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  1. Article: Disease mechanisms as subtypes: Microbiome.

    Bonvegna, Salvatore / Cilia, Roberto

    Handbook of clinical neurology

    2023  Volume 193, Page(s) 107–131

    Abstract: Abnormalities in gut microbiota have been suggested to be involved in the pathophysiology and progression of Parkinson's disease (PD). Gastrointestinal nonmotor symptoms often precede the onset of motor features in PD, suggesting a role for gut dysbiosis ...

    Abstract Abnormalities in gut microbiota have been suggested to be involved in the pathophysiology and progression of Parkinson's disease (PD). Gastrointestinal nonmotor symptoms often precede the onset of motor features in PD, suggesting a role for gut dysbiosis in neuroinflammation and α-synuclein (α-syn) aggregation. In the first part of this chapter, we analyze critical features of healthy gut microbiota and factors (environmental and genetic) that modify its composition. In the second part, we focus on the mechanisms underlying the gut dysbiosis and how it alters anatomically and functionally the mucosal barrier, triggering neuroinflammation and subsequently α-syn aggregation. In the third part, we describe the most common alterations in the gut microbiota of PD patients, dividing the gastrointestinal system in higher and lower tract to examine the association between microbiota abnormalities and clinical features. In the final section, we report on current and future therapeutic approaches to gut dysbiosis aiming to either reduce the risk for PD, modify the disease course, or improve the pharmacokinetic profile of dopaminergic therapies. We also suggest that further studies will be needed to clarify the role of the microbiome in PD subtyping and of pharmacological and nonpharmacological interventions in modifying specific microbiota profiles in individualizing disease-modifying treatments in PD.
    MeSH term(s) Humans ; Neuroinflammatory Diseases ; Dysbiosis ; Parkinson Disease ; Microbiota ; Gastrointestinal Microbiome/physiology
    Language English
    Publishing date 2023-02-20
    Publishing country Netherlands
    Document type Review ; Journal Article
    ISSN 0072-9752
    ISSN 0072-9752
    DOI 10.1016/B978-0-323-85555-6.00006-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: "Watch out for the break in the dam": Is Aquaporins dysfunction the missing link between immune dysregulation, glia activation, and neurodegeneration?

    Leta, Valentina / Cilia, Roberto

    Parkinsonism & related disorders

    2023  Volume 117, Page(s) 105938

    MeSH term(s) Humans ; Parkinson Disease ; Inflammation ; Neuroglia
    Language English
    Publishing date 2023-11-23
    Publishing country England
    Document type Editorial
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2023.105938
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Molecular Imaging of the Cannabinoid System in Idiopathic Parkinson's Disease.

    Cilia, Roberto

    International review of neurobiology

    2018  Volume 141, Page(s) 305–345

    Abstract: The endocannabinoid system is a modulator of neurotransmitter release and is involved in several physiological functions. Hence, it has been increasingly studied as a potential pharmacologic target of Parkinson's disease. Several preclinical and clinical ...

    Abstract The endocannabinoid system is a modulator of neurotransmitter release and is involved in several physiological functions. Hence, it has been increasingly studied as a potential pharmacologic target of Parkinson's disease. Several preclinical and clinical studies evidenced a substantial rearrangement of the endocannabinoid system in the basal ganglia circuit following dopamine depletion. The endocannabinoid system has been additionally implicated in the regulation of neuroinflammation and neuroprotection through the activation of CB2 receptors, suggesting a potential target for disease modifying therapies in Parkinson's disease. In this chapter, current pharmacological and physiological knowledge on the role of the endocannabinoid system will be reviewed, focusing on preclinical studies animal models and clinical studies in patients with idiopathic Parkinson's disease. The main strategies for imaging the brain cannabinoid system will be summarized to finally focus on in vivo imaging of patients with Parkinson's disease.
    MeSH term(s) Animals ; Arachidonic Acids/metabolism ; Endocannabinoids/metabolism ; Glycerides/metabolism ; Humans ; Molecular Imaging/methods ; Parkinson Disease/diagnostic imaging ; Parkinson Disease/metabolism ; Polyunsaturated Alkamides/metabolism ; Positron-Emission Tomography/methods ; Receptors, Cannabinoid/metabolism
    Chemical Substances Arachidonic Acids ; Endocannabinoids ; Glycerides ; Polyunsaturated Alkamides ; Receptors, Cannabinoid ; glyceryl 2-arachidonate (8D239QDW64) ; anandamide (UR5G69TJKH)
    Language English
    Publishing date 2018-09-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 209876-3
    ISSN 2162-5514 ; 0074-7742
    ISSN (online) 2162-5514
    ISSN 0074-7742
    DOI 10.1016/bs.irn.2018.08.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The challenges of finding novel and effective drugs targeting dementia and neuropsychiatric disturbances in PD: Insights from the SYNAPSE trial.

