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Article ; Online: Psychiatrists’ attitudes towards functional neurological disorders

Angela Marotta / Antonio Lasalvia / Mirta Fiorio / Enrico Zanalda / Guido Di Sciascio / Claudia Palumbo / Davide Papola / Corrado Barbui / Michele Tinazzi

Frontiers in Psychiatry, Vol

results from a national survey

2023 Volume 14

Abstract: IntroductionFunctional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists can ...

Abstract	IntroductionFunctional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists can play an essential role in diagnosing and managing these disorders. Hence, understanding their opinion and clinical experience with FND is of utmost importance to catch potential educational needs and improve healthcare services for patients. This study aims at assessing the knowledge, opinion, and clinical approach of Italian psychiatrists to FND.MethodsMembers of the Italian Society of Psychiatry completed a 14-item web-based survey investigating their approach to FND. Results. Overall, 174 questionnaires were completed. Our main findings suggest that Italian psychiatrists have a psychogenetic conceptualization of FND. “Conversion disorders”, in fact, is the term most frequently used by Italian psychiatrists to refer to FND, thus implying a psychological etiology of these disorders. Congruently with this view, psychotherapy associated with pharmacological therapy is considered the most appropriate treatment by psychiatrists, while physiotherapy is an under-recognized treatment option for FND.DiscussionThe present study highlights that a psychogenetic view of FND dominates among Italian psychiatrists. This could be due to out-of-date knowledge about the pathophysiology of this group of disorders. Promoting education about novel approaches to FND would be of crucial importance to improving care for patients suffering from this condition.
Keywords	functional neurological disorders ; conversion disorders ; psychosomatic medicine ; psychiatric practice ; education ; survey ; Psychiatry ; RC435-571
Subject code	150
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Age-related changes in the sense of body ownership

Angela Marotta / Massimiliano Zampini / Michele Tinazzi / Mirta Fiorio

PLoS ONE, Vol 13, Iss 11, p e

New insights from the rubber hand illusion.

2018 Volume 0207528

Abstract: How do age-related changes affect the sense of body ownership? This study tackles this issue by means of the rubber hand illusion (RHI), a widely used experimental tool for investigating the sense of body ownership. There is ample literature on the RHI ... ...

Abstract	How do age-related changes affect the sense of body ownership? This study tackles this issue by means of the rubber hand illusion (RHI), a widely used experimental tool for investigating the sense of body ownership. There is ample literature on the RHI in young populations, but research on age-related changes in the RHI is still scarce. Here we extend the use of the RHI to examine the changes in the sense of body ownership related to healthy aging. Subjective reports (i.e., questionnaire) and proprioceptive drift were compared among young (n = 22, age range 20-22 years), middle-aged (n = 22, age range 44-55 years), and older adults (n = 22, age range 60-72 years). A stronger subjective experience of illusion was observed in the young and older adults as compared to the middle-aged. No differences in proprioceptive drift were found between the three groups. These findings are discussed in relation to: 1) different stages of development of perceptual and cognitive components of the sense of body ownership, and 2) compensatory mechanisms.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Treating Patients Like Athletes

Raquel Bouça-Machado / Massimo Venturelli / Michele Tinazzi / Federico Schena / Joaquim J. Ferreira

Frontiers in Neurology, Vol

Sports Science Applied to Parkinson's Disease

2020 Volume 11

Abstract: The evidence demonstrating the benefits of exercise is indisputable for healthy subjects, and more recently, it is growing for Parkinson's disease (PD) patients. Due to its easy access, low cost, social facilitation and, above all, the symptomatic effect, ...

Abstract	The evidence demonstrating the benefits of exercise is indisputable for healthy subjects, and more recently, it is growing for Parkinson's disease (PD) patients. Due to its easy access, low cost, social facilitation and, above all, the symptomatic effect, clinical exercise may have a profound impact on PD management. Especially considering that in recent decades there have been no major advances from the pharmacological point of view. Despite this, clinical exercise use it stills limited by the existent flaws in the available evidence supporting its use and guiding its prescription as a PD therapeutic intervention. We believe that a approach from the most relevant scientific and clinical fields is crucial to establish the use of clinical exercise in PD patients' routine care. Therefore, in this viewpoint, we aim to highlight the importance of clinical exercise as a therapeutic intervention in PD, and particularly of the benefits of applying sports science principles to potentiate the use of clinical exercise as a therapeutic intervention in PD management.
Keywords	Parkinson's disease ; exercise ; principles of training ; sport science ; disease management ; integrated care ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	796
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Judging the position of the artificial hand induces a “visual” drift towards the real one during the rubber hand illusion

Roberto Erro / Angela Marotta / Michele Tinazzi / Elena Frera / Mirta Fiorio

Scientific Reports, Vol 8, Iss 1, Pp 1-

2018 Volume 10

Abstract: Abstract When subjects look at a rubber hand being brush-stroked synchronously with their own hidden hand, they might feel a sense of ownership over the rubber hand. The perceived mislocalization of the own hand towards the rubber hand (proprioceptive ... ...

