BACKGROUND: Olfactory function can be rapidly evaluated by means of standardized olfactory tests.... more BACKGROUND: Olfactory function can be rapidly evaluated by means of standardized olfactory tests. Multiple-choice smell identification tests can be conditioned by cultural background. To investigate a new tool for detecting olfactory deficit in Italian subjects we developed a multiple-choice identification test prepared with odorants belonging to the Italian culture. METHODS: The Italian Olfactory Identification Test (IOIT) was developed with 33 microencapsulated odorants with intensity of odors and headspace Gas Chromatography being tested. Test-retest reliability of the IOIT was evaluated. The IOIT was administered to 511 controls and 133 Parkinson's patients. RESULTS: In healthy subjects the number of IOIT errors increased with age for both females (p < 0.0001) and males (p < 0.0001), while in the Parkinson's disease group the number of IOIT errors was significantly greater where compared to healthy subjects (p < 0.0001 in all age groups). The reference limits applied to all age groups revealed an IOIT sensitivity of 93% and a specificity of 99%. The test-retest reliability was excellent. CONCLUSION: The IOIT is highly reliable, disposable, easy to administer, not fragile, and has a long shelf-life. All these features make the IOIT suitable for clinical use as well as for population screening and to discriminate…
To evaluate the prevalence of epilepsy syndromes in a district in Northwest Tuscany (Vecchiano, 9... more To evaluate the prevalence of epilepsy syndromes in a district in Northwest Tuscany (Vecchiano, 9,952 inhabitants) we identified all suspected cases (probable epilepsy) from several information sources: files of local doctors, prescriptions of antiepileptic drugs (AEDs), hospital files from the center for epilepsy at the University of Pisa, medical files from university and hospital departments in Pisa, and files of the school doctors and social workers in the district of Vecchiano. All persons suspected of having epilepsy were examined; 51 cases of epilepsy were found, i.e., a prevalence rate of 5.1 in 1,000. During a previous study performed in the same district with the "house-to-house" method, a lower rate was found. Our study confirms that use of different epidemiologic investigational methods can produce different results.
The nasal mucosa of several mammals contains a protein that binds several odorants with dissociat... more The nasal mucosa of several mammals contains a protein that binds several odorants with dissociation constants in the micromolar range and is not found anywhere else in the body. This protein, that is very abundant, accounting for up to 1% of total soluble protein in the nasal mucosa, has been first identified and purified from the cow (Pelosi et al.,1982; Bignetti et al.,1985a; Pevsner et al.,1985) and fully characterized both in terms of structure and of binding specificity (Bignetti et al.,1985b, 1987; Cavaggioni et al.,1987; Pelosi and Tirindelli, 1988; Pevsner et al., 1986, 1988b; Topazzini et al., 1985).
Various proteins have been detected in human nasal mucus, but their electrophoretic pattern has n... more Various proteins have been detected in human nasal mucus, but their electrophoretic pattern has not been extensively investigated. Therefore, we have studied this pattern in nasal mucus samples from a group of 40 healthy subjects (20 males and 20 females). The electrophoretic separations have been performed under both native and denaturing conditions. The electrophoretic pattern of nasal mucus obtained under denaturing conditions and stained with Coomassie brilliant blue R-250, reveals 17 distinguishable areas into which protein bands are divided, with no significant variations from one individual to another. Eight of these areas contain high concentrations of nasal mucus proteins, whereas lower concentrations are seen in the other nine areas. The electrophoretic patterns of nasal mucus differs from that of eye mucus. The method used for sampling is rapid, simple, requires no local anaesthetic, and supplies an adequate quantity of proteins for laboratory testing. Electrophoresis und...
Neuroleptic drugs represent the current therapy for Huntington's chorea (HC). However neurole... more Neuroleptic drugs represent the current therapy for Huntington's chorea (HC). However neuroleptics can improve involuntary movements, but not functional performance and disease progression. Several clinical and experimental data suggest the existence of functional relationship between corticosteroids and extrapyramidal system. We administered dexamethasone to six choreics, all female. Dexamethasone was given i.m. at dose of 4 mg/die for 20 days and 8 mg/die for 20 days more. Dexamethasone at both the doses used, determined significant improvement (p less than 0.05) of dyskinesia, evaluated by AIMS, and manual dexterity, evaluated by Tapping test. Although at present it is not clear which mechanism are responsible for this of dexamethasone favourable effect, it might open new perspectives in HC therapy.
