Matilde Leonardi

Matilde Leonardi
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta | IRCCS besta · Department of Neurology, Public Health and Disability

Neurologist, Paediatrician,

About

494
Publications
112,707
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Introduction
Neurologist, paediatrician, neonatologist, child neurologist. Specialized in Bioethics and Disability Management. Director Neurology, Public Health, Disability Unit and Coma Research Centre, IRCCS Istituto Neurologico Carlo Besta. Coordinator of EU & National projects on neurology,  disability, ageing, chronic conditions, NCDs, public health, neurorehabilitation, burden of neurological disorders, ICF (WHO Classification Functioning, Disability Health). WHO expert on ageing and disability. Director Italian WHO CC Research Branch. Professor Neuropsychiatry, Public Health, disability & member Bioethics Centre Catholic University. Member of the Pontificia Academia Pro Vita.
Additional affiliations
July 2001 - present
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Position
  • MD, Neurologist, Head of SOSD
July 2001 - present
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Position
  • Neurologist and Paediatrician
July 2001 - November 2018
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Position
  • Managing Director

Publications

Publications (494)
Article
Pain assessment and management represent a crucial issues in planning rehabilitative programmes and pharmacological therapies in chronic patients. In noncompetent and nonverbally communicative individuals, as for patients in a vegetative state or minimally conscious state, the evaluation of the presence and intensity of pain is often complex. Valid...
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Background This study identifies a set of psychosocial difficulties that are associated with short term changes in health outcomes across a heterogeneous set of brain disorders, neurological and psychiatric. Methods Longitudinal observational study over approximately 12 weeks with three time points of assessment and 741 patients with bipolar disor...
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Objective: To describes socio-demographic and clinical features of adults and children in vegetative state (VS) and minimally conscious state (MCS). Design: Observational cross-sectional study. Methods: Demographic, aetiological and clinical data were collected, together with patients' management procedures. Mann-Whitney U-test was used for co...
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The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition...
Article
Introduction: Brain fog has been described up to 1 year after SARS-CoV-2 infection, notwithstanding the underlying mechanisms are still poorly investigated. In this study, we aimed to evaluate the prevalence of cognitive complaints at 1-year follow-up and to identify the factors related to persistent brain fog in COVID-19 patients. Methods: Out...
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K + channels allow a very efficient passage of K + ions through the membrane while excluding Na + ions, and these properties are essential for life. The 3D structure of the KcsA K + channel, solved more than 20 years ago, allows to address many relevant aspects of K + permeation and selectivity mechanisms at the molecular level. Recent crystallogra...
Article
Background: The standardization of outcome measures is needed for comparing studies and using common measures in clinical practice. We aimed to identify cognitive and patient-reported outcomes and timing of assessment for glioma, meningioma, and vascular surgery. Method: A consensus study was conducted. Participants selected cognitive and patien...
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Background The increase in life expectancy is leading to a worldwide increase in chronic diseases and disability, with significant concern about their management and long-term care. Investigating the aging process using a bio-psychosocial perspective is essential to understanding how to reduce disability and improve the quality of life of aging peo...
Article
Background: Brain health is essential for health, well-being productivity and creativity across the entire life. Its definition goes beyond the absence of disease embracing all cognitive, emotional, behavioural and social functions which are necessary to cope with life situations. Methods: The EAN Brain Health Strategy responds to the high and i...
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The ATHLOS cohort is composed of several harmonized datasets of international groups related to health and aging. As a result, the Healthy Aging index has been constructed based on a selection of variables from 16 individual studies. In this paper, we consider additional variables found in ATHLOS and investigate their utilization for predicting the...
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Recent studies suggest that COVID-19 survivors may experience long-term health consequences: in particular, neurological and mental health symptoms might be associated with long-term negative outcomes. This study is a secondary analysis of a larger cohort study and aims to determine the extent to which neurological and mental health sequelae are as...
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Background Neurological conditions are highly prevalent and disabling, in particular in the elderly. The Italian population has witnessed sharp ageing and we can thus expect a rising trend in the incidence, prevalence and disability of these conditions.Methods We relied on the Global Burden of Disease 2019 study to extract Italian data on incidence...
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Purpose To identify the preoperative nonmedical predictors of functional impairment after brain tumor surgery. Methods Patients were evaluated before brain tumor surgery and after 3 months. The cognitive evaluation included MOCA for the general cognitive status, TMT for attention and executive functions, ROWL-IR and ROWL-DR for memory, and the F-A...
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Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and terri...
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Resting-state fMRI (rs-fMRI) is a widely used technique to investigate the residual brain functions of patients with Disorders of Consciousness (DoC). Nonetheless, it is unclear how the networks that are more associated with primary functions, such as the sensory–motor, medial/lateral visual and auditory networks, contribute to clinical assessment....
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To test the ability of different entropy measures to classify patients with different conditions of chronic disorder of consciousness, we applied the Lempel–Ziv complexity, the amplitude coalition entropy (ACE), and the synchrony coalition entropy (SCE) to the EEG signals recorded in 32 patients, clinically evaluated using the coma recovery scale r...
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Background Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels o...
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Chronic migraine (CM) diagnosis is nowadays based on the threshold of 15 headache days/month for three consecutive months, of which at least eight have migraine headache features. In recent years, proposals for reducing the threshold to 8 days/month have been proposed. The sole frequency parameter, however, is partial considering the variability in...
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Monitoring the level of responsiveness of patients with Disorders of Consciousness (DoCs) represents an issue in all the settings where there is not the daily presence of clinicians, such as long-term and domestic settings. The involvement of patients’ informal caregivers (i.e., patients’ family) in such a monitoring process is thus fundamental. Ho...
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Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for publ...
Article
Background: Several people affected by COVID-19 experienced neurological manifestations, altered sleep quality, mood disorders, and disability following hospitalization for a long time. Objective: To explore the impact of different neurological symptoms on sleep quality, mood, and disability in a consecutive series of patients previously hospita...
