Antonio Leo - Academia.edu (original) (raw)

Papers by Antonio Leo

European Journal of Neurology, 2012

BackgroundTo date there are no biomarkers with proven reliability as a measure of disease burden ... more BackgroundTo date there are no biomarkers with proven reliability as a measure of disease burden in amyotrophic lateral sclerosis (ALS). The aim of our study is to assess the neurofilament light chain (NFL) in cerebrospinal fluid (CSF) samples as a measure of disease activity and progression in ALS.MethodsThirty‐seven consecutive patients with ALS, 25 with chronic inflammatory demyelinating polyneuropathy and 21 with other neurodegenerative diseases were evaluated. CSF NFL levels were assayed by two‐site solid‐phase sandwich ELISA. In patients with ALS, neurological status was assessed by the revised ALS Functional Rating Scale (ALSFRS‐r) and the Medical Research Council scale, and the progression of the disease was evaluated using the ‘diagnostic delay’ and the ‘progression rate’.ResultsCerebrospinal fluid NFL levels were higher in ALS cases than in controls (P < 0.0001). Using receiver operating curve analysis, an optimal NFL cut‐off of 1981 ng/l discriminated between patients ...

Background and aim of the work: The Coronavirus has put a strain on the response capacity of heal... more Background and aim of the work: The Coronavirus has put a strain on the response capacity of health systems and there are various psychological effects on health workers. Aim of the study: To investigate the psychological impact of the coronavirus emergency on physicians and nurses. Methods: A study was conducted on a sample of nurses and physicians (n=770), who were asked to fill in a questionnaire investigating physical and psychological problems. It also included the IES (Impact Event Scale), STAI (State Trait Anxiety Inventory) scale and BDI (Beck Depression Inventory). Results: 87.7% of the sample was represented by nurses (n=675), 12.3% (n=95) by physicians. 52.3% (n=403). Among the psychological symptoms, stress (76.2%; n=587), anxiety (59.4%; n=457) and depression (11.8%) prevailed and only 3.9% of the healthcare personnel sought help from a psychologist. The total score of the IES-R scale was 3.47. A significant association emerged between exposure and the risk of contagion...

The International journal of social psychiatry, Feb 1, 2018

Informed consent is an essential element in doctor-patient relationship. In particular, obtaining... more Informed consent is an essential element in doctor-patient relationship. In particular, obtaining valid informed consent from patients with neurocognitive diseases is a critical issue at present. For this reason, we decided to conduct research on elderly patients with Alzheimer's disease ( Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to assess their capacity to make treatment decisions. The experimental group comprised 70 Alzheimer patients who were admitted to the Neurodegenerative Disease Unit of the University of Bari. The control group consisted of 83 elderly patients without neurocognitive disorders who were hospitalized in the Geriatric Unit at the same university. After providing written consent to participate in the research, each subject underwent the following assessments: (a) assessment of comprehension sheet, (b) Neuropsychiatric Inventory (NPI) and Global Functioning Evaluation (GFE), (c) neurological evaluation, (d) neuropsychological ...

Rivista di psichiatria

Multi-ethnicity has been persuading the healthcare professionals to increasingly learn new tools ... more Multi-ethnicity has been persuading the healthcare professionals to increasingly learn new tools in terms of cultural and social skills, in order to cope with a diversified variety of patients. The coexistence of different cultures in Italy can be found in the migration flows over the last few decades. The cohabitations between individuals with different ethnicity in our territory has led the health professionals to address some anthropological, moral, religious and political issues implied in populations and cultures different from ours. Clinical literature has made us aware of the importance of correct communication between doctor and patient in order to determine the diagnostic-therapeutic plan, especially in the patients with a foreign origin due to the linguistic and intercultural differences implicated. In an emergency condition, it may occur to cure the patients neglecting their cultural identity and, in so doing, to create misunderstandings that, in turn, can lead to a lack ...

