Corrado Zenesini

Istituto delle Scienze Neurologiche, Ospedale Bellaria | IRCCS Bologna · Neuroepidemiology

Background Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system requiring complex diagnostic and therapeutic management. Treatment with Disease Modifying Drugs (DMDs) is aimed at reducing relapse rate and disease disability. Few real-world, population-based data are available on the impact of adherence on relapse...

Recent studies reported increased plasma glial acidic fibrillary protein (GFAP) levels in amyotrophic lateral sclerosis (ALS) patients compared to controls. We expanded these findings in a larger cohort, including 156 ALS patients and 48 controls, and investigated the associations of plasma GFAP with clinical variables and other biofluid biomarkers...

Background: The levels of synaptic markers synaptosomal-associated protein 25 (SNAP-25) and neurogranin (Ng) have been shown to increase early in the cerebrospinal fluid (CSF) of patients with Creutzfeldt-Jakob disease (CJD) and to have prognostic potential. However, no validation studies assessed these biomarkers' diagnostic and prognostic value...

Background Lafora disease (LD) is a fatal form of progressive myoclonic epilepsy caused by biallelic pathogenic variants in EPM2A or NHLRC1 . With a few exceptions, the influence of genetic factors on disease progression has yet to be confirmed. We present a systematic review and meta-analysis of the known pathogenic variants to identify genotype–p...

Introduction Health administrative databases are widely used for the estimation of the prevalence of Parkinson's Disease (PD). Few in general, and none used in Italy, have been validated by testing their diagnostic accuracy. The primary objective was to validate two algorithms for the identification of persons with PD using clinical diagnosis as th...

Objective: In Alzheimer's disease (AD), the presence of circadian dysfunction is well-known and may occur early in the disease course. The melanopsin retinal ganglion cell (mRGC) system may play a relevant role in contributing to circadian dysfunction. In this study, we aimed at evaluating, through a multimodal approach, the mRGC system in AD at a...

Background: Lafora disease (LD) is a fatal form of progressive myoclonic epilepsy caused by biallelic pathogenic variants in EPM2A or NHLRC1. With a few exceptions, the influence of genetic factors on disease progression has yet to be confirmed. We present a systematic review and meta-analysis of the known pathogenic variants to identify genotype-p...

Background Phosphorylated-tau181 (p-tau181), a specific marker of Alzheimer’s disease (AD) pathology, was found elevated in plasma but not in cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). We expanded these findings in a larger patient cohort, exploring clinical/electrophysiological associations, prognostic value an...

Background The levels of synaptic markers synaptosomal-associated protein 25 (SNAP-25) and neurogranin (Ng) have been shown to increase early in the cerebrospinal fluid (CSF) of patients with Creutzfeldt-Jakob disease (CJD) and to have prognostic potential. However, no validation studies assessed these biomarkers' diagnostic and prognostic value in...

Background Immune checkpoint inhibitors (ICIs) represent an effective cancer immunotherapy yet are associated with immune-related adverse events (irAEs). The aim of this study was to characterize irAEs involving the peripheral nervous system (PNS-irAEs) in a real-world cohort of ICI-treated patients. Methods Cancer patients treated with ICIs betwe...

Objective: Due to significant risks on the offspring after intrauterine exposure, the European Medicines Agency (EMA) issued recommendations in 2014 and 2018, restricting the use of valproate (VPA) in women of childbearing age (WOCA). We aimed to evaluate their impact in the Emilia-Romagna Region (ERR), Northern Italy. Methods: Using administrat...

Study objectives: This study aimed to explore resilience and its possible association with sociodemographic and clinical features in patients with narcolepsy type 1 (NT1). Methods: Cross-sectional study involving patients with NT1 and age/sex-matched controls (comparison group). Sociodemographic and clinical data were collected through semi-stru...

In Italy, prevalence estimates of Parkinson's Disease show high variability and range from 0.6 to 6.2 cases per 1,000 inhabitants. The estimate found in the territory of the Local Health Trust of Bologna (4.3 per 1,000 inhabitants, 95% CI 4.2-4.4) is at the higher end of this range. This figure confirms the need to consider this disease, which burd...

