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Marco Trabucchi

Publications and source records attributed to Marco Trabucchi.

85 records · Page 5Linked to original sources
PubMed2002

Abnormalities in the pattern of platelet amyloid precursor protein forms in patients with mild cognitive impairment and Alzheimer disease.

CONTEXT: Patients affected by sporadic Alzheimer disease (AD) show a significant alteration of amyloid precursor protein (APP) forms in platelets when compared with patients with dementia but without AD and age-matched controls. OBJECTIVE: To evaluate the ratio of platelet APP forms (APPr) in early-stage AD and mild cognitive impairment (MCI) and its potential as a biomarker for the early identification of AD. SETTING: Community population-based sample of patients admitted to 4 AD centers for investigation of cognitive disturbances. DESIGN AND METHODS: Thirty-five patients with mild AD (mAD), 21 patients with very mild AD (vmAD), 30 subjects with MCI, and 25 age-matched controls were included. The APPr was evaluated by Western blot analysis in platelet homogenate. RESULTS: Compared with controls (mean +/- SD, 0.93 +/- 0.3), the mean APPr was decreased in patients with mAD (0.44 +/- 0.24; P<.001) and patients with vmAD (0.49 +/- 0.3; P<.001). Regarding the MCI group, a significant decrease in APPr was found compared with controls (0.62 +/- 0.33; P<.001). Fixing a cutoff score of 0.6, sensitivity was 88.6% (31/35) for patients with mAD and 85.7% (18/21) for patients with vmAD, whereas specificity was 88% (22/25) for controls. Among patients with MCI, 18 (60%) of 30 individuals displayed APPr values below the cutoff. CONCLUSIONS: Alteration of platelet APP forms is an early event in AD, and the measurement of APPr may be useful for the identification of preclinical AD in patients with MCI.

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PubMed2002

Geriatric Index of Comorbidity: validation and comparison with other measures of comorbidity.

BACKGROUND: the debate about measures of chronic comorbidity in the elderly is mainly due to the lack of consensus on pathogenetic models. OBJECTIVE: the aim of the present study was to compare the concurrent validity of a number of measures of chronic comorbidity assuming different pathogenic models, versus disability in elderly patients. SETTING: the Geriatric Evaluation and Rehabilitation Unit for subacute and disabled patients. PARTICIPANTS: 493 new and consecutive elderly patients (mean age 79 years, 71% females) admitted to the Geriatric Evaluation and Rehabilitation Unit. MEASUREMENTS: we evaluated age, gender, cognitive status, depressive symptoms, functional status, somatic health, and nutritional status on admission. Functional status was assessed by the self- or proxy reported Katz's BADL scale and by the performance-based Reuben's Physical Performance Test. Somatic health was assessed as presence and severity of diseases according to standardized criteria. Comorbidity was measured as number of diseases, sum of disease severity, and with a composite score (Geriatric Index of Comorbidity) which takes into account both number of diseases and occurrence of very severe diseases. Mortality was assessed after 12 months. RESULTS: specific diseases and their severity were found to be associated with disability measures. All measures of comorbidity were significantly correlated with disability, but only the Geriatric Index of Comorbidity was independently associated after adjustment for severity of individual diseases. In addition, increasing severity of comorbidity as defined by Geriatric Index of Comorbidity was associated with greater disability while this was not true for the other comorbidity measures (F statistics for the regression model including the Geriatric Index of Comorbidity=19.9). The Geriatric Index of Comorbidity, but not the other comorbidity measures, predicted mortality (relative risk of death 2.3, 95% confidence interval 1.7-3.1). CONCLUSION: the Geriatric Index of Comorbidity, a measure of comorbidity assuming that both number of diseases and occurrence of very severe diseases are determinants of health, has the greatest concurrent validity with disability and is the best predictor of mortality.

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PubMed2002

Radial width of the temporal horn: a sensitive measure in Alzheimer disease.

