G Sandrini

University of Pavia, Ticinum, Lombardy, Italy

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Publications (268)694.35 Total impact

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    ABSTRACT: The project aim is to establish a connection among Universities, Research Centers, Research and Clinical Institutions in Europe and in Latino-America, in order to create a multidisciplinary comprehensive tutorial promoting the transfer of knowledge, education and translational skills in the field of headache and comorbid neurobehavioral disorders. The activities programmed in order to be shared are: e-Learning, e-Health, promotion of the international activities of ISADH (International School on Adaptive Disorders and Headache) and UCADH (University Consortium for Adaptive Disorders and Head pain)
    Universidad 2014- 9th International Congress of Higher Education, La Habana, Cuba; 02/2014
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    ABSTRACT: The release of calcitonin gene-related peptide (CGRP) from trigeminal nerves plays a central role in the pathophysiology of migraine and clinical evidence shows an antimigraine effect for CGRP receptor antagonists. Systemic administration of nitroglycerin (NTG), a nitrovasodilator, consistently provokes spontaneous-like migraine attacks in migraine sufferers; in the rat, systemic NTG induces a condition of hyperalgesia, probably through the activation of cerebral/spinal structures involved in nociceptive transmission. The aim of this article is to test the analgesic effect of the CGRP receptor antagonist MK-8825 in two animal models of pain that may be relevant for migraine: the tail flick test and the formalin test performed during NTG-induced hyperalgesia. MK-8825 showed analgesic activity when administered alone at both the tail flick test and the formalin test. Furthermore, the CGRP antagonist proved effective in counteracting NTG-induced hyperalgesia in both tests. MK-8825 indeed reduced the nociceptive behavior when administered either simultaneously or prior to (30-60 minutes before) NTG. These data suggest that MK-8825 may represent a potential therapeutic tool for the treatment of migraine.
    Cephalalgia 12/2013; 34(8). DOI:10.1177/0333102413517776 · 4.12 Impact Factor
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    ABSTRACT: Background. Haptic robots allow the exploitation of known motor learning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality) were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test) and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements) outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain.
    Computational and Mathematical Methods in Medicine 11/2013; 2013:895492. DOI:10.1155/2013/895492 · 1.02 Impact Factor
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    ABSTRACT: Increased antagonist muscle co-activation, seen in motor-impaired individuals, is an attempt by the neuromuscular system to provide mechanical stability by stiffening joints. The aim of this study was to investigate the co-activation pattern of the antagonist muscles of the ankle and knee joints during walking in patients with cerebellar ataxia, a neurological disease that strongly affects stability. Kinematic and electromyographic parameters of gait were recorded in 17 patients and 17 controls. Ankle and knee antagonist muscle co-activation indexes were measured throughout the gait cycle and during the sub-phases of gait. The indexes of ataxic patients were compared with those of controls and correlated with clinical and gait variables. Patients showed increased co-activity indexes of both ankle and knee muscles during the gait cycle as well as during the gait sub-phases. Both knee and ankle muscle co-activation indexes were positively correlated with disease severity, while ankle muscle co-activation was also positively correlated with stance and swing duration variability. Significant negative correlations were observed between the number of self-reported falls per year and knee muscle co-activation. The increased co-activation observed in these cerebellar ataxia patients may represent a compensatory strategy serving to reduce gait instability. Indeed, this mechanism allows patients to reduce the occurrence of falls. The need for this strategy, which results in excessive muscle co-contraction, increased metabolic costs and cartilage degeneration processes, could conceivably be overcome through the use of supportive braces specially designed to provide greater joint stability.
    The Cerebellum 10/2013; 13(2). DOI:10.1007/s12311-013-0533-4 · 2.86 Impact Factor
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    ABSTRACT: The nociceptive withdrawal reflex (NWR), a defensive response that allows withdrawal from a noxious stimulus, is a reliable index of spinal nociception in humans. It has been shown that various kinds of stimuli (emotional, visual, auditory) can modulate the transmission and perception of pain. The aim of the present study was to evaluate, by means of the NWR, the modulatory effect on the spinal circuitry of olfactory stimuli with different emotional valence. The magnitude of the NWR elicited by electrical stimulation of the sural nerve was measured while 18 subjects (9 women, 9 men) smelled pleasant, unpleasant, or neutral odors. The NWR was conditioned by odor probe with interstimulus intervals (ISIs) of 500 ms and 1,500 ms. The magnitude of NWR was significantly greater after the unpleasant odor probe (P <.001) and reduced following the pleasant odor probe (P<.001) at both ISIs. A significant effect of olfactory stimuli on subjective pain ratings were found at both ISIs for pleasant vs unpleasant odors (P<.000), and for both pleasant and unpleasant odors vs neutral and basal conditions (P<.000). No statistical differences in subjective pain ratings at different ISIs were found. Consistent with the notion that NWR magnitude and pain perception can be modulated by stimuli with different emotional valence, these results show that olfactory stimuli, too, can modulate spinal nociception in humans.
