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Papers by M. V De Angelis

Research paper thumbnail of ECG monitoring of post-stroke occurring arrhythmias: an observational study using 7-day Holter ECG

Scientific Reports, 2022

Post-stroke arrhythmias represent a risk factor for complications and worse prognosis after cereb... more Post-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...

Research paper thumbnail of P1011Cryptogenic stoke and asymptomatic atrial fibrillation in a real world population: a single centre, implantable loop recorder study

Europace, 2020

None The incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studi... more None The incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studied in carefully controlled clinical trials, but real-world data are limited. Aim of this study was to investigated the incidence of AF in clinical practice among CS patients with an implantable cardiac monitor (ICM) recommended (IIA) for AF detection. Patients with CS admitted to our Stroke Unit were included in the study. Patiens received an ICM and were monitored for up to 2 years for AF detection (in-hospital clinic and remote monitoring). All detected AF episodes (≥30 sec) were considered. From March 2016 to March 2019, 58 patients (mean age 68 ±12 years, 67% male) received an ICM to detect AF after a CS. No patients were lost during follow-up. AF was detected in 23 patients (40% overall; AF group mean age 72 ± 11 years; 65% male) after a mean time of 6 months from ICM implantation (ranging from 2 days up to 2 years) and 8 months after CS (ranging from 1 month up to 2 years). In the...

Research paper thumbnail of Chronic inflammatory demyelinating polyneuropathy in diabetics: Motor conductions are important in the differential diagnosis with diabetic polyneuropathy

Clinical Neurophysiology

ABSTRACT

Research paper thumbnail of Long half-life and prolonged-release dopamine receptor agonists: a review of ropinirole prolonged-release studies

Parkinsonism & Related Disorders, 2009

Our review summarizes the five main studies conducted to evaluate the efficacy and pharmacokineti... more Our review summarizes the five main studies conducted to evaluate the efficacy and pharmacokinetics of ropinirole prolonged release (PR) in Parkinson's disease (PD). The PR formulation was developed with Geomatrix coating technology in order to obtain constant pharmacokinetics throughout 24 hours. The areas under the curve were not significantly different from those observed with similar doses of ropinirole immediate-release (IR) formulation, administered 3 times a day, but concentration fluctuations were less for ropinirole PR (2-fold vs 5-fold). The efficacy study of the PR versus IR formulations showed non-inferiority of the PR formulation, similar tolerability and feasibility of overnight switches, and indicated that the optimal doses of ropinirole in patients with de novo PD is in the range of 8-12 mg/day. The efficacy study in PD patients with motor fluctuations treated with L-dopa showed that adding ropinirole PR significantly reduced "off" time and increased "on" time in comparison with placebo. The study with ropinirole as an add-on to L-dopa showed a reduced incidence of dyskinesias.

Research paper thumbnail of Facioscapulohumeral muscular dystrophy presenting isolated monomelic lower limb atrophy. Report of two patients with and without 4q35 rearrangement

Neuromuscular Disorders, 2002

Research paper thumbnail of Teaching NeuroImages: A dangerous complication of spontaneous intracranial hypotension

Research paper thumbnail of Segmental conduction abnormalities and myelin thickenings in Val102/fs null mutation of MPZ gene

Research paper thumbnail of Dysmyelinating sensory-motor neuropathy in merosin-deficient congenital muscular dystrophy

Research paper thumbnail of JUVENILE, AUTOSOMAL DOMINANT, DISTAL SPINAL MUSCULAR ATROPHY AND NEUROSENSORIAL DEAFNESS NOT LINKED TO CHROMOSOME 12q24

Journal of the Peripheral Nervous System, 2000

Research paper thumbnail of Demyelinating motor guillain-barre syndrome following rubella

Journal of the Peripheral Nervous System, 2004

Research paper thumbnail of Experimental axonopathy induced by immunization with Campylobacter jejuni lipopolysaccharide from a patient with Guillain-Barré syndrome

