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Biomedical subjects

E Martignoni

Publications and source records attributed to E Martignoni.

At least 127 records · Page 7Linked to original sources

Benserazide induces migraine attacks. Irrelevance of concomitant hyperprolactinemia.

Migrainous women underwent acute administration of sulpiride (25 mg i.v.) and benserazide (125 mg per os), both drugs increasing prolactin secretion. A similar increase in prolactin levels was found following the administration of the two drugs. A typical migraine attack was observed only in the 4 women given benserazide. These data, though being preliminary, stress the scarce or irrelevant role of prolactin in the pathogenesis of the migraine attack.

Adult↗

Different patterns of central and peripheral beta EP, beta LPH and ACTH throughout life.

The aim of the present study was to evaluate the relationship between central and peripheral concentrations of proopiocortin-related peptides in different periods of life. One hundred and eighty-nine plasma samples from normal subjects (18-87 years) obtained in basal conditions, and 20 cerebrospinal fluid (CSF) samples obtained by lumbar puncture from healthy volunteers (18-75 years) were studied. beta Lipotropin (beta LPH), beta endorphin (beta EP) and ACTH were measured by specific RIA after silicic acid plasma extraction and gel chromatography (beta LPH and beta EP). No sex differences were found in the patterns of the three peptides either in the plasma or in CSF. In the plasma samples, both beta LPH and beta EP concentrations showed a pattern throughout life which was expressed by a paraboloid function with the lowest values found in young and old subjects and with peaks at 51.3 and 48.2 years, respectively. On the contrary, ACTH values failed to be represented by a significant linear or curvilinear regression and presented only a slight decrease in subjects over 75 years of age. CSF levels of beta LPH were significantly lower in 45-76 year old subjects (18.8 +/- 12.6 fmol/ml, M +/- SD) than in 18-44 year old subjects (34.5 +/- 15.8; p less than 0.05), as were those of beta EP (elderly: 41.2 +/- 19.7; young: 94.2 +/- 36.7; p less than 0.05), which showed a significantly linear inverse correlation with age (r = 0.6062, p less than 0.01). These CSF samples did not show any ACTH variations connected with age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

High-dose ropinirole in advanced Parkinson's disease with severe dyskinesias.

Levodopa (LD) is the gold standard of therapy for Parkinson's disease, but it is commonly associated with motor fluctuations and dyskinesias. Dopamine agonists are often used as adjuncts to LD in an attempt to reduce these complications. In this open-label study the authors investigated the effects of high doses of adjunctive ropinirole in 36 patients with advanced Parkinson's disease and normal cognitive status. The daily dose of ropinirole was increased from 18.4 +/- 3.5 mg to 34.7 +/- 5.5 mg, generally in four separate doses. The daily LD dose was decreased from 734.1 +/- 254.8 mg to 502.8 +/- 228.4 mg. After 12 months 25 patients were still on high doses of ropinirole whereas 11 patients had, after either the emergence of side effects or a worsening of their clinical conditions, decreased or interrupted ropinirole. At 12 months, the daily doses of LD and ropinirole were 489 +/- 243 mg and 34.6 +/- 4.6 mg respectively. There was a significant reduction in the Dyskinesia Rating Scale scores during both ON and OFF periods, indicating a reduction in dyskinesias during ON periods and a reduction in dystonias during OFF periods (p < 0.001). Both the intensity and the hours spent during OFF periods were reduced significantly (p < 0.001). Even though these results need to be confirmed through extended controlled studies, the high-dose dopamine agonist strategy is safe for patients with advanced PD in whom a marked motor response to LD (even at very low doses) is associated with severe dyskinesias, and may be used as a means of delaying surgery or as an alternative to continuous apomorphine infusion.

Aged↗

Premenstrual failure of alpha-adrenergic stimulation on hypothalamus-pituitary responses in menstrual migraine.

