Panagiotis Ioannidis

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• Professor
• Professor (Associate) at Aristotle University of Thessaloniki

Within the phenotypic spectrum of Alzheimer’s disease (AD), Creutzfeldt–Jakob disease (CJD) and cerebral amyloid angiopathy (CAA), dementia that is attributed to iatrogenic transmission has increasingly gained scientific attention recently. Newly recognized, this treatment-induced form of dementia may result from exposure to certain medical or surg...

Purpose Autoimmune encephalitis characterized by subacute impairment of cognitive functions, focal neurological symptoms as well as seizures. The diagnosis is based on clinical findings, laboratory and imaging tests. The electroencephalogram (EEG) is a basic tool in the diagnosis of autoimmune encephalitis. Method Presentation of the electroenceph...

Findings from functional neuroimaging techniques, such as single-photon emission computed tomography (SPECT), may add useful evidence improving Frontotemporal Dementia (FTD) diagnosis. The aim of the present study was to investigate patterns of hypoperfusion in a group of patients diagnosed with the behavioral variant of FTD (bvFTD) and to explore...

Cerebral amyloid angiopathy–related inflammation (CAA-ri) derives from inflammatory response to β-amyloid (Aβ) protein deposition within the cerebral blood vessel walls. We report a case that accentuates those clinical and imaging features that can contribute to raise suspicion for the condition and lead to early treatment initiation. A 72-year-old...

The purpose of this paper is to describe the first case report of a relapse of "Recurrent Painful Ophthalmoplegic Neuropathy" (RPON), formerly known as "Ophthalmoplegic Migraine", after COVID-19 immunization. RPON is a rare form of neuropathy characterized by repeated attacks of paresis of one or more ocular cranial nerves with ipsilateral headache...

Background: Alzheimer’s disease (AD) and epilepsy represent two complex neurological disorders with distinct clinical manifestations, yet recent research has highlighted their intricate interplay. This review examines the association between AD and epilepsy, with particular emphasis on late-onset epilepsy of unknown etiology, increasingly acknowled...

Syntactic deficits are not a core symptom of the semantic variant of primary progressive aphasia (svPPA). However, some studies indicate syntactic impairments that deteriorate with progress of the disease. The study addresses the presence of a syntactic deficit and its association with clinical, neuropsychological, neuroanatomical and demographic v...

We report a case of a 19-year-old woman with a subacute onset of visual disturbance and gait instability in the last three months. The neurological examination revealed horizontal nystagmus in the lateral gaze with a change of phase. The patient also described double vision in various gaze positions, with no clear opthalmoparesis. In her next visit...

Parkinsonism may be a clinical manifestation of a wide range of disease entities, and still poses a great diagnostic challenge. In an attempt to provide further insight into the differential diagnosis of PD versus progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and Lewy body dementia (LBD), seve...

Background and Objectives: Despite the increasing use of biomarkers, differentiation between Alzheimer’s disease (AD), behavioral variant Frontotemporal Dementia (bvFTD), and Primary Progressive Aphasia (PPA) remains a challenge. Apraxia is a supportive feature for diagnosing AD but is underrepresented in other dementia types. Herein, we investigat...

Objectives The aim of the present study was to adjust the frontier executive screen (FES) for the Greek population, to develop normative data, and to investigate its ability to discriminate patients diagnosed with frontotemporal dementia from healthy individuals. Methods The FES was administered to 142 community-dwelling healthy adults (age: M = 6...

The purpose of this review is to highlight the involvement of the immune system in Alzheimer's disease. According to the current literature, the immune system seems to be actively involved with mechanisms of innate and adaptive immunity in the attempt to restore the homeostasis of the affected brain in Alzheimer's disease, both through activation o...

The behavioral variant of frontotemporal dementia (bvFTD) has a devastating effect on multiple domains of daily living. The purpose of this PRISMA-compliant systematic review is to summarize the most important factors associated with functional impairment in this clinical group by critically analyzing the existing literature spanning the period fro...

The behavioral variant of frontotemporal dementia (bvFTD) has a devastating effect on multiple domains of daily living. The purpose of this PRISMA-compliant systematic review is to summarize the most important factors associated with functional impairment in this clinical group by critically analyzing the existing literature spanning the period fro...

Mild cognitive impairment (MCI) is characterized by cognitive deficits alongside essentially preserved competence in activities of daily living. It is a risk factor for the development of dementia and can reflect a prodromal predementia state of Alzheimer's disease (AD), vascular dementia (VD), Parkinson's disease dementia (PDD), and other degenera...

Secondary demyelinating diseases comprise a wide spectrum group of pathological conditions and may either be attributed to a disorder primarily affecting the neurons or axons, followed by demyelination, or to an underlying condition leading to secondary damage of the myelin sheath. In the elderly, primary demyelinating diseases of the central nervo...

