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Article ; Online: Dihydroergotamine mesylate nasal spray: an acute treatment option for migraine in adults.

Silvestro, Marcello / Orologio, Ilaria / Tessitore, Alessandro / Trojsi, Francesca / Tedeschi, Gioacchino / Russo, Antonio

Expert review of neurotherapeutics

2024 , Page(s) 1–10

Abstract: Introduction: Although the landscape of migraine symptomatic treatment has been enriched by novel effective drugs, it is mandatory to critically reappraise older molecules to ascertain whether they could still represent reliable alternatives in specific ...

Abstract	Introduction: Although the landscape of migraine symptomatic treatment has been enriched by novel effective drugs, it is mandatory to critically reappraise older molecules to ascertain whether they could still represent reliable alternatives in specific endophenotypes of patients or migraine attacks. Among these, dihydroergotamine (DHE) nasal spray has been shown to be effective and is characterized by greater tolerability and manageability than the parenteral DHE formulation. Areas covered: In this narrative review, the authors describe the pharmacodynamic and pharmacokinetic properties of DHE nasal spray and explore the results of the trials which explored its efficacy, safety and tolerability as migraine symptomatic treatment. They also discuss the limitations of the classically used device and the attempts that several companies are carrying out to generate devices warranting a more reproducible drug absorption. Expert opinion: DHE nasal spray could be considered as rescue treatment in patients who have failed other symptomatic therapeutic strategies. Nevertheless, in the perspective of tailored therapy, the intranasal route of administration and the consequent rapid onset of action may represent benefits putatively making DHE a treatment of choice for challenging migraine attacks such as those with nocturnal onset or quickly reaching the climax of both headache and neurovegetative associated symptoms.
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2112534-X
ISSN	1744-8360 ; 1473-7175
ISSN (online)	1744-8360
ISSN	1473-7175
DOI	10.1080/14737175.2024.2342446
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Article ; Online: Emerging drugs for the preventive treatment of migraine: a review of CGRP monoclonal antibodies and gepants trials.

Silvestro, Marcello / Orologio, Ilaria / Siciliano, Mattia / Trojsi, Francesca / Tessitore, Alessandro / Tedeschi, Gioacchino / Russo, Antonio

Expert opinion on emerging drugs

2023 Volume 28, Issue 2, Page(s) 79–96

Abstract: Introduction: Migraine is a leading cause of years lived with disability and preventive strategies represent a mainstay to reduce health-related disability and improve quality of life of migraine patients. Until a few years ago, migraine prevention was ... ...

Abstract	Introduction: Migraine is a leading cause of years lived with disability and preventive strategies represent a mainstay to reduce health-related disability and improve quality of life of migraine patients. Until a few years ago, migraine prevention was based on drugs developed for other clinical indications and relocated in the migraine therapeutic armamentarium, characterized by unfavorable tolerability profiles. The advent of monoclonal antibodies against Calcitonin Gene-Related Peptide (CGRP) and gepants, CGRP receptor antagonists, has been a turning point in migraine prevention owing to advantageous efficacy, safety and tolerability profiles.Nevertheless, while in an ideal scenario a drug characterized by significant greater efficacy and tolerability compared to existing therapeutic strategies should be adopted as a first-line treatment, cost-effectiveness analyses available for monoclonal antibodies against CGRP pathway tend to limit their administration to more severe migraine phenotypes. Areas covered: The present narrative review aims to provide a critical appraisal of phase II and III CGRP-mAbs and gepants trials to analyze their use in clinical practice. Expert opinion: Despite monoclonal antibodies against CGRP pathway and gepants can be undoubtedly considered top-of-the-range treatments, there are still issues deserving to be addressed in the coming years as the risk of off-target effects as well as their economic sustainability based on the considerable migraine burden.
MeSH term(s)	Humans ; Calcitonin Gene-Related Peptide/metabolism ; Calcitonin Gene-Related Peptide Receptor Antagonists/pharmacology ; Calcitonin Gene-Related Peptide Receptor Antagonists/therapeutic use ; Antibodies, Monoclonal/adverse effects ; Pharmaceutical Preparations ; Quality of Life ; Migraine Disorders/drug therapy ; Migraine Disorders/prevention & control
Chemical Substances	Calcitonin Gene-Related Peptide (JHB2QIZ69Z) ; Calcitonin Gene-Related Peptide Receptor Antagonists ; Antibodies, Monoclonal ; Pharmaceutical Preparations
Language	English
Publishing date	2023-04-28
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2061369-6
ISSN	1744-7623 ; 1472-8214
ISSN (online)	1744-7623
ISSN	1472-8214
DOI	10.1080/14728214.2023.2207819
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Article ; Online: Effectiveness and safety of CGRP monoclonal antibodies in migraine related to mitochondrial diseases in patients with NARP and PEO syndromes.

