Franco Cauda

Publications

• 2.29

  Impact points

  Neuropathic pain in post-burn hypertrophic scars: A psychophysical and neurophysiological study.

  Gianluca Isoardo, Maurizio Stella, Dario Cocito, Daniela Risso, Giuseppe Migliaretti, Franco Cauda, Angela Palmitessa, Giuliano Faccani, Palma Ciaramitaro

  Muscle & nerve. 06/2012; 45(6):883-90.

  Introduction: Pain complicates hypertrophic post-burn pathologic scars (PPS) Methods: To investigate the possible neuropathic origin of pain, 13 patients with painful PPS involving at least 1 hand underwent clinical examination, including the Douleur Neuropathique en 4 questions (DN4) questionnaire;... [more] Introduction: Pain complicates hypertrophic post-burn pathologic scars (PPS) Methods: To investigate the possible neuropathic origin of pain, 13 patients with painful PPS involving at least 1 hand underwent clinical examination, including the Douleur Neuropathique en 4 questions (DN4) questionnaire; median, ulnar, and radial nerve conduction studies (NCS); cold- (CDT) and heat-induced pain threshold evaluation by quantitative sensory testing; and cutaneous silent period (CSP) testing of the abductor pollicis brevis. Controls included 9 patients with non-painful PPS, 52 healthy subjects, and 28 patients with carpal tunnel syndrome (CTS). Results: All patients with painful PPS had possible neuropathic pain (DN4 score ≥4). NCS signs of CTS were similarly present in PPS subjects with or without pain. Hands with painful PPS had lower CDT and CSP duration, more frequent cold- and heat-pain hypesthesia, and more thermal allodynia than controls. Conclusions: In PPS, possible neuropathic pain is associated with psychophysical and neurophysiological abnormalities suggestive of small-fiber damage. Muscle Nerve 45: 883-890, 2012.
• 5.74

  Impact points

  Meta-analytic clustering of the insular cortex: Characterizing the meta-analytic connectivity of the insula when involved in active tasks.

  Franco Cauda, Tommaso Costa, Diana M E Torta, Katiuscia Sacco, Federico D'Agata, Sergio Duca, Giuliano Geminiani, Peter T Fox, Alessandro Vercelli

  NeuroImage. 04/2012;

  The human insula has been parcellated on the basis of resting state functional connectivity and diffusion tensor imaging. Little is known about the organization of the insula when involved in active tasks. We explored this issue using a novel meta-analytic clustering approach. We queried the BrainMa... [more] The human insula has been parcellated on the basis of resting state functional connectivity and diffusion tensor imaging. Little is known about the organization of the insula when involved in active tasks. We explored this issue using a novel meta-analytic clustering approach. We queried the BrainMap database asking for papers involving normal subjects that recorded activations in the insular cortex, retrieving 1305 papers, involving 22,872 subjects and a total of 2957 foci. Data were analyzed with several different methodologies, some of which expressly designed for this work. We used meta-analytic connectivity modeling and meta-analytic clustering of data obtained from the BrainMap database. We performed cluster analysis to subdivide the insula in areas with homogeneous connectivity, and density analysis of the activated foci using Voronoi tessellation. Our results confirm and extend previous findings obtained investigating the resting state connectivity of the anterior-posterior and left-right insulae. They indicate, for the first time, that some blocks of the anterior insula play the role of hubs between the anterior and the posterior insulae, as confirmed by their activation in several different paradigms. This finding supports the view that the network to which the anterior insula belongs is related to saliency detection. The insulae of both sides can be parcellated in two clusters, the anterior and the posterior: the anterior is characterized by an attentional pattern of connectivity with frontal, cingulate, parietal, cerebellar and anterior insular highly connected areas, whereas the posterior is characterized by a more local connectivity pattern with connections to sensorimotor, temporal and posterior cingulate areas. This antero-posterior subdivision, better characterized on the right side, results sharper with the connectivity based clusterization than with the behavioral based clusterization. The circuits belonging to the anterior insula are very homogeneous and their blocks in multidimensional scaling of MACM-based profiles are in central position, whereas those belonging to the posterior insula, especially on the left, are located at the periphery and sparse, thus suggesting that the posterior circuits bear a more heterogeneous connectivity. The anterior cluster is mostly activated by cognition, whereas the posterior is mostly activated by interoception, perception and emotion.