In nine women suffering from menstrual migraine (MM), and in six healthy asymptomatic volunteers, plasma beta-endorphin (beta-EP), growth hormone (GH), norepinephrine (NE), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) concentrations were measured in response to clonidine (0.075 mg, i.v.) stimulation. In MM patients clonidine testing was performed in both the early and the late luteal phases of the menstrual cycle. Premenstrual symptoms were prospectively evaluated in the actual cycle using the Moos Menstrual Distress Questionnaire. beta-EP (after gel chromatography) and GH were measured using radioimmunoassay. NE and MHPG were evaluated by HPLC using electrochemical detection. In both phases of the menstrual cycle clonidine significantly reduced NE and MHPG levels in MM patients and controls in a similar way. In MM patients beta-EP and GH plasma levels were stimulated by clonidine only in the early luteal phase, whereas they remained unchanged when they were stimulated in the premenstrual period. In controls the response of both hormones was not affected by the menstrual cycle. The lack of hormonal response to clonidine in MM may suggest a postsynaptic alpha 2-adrenoreceptor hyposensitivity during the premenstrual period. This demonstrates a transient vulnerability of the neuroendocrine/neurovegetative systems, and could thus be a factor facilitating the precipitation of both behavioral changes and migraine attacks.

Arousal↗

Changes of opioid modulation of the hypothalamo-pituitary-adrenal axis in patients with severe premenstrual syndrome.

To assess the function of the hypothalamus-pituitary-adrenal axis in patients with severe premenstrual syndrome (PMS) 28 patients and 14 asymptomatic controls were studied during the mid- to late-luteal phase of the menstrual cycle. The response of plasma cortisol to both high-dose naloxone and corticotropin-releasing hormone (CRH) was assessed. Naloxone stimulated a significant cortisol release in controls whereas it was otherwise almost absent in patients. CRH stimulated a greater release of cortisol in patients than in controls. Fifteen patients met criteria for either current anxiety and/or mood disorders. The cortisol secretion after both naloxone and CRH stimulations was similar for PMS patients with or without psychiatric disorders. These data indicate that endogenous opioids modulate the activity of the hypothalamus-pituitary-adrenal axis. Irrespective of the concomitant presence of menstrual migraine or psychiatric disorder, such control is altered in patients with severe PMS because of the possible hyposensitivity of opiate receptors. The hyperresponsiveness to CRH may be the consequence of the reduced inhibition that endogenous opioids tonically exert on HPA axis.

Adult↗

Active music therapy in Parkinson's disease: an integrative method for motor and emotional rehabilitation.

BACKGROUND: Modern management of Parkinson's disease (PD) aims to obtain symptom control, to reduce clinical disability, and to improve quality of life. Music acts as a specific stimulus to obtain motor and emotional responses by combining movement and stimulation of different sensory pathways. We explored the efficacy of active music therapy (MT) on motor and emotional functions in patients with PD. METHODS: This prospective, randomized, controlled, single-blinded study lasted 3 months. It consisted of weekly sessions of MT and physical therapy (PT). Thirty-two patients with PD, all stable responders to levodopa and in Hoehn and Yahr stage 2 or 3, were randomly assigned to two groups of 16 patients each. We assessed severity of PD with the Unified Parkinson's Disease Rating Scale, emotional functions with the Happiness Measure, and quality of life using the Parkinson's Disease Quality of Life Questionnaire. MT sessions consisted of choral singing, voice exercise, rhythmic and free body movements, and active music involving collective invention. PT sessions included a series of passive stretching exercises, specific motor tasks, and strategies to improve balance and gait. RESULTS: MT had a significant overall effect on bradykinesia as measured by the Unified Parkinson's Disease Rating Scale (p < .034). Post-MT session findings were consistent with motor improvement, especially in bradykinesia items (p < .0001). Over time, changes on the Happiness Measure confirmed a beneficial effect of MT on emotional functions (p < .0001). Improvements in activities of daily living and in quality of life were also documented in the MT group (p < .0001). PT improved rigidity (p < .0001). CONCLUSIONS: MT is effective on motor, affective, and behavioral functions. We propose active MT as a new method for inclusion in PD rehabilitation programs.