Journal of Neuroimmunology, 2006

New Zealand white rabbits were immunized with a lipopolysaccharide (LPS) extracted from a Campylo... more New Zealand white rabbits were immunized with a lipopolysaccharide (LPS) extracted from a Campylobacter jejuni HS:19 strain isolated from a GBS patient expressing GM1 and GD1a-like epitopes, Freund's adjuvant (group I) and Freund's adjuvant plus keyhole lympet hemocyanin (KLH) (group II). Both groups showed high titers of anti-LPS and anti-GM1 and lower titers of anti-GD1b and anti-GD1a antibodies. Weakness and axonal degeneration in sciatic nerves was detected in 1/11 of group I and 6/7 of group II. This model replicates, at least in part, the pathogenetic process hypothesized in the human axonal GBS with antiganglioside antibodies post C. jejuni infection and indicates that KLH plays an additional role in neuropathy induction.

Research paper thumbnail of Anti-GD1a antibodies from an acute motor axonal neuropathy patient selectively bind to motor nerve fiber nodes of Ranvier

Journal of Neuroimmunology, 2001

Acute motor axonal neuropathy (AMAN) is associated with high titer anti-GD1a antibodies. We have ... more Acute motor axonal neuropathy (AMAN) is associated with high titer anti-GD1a antibodies. We have found that very high titer IgG anti-GD1a antibodies (Ab) from one AMAN patient selectively bind to motor, but not sensory, nerve nodes of Ranvier. Binding is abolished by preadsorption with GD1a. Sera negative for Ab do not immunostain motor and sensory nerve roots. We have also found that botulinum toxin A (BTA), which binds to GD1a, stains both motor and sensory nerve nodes of Ranvier. Our results strongly support the pathogenetic role of anti-GD1a antibodies in AMAN. Why BTA also binds to sensory fibers still remains to be elucidated, although the different size of BTA and its specificity to other gangliosides present in sensory axons might represent important factors.

Research paper thumbnail of Effect of rhTNF-α injection into rat sciatic nerve

Journal of Neuroimmunology, 1999

Research paper thumbnail of Recurrent and fatal akinetic crisis in genetic-mitochondrial parkinsonisms

European Journal of Neurology, 2014

Research paper thumbnail of Minimal and asymptomatic chronic inflammatory demyelinating polyneuropathy

Clinical Neurophysiology, 1999

Show the chronic inflammatory demyelinating polyneuropathy (CIDP) is not only clinically heteroge... more Show the chronic inflammatory demyelinating polyneuropathy (CIDP) is not only clinically heterogeneous but extremely variable in severity. Three patients were referred for mild distal paresthesiae lasting more than 6 months and one for inguinal and thigh pain later ascribed to coxarthrosis. Strength was normal in all patients and tactile sensation reduced distally only in one. Tendon jerks were absent, except the knee jerks in one patient, reduced in lower limbs in two and normal in one. Electrophysiology showed a demyelinating neuropathy without motor conduction block. CSF protein content was increased in all patients. Nerve biopsies showed de-remyelination with varying degrees of axonal loss. Genetic studies excluded a demyelinating neuropathy associated with duplication or deletion of the 17p.11.2 segment. CIDP patients with pure sensory clinical presentation have been described but are generally more severely impaired. However, because of the mildness of symptoms and the unequivocal electrophysiological involvement of motor fibers, we think that in these cases the term minimal CIDP is more appropriate than sensory CIDP. These cases represent the most benign end of the CIDP spectrum. In our series minimal or even asymptomatic CIDP encompasses 8% of cases.

Research paper thumbnail of Chronic inflammatory demyelinating polyneuropathy in diabetics: motor conductions are important in the differential diagnosis with diabetic polyneuropathy

Clinical Neurophysiology, 1999

ABSTRACT

Research paper thumbnail of Inter-nerves and intra-nerve conduction heterogeneity in CMTX with Arg(15)Gln mutation

Clinical Neurophysiology, 2004

Research paper thumbnail of Efficacy of a soft hand brace and a wrist splint for carpal tunnel syndrome: a randomized controlled study

Acta Neurologica Scandinavica, 2009

Research paper thumbnail of Autosomal dominant distal spinal muscular atrophy: an Italian family not linked to 12q24 and 7p14

