- Analgesic effect of inhibition of fatty-acid amide hydrolase
Sezione di Pavia I                                         ...
EUROHEAD aims to clarify the genetic and neurobiological
basis of migraine: the initiation of attacks, the aura, and the  ...
Monday                                   Tuesday           Wednesday Thursday              Friday       admission and last...
Facilities                                                       - Department of Neuropsychiatry of Childhood and
The IRCC...
cramps. Exp Brain Res. 2007 Sep;182(3):301-8. Epub
                                                                       ...
functional neurology

The journal, founded in 1986, is published in English and
indexed in the main international database...
medical) working to educate and to inform people about
                                                                   ...
The staff for clinical activities consists of 3 neurologists: dr.
                                                        ...
6.   Courtine G, De Nunzio AM, Schmid M, Beretta MV,
                                                                     ...
Neurobiological correlates of alcoholism and other
                                                               addictio...
The inpatient headache service has about 40 ordinary
                                                                     ...
Our current multidisciplinary research programs,               4.   Balottin U, Ferri M, Termine C. Evidence-based
develop...
Co-opted members

                                                                                                        ...
neuroimaging, biochemical and neurophysiological research       6.   Di Lorenzo C, Sances G, Di Lorenzo G, Rengo C,
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Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
Ucadh report 2006-2007.doc.doc
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Ucadh report 2006-2007.doc.doc

  1. 1. - Analgesic effect of inhibition of fatty-acid amide hydrolase Sezione di Pavia I (FAAH) and of cannabinoid herbal extracts in animal pain models (Workpackage leader: R. Greco); UNIVERSITÀ DI PAVIA Innovative diagnostic and therapeutic approaches to NEUROPSICOBIOLOGIA DELLE CEFALEE E headache (Coordinator prof. G. Nappi) DISORDINI ADATTATIVI - Medication overuse headache project: the “Care” programme (Workpackage leaders: G. Sances - N. Ghiotto); RESPONSABILE - Evaluation of cognitive functions in medication overuse Giorgio Sandrini, PO headache patients (Workpackage leader: E. Sinforiani); Centro Interuniversitario Cefalee e Disordini Adattativi - Standardization of a headache diary for adults and children IRCCS Fondazione Istituto “C. Mondino” (Workpackage leaders: G. Sances - C. Tassorelli - C. Via Mondino 2 – 27100 Pavia Termine); Tel.: 0382-380279 / 0382-380479 / Fax: 0382-380448 - Computerised monitoring of medication overuse headache e-mail: gsandrin@unipv.it characteristics during detoxification (Workpackage leader: F. Antonaci); ANNUAL REPORT 2006-2007 - Botulinum toxin in the detoxification of medication overuse headache (Workpackage leader: G. Sandrini); - Knowledge, habits, perceptions and attitudes of headache RESEARCH ACTIVITY specialists towards complementary and alternative medicine: analysis in Western Countries (Workpackage The research activity is coordinated by the University leader: E. Pucci); Centre for Headache and Adaptive Disorders (UCADH), an - Evaluation of the effectiveness of herbal extracts in animal interuniversity structure directed by Prof. Giuseppe Nappi. models of migraine (Workpackage leader: C. Tassorelli). Research projects 2006-2008 (2007) Cardiovascular comorbidity of headache (Coordinator dr D. Bosone) funded by the italian ministry of health - Migraine and hypertension (Workpackage leader: N. Ghiotto); Clinical phenotypes of migraine (Coordinator prof. G. - Migraine with aura and patent foramen ovale (PFO): new Nappi) frontieers of diagnosis and treatment (Workpackage leader: - Role of personality and genetic substrates in medication N. Ghiotto). overuse headache (Workpackage leader: G. Sances); - The pharmacogenetics of triptan response (Workpackage Multiple sclerosis: clinical, neuroradiological, leader: G. Sances); immunological, endocrinological, neurophysiological - Migraine