Matteo Signorini - Academia.edu (original) (raw)
Papers by Matteo Signorini
The Journal of Trauma: Injury, Infection, and Critical Care, 1983
The remarkable progress achieved in control of infections in burned patients has significantly in... more The remarkable progress achieved in control of infections in burned patients has significantly increased survival rates. Nevertheless, septic complications are still the leading cause of death in these patients. The immunologic disturbances present after severe burns certainly play a key role in susceptibility to infection, and in particular the impairments of the phagocytic system warrant major investigative efforts in order to increase host defenses. Determination of phagocytic and microbicidal capacity of neutrophils from burned patients evidenced a marked functional impairment of these cells. The alterations recorded were partly due to intrinsic (cellular) defects, and partly to extrinsic (serum) defects. Indeed, opsonic factors are known to be reduced in these patients, but also phagocytosis-inhibiting factors such as immunocomplexes have been detected in the patients we have studied. Administration of the immunomodulating agents methysoprinol and timostimoline were found to be effective in partially restoring neutrophil function. Rational immunotherapy in burned patients will consist of replacement of humoral mediators, clearance of inhibitory factors and stimulation of the cellular effectors of immunity.
Aging Clinical and Experimental Research, 2013
Frontiers in Psychology, 2019
Neurological Sciences
Tele-neuropsychology, i.e., the application of remote audiovisual technologies to neuropsychologi... more Tele-neuropsychology, i.e., the application of remote audiovisual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cutoffs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cutoffs , are accessible on OSF at https:// osf. io/ t3bma/ under a Creative Commons license.
Frontiers in Psychology, 2019
European Geriatric Medicine, 2015
Abstract Introduction Dementia is one of the major causes of disability and dependency among olde... more Abstract Introduction Dementia is one of the major causes of disability and dependency among older people worldwide, and hospitalization occurs frequently in demented patients. The present study examined the course of behavioural symptoms and functional conditions in hospitalised older people with dementia. Materials and methods Prospective cohort study of 179 demented patients (age > 64 years) admitted to four geriatric units, evaluated at admission, discharge and at 6 months after discharge. An analysis of predictors of functioning improvement was performed. Results Patients with no symptoms at NeuroPsychiatric Inventory baseline assessment did not show any changes at both discharge and follow-up, while patients with symptoms at baseline showed an improvement in every subscale from admission to discharge. Using Barthel Index as a measure of functioning, we found a significant improvement in both "admission-discharge" and "discharge-follow-up" timeframe for the most impaired patients. However, for the less impaired patients, no significant changes emerged from admission to discharge, while a significant worsening occurred from discharge to follow-up. The significant associated variables with improvement in Barthel Index from discharge to follow-up were age and Blaylock Risk Assessment Screening Score at admission. Conclusion Interesting trends in the course of hospitalized older patients with dementia have been found, and they were associated to different levels of functional impairment at admission. Further research is still needed to understand the predictors of improvement and worsening in such hospitalized patients.
