Stefania Cattaldo

Background: Surfactant protein G (SP-G) is a recently characterized protein potentially involved in cerebrospinal fluid (CSF) dynamics. Its role in human neurodegenerative dementia remains unknown. Objective: To investigate the potential clinical relevance of CSF SP-G levels in neurodegenerative dementia (ND; including Alzheimer's disease [AD] and frontotemporal dementia [FTD]), idiopathic normal-pressure hydrocephalus (iNPH), vascular dementia (VaD), and clinical controls (CTR). Methods: CSF SP-G levels were quantified in 94 individuals: 35 with ND (11 AD + 24 FTD), 19 with iNPH, 13 with VaD, and 27 CTR. Group differences were analyzed using ANOVA with post hoc tests. ANCOVA was performed to adjust for age. Results: CSF SP-G levels differed significantly among groups in the primary analysis (ANOVA: F(3,90) = 3.862, p = 0.012), with higher levels in iNPH compared with ND (p = 0.012) and CTR (p = 0.026). No significant differences were observed between ND, VaD, and CTR groups. After adjustment for age, the group effect was no longer significant (F(3,89) = 2.253, p = 0.088). Conclusions: This is the first study to investigate CSF SP-G levels in neurodegenerative dementia. Our findings suggest that SP-G is more closely related to altered CSF physiology in iNPH than to neurodegenerative pathology, although the influence of age indicates that these observations should be interpreted with caution. SP-G may represent a candidate marker of CSF homeostasis and fluid dynamics. Larger, age-matched studies integrating SP-G with established CSF biomarkers and neuroimaging are needed to clarify its diagnostic and pathophysiological significance.

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized not only by motor impairments but also by debilitating non-motor symptoms (NMS) such as anxiety, depression, fatigue, and sleep disturbances. These symptoms are often resistant to dopaminergic therapies and significantly impact patients’ quality of life. Whole-body cryostimulation (WBC) has emerged as a promising non-pharmacological intervention with potential effects on stress modulation and psychological well-being. Materials and Methods: In total, 14 patients with idiopathic PD underwent 10 WBC sessions (−110 °C for 2 min) over two weeks. Blood samples for cortisol and serotonin were collected before and after the first and last sessions. Patients completed standardized questionnaires evaluating anxiety (STAI-Y1, Y2), depression (BDI), fatigue (FSS), sleep quality (SCI), and daytime sleepiness (ESS) at baseline and after the final session. Results: Significant reductions in serum cortisol and improvements in serotonin levels were observed. Psychological assessments showed decreased anxiety and depression scores, with improvements in fatigue and sleepiness (p < 0.05 for most scales). Discussion and Conclusions: Repeated WBC sessions were safe and well-tolerated and were associated with biochemical and psychological improvements. These preliminary findings support WBC as a promising complementary intervention for alleviating NMS in PD. Further randomized controlled studies are warranted to confirm these results.

Background: The mechanisms underlying cognitive impairment in obstructive sleep apnea syndrome (OSAS) remain incompletely understood. In particular, the relative contribution of daytime sleepiness versus the direct effects of hypoxia on the brain requires clarification. Objectives: This study aims to explore the association between verbal memory and problem-solving abilities, OSAS severity, self-reported daytime sleepiness, and neurofilament light chain (NfL) serum concentration, as marker of neuroaxonal injury possibly related to chronic hypoxia. Methods: In this cross-sectional study, cognitive performance was assessed in 72 patients with mild to severe OSAS using the Selective Reminding Test (SRT) and the Tower of London (ToL). The apnea–hypopnea index (AHI), the Epworth Sleepiness Scale (ESS) and serum NfL concentrations were collected. Hierarchical multiple linear regression analyses adjusting for age, years of education, body mass index, and duration of continuous positive airway pressure (CPAP) treatment, were conducted for each cognitive outcome. Results. Neither AHI, ESS scores nor serum NfL concentrations were significantly associated with verbal memory or problem-solving performance. Higher age and lower education were significant predictors of lower verbal memory indices, whereas longer CPAP treatment duration was positively correlated with verbal memory performance and problem-solving speed. Conclusions: In this sample, cognitive performance was more strongly related to demographic factors and CPAP exposure compared to disease severity, subjective sleepiness, or peripheral markers of neuroaxonal injury. These findings suggest that AHI, subjective measures of sleepiness and NfL may inadequately capture neurocognitive vulnerability in OSAS. Moreover, they underscore the imperative for longitudinal and larger studies to clarify mechanisms linking OSAS and cognitive impairments.