Neuromuscular Disorders, 2002

Distal spinal muscular atrophy is genetically heterogeneous, as sporadic cases and both autosomal... more Distal spinal muscular atrophy is genetically heterogeneous, as sporadic cases and both autosomal dominant and recessive inheritances have been described. An autosomal dominant distal spinal muscular atrophy with upper limb predominance has been mapped to chromosome 7p, and more recently, an autosomal dominant distal spinal muscular atrophy with lower limb predominance has been linked to chromosome 12q24.We describe a four generation Italian family with autosomal dominant distal spinal muscular atrophy starting between 8 and 30 years with weakness and atrophy of distal leg muscles. The older patients also presented sensorineural deafness. We performed genetic linkage analysis with microsatellite markers D12S366, D12S349, D12S86, D12S321, D12S1612, D12S1349, D12S342, PLA2A on chromosome 12q24 and D7S516, D7S2496, D7S632, D7S2252 on chromosome 7p14. No support for linkage to chromosome 12q24 and 7p14 was found in our family, confirming a genetic heterogeneity within autosomal dominant distal spinal muscular atrophy.

Research paper thumbnail of Low back pain due to hypertrophic roots as presenting symptom of CIDP

The Italian Journal of Neurological Sciences, Oct 1, 1997

Attention has recently been drawn to chronic inflammatory demyelinating polyneuropathy (CIDP) wit... more Attention has recently been drawn to chronic inflammatory demyelinating polyneuropathy (CIDP) with symptomatic nerve root hypertrophy. A 31-year-old woman had fluctuating and worsening low back pain. Absent tendon jerks and a slight weakness of the hand interossei muscles suggested a diffuse neuropathy. The electrophysiological and histological findings were diagnostic for CIDP. Lumbar spine MRI showed marked nerve root enlargement with gadolinium enhancement. This case widens the range of the clinical presentations of CIDP. Further studies are warranted to ascertain whether cauda equina gadolinium enhancement may be a useful tool in the diagnosis of CIDP and a marker of disease activity for monitoring response to therapy.

Research paper thumbnail of ECG monitoring of post-stroke occurring arrhythmias: an observational study using 7-day Holter ECG

Scientific Reports, 2022

Post-stroke arrhythmias represent a risk factor for complications and worse prognosis after cereb... more Post-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...

Research paper thumbnail of P1011Cryptogenic stoke and asymptomatic atrial fibrillation in a real world population: a single centre, implantable loop recorder study

Europace, 2020

None The incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studi... more None The incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studied in carefully controlled clinical trials, but real-world data are limited. Aim of this study was to investigated the incidence of AF in clinical practice among CS patients with an implantable cardiac monitor (ICM) recommended (IIA) for AF detection. Patients with CS admitted to our Stroke Unit were included in the study. Patiens received an ICM and were monitored for up to 2 years for AF detection (in-hospital clinic and remote monitoring). All detected AF episodes (≥30 sec) were considered. From March 2016 to March 2019, 58 patients (mean age 68 ±12 years, 67% male) received an ICM to detect AF after a CS. No patients were lost during follow-up. AF was detected in 23 patients (40% overall; AF group mean age 72 ± 11 years; 65% male) after a mean time of 6 months from ICM implantation (ranging from 2 days up to 2 years) and 8 months after CS (ranging from 1 month up to 2 years). In the...

Research paper thumbnail of Chronic inflammatory demyelinating polyneuropathy in diabetics: Motor conductions are important in the differential diagnosis with diabetic polyneuropathy

Clinical Neurophysiology

ABSTRACT

Research paper thumbnail of Long half-life and prolonged-release dopamine receptor agonists: a review of ropinirole prolonged-release studies

