alfonso giordano
@unicampania.it
I neurologia
AoU Vanvitelli
RESEARCH INTERESTS
Parkinson disease,epilepsy
Scopus Publications
Scopus Publications
Roberta Roberti, Gianfranco Di Gennaro, Francesca Anzellotti, Dario Arnaldi, Vincenzo Belcastro, Simone Beretta, Giovanni Boero, Paolo Bonanni, Laura Canafoglia, Alfredo D'Aniello,et al.
Wiley
AbstractObjectiveThere are few comparative data on the third‐generation antiseizure medications (ASMs). We aimed to assess and compare the effectiveness of brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were compared as secondary objectives.MethodsThis multicenter, retrospective study collected data from 22 Italian neurology/epilepsy centers. All adult PWE who started add‐on treatment with one of the studied ASMs between January 2018 and October 2021 were included. Retention rate was established as effectiveness measure and described using Kaplan–Meier curves and the best fitting survival model. The responder status and the occurrence of adverse events (AEs) were used to evaluate efficacy and safety, respectively. The odds of AEs and drug efficacy were estimated by two multilevel logistic models.ResultsA total of 960 patients (52.92% females, median age = 43 years) met the inclusion criteria. They mainly suffered from structural epilepsy (52.29%) with monthly (46.2%) focal seizures (69.58%). Compared with LCM, all the studied ASMs had a higher dropout risk, statistically significant in the BRV levetiracetam (LEV)‐naïve (hazard ratio [HR] = 1.97, 95% confidence interval [CI] = 1.17–3.29) and PER groups (HR = 1.64, 95% CI = 1.06–2.55). Women were at higher risk of discontinuing ESL (HR = 5.33, 95% CI = 1.71–16.61), as well as PER‐treated patients with unknown epilepsy etiology versus those with structural etiology (HR = 1.74, 95% CI = 1.05–2.88). BRV with prior LEV therapy showed lower odds of efficacy (odds ratio [OR] = .08, 95% CI = .01–.48) versus LCM, whereas a higher efficacy was observed in women treated with BRV and LEV‐naïve (OR = 10.32, 95% CI = 1.55–68.78) versus men. PER (OR = 6.93, 95% CI = 3.32–14.44) and BRV in LEV‐naïve patients (OR = 6.80, 95% CI = 2.64–17.52) had a higher chance of AEs than LCM.SignificanceComparative evidence from real‐world studies may help clinicians to tailor treatments according to patients' demographic and clinical characteristics.
Mattia Siciliano, Benzi Kluger, Rosa De Micco, Carlo Chiorri, Valeria Sant'Elia, Marcello Silvestro, Alfonso Giordano, Gioacchino Tedeschi, Luca Passamonti, Luigi Trojano,et al.
Wiley
Although disabling fatigue is common in Parkinson disease (PD), available consensus‐based diagnostic criteria have not yet been empirically validated. The aim of this study was to evaluate the clinimetric properties of the criteria.
Rosa De Micco, Sara Satolli, Mattia Siciliano, Antonio De Mase, Alfonso Giordano, Gioacchino Tedeschi, and Alessandro Tessitore
Springer Science and Business Media LLC
Abstract Introduction Parkinson’s disease (PD) patients in chronic levodopa treatment may experience motor and non-motor fluctuations, which may affect their quality of life. Safinamide is a new monoamine oxidase B inhibitor, also exerting a non-dopaminergic effect, recently approved as add-on therapy in fluctuating PD patients. Methods We performed a longitudinal prospective study in a cohort of 20 fluctuating PD patients, to test whether safinamide 50 mg may improve non-motor, cognitive, and behavioral symptoms over a 6-month treatment period. At each timepoint, clinical features were assessed by means of validated PD-specific scales. Neuropsychological assessment was performed by exploring all five cognitive domains. Results Compared to baseline, significant improvement was found in PD patients at 6-month follow-up in items investigating interest (p = 0.02), motivation (p = 0.02), and urinary disturbances (p = 0.03). Moreover, neuropsychiatric assessment showed a significant decrease in fatigue and apathy scores (p = 0.02 and p = 0.01, respectively). Motor assessment revealed a significant reduction in the total wake-up time spent in OFF state (p = 0.01). Follow-up neuropsychological evaluation did not reveal any change compared to baseline. Conclusions Our data reveal that, along with motor fluctuation improvement, treatment with safinamide 50 mg may significantly decrease non-motor symptom burden in PD patients. Interestingly, non-dopaminergic mechanisms, such as glutamatergic overdrive, have been demonstrated to play a role in many pathways underlying these symptoms. Thus, we hypothesize that the neurotransmitter receptor-binding profile of safinamide may explain our findings.
