Roberto Infante (Italy)

Fondazione Mondino - Istituto Neurologico Nazionale IRCCS Stroke Unit
I'm a young neurologist. I completed my training at the University of Milano-Bicocca within several hospital like "San Gerardo" (Monza), "Niguarda Ca' Granda" (Milan), "CTO Gaetano Pini" (Milan) and "CHU Grenoble-Alpes" (France), with a special focus on Movement Disorders (in particular Parkinson's disease), Emergency Neurology and Cerebrovascular Diseases. After a six-month period of work as a consultant in Monza Hospital for Neurology and COVID divisions, I'm actually working in the second level Stroke Unit of "San Matteo Hospital" (Pavia), which is managed by one of the biggest Institute of Neurology in north Italy, the "Fondazione Mondino".

Author Of 1 Presentation

 Conference Calendar
Free Communication

EFFECTS OF SUBTHALAMIC DEEP BRAIN STIMULATION ON NEUROPSYCHIATRIC FLUCTUATIONS IN PATIENTS WITH PARKINSON’S DISEASE (PSYCHOSTIM STUDY)

Session Type
Free Communication
Session Name
100 - WFN+SIN FREE COMMUNICATION: Movement Disorders (ID 39)
Date
03.10.2021, Sunday
Session Time
09:30 - 11:00
Room
Free Communication B
Lecture Time
09:30 - 09:40
Presenter
  • Roberto Infante (Italy)

Abstract

Background and Aims:

Neuropsychiatric Fluctuations (NPF) are frequent and disabling non-motor symptoms of advanced Parkinson’s Disease (PD). Little is known about the effects of bilateral subthalamic deep brain stimulation (STN-DBS) on NPF. We aimed at evaluating the effects of STN DBS on acute NPF using a dedicated scale, the Neuropsychiatric Fluctuation Scale (NFS). NFS combines items derived from various neuropsychiatric scales, in a simple, motor phase-dependant score (from -30 to +30 points).

npf.png

Methods:

31 PD patients treated with STN-DBS received preoperative and postoperative (at 1 year after surgery) motor and non-motor assessments. The MDS-UPRDS total and sub-scores, levodopa equivalent daily dose (LEDD), and neuropsychological scales, including the NFS, were administrated in four conditions: preoperative “OFF-Med” and “ON-Med”, postoperative “OFF-Med/ON-Stim” and “ON-Med/ON-Stim”. Statistical analysis was realised with T-Student test and “post-hoc” confirmation (Wilcoxon and Spearman).

nfs english.jpg

Results:

Mean postoperative “OFF-Med” NFS score significantly improved compared to the preoperative one (-14.4 vs -7.1 points; +49.3%; p=0.0003.), whereas “ON-Med” NFS score showed slight deterioration (+16.4 vs +13.8 points; -15.9%; p=0.48). NFS postoperative modifications did not correlate with the improvement of the MDS-UPDRS III or LEDD decrease. Conversely, postoperative decrease of the MDS-UPRDS II score correlated with the corresponding “OFF-Med” NFS score (p=0.019), but not with “ON-Med” NFS score (p=0.77).

population.png

Conclusions:

At 1-year follow-up, STN-DBS significantly improved NPF in the “OFF-Med” condition. This improvement was unrelated with the improvement of motor signs or medication reduction. The use of dedicated instruments (such as the NFS) appears to be very useful to monitor the impact of therapies in PD patients with non-motor fluctuations.

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Presenter of 1 Presentation

 Conference Calendar
Free Communication

EFFECTS OF SUBTHALAMIC DEEP BRAIN STIMULATION ON NEUROPSYCHIATRIC FLUCTUATIONS IN PATIENTS WITH PARKINSON’S DISEASE (PSYCHOSTIM STUDY)

Session Type
Free Communication
Session Name
100 - WFN+SIN FREE COMMUNICATION: Movement Disorders (ID 39)
Date
03.10.2021, Sunday
Session Time
09:30 - 11:00
Room
Free Communication B
Lecture Time
09:30 - 09:40
Presenter
  • Roberto Infante (Italy)

Abstract

Background and Aims:

Neuropsychiatric Fluctuations (NPF) are frequent and disabling non-motor symptoms of advanced Parkinson’s Disease (PD). Little is known about the effects of bilateral subthalamic deep brain stimulation (STN-DBS) on NPF. We aimed at evaluating the effects of STN DBS on acute NPF using a dedicated scale, the Neuropsychiatric Fluctuation Scale (NFS). NFS combines items derived from various neuropsychiatric scales, in a simple, motor phase-dependant score (from -30 to +30 points).

npf.png

Methods:

31 PD patients treated with STN-DBS received preoperative and postoperative (at 1 year after surgery) motor and non-motor assessments. The MDS-UPRDS total and sub-scores, levodopa equivalent daily dose (LEDD), and neuropsychological scales, including the NFS, were administrated in four conditions: preoperative “OFF-Med” and “ON-Med”, postoperative “OFF-Med/ON-Stim” and “ON-Med/ON-Stim”. Statistical analysis was realised with T-Student test and “post-hoc” confirmation (Wilcoxon and Spearman).

nfs english.jpg

Results:

Mean postoperative “OFF-Med” NFS score significantly improved compared to the preoperative one (-14.4 vs -7.1 points; +49.3%; p=0.0003.), whereas “ON-Med” NFS score showed slight deterioration (+16.4 vs +13.8 points; -15.9%; p=0.48). NFS postoperative modifications did not correlate with the improvement of the MDS-UPDRS III or LEDD decrease. Conversely, postoperative decrease of the MDS-UPRDS II score correlated with the corresponding “OFF-Med” NFS score (p=0.019), but not with “ON-Med” NFS score (p=0.77).

population.png

Conclusions:

At 1-year follow-up, STN-DBS significantly improved NPF in the “OFF-Med” condition. This improvement was unrelated with the improvement of motor signs or medication reduction. The use of dedicated instruments (such as the NFS) appears to be very useful to monitor the impact of therapies in PD patients with non-motor fluctuations.

Hide