Recently, there has been a growing research interest in utilizing the electroencephalogram (EEG) as a non-invasive diagnostic tool for neurodegenerative diseases. This article provides a detailed description of a resting-state EEG dataset of individuals with Alzheimer’s disease and frontotemporal dementia, and healthy controls. The dataset was coll...

Background: Metabolic syndrome is considered an important risk factor for cognitive decline and dementia. However, the evidence in middle-aged individuals is still conflicting. The aim of the study was to explore the association between metabolic syndrome and its individual components with cognitive function and to investigate possible interaction...

Objective: Frontotemporal dementia (FTD) impinges significantly on cognition, behavior, and everyday functioning. Goal of the present study is the detailed description of behavioral disturbances and functional limitations, as well as the investigation of associations between cognition, behavior, and functional impairment among FTD patients. Given t...

Background and Objectives: Rare diseases (RDs) are life-threatening or chronically impairing conditions that affect about 6% of the world’s population. RDs are often called ‘orphan’ diseases, since people suffering from them attract little support from national health systems. Aim: The aim of this study is to describe the clinical characteristics o...

Memory deficits are common in patients with dementia, such as Alzheimer’s disease, but also in patients with other neurological and psychiatric disorders, such as brain injury, multiple sclerosis, ischemic stroke and schizophrenia. Memory loss affects patients’ functionality and, by extension, their quality of life. Non-invasive brain training meth...

The case report covers the investigation of a 59-year-old woman, with the diagnosis of logopenic variant of primary progressive aphasia (lvPPA), who presented de novo visual artistic talent after the onset of language deficits. Similar cases have been described in patients with semantic and non-fluent/agrammatic variants of primary progressive apha...

Introduction: Dementia is a very common disorder that affects people over 65 years old all over the world. Apart from the cognitive decline, Behavioral and Psychological Symptoms of Dementia (BPSD) are a crucial matter in dementia, because they affect up to 90% of the patients during the course of their illness. Irritability has been found to be a...

Sporadic Creutzfeldt–Jakob disease (sCJD) is a rare transmissible disease. According to molecular classification, six clinical phenotypes of sCJD have been described: MM1, MM2, MV1, MV2, VV1 and VV2. MV2 subtype comprises 9% of sCJD cases. Atypical clinical course has been reported to be the main caveat for the diagnosis of the MV2 subtype. We here...

Objective: Cognitive screening instruments (CSIs) are essential for everyday practice. The Quick Mild Cognitive Impairment (Qmci) screen, a short instrument designed to identify mild cognitive impairment, was recently translated into Greek (Qmci-Gr). The present study compared its diagnostic value against the Montreal Cognitive Assessment (MoCA) sc...

Objective: We aimed to examine if single photon emission computed tomography (SPECT) can discriminate between variants of frontotemporal dementia (FTD). As a secondary investigation we identify and establish the linguistic differences between those variants. Materials and methods: Nine patients with semantic variant primary progressive aphasia (...

Alzheimer’s disease and vascular dementia account for the majority of cases of cognitive decline in elderly people. These two main forms of dementia, under which various subtypes fall, are often overlapping and, in some cases, definitive diagnosis may only be possible post-mortem. This has implications for the quality of care and the design of indi...

Objective: Hallucinations is a core characteristic symptom in Lewy Body Dementia (DLB) and Parkinson's Dementia (PDD). It may also appear at the late stages of Alzheimer's disease (AD). They are not easily managed, and they are associated with cognitive decline, earlier institutionalization, increased mortality, and increased caregivers' burden....

As research and services in the Mediterranean region continue to increase, so do opportunities for global collaboration. To support such collaborations, the Alzheimer's Association was due to hold its seventh Alzheimer's Association International Conference Satellite Symposium in Athens, Greece in 2021. Due to the COVID‐19 pandemic, the meeting was...

The hallmark of Multiple Sclerosis (MS) pathophysiology is the damage to the myelin sheath around axons. The cerebellum is a predilection site for demyelination with a well-recognized role in motor and a rather understudied contribution to cognitive functions. The aim of this study is to investigate patterns of cerebellar grey and white matter path...

Acute encephalopathy is a widely used term, implying a rapidly progressive multifocal or diffuse brain dysfunction, caused by acute structural disturbance or a myriad of metabolic, toxic, epileptic, or infection-related factors. Apart from the more common acquired causes, a broad range of rare inherited disorders may produce spells of encephalopath...

Background: Aberrant motor behaviour or wandering refers to aimless movement without a specific purpose. Wandering is common in patients with dementia and leads to early institutionalization and caregivers’ burden. Non-pharmacological interventions should be also considered as a first-line solution for the wandering because current pharmacological...

Executive processes that predominantly effect people living with human immunodeficiency virus remain to be understood. In the present case-control study, components summarizing executive functions were empirically determined to clarify the nature of executive difficulties observed in individuals with human immunodeficiency virus. One hundred and fi...