and reproductive life (Workpackage leader: G. aspects (Coordinator: dr R. Bergamaschi) Sances); - Association between multiple sclerosis and headache: - Rare headaches: hemicrania continua, hypnic headache applicability of ICHD-II criteria (Workpackage leader: G. (Workpackage leader: C. Tassorelli); Sances). - Nocturnal headaches: clinical and neurological study with definition of diagnostic and therapeutic avenues Building of a neurological portal based on a National (Workpackage leader: G. Sances). network of excellence in the area of neurology and rehabilitation (Coordinator: prof. Nappi) Identification of molecular mediators of migraine and pain EUROHEAD (www.eurohead.org) is the acronym of a (Coordinator prof. G. Sandrini) scientific project (sponsored by the European Commission - role of the endocannabinoid system in migraine pain: under the 6th Framework Programme) that gathers the study in an animal model (Workpackage leader: C. activities of a European research consortium currently Tassorelli); seeking to unravel the genetic and neurobiological basis of - role of endocannabinoid system in migraine pain: clinical migraine. study (Workpackage leader: G. Sandrini); The EUROHEAD project relies on the combined efforts of - Study of TNFalpha and IL-6 modulation in an animal a multidisciplinary (geneticists, neurologists, model of migraine (Workpackage leader: C. Tassorelli); neurophysiologists and electrophysiologists) research group, - Role of cycloxygenase 2 in an animal model of migraine: composed of nine member organisations from seven EU study of specific brain areas of the rat (Workpackage leader: countries (the Netherlands, Finland, the United Kingdom, C. Tassorelli); Italy, Germany, Denmark, and Belgium). - Study of mechanisms underlying translational regulation in The EUROHEAD consortium members operate at the neuropathic pain models (Workpackage leader: L. highest level in the international migraine research field, Berliocchi); and thus apply the highest research standards and latest scientific and technological advances.
  2. 2. EUROHEAD aims to clarify the genetic and neurobiological basis of migraine: the initiation of attacks, the aura, and the The clinical activity is based on the presence of outpatient pain. The project has the following objectives: and inpatient facilities and is always carried out in parallel 1.to establish a EUROHEAD centre of excellence, bringing with clinical and pre-clinical research. together the clinical, genetic and neurobiological expertise of leading European migraine research groups; The outpatient headache service 2.to create a EUROHEAD migraine patient resource, The outpatient activity consists of six weekly general pooling (for genetic and clinical research purposes) data on headache clinics and three clinics for specific disorders that well-characterised families, population-based cohorts, require a highly specialised approach: families of genetic isolates and twins; 1.“Menstrual migraine”, a clinic for women with headache 3.to identify new loci and gene variants in rare familial attacks associated with their menstrual cycle; hemiplegic migraine and common migraine with and 2.“Trigeminal-autonomic cephalalgias”, a clinic for patients without aura; suffering from cluster headache and other trigeminal 4.to test and validate the importance of migraine autonomic cephalalgias; susceptibility loci and genes in the clinical and population 3.“CARE”, special programme for the care and close follow cohorts of the EUROHEAD migraine patient resource; up of patients suffering from medication overuse headache 5.to analyse the functional consequences of migraine- after detoxification. associated gene variants and mutations in cellular and animal The figures in table 1 summarise the outpatient visits models. Techniques include cortical spreading depression, performed at the centre in 2007, while table 2 shows the electrophysiology, brainstem nociception, Ca2+-, and weekly planning and staffing of outpatient activities. neuroimaging; 6.to correlate genotypes with migraine-endophenotypes for Table 1. Outpatients seen at Pavia Headache Centre clinics future clinical classification systems based on genetic in 2007 information; 7.to promote and disseminate knowledge on headache Clinics First Follow-up Total science in Europe to various stakeholders; to this end, the visits visits consortium is running a website with detailed, up-to-date information on clinical and genetic aspects, animal models, General headache 1054 1266 2320 and neurophysiology. clinics (adults) Clinical trials General headache University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 coordinating centre 304 406 710 clinics (children) The centre participated to 5 interational clinical trials on Menstrual migraine headache and neuropathic pain, 3 trials as coordinator. 