS.

Recovery of circadian melatonin rhythm after a melatonin holiday in daytime haemodialysis patients on long-term exogenous melatonin.

Sparla S, Koch B C, Bosma R … +1 more , Nagtegaal E

Funct Neurol · 2018 · PMID 30663964

The effects of exogenous melatonin on sleep diminish after its long-term use in haemodialysis patients. Our aim was to determine whether melatonin levels accumulate after chronic (at least three months) use of exogenous... The effects of exogenous melatonin on sleep diminish after its long-term use in haemodialysis patients. Our aim was to determine whether melatonin levels accumulate after chronic (at least three months) use of exogenous melatonin, 5 mg daily, and whether discontinuation of this treatment improves endogenous melatonin production and improves the circadian sleep-wake rhythm. In this case series, stable haemodialysis patients discontinued their chronic exogenous melatonin usage for seven days and melatonin concentrations in saliva were analysed. The primary endpoint was recovery of a normal circadian melatonin rhythm. Secondary endpoints were the effects on melatonin pharmacokinetics and sleep parameters. At day three after discontinuation the normal circadian melatonin rhythm recovered in the two patients who discontinued the treatment for the full week. They also had an effective maximum trough level of melatonin. Discontinuing melatonin seems to result in recovery of the circadian rhythm, based on achievement of effective melatonin thresholds. Further research is necessary to investigate whether sleep parameters improve after a drug holiday.most appropriate treatment.

Clinical and neuroimaging spectrum of hyperglycemia-associated chorea-ballism: systematic review and exploratory analysis of case reports.

Gómez-Ochoa SA, Espín-Chico BB, Pinilla-Monsalve GD … +2 more , Kaas BM, Téllez-Mosquera LE

Funct Neurol · 2018 · PMID 30663963

Hyperglycemia-associated chorea-ballism (HCB) is an infrequent neurological syndrome occurring predominantly in elderly females and in the setting of non-ketotic hyperglycemia (NKH). A systematic review was conducted in... Hyperglycemia-associated chorea-ballism (HCB) is an infrequent neurological syndrome occurring predominantly in elderly females and in the setting of non-ketotic hyperglycemia (NKH). A systematic review was conducted in accordance with the PRISMA statement. Studies published between 1980 and 2018 that reported demographic, clinical, laboratory and imaging features from patients with HCB were screened. 136 studies describing 286 patients were included in the analysis. The patients included had a median age of 72 years; those with ketotic hyperglycemia (KH) were older (p<0.001). Women and NKH patients were the most frequently affected (63% and 92%, respectively). The median glucose level at admission was 420 mg/dL (IQR 328-535), and was significantly higher in KH (p=0.009). Moreover, the absence of a clear lesion on imaging studies and the finding of bilateral imaging evidence of lesions were each more frequent in the KH group (p=0.036 and p=0.008, respectively). 48 cases (19.4%) presented with bilateral CT/MRI lesions, having higher values of plasma osmolarity compared with the patients with unilateral lesions (p=0.011). Every patient received hypoglycemic treatment, but only 174 (60.84%) were prescribed neuroleptics. 213 patients (84.86%) showed a total recovery, after a median of 14 days (IQR 3-31). Bilateral chorea-ballism was supported by bilateral imaging evidence of involvement in only 60% of the cases (positive predictive value). Patients not prescribed neuroleptics, with negative lentiform nucleus involvement, and age within the third tertile (≥ 78 years) had an odds ratio of 6.6 (CI 95% 1.18-141.10) for a complete clinical recovery. Significant differences were identified between types of hyperglycemia and regarding the clinical and imaging laterality features. Furthermore, the predictor variables evaluated showed potential utility for assessing the prognosis of HCB patients.

Music and neurorehabilitation: Yes, we can!

Raglio A

Funct Neurol · 2018 · PMID 30663962

Abstract loading — click title to view on PubMed.

Shaping a pain-free future for cluster headache patients. The Declaration of Paris.

Rossi P, Bruce S, De Pascual MA … +3 more , Muller H, Tyminski EK, De La Torre ER

Funct Neurol · 2018 · PMID 30457971

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