Francesco Lullo - Academia.edu (original) (raw)

Papers by Francesco Lullo

Research paper thumbnail of Functional electrical stimulation for the upper limb in tetraplegic spinal cord injury: a systematic review

Journal of Medical Engineering & Technology, 2015

Introduction: Technological advances have helped to improve functional ability in spinal cord inj... more Introduction: Technological advances have helped to improve functional ability in spinal cord injury survivors. The aim of this study is to systematically review the evidence for functional electrical stimulation (FES) on functional tasks involving the upper limb in people with spinal cord injuries. Methods: We systematically searched from September 2009 to September 2014 in relevant databases using a combination of keywords covering spinal cord injury and FES. Studies were selected using predetermined criteria. Results: The search yielded 144 studies. Only five studies met our inclusion criteria. All five reported improvements immediately and at follow-up in functional ability as a result of FES or FES combined with conventional therapy. Discussion: There is some preliminary evidence that FES may reduce disability due to upper limb-related activity limitations in tetraplegic spinal cord injury. Further work needs to examine the role of FES in more detail, and in combination with other treatments.

Research paper thumbnail of Gait analysis: technical notes

Journal of Advanced Health Care, 2020

Biomedical technologies are having an increasingly central role in the modern medicine. In fact t... more Biomedical technologies are having an increasingly central role in the modern medicine. In fact they are at the root of the diagnosis and follow up of pathologies giving to the clinicians quantitative outcomes necessary on the choice of the right therapy. In this paper we will focus on biomedical technologies used in the context of gait analysis describing the main ones used in the clinical practice about pathologies of neurologic, orthopedic and rheumatic interest and underlining their importance in the clinical setting. The main systems for gait analysis will be presented in this article: system with passive markers, stereophotogrammetric system, force and pressure platforms, surface electromyography system, system based on inertial measurement units underling the importance of each in investigating a different aspect of movement and how integrating all of them we can have a depth and whole gait analysis. The main gait analysis protocols will be presented too. Finally, advantages ...

Research paper thumbnail of Central responses evoked by tactile stimulation: technical note

Neurological Sciences, 2001

The electrical stimulation of peripheral nerves is one of the commonest ways to study the sensory... more The electrical stimulation of peripheral nerves is one of the commonest ways to study the sensory pathways from the peripheral nerve to the cortex. Such stimulation, however, involves all types of nerve fibres regardless of their specific function. In the past, we devised a technical procedure to record peripheral responses by selectively activating fibres innervating cutaneous mechanoreceptors. In the present

Research paper thumbnail of Median nerve sensory responses evoked by tactile stimulation of the finger proximal and distal phalanx in normal subjects

Research paper thumbnail of Meissner Corpuscles in Patients with Congenital and Acquired Sensory Neuropathies

Journal of the Peripheral Nervous System, 2000

Research paper thumbnail of Distal degeneration of sensory and autonomic cutaneous nerve fibres in systemic sclerosis

Annals of the Rheumatic Diseases, 2005

but IL1 which has a pivotal role in the pathogenesis of AOSD 3 and systemic onset juvenile idiopa... more but IL1 which has a pivotal role in the pathogenesis of AOSD 3 and systemic onset juvenile idiopathic arthritis. 9 In these diseases and in other rare disorders with a single amino acid mutation in the NALP-3 gene which results in increased IL1 secretion, IL1 blockade seems to be the preferred treatment. 10 Furthermore, our case suggests that hypersensitivity to NSAIDs is not exclusively mediated by COX-1 blockade, but can also be provoked by selective COX-2 inhibitors that can function as haptens, resulting in anaphylaxis upon next exposure. 5 Our case shows that these reactions are not mediated by TNFa and not altered by TNFa neutralisation.