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• 0.97

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  Virtual navigation for memory rehabilitation in a traumatic brain injured patient.

  M Caglio, L Latini-Corazzini, F D'Agata, F Cauda, K Sacco, S Monteverdi, M Zettin, S Duca, G Geminiani

  Neurocase. 04/2012; 18(2):123-31.

  The use of 3D video games in memory rehabilitation has been explored very little. A virtual navigation task allows participants to encode the spatial layout of the virtual environment and activate areas involved in memory processing. We describe the rehabilitation of a 24-year-old man with traumatic... [more] The use of 3D video games in memory rehabilitation has been explored very little. A virtual navigation task allows participants to encode the spatial layout of the virtual environment and activate areas involved in memory processing. We describe the rehabilitation of a 24-year-old man with traumatic brain injury presenting memory deficits, and evaluate the efficacy of a navigational training program measuring neuropsychological changes and fMRI modification cerebral activations. Memory improvement appears to be present both after navigational training and in follow-up testing. Furthermore, fMRI data suggest that this training may increase activation of the hippocampal and parahippocampal brain regions. The results suggest that intensive training in virtual navigational tasks may result in an enhancement of memory function in brain-damaged adults.

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• 4.42

  Impact points

  Functional anatomy of cortical areas characterized by Von Economo neurons

  Alessandro Vercelli, Elisabetta Geda, Giuliano Geminiani, Federico D’Agata, Katiuscia Sacco, Franco Cauda, Sergio Duca, Diana Torta

  Brain Structure and Function. 01/2012;

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• Multimodal Approach to the Surgical Removal of Gliomas in Eloquent Brain Regions

  Giannantonio Spena, Antonio Pepoli, Marcella Bruno, Federico D�Agata, Franco Cauda, Katiuscia Sacco, Sergio Duca, Pietro Versari

  11/2011;

  ISBN: 978-953-307-284-5
• 6.26

  Impact points

  Discovering the somatotopic organization of the motor areas of the medial wall using low-frequency BOLD fluctuations.

  Franco Cauda, Geminiani Giuliano, D'Agata Federico, Duca Sergio, Sacco Katiuscia

  Human brain mapping. 10/2011; 32(10):1566-79.

  This study explored the somatotopy of the motor areas of the medial wall of the cerebral hemisphere, in the human brain. In a sample of 16 healthy participants, we drew 9 regions of interest (ROI) over the primary motor area (M1), each corresponding to a well-known somatic representation. Using func... [more] This study explored the somatotopy of the motor areas of the medial wall of the cerebral hemisphere, in the human brain. In a sample of 16 healthy participants, we drew 9 regions of interest (ROI) over the primary motor area (M1), each corresponding to a well-known somatic representation. Using functional magnetic resonance imaging, we investigated the resting state functional connectivity between each selected ROI and the motor areas of the medial wall. The main finding was the identification of a rostrocaudal gradient of connectivity in which the more we move from cranial to caudal body representation areas in M1, the more the corresponding connected area in the medial wall is shifted rostrocaudally, confirming the somatotopic schema found in the SMA. We also reanalyzed data obtained in a previous experiment, we performed using hand and foot motor tasks; the reanalysis consisted in traditional BOLD and functional connectivity analyses. Finally, we performed a meta-analysis of 28 studies of hand and foot motor tasks, mapping their cerebral representations using the tools provided by the Brainmap database. All data converge in confirming a somatotopic representation of the medial wall motor areas, with hand representation placed more rostrally and ventrally than that of the foot.

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• 4.87

  Impact points

  Grey matter abnormality in autism spectrum disorder: an activation likelihood estimation meta-analysis study.

  Franco Cauda, Elisabetta Geda, Katiuscia Sacco, Federico D'Agata, Sergio Duca, Giuliano Geminiani, Roberto Keller

  Journal of neurology, neurosurgery, and psychiatry. 06/2011; 82(12):1304-13.