    Pain 10/2013; 154(10):2054-9. DOI:10.1016/j.pain.2013.06.032 · 5.84 Impact Factor
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    ABSTRACT: The excitability of the motor areas of the cerebral cortex is reduced in ataxia. Since transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique able to increase the cortical excitability, we assessed the effect of anodal tDCS over the motor cortex in three patients with ataxia. A clinical evaluation, a video-taped SARA rating scale and a gait analysis with cinematic parameters, were performed pre- and post-sham and anodal tDCS cycle. The full cycle was composed by five consecutive constant current sessions of stimulation. Anodal tDCS (2.0 mA, 20 min, max current density: 0.0278 mA/cm(2), max total charge: 0.033 C/cm(2)) was performed on the M1 area of the most affected side. The contralateral primary motor cortex underwent cathodal stimulation (2.0 mA, 20 min, max current density: 0.0278 mA/cm(2), max total charge: 0.033 C/cm(2)). After anodal tDCS, gait analysis revealed an improvement of the symmetry of step execution and reduction of base-width lasting 30 days associated to patients' perception of amelioration. No relevant changes were found after sham stimulation. Our results suggest tDCS can improve gait symmetry in patients with ataxia for a short-term period. Future researches are needed in order to standardize time, amplitude, and area of stimulation in order to reach a long lasting effect on cerebellar ataxia.
    The Cerebellum 09/2013; 13(1). DOI:10.1007/s12311-013-0524-5 · 2.86 Impact Factor
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    ABSTRACT: Pain processing has been poorly studied in multiple system atrophy (MSA), notwithstanding these subjects complaint pain very frequently. We hypothesized that, as observed in other basal ganglia neurodegenerative disorders involving the striatonigral projections, also in MSA with predominant parkinsonian signs could be detected an abnormal pain processing. We used the temporal summation threshold (TST) of the nociceptive withdrawal reflex (NWR) and the related pain sensation to evaluate the temporal pain processing at spinal level in eleven MSA subjects and compared them with fifteen Parkinson's disease (PD) subjects, in both during "on" and "off" treatment with L-Dopa, and fifteen healthy subjects. MSA showed a significant reduction in NWR TST as well as facilitation in other pain responses when compared to healthy subjects; no differences were detected between "on" and "off" condition; no differences were detected between MSA and PD subjects in term of neurophysiological and pharmacological responses. We demonstrated a facilitated temporal processing of pain in MSA subjects paralleling findings from PD.We hypothesize that the abnormal pain processing detected in both MSA and PD, could represent a consequence of the striatonigral neurodegeneration which in turn make these subjects more prone to develop pain conditions.
    Neuroscience Letters 09/2013; DOI:10.1016/j.neulet.2013.09.035 · 2.06 Impact Factor
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    The Cerebellum 06/2013; 12(6). DOI:10.1007/s12311-013-0501-z · 2.86 Impact Factor
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    ABSTRACT: Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients and exerts a deep negative impact on quality of life interfering with familiar, social and career-related activities. To test the effectiveness of early cognitive rehabilitation treatment for inpatients affected by primary brain tumors. Out of 109 consecutive patients enrolled in the study, 58 patients were randomly assigned to a rehabilitation group or to a control group. The rehabilitation consisted of 16 one-hour individual sessions of therapist-guided cognitive training, spread over 4 weeks, combining computer exercises and metacognitive training. Patients in the control group received usual care without cognitive training. All patients were evaluated by means of a comprehensive neuropsychological battery at the admission (T0) and after 4 weeks (T1). Patients in the rehabilitation group showed a significant improvement of cognitive functions. In particular, the domains that benefited most from the training were visual attention and verbal memory. The control group exhibited only a slightly, not statistically relevant, enhancement of cognitive performances. Cognitive rehabilitation for neuro-oncological inpatients resulted in a significant enhancement of cognitive performances after the training, also providing a foundation for early administration. Future research should be aimed to clarify the patients' characteristics that predict neuropsychological improvement, to identify the most effective elements in rehabilitative programs and to study the effects of treatment extension to everyday life.
