Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

Cosmology with the Laser Interferometer Space Antenna

254 pags:, 44 figs.The Laser Interferometer Space Antenna (LISA) has two scientific objectives of cosmological focus: to probe the expansion rate of the universe, and to understand stochastic gravitational-wave backgrounds and their implications for early universe and particle physics, from the MeV to the Planck scale. However, the range of potential cosmological applications of gravitational-wave observations extends well beyond these two objectives. This publication presents a summary of the state of the art in LISA cosmology, theory and methods, and identifies new opportunities to use gravitational-wave observations by LISA to probe the universe.This work is partly supported by: A.G. Leventis Foundation; Academy of Finland Grants 328958 and 345070; Alexander S. Onassis Foundation, Scholarship ID: FZO 059-1/2018-2019; Amaldi Research Center funded by the MIUR program “Dipartimento di Eccellenza” (CUP: B81I18001170001); ASI Grants No. 2016-24-H.0 and No. 2016-24-H.1-2018; Atracción de Talento Grant 2019-T1/TIC-15784; Atracción de Talento contract no. 2019-T1/TIC-13177 granted by the Comunidad de Madrid; Ayuda ‘Beatriz Galindo Senior’ by the Spanish ‘Ministerio de Universidades’, Grant BG20/00228; Basque Government Grant (IT-979-16); Belgian Francqui Foundation; Centre national d’Etudes spatiales; Ben Gurion University Kreitman Fellowship, and the Israel Academy of Sciences and Humanities (IASH) & Council for Higher Education (CHE) Excellence Fellowship Program for International Postdoctoral Researchers; Centro de Excelencia Severo Ochoa Program SEV-2016-0597; CERCA program of the Generalitat de Catalunya; Cluster of Excellence “Precision Physics, Fundamental Interactions, and Structure of Matter” (PRISMA? EXC 2118/1); Comunidad de Madrid, Contrato de Atracción de Talento 2017-T1/TIC-5520; Czech Science Foundation GAČR, Grant No. 21-16583M; Delta ITP consortium; Department of Energy under Grant No. DE-SC0008541, DE-SC0009919 and DESC0019195; Deutsche Forschungsgemeinschaft (DFG), Project ID 438947057; Deutsche Forschungsgemeinschaft under Germany’s Excellence Strategy - EXC 2121 Quantum Universe - 390833306; European Structural and Investment Funds and the Czech Ministry of Education, Youth and Sports (Project CoGraDS - CZ.02.1.01/0.0/0.0/15 003/0000437); European Union’s H2020 ERC Consolidator Grant “GRavity from Astrophysical to Microscopic Scales” (Grant No. GRAMS-815673); European Union’s H2020 ERC, Starting Grant Agreement No. DarkGRA-757480; European Union’s Horizon 2020 programme under the Marie Sklodowska-Curie Grant Agreement 860881 (ITN HIDDeN); European Union’s Horizon 2020 Research and Innovation Programme Grant No. 796961, “AxiBAU” (K.S.); European Union’s Horizon 2020 Research Council grant 724659 MassiveCosmo ERC-2016-COG; FCT through national funds (PTDC/FIS-PAR/31938/2017) and through project “BEYLA – BEYond LAmbda” with Ref. Number PTDC/FIS-AST/0054/2021; FEDER-Fundo Europeu de Desenvolvimento Regional through COMPETE2020 - Programa Operacional Competitividade e Internacionalização (POCI-01-0145- FEDER-031938) and research Grants UIDB/04434/2020 and UIDP/04434/2020; Fondation CFM pour la Recherche in France; Foundation for Education and European Culture in Greece; French ANR project MMUniverse (ANR-19-CE31-0020); FRIA Grant No.1.E.070.19F of the Belgian Fund for Research, F.R. S.-FNRS Fundação para a Ciência e a Tecnologia (FCT) through Contract No. DL 57/2016/CP1364/ CT0001; Fundação para a Ciência e a Tecnologia (FCT) through Grants UIDB/04434/2020, UIDP/04434/ 2020, PTDC/FIS-OUT/29048/2017, CERN/FIS-PAR/0037/2019 and “CosmoTests – Cosmological tests of gravity theories beyond General Relativity” CEECIND/00017/2018; Generalitat Valenciana Grant PROMETEO/2021/083; Grant No. 758792, project GEODESI; Government of Canada through the Department of Innovation, Science and Economic Development and Province of Ontario through the Ministry of Colleges and Universities; Grants-in-Aid for JSPS Overseas Research Fellow (No. 201960698); I?D Grant PID2020-118159GB-C41 of the Spanish Ministry of Science and Innovation; INFN iniziativa specifica TEONGRAV; Israel Science Foundation (Grant No. 2562/20); Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Nos. 20H01899 and 20H05853; IFT Centro de Excelencia Severo Ochoa Grant SEV-2; Kavli Foundation and its founder Fred Kavli; Minerva Foundation; Ministerio de Ciencia e Innovacion Grant PID2020-113644GB-I00; NASA Grant 80NSSC19K0318; NASA Hubble Fellowship grants No. HST-HF2-51452.001-A awarded by the Space Telescope Science Institute with NASA contract NAS5-26555; Netherlands Organisation for Science and Research (NWO) Grant Number 680-91-119; new faculty seed start-up grant of the Indian Institute of Science, Bangalore, the Core Research Grant CRG/2018/002200 of the Science and Engineering; NSF Grants PHY-1820675, PHY-2006645 and PHY-2011997; Polish National Science Center Grant 2018/31/D/ ST2/02048; Polish National Agency for Academic Exchange within the Polish Returns Programme under Agreement PPN/PPO/2020/1/00013/U/00001; Pró-Reitoria de Pesquisa of Universidade Federal de Minas Gerais (UFMG) under Grant No. 28359; Ramón y Cajal Fellowship contract RYC-2017-23493; Research Project PGC2018-094773-B-C32 [MINECO-FEDER]; Research Project PGC2018-094773-B-C32 [MINECO-FEDER]; ROMFORSK Grant Project. No. 302640; Royal Society Grant URF/R1/180009 and ERC StG 949572: SHADE; Shota Rustaveli National Science Foundation (SRNSF) of Georgia (Grant FR/18-1462); Simons Foundation/SFARI 560536; SNSF Ambizione grant; SNSF professorship Grant (No. 170547); Spanish MINECO’s “Centro de Excelencia Severo Ochoa” Programme Grants SEV-2016- 0597 and PID2019-110058GB-C22; Spanish Ministry MCIU/AEI/FEDER Grant (PGC2018-094626-BC21); Spanish Ministry of Science and Innovation (PID2020-115845GB-I00/AEI/10.13039/ 501100011033); Spanish Proyectos de I?D via Grant PGC2018-096646-A-I00; STFC Consolidated Grant ST/T000732/1; STFC Consolidated Grants ST/P000762/1 and ST/T000791/1; STFC Grant ST/ S000550/1; STFC Grant ST/T000813/1; STFC Grants ST/P000762/1 and ST/T000791/1; STFC under the research Grant ST/P000258/1; Swiss National Science Foundation (SNSF), project The Non-Gaussian Universe and Cosmological Symmetries, Project Number: 200020-178787; Swiss National Science Foundation Professorship Grants No. 170547 and No. 191957; SwissMap National Center for Competence in Research; “The Dark Universe: A Synergic Multi-messenger Approach” Number 2017X7X85K under the MIUR program PRIN 2017; UK Space Agency; UKSA Flagship Project, Euclid.Peer reviewe