![Research paper thumbnail of Rapid Assessment of Regional Cerebral Metabolic Abnormalities in Single Subjects with Quantitative and Nonquantitative [18F]FDG PET: A Clinical Validation of Statistical Parametric Mapping](https://attachments.academia-assets.com/94744920/thumbnails/1.jpg)
](NeuroImage, 1999
The [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) method for measuring brain metabolism has not the wide... more The [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) method for measuring brain metabolism has not the wide clinical application that one might expect, partly because of its high cost and the complexity of the quantification procedure, but also because of reporting techniques based on region of interest (ROI) analysis, which are time-consuming and not fully objective. In this paper we report a clinical validation of statistical parametric mapping (SPM) using rCMRglc (quantitative) and radioactivity distribution (nonquantitative) [ 18 F]FDG PET data. We show that a 10-min noninteractive voxelbased SPM analysis on a standard workstation enables objective assessment, including localization in stereotactic space, of regional glucose consumption abnormalities, whose reliability can be assessed on statistical and clinical grounds. Clinical validity was established using a small series of patients with degenerative or developmental disorders, including probable Alzheimer's disease, progressive aphasia, multiple sclerosis, developmental specific language impairment, and epilepsy. Analysis of quantitative and nonquantitative data showed the same pattern of results, suggesting that, for clinical purposes, quantitation and invasive arterial cannulation can be avoided. This should facilitate a wider application of the technique and the extension of SPM clinical analysis to H 2 15 O PET or high resolution SPECT perfusion studies. 1999 Academic Press
NeuroImage, 2009
Vocabulary acquisition is such a major aspect of language learning in children, but also in adult... more Vocabulary acquisition is such a major aspect of language learning in children, but also in adults when learning a foreign language, that a dedicated vocabulary learning device may exist within the language organ. To identify the relevant brain systems, we performed regional cerebral blood flow measurements in normal subjects while they were learning a list of neologisms or a list of word-nonword pairs. Structures implicated in phonological short-term memory (Broca's area, left temporo-parietal junction) were steadily activated during nonwords learning, while the left temporal lobe neocortical and paralimbic structures (parahippocampal region), associated with long-term memory, contributed to learning in a time-dependent manner, with maximal activation at the beginning of the process. The neural system specifically activated when learning new vocabulary was strongly lateralized to the left hemisphere. This evidence refines current models of memory function and supports theories which emphasise the importance of phonological competence in hemispheric dominance for language.
NeuroImage, 2001
Vocabulary acquisition is major aspect of language learning in children but also in adults, parti... more Vocabulary acquisition is major aspect of language learning in children but also in adults, particularly when learning a foreign language. Selective impairment of vocabulary acquisition is observed in patients with auditory-verbal (phonological) short-term memory deficit, while a more general failure of long-term learning of verbal information is observed in amnesia. Anatomical studies in brain damaged patients have not been fully informative, as they fail to indicate the exact localization of the brain regions involved in vocabulary learning. To identify the relevant brain systems, we performed regional cerebral blood flow (rCBF) PET measurements in six normal subjects while they were learning a list of neologisms or a list of common words.
Movement Disorders, 2005
The impairment in action fluency task present in Parkinson's disease (PD) patients has been previ... more The impairment in action fluency task present in Parkinson's disease (PD) patients has been previously interpreted as an indicator of conversion from PD to PD with dementia or as a grammatical deficit for verbs and ascribed to a frontostriatal loop pathophysiology. In the present study, 20 patients with PD without dementia were longitudinally tested with overall cognitive decline scales and semantic, letter, and action fluency tasks in a 24-month follow-up study. In comparison with healthy age-matched controls, PD patients showed a stable and consistent impairment on action fluency without any sign of cognitive decline. Our findings suggest that action fluency task may be an early sign of impairment of frontostriatal circuits in PD and it cannot be considered an indicator of conversion from PD to PD with dementia.
Cortex, 2001
We report a left parietal damaged, acalculic, non aphasic patient who showed a specific deficit i... more We report a left parietal damaged, acalculic, non aphasic patient who showed a specific deficit in reading Arabic and spelled-out numerals. Word reading was flawless, while he showed a severe impairment in reading meaningless strings of phonemes (phonological alexia). He also showed a dissociation between the preserved ability to retrieve knowledge about general facts and the impairment in retrieving cardinal, personal and non-personal numerical facts. These findings point to a separate organization in the brain of the numerical domain.