  Autism spectrum disorder (ASD) is defined on a clinical basis by impairments in social interaction, verbal and non-verbal communication, and repetitive or stereotyped behaviours. Voxel based morphometry (VBM), a technique that gives a probabilistic measure of local grey matter (GM) and white matter ... [more] Autism spectrum disorder (ASD) is defined on a clinical basis by impairments in social interaction, verbal and non-verbal communication, and repetitive or stereotyped behaviours. Voxel based morphometry (VBM), a technique that gives a probabilistic measure of local grey matter (GM) and white matter concentration, has been used to study ASD patients: modifications in GM volume have been found in various brain regions, such as the corpus callosum, brainstem, amygdala, hippocampus and cerebellum. However, the findings are inconsistent with respect to the specific localisation and direction of GM modifications, and no paper has attempted to statistically summarise the results available in the literature. The present study is a quantitative meta-analysis of the current VBM findings aimed at delineating the cortical regions with consistently increased or reduced GM concentrations. The activation likelihood estimation (ALE) was used, which is a quantitative voxel based meta-analysis method which can be used to estimate consistent activations across different imaging studies. Co-occurrence statistics of a PubMed query were generated, employing 'autism spectrum disorder' as the neuroanatomical lexicon. Significant ALE values related to GM increases were observed bilaterally in the cerebellum, in the middle temporal gyrus, in the right anterior cingulate cortex, caudate head, insula, fusiform gyrus, precuneus and posterior cingulate cortex, and in the left lingual gyrus. GM decreases were observed bilaterally in the cerebellar tonsil and inferior parietal lobule, in the right amygdala, insula, middle temporal gyrus, caudate tail and precuneus and in the left precentral gyrus.

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• 4.42

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  Linking coordinative and executive dysfunctions to atrophy in spinocerebellar ataxia 2 patients.

  Federico D'Agata, Paola Caroppo, Andrea Boghi, Mario Coriasco, Marcella Caglio, Bruno Baudino, Katiuscia Sacco, Franco Cauda, Elisabetta Geda, Mauro Bergui, Giuliano Geminiani, Gianni Boris Bradac, Laura Orsi, Paolo Mortara

  Brain structure & function. 04/2011; 216(3):275-88.

  Spinocerebellar ataxias type 2 (SCA2) is a rare genetic disorder characterised by the degeneration of the Cerebellum, its connections and many Brainstem areas. A voxel-based morphometry (VBM) analysis was performed on 12 genetically determined SCA2 patients and 31 controls, normalising the brains wi... [more] Spinocerebellar ataxias type 2 (SCA2) is a rare genetic disorder characterised by the degeneration of the Cerebellum, its connections and many Brainstem areas. A voxel-based morphometry (VBM) analysis was performed on 12 genetically determined SCA2 patients and 31 controls, normalising the brains with two different atlases: one was created in-house with DARTEL (a diffeomorphic registration method) and the other was SUIT (an exclusive Cerebellum atlas). We administered two versions of a popular executive/planning functions test: the Tower of London, in the traditional and in a computerised version that does not require the use of hands, to correlate the regional atrophy with the tests' performances and to discover the different associations of Cerebellum's areas to cognitive dysfunctions. SCA2 showed a diffuse infratentorial atrophy with the whole Cerebellum and Brainstem affected, the overall patterns were highly overlapping between atlases with some minor differences. The DARTEL VBM also allowed detecting two sovratentorial clusters of atrophy, one in the left Inferior Parietal Lobule and the other in the Corticospinal Tracts. Additional analyses revealed a partial involvement of many White Matter tracts and of the Thalamus in the pathology. The classical Tower of London version correlated maximally with the right Lobule IV-V, when the computerised version correlated with the right Crus 1. The correlations of different versions of the test suggested a dissociation between the dysfunctions in SCA2: the Posterior Cerebellum was linked to the executive dysfunction while the Anterior Cerebellum was linked to the coordinative dysfunction.

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• 5.74

  Impact points

  Different functions in the cingulate cortex, a meta-analytic connectivity modeling study.

  D M Torta, F Cauda

  NeuroImage. 03/2011; 56(4):2157-72.