    Cilia, Roberto / Piacentini, Sylvie Hélène Marie Jeanne / Cummings, Jeffrey

    Parkinsonism & related disorders

    2023  Volume 114, Page(s) 105804

    MeSH term(s) Humans ; Dementia/drug therapy
    Language English
    Publishing date 2023-08-09
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2023.105804
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Delivery of Allied Health Therapies to People with Parkinson's Disease in Africa.

    Cilia, Roberto / Dekker, Marieke C J / Cubo, Esther / Agoriwo, Mary W

    Journal of Parkinson's disease

    2023  

    Abstract: Allied health therapies refer to a range of healthcare professionals, including physiotherapists, occupational and speech-language therapists, who aim to optimize daily function and quality of life in conjunction with medical care. In this narrative ... ...

    Abstract Allied health therapies refer to a range of healthcare professionals, including physiotherapists, occupational and speech-language therapists, who aim to optimize daily function and quality of life in conjunction with medical care. In this narrative review of literature on allied health therapies in people with Parkinson's disease (PD), we focused on the diversity in healthcare access, state of the art, current challenges in the African continent, and proposed solutions and future perspectives. Despite the increasing prevalence and awareness of PD in Africa, numerous challenges persist in its management. These include resource limitations, geographical barriers, sociocultural beliefs, and economic constraints. Nevertheless, innovative solutions, including telerehabilitation and community-based rehabilitation, offer hope. Collaborative efforts within the continent and internationally have shown potential in bridging training and resource gaps. Significant strides can be made with tailored interventions, technological advancements, and multifaceted collaborations. This review offers practical insights for healthcare professionals, policymakers, and caregivers to navigate and optimize PD care in the African context.
    Language English
    Publishing date 2023-12-16
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2620609-2
    ISSN 1877-718X ; 1877-7171
    ISSN (online) 1877-718X
    ISSN 1877-7171
    DOI 10.3233/JPD-230262
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Precision Medicine in Parkinson's Disease: From Genetic Risk Signals to Personalized Therapy.

    Straccia, Giulia / Colucci, Fabiana / Eleopra, Roberto / Cilia, Roberto

    Brain sciences

    2022  Volume 12, Issue 10

    Abstract: Understanding the pathophysiology and genetic background of Parkinson's disease (PD) increases the likelihood of developing effective disease-modifying therapeutic strategies. In particular, the discovery of genetic variants causing or increasing the ... ...

    Abstract Understanding the pathophysiology and genetic background of Parkinson's disease (PD) increases the likelihood of developing effective disease-modifying therapeutic strategies. In particular, the discovery of genetic variants causing or increasing the risk for PD has contributed to refining the clinical, biological, and molecular classification of the disease and has offered new insights into sporadic forms. It is even more evident that specific genetic mutations can show different responses to pharmacological and device-aided therapies. To date, several agents acting on multiple PD-causing pathogenic pathways have been tested as disease-modifying strategies, with disappointing results. This may be caused by the recruitment of PD populations whose underlying molecular pathophysiology is heterogeneous. We believe that an effective model of personalized medicine must be prioritized in the near future. Here, we review the current therapeutic options under clinical and preclinical development for PD and discuss the key pending questions and challenges to face for successful clinical trials. Furthermore, we provide some insights into the role of genetics in guiding the decision-making process on symptomatic and device-aided therapies for PD in daily clinical practice.
    Language English
    Publishing date 2022-09-28
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2651993-8
    ISSN 2076-3425
    ISSN 2076-3425
    DOI 10.3390/brainsci12101308
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Early cortico-muscular coherence and cortical network changes in Parkinson's patients treated with MRgFUS.