Cognitive and Behavioral Neurology, 2009
Objective: This study seeks to identify the possible relationship between certain executive funct... more Objective: This study seeks to identify the possible relationship between certain executive functions and the main personality traits in 25 nondemented Parkinson disease (PD) patients. Background: Both the presence of cognitive changes-mainly concerning executive functions-and peculiar personality traits, such as low novelty seeking, moral rigidity, industriousness, or introversion, were fully documented in PD patients. Methods: Patients underwent the Tower of London test and Alternating Fluency tasks for planning abilities and cognitive flexibility to be assessed. Personality features were evaluated using the Big Five Adjectives checklist. Results: The study provided evidence of a significant correlation between the Tower of London and the Emotional Stability factor and between Alternating Fluencies and the Openness to Experience factor. Conclusions: The Tower of London test and the Emotional Stability factor may require filtering of irrelevant information, activation of inhibition mechanisms, and use of negative feedback. The Alternating Fluency tasks and the Openness to Experience factor may require the ability to switch set and to express flexible thoughts or opinions in daily life. These results indicate that cognitive and personality changes in PD may be different expressions of a common psychologic mechanism related to the dysfunction of the frontostriatal system.
Brain and Language, 2000
Most nonhuman species are able to work through numerical quantities at various levels, such as me... more Most nonhuman species are able to work through numerical quantities at various levels, such as memorizing, comparing or adding, although at an approximate level. On the other hand, their ability to manipulate symbolic numerical labels is, at best, primitive (for a review see Dehaene, 1997; Butterworth, 1999). Similarly, while nonhuman species use elaborate communication systems, language, a formal grammatical system, is a species-specific innate ability (for a review see Pinker, 1994). From the above considerations the following questions arise: are number processing abilities and language underpinned by specific cognitive systems, provided with dedicated neural substrates, or do they share, partially or totally, the same functional and anatomical substrates? A substantial contribution, although not exhaustive, in trying to disentangle such problems has been offered by neuropsychology. Since Déjerine's (1892) pioneering observations of a selective sparing of numerical processing in pure alexia and the report of a relative preservation of number comprehension in comparison to other semantic category in a group of aphasic patients (Goodglass, Klein, Carey, & Jones, 1966), the independence of number and language processing seemed to be firmly established. Similarly, the report of pure acalculia following left parietal lesion highlighted the autonomy, both from an anatomical and functional point of view of calculation from language system.
BMC Geriatrics, 2013
Background: People with idiopathic Parkinson's disease (PD) frequently have low activity levels, ... more Background: People with idiopathic Parkinson's disease (PD) frequently have low activity levels, poor mobility and reduced quality of life. Although increased physical activity may improve mobility, balance and wellbeing, adherence to exercises and activity programs over the longer term can be challenging, particularly for older people with progressive neurological conditions such as PD. Physical activities that are engaging and enjoyable, such as dancing, might enhance adherence over the long term. The objective of this study was to evaluate the feasibility of a randomized controlled trial of Irish set dancing compared with routine physiotherapy for people with mild to moderately severe PD. Methods: Twenty-four people with idiopathic PD referred for movement rehabilitation were randomized to receive standard physiotherapy exercises or Irish set dancing classes once per week plus a weekly home program for 6 months (12 in each group). The feasibility and safety of the proposed RCT protocol was the main focus of this evaluation. The primary outcome was motor disability measured by the motor component of the UPDRS, which was assessed prior to and after therapy by trained assessors blinded to group assignment. The Timed Up and Go, the Berg Balance Scale and the modified Freezing of Gait Questionnaire were secondary measures. Quality of life of the people with PD was evaluated using the PDQ-39. Results: Both the Irish set dancing and physiotherapy exercise program were shown to be feasible and safe. There were no differences between groups in the rate of adverse events such as falls, serious injuries, death or rates of admission to hospital. The physiotherapists who provided usual care remained blind to group allocation, with no change in their standard clinical practice. Compliance and adherence to both the exercise and dance programs were very high and attrition rates were low over the 6 months of therapy. Although improvements were made in both groups, the dance group showed superior results to standard physiotherapy in relation to freezing of gait, balance and motor disability. Conclusions: Irish dancing and physiotherapy were both safe and feasible in this sample from Venice, with good adherence over a comparatively long time period of 6 months. A larger multi-centre trial is now warranted to establish whether Irish set dancing is more effective than routine physiotherapy for enhancing mobility, balance and quality of life in people living with idiopathic PD.
