Massimo Leandri - Academia.edu (original) (raw)

Papers by Massimo Leandri

Neurology, 1998

Alternative uses of lamotrigine and gabapentin in the treatment of trigeminal neuralgia

Clinical Neurophysiology, 2005

The trigeminal nerve and nuclei (the trigeminal complex) are unique in the human body with regard... more The trigeminal nerve and nuclei (the trigeminal complex) are unique in the human body with regard to their anatomical and physiological characteristics. They are also special regarding the lesions in which they are involved, both at the peripheral level because of the susceptibility of some terminal branches, and at the nuclei because of their large size and the large amount of connections with other centers. Conventional magnetic resonance imaging studies are often not sufficiently informative to demonstrate very tiny lesions that could be responsible for an important damage in the brainstem. Therefore, clinical neurophysiology and specifically, the techniques used in the study of the trigeminal functions, remain as convenient diagnostic and research tools to document clinically evident lesions or uncover subclinical abnormalities. This review is focussed on the clinical applicability of the study of trigeminal reflexes, including methods employed in the documentation of focal lesions of peripheral branches, trigeminal involvement of peripheral neuropathies, specific lesions of the trigeminal ganglia, central nervous dysfunctions causing abnormalities in the excitability of trigeminal neurons, and the possible use of trigeminal nerve reflexes in the study of facial pain syndromes and headache.

Frontiers in Neurology

BackgroundNabiximols is a cannabis-based drug to treat spasticity-associated symptoms currently a... more BackgroundNabiximols is a cannabis-based drug to treat spasticity-associated symptoms currently approved for patients with multiple sclerosis only. Cannabinoids are useful in an increasing number of medical conditions but may bear an increased risk for cardiovascular events. SativexStroke is a double-blind randomized placebo-controlled crossover monocentric clinical trial investigating the efficacy and safety of nabiximols in patients with spasticity following stroke.MethodsPatients were treated with nabiximols oromucosal spray or placebo and assessed before and after two phases of 1-month duration each. Cardiovascular safety was assessed before and during the trial. Primary endpoints were changes in spasticity numeric rating scale scores and electromyographic recording of the stretch reflex in affected wrist flexors. Secondary outcome measures were numeric rating scale scores for pain, sleep and bladder function, the number of daily spasms and clinical assessment of spasticity with...

European journal of physical and rehabilitation medicine, 2016

BACKGROUND Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have sensory an... more BACKGROUND Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have sensory and motor deficits leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training with computerized force platforms has been successfully used in rehabilitation of balance disturbances, but programs specifically developed for CIPN patients are lacking. AIM This pilot study evaluated a rehabilitation protocol exclusively based on visual computer-feedback balance training (VCFBT) to improve balance in patients with CIPN. DESIGN Open-label, non-randomized pilot study, 4-week intervention with pre- vs. post-treatment evaluation. SETTING Outpatients of the Rehabilitation Institute of the Salvatore Maugeri Foundation, in Genoa, Italy. POPULATION Seven out-patients with clinical-instrumental diagnosis of CIPN. METHODS At admission, patients were administered the Berg Balance Scale (BBS) and underwent static-dynamic posturography using a computerized f...

Journal of pain and symptom management, 1999

Journal of the Neurological Sciences, 2021

Background Cortical activity connected to movements has been investigated long since, and is rela... more Background Cortical activity connected to movements has been investigated long since, and is related, among other factors, to saliency of the gesture. However, experiments performed on movements in actual situations are rare, as most of them have been performed in laboratory simulations. Besides, no research seems to have been carried out on subjects during freehand drawing. New method We propose a method based upon a commercial drawing tablet and wireless pen, that has been synchronized with EEG recording by means of a piezoelectric sensor attached to the pen tip. Complete freedom of movement is allowed, and any kind of drawing style can be performed using currently available graphics software. Results EEG recordings during meaningful drawing were compared with recordings where the pen was tapped and shifted on tablet without specific purpose. With reference to T0 event (pen touching tablet), several components could be observed in pre- and post-T0 epochs. The most important appeared to be a triphasic wave (N-150, P-40 and N + 30), where P-40 showed a striking difference between drawing and tap session, being much larger in the former.