    Journal of Neuro-Oncology 05/2013; 114(1). DOI:10.1007/s11060-013-1153-z · 2.79 Impact Factor
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    ABSTRACT: In cluster headache (CH), pathogenesis has been emphasized the role of the posterior hypothalamus. It is part of a supraspinal network involved in the descending control of pain, including the diffuse noxious inhibitory control (DNIC), which in turn modulates the pain processing. We hypothesized that CH during the active phase facilitated temporal pain processing supported by abnormal functioning of the DNIC. We studied the functional activity of the DNIC by evaluating the effect of the cold pressor test (CPT) on the temporal summation threshold (TST) of the nociceptive withdrawal reflex. Ten subjects with episodic CH (2 women, 8 men) and 10 healthy subjects were recruited. Each subject underwent neurophysiological evaluation (nociceptive withdrawal reflex TST and related painful sensation) at baseline, then before (control session), during (pain session), and 5min after (aftereffect) the CPT (immersing hand in a 4°C water bath for 4-5min). Patients had been studied during both the active and remission phases. During the active phase, CH revealed a significant facilitation in temporal processing of pain stimuli (reduction of TST), which reverted during the remission phase. The CPT activating the DNIC did not produce any significant inhibitory effect of pain responses in CH during the active phase, whereas it induced a clear inhibition during the remission phase. We hypothesized that in CH, a dysfunction of the supraspinal control of pain related to the clinical activity of the disease, possibly supported by an abnormal hypothalamic function, leads to a facilitation in pain processing and a predisposition to pain attacks.
    Pain 04/2013; 154(8). DOI:10.1016/j.pain.2013.04.012 · 5.84 Impact Factor
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    ABSTRACT: Stopping during walking, a dynamic motor task frequent in everyday life, is very challenging for ataxic patients, as it reduces their gait stability and increases the incidence of falls. This study was conducted to analyse the biomechanical characteristics of upper and lower body segments during abrupt stopping in ataxic patients in order to identify possible strategies used to counteract the instability in the sagittal and frontal plane. Twelve patients with primary degenerative cerebellar ataxia and 12 age- and sex-matched healthy subjects were studied. Time-distance parameters, dynamic stability of the centre of mass, upper body measures and lower joint kinematic and kinetic parameters were analysed. The results indicate that ataxic patients have a great difficulty in stopping abruptly during walking and adopt a multi-step stopping strategy, occasionally with feet parallel, to compensate for their inability to coordinate the upper body and to generate a well-coordinated lower limb joint flexor-extensor pattern and appropriate braking forces for progressively decelerating the progression of the body in the sagittal plane. A specific rehabilitation treatment designed to improve the ability of ataxic patients to transform unplanned stopping into planned stopping, to coordinate upper body and to execute an effective flexion-extension pattern of the hip and knee joints may be useful in these patients in order to improve their stopping performance and prevent falls.
    The Cerebellum 03/2013; 12(5). DOI:10.1007/s12311-013-0467-x · 2.86 Impact Factor
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    ABSTRACT: BACKGROUND: The aim of this study was to evaluate the concept of a wearable device and, specifically: 1) to design and implement analysis procedures to extract clinically relevant information from data recorded using the wearable system; 2) to evaluate the design and placement of the strain sensors. METHODS: Different kinds of trunk movements performed by a healthy subject were acquired as a comprehensive data set of 639 multivariate time series and off-line analyzed. The space of multivariate signals recorded by the strain sensors was reduced by means of Principal Components Analysis, and compared with the univariate angles contemporaneously measured by an inertial sensor. RESULTS: Very high correlation between the two kinds of signals showed the usefulness of the garment for the quantification of the movements' range of motion that caused at least one strain sensor to lengthen or shorten accordingly. The repeatability of signals was also studied. The layout of a next garment prototype was designed, with additional strain sensors placed across the front and hips, able to monitor a wider set of trunk motor tasks. CONCLUSIONS: The proposed technologies and methods would offer a low-cost and unobtrusive approach to trunk motor rehabilitation.
    BioMedical Engineering OnLine 12/2012; 11(1):95. DOI:10.1186/1475-925X-11-95 · 1.75 Impact Factor
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    ABSTRACT: BACKGROUND: Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding.The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course. METHODS: A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics. RESULTS: The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questionnaires were developed in order to evaluate the participants' level of knowledge, while a semi-structured interview was prepared to investigate students' satisfaction. CONCLUSIONS: Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education programmes for graduate nurses. Developing expertise in neuro-rehabilitation for nurses, will be critical to improve overall care and care management of patients with highly complex disabilities as patients affected by brain tumors. The next step will be to start discussing, at the level of scientific societies linked to the field of neurorehabilitation and oncology, the development of a specialisation course in neurorehabilitation nursing.
