Mirella Russo
@unich.it
Department of Neurosciences, Imaging and Clinical Sciences
"G. d'Annunzio" University of Chieti-Pescara
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Mirella Russo, Fedele Dono, Marco Onofrj, and Stefano L. Sensi
Wiley
AbstractBackgroundDamage to the insula has been associated with various types of cardiovascular dysfunction, including arrhythmias and blood pressure imbalances. Acute neuroendocrine disturbances following insular damage have also been described.Case PresentationA 50‐year‐old right‐handed man with a left insular ischemic lesion exhibited aphasia and right central VII nerve palsy. Five days after the stroke, the patient exhibited severe bradycardia and hypotension. He had been treated for ocular trauma with prednisone for the preceding 3 weeks. Cortisol and adrenocorticotropic hormone levels indicated secondary adrenal insufficiency. Despite adequate fluid intake, the patient's blood pressure dropped, requiring norepinephrine administration. Midodrine was also initiated, leading to clinical improvement. The therapy was gradually discontinued as vital signs normalized. By Day 24, electrocardiogram monitoring was unremarkable, hormonal levels normalized, and the neurological examination revealed only mild residual speech fluency impairment. Computed tomography scans confirmed a recovering ischemic lesion of the left insula.ConclusionsThis case reveals the inhibitory effect exerted by a left‐sided insular stroke on the autonomic system. It also highlights the still largely unexplored neuroendocrine complications of damage to this brain region.
P. Quintieri, R. Speranza, M. Russo, F. Dono, M. Onofrj, and S. L. Sensi
Springer Science and Business Media LLC
Marco Onofrj, Mirella Russo, Stefano Delli Pizzi, Danilo De Gregorio, Antonio Inserra, Gabriella Gobbi, and Stefano L. Sensi
Springer Science and Business Media LLC
AbstractThe PD-DLB psychosis complex found in Parkinson’s disease (PD) and Dementia with Lewy Bodies (DLB) includes hallucinations, Somatic Symptom/Functional Disorders, and delusions. These disorders exhibit similar presentation patterns and progression. Mechanisms at the root of these symptoms also share similarities with processes promoting altered states of consciousness found in Rapid Eye Movement sleep, psychiatric disorders, or the intake of psychedelic compounds. We propose that these mechanisms find a crucial driver and trigger in the dysregulated activity of high-order thalamic nuclei set in motion by ThalamoCortical Dysrhythmia (TCD). TCD generates the loss of finely tuned cortico-cortical modulations promoted by the thalamus and unleashes the aberrant activity of the Default Mode Network (DMN). TCD moves in parallel with altered thalamic filtering of external and internal information. The process produces an input overload to the cortex, thereby exacerbating DMN decoupling from task-positive networks. These phenomena alter the brain metastability, creating dreamlike, dissociative, or altered states of consciousness. In support of this hypothesis, mind-altering psychedelic drugs also modulate thalamic-cortical pathways. Understanding the pathophysiological background of these conditions provides a conceptual bridge between neurology and psychiatry, thereby helping to generate a promising and converging area of investigation and therapeutic efforts.
Fedele Dono, Stefano Consoli, Maria Tappatà, Giacomo Evangelista, Mirella Russo, Jacopo Lanzone, Valeria Pozzilli, Bruna Nucera, Fabrizio Rinaldi, Martina Di Pietro,et al.
Wiley
AbstractSeveral reports have described the autoimmune encephalitis' (AE) possible onset during pregnancy. In this systematic review, we summarize the available data on the diagnostic and therapeutic approach to AE during pregnancy, highlighting the associated maternal and fetal clinical outcomes. A systematic search of the literature was performed. The following databases were used: PubMed, Google Scholar, EMBASE, and CrossRef. The revision was registered on the PROSPERO platform (CRD42022336357). Forty‐nine patients were included. AE onset was mainly observed during the first and the second trimester of pregnancy with psychiatric manifestations and seizures as main onset symptoms. CSF analysis showed AE‐specific autoantibody positivity in 33 patients (anti‐NMDA receptor as the most frequent). EEG generally showed normal findings. MRI revealed pathological findings in less than half of patients. Tumor screening was positive in 14 cases. First‐line immunotherapy (single or combined) was generally employed while second line was administered in a minority of patients. Levetiracetam was the most used antiseizure medication. Cesarean section was performed in 18 women. Most of the women had an excellent early outcome after delivery but 22 showed persistent neurological deficits in long‐term follow‐up. Fetal outcome was positive in 33 cases, whereas 12 cases of fetal death were reported. A logistic regression showed that no variable significantly influenced the odds of good/bad maternal and fetal clinical outcome. Diagnosis and treatment of AE during pregnancy is challenging. The rate of miscarriage in women with AE seems to be higher than the general population. In addition, mothers may show long‐term neurological deficits.