Purpose : To report the efficacy and tolerability of brivaracetam (BRV) in add-on therapy in pediatric patients with severe drug-resistant epilepsy. Prognostic factors of clinical outcome were also analyzed. Methods : This Italian multicenter retrospective observational study was conducted on 45 pediatric patients with severe drug-resistant epilep...

Objective: To study the evolution of the Tree Drawing Test (TDT) in a group of Alzheimer's disease (AD) patients. Methods: A total of 33 AD patients were consecutively evaluated by Mini Mental State Evaluation (MMSE) and TDT. The evolution of the TDT parameters, trunk-to-crown (TC) and space occupation (SO) index, were analyzed. Results: The m...

Autism spectrum disorder (ASD) is a clinically heterogeneous class of neurodevelopmental conditions with a strong, albeit complex, genetic basis. The genetic architecture of ASD includes different genetic models, from monogenic transmission at one end, to polygenic risk given by thousands of common variants with small effects at the other end. The...

Objective To investigate adolescents’ and parents’ preferences concerning information on narcolepsy. Methods During a one-year cross-sectional study, adolescents (12–20 years old) with narcolepsy and parents attending the Narcolepsy Center of Bologna (Italy) were invited to fill in a questionnaire including 28 pieces of information regarding narco...

Background Increasing evidence supports the use of plasma biomarkers of neurodegeneration and neuroinflammation to screen and diagnose patients with dementia. However, confirmatory studies are required to demonstrate their usefulness in the clinical setting. Methods We evaluated plasma and cerebrospinal fluid (CSF) samples from consecutive patient...

Study objectives Narcolepsy is a rare chronic central disorder of hypersomnolence with frequent endocrine-metabolic comorbidities. To address the complex care needs of patients during the COVID-19 emergency, we carried out a feasibility study of the TElemedicine for NARcolepsy (TENAR) protocol with the aim of assessing the feasibility of a multidis...

Lo studio della mobilità dei pazienti fra le Regioni italiane costituisce, oltre che uno strumento per comprendere i flussi migratori sanitari e per capire, quindi, la propensione dei cittadini ai servizi offerti dal SSN, un dispositivo di programmazione per le specifiche politiche sanitarie territoriali. L'Istituto delle Scienze Neurologiche di Bo...

Background Idiopathic normal pressure hydrocephalus (iNPH) is a clinico-radiological syndrome of elderly individuals likely sustained by different neurodegenerative changes as copathologies. Since iNPH is a potentially reversible condition, assessing neurodegenerative pathologies in vitam through CSF biomarkers and their influence on clinical featu...

Background Assessing the safety of SARS-CoV-2 mRNA vaccines and the effect of immunotherapies on the seroconversion rate in patients with autoimmune neurological conditions (ANC) is relevant to clinical practice. Our aim was to assess the antibody response to and safety of SARS-CoV-2 mRNA vaccines in ANC. Methods This longitudinal study included A...

Background: The patterns of long term risk of SARS-CoV-2 infection, hospitalization for COVID-19 and related death are uncertain in people with Parkinson's disease (PD) or parkinsonism (PS). The aim of the study was to quantify these risks compared to a control population cohort, during the period March 2020-May 2021, in Bologna, northern Italy....

Objective: Data on COVID-19 outcomes in persons with epilepsy (PWE) are scarce and inconclusive. We aimed to study the risk of hospitalization and death for COVID-19 in a large cohort of PWE from 01 March 2020 to 31 October 2021. Methods: Historical cohort design (EpiLink Bologna), comparing adult PWE grouped in people with focal epilepsy (PFE),...

Aim: Feasibility of repeated TELEVISITS for people with narcolepsy during 1 year of COVID-19 pandemic in Italy

AIM: To study the risk of hospitalization and death for COVID 19 in a large cohort of PWE from 01 March 2020 to 30 October 2021.