The Journal of Trauma: Injury, Infection, and Critical Care, 1983
The remarkable progress achieved in control of infections in burned patients has significantly in... more The remarkable progress achieved in control of infections in burned patients has significantly increased survival rates. Nevertheless, septic complications are still the leading cause of death in these patients. The immunologic disturbances present after severe burns certainly play a key role in susceptibility to infection, and in particular the impairments of the phagocytic system warrant major investigative efforts in order to increase host defenses. Determination of phagocytic and microbicidal capacity of neutrophils from burned patients evidenced a marked functional impairment of these cells. The alterations recorded were partly due to intrinsic (cellular) defects, and partly to extrinsic (serum) defects. Indeed, opsonic factors are known to be reduced in these patients, but also phagocytosis-inhibiting factors such as immunocomplexes have been detected in the patients we have studied. Administration of the immunomodulating agents methysoprinol and timostimoline were found to be effective in partially restoring neutrophil function. Rational immunotherapy in burned patients will consist of replacement of humoral mediators, clearance of inhibitory factors and stimulation of the cellular effectors of immunity.
Aging Clinical and Experimental Research, 2013
Frontiers in Psychology, 2019
Neurological Sciences
Tele-neuropsychology, i.e., the application of remote audiovisual technologies to neuropsychologi... more Tele-neuropsychology, i.e., the application of remote audiovisual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cutoffs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cutoffs , are accessible on OSF at https:// osf. io/ t3bma/ under a Creative Commons license.
Frontiers in Psychology, 2019
European Geriatric Medicine, 2015
Abstract Introduction Dementia is one of the major causes of disability and dependency among olde... more Abstract Introduction Dementia is one of the major causes of disability and dependency among older people worldwide, and hospitalization occurs frequently in demented patients. The present study examined the course of behavioural symptoms and functional conditions in hospitalised older people with dementia. Materials and methods Prospective cohort study of 179 demented patients (age > 64 years) admitted to four geriatric units, evaluated at admission, discharge and at 6 months after discharge. An analysis of predictors of functioning improvement was performed. Results Patients with no symptoms at NeuroPsychiatric Inventory baseline assessment did not show any changes at both discharge and follow-up, while patients with symptoms at baseline showed an improvement in every subscale from admission to discharge. Using Barthel Index as a measure of functioning, we found a significant improvement in both "admission-discharge" and "discharge-follow-up" timeframe for the most impaired patients. However, for the less impaired patients, no significant changes emerged from admission to discharge, while a significant worsening occurred from discharge to follow-up. The significant associated variables with improvement in Barthel Index from discharge to follow-up were age and Blaylock Risk Assessment Screening Score at admission. Conclusion Interesting trends in the course of hospitalized older patients with dementia have been found, and they were associated to different levels of functional impairment at admission. Further research is still needed to understand the predictors of improvement and worsening in such hospitalized patients.
