Anna Castelnovo

Ente Ospedaliero Cantonale Ospedale Civico di Lugano · Neurocenter of Southern Switzwerland

Benzodiazepine (BDZ) misuse is a growing health problem, with 1–2% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of this study was to assess the neuropsychological and neurophysiological pr...

Introduction: Disorders of arousal (DOA) are parasomnias that emerge from incomplete arousal out of Non-Rem Sleep (NREM) and lead to a broad variety of emotional and motor behaviours. Increasing evidence supports the hypothesis that specific psychopathological traits contribute to the multifactorial origin of these phenomena. The aim of the curren...

Background and objectives To define the boundaries and the overlaps between fatigue, sleepiness and depression in patients with multiple sclerosis (MS) by using different tools for each dimension, including instrumental sleep analysis. Methods In this cross-sectional, observational study, 71 MS patients (males/females: 20/51; mean age: 48.9 ± 10.5...

Confusional arousal is the milder expression of a family of disorders known as Disorders of Arousal (DOA) from non-REM sleep. These disorders are characterized by recurrent abnormal behaviors that occur in a state of reduced awareness for the external environment. Despite frequent amnesia for the nocturnal events, when actively probed, patients are...

Purpose: Disorders of arousal (DoA) are characterized by incomplete awakening from NREM sleep, with the admixture of both deep sleep and wake EEG activity. Previous observations suggested that changes in EEG activity could be detected in the seconds preceding DoA episodes. The aims of this work were to characterize the topography of EEG spectral c...

Introduction Sleep state misperception, or paradoxical insomnia, is a condition whereby an individual reports being awake even though polysomnographic evidence confirms they were asleep. Normally, an indication of sleep state misperception is determined by asking a patient to estimate the amount of wakefulness experienced after a full night of labo...

Disorders of arousal (DOA) are Non-Rem Sleep (NREM) parasomnias that emerge from incomplete arousal out of deep sleep and lead to a broad variety of emotional and motor behaviours. Increasing evidence supports the hypothesis that specific psychopathological traits contribute to the multifactorial origin of these phenomena. The aim of the current mu...

Disorders of arousal (DOA) are Non-Rem Sleep (NREM) parasomnias that emerge from incomplete arousal out of deep sleep and lead to a broad variety of emotional and motor behaviours. Increasing evidence supports the hypothesis that specific psychopathological traits contribute to the multifactorial origin of these phenomena. The aim of the current mu...

Objective: Recent years saw an increasing interest towards sleep microstructure abnormalities in attention-deficit/hyperactivity disorder (ADHD). However, the existing literature on sleep electroencephalographic (EEG) power in ADHD is still controversial, often based on single electrode recordings, and mainly focused on slow wave activity (SWA) du...

Parasomnias are a class of sleep disorders characterized by undesirable experiences or behaviors that occur mainly during a sleep period, the transition from wake to sleep or vice versa. These are divided based on the sleep phase in which they occur. Parasomnia are often benign, but in some cases they can represent the prodromal manifestation of a...

Study objectives: We tested the hypothesis that patients with extreme sleep state misperception display higher levels of psychopathology and reduced quantitative estimation abilities compared to other patients with insomnia. Secondary aims included the evaluation of group differences in subjective self-reported quality of life and sleep quality an...

Study objectives: To carry out an analysis of leg movement activity during sleep in a polysomnography (PSG) dataset of patients with multiple sclerosis (MS), in comparison to idiopathic restless legs syndrome (iRLS) and healthy controls. Methods: In this cross-sectional, observational, instrumental study, fifty-seven patients (males/females: 11/...

Background Fatigue is among the most frequent and disabling symptoms of multiple sclerosis (MS) and a close relation between fatigue and sleep quality has been hypothesized. In this study was investigated the contribution of sleep disturbances as measured by clinical and polysomnographic (PSG) parameters to fatigue in MS. Methods Prospective instr...

Objective/background: Night terrors, sleepwalking and confusional arousals are behavioral manifestations of incomplete awakenings from sleep. According to international diagnostic criteria, these behaviors occur in the absence of any mental experience, or in the presence of very limited cognition or dream imagery (eg, a single visual scene). The a...

The analysis of sleep microstructure in attention deficit hyperactivity disorder (ADHD) revealed an under‐representation of the EEG slow component during NREM sleep. Previous studies either excluded or did not characterize objectively sleep disorders, which notoriously affect sleep architecture. The present study aimed to investigate the cyclic alt...

Introduction The aim of this study was to assess the prevalence of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large population of patients with multiple sclerosis (MS), and to compare clinical and paraclinical findings between patients with and without RLS/PLMS. Methods In this cross–sectional,...

Study Objectives To assess the frequency of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large sample of patients with multiple sclerosis (MS). To compare clinical and paraclinical findings among four sub-groups of patients: RLS–/PLMS– (patients without RLS and PLMS), RLS+/PLMS– (patients with RLS...