Abstract	Abstract When subjects look at a rubber hand being brush-stroked synchronously with their own hidden hand, they might feel a sense of ownership over the rubber hand. The perceived mislocalization of the own hand towards the rubber hand (proprioceptive drift) would reflect an implicit marker of this illusion occurring through the dominance of vision over proprioception. This account, however, contrasts with principles of multisensory integration whereby percepts result from a “statistical sum” of different sensory afferents. In this case, the most-known proprioceptive drift should be mirrored by complementary visual drift of the rubber hand in the opposite direction. We investigated this issue by designing two experiments in which subjects were not only requested to localize their own hand but also the rubber hand and further explored the subjective feeling of the illusion. In both experiments, we demonstrated a (visual) drift in the opposite direction of the proprioceptive drift, suggesting that both hands converge toward each other. This might suggest that the spatial representations of the two hands are integrated in a common percept placed in between them, contradicting previous accounts of substitution of the real hand by the rubber hand.
Keywords	Medicine ; R ; Science ; Q
Subject code	390
Language	English
Publishing date	2018-02-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease

Valentina Varalta / Paola Poiese / Serena Recchia / Barbara Montagnana / Cristina Fonte / Mirko Filippetti / Michele Tinazzi / Nicola Smania / Alessandro Picelli

Journal of Personalized Medicine, Vol 11, Iss 687, p

A Pilot Randomized Cross-Over Study

2021 Volume 687

Abstract: Background: Parkinson’s disease (PD) is characterized by motor and cognitive dysfunctions that can usually be treated by physiotherapy or cognitive training, respectively. The effects of consecutive physiotherapy and cognitive rehabilitation programs on ... ...

Abstract	Background: Parkinson’s disease (PD) is characterized by motor and cognitive dysfunctions that can usually be treated by physiotherapy or cognitive training, respectively. The effects of consecutive physiotherapy and cognitive rehabilitation programs on PD deficits are less investigated. Objective: We investigated the effects of 3 months of physiotherapy (physiotherapy treatment group) or consecutive physiotherapy and cognitive (physiotherapy and cognitive treatment group) rehabilitation programs on cognitive, motor, and psychological aspects in 20 PD patients. Methods: The two groups switched programs and continued rehabilitation for another 3 months. The outcomes were score improvement on cognitive (Montreal Cognitive Assessment, Frontal Assessment Battery, Trail Making Test, Verbal Phonemic Fluency, Digit Span, and Rey Auditory Verbal Learning), motor (Unified Parkinson’s Disease Rating Scale-III, Berg Balance Scale, Two-Minute Walking Test, and Time Up and Go), and psychological (Beck Depression Inventory and State-Trait Anxiety Inventory) scales. Results: Between-group comparison revealed a significant difference in functional mobility between the two rehabilitation programs. Improvements in walking abilities were noted after both interventions, but only the patients treated with consecutive training showed better performance on functional mobility and memory tasks. Conclusion: Our findings support the hypothesis that consecutive physiotherapy plus cognitive rehabilitation may have a greater benefit than physiotherapy alone in patients with PD.
Keywords	rehabilitation ; cognition ; movement disorders ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Positive verbal suggestion optimizes postural control

Bernardo Villa-Sánchez / Mehran Emadi Andani / Giulia Menegaldo / Michele Tinazzi / Mirta Fiorio

Scientific Reports, Vol 9, Iss 1, Pp 1-

2019 Volume 10

Abstract: Abstract Balance is a very important function that allows maintaining a stable stance needed for many daily life activities and for preventing falls. We investigated whether balance control could be improved by a placebo procedure consisting of verbal ... ...

