Publications by authors named "Aglaia Vignoli"

Background: Immersive Virtual Reality (VR) could be a practical tool for supporting ADHD children in learning to manage their symptoms better. However, VR applications are often addressed to the adolescent/adult population only and few studies have applied VR in children with ADHD.

Objective: To evaluate the usability and acceptance of a custom-designed VR environment in children with ADHD and with neurotypical development.

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Objective: This study aimed to evaluate the efficacy and safety of adjunctive, highly purified Cannabidiol (Epidiolex®) in individuals with drug-resistant epilepsy (DRE) due to genetically determined typical Rett Syndrome (RTT) and CDKL5 Deficiency Disorder (CDD).

Methods: We recruited subjects with genetically confirmed typical RTT and CDD with drug-resistant seizures who received add-on treatment with highly purified Cannabidiol (CBD) through a national collaboration group. CBD treatment was titrated from 5 to 20 mg/kg/day; concurrent antiseizure medications (ASMs) could have been adjusted as clinically indicated.

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Objective: Patients with tuberous sclerosis complex (TSC), while considered genetically homogeneous, are clinically heterogeneous and present unique challenges for epilepsy surgery evaluation and treatment. Thus, the authors' goal was to identify factors associated with seizure outcomes in children with TSC who had undergone epilepsy surgery.

Methods: The PubMed, MEDLINE, Embase, CINAHL, and Web of Science databases were queried for relevant articles.

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Rett syndrome (RTT) is a severe, progressive, neurodevelopmental disorder, which affects predominantly females. In most cases, RTT is associated with pathogenic variants in MECP2. MeCP2, the protein product of MECP2, is known to regulate gene expression and is highly expressed in the brain.

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Purpose: We set out to characterize psychogenic non-epileptic seizures (PNES) in individuals with either intellectual disability (ID) or borderline intellectual function (BIF) in comparison to those with normal cognitive function. We aimed to identify differences between the two groups to improve clinical management protocols.

Methods: We conducted a retrospective, observational, single-center study.

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Background: Sleep is disturbed in Rett syndrome (RTT), a rare and progressive neurodevelopmental disorder primarily affecting female patients (prevalence 7.1/100,000 female patients) linked to pathogenic variations in the X-linked methyl-CpG-binding protein 2 () gene. Autonomic nervous system dysfunction with a predominance of the sympathetic nervous system (SNS) over the parasympathetic nervous system (PSNS) is reported in RTT, along with exercise fatigue and increased sudden death risk.

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Article Synopsis
  • - The study focuses on KBG syndrome (KBGS), a rare neurodevelopmental disorder caused by mutations in the ANKRD11 gene, exploring its clinical features in adults, which are less documented compared to children.
  • - Researchers collected data on 36 adults with confirmed KBGS from various families and found symptoms such as mild intellectual disabilities, motor difficulties, psychiatric issues, and other health concerns like seizures and vision problems.
  • - The findings reveal a diverse range of adult experiences and abilities related to education and employment, contributing to the understanding of long-term outcomes for individuals with KBGS.
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CDKL5 deficiency disorder (CDD) is a neurodevelopmental condition characterized by global developmental delay, early-onset seizures, intellectual disability, visual and motor impairments. Unlike Rett Syndrome (RTT), CDD lacks a clear regression period. Patients with CDD frequently encounter gastrointestinal (GI) disturbances and exhibit signs of subclinical immune dysregulation.

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Mannosyl-oligosaccharide glucosidase - congenital disorder of glycosylation (MOGS-CDG) is determined by biallelic mutations in the mannosyl-oligosaccharide glucosidase (glucosidase I) gene. MOGS-CDG is a rare disorder affecting the processing of N-Glycans (CDG type II) and is characterized by prominent neurological involvement including hypotonia, developmental delay, seizures and movement disorders. To the best of our knowledge, 30 patients with MOGS-CDG have been published so far.

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Background: Pallister-Killian syndrome (PKS) is a rare genetic disorder caused by mosaic tetrasomy of 12p with wide neurological involvement. Intellectual disability, developmental delay, behavioral problems, epilepsy, sleep disturbances, and brain malformations have been described in most individuals, with a broad phenotypic spectrum. This observational study, conducted through brain MRI scan analysis on a cohort of patients with genetically confirmed PKS, aims to systematically investigate the neuroradiological features of this syndrome and identify the possible existence of a typical pattern.

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Article Synopsis
  • Inherited glycosylphosphatidylinositol deficiency disorders (IGDs) are rare genetic conditions linked to pathogenic changes in GPI-AP genes, affecting multiple body systems and often presenting with severe neurological symptoms.
  • A study analyzed 83 individuals from 75 families with IGDs, revealing that core symptoms include developmental delays (90%), seizures (83%), and motor issues (64%), along with significant brain imaging findings like cerebral atrophy in 75% of cases.
  • The research highlights a wide range of phenotypic diversity, with no single dysmorphic feature being very common, and notes that individuals with certain genetic variants experience seizures earlier, indicating differences in prognosis based on genetic factors.
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Article Synopsis
  • * It can be classified based on its cause, distribution in the body, or the brain region involved, which helps determine observable patterns and treatment options.
  • * The review highlights myoclonus as often linked to epilepsy and aims to provide insights on its neurophysiology and classification, offering practical strategies for clinicians in diagnosis and treatment.
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The genetic causes of epilepsies and developmental and epileptic encephalopathies (DEE) with onset in early childhood are increasingly recognized. Their outcomes vary from benign to severe disability. In this paper, we wished to retrospectively review the clinical, genetic, EEG, neuroimaging, and outcome data of patients experiencing the onset of epilepsy in the first three years of life, diagnosed and followed up in four Italian epilepsy centres (Epilepsy Centre of San Paolo University Hospital in Milan, Child Neurology and Psychiatry Unit of AUSL-IRCCS di Reggio Emilia, Pediatric Neurology Unit of Vittore Buzzi Children's Hospital, Milan, and Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia).