Erratum to: Sarcopenia and sarcopenic obesity in comparison: prevalence, metabolic profile, and key differences. A cross-sectional study in Italian hospitalized elderly

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Preoperative Direct Puncture Embolization of Castleman Disease of the Parotid Gland: A Case Report

Background: Castleman disease (CD) is an uncommon benign lymphoproliferative disease characterized by hypervascular lymphoid hyperplasia. We present a unique case of unicentric CD of the parotid gland treated by preoperative direct puncture embolization. Case presentation: A 27-year-old female patient was admitted for a right neck mass. Ultrasound examination and MRI scan documented a hypervascular mass within the right parotid gland. Preoperative embolization was performed by direct puncture technique: a needle was inserted into the core of the mass under both ultrasound and fluoroscopic guidance and SQUID 12 was injected into the mass under fluoroscopic control, achieving a total devascularization. Conclusion: Preoperative direct puncture embolization was safe and effective and provides excellent hemostatic control during the surgical operation, limiting the amount of intraoperative bleeding

Cortical metabolic deficits in a rat model of cholinergic basal forebrain degeneration.

Evidence indicates that the degeneration of basal forebrain cholinergic neurons may represent an important factor underlying the progressive cognitive decline characterizing Alzheimer's disease (AD). However, the nature of the relationship between cholinergic depletion and AD is not fully elucidated. This study aimed at clarifying some aspects of the relation existing between deficits in cerebral energy metabolism and degeneration of cholinergic system in AD, by investigating the neuronal metabolic activity of several cortical areas after depletion of basal forebrain cholinergic neurons. In cholinergically depleted rats, we evaluated the neuronal metabolic activity by assaying cytochrome oxidase (CO) activity in frontal, parietal and posterior parietal cortices at four different time-points after unilateral injection of 192 IgG-saporin in the nucleus basalis magnocellularis. Unilateral depletion of cholinergic cells in the basal forebrain induced a bilateral decrease of metabolic activity in all the analyzed areas. Frontal and parietal cortices showed decreased metabolic activity even 3 days after the lesion, when the cholinergic degeneration was still incomplete. In posterior parietal cortex metabolic activity decreased only 7 days after the lesion. The possible molecular mechanisms underlying these findings were also investigated. Real-time PCR showed an increase of CO mRNA levels at 3, 7 and 15 days after the lesion both in frontal and parietal cortices, followed by normalization at 30 days. Western Blot analysis did not show any change in CO protein levels at any time-point after the lesion. Our findings support a link between metabolic deficit and cholinergic hypofunctionality characterizing AD pathology. The present model of cholinergic hypofunctionality provides a useful means to study the complex mechanisms linking two fundamental and interrelated phenomena characterizing AD from the early stages

Degenerative Disc Disease of the Spine: From Anatomy to Pathophysiology and Radiological Appearance, with Morphological and Functional Considerations

Degenerative disc disease is a common manifestation in routine imaging of the spine; this finding is partly attributable to physiological aging and partly to a pathological condition, and sometimes this distinction is simply not clear. In this review, we start focusing on disc anatomy and pathophysiology and try to correlate them with radiological aspects. Furthermore, there is a special focus on degenerative disc disease terminology, and, finally, some considerations regarding disc morphology and its specific function, as well as the way in which these aspects change in degenerative disease. Radiologists, clinicians and spine surgeons should be familiar with these aspects since they have an impact on everyday clinical practice

Emergency department accesses for diabetes-related complications during COVID-19 pandemic in people with type 2 diabetes and depression