Expert Opinion on Emerging Drugs, 2016

Currently available drugs against Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Currently available drugs against Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (AD) target cholinergic and glutamatergic neurotransmissions without affecting the underlying disease process. Putative disease-modifying drugs are in development and target β-amyloid (Aβ) peptide and tau protein, the principal neurophatological hallmarks of the disease. Areas covered: Phase III clinical studies of emerging anti-Aβ drugs for the treatment of AD were searched in US and EU clinical trial registries and in the medical literature until May 2016. Expert opinion: Drugs in Phase III clinical development for AD include one inhibitor of the β-secretase cleaving enzyme (BACE) (verubecestat), three anti-Aβ monoclonal antibodies (solanezumab, gantenerumab, and aducanumab), an inhibitor of receptor for advanced glycation end products (RAGE) (azeliragon) and the combination of cromolyn sodium and ibuprofen (ALZT-OP1). These drugs are mainly being tested in subjects during early phases of AD or in subjects at preclinical stage of familial AD or even in asymptomatic subjects at high risk of developing AD. The hope is to intervene in the disease process when it is not too late. However, previous clinical failures with anti-Aβ drugs and the lack of fully understanding of the pathophysiological role of Aβ in the development of AD, put the new drugs at substantial risk of failure.

Neurological Sciences, 2016

Upper limb dystonia is a focal dystonia that may affect muscles in the arm, forearm and hand. The... more Upper limb dystonia is a focal dystonia that may affect muscles in the arm, forearm and hand. The neuroanatomical substrates involved in upper limb dystonia are not fully understood. Traditionally, dysfunction of the basal ganglia is presumed to be the main cause of dystonia but a growing body of evidence suggests that a network of additional cortical and subcortical structures may be involved. To identify the brain regions that are affected in secondary upper limb dystonia may help to better understand the neuroanatomical basis of the condition. We considered only patients with focal upper limb dystonia associated with a single localized brain lesion. To identify these patients, we conducted a systematic review of the published literature as well as the medical records of 350 patients with adult-onset dystonia seen over past 15 years at our movement disorder clinic. The literature review revealed 36 articles describing 72 cases of focal upper limb dystonia associated with focal lesions. Among patients at our clinic, four had focal lesions on imaging studies. Lesions were found in multiple regions including thalamus (n = 39), basal ganglia (n = 17), cortex (n = 4), brainstem (n = 4), cerebellum (n = 1), and cervical spine (n = 7). Dystonic tremor was not associated with any particular site of lesion, whereas there was a trend for an inverse association between task specificity and thalamic involvement. These data in combination with functional imaging studies of idiopathic upper limb dystonia support a model in which a network of different regions plays a role in pathogenesis.

International Psychogeriatrics, 2016

ABSTRACTBackground:We detected the general level of knowledge about the early diagnosis of Alzhei... more ABSTRACTBackground:We detected the general level of knowledge about the early diagnosis of Alzheimer's disease (AD) and subsequent care in general practitioners (GPs) from Southern Italy. We explored also the GP perception about their knowledge and training on diagnosis and management of AD.Methods:On a sample of 131 GPs, we administered two questionnaires: the GP-Knowledge, evaluating GPs’ expertise about AD epidemiology, differential diagnosis, and available treatments, and the GP-QUestionnaire on Awareness of Dementia (GP-QUAD), assessing the GPs’ attitudes, awareness, and practice regarding early diagnosis of dementia.Results:Specific screening tests or protocols to diagnose and manage dementia were not used by 53% of our GPs. The training on the recognition of early AD signs and symptoms was considered inadequate by 55% of the participants. Females were more likely to consider their training insufficient (58%) compared to males (53%). Female GPs were less likely to prescrib...