2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2019
Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by disabling motor ... more Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by disabling motor and non-motor symptoms. Idiopathic hyposmia (IH), a reduced olfactory sensitivity, is a preclinical marker for the pathology and affects >95% of PD patients. In this paper, SensHand V1 and SensFoot V2, two inertial wearable sensors for upper and lower limbs, were developed to acquire motion data in ten tasks of the MDS-UPDRS III. Fifteen healthy subjects of control, 15 IH people, and 15 PD patients were enrolled. Seventy-one parameters per side were computed by spatiotemporal and frequency data analysis, and the most significant were selected to distinguish among the different classes. Performances of supervised learning algorithms (i.e., Support Vector Machine (SVM), and Random Forest (RF)) were compared on two-group and three-group classification and considering upper and lower limbs separately or together as a full system. Excellent results were obtained for healthy vs. patients classification (accuracy 1.00 for RF, and 0.97 for SVM), and good results were achieved by including IH subjects (0.92 F-measure with RF) within a three-group classification. Overall, the best performances were obtained using the full system with an RF classifier. The system is, thus, suitable to support an objective PD diagnosis. Furthermore, combining motion analysis with a validated olfactory screening test, people at risk for PD can be appropriately analyzed, and subtle changes in motor performance that characterize the prodromal phase and the early PD onset can be identified.
2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), 2020
Nowadays objective and efficient assessment of Parkinson Disease (PD) with machine learning techn... more Nowadays objective and efficient assessment of Parkinson Disease (PD) with machine learning techniques is a major focus for clinical management. This work presents a novel approach for classification of patients with PD (PwPD) and healthy controls (HC) using Bidirectional Long Short-Term Neural Network (BLSTM). In this paper, the SensHand and the SensFoot inertial wearable sensors for upper and lower limbs motion analysis were used to acquire motion data in thirteen tasks derived from the MDS-UPDRS III. Sixty-four PwPD and fifty HC were involved in this study. One hundred ninety extracted spatiotemporal and frequency parameters were applied as a single input against each subject to develop a recurrent BLSTM to discriminate the two groups. The maximum achieved accuracy was 82.4%, with the sensitivity of 92.3% and specificity of 76.2%. The obtained results suggest that the use of the extracted parameters for the development of the BLSTM contributed significantly to the classification of PwPD and HC.
In an open-label trial, we evaluated the efficacy of clozapine on abnormal involuntary movements ... more In an open-label trial, we evaluated the efficacy of clozapine on abnormal involuntary movements in five patients with Huntington's chorea. We administered clozapine at increasing doses of 25, 50, and 150 mg/d for 3 weeks. Subjective self-evaluation of all patients reported reduction of chorea and improvement of daily living activities. At the end of the trial, all patients requested to continue with clozapine. Objective evaluation with the Abnormal Involuntary Movements Scale demonstrated in all patients moderate-to-marked reduction of abnormal involuntary movements without any significant side effects; the improvement was dose-dependent and markedly decreased 1 week after drug withdrawal.
BACKGROUND: Olfactory function can be rapidly evaluated by means of standardized olfactory tests.... more BACKGROUND: Olfactory function can be rapidly evaluated by means of standardized olfactory tests. Multiple-choice smell identification tests can be conditioned by cultural background. To investigate a new tool for detecting olfactory deficit in Italian subjects we developed a multiple-choice identification test prepared with odorants belonging to the Italian culture. METHODS: The Italian Olfactory Identification Test (IOIT) was developed with 33 microencapsulated odorants with intensity of odors and headspace Gas Chromatography being tested. Test-retest reliability of the IOIT was evaluated. The IOIT was administered to 511 controls and 133 Parkinson's patients. RESULTS: In healthy subjects the number of IOIT errors increased with age for both females (p < 0.0001) and males (p < 0.0001), while in the Parkinson's disease group the number of IOIT errors was significantly greater where compared to healthy subjects (p < 0.0001 in all age groups). The reference limits applied to all age groups revealed an IOIT sensitivity of 93% and a specificity of 99%. The test-retest reliability was excellent. CONCLUSION: The IOIT is highly reliable, disposable, easy to administer, not fragile, and has a long shelf-life. All these features make the IOIT suitable for clinical use as well as for population screening and to discriminate…
To evaluate the prevalence of epilepsy syndromes in a district in Northwest Tuscany (Vecchiano, 9... more To evaluate the prevalence of epilepsy syndromes in a district in Northwest Tuscany (Vecchiano, 9,952 inhabitants) we identified all suspected cases (probable epilepsy) from several information sources: files of local doctors, prescriptions of antiepileptic drugs (AEDs), hospital files from the center for epilepsy at the University of Pisa, medical files from university and hospital departments in Pisa, and files of the school doctors and social workers in the district of Vecchiano. All persons suspected of having epilepsy were examined; 51 cases of epilepsy were found, i.e., a prevalence rate of 5.1 in 1,000. During a previous study performed in the same district with the "house-to-house" method, a lower rate was found. Our study confirms that use of different epidemiologic investigational methods can produce different results.
The nasal mucosa of several mammals contains a protein that binds several odorants with dissociat... more The nasal mucosa of several mammals contains a protein that binds several odorants with dissociation constants in the micromolar range and is not found anywhere else in the body. This protein, that is very abundant, accounting for up to 1% of total soluble protein in the nasal mucosa, has been first identified and purified from the cow (Pelosi et al.,1982; Bignetti et al.,1985a; Pevsner et al.,1985) and fully characterized both in terms of structure and of binding specificity (Bignetti et al.,1985b, 1987; Cavaggioni et al.,1987; Pelosi and Tirindelli, 1988; Pevsner et al., 1986, 1988b; Topazzini et al., 1985).