Introduction Mental disorders are leading causes of the global health-related burden. In 2020, COVID -19 pandemic has created an environment where many determinants of poor mental health exacerbated. Scientific literature has highlighted that people with diabetes are at higher risk of developing depression than the general population and that depression interferes with the course of diabetes. In fact, depression in type 2 diabetes mellitus (T2DM) increases the risk of developing acute and long-term complications. The aim is to evaluate whether depression in people with type 2 diabetes increases the number of Emergency Department (ED) accesses for acute and long-term diabetes-related complications during COVID-19 pandemic. Methods In this observational cohort study, data were retrospectively retrieved from the health administrative databases of the Local Health Authority of Romagna (about 1.1 million residents), in particular we used: Hospital Discharge Records and Pharmaceutical Prescriptions databases to identify T2DM patients; Mental Health Information System, Residential Mental Health care, HDR and PP databases to identify patients with depression. Prevalent cases of T2DM at 15/02/2020 were identified among individuals aged 18 years or older, residing in the LHA of Romagna, if they had in the preceding year at least one HDR claim with a primary or secondary diagnosis of diabetes (ICD-9-CM code: 250.xx), or at least two distinct prescriptions of Glucose-Lowering Medication (GLM) (ATC code: A10). The presence of depression was defined as at least one prescription of antidepressant drugs (ATC code: N06A), or at least one hospitalization/outpatients service with a primary or secondary diagnosis of depression (ICD-9-CM code: 296.2x, 296.3x, 296.9x, 300.4x, 309.0x, 309.1x, 311.xx) in the 10 preceding years. Therefore, patients were distinguished between T2DM with depression (T2DM-Dep) and without depression (T2DM-NoDep). The cohort was followed up over the next 12 months (until death or 15/02/2021, whichever came first) and the number of ED accesses for acute and long-term complications related to diabetes were investigated. With the same criteria, a prevalent cohort of T2DM at 15/02/2019 was identified to assess what was the impact of depression in a pre-pandemic period. The study was conducted according to the guidelines of the Declaration of Helsinki; the Ethics Committee of the Romagna Local Health Authority (C.E.R.O.M.) approved the study procedures (registration number: 9502/2020, 14.12.2020). This retrospective study was carried out in conformity with the regulations on data management with the Italian law on privacy (Legislation Decree 196/2003 amended by Legislation Decree 101/2018). Statistical analysis Demographic and clinical characteristics of T2DM-Dep and T2DM-NoDep 2020 prevalent cases were summarized using absolute frequencies and percentages. The impact of depression on the number of ED accesses was estimated with a multiple negative binomial regression model to calculate the incidence rate ratio (IRR) and its 95% confidence interval. The multiple model was adjusted for gender, age groups (18–39, 40–59, 60–74, > 74 years), drug therapy of the last 5 years (1 oral GLM, 2 or more oral GLM, insulin, insulin and oral GLM), number of comorbidities detected in the two previous years from prevalence date (0, 1, 2 or more comorbidities) and duration of diabetes (< 1, 1–4, 5–9, > 9 years). The number of comorbid conditions was determined for each patient using the Elixhauser algorithm. The significance level was set at p < 0.05. Statistical analyses were performed using IBM SPSS version 25.0 and Stata 15. Results At 15/02/2020 we found 61,887 prevalent cases of T2DM, 28.3% patients were in the T2DM-Dep group and 71.7% in the T2DM-NoDep group. During COVID-19 period 541 ED accesses were observed. T2DM-Dep patients had a higher rate of ED accesses for acute and long-term complications related to diabetes during COVID-19 pandemic compared to T2DM-NoDep patients (IRR = 1.47; 95% CI [1.18—1.83]), adjusted for gender, age groups, duration of T2DM, drug therapy of the last 5 years, and number of comorbidities. This significantly different rate of ED accesses was also observed in the prevalent cases of non-pandemic period (n = 60,618; total ED accesses = 659), in which T2DM-Dep patients had an IRR of 1.43 (95% CI [1.18–1.73]) compared to T2DM-NoDep patients, adjusted for clinical and demographic factors. The higher rate of ED accesses in T2DM-Dep group compared to T2DM-NoDep group was similar between COVID-19 period and the pre-pandemic period (group-period interaction term: IRR = 1.01; 95% CI [0.76–1.34]). Discussion The diagnosis of depression in type 2 diabetes is associated with a higher rate of ED accesses for acute and long-term complications, both during the COVID-19 pandemic and in the pre-pandemic period. Despite the overall decrease in ED access rate during the COVID-19 pandemic ( − 19.6% percentage variation compared to the preceding year) due to the restrictions, a clear difference in ED accesses was observed in patients with T2DM and depression compared to patients with T2DM without depression. This is consistent with evidence on the impact of depression on short-term complications in people with type 2 diabetes and depression. Since COVID-19 is associated with poor mental health, the special health needs of patients with diabetes and depression should be taken into account