    Visani, Elisa / Panzica, Ferruccio / Franceschetti, Silvana / Golfrè Andreasi, Nico / Cilia, Roberto / Rinaldo, Sara / Rossi Sebastiano, Davide / Lanteri, Paola / Eleopra, Roberto

    Frontiers in neurology

    2024  Volume 15, Page(s) 1362712

    Abstract: Introduction: To investigate cortical network changes using Magnetoencephalography (MEG) signals in Parkinson's disease (PD) patients undergoing Magnetic Resonance-guided Focused Ultrasound (MRgFUS) thalamotomy.: Methods: We evaluated the MEG signals ...

    Abstract Introduction: To investigate cortical network changes using Magnetoencephalography (MEG) signals in Parkinson's disease (PD) patients undergoing Magnetic Resonance-guided Focused Ultrasound (MRgFUS) thalamotomy.
    Methods: We evaluated the MEG signals in 16 PD patients with drug-refractory tremor before and after 12-month from MRgFUS unilateral lesion of the ventralis intermediate nucleus (Vim) of the thalamus contralateral to the most affected body side. We recorded patients 24 h before (T0) and 24 h after MRgFUS (T1). We analyzed signal epochs recorded at rest and during the isometric extension of the hand contralateral to thalamotomy. We evaluated cortico-muscular coherence (CMC), the out-strength index from non-primary motor areas to the pre-central area and connectivity indexes, using generalized partial directed coherence. Statistical analysis was performed using RMANOVA and
    Results: Most changes found at T1 compared to T0 occurred in the beta band and included: (1) a re-adjustment of CMC distribution; (2) a reduced out-strength from non-primary motor areas toward the precentral area; (3) strongly reduced clustering coefficient values. These differences mainly occurred during motor activation and with few statistically significant changes at rest. Correlation analysis showed significant relationships between changes of out-strength and clustering coefficient in non-primary motor areas and the changes in clinical scores.
    Discussion: One day after MRgFUS thalamotomy, PD patients showed a topographically reordered CMC and decreased cortico-cortical flow, together with a reduced local connection between different nodes. These findings suggest that the reordered cortico-muscular and cortical-networks in the beta band may represent an early physiological readjustment related to MRgFUS Vim lesion.
    Language English
    Publishing date 2024-03-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2024.1362712
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The gut microbiome in Parkinson's disease: A culprit or a bystander?

    Keshavarzian, Ali / Engen, Phillip / Bonvegna, Salvatore / Cilia, Roberto

    Progress in brain research

    2020  Volume 252, Page(s) 357–450

    Abstract: In recent years, large-scale metagenomics projects such as the Human Microbiome Project placed the gut microbiota under the spotlight of research on its role in health and in the pathogenesis several diseases, as it can be a target for novel ... ...