Parkinsonism & Related Disorders, 2009

Our review summarizes the five main studies conducted to evaluate the efficacy and pharmacokineti... more Our review summarizes the five main studies conducted to evaluate the efficacy and pharmacokinetics of ropinirole prolonged release (PR) in Parkinson's disease (PD). The PR formulation was developed with Geomatrix coating technology in order to obtain constant pharmacokinetics throughout 24 hours. The areas under the curve were not significantly different from those observed with similar doses of ropinirole immediate-release (IR) formulation, administered 3 times a day, but concentration fluctuations were less for ropinirole PR (2-fold vs 5-fold). The efficacy study of the PR versus IR formulations showed non-inferiority of the PR formulation, similar tolerability and feasibility of overnight switches, and indicated that the optimal doses of ropinirole in patients with de novo PD is in the range of 8-12 mg/day. The efficacy study in PD patients with motor fluctuations treated with L-dopa showed that adding ropinirole PR significantly reduced "off" time and increased "on" time in comparison with placebo. The study with ropinirole as an add-on to L-dopa showed a reduced incidence of dyskinesias.

Research paper thumbnail of Facioscapulohumeral muscular dystrophy presenting isolated monomelic lower limb atrophy. Report of two patients with and without 4q35 rearrangement

Neuromuscular Disorders, 2002

Research paper thumbnail of Teaching NeuroImages: A dangerous complication of spontaneous intracranial hypotension

Research paper thumbnail of Segmental conduction abnormalities and myelin thickenings in Val102/fs null mutation of MPZ gene

Research paper thumbnail of Dysmyelinating sensory-motor neuropathy in merosin-deficient congenital muscular dystrophy

Research paper thumbnail of JUVENILE, AUTOSOMAL DOMINANT, DISTAL SPINAL MUSCULAR ATROPHY AND NEUROSENSORIAL DEAFNESS NOT LINKED TO CHROMOSOME 12q24

Journal of the Peripheral Nervous System, 2000

Research paper thumbnail of Demyelinating motor guillain-barre syndrome following rubella

Journal of the Peripheral Nervous System, 2004

Research paper thumbnail of Experimental axonopathy induced by immunization with Campylobacter jejuni lipopolysaccharide from a patient with Guillain-Barré syndrome

Journal of Neuroimmunology, 2006

New Zealand white rabbits were immunized with a lipopolysaccharide (LPS) extracted from a Campylo... more New Zealand white rabbits were immunized with a lipopolysaccharide (LPS) extracted from a Campylobacter jejuni HS:19 strain isolated from a GBS patient expressing GM1 and GD1a-like epitopes, Freund's adjuvant (group I) and Freund's adjuvant plus keyhole lympet hemocyanin (KLH) (group II). Both groups showed high titers of anti-LPS and anti-GM1 and lower titers of anti-GD1b and anti-GD1a antibodies. Weakness and axonal degeneration in sciatic nerves was detected in 1/11 of group I and 6/7 of group II. This model replicates, at least in part, the pathogenetic process hypothesized in the human axonal GBS with antiganglioside antibodies post C. jejuni infection and indicates that KLH plays an additional role in neuropathy induction.

Research paper thumbnail of Anti-GD1a antibodies from an acute motor axonal neuropathy patient selectively bind to motor nerve fiber nodes of Ranvier

Journal of Neuroimmunology, 2001

Acute motor axonal neuropathy (AMAN) is associated with high titer anti-GD1a antibodies. We have ... more Acute motor axonal neuropathy (AMAN) is associated with high titer anti-GD1a antibodies. We have found that very high titer IgG anti-GD1a antibodies (Ab) from one AMAN patient selectively bind to motor, but not sensory, nerve nodes of Ranvier. Binding is abolished by preadsorption with GD1a. Sera negative for Ab do not immunostain motor and sensory nerve roots. We have also found that botulinum toxin A (BTA), which binds to GD1a, stains both motor and sensory nerve nodes of Ranvier. Our results strongly support the pathogenetic role of anti-GD1a antibodies in AMAN. Why BTA also binds to sensory fibers still remains to be elucidated, although the different size of BTA and its specificity to other gangliosides present in sensory axons might represent important factors.