Research paper thumbnail of Skin sympathetic adrenergic innervation: An immunofluorescence confocal study

Annals of Neurology, 2006

Research paper thumbnail of Peripheral Neuropathy in Patients Recovering from Severe COVID-19: A Case Series

Medicina

Background and Objectives: Neurological manifestations have been reported in a significant propor... more Background and Objectives: Neurological manifestations have been reported in a significant proportion of coronavirus disease 2019 (COVID-19) patients. We aimed to evaluate the prevalence and severity of peripheral nervous system (PNS) involvement in a large group of convalescent COVID-19 patients undergoing in-hospital multidisciplinary rehabilitation. Materials and Methods: Convalescent COVID-19 patients admitted to a Pulmonary Rehabilitation Unit were consecutively screened for inclusion within 48 h of discharge from an acute care setting. All included patients underwent electrophysiological examinations. Results: Among 102 enrolled patients (mean age 62.0 years, 82.4% males), PNS electrophysiological alterations were detected in 42.2%. Mononeuropathies exclusively involving the peroneal nerve were observed in 8.8% (n = 9), while multiple mononeuropathies were similarly reported in nine patients (8.8%). A symmetric sensorimotor polyneuropathy was documented in 24.5% of participant...

Research paper thumbnail of Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid

SPE Annual Technical Conference and Exhibition, 2003

... Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid Sandra L. Berry, SPE; Joel L. Bo... more ... Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid Sandra L. Berry, SPE; Joel L. Boles, SPE; Gino Francesco Di ... Pickling Solutions,” paper SPE 81138 presented Latin American and Caribbean Petroleum Engineering Conference in Port-of Spain, Trinidad, West Indies ...

Research paper thumbnail of Role Of Meissner Corpuscles In Tactile Potential Generation

Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinom... more Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinoma of the lung (SCLC), however lower motor neuron syndrome with or without upper motor neuron involvement may occur. Antineuronal antibodies, called "anti-Hu" , can be frequently demonstrated. Other antibodies that react with the carbohydrate epitope of ganglioside GM1, associated with primary motor PN, are not frequent. We describe a 73-year-old man with subacute onset of paraesthesiae starting in his finger and toes and spreading proximally. A few months later he developed generalized muscle weakness and was admitted to another hospital. On examination he was unable to write, as well as to stand or walk without support. Tendon reflexes were absent. He had no cranial nerve involvement and had no complain of pain. Pinprick, vibration and four limb positions were impaired distally. CSF study revealed increased protein (90 mg/dl) and lymphocytes (14/mm 3). SCLC was identified in paratracheal lymphnodes and treated with chemotherapy (Carboplatinum and Etopoxide) and mediastinum irradiation (36 Gray). No clinical improvement was observed after i.v. immunoglobulins (400 mg/kg/day for 5 days). He was wheelchair-bound and unable to feed himself or to recognize the four limb position when he was admitted in the Neurological Department, University of Verona. Eye movements and winking were markedly reduced. Median (48.6 m/s) and ulnar (46 m/s) nerve study revealed slow conductions. ESP were undetectable. SSEP could not be evoked from the four limbs. Cyclophosphamide (250 mg/day for 5 days), monthly plasma exchange associated with prednisone for six months, and Azatioprine were used. Ambigous low titre of antibodies against neuronal nuclei was identified but anti-Hu antibodies were not detected. The serum antibody titres against glycolipids (GM1, GM2, GM3, GQ1b, GD1a, GD1b, sulfatides) were elevated (Ͼ 1:720) and had no substantial change at the bimonthly controls in the last 36 months. As negative control case for GLa, we used the Hu-negative serum from a patient who had electrophysiologically confirmed selective sensory involvement associated with SCLC and long survival (29 months). We hypothesized that the neurological course with prominent motor deficit is probably related to serum anti-GL antibody specificities. The presence of ganglioside mimicry in the SCLC (Fuentes et al., Lung Cancer, 1997) appears to be determinant for the induction of anti-GLa. However the antineural immune-response may be related to host factors.