Abstract	Abstract Balance is a very important function that allows maintaining a stable stance needed for many daily life activities and for preventing falls. We investigated whether balance control could be improved by a placebo procedure consisting of verbal suggestion. Thirty healthy volunteers were randomized in two groups (placebo and control) and asked to perform a single-leg stance task in which they had to stand as steadily as possible on the dominant leg. The task was repeated in three sessions (T0, T1, T2). At T1 and T2 an inert treatment was applied on the leg, by informing the placebo group that it was effective in improving balance. The control group was overtly told that treatment was inert. An accelerometer applied on participants’ leg allowed to measure body sways in different directions. Subjective parameters, like perception of stability, were also collected. Results showed that the placebo group had less body sways than the control group at T2, both in the three-dimensional space and in the anterior-posterior direction. Furthermore, the placebo group perceived to be more stable than the control group. This study represents the first evidence that placebo effect optimizes posture, with a potential translational impact in patients with postural and gait disturbances.
Keywords	Medicine ; R ; Science ; Q
Subject code	150 ; 796
Language	English
Publishing date	2019-04-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The placebo effect in the motor domain is differently modulated by the external and internal focus of attention

Giacomo Rossettini / Mehran Emadi Andani / Francesco Dalla Negra / Marco Testa / Michele Tinazzi / Mirta Fiorio

Scientific Reports, Vol 8, Iss 1, Pp 1-

2018 Volume 14

Abstract: Abstract Among the cognitive strategies that can facilitate motor performance in sport and physical practice, a prominent role is played by the direction of the focus of attention and the placebo effect. Consistent evidence converges in indicating that ... ...

Abstract	Abstract Among the cognitive strategies that can facilitate motor performance in sport and physical practice, a prominent role is played by the direction of the focus of attention and the placebo effect. Consistent evidence converges in indicating that these two cognitive functions can influence the motor outcome, although no study up-to-now tried to study them together in the motor domain. In this explorative study, we combine for the first time these approaches, by applying a placebo procedure to increase force and by manipulating the focus of attention with explicit verbal instructions. Sixty healthy volunteers were asked to perform abduction movements with the index finger as strongly as possible against a piston and attention could be directed either toward the movements of the finger (internal focus, IF) or toward the movements of the piston (external focus, EF). Participants were randomized in 4 groups: two groups underwent a placebo procedure (Placebo-IF and Placebo-EF), in which an inert treatment was applied on the finger with verbal information on its positive effects on force; two groups underwent a control procedure (Control-IF and Control-EF), in which the same treatment was applied with overt information about its inefficacy. The placebo groups were conditioned about the effects of the treatment with a surreptitious amplification of a visual feedback signalling the level of force. During the whole procedure, we recorded actual force, subjective variables and electromyography from the hand muscles. The Placebo-IF group had higher force levels after the procedure than before, whereas the Placebo-EF group had a decrease of force. Electromyography showed that the Placebo-IF group increased the muscle units recruitment without changing the firing rate. These findings show for the first time that the placebo effect in motor performance can be influenced by the subject’s attentional focus, being enhanced with the internal focus of attention.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2018-08-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Individual Differences in the Rubber Hand Illusion Are Related to Sensory Suggestibility.

Angela Marotta / Michele Tinazzi / Clelia Cavedini / Massimiliano Zampini / Mirta Fiorio

PLoS ONE, Vol 11, Iss 12, p e

2016 Volume 0168489

Abstract: In the rubber hand illusion (RHI), watching a rubber hand being stroked in synchrony with one's own hidden hand may induce a sense of ownership over the rubber hand. The illusion relies on bottom-up multisensory integration of visual, tactile, and ... ...

Abstract	In the rubber hand illusion (RHI), watching a rubber hand being stroked in synchrony with one's own hidden hand may induce a sense of ownership over the rubber hand. The illusion relies on bottom-up multisensory integration of visual, tactile, and proprioceptive information, and on top-down processes through which the rubber hand is incorporated into pre-existing representations of the body. Although the degree of illusory experience varies largely across individuals, the factors influencing individual differences are unknown. We investigated whether sensory suggestibility might modulate susceptibility to the RHI. Sensory suggestibility is a personality trait related to how individuals react to sensory information. Because of its sensory nature, this trait could be relevant for studies using the RHI paradigm. Seventy healthy volunteers were classified by Sensory Suggestibility Scale (SSS) scores as having high or low suggestibility and assigned to either a high- (High-SSS) or a low-suggestibility (Low-SSS) group. Two components of the RHI were evaluated in synchronous and asynchronous stroking conditions: subjective experience of sense of ownership over the rubber hand via a 9-statement questionnaire, and proprioceptive drift as measured with a ruler. The High-SSS group was generally more susceptible to the subjective component; in the synchronous condition, they rated the statement assessing the sense of ownership higher than the Low-SSS group. The scores for this statement significantly correlated with the total SSS score, indicating that the higher the sensory suggestibility, the stronger the sense of ownership. No effect of sensory suggestibility on proprioceptive drift was observed, suggesting that the effect is specific for the subjective feeling of ownership. This study demonstrates that sensory suggestibility may contribute to participants' experience of the illusion and should be considered when using the RHI paradigm.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Modulation of inhibitory corticospinal circuits induced by a nocebo procedure in motor performance.