Background Apraxia is considered a supportive feature in Alzheimer’s disease (AD) patients. It has been reported that patients with frontotemporal dementia (FTD) may present apraxia, especially in the buccofacial area. The Apraxia Battery for Adults (ABA-2) is a brief and practical battery for praxis impairment and has been validated in Greek post-...

Background West Nile virus (WNV), a flavivirus transmitted through mosquitoes, is an established cause of human morbidity, including meningitis, encephalitis and acute flaccid paralysis due to anterior horn cells damage. Apart from its direct neuroinvasion potential, WNV has been reportedly associated with neurological disease, presumably via immun...

Background: Natalizumab (NTZ) and fingolimod (FTY) are second-line disease modifying treatments (DMTs) approved for Relapsing – Remitting Multiple Sclerosis (RRMS). Few studies are available on a direct comparison between NTZ and FTY, based on post-marketing experience, with conflicting results and reporting relatively short follow-up period. Aim:...

Dementia is the clinical syndrome characterized by progressive loss of cognitive and emotional abilities to a degree severe enough to interfere with daily functioning. Alzheimer’s disease (AD) is the most common neurogenerative disorder, making up 50–70% of total dementia cases. Another dementia type is frontotemporal dementia (FTD), which is assoc...

Introduction: Hereditary diffuse leukoencephalopathy with spheroids (HDLS) is an adult onset leukodystrophy, causally related to mutations in the colony-stimulating factor 1 receptor (CSF1R) gene. We report the unique case of a Greek HDLS patient, demonstrating an unusual phenotype, reminiscent of primary progressive aphasia (PPA). Methods: A 63...

Objective In the present study we evaluated the incremental contribution of executive cognition (EC) subprocesses to antiretroviral medication adherence. Method A comprehensive EC test battery assessing updating/working memory, mental flexibility, and inhibitory control, along with measures assessing non-executive cognitive functions were complete...

Background: Depression is accompanied by the early stages of Alzheimer’s disease (AD) and other forms of dementia. Depression can influence the daily functioning of the patients with dementia (PwD) and their cognitive abilities. Sometimes it is hard to diagnose because it may seem like apathy. The current pharmacological treatment can manage depres...

Acute myelitis, in conjunction with a longitudinally extensive MRI pattern, is a core feature of aquaporin 4 IgG-associated neuromyelitis optica spectrum disorders (NMOSD). According to current diagnostic criteria for transverse myelitis and NMOSD, clinical worsening should not exceed 3-4 weeks from attack onset. Recently, we were able to document,...

Hyper-religiosity in right temporal lobe atrophy

Rare neurological diseases are a heterogeneous group corresponding approximately to 50% of all rare diseases. Neurologists are among the main specialists involved in their diagnostic investigation. At the moment, a consensus guideline on which neurologists may base clinical suspicion is not available. Moreover, neurologists need guidance with respe...

Citation: Dimitrios Parissis., et al. "Acute Bibrachial Palsy: Another Forme Fruste of Guillain-Barré Syndrome". EC Neurology 12.8 (2020): 150-153. Abstract An acute onset of restricted brachial diparesis in a healthy individual is a rare clinical scenario, which requires prompt assessment through a wide differential diagnosis. In this paper, we re...

Background: In recent years, accumulating evidence has linked vitamin D deficiency to cognitive dysfunction and dementia. This study aimed at determining the relevance of serum 25-hydroxyvitamin D concentrations in mild cognitive impairment (MCI) and Alzheimer's disease (AD) in older Greek adults. It also examined whether the vitamin D level could...

In this explorative study, forty-seven patients with relapsing-remitting multiple sclerosis were randomized to a custom 6-week cognitive rehabilitation intervention (n = 23) using the BrainHQTM web-based platform and to a control group condition (n = 24). Cognitive rehabilitation intervention consisted of two 40-minute sessions per week. All patien...

Background: Sustained cognitive testing is used to detect cognitive fatigability and is often considered a substitute for subjective cognitive fatigue (CF). However, the relationship between cognitive fatigability and subjective CF in people with multiple sclerosis (PwMS) remains undetermined. Objective: To explore potential associations between...

Objectives: Natalizumab (NTZ), a treatment indicated for patients with highly active Relapsing – Remitting Multiple Sclerosis (RRMS), is known to induce increased relative frequency of lymphocytes. Progressive Multifocal Leukoencephalitis (PML) is a rare but serious adverse event related to NTZ. Moreover, reduced L-selectin (CD62L) expression in T-...

The present study aims at investigating verb inflection in aphasia and semantic dementia. In particular, it addresses the contribution of time reference and morphological complexity. Moreover, it investigates whether the lexical properties of the verb, such as argument structure and lexical aspect interact with the production of tense. Ten individu...