Research paper thumbnail of Effect of rhTNF-α injection into rat sciatic nerve

Journal of Neuroimmunology, 1999

Research paper thumbnail of Recurrent and fatal akinetic crisis in genetic-mitochondrial parkinsonisms

European Journal of Neurology, 2014

Research paper thumbnail of Minimal and asymptomatic chronic inflammatory demyelinating polyneuropathy

Clinical Neurophysiology, 1999

Show the chronic inflammatory demyelinating polyneuropathy (CIDP) is not only clinically heteroge... more Show the chronic inflammatory demyelinating polyneuropathy (CIDP) is not only clinically heterogeneous but extremely variable in severity. Three patients were referred for mild distal paresthesiae lasting more than 6 months and one for inguinal and thigh pain later ascribed to coxarthrosis. Strength was normal in all patients and tactile sensation reduced distally only in one. Tendon jerks were absent, except the knee jerks in one patient, reduced in lower limbs in two and normal in one. Electrophysiology showed a demyelinating neuropathy without motor conduction block. CSF protein content was increased in all patients. Nerve biopsies showed de-remyelination with varying degrees of axonal loss. Genetic studies excluded a demyelinating neuropathy associated with duplication or deletion of the 17p.11.2 segment. CIDP patients with pure sensory clinical presentation have been described but are generally more severely impaired. However, because of the mildness of symptoms and the unequivocal electrophysiological involvement of motor fibers, we think that in these cases the term minimal CIDP is more appropriate than sensory CIDP. These cases represent the most benign end of the CIDP spectrum. In our series minimal or even asymptomatic CIDP encompasses 8% of cases.

Research paper thumbnail of Chronic inflammatory demyelinating polyneuropathy in diabetics: motor conductions are important in the differential diagnosis with diabetic polyneuropathy

Clinical Neurophysiology, 1999

ABSTRACT

Research paper thumbnail of Inter-nerves and intra-nerve conduction heterogeneity in CMTX with Arg(15)Gln mutation

Clinical Neurophysiology, 2004

Research paper thumbnail of Efficacy of a soft hand brace and a wrist splint for carpal tunnel syndrome: a randomized controlled study

Acta Neurologica Scandinavica, 2009

Research paper thumbnail of Autosomal dominant distal spinal muscular atrophy: an Italian family not linked to 12q24 and 7p14

Neuromuscular Disorders, 2002

Distal spinal muscular atrophy is genetically heterogeneous, as sporadic cases and both autosomal... more Distal spinal muscular atrophy is genetically heterogeneous, as sporadic cases and both autosomal dominant and recessive inheritances have been described. An autosomal dominant distal spinal muscular atrophy with upper limb predominance has been mapped to chromosome 7p, and more recently, an autosomal dominant distal spinal muscular atrophy with lower limb predominance has been linked to chromosome 12q24.We describe a four generation Italian family with autosomal dominant distal spinal muscular atrophy starting between 8 and 30 years with weakness and atrophy of distal leg muscles. The older patients also presented sensorineural deafness. We performed genetic linkage analysis with microsatellite markers D12S366, D12S349, D12S86, D12S321, D12S1612, D12S1349, D12S342, PLA2A on chromosome 12q24 and D7S516, D7S2496, D7S632, D7S2252 on chromosome 7p14. No support for linkage to chromosome 12q24 and 7p14 was found in our family, confirming a genetic heterogeneity within autosomal dominant distal spinal muscular atrophy.

Research paper thumbnail of Low back pain due to hypertrophic roots as presenting symptom of CIDP

The Italian Journal of Neurological Sciences, Oct 1, 1997

Attention has recently been drawn to chronic inflammatory demyelinating polyneuropathy (CIDP) wit... more Attention has recently been drawn to chronic inflammatory demyelinating polyneuropathy (CIDP) with symptomatic nerve root hypertrophy. A 31-year-old woman had fluctuating and worsening low back pain. Absent tendon jerks and a slight weakness of the hand interossei muscles suggested a diffuse neuropathy. The electrophysiological and histological findings were diagnostic for CIDP. Lumbar spine MRI showed marked nerve root enlargement with gadolinium enhancement. This case widens the range of the clinical presentations of CIDP. Further studies are warranted to ascertain whether cauda equina gadolinium enhancement may be a useful tool in the diagnosis of CIDP and a marker of disease activity for monitoring response to therapy.