Probing anisotropies of the Stochastic Gravitational Wave Background with LISA

We investigate the sensitivity of the Laser Interferometer Space Antenna (LISA) to the anisotropies of the Stochastic Gravitational Wave Background (SGWB). We first discuss the main astrophysical and cosmological sources of SGWB which are characterized by anisotropies in the GW energy density, and we build a Signal-to-Noise estimator to quantify the sensitivity of LISA to different multipoles. We then perform a Fisher matrix analysis of the prospects of detectability of anisotropic features with LISA for individual multipoles, focusing on a SGWB with a power-law frequency profile. We compute the noise angular spectrum taking into account the specific scan strategy of the LISA detector. We analyze the case of the kinematic dipole and quadrupole generated by Doppler boosting an isotropic SGWB. We find that β ΩGW ∼ 2 × 10-11 is required to observe a dipolar signal with LISA. The detector response to the quadrupole has a factor ∼ 103 β relative to that of the dipole. The characterization of the anisotropies, both from a theoretical perspective and from a map-making point of view, allows us to extract information that can be used to understand the origin of the SGWB, and to discriminate among distinct superimposed SGWB sources

Probing anisotropies of the Stochastic Gravitational Wave Background with LISA

We investigate the sensitivity of the Laser Interferometer Space Antenna (LISA) to the anisotropies of the Stochastic Gravitational Wave Background (SGWB). We first discuss the main astrophysical and cosmological sources of SGWB which are characterized by anisotropies in the GW energy density, and we build a Signal-to-Noise estimator to quantify the sensitivity of LISA to different multipoles. We then perform a Fisher matrix analysis of the prospects of detectability of anisotropic features with LISA for individual multipoles, focusing on a SGWB with a power-law frequency profile. We compute the noise angular spectrum taking into account the specific scan strategy of the LISA detector. We analyze the case of the kinematic dipole and quadrupole generated by Doppler boosting an isotropic SGWB. We find that β ΩGW ∼ 2 × 10-11 is required to observe a dipolar signal with LISA. The detector response to the quadrupole has a factor ∼ 103 β relative to that of the dipole. The characterization of the anisotropies, both from a theoretical perspective and from a map-making point of view, allows us to extract information that can be used to understand the origin of the SGWB, and to discriminate among distinct superimposed SGWB sources