Giovanni Assenza

Giovanni Assenza
Università Campus Bio-Medico di Roma | unicampus · Neurology Unit

MD

About

135
Publications
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Introduction
Our research focuses on brain functional and effective connectivity in neurological disorders and how it is influenced by invasive and non-invasive brain stimulations. We study the structural and functional abnormalities of brains affected by neurological disorders through quantitative EEG and Evoked Potentials. rTMS, tDCS, tVNS and iVNS are the neuromodulatory techniques that we study to try to overcome clinical deficits. Epilepsy as a network disorder is our scientific model.

Publications

Publications (135)
Article
Full-text available
Objective Vagal Nerve Stimulation (VNS) is an effective treatment for Drug-Resistant (DR) epilepsy. Albeit the corroborated effectiveness of VNS, little is known about how VNS works. We aim to leverage quantitative Electroencephalography (qEEG) to study how the brain responds to VNS cycles. Methods Eighteen subjects with DR epilepsy were enrolled...
Preprint
Objective: To determine the effects of Levetiracetam (LEV) therapy using EEG microstates analysis in a population of newly diagnosed Temporal Lobe Epilepsy (TLE) patients. We hypothesized that the impact of LEV therapy on the electrical activity of the brain can be globally explored using EEG microstates. Methods: Twenty-seven patients with TLE wer...
Article
Full-text available
The eight-and-a-half syndrome is a rare neuro-ophthalmological condition caused by a structural lesion in the dorsal portion of the pons, involving critical areas of the brainstem, i.e., medial longitudinal fasciculus (MLF), abducens nucleus, facial genu, and colliculus. It is characterized by internuclear ophthalmoplegia with horizontal gaze palsy...
Article
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Background: The management of epilepsy in older adults has become part of daily practice because of an aging population. Older patients with epilepsy represent a distinct and more vulnerable clinical group as compared with younger patients, and they are generally under-represented in randomized placebo-controlled trials. Real-world studies can the...
Article
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Objective Quantitative Electroencephalography (qEEG) can capture changes in brain activity following stroke. qEEG metrics traditionally focus on oscillatory activity, however recent findings highlight the importance of aperiodic (power-law) structure in characterizing pathological brain states. We assessed neurophysiological alterations and recove...
Article
To determine the quantitative EEG responses in a population of drug-naïve patients with Temporal Lobe Epilepsy (TLE) after Levetiracetam (LEV) initiation as first antiepileptic drug (AED). We hypothesized that the outcome of AED treatment can be predicted from EEG data in patients with TLE. Methods: Twenty-three patients with TLE and twenty-five he...
Article
Objective Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-a...
Article
Introduction: The coronavirus disease 2019 (COVID-19) pandemic represented a relevant issue for people with epilepsy (PwE). Medical care and social restrictions exposed PwE to a high risk of seizure worsening. Medical institutions answered to the pandemic assuring only emergency care and implementing a remote assistance that highlighted the techno...
Article
Objective To determine the predictive power for seizure-freedom of 19-channels EEG, measured both before and after three months the initiation of the use of Levetiracetam (LEV), in a cohort of people after a new diagnosis of temporal-lobe epilepsy (TLE) using a machine-learning approach. Methods Twenty-three individuals with TLE were examined. We...
Preprint
Full-text available
Background Quantitative EEG (qEEG) can capture changes in brain activity that follow a stroke. Accordingly, EEG metrics could be used to monitor patients’ state and recovery. Although qEEG metrics traditionally focus on oscillatory activity, recent findings highlight the importance of aperiodic (power-law) structure in characterizing pathological b...
Article
Objective Quantitative Encephalography (qEEG) depicts synthetically the features of EEG signal and represents a promising tool in the assessment of neurophysiological changes brought about by Anti-Seizure Medications (ASMs). In this study we characterized qEEG alterations related to add-on therapy with Perampanel (PER). PER is the only ASM present...
Article
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Increasing evidence coming from both experimental and humans’ studies strongly suggest the existence of a link between epilepsy, in particular temporal lobe epilepsy (TLE), and Alzheimer’s disease (AD). Patients with mild cognitive impairment and AD are more prone to have seizures, and seizures seem to facilitate amyloid-β and tau deposits, thus pr...