  The cingulate cortex is a structurally heterogeneous brain region involved in emotional, cognitive and motor tasks. With the aim of identifying which behavioral domains are associated with the activation of the cingulate cortex, we performed a structure based-meta-analysis using the activation likel... [more] The cingulate cortex is a structurally heterogeneous brain region involved in emotional, cognitive and motor tasks. With the aim of identifying which behavioral domains are associated with the activation of the cingulate cortex, we performed a structure based-meta-analysis using the activation likelihood estimation (ALE), which assesses statistical significant convergence of neuroimaging studies using the BrainMap database. To map the meta-analytic coactivation maps of the cingulate cortex (MACM), we subdivided the parenchyma along the rostro-caudal axis in 12 bilateral equispaced ROIs. ROIs were not chosen according to previously suggested subdivisions, as to obtain a completely data-driven result. Studies were included with one or more activation coordinates in at least one of the 12 pre-defined ROIs. The meta-analytic connectivity profile and behavioral domains profiles were identified for each ROI. Cluster analysis was then performed on the MACM and behavioral domains to group together ROIs with similar profiles. The results showed that the cingulate cortex can be divided in three clusters according to the MACM parcellation and in four according to the behavioral domain-based parcellation. In addition, a behavioral-domain based meta-analysis was conducted and the spatial consistency of functional connectivity patterns across different domain-related ALE results was evaluated by computing probabilistic maps. These maps identified some portions of the cingulate cortex as involved in several tasks. Our results showed the existence of a more specific functional characterization of some portions of the cingulate cortex but also a great multifunctionality of others. By analyzing a large number of studies, structure based meta-analysis can greatly contribute to new insights in the functional significance of brain activations and in the role of specific brain areas in behavior.

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• 9.49

  Impact points

  Unawareness of deficits in Alzheimer's disease: role of the cingulate cortex.

  Martina Amanzio, Diana M E Torta, Katiuscia Sacco, Franco Cauda, Federico D'Agata, Sergio Duca, Daniela Leotta, Sara Palermo, Giuliano C Geminiani

  Brain : a journal of neurology. 03/2011; 134(Pt 4):1061-76.

  Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right do... [more] Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right dorsolateral prefrontal cortex, inferior parietal lobe, anterior cingulate gyri and limbic structures. Since this network plays an important role in response inhibition competence and patients with Alzheimer's disease who are unaware of their deficits exhibit impaired performance in response inhibition tasks, we predicted a relationship between unawareness of deficits and cingulate hypofunctionality. We tested this hypothesis in a sample of 29 patients with Alzheimer's disease (15 aware and 14 unaware of their disturbances), rating unawareness according to the Awareness of Deficit Questionnaire-Dementia scale. The cognitive domain was investigated by means of a wide battery including tests on executive functioning, memory and language. Neuropsychiatric aspects were investigated using batteries on behavioural mood changes, such as apathy and disinhibition. Cingulate functionality was assessed with functional magnetic resonance imaging, while patients performed a go/no-go task. In accordance with our hypotheses, unaware patients showed reduced task-sensitive activity in the right anterior cingulate area (Brodmann area 24) and in the rostral prefrontal cortex (Brodmann area 10). Unaware patients also showed reduced activity in the right post-central gyrus (Brodmann area 2), in the associative cortical areas such as the right parietotemporal-occipital junction (Brodmann area 39) and the left temporal gyrus (Brodmann areas 21 and 38), in the striatum and in the cerebellum. These findings suggest that the unawareness of deficits in early Alzheimer's disease is associated with reduced functional recruitment of the cingulofrontal and parietotemporal regions. Furthermore, in line with previous findings, we also found apathy and disinhibition to be prominent features of the first behavioural changes in unaware patients.

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• 5.74

  Impact points

  Functional connectivity of the insula in the resting brain.

  Franco Cauda, Federico D'Agata, Katiuscia Sacco, Sergio Duca, Giuliano Geminiani, Alessandro Vercelli

  NeuroImage. 03/2011; 55(1):8-23.