Mattia Siciliano, Rosa De Micco, Lugi Trojano, Valeria Sant’Elia, Alfonso Giordano, Antonio Russo, Luca Passamonti, Gioacchino Tedeschi, Carlo Chiorri, and Alessandro Tessitore
Elsevier BV
Mattia Siciliano, Lugi Trojano, Rosa De Micco, Valeria Sant’Elia, Alfonso Giordano, Antonio Russo, Luca Passamonti, Gioacchino Tedeschi, Carlo Chiorri, and Alessandro Tessitore
Springer Science and Business Media LLC
Abstract Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p < 0.01). Logistic regression confirmed that FSS and BDI scores distinguished the “Underestimators” group from the others (p < 0.05). Linear regression analyses also indicated that FSS and BDI scores positively related to objective-subjective cognitive discrepancy (p < 0.01). “Overestimators” scored lower than other groups on the MoCA’s total score and attention and working memory subscores (p < 0.01). Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting.
Alfonso Giordano, Mattia Siciliano, Rosa De Micco, Valeria Sant'Elia, Antonio Russo, Gioacchino Tedeschi, and Alessandro Tessitore
Elsevier BV
Rosa De Micco, Sara Satolli, Mattia Siciliano, Federica Nardo, Giuseppina Caiazzo, Antonio Russo, Alfonso Giordano, Fabrizio Esposito, Gioacchino Tedeschi, and Alessandro Tessitore
Wiley
Anxiety symptoms are common in Parkinson's disease (PD). A link between anxiety and cognitive impairment in PD has been demonstrated.
Rosa De Micco, Mattia Siciliano, Valeria Sant'Elia, Alfonso Giordano, Antonio Russo, Gioacchino Tedeschi, and Alessandro Tessitore
Wiley
Following the severe consequences of the COVID‐19 outbreak, on March 9, 2020, the Italian government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. This resulted in a rapid and profound change of people's daily lives.
M. Siciliano, L. Trojano, R. De Micco, A. Giordano, A. Russo, G. Tedeschi, C. Chiorri, and A. Tessitore
Elsevier BV
Mattia Siciliano, Rosa De Micco, Alfonso Giordano, Federica Di Nardo, Antonio Russo, Giuseppina Caiazzo, Antonio De Mase, Mario Cirillo, Gioacchino Tedeschi, Luigi Trojano,et al.
Springer Science and Business Media LLC
Alessandro Tessitore, Antonio Russo, Rosa De Micco, Michele Fratello, Giuseppina Caiazzo, Alfonso Giordano, Mario Cirillo, Gioacchino Tedeschi, and Fabrizio Esposito
Wiley
Despite its clinical relevance, the pathophysiology of pain in Parkinson's disease (PD) is still largely unknown, and both central and peripheral mechanisms have been invoked.
Alessandro Tessitore, Rosa De Micco, Alfonso Giordano, Federica di Nardo, Giuseppina Caiazzo, Mattia Siciliano, Manuela De Stefano, Antonio Russo, Fabrizio Esposito, and Gioacchino Tedeschi
Wiley
Background: Impulse control disorders can be triggered by dopamine replacement therapies in patients with PD. Using resting‐state functional MRI, we investigated the intrinsic brain network connectivity at baseline in a cohort of drug‐naive PD patients who successively developed impulse control disorders over a 36‐month follow‐up period compared with patients who did not.