Female↗

Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women.

A retrospective study was conducted on 1300 women suffering from migraine without aura referred to the Headache Centers of Parma and Pavia from 1984 to 1990. All the data concerning their reproductive life, and the modifications induced by it on the course of headache were obtained from record-charts. Migraine frequently started at menarche (10.7%); in 60% of cases the migraine attacks occurred mostly or exclusively in the perimenstrual period, in 67% of cases disappeared during pregnancy, and in 24.1% significantly (P < 0.0001) worsened with "pill" intake. This study also designated a migraine subgroup which is more influenced by changes in sexual hormones, i.e. migraine with onset at menarche. This form of migraine shows more frequently a menstrual periodicity, and usually improves during pregnancy. Furthermore, menstrual migraine patients show social and cultural characteristics with distinguish them from other women.

Adolescent↗

Electrophysiological study on jaw-opening reflex recorded from digastric muscle in Parkinson's disease and primary cranial dystonias.

We investigated digastric reflex excitability in normals and in patients with extrapyramidal disorders such as primary cranial dystonias and Parkinson's disease. Relationships between exteroceptive suppression of masseter muscle and digastric reflex were also investigated in some cases. Digastric reflex hyperexcitability was observed in dystonic patients when compared to normals and parkinsonian patients. Furthermore, some patients with cranial dystonia presented absence of exteroceptive suppression reflex in masseter muscle with enlarged digastric response. These results indicate hyperexcitability of the digastric reflex and abnormal agonist-antagonist muscle co-contraction in chewing reflexes of patients with cranial dystonias. This shows that digastric reflex is an important electrophysiological investigation to explore the physiopathological mechanisms of primary cranial dystonias.

Aged↗

Disordered sympathetic reactivity in menstrual migraine. A cardiopressor and biochemical evaluation.

Sympathetic reactivity in patients suffering from menstrual migraine has been evaluated by means of blood pressure, heart rate and catecholamine monitoring during the tilt-table test performed either in the follicular or in the luteal phase of menstrual cycle. A sympathoadrenal activation mainly described by increased plasma epinephrine levels, has been documented in menstrual migraine not only during the luteal period but also in the early phases of migraine attacks. On the other hand, the interval phases seem to be characterized by a sympathetic chronic hypofunction. Variations in catecholaminergic reactivity are discussed as factors conditioning headache pathophysiology and attack epiphenomena.

Adult↗

Pattern of plasma opioids in menstrually-related migraine and epilepsy.

Plasma estradiol (E2), progesterone (P), beta-endorphin (beta-EP) and beta-lipotropin (beta-LPH) were measured in the luteal phase of 8 patients affected by menstrually-related migraine (M) and in 3 cases of catamenial epilepsy (CE). Plasma P and E2 of the M patients were lower than in the CE group. Both beta-LPH and beta-EP showed a reduction in M patients near menses, while the opposite pattern was found in CE. These data demonstrate that premenstrual syndrome is sustained by different, neurobiological dysfunction even if endogenous opioids could be involved in both migraine and epilepsy.

Endorphins↗

Pain reflexes in the clinical assessment of migraine syndromes.

Nociceptive flexion reflexes, RIII reflex in particular, have been demonstrated to be a useful tool for pain research in humans, since the threshold of RIII reflex is that of pain. In this study a reduction of RIII reflex threshold, strictly related to the severity of the disease, is described in migraine with interval headache (MIH), that is considered a severe and evolutive form of common migraine (CM). These abnormalities were not found in CM or in other chronic pain conditions, i.e. chronic tensive headache (CTH), suggesting that this electrophysiological parameter may be useful in the clinical assessment of primary headache. Moreover, the administration of amitriptyline, a drug producing analgesia mainly by blocking serotonin uptake, was able to markedly increase the RIII reflex threshold in MIH. This fact supports the hypothesis that an impairment of serotoninergic antinociceptive system may exist in this type of headache. A significant correlation between percentage increase in RIII reflex threshold and reduction of PTI was also observed after amitriptyline treatment, indicating that pain reflex may be used for predicting treatment response in migraine.