Mehran Emadi Andani / Michele Tinazzi / Nicole Corsi / Mirta Fiorio

PLoS ONE, Vol 10, Iss 4, p e

2015 Volume 0125223

Abstract: As recently demonstrated, a placebo procedure in motor performance increases force production and changes the excitability of the corticospinal system, by enhancing the amplitude of the motor evoked potentials (MEP) and reducing the duration of the ... ...

Abstract	As recently demonstrated, a placebo procedure in motor performance increases force production and changes the excitability of the corticospinal system, by enhancing the amplitude of the motor evoked potentials (MEP) and reducing the duration of the cortical silent period (CSP). However, it is not clear whether these neurophysiological changes are related to the behavioural outcome (increased force) or to a general effect of expectation. To clarify this, we investigated the nocebo effect, in which the induced expectation decreases force production. Two groups of healthy volunteers (experimental and control) performed a motor task by pressing a piston with the right index finger. To induce a nocebo effect in the experimental group, low frequency transcutaneous electrical nerve stimulation (TENS) was applied over the index finger with instructions of its detrimental effects on force. To condition the subjects, the visual feedback on their force level was surreptitiously reduced after TENS. Results showed that the experimental group reduced the force, felt weaker and expected a worse performance than the control group, who was not suggested about TENS. By applying transcranial magnetic stimulation over the primary motor cortex, we found that while MEP amplitude remained stable throughout the procedure in both groups, the CSP duration was shorter in the experimental group after the nocebo procedure. The CSP reduction resembled previous findings on the placebo effect, suggesting that expectation of change in performance diminishes the inhibitory activation of the primary motor cortex, independently of the behavioural outcome.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Aristotle's illusion in Parkinson's disease

Mirta Fiorio / Angela Marotta / Sarah Ottaviani / Lara Pozzer / Michele Tinazzi

PLoS ONE, Vol 9, Iss 2, p e

evidence for normal interdigit tactile perception.

2014 Volume 88686

Abstract: Sensory alterations, a common feature of such movement disorders as Parkinson's disease (PD) and dystonia, could emerge as epiphenomena of basal ganglia dysfunction. Recently, we found a selective reduction of tactile perception (Aristotle's illusion, ... ...

Abstract	Sensory alterations, a common feature of such movement disorders as Parkinson's disease (PD) and dystonia, could emerge as epiphenomena of basal ganglia dysfunction. Recently, we found a selective reduction of tactile perception (Aristotle's illusion, the illusory doubling sensation of one object when touched with crossed fingers) in the affected hand of patients with focal hand dystonia. This suggests that reduced tactile illusion might be a specific feature of this type of dystonia and could be due to abnormal somatosensory cortical activation. The aim of the current study was to investigate whether Aristotle's illusion is reduced in the affected hand of patients with PD. We tested 15 PD patients, in whom motor symptoms were mainly localised to one side of the body, and 15 healthy controls. Three pairs of fingers were tested in crossed (evoking the illusion) or parallel position (not evoking the illusion). A sphere was placed in the contact point between the two fingers and the blindfolded participants had to say whether they felt one or two stimuli. Stimuli were applied on the affected and less or unaffected side of the PD patients. We found no difference in illusory perception between the PD patients and the controls, nor between the more affected and less/unaffected side, suggesting that Aristotle's illusion is preserved in PD. The retained tactile illusion in PD and its reduction in focal hand dystonia suggest that the basal ganglia, which are dysfunctional in both PD and dystonia, may not be causally involved in this function. Instead, the level of activation between digits in the somatosensory cortex may be more directly involved. Finally, the similar percentage of illusion in the more affected and less or unaffected body sides indicates that the illusory perception is not influenced by the presence or amount of motor symptoms.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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