Alessandro Tessitore, Gabriella Santangelo, Rosa De Micco, Alfonso Giordano, Simona Raimo, Marianna Amboni, Fabrizio Esposito, Paolo Barone, Gioacchino Tedeschi, and Carmine Vitale
Elsevier BV
Antonio Russo, Fabrizio Esposito, Francesca Conte, Michele Fratello, Giuseppina Caiazzo, Laura Marcuccio, Alfonso Giordano, Gioacchino Tedeschi, and Alessandro Tessitore
SAGE Publications
Objective A prospective clinical imaging study has been conducted to investigate pain processing functional pathways during trigeminal heat stimulation (THS) in patients with migraine without aura experiencing ictal cutaneous allodynia (CA) (MwoA CA+). Methods Using whole-brain BOLD-fMRI, functional response to THS at three different intensities (41°, 51° and 53℃) was investigated interictally in 20 adult MwoA CA+ patients compared with 20 MwoA patients without ictal CA (MwoA CA−) and 20 healthy controls (HCs). Secondary analyses evaluated associations between BOLD signal change and clinical features of migraine. Results During moderate-noxious THS (51℃), we observed a significantly greater activation in (a) the anterior cingulate cortex in MwoA CA+ patients compared to HCs and (b) the middle frontal gyrus in MwoA CA+ patients compared to both MwoA CA− patients and HCs. Furthermore, during high-noxious THS (53℃) a significantly decreased activation in the secondary somatosensory cortices was observed in (a) MwoA CA− patients compared to both MwoA CA+ patients and HCs and (b) MwoA CA+ patients compared to HCs. CA severity was positively correlated with the secondary somatosensory cortices activation. Conclusions Our findings suggest that CA may be subtended by both a dysfunctional analgesic compensatory mechanism and an abnormal internal representation of pain in migraine patients.
Alessandro Tessitore, Alfonso Giordano, Rosa De Micco, Giuseppina Caiazzo, Antonio Russo, Mario Cirillo, Fabrizio Esposito, and Gioacchino Tedeschi
Wiley
Fatigue is a common problem in PD either in the early or later stage of the disease. Using resting‐state functional MRI, we investigated the functional correlates of fatigue in a cohort of “drug‐naïve” patients with PD.
Alessandro Tessitore, Gabriella Santangelo, Rosa De Micco, Carmine Vitale, Alfonso Giordano, Simona Raimo, Daniele Corbo, Marianna Amboni, Paolo Barone, and Gioacchino Tedeschi
Elsevier BV
Gioacchino Tedeschi, Antonio Russo, Francesca Conte, Daniele Corbo, Giuseppina Caiazzo, Alfonso Giordano, Renata Conforti, Fabrizio Esposito, and Alessandro Tessitore
SAGE Publications
Objective To evaluate the resting-state visual network functional connectivity in patients with migraine with aura and migraine without aura during the interictal period. Population and methods Using resting-state functional magnetic resonance imaging, the resting-state visual network integrity was investigated in 20 patients with migraine with aura, 20 age- and sex-matched patients with migraine without aura and 20 healthy controls. Voxel-based morphometry and diffusion tensor imaging were used to assess whether between-groups differences in functional connectivity were dependent on structural or microstructural changes. Results Resting-state functional magnetic resonance imaging data showed that patients with migraine with aura, compared to both patients with migraine without aura and healthy controls, had a significant increased functional connectivity in the right lingual gyrus within the resting-state visual network ( p < 0.05, cluster-level corrected). This abnormal resting-state visual network functional connectivity was observed in the absence of structural or microstructural abnormalities and was not related to migraine severity. Conclusions Our imaging data revealed that patients with migraine with aura exhibit an altered resting-state visual network connectivity. These results support the hypothesis of an extrastriate cortex involvement, centred in the lingual gyrus, a brain region related to mechanisms underlying the initiation and propagation of the migraine aura. This resting-state functional magnetic resonance imaging finding may represent a functional biomarker that could differentiate patients experiencing the aura phenomenon from patients with migraine without aura, even between migraine attacks.