Research paper thumbnail of Role Of Meissner Corpuscles In Tactile Potential Generation

Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinom... more Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinoma of the lung (SCLC), however lower motor neuron syndrome with or without upper motor neuron involvement may occur. Antineuronal antibodies, called "anti-Hu" , can be frequently demonstrated. Other antibodies that react with the carbohydrate epitope of ganglioside GM1, associated with primary motor PN, are not frequent. We describe a 73-year-old man with subacute onset of paraesthesiae starting in his finger and toes and spreading proximally. A few months later he developed generalized muscle weakness and was admitted to another hospital. On examination he was unable to write, as well as to stand or walk without support. Tendon reflexes were absent. He had no cranial nerve involvement and had no complain of pain. Pinprick, vibration and four limb positions were impaired distally. CSF study revealed increased protein (90 mg/dl) and lymphocytes (14/mm 3). SCLC was identified in paratracheal lymphnodes and treated with chemotherapy (Carboplatinum and Etopoxide) and mediastinum irradiation (36 Gray). No clinical improvement was observed after i.v. immunoglobulins (400 mg/kg/day for 5 days). He was wheelchair-bound and unable to feed himself or to recognize the four limb position when he was admitted in the Neurological Department, University of Verona. Eye movements and winking were markedly reduced. Median (48.6 m/s) and ulnar (46 m/s) nerve study revealed slow conductions. ESP were undetectable. SSEP could not be evoked from the four limbs. Cyclophosphamide (250 mg/day for 5 days), monthly plasma exchange associated with prednisone for six months, and Azatioprine were used. Ambigous low titre of antibodies against neuronal nuclei was identified but anti-Hu antibodies were not detected. The serum antibody titres against glycolipids (GM1, GM2, GM3, GQ1b, GD1a, GD1b, sulfatides) were elevated (Ͼ 1:720) and had no substantial change at the bimonthly controls in the last 36 months. As negative control case for GLa, we used the Hu-negative serum from a patient who had electrophysiologically confirmed selective sensory involvement associated with SCLC and long survival (29 months). We hypothesized that the neurological course with prominent motor deficit is probably related to serum anti-GL antibody specificities. The presence of ganglioside mimicry in the SCLC (Fuentes et al., Lung Cancer, 1997) appears to be determinant for the induction of anti-GLa. However the antineural immune-response may be related to host factors.

Research paper thumbnail of Small fiber pathology parallels disease progression in Parkinson disease: a longitudinal study

Research paper thumbnail of Evidence of small fiber neuropathy in a patient with Ehlers–Danlos syndrome, hypermobility-type

Clinical Neurophysiology, 2015

Research paper thumbnail of The effects of the vibratory stimulation of the neck muscles for the evaluation of stepping performance in Parkinson's Disease

2015 IEEE International Symposium on Medical Measurements and Applications (MeMeA) Proceedings, 2015

Research paper thumbnail of Sensory nerve findings by tactile stimulation of median and ulnar nerves in healthy subjects of different ages

Electroencephalography and clinical neurophysiology, 1993

We studied orthodromic sensory conduction velocity along the distal and proximal segments of the ... more We studied orthodromic sensory conduction velocity along the distal and proximal segments of the median and ulnar nerves by tactile stimulation of the distal phalanx of the 3rd and 5th digits in 44 healthy subjects divided into 2 age groups: from 16 to 35 years and from 63 to 81 years. In the same nerves, we used selective electrical stimulation of the corresponding digital nerves to obtain sensory potentials. In both groups, responses to tactile stimuli had a longer latency and smaller amplitude than those to electrical stimulation, and they were distributed in a series of 6-7 main deflections, apparently regardless of whether the recording site was distal or proximal. Moreover, irrespective of the nerve and of subject age, conduction velocity along both the digit-wrist and the wrist-elbow nerve segments was significantly slower with tactile stimuli than with electrical stimuli. However, independently of the stimulus used, conduction velocity along the proximal nerve segment was si...