NeuroImage, 1999
The [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) method for measuring brain metabolism has not the wide... more The [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) method for measuring brain metabolism has not the wide clinical application that one might expect, partly because of its high cost and the complexity of the quantification procedure, but also because of reporting techniques based on region of interest (ROI) analysis, which are time-consuming and not fully objective. In this paper we report a clinical validation of statistical parametric mapping (SPM) using rCMRglc (quantitative) and radioactivity distribution (nonquantitative) [ 18 F]FDG PET data. We show that a 10-min noninteractive voxelbased SPM analysis on a standard workstation enables objective assessment, including localization in stereotactic space, of regional glucose consumption abnormalities, whose reliability can be assessed on statistical and clinical grounds. Clinical validity was established using a small series of patients with degenerative or developmental disorders, including probable Alzheimer's disease, progressive aphasia, multiple sclerosis, developmental specific language impairment, and epilepsy. Analysis of quantitative and nonquantitative data showed the same pattern of results, suggesting that, for clinical purposes, quantitation and invasive arterial cannulation can be avoided. This should facilitate a wider application of the technique and the extension of SPM clinical analysis to H 2 15 O PET or high resolution SPECT perfusion studies. 1999 Academic Press
NeuroImage, 2009
Vocabulary acquisition is such a major aspect of language learning in children, but also in adult... more Vocabulary acquisition is such a major aspect of language learning in children, but also in adults when learning a foreign language, that a dedicated vocabulary learning device may exist within the language organ. To identify the relevant brain systems, we performed regional cerebral blood flow measurements in normal subjects while they were learning a list of neologisms or a list of word-nonword pairs. Structures implicated in phonological short-term memory (Broca's area, left temporo-parietal junction) were steadily activated during nonwords learning, while the left temporal lobe neocortical and paralimbic structures (parahippocampal region), associated with long-term memory, contributed to learning in a time-dependent manner, with maximal activation at the beginning of the process. The neural system specifically activated when learning new vocabulary was strongly lateralized to the left hemisphere. This evidence refines current models of memory function and supports theories which emphasise the importance of phonological competence in hemispheric dominance for language.
NeuroImage, 2001
Vocabulary acquisition is major aspect of language learning in children but also in adults, parti... more Vocabulary acquisition is major aspect of language learning in children but also in adults, particularly when learning a foreign language. Selective impairment of vocabulary acquisition is observed in patients with auditory-verbal (phonological) short-term memory deficit, while a more general failure of long-term learning of verbal information is observed in amnesia. Anatomical studies in brain damaged patients have not been fully informative, as they fail to indicate the exact localization of the brain regions involved in vocabulary learning. To identify the relevant brain systems, we performed regional cerebral blood flow (rCBF) PET measurements in six normal subjects while they were learning a list of neologisms or a list of common words.
Movement Disorders, 2005
The impairment in action fluency task present in Parkinson's disease (PD) patients has been previ... more The impairment in action fluency task present in Parkinson's disease (PD) patients has been previously interpreted as an indicator of conversion from PD to PD with dementia or as a grammatical deficit for verbs and ascribed to a frontostriatal loop pathophysiology. In the present study, 20 patients with PD without dementia were longitudinally tested with overall cognitive decline scales and semantic, letter, and action fluency tasks in a 24-month follow-up study. In comparison with healthy age-matched controls, PD patients showed a stable and consistent impairment on action fluency without any sign of cognitive decline. Our findings suggest that action fluency task may be an early sign of impairment of frontostriatal circuits in PD and it cannot be considered an indicator of conversion from PD to PD with dementia.
Cortex, 2001
We report a left parietal damaged, acalculic, non aphasic patient who showed a specific deficit i... more We report a left parietal damaged, acalculic, non aphasic patient who showed a specific deficit in reading Arabic and spelled-out numerals. Word reading was flawless, while he showed a severe impairment in reading meaningless strings of phonemes (phonological alexia). He also showed a dissociation between the preserved ability to retrieve knowledge about general facts and the impairment in retrieving cardinal, personal and non-personal numerical facts. These findings point to a separate organization in the brain of the numerical domain.
