Davide Martino

University of London, Londinium, England, United Kingdom

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Publications (125)494.1 Total impact

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    ABSTRACT: Objective: To evaluate the diagnostic accuracy of clinical diagnosis of Parkinson disease (PD) reported in the last 25 years by a systematic review and meta-analysis. Methods: We searched for articles published between 1988 and August 2014. Studies were included if reporting diagnostic parameters regarding clinical diagnosis of PD or crude data. The selected studies were subclassified based on different study setting, type of test diagnosis, and gold standard. Bayesian meta-analyses of available data were performed. Results: We selected 20 studies, including 11 using pathologic examination as gold standard. Considering only these 11 studies, the pooled diagnostic accuracy was 80.6% (95% credible interval [CrI] 75.2%-85.3%). Accuracy was 73.8% (95% CrI 67.8%-79.6%) for clinical diagnosis performed mainly by nonexperts. Accuracy of clinical diagnosis performed by movement disorders experts rose from 79.6% (95% CrI 46%-95.1%) of initial assessment to 83.9% (95% CrI 69.7%-92.6%) of refined diagnosis after follow-up. Using UK Parkinson's Disease Society Brain Bank Research Center criteria, the pooled diagnostic accuracy was 82.7% (95% CrI 62.6%-93%). Conclusion: The overall validity of clinical diagnosis of PD is not satisfying. The accuracy did not significantly improve in the last 25 years, particularly in the early stages of disease, where response to dopaminergic treatment is less defined and hallmarks of alternative diagnoses such as atypical parkinsonism may not have emerged. Misclassification rate should be considered to calculate the sample size both in observational studies and randomized controlled trials. Imaging and biomarkers are urgently needed to improve the accuracy of clinical diagnosis in vivo.
    No preview · Article · Jan 2016 · Neurology

  • No preview · Article · Nov 2015 · Autoimmunity reviews
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    ABSTRACT: Background and aims: Impaired emotional facial expressiveness is an important feature in Parkinson's disease (PD). Although there is evidence of a possible relationship between reduced facial expressiveness and altered emotion recognition or imagery in PD, it is unknown whether other aspects of the emotional processing, such as subjective emotional experience (alexithymia), might influence hypomimia in this condition. In this study wee aimed to investigate possible relationship between reduced facial expressiveness and altered emotion processing (including facial recognition and alexithymia) in patients with PD. Methods: Forty PD patients and seventeen healthy controls were evaluated. Facial expressiveness was rated on video recordings, according to the UPDRS-III item 19 and using an ad hoc scale assessing static and dynamic facial expression and posed emotions. Six blind raters evaluated the patients' videos. Emotion facial recognition was tested using the Ekman Test; alexithymia was assessed using Toronto Alexithymia Scale (TAS-20). Results: PD patients had a significantly reduced static and dynamic facial expressiveness and a deficit in posing happiness and surprise. They performed significantly worse than healthy controls in recognizing surprise (p=0.03). The Ekman total score positively correlated with the global expressiveness (R^2=0.39, p=0.01) and with the expressiveness of disgust (R^2=0.32, p=0.01). The occurrence of alexithymia was not different between PD patients and HC; however, a significant negative correlation between the expressiveness of disgust was found for a subscore of TAS (R^2=-.447, p=0.007). Conclusions: Reduced facial expressiveness in PD may be in part related to difficulties with emotional recognition in a context of an unimpaired subjective emotional experience.
    Full-text · Article · Sep 2015 · Journal of the neurological sciences
  • Antonella Macerollo · Davide Martino
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    ABSTRACT: HSP-7;cerebellar syndrome;ocular movements disorder
    No preview · Article · Sep 2015
  • Clare M Eddy · Davide Martino · Andrea E Cavanna
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    ABSTRACT: Objective In Tourette syndrome (TS), multiple motor and vocal tics are frequently accompanied by complex tics with social significance, including imitation (echophenomena), and urges to perform socially inappropriate behaviours. Furthermore, previous studies have highlighted differences in the way individuals with TS reason about social and emotional information. In this study we explored whether TS may be characterised by differences in the tendency to adopt alternative perspectives and to relate emotionally to others in everyday life. Method We administered the Interpersonal Reactivity Index to a total of 155 adults, of whom 95 had TS and the remainder were healthy controls. Between-group comparisons were conducted separately for males and females, and within-group analyses explored whether any clinical features (tics, premonitory urges, symptoms of common co-morbid disorders) were linked to scale ratings. Results Both males and females with TS were found to exhibit a different Interpersonal Reactivity Profile to healthy gender-matched controls, which consisted of a reduced tendency to take the perspective of others, and elevated personal distress when faced with other people in crises. There were no group differences for the fantasy or empathic concern subscales. Personal distress ratings were strongly associated with tic severity and weakly related to attention problems. Conclusion The pattern of interpersonal reactivity ratings suggests that an elevated distress response to witnessing highly emotive situations may encourage a defensive strategy of reduced perspective taking in TS. These findings provide further evidence that TS is associated with changes in social cognition, as reflected in patients' self-reported everyday behaviour.
    No preview · Article · Sep 2015 · Journal of Neurology Neurosurgery & Psychiatry
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    Full-text · Dataset · Aug 2015
  • Giovanni Rizzo · Davide Martino · Giancarlo Logroscino