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Article Synopsis
  • EEM is a generalized epilepsy marked by eyelid myoclonia and other symptoms, showing a potential genetic link which is under investigation.
  • A study involved 105 individuals with EEM, using whole exome sequencing to analyze genetic variants between two groups: those with isolated EEM (EEM-) and those with additional intellectual disabilities or psychiatric disorders (EEM+).
  • Findings revealed that pathogenic variants were predominantly in the CHD2 gene for the EEM+ group, suggesting a stronger genetic association with this subtype, while evidence for a connection in the EEM- group remains inconclusive.
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Objective: This study aimed to describe the intellectual profile based on the Wechsler Intelligence Scale for Children 4th edition (WISC-IV) in children with self-limited epilepsy with centrotemporal spikes (SeLECTS), with an attempt to define possible predictive epilepsy-related variables of cognitive performance.

Methods: The WISC-IV was assessed in 161 children with SeLECTS and their cognitive profiles were compared to a matched sample of healthy control children.

Results: Children with SeLECTS performed within normal range across all indices, demonstrating particular strength based on the Perceptual Reasoning Index.

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Article Synopsis
  • - The study examined the long-term effectiveness of perampanel (PER) as an additional treatment for patients with Lennox-Gastaut syndrome (LGS), focusing on treatment failure and seizure relapse rates in those who initially responded.
  • - Out of 87 patients, 59.8% experienced treatment failure after a median of 12 months, primarily due to lack of efficacy or tolerability, while slower titration of the drug was linked to a lower risk of failure.
  • - Of the initial responders, 36.1% experienced a seizure relapse after a median of 21 months, resulting in an overall seizure responder rate of 26.4% by the end of the study, providing insight into PER's real
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Background: People with epilepsy have a higher prevalence of behavioral and neuropsychiatric comorbidities compared to the general population and those with other chronic medical conditions, although the underlying clinical features remain unclear. The goal of the current study was to characterize behavioral profiles of adolescents with epilepsy, assess the presence of psychopathological disorders, and investigate the reciprocal interactions among epilepsy, psychological functioning, and their main clinical variables.

Methods: Sixty-three adolescents with epilepsy were consecutively recruited at the Epilepsy Center, Childhood and Adolescence Neuropsychiatry Unit of Santi Paolo e Carlo hospital in Milan (five of them were excluded) and assessed with a specific questionnaire for psychopathology in adolescence, such as the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD).

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  • Gelastic seizures are rare forms of epilepsy, often marked by laughter or smiles, primarily caused by hypothalamic hamartoma, although other brain lesions can also be involved.
  • A study of 16 patients found that most had laughter as the main seizure sign, with emotional laughter linked to lesions in the hypothalamic region, while mechanical laughter occurred in those with lesions elsewhere.
  • The findings suggest that emotional expressions during gelastic seizures, especially in children, are more likely tied to hypothalamic hamartoma, whereas less expressive laughter points to extra-hypothalamic issues.
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Rett syndrome caused by variants is characterized by a heterogenous clinical spectrum accounted for in 60% of cases by hot-spot variants. Focusing on the most frequent variants, we generated in vitro iPSC-neurons from the blood of RTT girls with p.Arg133Cys and p.

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Purpose: The worldwide pandemic caused by SARS-CoV-2 virus posed many challenges to the scientific and medical communities, including the protection and management of fragile populations. People with epilepsy (PWE) are a heterogenous group of subjects, with different treatment regimens and severity of symptoms. During the National lockdown, in Italy many patients with chronic conditions lost their regular follow-up program.

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Sydenham's chorea (SC) is a post-streptococcal autoimmune disorder of the central nervous system, and it is a major criterium for the diagnosis of acute rheumatic fever (ARF). SC typically improves in 12-15 weeks, but patients can be affected for years by persistence and recurrencies of both neurological and neuropsychiatric symptoms. We enrolled 48 patients with a previous diagnosis of ARF, with or without SC, in a national multicenter prospective study, to evaluate the presence of neuropsychiatric symptoms several years after SC's onset.

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Article Synopsis
  • The study focuses on adults with STXBP1-related developmental and epileptic encephalopathy (STXBP1-DEE), examining seizure types, movement disorders, and functional independence.
  • It included 30 adult patients with severe epilepsy; 80% had treatment-resistant seizures, and most exhibited significant developmental impairment and behavioral challenges.
  • Video assessments revealed gait and movement disorders in patients, with varying levels of mobility and a high prevalence of severe intellectual disability and autistic features.
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Background: The use of tele-rehabilitation in children was limited before the COVID-19 pandemic, due to culture, technology access, regulatory and reimbursement barriers.

Methods: The study was conducted according to the CHERRIES (Checklist for reporting results of internet E-surveys) guidelines in order to provide quantitative and qualitative data about experience of patients with disabilities and their caregivers during Phase 1 of the COVID-19 pandemic, and their level of satisfaction. An online survey was developed using Google Forms and sent via email.

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Article Synopsis
  • The study investigates the neurodevelopmental outcomes in patients with developmental and epileptic encephalopathy (DEE), focusing on the relationship between neurodevelopment and epilepsy.
  • Researchers analyzed clinical data from 48 patients and found that seizure onset age influences developmental progress, with later onset linked to better outcomes, while seizure duration and remission age did not significantly affect development.
  • The results highlight two main disease trajectories—either early seizure remission or drug-resistant epilepsy—suggesting a wide range of neurodevelopmental impacts and the need for more focused future research on DEE.
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