Cristina Dolciotti

Università di Pisa, Pisa, Tuscany, Italy

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Publications (10)15.89 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: More than 100 years ago, Alois Alzheimer first described the clinical and pathological features of an unusual brain disease during the meeting of the Society of Southwest German Psychiatrists in Tübingen: the patient, Auguste Deter, suffered memory loss, disorientation, hallucinations and delusions and died at the age of 55. In 1910, Emil Kraepelin named the condition with the eponym of "Alzheimer's disease" (AD) that is, now, the most common neurodegenerative disease with more than 25 million cases worldwide and a major medical problem nearing catastrophic levels. The present article discusses Alzheimer's work in the context of his life and time.
    Neurological Sciences 04/2011; 32(2):275-9. · 1.41 Impact Factor
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    ABSTRACT: IntroductionPeople with Down's syndrome (DS) have an increased risk of developing Alzheimer's disease (AD) during middle age. Both disorders can present with a decline in cognitive skills and behavioral symptoms. Therefore, dementia, particularly in its early stages, can be difficult to diagnose in this population.Materials and methodsWe conducted a search of electronic databases for literature on the relationship between AD and DS. The key words used were: “Down syndrome”, “Alzheimer's disease”, “dementia”, and “mental retardation”.ResultsAD onset has been reported as early as age 30 in individuals with DS, and there is a dramatic increase in prevalence rates in older age groups. This trend reflects increased survival of persons with DS probably as a result of advances in medical treatment and improved living conditions. Even with careful clinical assessment, it can be very difficult to identify early symptoms of dementia when it is superimposed on a background of intellectual disability. The reasons include the wide intra-individual variability in cognitive functioning and difficulties involved in establishing baseline levels of the premorbid condition. Many frontal lobe-related symptoms usually associated with later stages of dementia in the general population are commonly seen in the early stage of the dementia that develops in adults with DS.DiscussionAfter onset, the clinical symptoms of dementia progress rapidly in all subjects with DS. Research suggests that the presentation of dementia in people with DS may differ from that typical of AD in the general population. Early changes tend to involve personality and behaviour rather than memory. DS can be best understood as a complex syndrome of genetic origin that has protean neurobiological consequences and numerous clinical characteristics.
    Quaderni Italiani di Psichiatria. 01/2011;
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    ABSTRACT: Idiopathic low cerebrospinal fluid (CSF) pressure headache is considered to be one that worsens within 15 min of sitting-up or standing-up, accompanied by at least one of the following: neck stiffness, tinnitus, hypacusia, photophobia and nausea. Several reports suggest that a substantial number of idiopathic low CSF pressure cases do not present typical clinical symptoms and that a considerable clinical variability exists. We report the case of an idiopathic low CSF pressure presenting as a cough headache.
    Neurological Sciences 12/2010; 31(6):789-91. · 1.41 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: More than 100 years ago, Alois Alzheimer first described the clinical and pathological features of an unusual brain disease during the meeting of the Society of Southwest German Psychiatrists in Tübingen: the patient, Auguste Deter, suffered memory loss, disorientation, hallucinations and delusions and died at the age of 55. In 1910, Emil Kraepelin named the condition with the eponym of "Alzheimer's disease" (AD) that is, now, the most common neurodegenerative disease with more than 25 million cases worldwide and a major medical problem nearing catastrophic levels. The present article discusses Alzheimer's work in the context of his life and time.
    Neurological Sciences 12/2010; 32(2):275-9. · 1.41 Impact Factor
