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Article: Diagnosis and Treatment of Drug-Resistant Epilepsy: Present and Future Perspectives.

Assenza, Giovanni

2020 Volume 10, Issue 11

Abstract: The introduction of the operative definition of drug-resistant epilepsy (DRE) was a turning point for clinicians and people with epilepsy (PwE) [ ... ]. ...

Abstract	The introduction of the operative definition of drug-resistant epilepsy (DRE) was a turning point for clinicians and people with epilepsy (PwE) [...].
Language	English
Publishing date	2020-10-26
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci10110779
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Article: Editorial: Advances in brain imaging and stimulation methods for cognitive function investigation.

Palm, Ulrich / Assenza, Giovanni / Boettiger, Charlotte A / Yuan, Zhen

Frontiers in human neuroscience

2023 Volume 17, Page(s) 1280782

Language	English
Publishing date	2023-08-30
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2425477-0
ISSN	1662-5161
ISSN	1662-5161
DOI	10.3389/fnhum.2023.1280782
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Article ; Online: Quantitative Analysis of Cenobamate and Concomitant Anti-Seizure Medications in Human Plasma via Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry.

Molteni, Linda / Charlier, Bruno / Coglianese, Albino / Izzo, Viviana / Assenza, Giovanni / Menna, Pierantonio / de Grazia, Ugo / D'Urso, Annachiara

Molecules (Basel, Switzerland)

2024 Volume 29, Issue 4

Abstract: Cenobamate (CNB) is a new anti-seizure medication (ASM) recently introduced in clinical practice after approval by the FDA and EMA for the add-on treatment of focal onset seizures in adult patients. Although its mechanism of action has not been fully ... ...

Abstract	Cenobamate (CNB) is a new anti-seizure medication (ASM) recently introduced in clinical practice after approval by the FDA and EMA for the add-on treatment of focal onset seizures in adult patients. Although its mechanism of action has not been fully understood, CNB showed promising clinical efficacy in patients treated with concomitant ASMs. The accessibility of CNB could pave a way for the treatment of refractory or drug-resistant epilepsies, which still affect at least one-third of the patients under pharmacological treatment. In this context, therapeutic drug monitoring (TDM) offers a massive opportunity for better management of epileptic patients, especially those undergoing combined therapy. Here, we describe the first fully validated ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the quantification of CNB and concomitant ASMs in human plasma, with samples extracted either manually or by means of a liquid handler. Our method was validated according to the most recent ICH International Guideline M10 for Bioanalytical Method Validation and Study Sample Analysis. The method proved to be selective for CNB and displayed a linear range from 0.8 to 80 mg/L; no matrix effect was found (98.2 ± 4.1%), while intra-day and inter-day accuracy and precision were within the acceptance range. Also, CNB short- and long-term stability in plasma under different conditions was assessed. Leftover human plasma samples were employed as study samples for method validation. Our method proved to be highly sensitive and selective to quantify CNB and concomitant ASMs in human plasma; therefore, this method can be employed for a routinely TDM-based approach to support physicians in the management of an epileptic patient.
MeSH term(s)	Adult ; Humans ; Chromatography, High Pressure Liquid/methods ; Tandem Mass Spectrometry/methods ; Carbamates ; Chlorophenols ; Epilepsy/drug therapy ; Reproducibility of Results ; Tetrazoles
Chemical Substances	Cenobamate (P85X70RZWS) ; Carbamates ; Chlorophenols ; Tetrazoles
Language	English
Publishing date	2024-02-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1413402-0
ISSN	1420-3049 ; 1431-5165 ; 1420-3049
ISSN (online)	1420-3049
ISSN	1431-5165 ; 1420-3049
DOI	10.3390/molecules29040884
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Article ; Online: Assessing cortical excitability with electroencephalography: A pilot study with EEG-iTBS.