Giovanna Scorrano, Mirella Russo, Giovanni Prezioso, Stefano L. Sensi, and Francesco Chiarelli
Springer Science and Business Media LLC
Gaetano Polito, Mirella Russo, Matteo Santilli, Cristina Cantarella, Carlo D'Aurizio, and Stefano L Sensi
BMJ
Bilateral thalamic stroke is a rare condition, mostly related to the presence of the artery of Percheron (AoP) variant. The clinical presentation of AoP-related strokes is remarkably heterogeneous and often includes cognitive and behavioural alterations. Our report describes the clinical course of an AoP-related bilateral thalamic stroke and highlights the pivotal role of a tailored rehabilitation programme plays in enhancing recovery. A man in his 40s was admitted to the neurology ward due to the abrupt onset of mental status alterations and weakness in his left limbs. The first brain CT scan and subsequent MRI exam revealed a bilateral thalamic stroke and the presence of an AoP anatomical variant. After the first critical phase, the patient’s condition became stable, but he still suffered from severe attention, memory and speech deficits. The patient was then transferred to the rehabilitation unit and was subjected to a tailored neurorehabilitation programme that allowed a complete recovery of the symptoms. Neurorehabilitation plays a pivotal role in the patient’s recovery and should always be pursued to minimise the residual deficits and, most importantly, to prevent permanent cognitive deficits.
Clarissa Corniello, Fedele Dono, Giacomo Evangelista, Stefano Consoli, Sibilla De Angelis, Sara Cipollone, Davide Liviello, Gaetano Polito, Sara Melchiorre, Mirella Russo,et al.
Elsevier BV
Giacomo Evangelista, Fedele Dono, Stefano Consoli, Jacopo Lanzone, Clarissa Corniello, Mirella Russo, Francesca Anzellotti, Marco Onofrj, Catello Vollono, and Stefano L. Sensi
Wiley
INTRODUCTION
Sudden Unexpected Death in Epilepsy (SUDEP) is a sudden, unexpected death in people with epilepsy, with or without evidence of an epileptic seizure. The pathophysiological mechanism underlying the SUDEP appears to be partly associated with an autonomic nervous system (ANS) dysfunction. Heart Rate Variability (HRV) analysis is a reliable non-invasive method for detecting fluctuations in the ANS. In this systematic review, we analyzed the data available in the literature on changes in HRV parameters in patients with SUDEP.
METHODS
We carried out a systematic search of the literature to identify the quantitative variations of HRV in epileptic patients with SUDEP. The following databases were used: Pubmed, Google Scholar, EMBASE, and CrossRef. A pooled analysis was carried out, and the results obtained were compared using mean difference (MD). The review was registered on the PROSPERO platform (CRD42021291586).
RESULTS
Seven articles were included, with a total of 72 SUDEP cases associated with altered HRV parameters. Generally, a reduction of SDNN and RMSSD was reported in most SUDEP patients. According to MD, the SUDEP patients showed no differences in time and frequency-domain parameters compared to controls. However, a trend toward increased low-frequency and high-frequency ratio (LF/HF) was observed in the SUDEP patients.
CONCLUSION
HRV analysis is a valuable method for assessing cardiovascular risk and cardioautonomic impairment. Although a possible association between HRV variation and SUDEP has been reported, further studies are needed to assess the potential role of HRV modifications as a SUDEP biomarker.
Dario Calisi, Matteo A De Rosa, Mirella Russo, and Stefano L Sensi
BMJ
Facio-scapulo-humeral dystrophy (FSHD) is a common muscular dystrophy featuring progressive weakness, mostly involving facial muscles and the scapular cingulum. FSHD is an autosomal-dominant inherited disease driven by the contraction of the D4Z4 region of chromosome 4. Patients with FSHD have a high life expectancy, about 20% of FSHD subjects need wheelchairs in their 50s, and extramuscular involvement is rare, however, no epidemiological studies have been carried out on this data.Our case describes a man affected by FSHD who, in his 60s, developed atypical Parkinsonism diagnosed as progressive supranuclear palsy (PSP).FSHD symptoms can hide other neuromuscular diseases developed on ageing. This case highlights the importance of considering possible overlaps with other neurodegenerative diseases.
