
Antonella Conte- MD, PhD
- Professor (Full) at Sapienza University of Rome
Antonella Conte
- MD, PhD
- Professor (Full) at Sapienza University of Rome
Full Professor of Neurology. Department of Human Neurosciences, Sapienza, University of Rome, Italy
About
282
Publications
41,091
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
6,095
Citations
Introduction
Current institution
Additional affiliations
Sapienza University of Rome and IRCCS Neuromed, Italy
Position
- Professor (Associate)
January 2005 - December 2011
Università degli Studi di Roma "La Sapienza"
January 2004 - December 2012
Publications
Publications (282)
Multiple sclerosis (MS) is an autoimmune condition characterized by inflammatory demyelination that leads to irreversible neurological damage within the central nervous system (CNS). This review examines the therapeutic potential and clinical efficacy of cladribine tablets (CladT) for treating MS, focusing on the immune reconstitution mechanism and...
Background
People with multiple sclerosis(pwMS) treated with disease-modifying therapies(DMTs) are at high risk of reactivation by CMV, EBV and VZV. An effective T-cell response ensures host control over viral infections. The aim of this study was to characterize the specific T-cell response to CMV, EBV and VZV in pwMS.
Materials and Methods
pwMS...
Objective
The increasing availability of disease-modifying therapies (DMTs) may provide more personalized treatment options for multiple sclerosis (MS) based on various factors, including patients’ characteristics, prognostic indicators, comorbidities, and safety. In Italy, recent efforts focused on promoting interdisciplinary, patient-centered car...
Background
Multiple sclerosis (MS) often causes impairment in working memory (WM), information processing speed (IPS), and verbal memory (VM). These deficits are linked to disrupted neural oscillatory activity. Transcranial alternating current stimulation (tACS), which modulates cortical oscillations, may hold promise for treating cognitive impairm...
Introduction
Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar puncture (LP), often leading to extended hospitalization and additional medication use. Clinical studies have shown that anodal transcranial direct current stimulation (a-tDCS) is effective against migraine, and thus we decided to assess whether a-tDCS wa...
Background/Objectives: Blepharospasm (BSP) is a focal dystonia characterized by involuntary, bilateral spasms of the orbicularis oculi muscle. While botulinum toxin (BoNT) is the standard treatment, cognitive tasks such as reading and writing may exert transient modulatory effects on spontaneous blinking and dystonic spasms. This study investigates...
Urinary symptoms represent a significant source of distress and disability in multiple sclerosis (MS), but the factors influencing their occurrence and exacerbation remain unclear. Frailty has been proposed as a measure of clinical complexity in MS and has been associated with its main phenotypic manifestations. The present study investigated the r...
In this “centenary” paper, an expert panel revisited Hans Berger’s groundbreaking discovery of human resting state electroencephalographic (rsEEG) alpha rhythms (8–12 Hz) in 1924, his foresight of substantial clinical applications in patients with “senile dementia,” and new developments in the field, focusing on Alzheimer’s disease (AD), the most p...
Background and objectives:
According to the dual syndrome hypothesis, patients with Parkinson disease (PD) with visuospatial deficits are more likely to progress to dementia, compared with patients with a prevalent dysexecutive syndrome. In this study, we aimed to investigate whether early connectivity changes in the dorsolateral prefrontal cortex...
Background
In Parkinson's Disease (PD), upper limb tremor during walking (TW) is observed and clinical observations suggest it may represent a variant of rest tremor. However, its neurophysiological characteristics remain unexplored.
Objectives
This study compared the neurophysiological features of TW with other PD tremors and tested whether TW ar...
Bowel and bladder symptoms are frequent in people with Multiple Sclerosis (PwMS) and early diagnosis and treatment become crucial to improve their quality of life (QoL). The study aims to design a multidisciplinary questionnaire for screening bladder and bowel symptoms in PwMS.
The Bowel and Bladder Symptoms Screening in Multiple Sclerosis (BBSS-MS...
Alzheimer disease (AD) remains a significant global health concern. The progression from preclinical stages to overt dementia has become a crucial point of interest for researchers. This paper reviews the potential of neurophysiological biomarkers in predicting AD progression, based on a systematic literature search following PRISMA guidelines, inc...