Article
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Introduction: Progressive myoclonic epilepsies (PMEs) are a heterogenous group of genetic diseases presenting with epilepsy, cognitive impairment, and severe action myoclonus, which can severely affect daily life activities and independent walking ability. Perampanel is a recent commercially available antiseizure medication with high efficacy again...
Article
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Objectives: Restrictive measures adopted during the COVID-19 pandemic, in order to limit contagion, have had a severe impact on mental health. The burden of lockdown has been particularly heavy on patients with chronic neurologic diseases such as People with Epilepsy (PwE). Our survey aims to describe the struggles and needs of Drug-Resistant (DR)...
Article
Objective We designed a longitudinal cohort study on People with Epilepsy (PwE) with the aim of assessing the effect of Perampanel (PER) on cortico-subcortical networks, as measured by high-frequency oscillations of somatosensory evoked potentials (SEP-HFOs). SEP-HFOs measure the excitability of both thalamo-cortical projections (early HFOs) and in...
Article
Purpose: In March 2020, the World Health Organization declared the SARS-CoV-2 infection related coronavirus Disease (COVID-19) a pandemic. During the first and second wave of the pandemic spread, there have been several reports of COVID-19 associated neurological manifestations, including acute seizures and status epilepticus (SE). In this systemat...
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Background The aim of the present systematic revision is to analyze existing published reports about the use of home-videos recordings (HVRs) to support physicians in the differential diagnosis of paroxysmal seizure-like episodes (PSLE). We also developed practical recommendations in order to ensure adequate quality standards and safety advice for...
Article
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PurposeTo assess quality of life (QoL) in adult people with epilepsy (PWE) and identify the main factors affecting it.Methods We enrolled consecutively 122 PWE. They were interviewed for a careful collection of demographic and clinical data. Patients completed dedicated questionnaires for the assessment of the quality of life (Quality of Life in Ep...
Article
Objective The concept of alexithymia refers to difficulty perceiving, identifying, and describing emotions. We aimed at evaluating the prevalence of alexithymia in a sample of adult people with epilepsy (PWE) with and without psychogenic nonepileptic seizures (PNES) and healthy control subjects (HC) and identifying major factors able to affect it....
Article
Objective: To determine the quantitative EEG responses in a population of drug-naïve patients with temporal lobe epilepsy (TLE) after Levetiracetam (LEV) initiation as first antiepileptic drug (AED). We hypothesized that the outcome of AED treatment can be predicted from EEG data in patients with TLE. Methods Twenty-three patients with TLE and twe...
Article
Full-text available
The introduction of the operative definition of drug-resistant epilepsy (DRE) was a turning point for clinicians and people with epilepsy (PwE). It is based on the indisputable phenomenon that resistance to antiseizure medications (ASM) is not dependent on the type of drugs when they are appropriately administrated. Indeed, after the failure of two...
Article
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Transcutaneous vagus nerve stimulation (tVNS) is an alternative non-invasive method for the electrical stimulation of the vagus nerve with the goal of treating several neuropsychiatric disorders. The objective of this study is to assess the effects of tVNS on cerebral cortex activity in healthy volunteers using resting-state microstates and power s...
Article
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Stroke, if not lethal, is a primary cause of disability. Early assessment of markers of recovery can allow personalized interventions; however, it is difficult to deliver indexes in the acute phase able to predict recovery. In this perspective, evaluation of electrical brain activity may provide useful information. A machine learning approach was e...
Article
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Transient epileptic amnesia (TEA) is a rare epileptic condition, often confused with transient global amnesia (TGA). In a real-life scenario, differential diagnosis between these two conditions can be hard. In this study we use power spectral analysis empowered by exact Low Resolution Brain Electromagnetic Tomography (eLORETA) to evidence the diffe...
Article
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Objectives: To describe how the recent lock-down, related to SARS-COV-II outbreak in Italy, affected People With Epilepsy (PwE), we designed a survey focused on subjective reactions. Using Natural Language Processing (NLP), we analyzed words PwE and People without Epilepsy (PwoE) chose to express their reactions. Methods: As a subset of a larger s...
Article
Seizures in Hereditary Aceruloplasminemia - Massimo Marano, Francesco Bove, Lorenzo Ricci, Mohammad Rohani, Vincenzo Di Lazzaro, Giovanni Assenza, Alfonso Fasano
Article
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Background During COVID-19 lockdown, non-urgent medical procedures were suspended. Grade of urgency of electroencephalography (EEG) may vary according to the clinical indication, setting, and status of infection of SARS-CoV-2 virus. “Italian Society of Clinical Neurophysiology” (SINC), “Italian League Against Epilepsy” (LICE), and the “Italian Asso...