Audiology and Neurotology, 2015

and central type [Gates et al., 2002], has been associated with incidental dementia and usually p... more and central type [Gates et al., 2002], has been associated with incidental dementia and usually precedes the manifestation of the disease. ARHL, or presbycusis, is the most common sensory deficit in the elderly [Quaranta et al., 1996; Huang and Tang, 2010]. It is a multifactorial condition that involves a multitude of intrinsic and extrinsic factors [Van Eyken et al., 2007; Willot, 1991] acting on the inner ear over a lifetime that cumulatively lead to impairments in cochlear transduction of acoustic signals [Ohlenmiller, 2009]. Once hearing loss begins to occur in adulthood, it tends to become more pronounced and accelerated with each passing decade, with high-frequency loss developing more quickly than low-frequency losses, at all ages [Hinchcliffe, 1959]. ARHL is characterized by a loss of hearing sensitivity and a decreased ability to understand speech in the presence of background noise [Working Group on Speech Understanding and Aging, 1988]. Some subjects, even in the presence of normal hearing thresholds, present with impaired speech understanding. This phenomenon has been defined as central auditory processing disorder (CAPD) and refers to an impairment in the central auditory pathways, such as neural transmission, feature extraction deficit, or information processing problems that lead to impaired speech understanding [Humes et al., 1992]. Using the WHO (World Health Organization) definition of hearing loss (pure tone average, PTA, >25 dB for the frequencies 0.5-4 kHz), in the USA, the prevalence of hearing loss approximately doubles every decade of life from the second through seventh decades reaching the 45.6% in subjects aged 70-74 years, 67.6% in subjects aged 75-79, 78.2% in subjects aged 80-84 and 80.6% in subjects older than 85 [Lin et al., 2011c]. In Europe, roughly 30% of men and 20% of women have a hearing loss of 30 dB HL or more by age 70 years, and 55% of men and 45% of women by age 80 years [Roth et al., 2011]. According to the United Nations, the overall global population will grow from 6.9 billion in 2010 to 9.3 billion in 2050. The proportion of the population aged 60 or older will nearly double in the same period, reaching 21% of the total population or nearly 2 billion people in 2050. The 2008 data from the WHO estimated that over 360 million people (5.3% of the global population) had disabling hearing loss [Stevens et al., 2013]; in 2050, the number of hearing-impaired people will reach an impressive number. The prevalence of CAPD has been shown to increase with age, and Gates et al. [1990], in a sample of 1,026 elderly subjects, reported that the prevalence of CAPD was between 0.75 and 14.6% according to the tests used for diagnosis. Alzheimer's disease (AD) is the most common form of dementia. It is characterized by decline in cognition, memory and performance of activities in daily life. In 2005, 24.3 million people were estimated to have dementia, with 4.6 million new cases of dementia every year (one new case every 7 s). This number is expected to double every 20 years to 8.1 million people by 2040 [Ferri et al., 2005]. In Europe, the prevalence of AD increases exponentially with age [Wancata et al., 2003]. Subtle loss of cognitive function may be symptomatic of normal aging or a transition to early AD.

Archives of Neurology, 2011

Background: N-acetylaspartate (NAA) level is a biomarker of functional integrity and vitality in ... more Background: N-acetylaspartate (NAA) level is a biomarker of functional integrity and vitality in neurons. In vivo multisection proton (1 H)-magnetic resonance spectroscopy studies indicate that NAA level decreases in specific cortical brain areas of patients with amyotrophic lateral sclerosis (ALS). Objective: To study NAA level in serum samples as a possible biomarker of ALS. Design: Serum NAA assay by liquid chromatographymass spectrometry in a case-control series.

Journal of Neurology, 2011

Urate is a natural antioxidant, and high serum urate levels could be protective against the devel... more Urate is a natural antioxidant, and high serum urate levels could be protective against the development of amyotrophic lateral sclerosis (ALS). To determine if serum urate concentrations were lower in ALS patients than in healthy controls, we compared serum urate levels in 132 ALS patients and 337 age/sex-matched controls. Median urate levels were lower in ALS patients compared to controls