Research paper thumbnail of Relationships of kinematics indexes with amplitude and velocity of upper arm reaching movement

2013 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2013

ABSTRACT Arm reaching movements (ARM) are mainly used in rehabilitative settings, as robot mediat... more ABSTRACT Arm reaching movements (ARM) are mainly used in rehabilitative settings, as robot mediated therapies, virtual reality and motion capture systems in exergaming. ARM typical consist of gaussian-like bell shaped velocity profile. No previous paper addressed in details their relationships with amplitude and speed of the movement and aim of the paper is to study existing correlations between quantitative kinematics indexes (KI) and to describe their relationships with the amplitude and the velocity of the movement in normal subjects. We studied about one thousands of horizontal and vertical ARM of 10 normal subjects at four amplitude's values (15-20-25- 30°) and at three different target velocity (20-30- 40°/s), quantitatively evaluated by symmetry, skewness, kurtosis and smoothness indexes. KI showed extremely low correlations to each other, clearly describing different ARM features, higher correlations with the velocity than with the amplitude of the movement, and in vertical antigravitary rather than horizontal ARM. Among all KI, smoothness showed the higher correlations' values, following an exponential growth relationship both with velocity and amplitude in horizontal and vertical ARM.

Research paper thumbnail of Kinematic Indexes’ Reproducibility of Horizontal Reaching Movements

Research paper thumbnail of Kinematic and EMG patterns evaluation of upper arm reaching movements

2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob), 2012

ABSTRACT Variations in kinematic performances and muscle activations, underlying improvements in ... more ABSTRACT Variations in kinematic performances and muscle activations, underlying improvements in muscle function and strength, in response to upper arm training of patients with congenital or acquired brain injuries, are still poorly understood. One of the most interesting features of a robot-mediated therapy is the ability to quantify the performance of the rehabilitation tasks proposed to the patient. Although the shoulder is the most complex joint in the body, both for the range of freedom of movements and for the muscular-tendon structure, not so many commercial or research devices have been proposed to study its movements and no study have proposed a standardized, quantitative kinematic and electromyographic assessment. This study aimed to develop a quantitative assessment of kinematics and electromyographic pattern of the arm's muscles involved in reaching robot-assisted movements by means of indices effectively describing the main pattern features in ten normal subjects. Each subject underwent a specific eight sequences motor task protocol. The system automatically classify each movement detecting its start/end times, extract main kinematic indexes plotting activation and deactivation graphs related to eight emg channels. Results showed that particularly movement smoothness indexes and timing of emg patterns may provide an effective upper arm reaching movement assessment.

Research paper thumbnail of Effects of Regent Suit on lower limb electromyographic patterns

2013 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2013

ABSTRACT Functional recovery of limb mobility of patients with spinal or cerebral injuries can ta... more ABSTRACT Functional recovery of limb mobility of patients with spinal or cerebral injuries can take great advantage of the basic role played by sensorial and proprioceptive stimulations. On this base the Institute of Biomedical Problems of the Russian Academy of Sciences have recently developed the “Regent Suit” (RS), an experimental medical device derived from a suits worn by astronauts for therapeutical purposes during space flights. Although preliminary studies describe rehabilitation outcome of the RS in stroke, EMG changes induced by the suit are not known. Aim of the paper is to describe the effects of RS on lower limb EMG patterns on normal subjects. We studied 30 EMG gait analysis of 5 normal subjects without and with RS. Timing of maximum muscle effort over the gait cycle has been detected by the dominant peak phase of the Gaussian decomposition of the EMG envelope. Results showed a significant anticipatory effect on Soleus and Vastus Lateralis and a delay on the Tibialis Anterior and Semitendinosus due to RS elastic force recall facilitating the agonist muscle activation step. Comprehension of these EMG patterns modifications is at the base of a correct clinical use of the device, for both valid rehabilitative protocols and quantitative outcome evaluation.

Research paper thumbnail of Reproducibility of kinematics indexes of upper arm reaching movement in robot assisted therapy

2012 IEEE International Symposium on Medical Measurements and Applications Proceedings, 2012

One of the most appealing features of robot-assisted-therapy (RMT) consists in the possibility to... more One of the most appealing features of robot-assisted-therapy (RMT) consists in the possibility to quantify the performances of the rehabilitation task proposed to the patient. The analysis of kinematics indexes, providing quantitative information about movement patterns that is not captured using clinical measures, could be used as reliable outcome measures in clinical upper limb rehabilitative settings. Few papers have actually