Article
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Background: Ictal asystole (IA) is a rare event observed in people with epilepsy (PwE). Clinical and IA video-electroencephalographic findings may be helpful in screening for high-risk subjects. Methods: From all PwE undergoing video-EEG for presurgical evaluation between 2000 and 2019, we retrospectively selected those with at least one IA (R-R i...
Article
Objective: In early 2020, Italy struggled with an unprecedented health emergency related to the COVID-19 pandemic. Medical care of chronic neurological diseases, such as epilepsy, is being sorely neglected. In this national survey, we aimed at understanding the impact of COVID-19 lockdown on the care of people with epilepsy (PwE) and identifying Pw...
Preprint
Full-text available
Objective In early 2020 Italy struggled with an unprecedent health emergency related to COVID-19 pandemic. Medical care of chronic neurologic diseases, such as epilepsy, are being forcefully neglected. In this national survey we aimed at understanding the impact of COVID-19 breakdown on people with epilepsy (PwE) care and identifying PwE risk facto...
Article
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Background Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic revi...
Article
Objective The objective of the study was to assess depressive symptoms (DS) and difficulties in emotion regulation (ER) in adult people with epilepsy (PWE) and their correlation with quality of life and stigmatization feelings of patients. Materials and methods We enrolled consecutively 110 PWE who completed the Beck Depression Inventory-II (BDI-I...
Article
Objectives High frequency oscillations (HFOs) of Somatosensory evoked potentials (SEPs) reflect the activity of thalamo-cortical and cortical neurons from the sensory pathway. Antiepileptic-drugs (AEDs) reduce seizures acting on the balance between excitation and inhibition. We aimed to study the effect of AED mono and polytherapy on SEP-HFO’s comp...
Article
Objective During the Covid-19 pandemic, government restrictions limited health care to urgent needs. Neurophysiology centers had to suddenly reschedule their activities, with a lack of specific recommendations about electroencephalography (EEG) execution. During the pandemic phase 1, we launched an online survey to understand the flaws and strength...
Article
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Anti-Myelin Associated Glycoprotein (anti-MAG) neurological involvement classically manifests as a peripheral neuropathy with prominent sensitive symptoms. We describe a case report of a patient with positive anti-MAG antibodies presenting with clinical and neurophysiological evidence of spinal cord impairment. A 69-year-old woman came to our atten...
Article
Objectives Juvenile myoclonic epilepsy (JME) is a genetic generalized epilepsy marked by cortical hyperexcitability. Recent neuroimaging data suggested also a thalamic role in sustaining epileptic propensity in JME. However, thalamic hyperexcitability was not demonstrated so far. Low-frequency (LF-SEPs) and high-frequency somatosensory evoked poten...
Article
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Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) findings strongly support the diagnosis, electroence...
Article
Purpose: To assess the efficacy, safety and tolerability of eslicarbazepine acetate (ESL) in patients transitioning from carbamazepine or oxcarbazepine to ESL in clinical practice, by analysing data from the Euro-Esli study. Methods: Euro-Esli was a pooled analysis of 14 European clinical practice studies. Effectiveness assessments included resp...
Article
Abstract Objectives Imaging and neurophysiological data shows that the cortical disfunction caused by focal epilepsy is not limited to the epileptic focus, thus raising the modern vision of focal epilepsy as a network disorder. The involvement of deep thalamo-cortical projections in temporal lobe epilepsy is a clear example. We aimed at demonstrat...
Article
Abstract Objective The objective of this study was to assess the stigma related to epilepsy from the perspective of people with epilepsy (PWE) and from the Italian community (Rome and central Italy); moreover, the impact of the perceived stigma on the mood and quality of life of patients was also evaluated. Materials and methods We consecutively...
Article
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The identification of individual factors modulating clinical recovery after a stroke is fundamental to personalize the therapeutic intervention to enhance the final clinical outcome. In this framework, electrophysiological factors are promising since are more directly related to neuroplasticity, which supports recovery in stroke patients, than neur...