BACKGROUND AND PURPOSE: Atrophy in the medial temporal lobe (MTL) structures depicted with brain imaging is one of the most accurate markers of Alzheimer disease (AD), but practical considerations have thus far limited their routine clinical use. The aim of this study was to explore the validity of a CT- and MR-based measure of MTL atrophy that would be feasible for routine clinical use. METHODS: We acquired brain CT scans in the temporal lobe plane with thin sections in 42 patients with AD and in 29 control patients without dementia. We also acquired MR images (according to a 3D magnetization-prepared rapid gradient-echo protocol) in 28 patients with AD and in 28 control subjects without dementia. The radial width of the temporal horn (rWTH) of the lateral ventricle was measured with a precision caliper at the tip of the horn on CT scans or high-quality MR images. The validity of the rWTH variable was assessed by test-retest and interrater reliability, convergent and discriminant validity compared with progressively distant brain regions, and known-group validity (accuracy of the separation of patients with AD from control subjects). Convergent and discriminant validity compared with volumetric measures was tested in the patients who underwent MR imaging. RESULTS: Intraclass correlation coefficients for inter- and intrarater reliability were between 0.94 and 0.98. On CT scans, Pearson's correlation of the rWTH with the transverse width of the temporal horn was between 0.60 and 0.79; with Jobst's minimum thickness of the MTL, between 0.63 and 0.78 (interuncal distance approximately 0.50); and with an index of frontal atrophy, between 0.35 and 0.42. On MR images, the correlation with volumetric MR measures was 0.80 in the temporal horn, 0.74 in the hippocampus, 0.68 in the temporal lobe, 0.58 in the entorhinal cortex, and 0.49 in the frontal lobe. On CT scans (cutoff value for AD, >5.3 mm; age range of subjects, 50-90 y), the rWTH measure was a sensitive marker for AD in 39 of 42 patients with AD (sensitivity, 93%) and was a specific marker in 28 of the 29 control patients (specificity, 97%). On MR images (cutoff 3.6-6.7 mm; age range of subject, 50-90 y), the rWTH was a sensitive marker for AD in 21 of 28 patients with AD (sensitivity, 75%) and was a specific marker in 26 of 28 control subjects (specificity, 93%). The accuracy of other linear CT-based measures of MTL atrophy and linear and volumetric MR-based measures was lower. With specificity set to 95%, sensitivity ranged from 57% to 74% for CT-based measures and from 52% to 74% for MR-based measures. CONCLUSION: The rWTH is an accurate marker of AD that could be used in routine clinical settings.

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PubMed2002

Paroxetine and fluoxetine effects on mood and cognitive functions in depressed nondemented elderly patients.

BACKGROUND: A large proportion of the elderly population complains of depressive symptoms. The ideal antidepressant for these patients, who often suffer from numerous concomitant diseases, should not worsen their cognitive functions and should be free of contraindications. METHOD: To assess the effects of 2 selective serotonin reuptake inhibitors on cognitive functions in elderly depressed patients (ICD-10 criteria), we conducted a double-blind, randomized, parallel-group, multicenter study comparing paroxetine (20-40 mg daily) and fluoxetine (20-60 mg daily) treatment for 1 year. Cognitive performance was evaluated by means of the Buschke Selective Reminding Test, the Blessed Information and Memory Test, the Clifton Assessment Schedule, the Cancellation Task Test, and the Wechsler Paired Word Test; the Hamilton Rating Scale for Depression (HAM-D) and the Clinical Anxiety Scale were administered to assess the course of depressive and anxiety symptoms, respectively. RESULTS: 242 patients were enrolled (mean +/- SD age = 75.4 +/- 6.6 years). During the study, no deterioration of cognition was observed; on the contrary, most of the tested cognitive functions improved. Good antidepressant efficacy was maintained for over 1 year with both drugs, based on the percentage of responders to treatment (patients achieving a HAM-D total score < 10; 60%). Both drugs showed a good tolerability and safety profile. CONCLUSION: The 2 antidepressants proved to be suitable for the long-term treatment of depression in the elderly and to be devoid of detrimental effects on the tested cognitive functions.

Affect↗
PubMed2001

In reply to Cheng.

Explore the source record for details and available documents.

Journal Article↗
PubMed1981

Effect of transcutaneous electrotherapy on CSF beta-endorphin content in patients without pain problems.

To test the hypothesis of opiate-like peptide release after transcutaneous electrotherapy we measured beta-endorphin cerebrospinal fluid (CSF) content in 13 patients without pain problems. The results indicate a time dependent increase of CSF beta-endorphin in the group of patients studied. This fact suggests that the analgesic properties of the treatment may be ascribed to an involvement of the endogenous opiates system, independently from the basal clinical conditions of the patients.

Adult↗
PubMedDate not supplied

Effect of high climate temperature on the behavioral and psychological symptoms of dementia.

OBJECTIVE: The objective of this study was to investigate if high climate temperature could have a negative effect on behavioral and psychological symptoms of dementia (BPSD). DESIGN: We conducted a retrospective study. SETTING AND PATIENTS: Six patients discharged from the "Richiedei" Alzheimer Rehabilitation Unit-Italy during a period of very high climate temperature (June 14-21, 2002, 30.4 degrees C [86.7 degrees F]) are defined as the case-group. Sociodemographic, clinical, and therapeutic characteristics are compared with those of patients discharged during the previous 5 weeks (I control-group, n = 10) and the following 5 weeks (II control-group, n = 9). METHODS: On admission and on discharge, a multidimensional evaluation was performed assessing mental and functional status, BPSD (Neuropsychiatric Inventory, NPI), somatic health status, and pharmacotherapy. Changes in BPSD severity was computed as the difference in NPI total score (Delta-NPI) between the last and the first week of stay. Atmospheric temperature was also considered. RESULTS: The three groups did not differ with respect to sociodemographic, clinical, and therapeutic characteristics. On admission, frequency and severity of BPSD were similar among groups; whereas on discharge, the case-group had an increase in NPI scores (NPI during the first week [median], 13 in the case-group vs. 21 in the I control-group vs. 20.5 in the II one; during the last week: 24.5 vs. 9.5 vs. 15, respectively). CONCLUSION: High climate temperature could have a negative impact on behavior in demented patients. To explain the possible mechanisms of the negative impact of high climate temperature on behavior, two hypotheses are proposed.

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