Rationale: Multiple system atrophy is a late-onset rare neurodegenerative movement disorder which results in debilitating disease. Fever frequently ensues in the context of infections which can be associated with significant morbidity and mortality, but among alternative diagnostic possibilities neoplasms and autoimmune disorders should be conside...

Alzheimer’s Disease (AD) is a neurogenerative disorder and the most common type of dementia with a rapidly increasing world prevalence. In this paper, the ability of several statistical and spectral features to detect AD from electroencephalographic (EEG) recordings is evaluated. For this purpose, clinical EEG recordings from 14 patients with AD (8...

Alzheimer's Disease (AD) is the most common type of dementia with world prevalence of more than 46 million people. The Mini-Mental State Examination (MMSE) score is used to categorize the severity and evaluate the disease progress. The electroencephalogram (EEG) is a cost-effective diagnostic tool and lately, new methods have developed for MMSE sco...

Background Studies have reported conflicting results regarding the potential benefit of prolonged release (PR) fampridine in other domains besides walking. Moreover, only a small number of studies have explored long- term effects of PR fampridine. The aim of this study was to assess cognitive function, quality of life, mood and fatigue in MS patien...

Background and objective: Cognitive reserve (CR) mediates the clinical expression of brain pathology in Alzheimer's disease, while there are much less relevant data in frontotemporal dementia (FTD). In the present study we examined whether CR, measured using the Cognitive Reserve Index (CRI), correlated with regional cerebral blood flow (rCBF) in...

About half of patients with multiple sclerosis exhibit cognitive impairment which negatively affects their quality of life. The assessment of cognitive function in routine clinical practice is still undervalued, although various tools have been proposed for this reason. In this article, we describe the potential benefits of implementing cognitive a...

Purpose Language production in semantic dementia (SD) is characterized by a lexical–semantic deficit and largely preserved argument structure and inflection production. This study investigates (a) the effect of argument structure on verb retrieval and (b) the interrelation between inflection marking and verb retrieval in SD. Method Seven individua...

The present multiple case study investigates the production of compound words in three Greek-speaking individuals with agrammatism, as a symptom either of stroke-induced aphasia or Primary Progressive Aphasia (PPA). Two off-line tasks were conducted, a picture naming and a production by definition task, using different types of compounds, in order...

Gangliocytomas are neoplasms of the central nervous system which are deriving from mature neuron cells. In the following case, we present the clinical, neuroimaging, and histopathological findings of a massive ganglion cell tumor involving the left cerebellar hemisphere with extension throughout the whole brainstem, including midbrain, pons and med...

The paper reports findings obtained from a naming by definition task in two Greek-speaking individuals with the agrammatic variant of Primary Progressive Aphasia (PPA-G). One of the patients was at an early stage of the disease while the other was at a more advanced stage. The patient who was at a later stage produced a greater number of errors tha...

X-linked Charcot-Marie-Tooth disease (CMT 1X) is the second most common form of inherited demyelinating neuropathy. It is established that patients suffering from CMT 1X can have episodes of hemiparesis, paraparesis, quadriparesis, ataxia, aphasia, and dysarthria, which can be fully reversible, and 'trigger' factors for these episodes are usually f...

Acquired neuromyotonia (NMT) is a part of the spectrum of peripheral nerve hyperexcitability (PNH) syndrome, characterized by spontaneous and continuous muscle fiber activity, cramps and stiffness of peripheral nerve origin [1]. We report the interesting case of a patient with myasthenia gravis, who developed isolated facial and lingual NMT.

Aim: The present study aims to investigate the relationship between cognitive control (Cc) and Theory of Mind(ToM) in elderly cognitively healthy adults and older adults with frontal variant of Frontotemporal Dementia (fvFTD). Method: The three groups (healthy elderly adults-HEA, cognitively intact older adults with vascular risk factors-VRF, ftFTD...

Severity assessment scales for frontotemporal lobar degeneration (FTLD) have been recently introduced. In the present study, the authors examined whether the FTLD-modified Clinical Dementia Rating (FTLD-CDR) scale and the Frontotemporal Dementia Rating Scale (FRS) correlated with regional brain perfusion in Greek FTLD patients. A total of 47 behavi...

Background: Cognitive impairment is experienced by about 50% of patients with Multiple Sclerosis (MS) worldwide and affects their employment, disease management and quality of life in general. The Brief International Cognitive assessment for MS (BICAMS) is a brief, practical and potentially universal battery for cognitive impairment in MS patients...

Movement disorders are not frequently described in multiple sclerosis (MS). After tremor, paroxysmal dystonia is the second most common disorder in MS patients. The episodes are characterized by stereotyped attacks that last only a few minutes, happen many times a day and consist of tonic contractions of muscles of one or two limbs, trunk and occas...