Fedele Dono, Giacomo Evangelista, Stefano Consoli, Romina Venditti, Mirella Russo, Maria Vittoria De Angelis, Massimiliano Faustino, Angelo Di Iorio, Catello Vollono, Francesca Anzellotti,et al.
Elsevier BV
Fabrizio Sallustio, Giovanni Pracucci, Manuel Cappellari, Valentina Saia, Alfredo Paolo Mascolo, Federico Marrama, Roberto Gandini, Giacomo Koch, Marina Diomedi, Federica D’Agostino,et al.
Springer Science and Business Media LLC
Raffaella Franciotti, Davide Nardini, Mirella Russo, Marco Onofrj, and Stefano L. Sensi
Elsevier BV
Vincenzo Di Stefano, Maria Vittoria De Angelis, Chiara Montemitro, Mirella Russo, Claudia Carrarini, Massimo di Giannantonio, Filippo Brighina, Marco Onofrj, David J. Werring, and Robert Simister
Springer Science and Business Media LLC
Marco Onofrj, Paola Ajdinaj, Anna Digiovanni, Naveed Malek, Giovanni Martinotti, Filippo Maria Ferro, Mirella Russo, Astrid Thomas, and Stefano Luca Sensi
Frontiers Media SA
In recent years, some neurologists reconsidered their approach to Medically Unexplained Symptoms and proposed Functional Neurologic Disorders (FND) as a new entity, claiming that neurology could offer alternative treatment options to the psychotherapies provided in psychiatry settings. FNDs, for this purpose, should include only the disorders listed as Conversion from the Somatic Symptom and Related Disorders (SSRD) group. The present review analyzes the rationale of this position and challenges the arguments provided for its support. The review also discusses the systematization of these disorders as provided by public health systems. It outlines risks stemming from economic support and public funding uncertainty, given their negligible epidemiological dimensions resulting from the parcellation of SSRD. The review underlines the unresolved issue of Factitious Disorders, which are in the same SSRD category of the international classification but are, nonetheless, overlooked by the theoretical proponents of the FND entity. Comorbidity with other psychiatric disorders is also analyzed. We propose a model that supports the continuum between different SSRD conditions, including Factitious Disorders. The model is based on the emergence of feigned death reflex and deception from frontal lobe dysfunction. Finally, the paper summarizes the wealth of historical psychiatric and psychodynamic approaches and critical reviews. The study also puts in context the categorization and interpretation efforts provided by the most eminent researchers of the past century.
Stefano L. Sensi, Mirella Russo, and Pietro Tiraboschi
Elsevier
Anna Digiovanni, Paola Ajdinaj, Mirella Russo, Stefano L. Sensi, Marco Onofrj, and Astrid Thomas
Frontiers Media SA
Psychiatric symptoms frequently predate or complicate neurological disorders, such as neurodegenerative diseases. Symptoms of bipolar spectrum disorders (BSD), like mood, behavioral, and psychotic alterations, are known to occur – individually or as a syndromic cluster – in Parkinson’s disease and in the behavioral variant of frontotemporal dementia (FTD). Nonetheless, due to shared pathophysiological mechanisms, or genetic predisposition, several other neurological disorders show significant, yet neglected, clinical and biological overlaps with BSD like neuroinflammation, ion channel dysfunctions, neurotransmission imbalance, or neurodegeneration. BSD pathophysiology is still largely unclear, but large-scale network dysfunctions are known to participate in the onset of mood disorders and psychotic symptoms. Thus, functional alterations can unleash BSD symptoms years before the evidence of an organic disease of the central nervous system. The aim of our narrative review was to illustrate the numerous intersections between BSD and neurological disorders from a clinical-biological point of view and the underlying predisposing factors, to guide future diagnostic and therapeutical research in the field.