    No preview · Article · Jul 2015
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    ABSTRACT: Tourette syndrome (TS) frequently involves complex tics with social significance, including imitation or socially inappropriate behaviour. This study explored every-day perspective taking and empathic tendencies in 95 patients with TS and 60 healthy controls. Analyses indicated that both males and females with TS exhibited a different interpersonal reactivity profile to controls, characterised by a reduced tendency to take other people's perspectives, and elevated personal distress in response to intense emotional situations (e.g. people experiencing crises). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jun 2015

  • No preview · Conference Paper · Apr 2015

  • No preview · Article · Apr 2015 · Movement Disorders
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    ABSTRACT: Background A contribution of aberrant interoceptive awareness to the perception of premonitory urges in Gilles de la Tourette syndrome (GTS) has been hypothesized. Methods We assessed interoceptive awareness in 19 adults with GTS and 25 age-matched healthy controls using the heartbeat counting task. We also used multiple regression to explore whether the severity of premonitory urges was predicted by interoceptive awareness or severity of tics and obsessive-compulsive symptoms. Results We observed lower interoceptive awareness in GTS compared with controls. Interoceptive awareness was the strongest predictor of premonitory urges in GTS, with greater interoceptive awareness being associated with more urges. Greater tic severity was also associated with higher rates of premonitory urges. Conclusion The observed relationship between severity of premonitory urges and interoceptive awareness suggests that interoception might be involved in self-reported premonitory urges in GTS. High levels of interoceptive awareness might reflect a self-attentive capacity to perceive urges.
    No preview · Article · Apr 2015 · Movement Disorders
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    Renata Rizzo · Davide Martino
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    ABSTRACT: Guanfacine is an α2A-adrenoreceptor agonist currently indicated for the treatment of attention deficit hyperactivity disorder (ADHD). This article reviews the chemistry, pharmacodynamics and pharmacokinetics of guanfacine, as well as the clinical trial literature on guanfacine for the treatment of ADHD in children and adolescents, mainly focusing on the use of guanfacine extended-release (GXR). Six already published prospective randomized controlled trials (RCTs) and one unpublished RCT study were identified for GXR in the treatment of ADHD. All RCTs trials showed superiority over placebo on the primary outcome measure. Guanfacine, especially XR, seems to be an effective and safe treatment option for ADHD in children and adolescents.
    Full-text · Article · Mar 2015 · Expert Review of Neurotherapeutics
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    ABSTRACT: Tics are the hallmark feature of Tourette syndrome. The basic phenomenological and neurophysiological characteristics of tics have been widely investigated. Interestingly, the spatial distribution of tics across different body parts has received little attention. No previous study has investigated whether the capacity for voluntary tic inhibition also varies across body parts. We analyzed video sequences of 26 adolescents with Tourette syndrome in a "tic freely" condition, and in a "voluntary tic inhibition" condition, to obtain absolute tic counts for different body parts. Two measures of the spatial distribution of tics were then analyzed. Linear regression analyses were employed to investigate the relation between the contribution of each body part to overall tic behavior and the ability to inhibit tics in that body part, averaged over our patient group. Tic distribution across patients showed a characteristic somatotopic pattern, with the face most strongly represented. A significant negative relation was found between the ability to inhibit tics and pooled tic frequency across body parts. The body parts that exhibited the fewest tics were the ones for which tic inhibition was most effective. Our data are consistent with the idea that tic recruitment order reflects a "tic generator" spreading across a somatotopic map in the brain. Voluntary tic inhibition did not simply cause a proportional reduction of tics in each body part. Rather, the least affected body parts showed most effective voluntary tic inhibition. The results are discussed in terms of signal and noise within cortical-subcortical motor loops. © 2015 International Parkinson and Movement Disorder Society. © 2015 International Parkinson and Movement Disorder Society.
    Full-text · Article · Mar 2015 · Movement Disorders
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    ABSTRACT: It is increasingly clear that we extract patterns of temporal regularity between events to optimize information processing. The ability to extract temporal patterns and regularity of events is referred as temporal expectation. Temporal expectation activates the same cerebral network usually engaged in action selection, comprising cerebellum. However, it is unclear whether the cerebellum is directly involved in temporal expectation, when timing information is processed to make predictions on the outcome of a motor act. Healthy volunteers received one session of either active (inhibitory, 1Hz) or sham repetitive transcranial magnetic stimulation covering the right lateral cerebellum prior the execution of a temporal expectation task. Subjects were asked to predict the end of a visually perceived human body motion (right hand handwriting) and of an inanimate object motion (a moving circle reaching a target). Videos representing movements were shown in full; the actual tasks consisted of watching the same videos, but interrupted after a variable interval from its onset by a dark interval of variable duration. During the 'dark' interval, subjects were asked to indicate when the movement represented in the video reached its end by clicking on the spacebar of the keyboard. Performance on the timing task was analyzed measuring the absolute value of timing error, the coefficient of variability and the percentage of anticipation responses. The active group exhibited greater absolute timing error compared with the sham group only in the human body motion task. Our findings suggest that the cerebellum is engaged in cognitive and perceptual domains that are strictly connected to motor control.
    Full-text · Article · Feb 2015 · PLoS ONE
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    ABSTRACT: In this study, we have tested the effects of the dopamine D2 receptor blocker pimozide on timing performance in patients with Tourette syndrome (TS). Nine children with TS were tested off-medication and following 3 months of daily treatment with pimozide. Subjects completed a time reproduction and a time production task using supra-second temporal intervals. We show that pimozide improves motor timing performance by reducing the patients' variability in reproducing the duration of visual stimuli. On the other hand, this medication has no effect on the reproduction accuracy and on both variability and accuracy of the performance on the time production task. Our results suggest that pimozide might have improved motor timing variability as a result of its beneficial side effect on endogenous dopamine levels (i.e., normalization). © 2015 The British Psychological Society.
    Full-text · Article · Jan 2015 · Journal of Neuropsychology
  • Christos Ganos · Davide Martino
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    ABSTRACT: Gilles de la Tourette syndrome is a common neuropsychiatric disorder spectrum with tics as the defining feature. Comorbidities such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and autism spectrum disorder often complicate clinical presentation. Their recognition is paramount for the introduction of efficient treatment strategies to promote healthy development and good quality of life. Here, knowledge on the movement disorder of tics, the spectrum of associated comorbidities, and the list of differential diagnoses of tic disorders are summarized. Also, an account of the prevailing pathophysiologic models of tic generation is provided, and a concise update on contemporary treatment strategies is presented. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Nov 2014 · Neurologic Clinics