Pellegrino, Giovanni / Schuler, Anna-Lisa / Cai, Zhengchen / Marinazzo, Daniele / Tecchio, Franca / Ricci, Lorenzo / Tombini, Mario / Di Lazzaro, Vincenzo / Assenza, Giovanni

Brain stimulation

2024 Volume 17, Issue 2, Page(s) 176–183

Abstract: Background: Cortical excitability measures neural reactivity to stimuli, usually delivered via Transcranial Magnetic Stimulation (TMS). Excitation/inhibition balance (E/I) is the ongoing equilibrium between excitatory and inhibitory activity of neural ... ...

Abstract	Background: Cortical excitability measures neural reactivity to stimuli, usually delivered via Transcranial Magnetic Stimulation (TMS). Excitation/inhibition balance (E/I) is the ongoing equilibrium between excitatory and inhibitory activity of neural circuits. According to some studies, E/I could be estimated in-vivo and non-invasively through the modeling of electroencephalography (EEG) signals and termed 'intrinsic excitability' measures. Several measures have been proposed (phase consistency in the gamma band, sample entropy, exponent of the power spectral density 1/f curve, E/I index extracted from detrend fluctuation analysis, and alpha power). Intermittent theta burst stimulation (iTBS) of the primary motor cortex (M1) is a non-invasive neuromodulation technique allowing controlled and focal enhancement of TMS cortical excitability and E/I of the stimulated hemisphere. Objective: Investigating to what extent E/I estimates scale with TMS excitability and how they relate to each other. Methods: M1 excitability (TMS) and several E/I estimates extracted from resting state EEG recordings were assessed before and after iTBS in a cohort of healthy subjects. Results: Enhancement of TMS M1 excitability, as measured through motor-evoked potentials (MEPs), and phase consistency of the cortex in high gamma band correlated with each other. Other measures of E/I showed some expected results, but no correlation with TMS excitability measures or strong consistency with each other. Conclusions: EEG E/I estimates offer an intriguing opportunity to map cortical excitability non-invasively, with high spatio-temporal resolution and with a stimulus independent approach. While different EEG E/I estimates may reflect the activity of diverse excitatory-inhibitory circuits, spatial phase synchrony in the gamma band is the measure that best captures excitability changes in the primary motor cortex.
MeSH term(s)	Humans ; Transcranial Magnetic Stimulation/methods ; Electroencephalography/methods ; Pilot Projects ; Male ; Adult ; Female ; Motor Cortex/physiology ; Evoked Potentials, Motor/physiology ; Cortical Excitability/physiology ; Young Adult
Language	English
Publishing date	2024-01-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2394410-9
ISSN	1876-4754 ; 1935-861X
ISSN (online)	1876-4754
ISSN	1935-861X
DOI	10.1016/j.brs.2024.01.004
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Article: A Rare Neuro-Ophthalmological Condition in a Patient with Lung Adenocarcinoma: The Eight-and-a-Half Syndrome, Case Report and Review of the Literature.

Cruciani, Alessandro / Motolese, Francesco / Todisco, Antonio / Di Lazzaro, Vincenzo / Assenza, Giovanni

Brain sciences

2022 Volume 12, Issue 4

Abstract: The eight-and-a-half syndrome is a rare neuro-ophthalmological condition caused by a structural lesion in the dorsal portion of the pons, involving critical areas of the brainstem, i.e., medial longitudinal fasciculus (MLF), abducens nucleus, facial genu, ...

Abstract	The eight-and-a-half syndrome is a rare neuro-ophthalmological condition caused by a structural lesion in the dorsal portion of the pons, involving critical areas of the brainstem, i.e., medial longitudinal fasciculus (MLF), abducens nucleus, facial genu, and colliculus. It is characterized by internuclear ophthalmoplegia with horizontal gaze palsy and peripheral facial palsy. Although the syndrome is most frequently caused by vascular or demyelinating diseases, several different underlying causes might occur. Herein, we describe a case of the eight-and-a-half syndrome caused by a lung adenocarcinoma metastasis localized in the lower pontine tegmentum. Then, we review the current literature on the underlying causes of the eight-and-a-half syndrome.
Language	English
Publishing date	2022-03-28
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci12040451
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Article ; Online: Traduzione e adattamento alla lingua italiana del glossario dei termini più comunemente usati dagli elettroencefalografisti clinici e proposta per il formato del referto EEG (Revisione IFCN 2017).