42 87 129 clinics participating centre Cluster headache 86 169 255 clinics Participation to national and international pharmacologic studies. Medication overuse headache (CARE - 368 368 Research staff programme) clinics Total 1486 2296 3782 Giuseppe Nappi, president of UCADH Neuropsychobiology of headache and adaptive disorders Table 2. Weekly outpatient planning Giorgio Sandrini, director of the section Grazia Sances, head of the Headache Unit Fabio Antonaci, assistant professor Ennio Pucci, assistant professor Cristina Tassorelli, assistant professor Natascia Ghiotto, junior consultant neurologist Armando Perrotta, junior consultant neurologist Elena Guaschino, neurology resident Natalia Arce-Leal, PhD student Rossella E. Nappi, consultant Rosaria Greco, biologist Clinical activity 32
  3. 3. Monday Tuesday Wednesday Thursday Friday admission and lasts for the entire hospital stay. During the hospitalisation, patients are screened by a psychologist General “CARE General General General specialised in headache assessment and subsequently receive (adults) programme” (adults) (adults) (adults) daily psychology sessions aimed at teaching them how best to manage and cope with their headache at home. Further neurological investigation is performed as required. Before General Cluster Menstrual General discharge, patients are started on headache prophylaxis (adults) headache migraine (children) which is personalised according to the presence of comorbidities and previous responses to treatments. General Patients are then scheduled for regular follow ups (usually, (adults) in accordance with the CARE programme, at 2, 6, 12, 18 and 24 months after discharge). They are also given headache diary in which to record days with headache and use of symptomatic drugs. We inform each patient’s general Diagnosis Number practitioner (in a letter that also gives the name and contact numbers of the neurologist who was in charge of the patient Migraine with aura 60 during the detoxification treatment) about the procedures Migraine without aura 76 followed during the hospitalisation and of the treatment suggested after discharge. Tension-type headache 12 Of the 12 beds available at the centre, 2 are used as day hospital beds for the investigation and observation of Cluster headache and other TACs* 10 patients suffering from unusual headaches or for the Other primary headaches 2 administration of invasive therapeutic techniques. The characteristics of the patients that admitted as day hospital Medication overuse headache 31 patients in the course of 2006 are illustrated in table 4. Other headaches 11 Total 202 Table 4. Characteristics of day hospital patients evaluated at the Pavia Headache Centre in 2007 physicians staffing the outpatient clinics University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 Adult Neurologists *trigeminal autonomic cephalalgias Grazia Sances Giorgio Sandrini Fabio Antonaci (as of July 2006) Natascia Ghiotto Ennio Pucci Cristina Tassorelli Diagnosis Number The inpatient headache service Medication overuse headache 280 The inpatient service now has 12 beds, reserved for the Other headache diagnosis 30 medication overuse headache detoxification programme. These beds are in the Department of Clinical Neurology and Total 310 Rehabilitation, directed by Prof. A. Moglia. The inpatient headache service is headed by Dr G. Sances and staffed by Drs F. Antonaci (senior consultant neurologist), N. Ghiotto (junior consultant neurologist), E. Guaschino (neurology resident). Table 3 shows the number and characteristics of patients detoxified and discharged from the centre in 2007. Inpatient service staff Table 3. Characteristics of patients hospitalised at the Pavia Grazia Sances, head; Headache Centre in 2007 Fabio Antonaci, senior consultant