Silvestro, Marcello / Orologio, Ilaria / Trojsi, Francesca / Tessitore, Alessandro / Tedeschi, Gioacchino / Russo, Antonio

Clinical neurology and neurosurgery

2023 Volume 226, Page(s) 107611

MeSH term(s)	Humans ; Antibodies, Monoclonal ; Calcitonin Gene-Related Peptide ; Syndrome ; Migraine Disorders ; Mitochondrial Diseases
Chemical Substances	Antibodies, Monoclonal ; Calcitonin Gene-Related Peptide (JHB2QIZ69Z)
Language	English
Publishing date	2023-01-27
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107611
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Article ; Online: Selective degeneration of amygdalar nuclei in amyotrophic lateral sclerosis.

Trojsi, Francesca / Siciliano, Mattia / Tedeschi, Gioacchino

Journal of the neurological sciences

2020 Volume 417, Page(s) 117038

MeSH term(s)	Amygdala ; Amyotrophic Lateral Sclerosis ; Humans ; Motor Neuron Disease
Language	English
Publishing date	2020-07-16
Publishing country	Netherlands
Document type	Editorial ; Comment
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2020.117038
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Article ; Online: Digital triage for people with multiple sclerosis in the age of COVID-19 pandemic.

Bonavita, Simona / Tedeschi, Gioacchino / Atreja, Ashish / Lavorgna, Luigi

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

2020 Volume 41, Issue 5, Page(s) 1007–1009

Abstract: We propose a possible approach for the remote monitoring of infection risk in people with multiple sclerosis, especially those on immunosuppressant drugs, during COVID-19 pandemic. We developed a digital triage tool to be sent to patients to quickly ... ...

Abstract	We propose a possible approach for the remote monitoring of infection risk in people with multiple sclerosis, especially those on immunosuppressant drugs, during COVID-19 pandemic. We developed a digital triage tool to be sent to patients to quickly identify people with high risk of COVID-19 infection. This tool will also limit unnecessary accesses to the MS centers reducing the risk of spreading the infection.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Diagnostic Tests, Routine ; Disease Outbreaks ; Humans ; Immunocompromised Host ; Multiple Sclerosis/complications ; Multiple Sclerosis/therapy ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Practice Guidelines as Topic ; SARS-CoV-2 ; Telemedicine ; Triage
Keywords	covid19
Language	English
Publishing date	2020-04-17
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/s10072-020-04391-9
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Article ; Online: Migraine in the Time of COVID-19.

Silvestro, Marcello / Tessitore, Alessandro / Tedeschi, Gioacchino / Russo, Antonio

Headache

2020 Volume 60, Issue 5, Page(s) 988–989

MeSH term(s)	COVID-19 ; Coronavirus Infections/epidemiology ; Humans ; Migraine Disorders/therapy ; Pandemics ; Pneumonia, Viral/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-04-08
Publishing country	United States
Document type	Letter
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.13803
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Article: Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis.