Computational and Mathematical Methods in Medicine, 2021

Interpretation of averaged evoked potentials is difficult when the time relationship between stim... more Interpretation of averaged evoked potentials is difficult when the time relationship between stimulus and response is not constant. Later components are more prone to latency jitter, making them insufficiently reliable for routine clinical use even though they could contribute to greater understanding of the functioning of polysynaptic components of the afferent nervous system. This study is aimed at providing a simple but effective method of identifying and quantifying latency jitter in averaged evoked potentials. Autocorrelation techniques were applied within defined time windows on simulated jittered signals embedded within the noise component of recorded evoked potentials and on real examples of somatosensory evoked potentials. We demonstrated that the technique accurately identifies the distribution and maximum levels of jitter of the simulated components and clearly identifies the jitter properties of real evoked potential recording components. This method is designed to compl...

Clinical Neurophysiology, 2021

Competing interest statement: the micropatterned 150 IDE is the object of a patent registration, ... more Competing interest statement: the micropatterned 150 IDE is the object of a patent registration, joint property of the University of Genova and the Italian National Research Council (CNR). The author M. Leandri, as one of the inventors, may receive a share of profits in case of commercialization and he declares a potential conflict of interest. All other authors have no conflict of interest.

Journal of Neuroscience Methods, 2020

Evoked potentials are conventionally recorded and analysed using signal averaging Averaging can p... more Evoked potentials are conventionally recorded and analysed using signal averaging Averaging can produce misleading results if the conditions are not ideal Using pairwise correlation coefficients produces a good measure of signal reliability Reliability measures displayed on the averaged trace show the reliable components This technique shows the reliability of averaged components and identifies artefacts *Highlights (for review)

European Journal of Pain, 2020

Significance: 150IDE is a promising new tool for investigating nociceptive system in patients wit... more Significance: 150IDE is a promising new tool for investigating nociceptive system in patients with neuropathic pain.

Journal of the Peripheral Nervous System, 2019

People interested in the research are advised to contact the author for the final version of the ... more People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:

Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section, 1988

Early scalp responses evoked by stimulation of the infraorbital nerve (W1, W2, W3) have been inve... more Early scalp responses evoked by stimulation of the infraorbital nerve (W1, W2, W3) have been investigated in 23 patients affected by tumours of the base of the skull (parasellar area and cerebello-pontine angle) and in 38 patients suffering from 'idiopathic' trigeminal neuralgia. Differences in conduction times between healthy and affected side were evaluated and confronted with data obtained from 30 normal volunteers. Alterations of the response were found in all the patients with tumours of the base of the skull who had clinical signs in the trigeminal area and in 7 of the 12 cases without such signs. The usual pattern of alteration in cases with tumours of the parasellar area was a parallel involvement of W2 and W3 (both absent or delayed to the same extent), whereas in tumours of the cerebello-pontine angle W3 was more seriously affected than W2. Wave W1 was never altered. Pre- and post-operative recording sessions in 2 patients showed definite improvement of the responses after removal of the tumour. In 9 patients suffering from 'idiopathic' trigeminal neuralgia delays of conduction were found on the painful side, suggesting that damage to the trigeminal root, possibly at its entry zone into the pons, had taken place. Retrogasserian injection of glycerol was performed in 12 of the 38 patients with trigeminal neuralgia. Stimulation of the operated side showed disappearance of W2 and W3 in 9 cases, prolonged W1-W3 interval in 2 cases and no alterations in 1 case. The extent of response alteration usually paralleled the clinical results.

Electroencephalography and Clinical Neurophysiology, 1984

The effects of high pass filters with cut-off frequencies of 160 and 320 Hz on computer-construct... more The effects of high pass filters with cut-off frequencies of 160 and 320 Hz on computer-constructed potentials with known parameters were studied. It is concluded that high pass filtering using high cut-off frequencies introduces temporal and amplitude distortions and artefacts which may not be distinguished from true potentials.