Research paper thumbnail of Functional electrical stimulation for the upper limb in tetraplegic spinal cord injury: a systematic review

Journal of Medical Engineering & Technology, 2015

Introduction: Technological advances have helped to improve functional ability in spinal cord inj... more Introduction: Technological advances have helped to improve functional ability in spinal cord injury survivors. The aim of this study is to systematically review the evidence for functional electrical stimulation (FES) on functional tasks involving the upper limb in people with spinal cord injuries. Methods: We systematically searched from September 2009 to September 2014 in relevant databases using a combination of keywords covering spinal cord injury and FES. Studies were selected using predetermined criteria. Results: The search yielded 144 studies. Only five studies met our inclusion criteria. All five reported improvements immediately and at follow-up in functional ability as a result of FES or FES combined with conventional therapy. Discussion: There is some preliminary evidence that FES may reduce disability due to upper limb-related activity limitations in tetraplegic spinal cord injury. Further work needs to examine the role of FES in more detail, and in combination with other treatments.

Research paper thumbnail of Gait analysis: technical notes

Journal of Advanced Health Care, 2020

Biomedical technologies are having an increasingly central role in the modern medicine. In fact t... more Biomedical technologies are having an increasingly central role in the modern medicine. In fact they are at the root of the diagnosis and follow up of pathologies giving to the clinicians quantitative outcomes necessary on the choice of the right therapy. In this paper we will focus on biomedical technologies used in the context of gait analysis describing the main ones used in the clinical practice about pathologies of neurologic, orthopedic and rheumatic interest and underlining their importance in the clinical setting. The main systems for gait analysis will be presented in this article: system with passive markers, stereophotogrammetric system, force and pressure platforms, surface electromyography system, system based on inertial measurement units underling the importance of each in investigating a different aspect of movement and how integrating all of them we can have a depth and whole gait analysis. The main gait analysis protocols will be presented too. Finally, advantages ...

Research paper thumbnail of Central responses evoked by tactile stimulation: technical note

Neurological Sciences, 2001

The electrical stimulation of peripheral nerves is one of the commonest ways to study the sensory... more The electrical stimulation of peripheral nerves is one of the commonest ways to study the sensory pathways from the peripheral nerve to the cortex. Such stimulation, however, involves all types of nerve fibres regardless of their specific function. In the past, we devised a technical procedure to record peripheral responses by selectively activating fibres innervating cutaneous mechanoreceptors. In the present

Research paper thumbnail of Median nerve sensory responses evoked by tactile stimulation of the finger proximal and distal phalanx in normal subjects

Research paper thumbnail of Meissner Corpuscles in Patients with Congenital and Acquired Sensory Neuropathies

Journal of the Peripheral Nervous System, 2000

Research paper thumbnail of Distal degeneration of sensory and autonomic cutaneous nerve fibres in systemic sclerosis

Annals of the Rheumatic Diseases, 2005

but IL1 which has a pivotal role in the pathogenesis of AOSD 3 and systemic onset juvenile idiopa... more but IL1 which has a pivotal role in the pathogenesis of AOSD 3 and systemic onset juvenile idiopathic arthritis. 9 In these diseases and in other rare disorders with a single amino acid mutation in the NALP-3 gene which results in increased IL1 secretion, IL1 blockade seems to be the preferred treatment. 10 Furthermore, our case suggests that hypersensitivity to NSAIDs is not exclusively mediated by COX-1 blockade, but can also be provoked by selective COX-2 inhibitors that can function as haptens, resulting in anaphylaxis upon next exposure. 5 Our case shows that these reactions are not mediated by TNFa and not altered by TNFa neutralisation.