Introduction
This study aims to evaluate the effect of an occupation-focused and occupation-based group intervention for fatigue management on the perception of environment barriers and social participation, and secondarily the impact on quality of life and sleep quality.
Material and Methods
For this quasi-experimental study, 19 participants with...
With the recent introduction of a number of highly effective disease-modifying treatments (DMTs) and the resulting almost complete prevention of acute relapses in many patients with multiple sclerosis (MS), the interest of MS clinicians has gradually shifted from relapse prevention to counteraction of disease progression and the treatment of residu...
Background
Evidence on the impact of dimethyl fumarate (DMF) during pregnancy in women with multiple sclerosis (MS) is limited.
Objectives
To investigate disease activity and pregnancy outcomes in a retrospective cohort of women exposed to DMF in early pregnancy.
Methods
Women discontinuing DMF after pregnancy confirmation were identified from 29...
In multiple sclerosis (MS), alongside the physical symptoms, individuals often grapple with anxiety and depressive symptoms as prevalent comorbidity. Mood disturbances, frequently undertreated in clinical practice, significantly impact the quality of life of individuals with MS, exacerbating disability and hindering overall well-being. Furthermore,...
Motor fatigue in Multiple Sclerosis (MS) is due to reduced motor cortex (M1) output and altered sensorimotor network (SMN) modulation. Natalizumab, a disease-modifying therapy, reduces neuroinflammation and improves fatigue. However, some patients treated with natalizumab experience fatigue recurrence (‘wearing-off’) before subsequent infusions. We...
Background
The risk of reactivation of latent herpesvirus infection, such as cytomegalovirus (CMV), is increased by therapies that affect cellular immunity, such as disease-modifying therapies (DMTs) that can reduce multiple sclerosis (MS) activity and progression. In this context, our study aimed to characterize CMV T-cell-specific response in peo...
Background
Transcranial magnetic stimulation‐electroencephalography (TMS‐EEG) has demonstrated decreased excitability in the primary motor cortex (M1) and increased excitability in the pre‐supplementary motor area (pre‐SMA) in moderate‐advanced Parkinson's disease (PD).
Objectives
The aim was to investigate whether these abnormalities are evident...
Increasing evidence suggests that the cerebellum may have a role in the pathophysiology of Parkinson's disease (PD). Hence, the scope of this study was to investigate whether there are structural and functional alterations of the cerebellum and whether they correlate with motor and non-motor symptoms in early PD patients. Seventy-six patients with...
The current hypothesis on the pathophysiology of multiple sclerosis (MS) suggests the involvement of both inflammatory and neurodegenerative mechanisms. Disease Modifying Therapies (DMTs) effectively decrease relapse rates, thus reducing relapse-associated disability in people with MS. In some patients, disability progression, however, is not solel...
Neuromyelitis optica spectrum disorders (NMOSD) include a rare group of autoimmune conditions that primarily affect the central nervous system. They are characterized by inflammation and damage to the optic nerves, brain and spinal cord, leading to severe vision impairment, locomotor disability and sphynteric disturbances. In the majority of cases,...
Pain is a common non-motor symptom in patients with cervical dystonia (CD), severely impacting their quality of life. The pathophysiology of CD is incompletely understood but it involves altered processing of proprioceptive and pain signals.
The purpose of this proof-of-concept study was to determine if vibro-tactile stimulation (VTS)—a non-invasiv...
Treatment options for secondary progressive MS (SPMS) are limited, especially considering that the new drugs recently approved are licensed for actively relapsing patients. We aimed to compare the disability progression in a real-world cohort of SPMS patients treated with natalizumab (NTZ) or interferon beta-1b (IFNb-1b). This multicenter retrospec...
Oligomeric alpha-synuclein (α-syn) in saliva and phosphorylated α-syn deposits in the skin have emerged as promising diagnostic biomarkers for Parkinson’s disease (PD). This study aimed to assess and compare the diagnostic value of these biomarkers in discriminating between 38 PD patients and 24 healthy subjects (HSs) using easily accessible biolog...