Adult↗

Abnormal pro-opiomelanocortin processing in Alzheimer's disease. A case report.

Several authors have reported reduced levels of pro-opiomelanocortin (POMC)-related peptides in the cerebrospinal fluid (CSF) of patients with Alzheimer's disease (AD), but the mechanisms regulating the CSF content of these substances are still debated. In this case report the processing of POMC peptides has been investigated post-mortem (HPLC and RIA methods) at the pituitary and hypothalamic level in an AD patient and in a control subject. From the results obtained it seems likely that defects of axonal transport and/or secretion rather than synthesis could account for the abnormalities of POMC peptides in the CSF.

Alzheimer Disease↗

Functional opioid activity variates according to the different fashion of alcohol abuse.

Two groups of alcohol addicts (total of 14 subjects), were submitted to Traditional Manual Acupuncture and pituitary hormone plasma levels, including B-Endorphin (B-EP), were measured in basal condition and after 1, 5, 20 and 60 minutes from needle withdrawal. Group A patients had a polarity towards negative affective tone presenting signs of dysphoria while group B was composed of the so-called "social drinkers". No difference existed in basal hormonal values, except slightly elevated plasma B-EP levels in group A. No significant responses to TMA were recorded in plasma ACTH, Cortisol, Prolactin or GH levels in groups A and B. Social drinkers showed an increase of B-EP plasma levels in response to TMA (128 +/- 62.1%, mean +/- SD) which on the contrary was absent in dysphoric alcoholics (2.8 +/- 38.6%, p less than 0.01). The same was true for B-Lipotropin plasma levels. These preliminary results suggest that different fashions of alcohol abuse may be associated with different reactivity of the endogenous opioid system.

Acupuncture Therapy↗

Terguride in stable Parkinson's disease.

Terguride (TER) (2 mg/day) was compared with a placebo in 41 stable Parkinson's disease (PD) patients, so as to test its efficacy as an add-on treatment to spare levodopa (LD). After the 4th week of add-on treatment, LD was reduced by about 25%. The number of "stable" patients (--those with an increase of no more than 20% of the basal Columbia University Rating Scale (CURS) score--remaining after LD reduction was used to compare the two add-on treatments. Most patients, remained "stable" in spite of LD reduction, and no significant differences between the therapies were discovered; the CURS score decreased over time only in the TER group. Hence, TER was shown to be a drug that has DA-ergic properties but with minimal antiparkinsonian efficacy.

Aged↗

Further characterization of autonomic involvement in multiple system atrophy: a pupillometric study.

Pupillometry is a simple non-invasive technique which allows early detection of an altered functioning of both branches of the Autonomic Nervous System (ANS). In the present study, the pupillometric findings (dark and light diameters and light reflex) obtained in 14 Multiple System Atrophy (MSA) patients (5 with the striatonigral degeneration (SND) type and 9 with the olivopontocerebellar (OPCA) type were compared with those of a sex- and age-matched control group and with a group patients suffering from idiopathic parkinsonism who had never undergone treatment previously. MSA patients showed larger pupils after dark and light adaptation, high degrees of anisocoria after light adaptation and a complex impairment of pupil response to light (mainly occurring in the OPCA-type of MSA) represented by an increase in latency, contraction time and a reduction in contraction amplitude. These data point to the existence in MSA (particularly of OPCA-type) of a pupillary imbalance, mainly involving the parasympathetic branch of the ANS, which is likely to be due to an impairment of the central pathways subserving pupil response to light and is probably detectable in the early stages of the disease by means of dynamic pupillometric evaluation.

Adult↗