Strigaro, Gionata / Bisulli, Francesca / Assenza, Giovanni / Mecarelli, Oriano / Grippo, Antonello / Meletti, Stefano

Clinical neurophysiology practice

2022 Volume 7, Page(s) 325–365

Language	English
Publishing date	2022-11-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2467-981X
ISSN (online)	2467-981X
DOI	10.1016/j.cnp.2022.09.006
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Article: Editorial: The comorbid anxiety and depression disorder in patients with epilepsy: Diagnosis, prevention and treatment.

Xu, Zucai / Tian, Xin / Wang, Xuefeng / Chen, Yangmei / Xu, Qi / Assenza, Giovanni

Frontiers in neurology

2022 Volume 13, Page(s) 974462

Language	English
Publishing date	2022-09-14
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.974462
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Article ; Online: Overnight switch from carbamazepine to eslicarbazepine in a real-life clinical scenario: a retrospective study.

Sancetta, Biagio Maria / Ricci, Lorenzo / Lanzone, Jacopo / Boscarino, Marilisa / Narducci, Flavia / Lippa, Giulia / Nesta, Marianna / Di Lazzaro, Vincenzo / Tombini, Mario / Assenza, Giovanni

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2024

Abstract: Background: Carbamazepine (CBZ) is a first-choice anti-seizure medication (ASM) whose efficacy is often invalidated by adverse effects (AEs). Eslicarbazepine (ESL) is a structural derivative of CBZ with better pharmacokinetic/tolerability profiles. We ... ...

Abstract	Background: Carbamazepine (CBZ) is a first-choice anti-seizure medication (ASM) whose efficacy is often invalidated by adverse effects (AEs). Eslicarbazepine (ESL) is a structural derivative of CBZ with better pharmacokinetic/tolerability profiles. We describe our experience of the overnight CBZ to ESL switch in people with epilepsy (PwE) to improve seizure control, AEs, and ASMs adherence. Methods: We retrospectively included 19 PwE (12 females, 53 ± 21 years old) who underwent CBZ to ESL overnight switch due to single/multiple issues: poor efficacy (pEff, N = 8, 42%), tolerability (pToll, N = 11, 58%), adherence (pAdh, N = 2, 10%). 9/19 (47%) had psychiatric comorbidities. Clinical variables, seizure frequency, and AEs were recorded at switch time (T0) after 3.5 ± 3 (T1) and 6.5 ± 1.5 months (T2). Results: At T1, in pEff group, 1/8 (13%) was seizure free, 2/8 (25%) were responders (> 50% seizure reduction), 2/8 (25%) had no seizure changes, 3/8 (37%) had seizure worsening; the latter were those with the most severe epilepsy and encephalopathy. In pToll group, all PwE experienced AEs disappearance/amelioration. In pAdh group, all PwE reported adherence amelioration. Four dropouts. At T2, no changes were recorded within groups, while in the whole sample, 6/15 (40%) were responders, and 4/15 (27%) were seizure-free. No one complained of Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation psychiatric worsening, while 6/19 (32%) experienced mood/behavior benefits. Conclusions: CBZ to ESL overnight switch offers an opportunity to improve efficacy, tolerability, adherence, and psychiatric symptoms.
Language	English
Publishing date	2024-02-05
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-024-07354-6
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Zs.A 1877: Show issues

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Article ; Online: Cortical inhibitory dysfunction in epilepsia partialis continua: A high frequency oscillation somatosensory evoked potential study.

Insola, Angelo / Di Lazzaro, Vincenzo / Assenza, Giovanni

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2019 Volume 130, Issue 4, Page(s) 439–444

Abstract: Objective: The pathophysiology of epilepsia partialis continua (EPC) is still unclear, a thalamo-cortical circuit dysfunction has been hypothesized. The aim of present study is the functional evaluation of the thalamo-cortical network in EPC by means of ...