  The human insula is hidden in the depth of the cerebral hemisphere by the overlying frontal and temporal opercula, and consists of three cytoarchitectonically distinct regions: the anterior agranular area, posterior granular area, and the transitional dysgranular zone; each has distinct histochemica... [more] The human insula is hidden in the depth of the cerebral hemisphere by the overlying frontal and temporal opercula, and consists of three cytoarchitectonically distinct regions: the anterior agranular area, posterior granular area, and the transitional dysgranular zone; each has distinct histochemical staining patterns and specific connectivity. Even though there are several studies reporting the functional connectivity of the insula with the cingulated cortex, its relationships with other brain areas remain elusive in humans. Therefore, we decided to use resting state functional connectivity to elucidate in details its connectivity, in terms of cortical and subcortical areas, and also of lateralization. We investigated correlations in BOLD fluctuations between specific regions of interest of the insula and other brain areas of right-handed healthy volunteers, on both sides of the brain. Our findings document two major complementary networks involving the ventral-anterior and dorsal-posterior insula: one network links the anterior insula to the middle and inferior temporal cortex and anterior cingulate cortex, and is primarily related to limbic regions which play a role in emotional aspects; the second links the middle-posterior insula to premotor, sensorimotor, supplementary motor and middle-posterior cingulate cortices, indicating a role for the insula in sensorimotor integration. The clear bipartition of the insula was confirmed by negative correlation analysis. Correlation maps are partially lateralized: the salience network, related to the ventral anterior insula, displays stronger connections with the anterior cingulate cortex on the right side, and with the frontal cortex on the left side; the posterior network has stronger connections with the superior temporal cortex and the occipital cortex on the right side. These results are in agreement with connectivity studies in primates, and support the use of resting state functional analysis to investigate connectivity in the living human brain.

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• 1.55

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  A combined robotic and cognitive training for locomotor rehabilitation: evidences of cerebral functional reorganization in two chronic traumatic brain injured patients.

  Katiuscia Sacco, Franco Cauda, Federico D'Agata, Sergio Duca, Marina Zettin, Roberta Virgilio, Alberto Nascimbeni, Guido Belforte, Gabriella Eula, Laura Gastaldi, Silvia Appendino, Giuliano Geminiani

  Frontiers in human neuroscience. 01/2011; 5:146.

  It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients ... [more] It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients with cerebral lesions could be that these patients, besides stimulation of physiological motor patterns through passive leg movements, also need to train the cognitive aspects of motor control. Indeed, another way to stimulate cerebral motor areas in paretic patients is to use the cognitive function of motor imagery. A promising possibility is thus to combine sensorimotor training with the use of motor imagery. The aim of this paper is to assess changes in brain activations after a combined sensorimotor and cognitive training for gait rehabilitation. The protocol consisted of the integrated use of a robotic gait orthosis prototype with locomotor imagery tasks. Assessment was conducted on two patients with chronic traumatic brain injury and major gait impairments, using functional magnetic resonance imaging. Physiatric functional scales were used to assess clinical outcomes. Results showed greater activation post-training in the sensorimotor and supplementary motor cortices, as well as enhanced functional connectivity within the motor network. Improvements in balance and, to a lesser extent, in gait outcomes were also found.

• Functional Connectivity and Coactivation of the Nucleus Accumbens: A Combined Functional Connectivity and Structure-Based Meta-analysis.

  Franco Cauda, Andrea E. Cavanna, Federico D'agata, Katiuscia Sacco, Sergio Duca, Giuliano Carlo Geminiani

  J. Cognitive Neuroscience. 01/2011; 23:2864-2877.
• 6.26

  Impact points

  Activation Likelihood Estimation meta-analysis of brain correlates of placebo analgesia in human experimental pain

  Amanzio M. Benedetti F. Porro CA. Geminiani GC., Cauda F

  Human Brain Mapping. 01/2011;

  Placebo analgesia is one of the most studied placebo effects. Brain imaging studies published over the last decade, using either positron emission tomography (PET) or functional magnetic resonance imaging (fMRI), suggest that multiple brain regions may play a pivotal role in this process. However, t... [more] Placebo analgesia is one of the most studied placebo effects. Brain imaging studies published over the last decade, using either positron emission tomography (PET) or functional magnetic resonance imaging (fMRI), suggest that multiple brain regions may play a pivotal role in this process. However, there continues to be much debate as to which areas consistently contribute to placebo analgesia-related networks. In the present study, we used activation likelihood estimation (ALE) meta-analysis, a state-of-the-art approach, to search for the cortical areas involved in placebo analgesia in human experimental pain models. Nine fMRI studies and two PET studies investigating cerebral hemodynamic changes were included in the analysis. During expectation of analgesia, activated foci were found in the left anterior cingulate, right precentral and lateral prefrontal cortex, and in the left periaqueductal gray. During noxious stimulation, placebo-related activations were detected in the anterior cingulate and medial and lateral prefrontal cortices, in the left inferior parietal lobule and postcentral gyrus, anterior insula, thalamus, hypothalamus, periaqueductal grey and pons; de-activations were found in the left mid- and posterior cingulate cortex, superior temporal and precentral gyri, in the left anterior and right posterior insula, in the claustrum and putamen, and in the right thalamus and caudate body. Our results suggest on one hand that the modulatory cortical networks involved in placebo analgesia largely overlap those involved in the regulation of emotional processes, on the other that brain nociceptive networks are down-regulated in parallel with behavioral analgesia.