Ricciardi, Dario / Amitrano, Federica / Coccia, Armando / Todisco, Vincenzo / Trojsi, Francesca / Tedeschi, Gioacchino / Cirillo, Giovanni

Brain sciences

2022 Volume 12, Issue 11

Abstract: In this work, we aim to identify sensitive neurophysiological biomarkers of axonal degeneration in CIDP patients. A total of 16 CIDP patients, fulfilling the clinical and neurophysiological criteria for typical CIDP, treated with subcutaneous ... ...

Abstract	In this work, we aim to identify sensitive neurophysiological biomarkers of axonal degeneration in CIDP patients. A total of 16 CIDP patients, fulfilling the clinical and neurophysiological criteria for typical CIDP, treated with subcutaneous immunoglobulin (ScIg) (0.4 g/kg/week) were evaluated at baseline (before ScIg treatment) and after long-term treatment with ScIg (24 months) by clinical assessment scales, nerve conduction studies (NCS) and electromyography (EMG). Conventional and non-conventional neurophysiological parameters: motor unit potential (MUP) analysis, MUP thickness and size index (SI)] and interference pattern (IP) features were evaluated after long-term treatment (24 months) and compared with a population of 16 healthy controls (HC). An increase of distal motor latency (DML) and reduced compound motor action potential (CMAP) amplitude and area in CIDP patients suggest axonal damage of motor fibers, together with a significant increase of MUP amplitude, duration and area. Analysis of non-conventional MUP parameters shows no difference for MUP thickness; however, in CIDP patients, SI is increased and IP area and amplitude values are lower than HC. Despite clinical and neurophysiological improvement after ScIg treatment, neurophysiological analysis revealed axonal degeneration of motor fibers and motor unit remodeling. Correlation analysis shows that the axonal degeneration process is related to the diagnostic and therapeutic delay. MUP area and SI parameters can detect early signs of axonal degeneration, and their introduction in clinical practice may help to identify patients with the worst outcome.
Language	English
Publishing date	2022-11-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci12111510
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Article ; Online: Explaining neural activity in human listeners with deep learning via natural language processing of narrative text.

Russo, Andrea G / Ciarlo, Assunta / Ponticorvo, Sara / Di Salle, Francesco / Tedeschi, Gioacchino / Esposito, Fabrizio

Scientific reports

2022 Volume 12, Issue 1, Page(s) 17838

Abstract: Deep learning (DL) approaches may also inform the analysis of human brain activity. Here, a state-of-art DL tool for natural language processing, the Generative Pre-trained Transformer version 2 (GPT-2), is shown to generate meaningful neural encodings ... ...

Abstract	Deep learning (DL) approaches may also inform the analysis of human brain activity. Here, a state-of-art DL tool for natural language processing, the Generative Pre-trained Transformer version 2 (GPT-2), is shown to generate meaningful neural encodings in functional MRI during narrative listening. Linguistic features of word unpredictability (surprisal) and contextual importance (saliency) were derived from the GPT-2 applied to the text of a 12-min narrative. Segments of variable duration (from 15 to 90 s) defined the context for the next word, resulting in different sets of neural predictors for functional MRI signals recorded in 27 healthy listeners of the narrative. GPT-2 surprisal, estimating word prediction errors from the artificial network, significantly explained the neural data in superior and middle temporal gyri (bilaterally), in anterior and posterior cingulate cortices, and in the left prefrontal cortex. GPT-2 saliency, weighing the importance of context words, significantly explained the neural data for longer segments in left superior and middle temporal gyri. These results add novel support to the use of DL tools in the search for neural encodings in functional MRI. A DL language model like the GPT-2 may feature useful data about neural processes subserving language comprehension in humans, including next-word context-related prediction.
MeSH term(s)	Humans ; Brain Mapping ; Comprehension ; Brain/diagnostic imaging ; Natural Language Processing ; Deep Learning ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2022-10-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-21782-4
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Article ; Online: Cluster headache pathophysiology: What we have learned from advanced neuroimaging.