Background
Physical fatigue is one of the most disabling symptoms in people with Multiple Sclerosis (PwMS). Several factors might influence the development of fatigue, such as gender, education, body mass index (BMI), Expanded Disability Status Scale (EDSS), disease duration, working status (Ws), physiotherapy (Ph), and disease-modifying therapies...
Introduction
Restless Legs Syndrome (RLS) is a widely prevalent and complex neurological disorder. Despite notable advancements in managing RLS, the disorder continues to face challenges related to its recognition and management.
Objective
This study seeks to gain comprehensive insights into the knowledge and clinical practices among Italian neuro...
Background:
Ischemic stroke may trigger neuroplastic changes via proliferation, migration towards the lesion, and differentiation of neuroprogenitor cells into mature neurons. Repetitive Transcranial Magnetic Stimulation (rTMS) may promote brain plasticity. This study aimed to assess rTMS's effect on post-stroke endogenous neuroplasticity by dosin...
Simple Summary
Natural killer cells and cytotoxic CD8+ T cells play a complementary role in controlling cytomegalovirus, a ubiquitous herpesvirus that establishes a lifelong latent infection in the host. Due to its ability to modulate the immune response, cytomegalovirus can impact the course of multiple sclerosis, an immune-mediated disease of the...
Background
Generally infrequent, multiple sclerosis (MS) with late onset (LOMS) is characterized by an onset over the age of 50 and a mainly progressive course, while relapsing–remitting (RR) forms are less frequently observed and explored. This study aimed to characterize a large cohort of MS patients with RRMS at onset to assess the baseline fact...
Botulinum toxin (BoNT) is an effective and safe therapy for the symptomatic treatment of several neurological disturbances. An important line of research has provided numerous pieces of evidence about the mechanisms of action of BoNT in the central nervous system, especially in the context of dystonia and spasticity. However, only a few studies foc...
Background
Active relapsing–remitting (RR) and secondary progressive (SP) multiple sclerosis (MS) are currently defined as “relapsing MS” (RMS). The aim of this cross-sectional study was to assess drivers of treatment switches due to clinical relapses in a population of RMS patients collected in the Italian MS and Related Disorders Register (I-MS&R...
Background and objectives
Multiple sclerosis (MS) is a chronic, progressive neurological disease characterized by early-stage neuroinflammation, neurodegeneration, and demyelination that involves a spectrum of heterogeneous clinical manifestations in terms of disease course and response to therapy. Even though several disease-modifying therapies (D...
Importance
Although up to 20% of patients with multiple sclerosis (MS) experience onset before 18 years of age, it has been suggested that people with pediatric-onset MS (POMS) are protected against disability because of greater capacity for repair.
Objective
To assess the incidence of and factors associated with progression independent of relapse...
Introduction
During the COVID-19 pandemic, ocrelizumab (OCR) infusions for MS patients were often re-scheduled because of MS center's disruption and concerns regarding immunosuppression. The aim of the present study was to assess changes in OCR schedule during the first wave of pandemic in Italy and to evaluate the effect of delayed infusion on cli...
To assess the state of neurological scientific research in Italy in the time interval 2020–2023.
Elsevier’s modular integrated platform “SciVal” was used to analyze bibliometric research products starting from scientific production data uploaded onto Scopus. We considered the research area “Neurology” in the 01/01/2020–14/06/2023 time interval, and...
Background Fatigue is a disabling symptom of multiple sclerosis (MS) and impacts on daily life. The Fatigue Symptoms and Impacts Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) is a new 20-item tool that investigates the aspects of fatigue in MS. It concerns motor, cognitive, social, and emotional aspects of fatigue. We aim at validating the...
Introduction: Physical fatigue can be a common reason for early retirement or sick leave since it appears in the earliest stages of multiple sclerosis (MS). Therefore, a prompt and accurate diagnosis is essential. This systematic review aims to identify and describe the instruments used to assess physical fatigue in MS patients with consideration f...
EASIER is a multicenter, observational, cross-sectional study investigating the consumption of healthcare resources, including healthcare professional (HCP) active working time, the costs associated with the current natalizumab intravenous (IV) administration, and the potential impact of the adoption of subcutaneous (SC) route.