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• Unawareness of deficits in Alzheimer's disease: role of the cingulate cortex

  Amanzio M. Torta D. Katiuscia S. Cauda F. D’Agata F. Duca S. Leotta D. Palermo S. Geminiani G

  Brain. 01/2011;

  Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right do... [more] Unawareness of deficits is a symptom of Alzheimer's disease that can be observed even in the early stages of the disease. The frontal hypoperfusion associated with reduced awareness of deficits has led to suggestions of the existence of a hypofunctioning prefrontal pathway involving the right dorsolateral prefrontal cortex, inferior parietal lobe, anterior cingulate gyri and limbic structures. Since this network plays an important role in response inhibition competence and patients with Alzheimer's disease who are unaware of their deficits exhibit impaired performance in response inhibition tasks, we predicted a relationship between unawareness of deficits and cingulate hypofunctionality. We tested this hypothesis in a sample of 29 patients with Alzheimer's disease (15 aware and 14 unaware of their disturbances), rating unawareness according to the Awareness of Deficit Questionnaire-Dementia scale. The cognitive domain was investigated by means of a wide battery including tests on executive functioning, memory and language. Neuropsychiatric aspects were investigated using batteries on behavioural mood changes, such as apathy and disinhibition. Cingulate functionality was assessed with functional magnetic resonance imaging, while patients performed a go/no-go task. In accordance with our hypotheses, unaware patients showed reduced task-sensitive activity in the right anterior cingulate area (Brodmann area 24) and in the rostral prefrontal cortex (Brodmann area 10). Unaware patients also showed reduced activity in the right post-central gyrus (Brodmann area 2), in the associative cortical areas such as the right parietotemporal-occipital junction (Brodmann area 39) and the left temporal gyrus (Brodmann areas 21 and 38), in the striatum and in the cerebellum. These findings suggest that the unawareness of deficits in early Alzheimer's disease is associated with reduced functional recruitment of the cingulofrontal and parietotemporal regions. Furthermore, in line with previous findings, we also found apathy and disinhibition to be prominent features of the first behavioural changes in unaware patients.

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• Linking coordinative and executive dysfunctions to atrophy in Spinocerebellar Ataxia 2 patients

  D’Agata F. Caroppo P. Boghi A. Coriasco M. Caglio M. Baudino B. Sacco K. Cauda F. Geda E. Bergui M. Geminiani GC. Bradac GB. Orsi L. Mortara P

  Brain Structure and Functions. 01/2011;

  Spinocerebellar ataxias type 2 (SCA2) is a rare genetic disorder characterized by the degeneration of the Cerebellum, its connections and many Brainstem areas. A voxel based morphometry (VBM) analysis was performed on 12 genetically determined SCA2 patients and 31 controls, normalizing the brains wi... [more] Spinocerebellar ataxias type 2 (SCA2) is a rare genetic disorder characterized by the degeneration of the Cerebellum, its connections and many Brainstem areas. A voxel based morphometry (VBM) analysis was performed on 12 genetically determined SCA2 patients and 31 controls, normalizing the brains with two different atlases: one was created in-house with DARTEL (a diffeomorphic registration method) and the other was SUIT (an exclusive Cerebellum atlas). We administered two versions of a popular executive/planning functions test: the Tower of London, in the traditional and in a computerized version that does not require the use of hands, to correlate the regional atrophy with the tests’ performances and to discover the different associations of Cerebellum’s areas to cognitive dysfunctions. Results: SCA2 showed a diffuse infratentorial atrophy with the whole Cerebellum and Brainstem affected, the overall patterns were highly overlapping between atlases with some minor differences. The DARTEL VBM also allowed to detect two sovratentorial clusters of atrophy, one in the left Inferior Parietal Lobule and the other in the Corticospinal Tracts. Additional analyses revealed a partial involvement of the Cingulum and of the Thalamus in the pathology. The classical Tower of London version correlated maximally with the right Lobule IV-V, when the computerized version correlated with the right Crus 1. Conclusions: The correlations of different versions of the test suggested a dissociation between the dysfunctions in SCA2: the Posterior Cerebellum was linked to the executive dysfunction while the Anterior Cerebellum was linked to the coordinative dysfunction.