Research paper thumbnail of Skin sympathetic adrenergic innervation: An immunofluorescence confocal study

Annals of Neurology, 2006

Research paper thumbnail of Peripheral Neuropathy in Patients Recovering from Severe COVID-19: A Case Series

Medicina

Background and Objectives: Neurological manifestations have been reported in a significant propor... more Background and Objectives: Neurological manifestations have been reported in a significant proportion of coronavirus disease 2019 (COVID-19) patients. We aimed to evaluate the prevalence and severity of peripheral nervous system (PNS) involvement in a large group of convalescent COVID-19 patients undergoing in-hospital multidisciplinary rehabilitation. Materials and Methods: Convalescent COVID-19 patients admitted to a Pulmonary Rehabilitation Unit were consecutively screened for inclusion within 48 h of discharge from an acute care setting. All included patients underwent electrophysiological examinations. Results: Among 102 enrolled patients (mean age 62.0 years, 82.4% males), PNS electrophysiological alterations were detected in 42.2%. Mononeuropathies exclusively involving the peroneal nerve were observed in 8.8% (n = 9), while multiple mononeuropathies were similarly reported in nine patients (8.8%). A symmetric sensorimotor polyneuropathy was documented in 24.5% of participant...

Research paper thumbnail of Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid

SPE Annual Technical Conference and Exhibition, 2003

... Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid Sandra L. Berry, SPE; Joel L. Bo... more ... Evaluation of a Safe, Slightly Acidic Tubing Clean-Out Fluid Sandra L. Berry, SPE; Joel L. Boles, SPE; Gino Francesco Di ... Pickling Solutions,” paper SPE 81138 presented Latin American and Caribbean Petroleum Engineering Conference in Port-of Spain, Trinidad, West Indies ...

Research paper thumbnail of Role Of Meissner Corpuscles In Tactile Potential Generation

Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinom... more Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinoma of the lung (SCLC), however lower motor neuron syndrome with or without upper motor neuron involvement may occur. Antineuronal antibodies, called "anti-Hu" , can be frequently demonstrated. Other antibodies that react with the carbohydrate epitope of ganglioside GM1, associated with primary motor PN, are not frequent. We describe a 73-year-old man with subacute onset of paraesthesiae starting in his finger and toes and spreading proximally. A few months later he developed generalized muscle weakness and was admitted to another hospital. On examination he was unable to write, as well as to stand or walk without support. Tendon reflexes were absent. He had no cranial nerve involvement and had no complain of pain. Pinprick, vibration and four limb positions were impaired distally. CSF study revealed increased protein (90 mg/dl) and lymphocytes (14/mm 3). SCLC was identified in paratracheal lymphnodes and treated with chemotherapy (Carboplatinum and Etopoxide) and mediastinum irradiation (36 Gray). No clinical improvement was observed after i.v. immunoglobulins (400 mg/kg/day for 5 days). He was wheelchair-bound and unable to feed himself or to recognize the four limb position when he was admitted in the Neurological Department, University of Verona. Eye movements and winking were markedly reduced. Median (48.6 m/s) and ulnar (46 m/s) nerve study revealed slow conductions. ESP were undetectable. SSEP could not be evoked from the four limbs. Cyclophosphamide (250 mg/day for 5 days), monthly plasma exchange associated with prednisone for six months, and Azatioprine were used. Ambigous low titre of antibodies against neuronal nuclei was identified but anti-Hu antibodies were not detected. The serum antibody titres against glycolipids (GM1, GM2, GM3, GQ1b, GD1a, GD1b, sulfatides) were elevated (Ͼ 1:720) and had no substantial change at the bimonthly controls in the last 36 months. As negative control case for GLa, we used the Hu-negative serum from a patient who had electrophysiologically confirmed selective sensory involvement associated with SCLC and long survival (29 months). We hypothesized that the neurological course with prominent motor deficit is probably related to serum anti-GL antibody specificities. The presence of ganglioside mimicry in the SCLC (Fuentes et al., Lung Cancer, 1997) appears to be determinant for the induction of anti-GLa. However the antineural immune-response may be related to host factors.