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    ABSTRACT: To evaluate levodopa responsiveness in patients with probable dementia with Lewy bodies (DLB) compared to early Parkinson's disease (PD) patients. Twenty four cases with DLB and 21 with PD underwent a baseline assessment with UPDRS (sub-item II and III) and an acute levodopa challenge test. Positive response to acute levodopa test was defined as an improvement of at least 15% in the tapping test, and at least 25% in the walking test and rigidity or tremor score. Subsequently, all patients were treated continuously with levodopa and evaluated after 6 and 12 months by means of UPDRS II/III. Positive response to the acute levodopa test was observed in 55% of DLB patients (acute DLB responders), and in 90% of PD patients (acute PD responders). Acute DLB responders showed increased latency, and reduction of both duration and amplitude of response to acute levodopa in comparison with acute PD responders. At the 6-month follow-up visit, acute DLB responders showed a greater motor benefit compared with acute DLB non-responders. This improvement was similar to that observed in PD patients. However, at 1-year follow-up acute DLB responders showed a faster worsening of UPDRS III scores compared with acute PD responders, implying a reduction of levodopa efficacy. Positive response to acute levodopa test can occur in DLB patients and may be predictive of long-term benefit of chronic levodopa therapy, although the motor improvement is less impressive than in PD patients.
    Parkinsonism & Related Disorders 09/2010; 16(8):522-6. · 3.27 Impact Factor
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    ABSTRACT: There are several reports of central pontine myelinolysis (CPM) in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561-567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms.
    Case Reports in Neurology 09/2010; 2(3):157-62.
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    Cephalalgia 05/2010; 30(5):624-5. · 3.49 Impact Factor
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    ABSTRACT: Idiopathic low cerebrospinal fluid (CSF) pressure headache is considered to be one that worsens within 15 min of sitting-up or standing-up, accompanied by at least one of the following: neck stiffness, tinnitus, hypacusia, photophobia and nausea. Several reports suggest that a substantial number of idiopathic low CSF pressure cases do not present typical clinical symptoms and that a considerable clinical variability exists. We report the case of an idiopathic low CSF pressure presenting as a cough headache.
    Neurological Sciences 03/2010; 31(6):789-91. · 1.41 Impact Factor
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    ABSTRACT: Cotard’s syndrome was originally described in 1880 by the French psychiatrist Jules Cotard; this relatively rare disorder is characterized by the presence of nihilistic delusion (délire des négations). Typically, patients believe they have lost their organs, blood or body parts, or even they are dead; the delusion is accompanied by guilt as well as the belief to be immortal. This highly impressive psychopathological condition exists in patients with depression, schizophrenia, and other psychotic disorders but it may also occur in neurologicalpractice. A propos of one case seen in our hospital, we present an overview of the historical aspects, classification, neurological characteristics (neurostructural, We searched electronic databases and key journals using appropriate search terms: Jules Cotard; Cotard syndrome; Cotard’s delusion; nihilistic delusion; internalising attributional style and depression. Various organic conditions such as multiple sclerosis, temporal lobe epilepsy, brain tumors, brain injuries, and migraine have been reported in association with Cotard’s syndrome. The most commonly reported neurological abnormalities in these patients include structural brain changes (bilateral cerebral atrophy, enlarged interhemispheric fissure), functional brain changes (hypoperfusion in the frontal and parietal cortices) and neuropsychological abnormalities (impaired face recognition, impaired executive functions and internalising attributional style) The pharmacological treatment must be congruent with the underlying disorder. There are several reports of successful pharmacologic treatment of Cotard’s syndrome, most often regarding monotherapy with antidepressant agents or with combinations strategies. The presented case set the issue of the differential diagnosis between dementia and Cotard’s syndrome. Fast cognitive and psychopathological symptom progression combined with substantially negative clinical investigations (brain NMR, EEG, blood chemistry) and the response to administered drug treatment prompted us to diagnose Cotard’s syndrome in the context of a major depressive episode.
    Giorn Ital Psicopat 2010;16:174-181. 01/2010;
  • Cephalalgia 08/2009; 30(5):624-5. · 3.49 Impact Factor

Publication Stats

22 Citations
15.89 Total Impact Points

Institutions

  • 2010–2011
    • Università di Pisa
      • Department of Clinical and Experimental Medicine
      Pisa, Tuscany, Italy