Clinical Neurophysiology, 2016

to conventional syntomatic and/or prophylactic polytherapy, afferent to the Regional Reference Ce... more to conventional syntomatic and/or prophylactic polytherapy, afferent to the Regional Reference Center of Chemical denervation (RRCCd) of Careggi Hospital, in 2011-2014 period. Each patient was treated (after informed consent) with onabotulinum-toxin A (dose-range 155-195U) every 3 months, according to Blumenfeld's protocol. We considered the following parameters: frequence (F) and intensity (I) of migraine attacks and drug's use (D). We employed an ANOVA for repeated measures to test for changes across time. All 76 patients received the toxin treatment at least four time: 44/76 responded to treatment (38F-6M).The parameters F, I, D showed a progressive and gradual decline with time (p < 0.001 for each variables), reaching the maximum effect from the IV treatment. Only one patient (1, 3%) dropped out for neck pain. In our study a high percentage of patients (58%) showed an improvement of the quality of life with a reduction of frequency/intensity of migraine attack and a reduction in drugs consumption. OnabotulinumtoxinA represents a safe, tollerated and effective prophylactic treatment in ''refractory" chronic migraine.

Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section, 1986

The origins of early waves recorded from the scalp of man after stimulation of the infraorbital n... more The origins of early waves recorded from the scalp of man after stimulation of the infraorbital nerve have been investigated by sinmltaneous recording from the scalp and from the trigeminal pathway in patients undergoing thermocoagulation rhizotomy. It has been found that the surface-recorded W1, W2 and W3 waves correspond respectively to the activity of the point of entry of the maxillary nerve into the gasserian ganglion, the point of entry of the trigeminal root into the pons and the presynaptic portion of the trigerninal spinal tract. It is remarked that depth recording during surgery may provide useful information about the positioning of the thermocoagulation electrode.

Journal of neuroscience methods, Jan 9, 2017

No satisfactory neurophysiological test for nociceptive afferents is available to date. Laser sti... more No satisfactory neurophysiological test for nociceptive afferents is available to date. Laser stimuli present risks of skin damage, whilst electrical stimulation through specially designed electrodes is not selective enough. We present a new electrode designed according to critical issues identified in preliminary computer simulations concerning electric field gradient through the skin. To provide selective stimulation the activating electric field must be limited to intraepidermal free nerve endings. To this end, a new interdigitated electrode (IDE) was made of conductive rails arranged in a comb-like micropattern, situated only 150μm apart from each other (150 IDE) and alternately connected to the opposite poles of the stimulator. Evoked potentials recorded from the scalp were obtained after stimulation with the 150 IDE and with a similarly designed, but more widely spaced electrode (1000μm, or 1000 IDE). Small amplitude early and medium latency components were recorded with the 1...

Physical Therapy, 1986

The purpose of this study was to determine whether some types of transcutaneous electrical nerve ... more The purpose of this study was to determine whether some types of transcutaneous electrical nerve stimulation cause local vasodilation. The amount of vascular perfusion was monitored using telethermography to gauge the skin temperature of the area to which TENS was applied. We studied the effects of four different modalities of TENS (intensities of 1.5 and 3 times the sensory threshold and frequencies of 3 pulses per second [pps] and 100 pps), delivered through small and large electrodes (1.5 cm and 4 cm in diameter), on 10 healthy subjects. Stimulation at 3 times the sensory threshold produced local hyperthermia, which was maximal when a current of 100 pps was delivered through small electrodes. Because any physical or chemical effects of the current could be eliminated as causes of hyperthermia, the rise in skin temperature was considered to be a result of increased vascular perfusion. The results of the study demonstrate that some types of TENS cause local vasodilation. This effect may represent another mechanism by which such techniques provide pain relief, particularly in the treatment of myofascial syndromes.