Introduction. Anorexia nervosa severely impacts the physical body and mental body (i.e., body image). In this retrospective study, we investigated the relationship between the perceived body image and body composition in women with anorexia nervosa. Specifically, we aimed to verify what components (i.e., weight, body composition, and micronutrients) may predict a higher number of symptoms of negative body image in this clinical condition. Methods. Weight status and body composition, including the expressions of vitamins, and body image concerns were measured in a sample of 112 women with anorexia nervosa (age in years M = 26.78; SD = 12; range = 14–67). Results. According to the regression analysis, a higher skeletal muscle mass and a higher concentration of vitamin B6 seemed to predict a higher number of symptoms of negative body image in our sample. Conclusions. This study pointed out muscle mass and the concentration of vitamin B6 as involved in the psychological expression of body image concerns in anorexia nervosa, especially at the beginning of the disease. Thus, we may suggest including and monitoring these parameters in routine care for anorexia nervosa.

Background: Parkinson’s disease (PD) is a multifaceted neurodegenerative disorder that progressively affects both the central and peripheral nervous systems. This pilot study aimed to examine the effects of repeated whole-body cryostimulation (WBC) sessions on the sympathovagal balance in PD patients and correlate heart rate variability (HRV) indexes with peripheral biomarkers of the autonomic nervous system (ANS). Methods: Seventeen PD patients with mild to moderate motor severity underwent a 10-session WBC cycle over 5 consecutive days. Thirteen patients (6 males, 7 females; mean age 64.5 ± 9.01 years; mean disease duration 5.4 ± 2.3 years) completed the protocol. Cardiac autonomic activity was assessed through HRV measures including RR interval variability (RR mean, RR min, RR max), power density of high and low frequencies (HF, LF), RMSSD, and the LF/HF ratio. Systemic sympathetic activity was evaluated via circulating blood catecholamine levels. Results: Significant increases were observed in RR mean, RR min, RR max, RMSSD, and HF spectrum, indicating enhanced parasympathetic activity. Blood pressure remained stable, suggesting safety. Conclusions: These findings provide initial support to WBC as a potential “rehabilitation booster” in PD, enhancing sympathovagal balance. Further research is needed to explore the long-term benefits of WBC in PD management.

Background: Beyond memory deterioration, spatial disorientation may occur along the continuum of normal aging—dementia of Alzheimer’s type. The present study aims at detecting behavioral disorders of spatial cognition in prodromal Alzheimer’s disease (AD) and verifying the association between Apolipoprotein E-ε4 (ApoE-ε4) genotype and gait patterns during a real-world naturalistic task. Methods: A sample of 58 elderly participants, of which 20 patients with mild cognitive impairment with CFS biomarker evidence of AD, 23 individuals with subjective cognitive decline (SCD), and 15 healthy controls (HCs), was tested by a modified version of the Detour Navigation Test (DNT-mv). Generalized linear models were run to explore the association between group belonging and wrong turns (WTs)/moments of hesitation (MsH) as behavioral disorientation scores of the DNT-mv as well as the effect of ApoE-ε4 genotype on time and walking speed registered by a smartphone app providing GPS tracking of body movement around urban environments. Results: Patients with MCI due to AD reported more WTs than individuals with SCD and HCs. Further, the ApoE-ε4 genotype determined a lower capacity in spatial information processing, influencing gait during naturalistic spatial navigation tasks. Conclusions: Behavior alterations of spatial cognition can be detected ecologically in prodromal AD. The use of technological solutions supporting gait analysis may help in corroborating the experimental observation.