    Journal of Experimental & Clinical Cancer Research 10/2012; 31(1):82. DOI:10.1186/1756-9966-31-82 · 3.27 Impact Factor
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    ABSTRACT: Objective.- In this study, we evaluated the influence of sex and estrogen treatment on nitroglycerin (NTG)-induced neuronal activation in the rat brain. Background.- Systemic NTG activates cerebral nuclei of rat involved in nociceptive transmission, as well as in neuroendocrine and autonomic functions. These changes are considered relevant for migraine, since NTG consistently induces spontaneous-like attacks in migraineurs. Methods.- Intact and castrated male and female rats, and castrated female rats treated with estradiol benzoate (or placebo) were injected with NTG and sacrificed after 4 hours. Rats were perfused, and their brains were processed for Fos protein, a marker of neuronal activation. Results.- Data showed a reduced expression of NTG-induced Fos protein in the paraventricular nucleus (PVH), supraoptic nucleus (SON), and nucleus trigeminalis caudalis (SPVC) of male rats in comparison with female rats. Furthermore, in castrated female rats, NTG-induced neuronal activation was reduced in PVH, SON, central nucleus of the amygdala (AMI), nucleus tractus solitarius (NTS), area postrema (AP), and SPVC, while in castrated male rats Fos expression was reduced uniquely in the SPVC. Chronic administration of estrogens restored Fos protein expression in PVH, SON, AMI, NTS, AP, and SPVC in castrated female rats. Conclusion.- These data provide a support for the existence of a sexual dimorphism in NTG-induced neuronal activation, and they prompt a specific model for evaluating and modulating the influence of estrogens upon the cerebral structures implicated in the pathophysiology of migraine.
    Headache The Journal of Head and Face Pain 08/2012; 53(2). DOI:10.1111/j.1526-4610.2012.02249.x · 3.19 Impact Factor
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    ABSTRACT: The aims of this study were to develop a kinematic model of the spine, seen as a continuous deformable body and to identify the smallest set of surface markers allowing adequate measurements of spine motion. The spine is widely considered as a rigid body or as a kinematic chain made up of a smaller number of segments, thereby introducing an approximation. It would be useful to have at our disposal a technique ensuring accurate and repeatable measurement of the shape of the whole spine. Ten healthy subjects underwent a whole-spine radiographic assessment and, simultaneously, an optoelectronic recording. Polynomial interpolations of the vertebral centroids, of the whole set of markers were performed. The similarity of the resulting curves was assessed. Our findings indicate that spine shape can be reproduced by 5th order polynomial interpolation. The best approximating curves are obtained from either 10- or 9-marker sets. Sagittal angles are systematically underestimated.
    Applied ergonomics 08/2012; 44(2). DOI:10.1016/j.apergo.2012.07.004 · 1.33 Impact Factor
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    ABSTRACT: Turning while walking is a common but demanding task requiring modification of the motor program from linear walking to lateral turning and it is associated with a high risk of falls. Patients with cerebellar ataxia have unstable gait and report a high incidence of falls. In the present study, we investigated the motor strategies adopted by ataxic patients when performing turns of different degrees and directions of rotation. Ten ataxic patients and 10 controls were analyzed while performing 30°/90° turns to the right/left. We recorded the number of completed turn tasks, the number of steps needed, and the time taken to complete the task, time-distance parameters and the onset of head, trunk and pelvis reorientation. The ataxic patients were less able to complete 90° turns, displayed a greater stride width, shorter step length, and greater number of steps when turning, and were unable to flexibly adjust their stride width across the turning task. The duration of the turning task and of the segmental reorientation did not differ from control values. Our findings indicate that ataxic patients have more difficulties in performing large turns and adopt a series of compensatory strategy aimed at reducing the instability associated with turning, such as enlarge the base of support, shorten the step length, increase the number of steps, and use the "multi-step" rather than the "spin-turn" strategy. Given the high risk of falls related to this task, it would be useful to include turning training in the rehabilitation protocol of ataxic patients.