Claudia Carrarini, V. Di Stefano, M. Russo, F. Dono, M. Di Pietro, N. Furia, M. Onofrj, L. Bonanni, M. Faustino, and M. V. De Angelis
Springer Science and Business Media LLC
AbstractPost-stroke arrhythmias represent a risk factor for complications and worse prognosis after cerebrovascular events. The aims of the study were to detect the rate of atrial fibrillation (AF) and other cardiac arrhythmias after acute ischemic stroke, by using a 7-day Holter ECG which has proved to be superior to the standard 24-h recording, and to evaluate the possible association between brain lesions and arrhythmias. One hundred and twenty patients with cryptogenic ischemic stroke underwent clinical and neuroimaging assessment and were monitored with a 7-day Holter ECG. Analysis of the rhythm recorded over 7 days was compared to analysis limited at the first 24 h of monitoring. 7-day Holter ECG detected AF in 4% of patients, supraventricular extrasystole (SVEB) in 94%, ventricular extrasystole (VEB) in 88%, short supraventricular runs (SVRs) in 54%, supraventricular tachycardia in 20%, and bradycardia in 6%. Compared to the first 24 h of monitoring, 7-Holter ECG showed a significant higher detection for all arrhythmias (AF p = 0.02; bradycardia p = 0.03; tachycardia p = 0.0001; SVEB p = 0.0002; VEB p = 0.0001; SVRs p = 0.0001). Patients with SVRs and bradycardia were older (p = 0.0001; p = 0.035) and had higher CHA2DS2VASc scores (p = 0.004; p = 0.026) respectively, in the comparison with patients without these two arrhythmias. An association was found between SVEB and parietal (p = 0.013) and temporal (p = 0.013) lobe lesions, whereas VEB correlated with insular involvement (p = 0.002). 7-day Holter ECG monitoring proved to be superior as compared to 24-h recording for the detection of all arrhythmias, some of which (SVEB and VEB) were associated with specific brain areas involvement. Therefore, 7-day Holter ECG should be required as an effective first-line approach to improve both diagnosis and therapeutic management after stroke.
Fedele Dono, Giacomo Evangelista, Stefano Consoli, Francesco Pasini, Mirella Russo, Bruna Nucera, Fabrizio Rinaldi, Giulia Battaglia, Catello Vollono, Francesco Brigo,et al.
Elsevier BV
Delli Pizzi Stefano, Raffaella Franciotti, Piero Chiacchiaretta, Antonio Ferretti, Richard A. Edden, Carlo Sestieri, Mirella Russo, Stefano L. Sensi, and Marco Onofrj
Wiley
BACKGROUND
The high co-occurrence of somatic symptom disorder (SSD) in Parkinson's disease (PD) patients suggests overlapping pathophysiology. However, little is known about the neural correlates of SSD and their possible interactions with PD. Existing studies have shown that SSD is associated with reduced task-evoked activity in the medial prefrontal cortex (mPFC), a central node of the default-mode network (DMN). SSD is also associated with abnormal γ-aminobutyric acid (GABA) content, a marker of local inhibitory tone and regional hypoactivity, in the same area when SSD co-occurs with PD.
OBJECTIVES
To disentangle the individual and shared effects of SSD and PD on mPFC neurotransmission and connectivity patterns and help disclose the neural mechanisms of comorbidity in the PD population.
METHODS
The study cohort included 18 PD patients with SSD (PD + SSD), 18 PD patients, 13 SSD patients who did not exhibit neurologic disorders, and 17 healthy subjects (HC). Proton magnetic resonance (MR) spectroscopy evaluated GABA levels within a volume of interest centered on the mPFC. Resting-state functional MR imaging investigated the region's functional connectivity patterns.
RESULTS
Compared to HC or PD groups, the mPFC of SSD subjects exhibited higher GABA levels and connectivity. Higher mPFC connectivity involved DMN regions in SSD patients without PD and regions of the executive and attentional networks (EAN) in patients with PD comorbidity.
CONCLUSIONS
Aberrant reconfigurations of connectivity patterns between the mPFC and the EAN are distinct features of the PD + SSD comorbidity. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Mirella Russo, Matteo A. De Rosa, Dario Calisi, Stefano Consoli, Giacomo Evangelista, Fedele Dono, Matteo Santilli, Alberto Granzotto, Marco Onofrj, and Stefano L. Sensi
MDPI AG
Migraine is a common neurological disorder impairing the quality of life of patients. The condition requires, as an acute or prophylactic line of intervention, the frequent use of drugs acting on the central nervous system (CNS). The long-term impact of these medications on cognition and neurodegeneration has never been consistently assessed. The paper reviews pharmacological migraine treatments and discusses their biological and clinical effects on the CNS. The different anti-migraine drugs show distinct profiles concerning neurodegeneration and the risk of cognitive deficits. These features should be carefully evaluated when prescribing a pharmacological treatment as many migraineurs are of scholar or working age and their performances may be affected by drug misuse. Thus, a reconsideration of therapy guidelines is warranted. Furthermore, since conflicting results have emerged in the relationship between migraine and dementia, future studies must consider present and past pharmacological regimens as potential confounding factors.