Research paper thumbnail of Role Of Meissner Corpuscles In Tactile Potential Generation

Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinom... more Subacute sensory neuronopathy (SSN) is most commonly seen in association with small cell carcinoma of the lung (SCLC), however lower motor neuron syndrome with or without upper motor neuron involvement may occur. Antineuronal antibodies, called "anti-Hu" , can be frequently demonstrated. Other antibodies that react with the carbohydrate epitope of ganglioside GM1, associated with primary motor PN, are not frequent. We describe a 73-year-old man with subacute onset of paraesthesiae starting in his finger and toes and spreading proximally. A few months later he developed generalized muscle weakness and was admitted to another hospital. On examination he was unable to write, as well as to stand or walk without support. Tendon reflexes were absent. He had no cranial nerve involvement and had no complain of pain. Pinprick, vibration and four limb positions were impaired distally. CSF study revealed increased protein (90 mg/dl) and lymphocytes (14/mm 3). SCLC was identified in paratracheal lymphnodes and treated with chemotherapy (Carboplatinum and Etopoxide) and mediastinum irradiation (36 Gray). No clinical improvement was observed after i.v. immunoglobulins (400 mg/kg/day for 5 days). He was wheelchair-bound and unable to feed himself or to recognize the four limb position when he was admitted in the Neurological Department, University of Verona. Eye movements and winking were markedly reduced. Median (48.6 m/s) and ulnar (46 m/s) nerve study revealed slow conductions. ESP were undetectable. SSEP could not be evoked from the four limbs. Cyclophosphamide (250 mg/day for 5 days), monthly plasma exchange associated with prednisone for six months, and Azatioprine were used. Ambigous low titre of antibodies against neuronal nuclei was identified but anti-Hu antibodies were not detected. The serum antibody titres against glycolipids (GM1, GM2, GM3, GQ1b, GD1a, GD1b, sulfatides) were elevated (Ͼ 1:720) and had no substantial change at the bimonthly controls in the last 36 months. As negative control case for GLa, we used the Hu-negative serum from a patient who had electrophysiologically confirmed selective sensory involvement associated with SCLC and long survival (29 months). We hypothesized that the neurological course with prominent motor deficit is probably related to serum anti-GL antibody specificities. The presence of ganglioside mimicry in the SCLC (Fuentes et al., Lung Cancer, 1997) appears to be determinant for the induction of anti-GLa. However the antineural immune-response may be related to host factors.

Research paper thumbnail of Small fiber pathology parallels disease progression in Parkinson disease: a longitudinal study

Research paper thumbnail of Evidence of small fiber neuropathy in a patient with Ehlers–Danlos syndrome, hypermobility-type

Clinical Neurophysiology, 2015

Research paper thumbnail of The effects of the vibratory stimulation of the neck muscles for the evaluation of stepping performance in Parkinson's Disease

2015 IEEE International Symposium on Medical Measurements and Applications (MeMeA) Proceedings, 2015

Research paper thumbnail of Sensory nerve findings by tactile stimulation of median and ulnar nerves in healthy subjects of different ages

Electroencephalography and clinical neurophysiology, 1993

We studied orthodromic sensory conduction velocity along the distal and proximal segments of the ... more We studied orthodromic sensory conduction velocity along the distal and proximal segments of the median and ulnar nerves by tactile stimulation of the distal phalanx of the 3rd and 5th digits in 44 healthy subjects divided into 2 age groups: from 16 to 35 years and from 63 to 81 years. In the same nerves, we used selective electrical stimulation of the corresponding digital nerves to obtain sensory potentials. In both groups, responses to tactile stimuli had a longer latency and smaller amplitude than those to electrical stimulation, and they were distributed in a series of 6-7 main deflections, apparently regardless of whether the recording site was distal or proximal. Moreover, irrespective of the nerve and of subject age, conduction velocity along both the digit-wrist and the wrist-elbow nerve segments was significantly slower with tactile stimuli than with electrical stimuli. However, independently of the stimulus used, conduction velocity along the proximal nerve segment was si...