    Experimental Brain Research 07/2012; 222(1-2):65-75. DOI:10.1007/s00221-012-3197-2 · 2.17 Impact Factor
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    ABSTRACT: Modulation of nociceptive withdrawal reflex (NWR) excitability was evaluated during gait initiation in 10 healthy subjects to investigate how load- and movement-related joint inputs activate lower spinal centres in the transition from quiet stance to walking. A motion analysis system integrated with a surface EMG device was used to acquire kinematic, kinetic and EMG variables. Starting from a quiet stance, subjects were asked to walk forward, at their natural speed. The sural nerve was stimulated and EMG responses were recorded from major hip, knee and ankle muscles. Gait initiation was divided into four subphases based on centre of pressure and centre of mass behaviours, while joint displacements were used to categorise joint motion as flexion or extension. The reflex parameters were measured and compared between subphases and in relation to the joint kinematics. The NWR was found to be subphase-dependent. NWR excitability was increased in the hip and knee flexor muscles of the starting leg, just prior to the occurrence of any movement, and in the knee flexor muscles of the same leg as soon as it was unloaded. The NWR was hip joint kinematics-dependent in a crossed manner. The excitability of the reflex was enhanced in the extensor muscles of the standing leg during the hip flexion of the starting leg, and in the hip flexors of the standing leg during the hip extension of the starting leg. No notable reflex modulation was observed in the ankle muscles. Our findings show that the NWR is modulated during the gait initiation phase. Leg unloading and hip joint motion are the main sources of the observed modulation and work in concert to prepare and assist the starting leg in the first step while supporting the contralateral leg, thereby possibly predisposing the lower limbs to the cyclical pattern of walking.
    BMC Neuroscience 07/2012; 13:80. DOI:10.1186/1471-2202-13-80 · 2.85 Impact Factor
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    ABSTRACT: Objectives.- We investigated (1) a possible relationship between the functional activity of the endocannabinoid system and the facilitation of pain processing in migraineurs with medication-overuse headache, and (2) the effect of withdrawal treatment on both. Background.- The endocannabinoid system antinociception effect includes prevention of nociceptive pathways sensitization. The sensitization of the pain pathways has been demonstrated to be pivotal in the development and maintenance of chronic form of migraine, including medication-overuse headache. Methods.- We used the temporal summation threshold of the nociceptive withdrawal reflex to explore the spinal cord pain processing, and the platelet activity of the enzyme fatty acid amide hydrolase to detect the functional state of the endocannabinoid system in 27 medication-overuse headache subjects before and 10 and 60 days after a standard withdrawal treatment and compared results with those of 14 controls. Results.- A significantly reduced temporal summation threshold and increased related pain sensation was found in subjects before withdrawal treatment when compared with controls. A significant fatty acid amide hydrolase activity reduction coupled with a significant improvement (reduction) in facilitation of spinal cord pain processing (increase in temporal summation threshold and reduction in related pain sensation) was found in medication-overuse headache subjects at both 10 and 60 days after withdrawal treatment when compared with medication-overuse headache subjects before withdrawal treatment. Conclusions.- We demonstrated a marked facilitation in spinal cord pain processing in medication-overuse headache before withdrawal treatment when compared with controls. Furthermore, the acute reduction of the fatty acid amide hydrolase activity coupled with a reduction of the facilitation in pain processing immediately (10 days) after withdrawal treatment and its persistence 60 days after withdrawal treatment could represent the consequence of a mechanism devoted to acutely reduce the degradation of endocannabinoids and aimed to increase the activity of the endocannabinoid system that results in an antinociceptive effect.
    Headache The Journal of Head and Face Pain 06/2012; 52(9):1350-1361. DOI:10.1111/j.1526-4610.2012.02170.x · 3.19 Impact Factor
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    ABSTRACT: The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105-190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version.
    The Journal of Headache and Pain 05/2012; 13 Suppl 2(Suppl 2):S31-70. DOI:10.1007/s10194-012-0437-6 · 3.28 Impact Factor
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    ABSTRACT: Background / Purpose: Computerization of cognitive rehabilitation therapy is aimed at making it easier and quicker for the user (the therapist as well as the patient) to generate and execute exercises and treatment plans. Main conclusion: Our system automatically generates personalized exercises and treatment plans based on a wide range of stimuli, and monitors the patient’s vitals during the rehabilitation session. This makes it possible to cope with boredom and fatigue, as well as prevent stress events which could reduce the patient’s compliance.
    Up Close and Personalized, International Congress on Personalized Medicine 2012; 03/2012

Publication Stats

4k Citations
694.35 Total Impact Points

Institutions

  • 1977–2015
    • University of Pavia
      • • Department of Brain and Behavioral Sciences
      • • Department of Public Health, Experimental and Forensic Medicine
      Ticinum, Lombardy, Italy
  • 1998–2014
    • IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino
      • • University Centre for Adaptive Disorders and Headache (UCADH)
      • • Headache Science Center
      Ticinum, Lombardy, Italy
  • 2003–2010
    • Sapienza University of Rome
      • Department of Medico-Surgical Sciences and Biotechnologies
      Roma, Latium, Italy
    • Foundation Santa Lucia
      Roma, Latium, Italy
  • 1995
    • Università degli studi di Parma
      • Department of Neurosciences
      Parma, Emilia-Romagna, Italy