Various proteins have been detected in human nasal mucus, but their electrophoretic pattern has n... more Various proteins have been detected in human nasal mucus, but their electrophoretic pattern has not been extensively investigated. Therefore, we have studied this pattern in nasal mucus samples from a group of 40 healthy subjects (20 males and 20 females). The electrophoretic separations have been performed under both native and denaturing conditions. The electrophoretic pattern of nasal mucus obtained under denaturing conditions and stained with Coomassie brilliant blue R-250, reveals 17 distinguishable areas into which protein bands are divided, with no significant variations from one individual to another. Eight of these areas contain high concentrations of nasal mucus proteins, whereas lower concentrations are seen in the other nine areas. The electrophoretic patterns of nasal mucus differs from that of eye mucus. The method used for sampling is rapid, simple, requires no local anaesthetic, and supplies an adequate quantity of proteins for laboratory testing. Electrophoresis und...
Neuroleptic drugs represent the current therapy for Huntington's chorea (HC). However neurole... more Neuroleptic drugs represent the current therapy for Huntington's chorea (HC). However neuroleptics can improve involuntary movements, but not functional performance and disease progression. Several clinical and experimental data suggest the existence of functional relationship between corticosteroids and extrapyramidal system. We administered dexamethasone to six choreics, all female. Dexamethasone was given i.m. at dose of 4 mg/die for 20 days and 8 mg/die for 20 days more. Dexamethasone at both the doses used, determined significant improvement (p less than 0.05) of dyskinesia, evaluated by AIMS, and manual dexterity, evaluated by Tapping test. Although at present it is not clear which mechanism are responsible for this of dexamethasone favourable effect, it might open new perspectives in HC therapy.
2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2019
Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by disabling motor ... more Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by disabling motor and non-motor symptoms. Idiopathic hyposmia (IH), a reduced olfactory sensitivity, is a preclinical marker for the pathology and affects >95% of PD patients. In this paper, SensHand V1 and SensFoot V2, two inertial wearable sensors for upper and lower limbs, were developed to acquire motion data in ten tasks of the MDS-UPDRS III. Fifteen healthy subjects of control, 15 IH people, and 15 PD patients were enrolled. Seventy-one parameters per side were computed by spatiotemporal and frequency data analysis, and the most significant were selected to distinguish among the different classes. Performances of supervised learning algorithms (i.e., Support Vector Machine (SVM), and Random Forest (RF)) were compared on two-group and three-group classification and considering upper and lower limbs separately or together as a full system. Excellent results were obtained for healthy vs. patients classification (accuracy 1.00 for RF, and 0.97 for SVM), and good results were achieved by including IH subjects (0.92 F-measure with RF) within a three-group classification. Overall, the best performances were obtained using the full system with an RF classifier. The system is, thus, suitable to support an objective PD diagnosis. Furthermore, combining motion analysis with a validated olfactory screening test, people at risk for PD can be appropriately analyzed, and subtle changes in motor performance that characterize the prodromal phase and the early PD onset can be identified.
2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), 2020
Nowadays objective and efficient assessment of Parkinson Disease (PD) with machine learning techn... more Nowadays objective and efficient assessment of Parkinson Disease (PD) with machine learning techniques is a major focus for clinical management. This work presents a novel approach for classification of patients with PD (PwPD) and healthy controls (HC) using Bidirectional Long Short-Term Neural Network (BLSTM). In this paper, the SensHand and the SensFoot inertial wearable sensors for upper and lower limbs motion analysis were used to acquire motion data in thirteen tasks derived from the MDS-UPDRS III. Sixty-four PwPD and fifty HC were involved in this study. One hundred ninety extracted spatiotemporal and frequency parameters were applied as a single input against each subject to develop a recurrent BLSTM to discriminate the two groups. The maximum achieved accuracy was 82.4%, with the sensitivity of 92.3% and specificity of 76.2%. The obtained results suggest that the use of the extracted parameters for the development of the BLSTM contributed significantly to the classification of PwPD and HC.
In an open-label trial, we evaluated the efficacy of clozapine on abnormal involuntary movements ... more In an open-label trial, we evaluated the efficacy of clozapine on abnormal involuntary movements in five patients with Huntington's chorea. We administered clozapine at increasing doses of 25, 50, and 150 mg/d for 3 weeks. Subjective self-evaluation of all patients reported reduction of chorea and improvement of daily living activities. At the end of the trial, all patients requested to continue with clozapine. Objective evaluation with the Abnormal Involuntary Movements Scale demonstrated in all patients moderate-to-marked reduction of abnormal involuntary movements without any significant side effects; the improvement was dose-dependent and markedly decreased 1 week after drug withdrawal.
Uploads
Papers by Carlo Maremmani