•EAA is an innovative, promising, safe and effective approach for 3VCPs.•Key of success is surgeon learning curve in endoscopy and patients selection.•With correct indications, EEA gives GTR and morbidity rate similar to other routes.•Clinical, tumoral and anatomical features should be considered for EEA selection.

Introduction Neurosurgical education should start during medical school to involve more students, favoring the recruitment of the most prepared and motivated ones and spreading this subject to the future medical generations. Despite multiple investigations, a dedicated educational plan does not exist. This study aims to assess the undergraduates' i...

Background The indirect impact of the COVID-19 epidemic on major clinical outcomes of people with Parkinson's disease (PD) or other parkinsonism is unknown. Objectives The study aimed to (1) describe changes in healthcare services during the first epidemic bout in people with PD or parkinsonism; (2) compare the occurrence of hospitalization for an...

Objective To identify predisposing factors for hyperkinetic seizure occurrence in a representative cohort of surgically treated patients with drug-resistant focal epilepsy. Methods We retrospectively recruited all seizure-free patients after epilepsy surgery with a postoperative follow-up ≥12 months. Patients were classified as presenting with hyp...

Background. Increasing evidence support the clinical implementation of plasma biomarkers of neurodegeneration and neuroinflammation for the screening and diagnosis of patients with dementia. However, confirmatory studies are required to demonstrate their usefulness in the real-world clinical setting, in which co-existence of multiple pathologies in...

Objective The aim of the present study is to evaluate a neurocognitive outcome in patients affected by late-onset idiopathic aqueductal stenosis (LIAS) who underwent endoscopic third ventriculostomy (ETV). Materials and Methods A prospective study was conducted between January 2015 and December 2017 in a series of 10 consecutive adult patients ref...

Background Hypopituitarism seems to be rather common following aneurysmal subarachnoid haemorrhage (aSAH), even though its real prevalence remains unclear and the effects on six-month patient functional outcomes are debatable. This study correlated hypopituitarism after aSAH and cognitive performances using neuropsychological tests. Methods In a p...

Narcolepsy type 1 (NT1) is due to selective loss of hypocretin (hcrt)-producing-neurons. Hcrt is a neuropeptide regulating the sleep/wake cycle, as well as feeding behavior. A subset of NT1 patients become overweight/obese, with a dysmetabolic phenotype. We hypothesized that mitochondrial DNA (mtDNA) sequence variation might contribute to the metab...

INTRODUZIONE Durante il primo lockdown (marzo-maggio 2020), l'AUSL di Bologna (bacino di utenza c. 900.000 persone) ha ridotto l'erogazione di servizi sanitari anche a pazienti con patologie croniche, con possibili conseguenze sulla salute. La malattia di Parkinson (MdP) e i parkinsonismi (PKS) sono due condizioni di vulnerabilità estrema, e nell'A...

Background Lafora disease (LD) is a rare fatal autosomal recessive form of progressive myoclonus epilepsy. It affects previously healthy children or adolescents, causing pharmacoresistant epilepsy, myoclonus and severe psychomotor deterioration. This work aims to describe the clinical course of LD and identify predictors of outcome by means of a pr...

A prodromal phase of Parkinson’s disease (PD) may precede motor manifestations by decades. PD patients’ siblings are at higher risk for PD, but the prevalence and distribution of prodromal symptoms are unknown. The study objectives were (1) to assess motor and non-motor features estimating prodromal PD probability in PD siblings recruited within th...

Introduction Epilepsy is a chronic condition requiring consistent follow-up aimed at seizure control, and monitoring of anti-seizure medication (ASM) levels and side effects. Telemedicine (TM) offers invaluable support to patient follow-up, guaranteeing the prompt availability of a team of experts for persons with epilepsy (PWE) widely distributed...

Background: Injections targeting the occipital nerve are used to reduce headache attacks and abort cluster bouts in cluster headache patients. There is no widely accepted agreement over the optimal technique of injection, type and doses of steroids and/or anesthetics to use, as well as injection regimens. The aim of this study was to verify the ef...