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• Multimodal Approach to the Surgical Removal of Gliomas in Eloquent Brain Regions

  Spena G, Pepoli A, Bruno M, D'Agata F, Cauda F, Sacco K, Duca S, Versari P.

  01/2011: pages 339-362;

  ISBN: 978-953-307-284-5

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• 1.55

  Impact points

  A combined robotic and cognitive training for locomotor rehabilitation: Evidences of cerebral functional reorganization in two chronic traumatic brain injured patients

  Sacco K, Cauda F, D'Agata F, Duca S, Zettin M, Virgilio R, Nascimbeni A, Belforte G, Eula G, Gastaldi L, Appendino S, Geminiani GC.

  Frontiers in Human Neuroscience. 01/2011;

  It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients ... [more] It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients with cerebral lesions could be that these patients, besides stimulation of physiological motor patterns through passive leg movements, also need to train the cognitive aspects of motor control. Indeed, another way to stimulate cerebral motor areas in paretic patients is to use the cognitive function of motor imagery. A promising possibility is thus to combine sensorimotor training with the use of motor imagery. The aim of this paper is to assess changes in brain activations after a combined sensorimotor and cognitive training for gait rehabilitation. The protocol consisted of the integrated use of a robotic gait orthosis prototype with locomotor imagery tasks. Assessment was conducted on two patients with chronic traumatic brain injury and major gait impairments, using functional magnetic resonance imaging. Physiatric functional scales were used to assess clinical outcomes. Results showed greater activation post-training in the sensorimotor and supplementary motor cortices, as well as enhanced functional connectivity within the motor network. Improvements in balance and, to a lesser extent, in gait outcomes were also found.

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• Neuropathic pain in post-burn hypertrophic scars: A psychophysical and neurophysiological study

  Isoardo G. Stella M. Risso D. Migliaretti G. Cauda F. Palmitessa A. Faccani G., Ciaramitaro P.

  Muscle and Nerve. 01/2011;

  Introduction. Pain complicates hypertrophic post-burn pathologic scars (PPS) Methods. To investigate the possible neuropathic origin of pain, 13 patients with painful-PPS involving at least one hand underwent clinical examination including the Douleur Neuropathique en 4 questions (DN4) questionnai... [more] Introduction. Pain complicates hypertrophic post-burn pathologic scars (PPS) Methods. To investigate the possible neuropathic origin of pain, 13 patients with painful-PPS involving at least one hand underwent clinical examination including the Douleur Neuropathique en 4 questions (DN4) questionnaire, median, ulnar and radial nerve conduction studies (NCS), cold (CDT) and heat-induced pain thresholds evaluation by quantitative sensory testing, and cutaneous silent period (CSP) of the abductor pollicis brevis. Controls were 9 patients with non painful-PPS, 52 healthy subjects, and 28 patients with carpal tunnel syndrome (CTS). Results. All patients with painful-PPS had possible neuropathic pain (DN4 score ≥ 4). NCS signs of CTS were similarly present in PPS subjects with or without pain. Hands with painful-PPS had lower CDT and CSP duration, more frequent cold and heat pain hypesthesia and thermal allodynia than controls. Discussion. In PPS, possible neuropathic pain is associated with psychophysical and neurophysiological abnormalities suggestive of small fiber damage.

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• Virtual navigation for memory rehabilitation in a traumatic btain injured patient

  Caglio M. Latini Corazzini L. D’Agata F. Cauda F. Sacco K. Monteverdi S. Zettin M. Duca S. Geminiani G.

  Neurocase. 01/2011;

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