A systematic review on the risk of neurodegenerative diseases and neurocognitive disorders in professional and varsity athletes.

OBJECTIVE: The aim of this systematic review (SR) was to gather all available epidemiological evidence on former participation in any type of sport, at a professional and varsity level, as a potential risk factor for neurodegenerative diseases (NDs) and neurocognitive disorders (NCDs). DESIGN: Systematic searches were performed on PubMed, the Cochrane databases, and the ISI Web of Knowledge databases. Included studies were assessed using the NOS checklist. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All epidemiological studies reporting data on the possible association between a clinical diagnosis of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND), dementia or mild cognitive impairment (MCI), Parkinson's disease (PD), chronic traumatic encephalopathy (CTE) at any stage and with any clinical pattern and the former participation in any types of sport at a varsity and professional level were included. RESULTS: Data from the 17 included studies showed a higher frequency of NDs and NCDs in former soccer and American football players. Updating the previous SR confirmed a higher frequency of ALS/MND in former soccer players. Data reported a significantly higher risk of dementia/AD in former soccer players, and of MCI in former American football players. Results also showed a significantly higher risk of PD in former soccer and American football players, and a significantly higher risk of CTE in former boxers and American football players. This SR confirmed a higher risk of NDs and NCDs in former professional/varsity athletes. However, the pathological mechanisms underlying this association remain unclear, and further high-quality studies should be performed to clarify whether the association could be sport specific.

The Italian technical/administrative recommendations for telemedicine in clinical neurophysiology.

Recent advances in technology, information technology, Internet networks, and, more recently, fiber optics in industrialized countries allow the exchange of a huge amount of data, in real time, across the globe. The acquisition of increasingly sophisticated technologies has made it possible to develop telemedicine, by which the specialist's evaluation can be carried out on the patient even remotely. In Italy, this very useful tool, although possible from a technological and information technology point of view, has not been developed because of the lack of clear and univocal rules and of major administrative obstacles related to the Italian Public Health System. To promote telemedicine implementation in Italy, the Italian Society of Clinical Neurophysiology and the Italian Society of Telemedicine together with the National Centre for Telemedicine and New Assistive Technologies of the Italian Higher Institute of Health prepared these inter-society recommendations. Because of potential forensic value of these recommendations, they were prepared considering the current regulations and the General Data Protection Regulation and will provide the basis for a Consensus Conference planned to discuss and prepare National Telemedicine Guidelines.

Effects of sciatic nerve grafts on choline acetyltransferase and p75 expression in transected adult hypoglossal motoneurons.

We previously reported that a permanent transection of adult rat sciatic and hypoglossal nerves resulted in distinct changes in the levels of both low-affinity nerve growth factor receptor (p75) and choline acetyltransferase in the corresponding motoneurons as determined by immunoreactivity. Permanent axotomy of hypoglossal motoneurons induced a progressive loss of choline acetyltransferase immunoreactivity and a persistent expression of p75 immunoreactivity, phenomena that were not observed in spinal motoneurons. These observations indicated that spinal and brainstem motoneurons respond to permanent axotomy with a differential immunoreactivity for p75 and choline acetyltransferase. Such differences could be ascribed to specific intrinsic properties of each population of motoneurons or, alternatively, to different factors present in the periphery (nerve stump or target muscle). The aim of the present study was to test these two possibilities by determining if a segment of sciatic nerve transplanted to a transected hypoglossal nerve may counteract or attenuate the loss of choline acetyltransferase immunoreactivity in injured hypoglossal motoneurons. In addition, as further parameter, we analysed the presence of p75 immunoreactivity. Prior to grafting, segments of sciatic nerve were prepared by one of three methods: (i) a fresh piece; (ii) a degenerated piece; and (iii) a heated piece. Seven and 30 days following the placement of grafts, hypoglossal motoneurons were analysed for choline acetyltransferase and p75 immunolabelling. The results revealed that viable sciatic grafts (fresh and degenerated) are able to partially attenuate the loss in the number of choline acetyltransferase-positive injured hypoglossal motoneurons, even if an important decrease in choline acetyltransferase still persists with respect to the contralateral nucleus. In addition, viable sciatic grafts decreased the number of p75 immunoreactive hypoglossal motoneurons both at seven and at 30 days. In conclusion, the effects of viable sciatic grafts on the number of choline acetyltransferase and p75-labelled hypoglossal motoneurons indicate that these adult neurons are able to respond to factors released from the sciatic nerve, and that the number of injured motoneurons positive for choline acetyltransferase and p75 can be influenced by the presence of factors that may reach their proximal stumps. Furthermore, we hypothesize that the differential expression patterns between hypoglossal and sciatic motoneurons may be due, at least in part, to factors released from the nerve trunks themselves.