Abstract	Objective: The pathophysiology of epilepsia partialis continua (EPC) is still unclear, a thalamo-cortical circuit dysfunction has been hypothesized. The aim of present study is the functional evaluation of the thalamo-cortical network in EPC by means of the study of low- and high-frequency somatosensory evoked potentials (LF-SEP and HF-SEP). Methods: Median LF-SEP and HF-SEP were recorded in 3 patients with EPC and in 2 patients with rolandic lesions without EPC (non-EPC). Recording electrodes were placed on P3, C3, F3 and P4, C4, F4 of scalp regions. HF-SEP were obtained by an offline 400-800 Hz filtering of P3-F3 and P4-F4 traces. Results: In EPC patients, we found a significant suppression of post-synaptic HF-SEP burst and an amplitude reduction of the P24 wave of the LF-SEPs. Both these components are related to cortical inhibitory interneuron activity. HF-SEP and LF-SEP were normal in non-EPC patients. Conclusion: The different results obtained in patients with a rolandic lesion with and without EPC supports the hypothesis that EPC might be correlated to a dysfunction of gabaergic interneurons of a cortical sensory-motor network. Significance: Our results might contribute to the understanding of the physiological basis of the cortical dysfunction causing epilepsia partialis continua.
MeSH term(s)	Aged ; Aged, 80 and over ; Electroencephalography ; Epilepsia Partialis Continua/physiopathology ; Evoked Potentials, Somatosensory/physiology ; Female ; Humans ; Male ; Nerve Net/physiopathology ; Neural Inhibition/physiology ; Somatosensory Cortex/physiopathology
Language	English
Publishing date	2019-01-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2019.01.005
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Article ; Online: Epilepsy and quality of life: what does really matter?

Tombini, Mario / Assenza, Giovanni / Quintiliani, Livia / Ricci, Lorenzo / Lanzone, Jacopo / Di Lazzaro, Vincenzo

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2021 Volume 42, Issue 9, Page(s) 3757–3765

Abstract: Purpose: To assess quality of life (QoL) in adult people with epilepsy (PWE) and identify the main factors affecting it.: Methods: We enrolled consecutively 122 PWE. They were interviewed for a careful collection of demographic and clinical data. ... ...

Abstract	Purpose: To assess quality of life (QoL) in adult people with epilepsy (PWE) and identify the main factors affecting it. Methods: We enrolled consecutively 122 PWE. They were interviewed for a careful collection of demographic and clinical data. Patients completed dedicated questionnaires for the assessment of the quality of life (Quality of Life in Epilepsy Scale-31) (Q31) as well as psychosocial features: depressive symptoms (DS) (Beck Depression Inventory-II/BDI-II), difficulties of emotion regulation (Difficulties of Emotion Regulation Scale/DERS), and stigma related to epilepsy (Stigma Scale of Epilepsy/SSE and Jacoby's Stigma Scale/JSS). The results of Q31 and their subscales were correlated with clinical details of PWE, as well as the other scores. A stepwise multiple regression analysis was applied to identify the main factors affecting QoL. Results: Quality of life is inversely correlated mostly with psychosocial features, as DS, emotion dysregulation, and stigma perception, as well as with epilepsy-related factors, as the seizure frequency and number of antiseizure medications (ASMs). The combination of DS, perceived stigma, and number of ASMs best explained the QoL. Worse features of QoL were detected in females and in patients with age of epilepsy onset in adulthood. Conclusion: Quality of life in adult PWE is predominantly affected by psychosocial factors more than epilepsy-related ones. These findings suggest that effective epilepsy management requires more than seizure control, and early detection of psychological dysfunction and tailored interventions to improve the QoL should be considered.
MeSH term(s)	Adult ; Depression ; Epilepsy ; Female ; Humans ; Quality of Life ; Seizures ; Social Stigma ; Surveys and Questionnaires
Language	English
Publishing date	2021-01-15
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-020-04990-6
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