Cognitive and Behavioral Neurology, 2009
Objective: This study seeks to identify the possible relationship between certain executive funct... more Objective: This study seeks to identify the possible relationship between certain executive functions and the main personality traits in 25 nondemented Parkinson disease (PD) patients. Background: Both the presence of cognitive changes-mainly concerning executive functions-and peculiar personality traits, such as low novelty seeking, moral rigidity, industriousness, or introversion, were fully documented in PD patients. Methods: Patients underwent the Tower of London test and Alternating Fluency tasks for planning abilities and cognitive flexibility to be assessed. Personality features were evaluated using the Big Five Adjectives checklist. Results: The study provided evidence of a significant correlation between the Tower of London and the Emotional Stability factor and between Alternating Fluencies and the Openness to Experience factor. Conclusions: The Tower of London test and the Emotional Stability factor may require filtering of irrelevant information, activation of inhibition mechanisms, and use of negative feedback. The Alternating Fluency tasks and the Openness to Experience factor may require the ability to switch set and to express flexible thoughts or opinions in daily life. These results indicate that cognitive and personality changes in PD may be different expressions of a common psychologic mechanism related to the dysfunction of the frontostriatal system.
Brain and Language, 2000
Most nonhuman species are able to work through numerical quantities at various levels, such as me... more Most nonhuman species are able to work through numerical quantities at various levels, such as memorizing, comparing or adding, although at an approximate level. On the other hand, their ability to manipulate symbolic numerical labels is, at best, primitive (for a review see Dehaene, 1997; Butterworth, 1999). Similarly, while nonhuman species use elaborate communication systems, language, a formal grammatical system, is a species-specific innate ability (for a review see Pinker, 1994). From the above considerations the following questions arise: are number processing abilities and language underpinned by specific cognitive systems, provided with dedicated neural substrates, or do they share, partially or totally, the same functional and anatomical substrates? A substantial contribution, although not exhaustive, in trying to disentangle such problems has been offered by neuropsychology. Since Déjerine's (1892) pioneering observations of a selective sparing of numerical processing in pure alexia and the report of a relative preservation of number comprehension in comparison to other semantic category in a group of aphasic patients (Goodglass, Klein, Carey, & Jones, 1966), the independence of number and language processing seemed to be firmly established. Similarly, the report of pure acalculia following left parietal lesion highlighted the autonomy, both from an anatomical and functional point of view of calculation from language system.
BMC Geriatrics, 2013
Background: People with idiopathic Parkinson's disease (PD) frequently have low activity levels, ... more Background: People with idiopathic Parkinson's disease (PD) frequently have low activity levels, poor mobility and reduced quality of life. Although increased physical activity may improve mobility, balance and wellbeing, adherence to exercises and activity programs over the longer term can be challenging, particularly for older people with progressive neurological conditions such as PD. Physical activities that are engaging and enjoyable, such as dancing, might enhance adherence over the long term. The objective of this study was to evaluate the feasibility of a randomized controlled trial of Irish set dancing compared with routine physiotherapy for people with mild to moderately severe PD. Methods: Twenty-four people with idiopathic PD referred for movement rehabilitation were randomized to receive standard physiotherapy exercises or Irish set dancing classes once per week plus a weekly home program for 6 months (12 in each group). The feasibility and safety of the proposed RCT protocol was the main focus of this evaluation. The primary outcome was motor disability measured by the motor component of the UPDRS, which was assessed prior to and after therapy by trained assessors blinded to group assignment. The Timed Up and Go, the Berg Balance Scale and the modified Freezing of Gait Questionnaire were secondary measures. Quality of life of the people with PD was evaluated using the PDQ-39. Results: Both the Irish set dancing and physiotherapy exercise program were shown to be feasible and safe. There were no differences between groups in the rate of adverse events such as falls, serious injuries, death or rates of admission to hospital. The physiotherapists who provided usual care remained blind to group allocation, with no change in their standard clinical practice. Compliance and adherence to both the exercise and dance programs were very high and attrition rates were low over the 6 months of therapy. Although improvements were made in both groups, the dance group showed superior results to standard physiotherapy in relation to freezing of gait, balance and motor disability. Conclusions: Irish dancing and physiotherapy were both safe and feasible in this sample from Venice, with good adherence over a comparatively long time period of 6 months. A larger multi-centre trial is now warranted to establish whether Irish set dancing is more effective than routine physiotherapy for enhancing mobility, balance and quality of life in people living with idiopathic PD.