Article
Psychiatric and intellectual comorbidities are common in patients with epilepsy. However, data on the use of antiepileptic drugs in these patients are still lacking. This study assessed the real-world effectiveness and safety/tolerability of eslicarbazepine acetate (ESL)in patients with intellectual disability and psychiatric comorbidities, includi...
Article
Objective: The pathophysiology of epilepsia partialis continua (EPC) is still unclear, a thalamo-cortical circuit dysfunction has been hypothesized. The aim of present study is the functional evaluation of the thalamo-cortical network in EPC by means of the study of low- and high-frequency somatosensory evoked potentials (LF-SEP and HF-SEP). Meth...
Article
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Introduction: Eslicarbazepine acetate (ESL) is an antiepileptic drug approved as monotherapy or add-on for the treatment of epilepsy with seizures of focal onset. ESL owns a good profile in terms of efficacy and tolerability, but its effects on EEG activity and connectivity are unknown. The purpose of this study was to investigate EEG activity and...
Article
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The clinical course after ischemic stroke can vary considerably despite similar lesions and clinical status at the onset of symptoms, suggesting that individual factors modulate clinical recovery. Here, we sought to test the working hypothesis that elevated copper values provide prognostic information, and specifically predict worse clinical recove...
Article
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Focal epilepsy is a network pathology, where the brain connectivity of the epileptic focus (EF) influences seizure frequency and cortical dysfunction. Growing evidence supports a clinical efficacy of cathodal transcranial direct current stimulation (ctDCS) in drug-resistant epilepsy (DRE). ctDCS effects can be merely attributed to the inhibition of...
Article
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Purpose: To evaluate serum markers of calcium metabolism in adult patients with epilepsy (PWE) treated with antiepileptic drugs (AEDs) and the effect of vitamin D supplementation on seizure frequency. Methods: Serum levels of calcium, phosphate, intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D (25[OH]D) were compared in 160 PWE on chron...
Article
Purpose: Eslicarbazepine acetate (ESL) is a third-generation member of the dibenzazepine family approved in 2009 by the European Medicines Agency with the indication of adjunctive therapy in adult people with partial-onset seizures (PPOS). We aimed at assessing the ESL impact on seizure frequency and quality of life in PPOS with a particular atten...
Article
Background Stroke patients’ clinical course can be largely variable despite similar lesions and clinical states at symptoms’ onset. We sought to identify new serum biomarkers for poststroke functional recovery. Methods We assessed iron, copper, free copper, total antioxidant status (TAS), peroxides, ceruloplasmin (Cp) concentration and activity, f...
Article
Cathodal transcranial direct current stimulation (ctDCS) is a technique able to non-invasively inhibit cortical excitability, which is abnormally increased in epilepsy, but its efficacy in reducing seizures and in modulating epileptic network is still under debate. We evaluated the efficacy of 20-min 1 mA ctDCS vs sham-tDCS in reducing seizure freq...
Article
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Given the importance of neuronal plasticity in recovery from a stroke and the huge variability of recovery abilities in patients, we investigated neuronal activity in the acute phase to enhance information about the prognosis of recovery in the stabilized phase. We investigated the microstates in 47 patients who suffered a first-ever mono-lesional...
Article
Purpose One-third of epilepsy patients develop drug resistance epilepsy (DRE), and half of them can benefit from the surgical removal of epileptic focus (EF). Neuromodulation represents the only hope to ameliorate the quality of life of the remaining patients. Cathodal transcranial direct current stimulation (ctDCS) is a techniques able to non-inva...
Article
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An author name was incorrectly spelled as Giovanni A. The correct spelling is Giovanni Assenza; the correct surname (family name) is Assenza; the correct name is Giovanni; thus when abbreviated it should be cited as Assenza G. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any w...
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Non-invasive brain stimulation (NIBS) has been under investigation as adjunct treatment of various neurological disorders with variable success. One challenge is the limited knowledge on what would be effective neuronal targets for an intervention, combined with limited knowledge on the neuronal mechanisms of NIBS. Motivated on the one hand by rece...
Article
We describe a women 54-year-old, heavy smoker (20 cigarettes/day) who was admitted to our hospital after emergency department admission because of an acute flaccid tetra paresis. Lumbar puncture revealed albumino-cytologic dissociation with 4, 3 gr/L proteins and no cells in CSF. Electromyography concluded for a demielinating poliradicoloneuropathy...