Silvestro, Marcello / Tessitore, Alessandro / Orologio, Ilaria / Battista, Giorgia / Siciliano, Mattia / Tedeschi, Gioacchino / Russo, Antonio

Headache

2022 Volume 62, Issue 4, Page(s) 436–452

Abstract: Background: Although remarkable progress has been achieved in understanding cluster headache (CH) pathophysiology, there are still several gaps about the mechanisms through which independent subcortical and cortical brain structures interact with each ... ...

Abstract	Background: Although remarkable progress has been achieved in understanding cluster headache (CH) pathophysiology, there are still several gaps about the mechanisms through which independent subcortical and cortical brain structures interact with each other. These gaps could be partially elucidated by structural and functional advanced neuroimaging investigations. Objective: Although we are aware that substantial achievements have come from preclinical, neurophysiological, and biochemical experiments, the present narrative review aims to summarize the most significant findings from structural, microstructural, and functional neuroimaging investigations, as well as the consequent progresses in understanding CH pathophysiological mechanisms, to achieve a comprehensive and unifying model. Results: Advanced neuroimaging techniques have contributed to overcoming the peripheral hypothesis that CH is of cavernous sinus pathology, in transitioning from the pure vascular hypothesis to a more comprehensive trigeminovascular model, and, above all, in clarifying the role of the hypothalamus and its connections in the genesis of CH. Conclusion: Altogether, neuroimaging findings strongly suggest that, beyond the theoretical model of the "pain matrix," the model of the "neurolimbic pain network" that is accepted in migraine research could also be extended to CH. Indeed, although the hypothalamus' role is undeniable, the genesis of CH attacks is complex and seems to not be just the result of a single "generator." Cortical-hypothalamic-brainstem functional interconnections that can switch between out-of-bout and in-bout periods, igniting the trigeminovascular system (probably by means of top-down mechanisms) and the consensual trigeminal autonomic reflexes, may represent the "neuronal background" of CH.
MeSH term(s)	Cluster Headache ; Functional Neuroimaging ; Humans ; Migraine Disorders ; Neuroimaging/methods ; Pain
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.14279
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Article: Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions-A Systematic Review.

Sharbafshaaer, Minoo / Gigi, Ilaria / Lavorgna, Luigi / Esposito, Sabrina / Bonavita, Simona / Tedeschi, Gioacchino / Esposito, Fabrizio / Trojsi, Francesca

Journal of clinical medicine

2023 Volume 12, Issue 19

Abstract: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known ... ...

Abstract	Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known about the effectiveness of rTMS intervention on different cognitive domains in patients with mild cognitive impairment (MCI) and to address potential neuromodulation approaches in combination with electroencephalography (EEG) and neuroimaging, especially functional magnetic resonance imaging (fMRI). In this systematic review, we consulted three main databases (PubMed, Science Direct, and Scopus), and Google Scholar was selected for the gray literature search. The PRISMA flowchart drove the studies' inclusion. The selection process ensured that only high-quality studies were included; after removing duplicate papers, explicit ratings were given based on the quality classification as high (A), moderate (B), or low (C), considering factors such as risks of bias, inaccuracies, inconsistencies, lack of direction, and publication bias. Seven full-text articles fulfilled the stated inclusion, reporting five double-blind, randomized, sham-controlled studies, a case study, and a randomized crossover trial. The results of the reviewed studies suggested that rTMS in MCI patients is safe and effective for enhancing cognitive functions, thus making it a potential therapeutic approach for MCI patients. Changes in functional connectivity within the default mode network (DMN) after targeted rTMS could represent a valuable indicator of treatment response. Finally, high-frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) has been shown to significantly enhance cognitive functions, such as executive performance, together with the increase of functional connectivity within frontoparietal networks. The main limitations were the number of included studies and the exclusion of studies using intermittent theta-burst stimulation, used in studies on Alzheimer's disease. Therefore, neuroimaging techniques in combination with rTMS have been shown to be useful for future network-based, fMRI-guided therapeutic approaches.
Language	English
Publishing date	2023-09-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12196190
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