The EASIER study has...
Background
Physical fatigue is one of the most disabling symptoms in people with Multiple Sclerosis (PwMS). Several factors might influence the development of fatigue, such as gender, education, body mass index (BMI), Expanded Disability Status Scale (EDSS), disease duration, working status (Ws), physiotherapy (Ph), and disease-modifying therapies...
Postural instability (PI) in Parkinson’s disease (PD) exposes patients to an increased risk of falls (RF). While dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF remain elusive. PI and RF were assessed using a stabilometric platform in six advanced PD patients. Patie...
Postural instability (PI) in Parkinson’s disease (PD) exposes patients to increased risk of falls (RF). Although dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF are not clear. PI and RF were assessed by a stabilometric platform in 6 advanced PD patients. Patients we...
Background. 80% of people with Multiple Sclerosis (MS) describe fatigue as the most disabling symptom. Several studies have demonstrated the effectiveness of fatigue management programs in reducing the impact of fatigue and improving the Quality of Life (QoL). None of these were based on the benefit that this intervention has on social participatio...
Background
Distal upper limb tremor during walking (TW) is frequently observed in Parkinson's disease (PD) but its clinical features are unknown.
Objective
To characterize the occurrence and the clinical features of TW in comparison to the other types of tremors in PD.
Methods
Fifty‐one PD patients with rest tremor were evaluated off‐ and on‐trea...
Introduction
Over the years, disease registers have been increasingly considered a source of reliable and valuable population studies. However, the validity and reliability of data from registers may be limited by missing data, selection bias or data quality not adequately evaluated or checked.
This study reports the analysis of the consistency and...
Background:
The overall disability in patients with relapsing-remitting multiple sclerosis (RRMS) is likely to be partly rather than entirely attributed to relapse.
Materials and methods:
We aimed to investigate the determinants of recovery from first relapse and relapse associated worsening (RAW) in RRMS patients from the Italian MS registry du...
Paired associative stimulation (PAS) is a non-invasive brain stimulation technique that modulates synaptic plasticity in the human motor cortex (M1). Since previous studies have primarily used motor-evoked potentials (MEPs) as outcome measure, cortical correlates of PAS-induced plasticity remain unknown. Therefore, the aim of this observational stu...
Background
In the general population, maternal SARS-CoV-2 infection during pregnancy is associated with worse maternal outcomes; however, only one study so far has evaluated COVID-19 clinical outcomes in pregnant and postpartum women with multiple sclerosis, showing no higher risk for poor COVID-19 outcomes in these patients.
Objective
In this mul...
Over the past 30 years, Botulinum toxin (BoNT) has emerged as an effective and safe therapeutic tool for a number of neurological conditions, including dystonia. To date, the exact mechanism of action of BoNT in dystonia is not fully understood. Although it is well known that BoNT mainly acts on the neuromuscular junction, a growing body of evidenc...
Background:
Although two doses of Covid-19 vaccine elicited a protective humoral response in most persons with multiple sclerosis (pwMS), a significant group of them treated with immunosuppressive disease modifying therapies (DMTs) showed less efficient responses.
Methods:
This prospective multiCenter observational study evaluates differences in...
Paired associative stimulation (PAS) is a non-invasive brain stimulation technique that modulates synaptic plasticity in the human motor cortex (M1). Since previous studies have primarily used motor evoked potentials (MEPs) as outcome measure, cortical correlates of PAS-induced plasticity remain unknown. Therefore, the aim of this observational stu...
Background:
Regulatory agencies have been responsive to public demand for inclusion of the patient experience in evaluating and approving therapies. Over the years, patient-reported outcome measures (PROMs) have become increasingly prevalent in clinical trial protocols; however, their influence on regulators, payers, clinicians, and patients' deci...
Background: The ability to perceive two tactile stimuli as asynchronous can be measured using the somatosensory temporal discrimination threshold (STDT). In healthy humans, the execution of a voluntary movement determines an increase in STDT values, while the integration of STDT and movement execution is abnormal in patients with basal ganglia diso...