  • No preview · Conference Paper · Nov 2014

  • No preview · Article · Oct 2014

  • No preview · Conference Paper · Sep 2014
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    ABSTRACT: Objective Background and aims: It is recognized that emotional deficits are part of the non-motor features of Parkinson's disease but scant attention has been paid to specific aspects such as emotional facial expression, subjective emotional experience (alexithymia) and recognition of facial emotion expressions. This study aimed to investigate the relationship between alexithymia, emotion facial recognition, and emotion facial expression in PD patients. Method Forty-one PD patients and seventeen healthy controls, matched for demographical characteristics, were enrolled in the study. Alexithymia was assessed by means of Toronto Alexithymia Scale (TAS-20), emotion facial recognition was tested by means of the Ekman 60 Faces Test, emotion facial expression was investigated with a video protocol encompassing of a static expression recording (subject watching the camera in silence for 30 seconds), a dynamic expression recording (subject recorded while talking for 30 seconds) and emotion expression (subject was asked to express with his/her face the six main human expressions: happiness, sadness, anger, fear, surprise, disgust). Six blind raters evaluated the patients' video recordings. Results No difference in alexithymia was detected between PD patients and HC. PD patients performed significantly worse than HC in recognizing Surprize (p=0.03) and showed significant poorer global facial expression than HC (in static, dynamic and emotion facial expression). There was a significant negative correlation between the factor F3 of TAS (externally orientated thoughts) and the patient's capability to express disgust (−0.447, p=0.007). Elkman total score positively correlates with the patient's capability to express disgust with his face (0.325, p=0.006). Conclusion These results suggest that PD patients have difficulties with emotional recognition and expression in a contest of a unimpaired subjective emotional experience. These deficits need to be targeted in clinical practise for rehabilitation purposes.
    Full-text · Article · Aug 2014 · Journal of Neurology Neurosurgery & Psychiatry

Publication Stats

2k Citations
494.10 Total Impact Points


  • 2015
    • University of London
      Londinium, England, United Kingdom
    • King's College Hospital NHS Foundation Trust
      • Department of Neurology
      Londinium, England, United Kingdom
  • 2013-2015
    • Queen Elizabeth Hospital Birmingham
      Birmingham, England, United Kingdom
  • 2012-2015
    • Queen Mary, University of London
      • Centre for Neuroscience and Trauma
      Londinium, England, United Kingdom
  • 2014
    • The Queen Elizabeth Hospital
      Tarndarnya, South Australia, Australia
    • Università degli Studi di Messina
      Messina, Sicily, Italy
  • 2000-2013
    • Università degli Studi di Bari Aldo Moro
      • Dipartimento di Scienze Biomediche ed Oncologia Umana (DIMO)
      Bari, Apulia, Italy
  • 2011
    • Universitätsklinikum Dresden
      Dresden, Saxony, Germany
    • Hannover Medical School
      Hanover, Lower Saxony, Germany
  • 2005-2009
    • University College London
      • • Institute of Neurology
      • • Sobell Department of Motor Neuroscience and Movement Disorders
      Londinium, England, United Kingdom
  • 2008
    • London Research Institute
      Londinium, England, United Kingdom