INTRODUZIONE Il rischio di ospedalizzazione da Sars-Cov-2 sembra più elevato in popolazioni vulnerabili (ad esempio patologie croniche). Non è chiaro se questi rischi siano rimasti costanti durante tutto il periodo epidemico. OBIETTIVI Valutare il rischio di ospedalizzazione da Sars-Cov-2 e relativa mortalità in una coorte di pazienti con Malattia...

Neurofilament light chain (NfL) and α-synuclein oligomeric seeds (α-syn-s) are promising biomarkers for patients with parkinsonism. We assessed their performance in discriminating Parkinson disease (PD) from atypical parkinsonisms (APDs) and evaluated the association between NfL levels and clinical measures of disease severity. We measured NfL in c...

Background: Neurofilament light chain (NfL) is a validated biofluid marker of neuroaxonal damage with great potential for monitoring patients with neurodegenerative diseases. We aimed to further validate the clinical utility of plasma (p) vs. CSF (c) NfL for distinguishing patients with Amyotrophic Lateral Sclerosis (ALS) from ALS mimics. We also a...

Introduction : Data on seizure course during pregnancy in women with epilepsy are limited. In particular, little is known about the causes underlying possible seizure worsening in this population. We therefore set out to explore worsening, in pregnancy, of sleep-related hypermotor epilepsy (SHE), a syndrome in which seizures are known to be trigger...

Introduction: Surrogate cerebrospinal fluid (CSF) biomarkers of neurodegeneration still have a central role in the first-line screening of patients with suspected Creutzfeldt-Jakob disease (CJD). Recently, CSF α-synuclein, a marker of synaptic damage, showed a close to optimal performance in distinguishing between CJD and other neurodegenerative d...

Objective : We describe a multicenter experience with VNS implantation in pediatric patients with epileptic encephalopathy. Our goal was to assess VNS efficacy and identify potential predictors of favorable outcome. Methods : This was a retrospective study. Inclusion criteria were: ≤18 years at the time of VNS implantation and at least one year of...

Objective: To describe the clinical course of Lafora Disease (LD) and identify predictors of outcome by means of a prognostic systematic review with individual participant data meta-analysis. Methods: A search was conducted on MEDLINE and Embase with no restrictions on publication date. Only studies reporting genetically confirmed LD cases were inc...

During the first 7 months of epidemic bout of COVID-19, including 3 months of strict social lockdown measures and drastic healthcare organizations followed by 4 months of gradual recovery, we observed a harsh restriction of all scheduled healthcare provisions in a population based cohort of Parkinson's disease and parkinsonism of a province of Nort...

Protocol of systematic review (PROSPERO database, CRD42020190877)

Background Depression is more frequently associated with akinetic-rigid/postural instability gait difficulty subtypes of Parkinson's disease than with tremor-dominant subtype. Objectives The aim of the study is to investigate the frequency of exposure to antidepressant drugs, as proxy of depression, before motor onset according to Parkinson's dise...

Introduction: Known risk factors for multiple sclerosis (MS) include smoking, a low vitamin D status, obesity, and EBV, while the inflammatory feature of the disease strongly suggests the presence of additional infectious agents. The association between use of antibiotics and MS risk that could shed light on these factors is still undetermined. We...

During the COVID-19 outbreak, individuals with or without mental disorders may resort to dysfunctional psychological strategies that could trigger or heighten their emotional distress. The current study aims to explore the links between maladaptive daydreaming (MD, i.e., a compulsive fantasy activity associated with distress and psychological impa...

Background and Importance The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary bas...

Background Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (AD...

The study aims to characterize the epilepsy phenotype of maternally inherited Leigh's syndrome (MILS) and neuropathy, ataxia, retinitis pigmentosa (NARP) due to mutations in the mitochondrial ATP6 gene and to correlate electroclinical features with mutant heteroplasmy load (HL). We investigated 17 individuals with different phenotype, from asymptom...

