Institutes
Peripheral neuropathies
Neuromuscular diseases are a very heterogeneous group of neurological diseases but unit interest is peripheral neuropathies and in particular those related to the immune system alteration. In this department a patient affected of peripheral neuropathies can find full diagnostic tools (from neurophysiologic to neuropathological studies including sural nerve biopsies, motor biopsies and skin biopsies, from routine haematological exams to immunological ones). Patients so characterized can have the best therapies from the classical therapies to the innovative ones (off-label therapies and clinical trials) in order to improve our capability to modifying the natural history of these peripheral neuropathies in particular those cause by immunity disorders.
Research activity
In the last five years, Peripheral neuropathies Unit studied the efficacy of subcutaneous immunoglobulins instead of IVIG in the treatment of CIDP (chronic inflammatory demyelinating poly radiculopathy). Only 2/3 patients respond to first line treatment (IGIV or steroids) so this unit did clinical studies in order to investigate other immune modulating or immuno-suppressive therapies with an open multicentric study to evaluate the immunosuppressive therapy in CIDP patients.
The unit participated to a multicentric international double blind clinical trial in order to investigated the possible good effect of fingolimod, a promising drug used in multiple sclerosis, and demonstrated in a pilot study the efficacy of a Mab (rituximab) in non-responder patients. This pilot study let the group begin a more large study about the possible beneficial role of rituximab in CIDP.
The group participates to a database for MMN (multifocal motor neuropathy), a rarest peripheral nerve disease once considered as a subgroup of CIDP, to the Italian CIDP register and an international Guillain Barrè register, in order to increase our better knowledge of the natural history of these diseases.
The unit researchers are looking for symptomatic therapies too. They studied a new FKT approach in ataxic patients affected by peripheral neuropathies. All these clinical trials are organized in different experimental designs from controlled multi centric trials to local observational and retrospective studies.
Zoccarato M, Gastaldi M, Zuliani L, Biagiotti T, Brogi M, Bernardi G, Corsini E, Bazzigaluppi E, Fazio R, Giannotta C, Nobile-Orazio E, Costa G, Iorio R, Evoli A, Mariotto S, Ferrari S, Galloni E, De Riva V, Zardini E, Franciotta D, Giometto B. Diagnostics of paraneoplastic neurological syndromes. Neurol Sci. 2017 Oct;38(Suppl 2):237-242.
Campagnolo M, Zanello R, Nobile Orazio E, Benedetti l, Marfia GA, Riva N, Castellani F, Bianco M, Salvaggio A, Garnero M Riuz M, Malatuni G, Fazio R, Ermani M, Briani C. IgM Mgus and Waldestrom-associated anti-Mag neuropathies display similar response to rituximab therapy. JNNP. 2017 Dec;88(12):1094-1097.
Velardo D, Riva N,Del Carro U, Bianchi F, Comi G, Fazio R. Rituximab in refractory chronic inflammatory demyelinating polyradiculo neuropathy: report of four cases. J Neurol. 2017 May;264(5):1011-1014.
Cocito D, Merola A, Romagnolo A, Peci E, Toscano A, Mazzeo A, Gentile L, Russo M, Fazio R, Filosto M, Siciliano G, Schirinzi E, Nobile- Orazio E, Lopiano L. Subcutaneous immunoglobulin in CIDP and MMN: a different long-term clinical response? J neurol neurosurg psychiatry. 2016 Jul;87(7):791-3.
Cocito D, Merola A, Peci E, Mazzeo A, Fazio R, Francia A, Valentino P, Liguori R, Filosto M, Siciliano G, Clerici AM, Lelli S, Marfia GA, Antonini G, Cecconi I, Nobile-Orazio E, Lopiano L. Subcutaneous immunoglobulins in CIDP and MMN: a short-term nationwide study. J neurol. 2014 nov. 261(11):2159-64.
Nobile-Orazio E, Cocito D, Jann S, Uncini A, Messina P, Antonini G, Fazio R, Gallia F, Schenone A, Francia A, Pareyson D, Santoro L, Tamburin S, Cavaletti G, Giannini F, Sabatelli M, Beghi E; for the IMC Trial Group. Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP. J Neurol Neursurg Psychiatry. 2015 Jul;86(7):729-34.
Riva N1, Faccendini S, Lopez ID, Fratelli A, Velardo D, Quattrini A, Gatti R, Comi G, Comola M, Fazio R. Balance exercise in patients with chronic sensory ataxic neuropathy: a pilot study. J Periph. Nerv Syst. 2014 Jun;19(2):145-51.
Rocca MA, Valsasina P, Fazio R, Previtali SC, Messina R, Falini A, Comi G, Filippi M. Brain connectivity abnormalities extend beyond the sensorimotor network in peripheral neuropathy. Human brain map. 2014; 35(2): 513- 526, 2014.
Nobile-Orazio E, Cocito D, Jann S, Uncini A, Beghi E, Messina P, Antonini G, Fazio R, Gallia F, Schenone A, Francia A, Pareyson D, Santoro L, Tamburin S, Macchia R, Cavaletti G, Giannini F, Sabatelli M. Intravenous immunoglobulin versus intravenous methylprednisolone for chronic nflammatory demyelinating polyradicoloneuropathy: a randomized controlled trial. Lancet Neurol. 2012 Jun;11(6):493-502.
Dacci P, Amadio S, Gerevini S, Moiola L, Del Carro U, Radaelli M, Figlia G, Martinelli V, Comi G, Fazio R. Practice of yoga may cause damage of both sciatic nerves: a case report. Neurol Sci. 2013 Mar;34(3):393-6.