Background Despite insomnia diagnosis is based only on subjective sleep assessment, recent literature suggested the usefulness of objective sleep duration for the identification of two insomnia phenotypes based on objective total sleep time (oTST). In particular, insomnia with short sleep duration (SS) (oTST<6 hours) seems to receive less benefit f...

Emotion processing abnormalities and sleep pathology are central to the phenomenology of paediatric posttraumatic stress disorder, and sleep disturbance has been linked to the development, maintenance and severity of the disorder. Given emerging evidence indicating a role for sleep in emotional brain function, it has been proposed that dysfunctiona...

Disorders of arousals are common sleep disorders characterized by complex motor behaviours that arise episodically out of slow-wave sleep. Psychological distress has long been associated with disorders of arousal, but this link remains controversial, especially in children and adolescents. The aim of this multi-centre study was to characterize beha...

Introduction Sleepwalking belongs to a family of disorders (Disorders of Arousal - DOA) that are thought to derive from incomplete arousals out of Non Rapid Eye Movement (NREM) sleep. At yet, our knowledge about the specific neural dynamics occurring during clinical episodes is limited and relies on one SPECT case study, four stereo-EEG case report...

Introduction Sleep disturbance is central to the phenomenology of PTSD across the lifespan with up to 90% of youth with PTSD reporting sleep disturbance. Subjective sleep dysfunction has also been linked to the development, maintenance and severity of the disorder. However, to date there have been no objective EEG assessments of sleep in youth with...

Introduction Although sleep in patients with Multiple Sclerosis (MS) has been investigated in several studies using subjective measures, objective sleep data collected using polysomnography (PSG) are still scanty and often divergent. We herein present the largest study to date evaluating sleep architecture and total leg movement activity during sle...

Background Slow waves, the hallmark of the deep nonrapid eye movement sleep electroencephalogram (EEG), are critical for restorative sleep and brain plasticity. They arise from the synchronous depolarization and hyperpolarization of millions of cortical neurons and their proper generation and propagation relies upon the integrity of widespread cort...

Abnormal sleep oscillations have recently been proposed as endophenotypes of schizophrenia. However, optimization of methodological approaches is still necessary to standardize analyses of their microstructural characteristics. Additionally, some relevant features of these oscillations remain unexplored in pathological conditions. Among others, slo...

Sleep disturbance is central to the pathophysiology of PTSD across the lifespan, and increasing evidence supports the idea that sleep’s role in emotion processing may play a key role in the maintenance and/or exacerbation of the disorder. Using high-density EEG we record baseline sleep and sleep following performance on a task designed to assess me...

The pathophysiology of insomnia remains poorly understood, yet emerging cross-disciplinary approaches integrating natural history, observational studies in traditional populations, gene-phenotype expression and experiments, are opening up new avenues to investigate the evolutionary origins of sleep disorders, with the potential to inform innovation...

Multiple sclerosis (MS) is a mainly demyelinating, autoimmune, and disabling neurological disease. In addition to well-known clinically evident symptoms such as coordination or motor problems, increasing attention has been posed to a constellation of less evident symptoms significantly contributing to the clinical impact of MS. Among others, sleep...

Sleep occupies a third of our life and is a primary need for all animal species studied so far. Nonetheless, chronic sleep restriction is a growing source of morbidity and mortality in both developed and developing countries. Sleep loss is associated with the subjective feeling of sleepiness and with decreased performance, as well as with detriment...

Abstract Humans typically lack awareness that they are dreaming while dreaming. However, at times a remarkable exception occurs and reflective consciousness can be regained while dreaming, referred to as lucid dreaming. While most individuals experience lucid dreams rarely there is substantial variance in lucid dream frequency. The neurobiological...

Sleep spindles and slow waves are the main brain oscillations occurring in non-REM sleep. Several lines of evidence suggest that spindles are initiated within the thalamus, whereas slow waves are generated and modulated in the cortex. A decrease in sleep spindle activity has been described in Schizophrenia (SCZ), including chronic, early course, an...

Paradoxical insomnia is one of the most intriguing yet challenging subtypes of insomnia. Despite being recognized for a long time by the international community, it is still unclear whether this entity really exists, which are its features and boundaries. Much of the debate is fuelled by the lack of a consensus on its precise definition. To help fi...

It is often assumed that during rapid eye movement (REM) sleep the cerebral cortex homogenously shows electroencephalogram (EEG) activity highly similar to wakefulness. However, to date no studies have compared neural oscillatory activity in human REM sleep to resting wakefulness with high spatial sampling. In the current study, we evaluated high-r...