    Abstract In recent years, large-scale metagenomics projects such as the Human Microbiome Project placed the gut microbiota under the spotlight of research on its role in health and in the pathogenesis several diseases, as it can be a target for novel therapeutical approaches. The emerging concept of a microbiota modulation of the gut-brain axis in the pathogenesis of neurodegenerative disorders has been explored in several studies in animal models, as well as in human subjects. Particularly, research on changes in the composition of gut microbiota as a potential trigger for alpha-synuclein (α-syn) pathology in Parkinson's disease (PD) has gained increasing interest. In the present review, we first provide the basis to the understanding of the role of gut microbiota in healthy subjects and the molecular basis of the gut-brain interaction, focusing on metabolic and neuroinflammatory factors that could trigger the alpha-synuclein conformational changes and aggregation. Then, we critically explored preclinical and clinical studies reporting on the changes in gut microbiota in PD, as compared to healthy subjects. Furthermore, we examined the relationship between the gut microbiota and PD clinical features, discussing data consistently reported across studies, as well as the potential sources of inconsistencies. As a further step toward understanding the effects of gut microbiota on PD, we discussed the relationship between dysbiosis and response to dopamine replacement therapy, focusing on Levodopa metabolism. We conclude that further studies are needed to determine whether the gut microbiota changes observed so far in PD patients is the cause or, instead, it is merely a consequence of lifestyle changes associated with the disease. Regardless, studies so far strongly suggest that changes in microbiota appears to be impactful in pathogenesis of neuroinflammation. Thus, dysbiotic microbiota in PD could influence the disease course and response to medication, especially Levodopa. Future research will assess the impact of microbiota-directed therapeutic intervention in PD patients.
    MeSH term(s) Animals ; Dopamine Agents/pharmacology ; Dysbiosis/immunology ; Dysbiosis/metabolism ; Dysbiosis/microbiology ; Gastrointestinal Microbiome/immunology ; Humans ; Inflammation/immunology ; Inflammation/metabolism ; Inflammation/microbiology ; Life Style ; Parkinson Disease/drug therapy ; Parkinson Disease/immunology ; Parkinson Disease/metabolism ; Parkinson Disease/microbiology ; alpha-Synuclein/metabolism
    Chemical Substances Dopamine Agents ; alpha-Synuclein
    Language English
    Publishing date 2020-03-05
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ISSN 1875-7855 ; 0079-6123
    ISSN (online) 1875-7855
    ISSN 0079-6123
    DOI 10.1016/bs.pbr.2020.01.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Mucuna pruriens to treat Parkinson's disease in low-income countries: Recommendations and practical guidelines from the farmer to clinical trials. Paving the way for future use in clinical practice.

    Caronni, Serena / Del Sorbo, Francesca / Barichella, Michela / Fothergill-Misbah, Natasha / Denne, Tanya / Laguna, Janeth / Urasa, Sarah / Dekker, Marieke C J / Akpalu, Albert / Sarfo, Fred Stephen / Cham, Momodou / Pezzoli, Gianni / Cilia, Roberto

    Parkinsonism & related disorders

    2024  , Page(s) 106983

    Abstract: Parkinson's disease (PD) is a progressive and disabling neurodegenerative disease that rapidly worsens and results in premature mortality if left untreated. Although levodopa is the gold standard treatment for PD globally, its accessibility and ... ...

    Abstract Parkinson's disease (PD) is a progressive and disabling neurodegenerative disease that rapidly worsens and results in premature mortality if left untreated. Although levodopa is the gold standard treatment for PD globally, its accessibility and affordability are severely limited in low- and middle-income countries worldwide. In this scenario, Mucuna pruriens (MP), a leguminous plant growing wild in tropical regions, emerges as a potential alternative or adjunct to levodopa-based medications due to its cost-effectiveness and global natural availability. Recent studies have demonstrated that MP can significantly ameliorate motor symptoms, although tolerability may vary. The proposition that MP could play a pivotal role in providing affordable and symptomatic relief for PD in low- and middle-income countries is grounded in its promising therapeutic profile, yet caution is warranted until more comprehensive data on the long-term safety and efficacy of MP become available. This manuscript summarizes the knowledge gained about MP by the authors, focusing on how to cultivate, store, and provide it to patients in the safest and most effective way in clinical trials. We aim to increase clinical trials investigating its safety and efficacy in PD, before promoting individual use of MP on a global scale, particularly in countries where availability and affordability of levodopa-based medications is still limited.
    Language English
    Publishing date 2024-05-08
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2024.106983
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Telemedicine for parkinsonism: A two-step model based on the COVID-19 experience in Milan, Italy.

    Cilia, Roberto / Mancini, Francesca / Bloem, Bastiaan R / Eleopra, Roberto

    Parkinsonism & related disorders

    2020  Volume 75, Page(s) 130–132

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Neurologists/trends ; Pandemics/prevention & control ; Parkinsonian Disorders/diagnosis ; Parkinsonian Disorders/epidemiology ; Parkinsonian Disorders/therapy ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; SARS-CoV-2 ; Telemedicine/methods ; Telemedicine/trends ; Telenursing/methods ; Telenursing/trends ; Triage/methods ; Triage/trends
    Keywords covid19
    Language English
    Publishing date 2020-06-10
    Publishing country England
    Document type Letter
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2020.05.038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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