Mirella Russo, Dario Calisi, Matteo A. De Rosa, Giacomo Evangelista, Stefano Consoli, Fedele Dono, Matteo Santilli, Francesco Gambi, Marco Onofrj, Massimo Di Giannantonio,et al.
Elsevier BV
Mirella Russo, Matteo Santilli, Matteo A. De Rosa, Dario Calisi, Fedele Dono, Maria Vittoria Mattoli, Laura Bonanni, Marco Onofrj, and Stefano L. Sensi
IOS Press
A 43-year-old came to our observation for progressive cognitive impairment, confirmed by the neuropsychological evaluation. A diagnosis of multidomain amnestic mild cognitive impairment, due to unknown reasons, was posited at the first assessment. The patient’s neurological exam was otherwise completely normal. The patient’s mother was clinically diagnosed with frontotemporal dementia in her forties. The patient underwent neuroimaging investigations and cerebrospinal fluid analysis. Our diagnostic work-up pointed toward a neurodegenerative etiology, but the presence of concurrent cardiomyopathy emerged in the meantime. Due to the patient’s family history, a thorough genetic screening was performed. The results revealed a unique genetic asset, with heterozygotic variants of three amyloid-related genes (PSEN1, APP, and MYBPC3). PSEN1 and MYBPC3 mutations showed distinct pathogenic features and accounted for the patient’s brain and cardiac amyloidosis, whereas the APP variant was of uncertain pathological implications.
Fedele Dono, Giacomo Evangelista, Stefano Consoli, Davide Rodorigo, Mirella Russo, Claudia Carrarini, Martina Di Pietro, Maria Vittoria De Angelis, Massimiliano Faustino, Francesca Anzellotti,et al.
Elsevier BV
Mirella Russo, Claudia Carrarini, Angelo Di Iorio, Raffaello Pellegrino, Amalia Cecilia Bruni, Salvatore Caratozzolo, Annalisa Chiari, Stefano Pretta, Camillo Marra, Maria Sofia Cotelli,et al.
Springer Science and Business Media LLC
Abstract Introduction Dementia with Lewy bodies (DLB) may represent a diagnostic challenge, since its clinical picture overlaps with other dementia. Two toolkits have been developed to aid the clinician to diagnose DLB: the Lewy Body Composite Risk Score (LBCRS) and the Assessment Toolkit for DLB (AT-DLB). We aim to evaluate the reliability of these two questionnaires, and their ability to enhance the interpretation of the international consensus diagnostic criteria. Methods LBCRS and AT-DLB were distributed to 135 Italian Neurological Centers for Cognitive Decline and Dementia (CDCDs), with the indication to administer them to all patients with dementia referred within the subsequent 3 months. We asked to subsequently apply consensus criteria for DLB diagnosis, to validate the diagnostic accuracy of the two toolkits. Results A total of 23 Centers joined the study; 1854 patients were enrolled. We found a prevalence of possible or probable DLB of 13% each (26% total), according to the consensus criteria. LBCRS toolkit showed good reliability, with a Cronbach alpha of 0.77, stable even after removing variables from the construct. AT-DLB toolkit Cronbach alpha was 0.52 and, after the subtraction of the “cognitive fluctuation” criterion, was only 0.31. Accuracy, sensitivity, and specificity were higher for LBCRS vs. AT-DLB. However, when simultaneously considered in the logistic models, AT-DLB showed a better performance (p < 0.001). Overall, the concordance between LBCRS positive and AT-DLB possible/probable was of 78.02% Conclusions In a clinical setting, the LBCRS and AT-DLB questionnaires have good accuracy for DLB diagnosis.
Giacomo Evangelista, Fedele Dono, Stefano Consoli, Valeria Pozzilli, Dario Calisi, Mirella Russo, Claudia D'Orazio, Anna D'Andreagiovanni, Giovanna Montesano, Sabina Rapini,et al.
Wiley
TCC is a semisynthetic molecule widely used in clinical settings as a pain killer and myorelaxant. Several neurological side effects have been reported in association with TCC treatment including somnolence, confusion and seizure, the latter in a lower percentage of patients. Some previous reports described seizure onset after TCC intake in adulthood. However, major epileptological complication, namely status epilepticus, has never been previously reported in association with TCC treatment. In our report, we describe a case of acute refractory NCSE in the context of a TCC-induced acute toxic encephalopathy (ATE) in a woman without any previous neurological or physical comorbidities.