Caloric vestibular stimulation reduces pain and somatoparaphrenia in a severe chronic central post-stroke pain patient: a case study

Central post-stroke pain is a neuropathic syndrome characterized by intolerable contralesional pain and, in rare cases, somatic delusions. To date, there is limited evidence for the effective treatments of this disease. Here we used caloric vestibular stimulation to reduce pain and somatoparaphrenia in a 57-year-old woman suffering from central post-stroke pain. Resting-state functional magnetic resonance imaging was used to assess the neurological effects of this treatment. Following vestibular stimulation we observed impressive improvements in motor skills, pain, and somatic delusions. In the functional connectivity study before the vestibular stimulation, we observed differences in the patient's left thalamus functional connectivity, with respect to the thalamus connectivity of a control group (N = 20), in the bilateral cingulate cortex and left insula. After the caloric stimulation, the left thalamus functional connectivity with these regions, which are known to be involved in the cortical response to pain, disappeared as in the control group. The beneficial use of vestibular stimulation in the reduction of pain and somatic delusion in a CPSP patient is now documented by behavioral and imaging data. This evidence can be applied to theoretical models of pain and body delusions

Automated and traceable processing for large-scale high-throughput sequencing facilities

Scaling up production in medium and large high-throughput sequencing facilities presents a number of challenges. As the rate of samples to process increases, manually performing and tracking the center’s operations becomes increasingly difficult, costly and error prone, while processing the massive amounts of data poses significant computational challenges. We present our ongoing work to automate and track all data-related procedures at the CRS4 Sequencing and Genotyping Platform, while integrating state-of-the-art processing technologies such as Hadoop, OMERO, iRODS, and Galaxy into our automated workflows. Currently, the core system is in its testing phase and it is on schedule to be in production use at CRS4 by May 2013. The results thus far obtained are encouraging and the authors are confident that the CRS4 Platform will increase its efficiency and capacity thanks to this system. In the near future, the integration components will be released as as open source software.23-24Pubblicat

Cohort profile: the Turin prostate cancer prognostication (TPCP) cohort

IntroductionProstate cancer (PCa) is the most frequent tumor among men in Europe and has both indolent and aggressive forms. There are several treatment options, the choice of which depends on multiple factors. To further improve current prognostication models, we established the Turin Prostate Cancer Prognostication (TPCP) cohort, an Italian retrospective biopsy cohort of patients with PCa and long-term follow-up. This work presents this new cohort with its main characteristics and the distributions of some of its core variables, along with its potential contributions to PCa research.MethodsThe TPCP cohort includes consecutive non-metastatic patients with first positive biopsy for PCa performed between 2008 and 2013 at the main hospital in Turin, Italy. The follow-up ended on December 31st 2021. The primary outcome is the occurrence of metastasis; death from PCa and overall mortality are the secondary outcomes. In addition to numerous clinical variables, the study’s prognostic variables include histopathologic information assigned by a centralized uropathology review using a digital pathology software system specialized for the study of PCa, tumor DNA methylation in candidate genes, and features extracted from digitized slide images via Deep Neural Networks.ResultsThe cohort includes 891 patients followed-up for a median time of 10 years. During this period, 97 patients had progression to metastatic disease and 301 died; of these, 56 died from PCa. In total, 65.3% of the cohort has a Gleason score less than or equal to 3 + 4, and 44.5% has a clinical stage cT1. Consistent with previous studies, age and clinical stage at diagnosis are important prognostic factors: the crude cumulative incidence of metastatic disease during the 14-years of follow-up increases from 9.1% among patients younger than 64 to 16.2% for patients in the age group of 75-84, and from 6.1% for cT1 stage to 27.9% in cT3 stage.DiscussionThis study stands to be an important resource for updating existing prognostic models for PCa on an Italian cohort. In addition, the integrated collection of multi-modal data will allow development and/or validation of new models including new histopathological, digital, and molecular markers, with the goal of better directing clinical decisions to manage patients with PCa

Right but not left angular gyrus modulates the metric component of the mental body representation: a tDCS study

The parietal lobes contribute to body-space representation. The present work aims at characterizing the functional role of the inferior parietal lobe in body-space representation and at studying the different roles of the angular gyrus in the right and left hemisphere. We conducted three separate transcranial direct current stimulation (tDCS) experiments using "tactile distance task" as an implicit measure of body representation. Whereas anodal tDCS on the right angular gyrus influences vocal reaction times (vRT) for stimuli delivered on the ipsilateral body parts without changes of accuracy, right tDCS improved both vRT and accuracy for tactile stimuli on the contralateral limbs. Sham or left parietal anodal tDCS had no effect. These evidences support the view that right parietal areas have a crucial role in the metric component of the body representation

MRI scan of patient SF and behavioral results before and after CVS.

<p>(A) T1–weighted sequence reveals subcortical lesions that were also present in a small portion of the left lateral thalamus. (B–E) The effects of CVS were determined for several symptoms including pain (B), motor function (C), somatoparaphrenia (D), and articulation (E). All the histograms refer to the patient’s subjective evaluation. In graphs B-C-D, the Y axis shows the level of impairment (0 = no impairment; 100 = totally impaired). In graph E Y axis = 0 excellent (no altered articulation characteristics), 1 slight disorder, 2 moderate disorder, 3 severe disorder]. In all panels, post–CVS (5’) refers to measurements collected immediately after CVS, and post–CVS (30’) refers to measurements collected 30 minutes after the CVS.</p

Functional connectivity of the left thalamus.

<p>(A–B) Comparison between the functional connectivity of the left thalamus between SF and a control group prior to CVS. Blue blobs = abnormally negative functional connectivity; Red blobs = abnormally positive connectivity. (C) Functional connectivity values (upper panel = negative and lower panel = positive) of the control group (black dots) and the patient (blue dot = Pre–CVS and green dot = Post–CVS). aCing = anterior cingulum; LG = lingual gyrus; PC = parietal cortex; pIns = posterior insula.</p

Neuropsychological test scores and performance on tactile acuity tests of S.F.

<p>Neuropsychological test scores and performance on tactile acuity tests of S.F.</p

Molecular-Biology-Driven Treatment for Metastatic Colorectal Cancer

Background: Metastatic CRC (mCRC) is a molecular heterogeneous disease. The aim of this review is to give an overview of molecular-driven treatment of mCRC patients. Methods: A review of clinical trials, retrospective studies and case reports was performed regarding molecular biomarkers with therapeutic implications. Results: RAS wild-type status was confirmed as being crucial for anti-epidermal growth factor receptor (EGFR) monoclonal antibodies and for rechallenge strategy. Antiangiogenic therapies improve survival in first- and second-line settings, irrespective of RAS status, while tyrosine kinase inhibitors (TKIs) remain promising in refractory mCRC. Promising results emerged from anti-HER2 drugs trials in HER2-positive mCRC. Target inhibitors were successful for BRAFV600E mutant mCRC patients, while immunotherapy was successful for microsatellite instability-high/defective mismatch repair (MSI-H/dMMR) or DNA polymerase epsilon catalytic subunit (POLE-1) mutant patients. Data are still lacking on NTRK, RET, MGMT, and TGF-&beta;, which require further research. Conclusion: Several molecular biomarkers have been identified for the tailored treatment of mCRC patients and multiple efforts are currently ongoing to increase the therapeutic options. In the era of precision medicine, molecular-biology-driven treatment is the key to impro patient selection and patient outcomes. Further research and large phase III trials are required to ameliorate the therapeutic management of these patients