Zolpidem is an imidazopyridine nonbenzodiazepine hypnotic drug with a high affinity to the α1 subunit of the gamma amino butyric acid A receptor It is the first pharmacological option in the short-term management of sleep-onset insomnia. Initially considered a safer drug compared to benzodiazepines because of lower liability for abuse and dependenc...

Non-rapid eye movement (NREM) sleep parasomnias (or NREM parasomnias) are fascinating disorders with mysterious neurobiological substrates. These conditions are common and often severe, with social, personal and forensic implications. The NREM parasomnias include sleepwalking, sleep terrors and confusional arousals - collectively termed disorders o...

Introduction Paradoxical insomnia, otherwise known as “misperceptive insomnia”, is definitively the most intriguing yet challenging subtype of insomnia. However, the boundaries of this insomnia subtype remain blurred. A Mispeception Index (MI) was validated by our group as the difference between objective and subjective Total Sleep Time (o-TST and...

Introduction Sleep disturbance is a core symptom of Pediatric post-traumatic stress disorder (PPTSD). Given the link between sleep and affective processing, disruptions in sleep-dependent processing of emotional material have been suggested to contribute to symptom maintenance. In this study we sought to asses the relationship between sleep and emo...

Study objectives: to examine scalp and source power topography in sleep arousals disorders (SADs) using hdEEG. Methods: Fifteen adult subjects with sleep arousal disorders (SADs) and 15 age- and gender-matched good sleeping healthy controls were recorded in a sleep laboratory setting using a 256 channel EEG system. Results: Scalp EEG analysis...

Sleep spindles are wax and waning brain oscillations at a frequency range of 11–16 Hz, lasting 0.5–2 s, that define non-rapid eye movement sleep stage 2. Over the past few years, several independent studies pointed to a decrease of sleep spindles in schizophrenia. The aim of this review is to contextualize these findings within the growing literatu...

Asenapine is a second-generation antipsychotic with a unique pharmacological profile that was recently approved for the treatment of moderate/severe manic episodes. Real-world data on rapidity of action in inpatient settings are lacking.The aims of the current real-world observational study were to evaluate: (i) short-term efficacy of asenapine aft...

Schizophrenia (SCZ) has long been associated with multifaceted dysfunctions and multiple genetic as well as environmental etiological factors (Rethelyi et al., 2013). Therefore, after a century of inconsistent results, the search for a unifying pathogenetic mechanism has become one of the most challenging issues in SCZ research. During the last de...

The story-like organization of dreams is characterized by a pervasive bizarreness of events and actions that resembles psychotic thought, and largely exceeds that observed in normal waking fantasies. Little is known about the neural correlates of the confabulatory narrative construction of dreams. In this study, dreams, fantasies elicited by ambigu...

This chapter provides an overview of epidemiological studies on the recurrence of hallucinatory phenomena in the general population and addresses the role of visual hallucinations found in sleep and during states of transition to/from wakefulness. It describes the visual hallucinations during sensory deprivation and bereavement is discussed. The ch...

Aims Reduced sleep spindle activity has recently been described in chronic, medicated Schizophrenia and in subjects with early-course psychotic disorders (Ferrarelli et al., 2010, Keshavan et al., 2011). Our aim is to explore the validity of this putative biological marker by confirming its presence in drug-naïve subjects with First-Episode Psycho...

Background: Surprisingly few delusional themes are known to recur in psychosis. However, cultural variables determine specific contents within the delusions. The terms "Truman syndrome" and "Truman Show delusion" have been used to describe a novel content emerging in Western civilization. We describe the first case outside of English-speaking count...

Cognitive bizarreness has been shown to be equally elevated in the dream and waking mentation of acutely symptomatic inpatients diagnosed with affective and non-affective psychoses. Although some studies have reported on dream content in non-psychotic depression, no study has previously measured this formal aspect of cognition in patients hospitali...

One of the major differences between dreaming and being awake lies in the subject's preserved ability to distinguish real and internally fabricated images only in the latter state of consciousness. Although every human's life is characterized by the brain's continuous distinction between these two modalities, this type of self-reflective ability is...

Efficacy of antipsychotic medications is nowadays confirmed, but their effectiveness is biased by the generally low compliance to therapy associated to psychotic patients. Psychiatric intramuscular depot pharmacotherapy represents a good option to increase compliance and to improve the outcome.Objective We indirectly assessed compliance to oral ant...

Genetic factors and gene-environment interactions together contribute over 80% of the liability for developing schizophrenia. Schizophrenia runs in families and there are significant variations in the incidence of schizophrenia, with urbanicity, male gender, and a history of migration being associated with a higher risk for developing the illness.O...

We have studied the strategic behaviour of schizophrenic patients playing the Dictator Game (DG) and the Ultimatum Game (UG). The model of Homo economicus predicted by traditional economical theories describes the individual involved in economical negotiations as a selfish, rational trader, whose leading purpose is to maximize his utility function....