Z-statistic images showing clusters of significantly increased RSFC (p < 0.05, cluster-level FWE corrected) after one session of effective AMPS of the primary sensory motor cortex (a), the nuclei striati (c) and the cerebellum (d), overlaid onto a MNI-registered anatomical 3D-T1 volume.

<p>Seed regions of interest are red-coloured in the panels on the left. MNI coordinates (x, y, z) of the maximal Z-scores are presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137977#pone.0137977.t002" target="_blank">Table 2</a>. Coronal and axial views follow the neurological convention.</p

Demographic and clinical parameters of patients with Parkinson’s disease before and after effective AMPS and sham stimulation.

<p>Acronyms: M: male; F: female; DD: disease duration; H&Y: Hoehn and Yahr; MMSE: Mini-Mental State Examination; Side: Symtom-dominant side; LEDD: L-dopa equivalent daily dose; UPDRS: Unified Parkinson’s Disease Rating Scale; PIGD: Postural Instability Gait Disturbances</p><p>^# Data from the total group of patients (n = 11)</p><p>* Data from the group of patients eligible for fMRI analysis (n = 7).</p><p>^a Tremor sub score represents the sum of the UPDRS items in OFF condition: 3.15, 3.16, 3.17 e 3.18.</p><p>^b PIGD subscore represents the sum of the UPDRS items in OFF condition: 3.9, 3.10, 3.11, 3.12, 3.13, 3.14.</p><p>^c Rigidity subscore represents the sum of the UPDRS items in OFF condition: 3.3.</p><p>Statistically significant P-values (p < 0.05) are presented in bold.</p><p>Demographic and clinical parameters of patients with Parkinson’s disease before and after effective AMPS and sham stimulation.</p

Z-statistic images showing clusters of significantly increased RSFC (p < 0.05, cluster-level FWE corrected) in the effective AMPS vs. sham stimulation for the nuclei striati (a) and the cerebellum (b).

<p>Seed regions of interest are red-coloured in the panels on the left. MNI coordinates (x, y, z) of the maximal Z-scores are presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137977#pone.0137977.t003" target="_blank">Table 3</a>. Coronal and axial views follow the neurological convention.</p

The device used for the AMPS treatment (a), the sites of feet stimulation (b), the effective AMPS (c), and the sham stimulation (d).

<p>The device used for the AMPS treatment (a), the sites of feet stimulation (b), the effective AMPS (c), and the sham stimulation (d).</p

AMPS_Pilot_MRI data

AMPS_Pilot_MRI dat

Flowchart of the experimental protocol of the pilot interventional study as approved by the local ethical committee.

<p>Flowchart of the experimental protocol of the pilot interventional study as approved by the local ethical committee.</p

Table_1_Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma.docx

IntroductionPituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor.MethodsWe present the case of a 58 years-old-man who reported a three-month history of polyuria-polydipsia syndrome, generalized asthenia, panhypopituitarism and bitemporal hemianopsia. Brain-MRI showed a voluminous pituitary mass causing posterior sellar enlargement and compression of the surrounding structures including pituitary stalk, optic chiasm, and optic nerves.ResultsThe patient underwent neurosurgical removal of the mass. Histological examination revealed a poorly differentiated adenocarcinoma of uncertain origin. A total body CT scan showed a mass in the left kidney that was subsequently removed. Histological features were consistent with a clear cell carcinoma. However, endoscopic examination of the digestive tract revealed an ulcerating and infiltrating adenocarcinoma of the gastric cardia. Total body PET/CT scan with 18F-FDG confirmed an isolated area of accumulation in the gastric cardia, with no hyperaccumulation at other sites.ConclusionTo the best of our knowledge, there are no reports of pituitary metastases from gastric cardia adenocarcinoma. Our patient presented with symptoms of sellar involvement and without evidence of other body metastases. Therefore, sudden onset of diabetes insipidus and visual deterioration should lead to the suspicion of a rapidly growing pituitary mass, which may be the presenting manifestation of a primary extracranial adenocarcinoma. Histological investigation of the pituitary mass can guide the diagnostic workup, which must however be complete.</p