Studio di un prototipo di game interattivo per la riabilitazione motoria del parkinsoniano

Si descrive un prototipo di game interattivo per la riabilitazione cognitivo-motoria di soggetti affetti da malattia di Parkinso

Valutazione dell'attenzione selettiva in pazienti con sclerosi laterale amiotrofica mediante "eye tracking system"

Il grave deficit motorio impedisce in p. con SLA in fase avanzata, la somministrazione di test neuropsicologici carta e penna. Si presenta un sistema computerizzato alternativ

Micro-RNA carrying exosomes in motor neuron disease patients

Overexpression of miR-206 and miR-29 could delay the muscle weakness observed in ALS/MND patients, thus providing a potential therapeutic target

Blood inflammatory markers in motor neuron disease patients: pattern changes over time along disease progression

In ALS patients, we observed a direct correlation between the ALSFRS scores and the levels of some blood analytes (CD3, CD16, CD25, IL17, CD44, sTNF-R2, VCAM, Eselectin) and an inverse correlation with others (CD19,sIL6-R, sTNF-R1, TGF, IGF, PDGF, VEGF, P-selectin);whereas, in l-MND patients, a direct correlation was found with some analytes (CD19, IFNbeta), but an inverse one with others (EPO, IL6, sTNF-R1, PDGF, E and P selectins). We found that CD3, CD4, CD8, CD16, CD25, sIL6-R, IL5 and VCAM are differentially expressed in ALS and in l-MND patients. Conclusion: Our findings are useful as prognostic and diagnostic tools for ALS/MND patients. DOI: 10.1080/21678421.2017.1371525/001

Using blood data for the differential diagnosis and prognosis of motor neuron diseases: a new dataset for machine learning applications

Early differential diagnosis of several motor neuron diseases (MNDs) is extremely challenging due to the high number of overlapped symptoms. The routine clinical practice is based on clinical history and examination, usually accompanied by electrophysiological tests. However, although previous studies have demonstrated the involvement of altered metabolic pathways, biomarker-based monitoring tools are still far from being applied. In this study, we aim at characterizing and discriminating patients with involvement of both upper and lower motor neurons (i.e., amyotrophic lateral sclerosis (ALS) patients) from those with selective involvement of the lower motor neuron (LMND), by using blood data exclusively. To this end, in the last ten years, we built a database including 692 blood data and related clinical observations from 55 ALS and LMND patients. Each blood sample was described by 108 analytes. Starting from this outstanding number of features, we performed a characterization of the two groups of patients through statistical and classification analyses of blood data. Specifically, we implemented a support vector machine with recursive feature elimination (SVM-RFE) to automatically diagnose each patient into the ALS or LMND groups and to recognize whether they had a fast or slow disease progression. The classification strategy through the RFE algorithm also allowed us to reveal the most informative subset of blood analytes including novel potential biomarkers of MNDs. Our results show that we successfully devised subject-independent classifiers for the differential diagnosis and prognosis of ALS and LMND with remarkable average accuracy (up to 94%), using blood data exclusively

Retrospective observational study on the use of acetyl-l-carnitine in ALS

ALCAR (Acetyl-L-carnitine) is a donor of acetyl groups and increases the intracellular levels of carnitine, the primary transporter of fatty acids across the mitochondrial membranes. In vivo studies showed that ALCAR decrease oxidative stress markers and pro-inflammatory cytokines. In a previous double-blind placebo-controlled phase II trial showed positive effects on self-sufficiency (defined as a score of 3+ on the ALSFRS-R items for swallowing, cutting food and handling utensils, and walking) ALSFRS-R total score and FVC. We conducted an observational, retrospective, multicentre, case-control study to provide additional data on the effects of ALCAR in subjects with ALS in Italy. Subjects treated with ALCAR 1.5 g/day or 3 g/day were included and matched with not treated subjects by sex, age at diagnosis, site of onset, and time from diagnosis to baseline, (45 subjects per group). ALCAR 3 g/day vs not treated: 22 not treated subjects (48.9%) were still alive at 24 months after baseline, compared to 23 (51.1%) treated subjects (adj. OR 1.18, 95% CI 0.46-3.02). No statistically significant differences were detected in ALSFRS nor FVC nor self-sufficiency. ALCAR 1.5 g/day vs not treated: 22 not treated subjects (48.9%) were still alive at 24 months after baseline, compared to 32 (71.1%) treated subjects (adj. OR 0.27, 95% CI 0.10-0.71). For ALSFRS-R, a mean slope of - 1.0 was observed in treated subjects compared to - 1.4 in those not treated (p = 0.0575). No statistically significant difference was detected in the FVC nor self-sufficiency. Additional evidence should be provided to confirm the efficacy of the drug and provide a rationale for the dosage