Research paper thumbnail of Relationships of kinematics indexes with amplitude and velocity of upper arm reaching movement

2013 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2013

ABSTRACT Arm reaching movements (ARM) are mainly used in rehabilitative settings, as robot mediat... more ABSTRACT Arm reaching movements (ARM) are mainly used in rehabilitative settings, as robot mediated therapies, virtual reality and motion capture systems in exergaming. ARM typical consist of gaussian-like bell shaped velocity profile. No previous paper addressed in details their relationships with amplitude and speed of the movement and aim of the paper is to study existing correlations between quantitative kinematics indexes (KI) and to describe their relationships with the amplitude and the velocity of the movement in normal subjects. We studied about one thousands of horizontal and vertical ARM of 10 normal subjects at four amplitude's values (15-20-25- 30°) and at three different target velocity (20-30- 40°/s), quantitatively evaluated by symmetry, skewness, kurtosis and smoothness indexes. KI showed extremely low correlations to each other, clearly describing different ARM features, higher correlations with the velocity than with the amplitude of the movement, and in vertical antigravitary rather than horizontal ARM. Among all KI, smoothness showed the higher correlations' values, following an exponential growth relationship both with velocity and amplitude in horizontal and vertical ARM.

Research paper thumbnail of Kinematic Indexes’ Reproducibility of Horizontal Reaching Movements

Research paper thumbnail of Kinematic and EMG patterns evaluation of upper arm reaching movements

2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob), 2012

ABSTRACT Variations in kinematic performances and muscle activations, underlying improvements in ... more ABSTRACT Variations in kinematic performances and muscle activations, underlying improvements in muscle function and strength, in response to upper arm training of patients with congenital or acquired brain injuries, are still poorly understood. One of the most interesting features of a robot-mediated therapy is the ability to quantify the performance of the rehabilitation tasks proposed to the patient. Although the shoulder is the most complex joint in the body, both for the range of freedom of movements and for the muscular-tendon structure, not so many commercial or research devices have been proposed to study its movements and no study have proposed a standardized, quantitative kinematic and electromyographic assessment. This study aimed to develop a quantitative assessment of kinematics and electromyographic pattern of the arm's muscles involved in reaching robot-assisted movements by means of indices effectively describing the main pattern features in ten normal subjects. Each subject underwent a specific eight sequences motor task protocol. The system automatically classify each movement detecting its start/end times, extract main kinematic indexes plotting activation and deactivation graphs related to eight emg channels. Results showed that particularly movement smoothness indexes and timing of emg patterns may provide an effective upper arm reaching movement assessment.

Research paper thumbnail of Effects of Regent Suit on lower limb electromyographic patterns

2013 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2013

ABSTRACT Functional recovery of limb mobility of patients with spinal or cerebral injuries can ta... more ABSTRACT Functional recovery of limb mobility of patients with spinal or cerebral injuries can take great advantage of the basic role played by sensorial and proprioceptive stimulations. On this base the Institute of Biomedical Problems of the Russian Academy of Sciences have recently developed the “Regent Suit” (RS), an experimental medical device derived from a suits worn by astronauts for therapeutical purposes during space flights. Although preliminary studies describe rehabilitation outcome of the RS in stroke, EMG changes induced by the suit are not known. Aim of the paper is to describe the effects of RS on lower limb EMG patterns on normal subjects. We studied 30 EMG gait analysis of 5 normal subjects without and with RS. Timing of maximum muscle effort over the gait cycle has been detected by the dominant peak phase of the Gaussian decomposition of the EMG envelope. Results showed a significant anticipatory effect on Soleus and Vastus Lateralis and a delay on the Tibialis Anterior and Semitendinosus due to RS elastic force recall facilitating the agonist muscle activation step. Comprehension of these EMG patterns modifications is at the base of a correct clinical use of the device, for both valid rehabilitative protocols and quantitative outcome evaluation.

Research paper thumbnail of Reproducibility of kinematics indexes of upper arm reaching movement in robot assisted therapy

2012 IEEE International Symposium on Medical Measurements and Applications Proceedings, 2012

One of the most appealing features of robot-assisted-therapy (RMT) consists in the possibility to... more One of the most appealing features of robot-assisted-therapy (RMT) consists in the possibility to quantify the performances of the rehabilitation task proposed to the patient. The analysis of kinematics indexes, providing quantitative information about movement patterns that is not captured using clinical measures, could be used as reliable outcome measures in clinical upper limb rehabilitative settings. Few papers have actually