Article
Background Cognitive deficits have been increasingly reported as possible long-term manifestations after SARS-CoV-2 infection.AimsIn this study we aimed at evaluating the factors associated with cognitive deficits 6 months after hospitalization for Coronavirus Disease 2019 (COVID-19).Methods One hundred and six patients, discharged from a pneumolog...
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Background Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for publi...
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Background The COVID-19 pandemic outbreak has dramatically disrupted healthcare systems. Two rapid WHO pulse surveys studied disruptions in mental health services, but did not particularly focus on neurology. Here, a global survey was conducted and addresses the impact of the pandemic on neurology services. Methods A cross-sectional study was carr...
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Sleep disorders are among the main comorbidities in patients with a Disorder of Consciousness (DOC). Given the key role of sleep in neural and cognitive functioning, detecting and treating sleep disorders in DOCs might be an effective therapeutic strategy to boost consciousness recovery and levels of awareness. To date, no systematic reviews have b...
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The present article aims to highlight methodological aspects related to understanding and conceptualising social capital for the purposes of population research as well as describing the key challenges in the harmonisation process of indicators of social capital. The study was conducted in the frame of the Ageing Trajectories of Health: Longitudina...
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In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primar...
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Background There have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Euro...
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Background Health economic evaluations support health-care decision-making by providing information on the costs and consequences of health interventions. No universally accepted methodology exists for modelling effectiveness and cost-effectiveness of interventions designed to close treatment gaps for headache disorders in countries of Europe (or e...
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Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health...
Technical Report
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Redatto il 10 ottobre 2021 a conclusione del webinar della “Giornata nazionale dei risvegli per la ricerca sul coma - vale la pena” promossa da Gli amici di Luca sotto l’Alto Patronato del Presidente della Repubblica. Nel presente documento le persone in coma, Stato Vegetativo e di Minima Coscienza sono persone che presentano gravissima disabilità...
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Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a...
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Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex an...
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Background Clinical investigations have argued for long-term neurological manifestations in both hospitalised and non-hospitalised COVID-19 patients. It is unclear whether long-term neurological symptoms and features depend on COVID-19 severity. Methods From a sample of 208 consecutive non-neurological patients hospitalised for COVID-19 disease, 1...
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Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential traject...
Article
Introduction: Glioma is the most common primary brain cancer in adults. Long-term and progression-free survivals are dependent on the type and grade of glioma, as well as on the extent of resection and postoperative treatments. In Italy, it is unclear how long follow-up care should last and whether the primary care sector is either willing or able...
Article
Preventive healthcare is a crucial pillar of health as it contributes to staying healthy and having immediate treatment when needed. Mining knowledge from longitudinal studies has the potential to significantly contribute to the improvement of preventive healthcare. Unfortunately, data originated from such studies are characterized by high complexi...
Data
This is a supplementary material for the article entitled "Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019"
Article
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Objectives The management of chronic migraine (CM) with Medication Overuse Headache (MOH) consists of withdrawal therapy, education on medications’ use and prescription of prophylaxis. Little attention has been given to patients who fail in achieving a successful short-term outcome after withdrawal: we aim to describe predictors of failure. Method...
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The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in e...
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Background: Lombardy was severely hit by the COVID-19 pandemic since February 2020 and the Health System underwent rapid reorganization. Outpatient clinics were stopped for non-urgent patients: it became a priority to manage hundreds of fragile neurological patients who suddenly had less reference points. In Italy, before the pandemic, Televisits...
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The amount of knowledge on human consciousness has created a multitude of viewpoints and it is difficult to compare and synthesize all the recent scientific perspectives. Indeed, there are many definitions of consciousness and multiple approaches to study the neural correlates of consciousness (NCC). Therefore, the main aim of this article is to co...
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There is an accumulating volume of research into neurological manifestations of COVID‐19. However, inconsistent study designs, inadequate controls, poorly‐validated tests, and differing settings, interventions, and cultural norms weaken study quality, comparability, and thus the understanding of the spectrum, burden and pathophysiology of these com...
Preprint
Recent technological advancements in various domains, such as the biomedical and health, offer a plethora of big data for analysis. Part of this data pool is the experimental studies that record various and several features for each instance. It creates datasets having very high dimensionality with mixed data types, with both numerical and categori...
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The purpose of the present study was to review the existing data on preoperative nonmedical factors that are predictive of outcome in brain tumor surgery. Our hypothesis was that also the individual characteristics (e.g., emotional state, cognitive status, social relationships) could influence the postoperative course in addition to clinical factor...
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The analysis of the central and the autonomic nervous systems (CNS, ANS) activities during general anesthesia (GA) provides fundamental information for the study of neural processes that support alterations of the consciousness level. In the present pilot study, we analyzed EEG signals and the heart rate (HR) variability (HRV) in a sample of 11 pat...
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Significant side effects or drug interactions can make pharmacological management of headache disorders very difficult. Non-conventional and non-pharmacological treatments are becoming increasingly used to overcome these issues. In particular, non-invasive neuromodulation, nutraceuticals, and behavioral approaches are well tolerated and indicated f...
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Objective: To investigate the differences between patients returning to work and those who did not after brain tumor surgery. Methods: Patients were evaluated before surgery and after 3 months. The Montreal Cognitive Assessment test, Trail-Making Test (parts A and B), 15-word Rey–Osterrieth Word List (immediate and delayed recall), F-A-S tests, and...