Simple Summary
Since B cells have been linked to multiple sclerosis (MS) and its progression as well as T cells, the second-generation anti-CD20 recombinant humanized monoclonal antibody ocrelizumab has been approved for MS treatment. Although ocrelizumab efficiently depletes B cells in peripheral blood, some B cells and CD20 negative plasma cells...
Objective:
To comprehensively investigate excitability in face and hand M1 and sensorimotor integration in oromandibular dystonia (OMD) patients.
Methods:
Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), short (SAI) and long (LAI) afferent inhibition were investigated in face and hand M1 using transcranial magnet...
Timely diagnosis of secondary progressive multiple sclerosis (SPMS) represents a clinical challenge. The Frailty Index, a quantitative frailty measure, and the Neurophysiological Index, a combined measure of sensorimotor cortex inhibitory mechanism parameters, have recently emerged as promising tools to support SPMS diagnosis. The aim of this study...
Good health and well-being for all, including those with disabilities, is one of the main sustainable development goals. Data on refugees and asylum seekers with disabilities are limited. Refugees have poor access to rehabilitation and assistive technologies, although laws and policies in Italy guarantee this type of healthcare. However, there are...
Dystonia is thought to be a network disorder due to abnormalities in the basal ganglia-thalamo-cortical circuit. We aimed to investigate the white matter (WM) microstructural damage of bundles connecting pre-defined subcortical and cortical regions in cervical dystonia (CD) and blepharospasm (BSP). Thirty-five patients (17 with CD and 18 with BSP)...
Motor fatigue is one of the most common symptoms in multiple sclerosis (MS) patients. Previous studies suggested that increased motor fatigue in MS may arise at the central nervous system level. However, the mechanisms underlying central motor fatigue in MS are still unclear. This paper investigated whether central motor fatigue in MS reflects impa...
Patients with cervical dystonia (CD) often show an improvement in dystonic posture after sensory trick (ST), though the mechanisms underlying ST remain unclear. In this study, we aimed to investigate the effects of ST on cortical activity in patients with CD and to explore the contribution of motor and sensory components to ST mechanisms. To this p...
Purpose
The aim of this systematic review was to evaluate the psychometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).
Materials and methods
Searches were conducted in August 2021 on four electronic databases: MEDLINE, CINAHL, Scopus, and Web of Science. Eligible papers included cross-sectional valid...
Objective
To investigate molecular biomarkers of a‐synuclein and tau aggregation, autophagy, and inflammation in the saliva of de novo Parkinson's disease (PD) patients in comparison to healthy subjects (HS), and to correlate molecular data with clinical features of PD patients, in order to establish whether abnormalities of these parameters are as...
Good health for All is one of the main targets of the Sustainable Development Goals, ensuring quality of care for all people, including of course people with disability. Migrants with disability represent an invisible group of individuals who are forced to leave their countries. Data on refugees and asylum seekers with disability are lacking. They...
Background and Objectives
Uncontrolled evidence suggests that autologous hematopoietic stem cell transplantation (AHSCT) can be effective in people with active secondary progressive multiple sclerosis (SPMS). In this study we compared the effect of AHSCT with that of other anti-inflammatory disease modifying therapies (DMT) on long-term disability...
Background
Many studies investigated the association between air pollution and Covid-19 severity but the only study focusing on patients with Multiple Sclerosis (MS) exclusively evaluated exposure to PM2.5. We aim to study, in a sample of MS patients, the impact of long-term exposure to PM2.5, PM10 and NO2 on Covid-19 severity, described as occurre...
Background
The mRNA vaccines help protect from COVID-19 severity, however multiple sclerosis (MS) disease modifying therapies (DMTs) might affect the development of humoral and T-cell specific response to vaccination.
Methods
The aim of the study was to evaluate humoral and specific T-cell response, as well as B-cell activation and survival factor...
The diagnostic framework and the therapeutic management of patients with adult dystonia can represent a challenge for clinical neurologists. The objective of the present paper is to delineate diagnostic and therapeutic recommendations for dystonia provided by a panel of Italian experts afferent to the Italian Society of Neurology, the Italian Acade...