Paediatric Type 1 Narcolepsy (NT1) is often associated with overweight and obesity. Sodium oxybate (SO), approved for the treatment of narcolepsy with cataplexy from the age of 7 years old in US, has been associated with weight loss, although longitudinal paediatric studies are lacking. We report a retrospective cohort of 129 consecutive patients w...

Epilepsy with Auditory Features (EAF) is a focal epilepsy syndrome mainly of unknown aetiology. LGI1 and RELN have been identified as the main cause of Autosomal Dominant EAF and anecdotally reported in non-familial cases. Pathogenic variants in SCN1A and DEPDC5 have also been described in a few EAF probands belonging to families with heterogeneous...

Introduction We aimed to create standardized protocol for language examination in patients who underwent video-EEG recording and assessed its efficacy in the characterization of ictal language impairment, its ability to differentiate this from impaired awareness, and interobserver reliability in clinical practice. Methods From our database of vide...

Background The risk of COVID‐19 and related death in people with Parkinson's disease or parkinsonism is uncertain. Objectives The aim of the study was to assess the risk of hospitalization for COVID‐19 and death in a cohort of patients with Parkinson's disease or parkinsonism compared to a control population cohort, during the epidemic bout (March...

Background: Coronavirus disease 2019 (COVID-19) seriously affected the whole of Italy. The extreme virulence and the speed of propagation resulted in restrictions and home confinement. This change was immediately perceived by people who found themselves exposed to feelings of uncertainty, fear, anger, stress, and a drastic change in the diurnal but...

Background: The COVID-19 outbreak is severely affecting the overall mental health with unknown psychological consequences. Although a strong psychological impact is possible, scant evidence is available to date. Past studies have shown that resilience decreases the negative effects of stress. This study aimed to examine depression, anxiety, and st...

Objective Sleep‐related hypermotor epilepsy (SHE) is a focal epilepsy characterized by seizures occurring mostly during sleep, ranging from brief seizures with paroxysmal arousals (SPAs) to hyperkinetic seizures and ambulatory behaviors. SPAs are brief and stereotypic seizures representing the beginning of a major seizure. Distinguishing SPAs from...

Objective: To compare the diagnostic accuracy and the prognostic value of blood and cerebrospinal fluid (CSF) tests across prion disease subtypes. Methods: We used a single-molecule immunoassay to measure tau and neurofilament light chain (NfL) protein levels in the plasma and assessed CSF total(t)-tau, NfL and protein 14-3-3 levels in patients...

Intrinsically photosensitive melanopsin retinal ganglion cells (mRGCs) are crucial for non-image forming functions of the eye, including the photoentrainment of circadian rhythms and the regulation of the pupillary light reflex (PLR). Chromatic pupillometry, using light stimuli at different wavelengths, makes possible the isolation of the contribut...

Objective To compare the diagnostic accuracy of ice-pack test (IPT) and single fiber EMG (SF-EMG) in patients with suspected Ocular Myasthenia (OM) presenting with ptosis. Methods We studied consecutive patients referred for the clinical suspicion of OM. Patients underwent IPT and stimulated SF-EMG on the orbicularis oculi muscle. ROC curve analys...

Background Dysautonomic symptoms (DS) are frequent but often underrecognized in multiple sclerosis (MS) patients, despite the relevant impact on quality of life and physical performance.Objectives To assess frequency and characteristics of DS in our MS population compared with healthy controls (HC). To investigate the relationship between DS and di...

Objectives Research was conducted to study the efficacy of analgesic infiltration treatment in a well-selected population of patients with non-specific drug-resistant chronic low back pain. It studied the pain on a numeric rating scale and the physical and mental condition of patients using a short-form health survey-36, before and six months after...

Background The COVID-19 outbreak is severely affecting overall mental health with unknown psychological consequences. The Italian Government has implemented a massive lockdown to decrease the spread of the virus. Although a strong psychological impact is possible, few evidences are still available. Past studies have shown that resilience decreases...