Alessandro Tessitore, Alfonso Giordano, Antonio Russo, and Gioacchino Tedeschi
Elsevier BV
Antonio Russo, Alessandro Tessitore, Francesca Conte, Laura Marcuccio, Alfonso Giordano, and Gioacchino Tedeschi
Springer Science and Business Media LLC
Abstract Background Transcutaneous supraorbital neurostimulation (tSNS) has been recently found superior to sham stimulation for episodic migraine prevention in a randomized trial. We evaluated both the safety and efficacy of a brief period of tSNS in a group of patients with migraine without aura (MwoA). Methods We enrolled 24 consecutive patients with MwoA experiencing a low frequency of attacks, which had never taken migraine preventive drugs in the course of their life. Patients performed a high frequency tSNS and were considered “compliant” if they used the tSNS for ≥ 2/3 of the total time expected. For this reason, four patients were excluded from the final statistical analysis. Primary outcome measures were the reduction migraine attacks and migraine days per month (p < 0.05). Furthermore, we evaluated the percentage of patients having at least 50 % reduction of monthly migraine attacks and migraine days. Secondary outcome measures were the reduction of headache severity during migraine attacks and HIT-6 (Headache Impact Test) rating as well as in monthly intake of rescue medication (p < 0.05). Finally, compliance and satisfaction to treatment and potential adverse effects related to tSNS have been evaluated. Results Between run-in and second month of tSNS treatment, both primary and secondary endpoints were met. Indeed, we observed a statistically significant decrease in the frequency of migraine attacks (p < 0.001) and migraine days (p < 0.001) per month. We also demonstrated at least 50 % reduction of monthly migraine attacks and migraine days in respectively 81 and 75 % of patients. Furthermore, a statistically significant reduction in average of pain intensity during migraine attacks (p = 0.002) and HIT-6 rating (p < 0.001) and intake of rescue medication (p < 0.001) has been shown. All patients showed good compliance levels and no relevant adverse events. Conclusion In patients experiencing a low frequency of attacks, significant improvements in multiple migraine severity parameters were observed following a brief period of high frequency tSNS. Therefore, tSNS may be considered a valid option for the preventive treatment of migraine attacks in patients who cannot or are not willing to take daily medications, or in whom low migraine frequency and/or intensity would not require pharmacological preventive therapies.
Antonio Russo, Francesca Conte, Laura Marcuccio, Fabrizio Esposito, Alfonso Giordano, Manuela De Stefano, Mario Cirillo, Alessandro Tessitore, and Gioacchino Tedeschi
Springer Science and Business Media LLC
Antonio Russo, Fabrizio Esposito, Francesca Conte, Laura Marcuccio, Michele Fratello, Giuseppina Caiazzo, Alfonso Giordano, Renata Conforti, Alessandro Tessitore, and Gioacchino Tedeschi
Springer Science and Business Media LLC
Francesca Conte, Alfonso Giordano, Fabio Tortora, Giuseppina Caiazzo, Anna Ladogana, Gioacchino Tedeschi, and Alessandro Tessitore
Elsevier BV
Alessandro Tessitore, Antonio Russo, Francesca Conte, Alfonso Giordano, Manuela De Stefano, Luigi Lavorgna, Daniele Corbo, Giuseppina Caiazzo, Fabrizio Esposito, and Gioacchino Tedeschi
Wiley
To evaluate the executive control network connectivity integrity in patients with migraine with aura, in the interictal period, in comparison to patients with migraine without aura and healthy controls.
A. Giordano, G. Tedeschi, and A. Tessitore
Ovid Technologies (Wolters Kluwer Health)
A 75-year-old woman presented with a sudden onset of blurred vision and abnormal neck posture. Neurologic examination showed pseudo-retrocollis (RC) (figure 1), reduced by closing her eyes, and a right side visual field defect. CT scan showed a left temporo-occipital ischemic lesion and visual field campimetry revealed right superior homonymous quadrantanopia (sHQ) (figure 2, A and B).
Marianna Amboni, Alessandro Tessitore, Fabrizio Esposito, Gabriella Santangelo, Marina Picillo, Carmine Vitale, Alfonso Giordano, Roberto Erro, Rosa de Micco, Daniele Corbo,et al.
Springer Science and Business Media LLC