Measuring disability among migrants is a significant challenge; however, there is no consensus on how to measure disability and functional limitations. The present study reports a methodological approach to measure disability in refugees and asylum seekers using Washington Group (WG) tools, namely the WG Short Set (WG-SS), the Short Set Enhanced (W...
Background
Patients with Parkinson’s disease (PD) and rest tremor may also have tremor during posture holding, with tremor being transiently suppressed during the transition between resting and posture holding. Other PD patients show no tremor suppression between resting and posture holding. The mechanisms responsible for tremor suppression in PD a...
Background
Definitions for reliable identification of transition from relapsing-remitting multiple sclerosis (MS) to secondary progressive (SP)MS in clinical cohorts are not available.
Objectives
To compare diagnostic performances of two different data-driven SPMS definitions.
Methods
Data-driven SPMS definitions based on a version of Lorscheider...
Introduction
Transcranial magnetic stimulation-evoked electroencephalography potentials (TEPs) have been used to study motor cortical excitability in healthy subjects and several neurological conditions. However, optimal recording parameters for TEPs are still debated. Stimulation rates could affect TEP amplitude due to plasticity effects, thus con...
Background
In multiple sclerosis (MS), bridging therapies are usually administered when switching from one therapy to another. Such treatments generally consist of injectable immunomodulatory drugs (interferon or glatiramer acetate), whose efficacy, safety, and tolerability data are consolidated for use even in fragile patients. We performed a nati...
Background
Patients with multiple sclerosis (pwMS) treated with anti-CD20 or fingolimod showed a reduced humoral response to SARS-CoV-2 vaccines.
Objective
In this study we aimed to monitor the risk of breakthrough SARS-CoV-2 infection in pwMS on different disease-modifying therapies (DMTs).
Methods
Data on the number of vaccinated patients and t...
Hyperkinesias are heterogeneous involuntary movements that significantly differ in terms of clinical and semeiological manifestations, including rhythm, regularity, speed, duration, and other factors that determine their appearance or suppression. Hyperkinesias are due to complex, variable, and largely undefined pathophysiological mechanisms that m...
Background
Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part.
Methods
This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related...
Background:
Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS), and has a major impact on their quality of life. Measurement tools that assess the patient's condition are commonly used in the neurological field, though diagnostic tools are currently unable to distinguish potential alternative causes of fatigue in i...
Background:
Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduc...
Background:
Fatigue is a disabling symptom of multiple sclerosis (MS) and impacts on daily life. The Fatigue Symptoms and Impacts Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) is a new 20-item tool that investigates the aspects of fatigue in MS. It concerns motor, cognitive, social, and emotional aspects of fatigue. We aim at validating th...
Background:
Sativex (USAN: nabiximols) oromucosal spray is indicated for treatment of multiple sclerosis (MS) patients with moderate to severe spasticity and inadequate response to other antispasticity medications who demonstrate clinically significant improvement during an initial trial of therapy. This narrative review investigated the efficacy...
We evaluated levels of serum neurofilament light chains (NfL), a known biomarker of neuroaxonal damage, in patients with cervical dystonia (CD) and healthy controls (HCs). CD patients had normal NfL levels supporting the hypothesis that CD may be considered as a functional network disorder rather than as a neurodegenerative disease.
Background
Non-genetic risk factors play a relevant role in Parkinson's disease (PD) development but the relationship between these factors and PD clinical features is unknown.
Objective
The aim of the present multicenter study was to investigate possible relationship between risk factors and clinical motor and non-motor features in a large sample...
Introduction
The Health Assessment Questionnaire (HAQ) has been translated into many languages and it has been classified as the predictor of disability and medical costs, however, the psychometric properties of the HAQ have never been studied in a population with neurological disease. The purpose of this study was the evaluation of the psychometri...
Introduction
The Jebsen Taylor Hand Function Test (JTHFT) is a non-diagnostic assessment scale for hand and upper limb dexterity that is commonly used in various countries around the world for diseases, such as muscular dystrophy, stroke, spinal cord injury, Parkinson, carpal tunnel syndrome, and rheumatoid arthritis. This study aimed to evaluate t...