neurologist; Natascia Ghiotto, junior consultant neurologist; The service has also three external consultants: Dr R. E. Marta Allena, junior consultant neurologist; Nappi, endocrinologist and gynaecologist, Dr T. Forciniti, Elena Guaschino, neurology resident; gnathologist and Dr M. S.Verticale, psychologist. Rossella E. Nappi, consultant; Patients with medication overuse headache are generally Tommaso Forciniti, consultant; hospitalised for 8-10 days. The first day is spent carefully reviewing the clinical history and performing general and Head nurse neurological examinations. The detoxification programme Mrs Emanuela Sacchi consists of intravenous therapy and starts on the day of 31
  4. 4. Facilities - Department of Neuropsychiatry of Childhood and The IRCCS “C. Mondino Institute of Neurology” Adolescence, University of Vienna, Austria (Çiçek Wöber- Foundation is located on the outskirts of Pavia and close to Bingöl); the various university institutes. The hospital rooms and - Department de Neurophysiologie Clinique, Centre clinics are of the highest standard. In addition, the research Hospitalo-Universitaire, Pitié-Salpêtrière, Paris, France laboratories are grouped in a new tower entirely devoted to (Jean Claude Willer) ; research activities. - Department of Health Sciences and Technology, Allborg University, Denmark (Lars Arendt-Nielsen and Ole K. Research and clinical collaborations Andersen); - Department of Clinical Neurophysiology, 'St Naum' Departments of the IRCCS “C. Mondino Institute of University Hospital of Neurology and Psychiatry Sofia, Neurology” Foundation Bulgaria (Ivan Milanov); - Neuroradiology (Stefano Bastianello); - Department of Neurology, Tbilisi Medical University, - Epilepsy and Sleep Centre (Raffaele Manni) Georgia (Zaza Katzarava); - Department of Neurology, University of Moscow, Russia National Collaborations (Vera Osipova); - III Neurological Clinic, University Neurological Hospital, - Research Centre for Reproductive Medicine, Department Sofia, Bulgaria (Ivan Milanov); of Morphological, Eidological and Clinical Sciences, & - FLENI, Raúl Carrea Institute for Neurological Research, Gynaecological Endocrinology Unit - Department of Buneos Aires, Argentina (Jeorge Leston); Internal Medicine & Endocrinology IRCCS S. Maugeri - Department of Neurology, University of Cordoba, Foundation, University of Pavia, Italy (Rossella E. Nappi); Hospital National de Clinicas, Cordoba, Argentina - Department of Child and Adolescent Neurology and (Federico Buonanotte and Maria de Lourdes Figuerola). Psychiatry - Headache Centre, University of Rome “La Sapienza”, Italy (Vincenzo Guidetti); Publications (2007) - University of Padua, Padua, Italy (Daniela Pietrobon); - “Istituto Scientifico Universitario San Raffaele”, Milan, Italy (Giorgio Casari); 1: Magis D, Bendtsen L, Goadsby PJ, May A, Sánchez del - Unit of Dental Prosthesis and Gnathology, IRCCS Rio M, Sandór PS, Kaube H, Sandrini G, Schoonman “Policlinico San Matteo”, University of Pavia, Italy GG, Schoenen J; EUROHEAD Project. Evaluation University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 (Tommaso Forciniti); and proposal for optimization of neurophysiological - Institute of Infectious Diseases, IRCCS “Policlinico San tests in migraine: part 2--neuroimaging and the Matteo”, University of Pavia, Italy (Lorenzo Minoli); nitroglycerin test. Cephalalgia. 2007 - Child Neuropsychiatry Unit, Department of Clinical and Dec;27(12):1339-59 Biological Sciences, University of Insubria (Umberto Balottin); 2: Tassorelli C, Armentero MT, Greco R, Fancellu R, - “Istituto Mario Negri”, Milan, Italy (Ettore Beghi); Sandrini G, Nappi G, Blandini F. Behavioral responses - University of Tor Vergata, Rome, Italy (Giuseppe and Fos activation following painful stimuli in a rodent Nisticò); model of Parkinson's disease. Brain Res. 2007 Oct - Headache Clinic, INI Grottaferrata, Grottaferrata, Italy 24;1176:53-61. Epub 2007 Aug 14 (Paolo Rossi); IRCCS Stella Maris, Pisa, Italy (Giovanni Muratori); 3: Tassorelli C, Greco R, Armentero MT, Blandini F, CBIM – Consorzio di Bioingegneria ed Informatica Medica, Sandrini G, Nappi G. A role for brain Pavia, Italy (Stefania Pazzi, Marco Pagani). cyclooxygenase-2 and prostaglandin-E2 in migraine: effects of nitroglycerin. Int Rev Neurobiol. International Collaborations 2007;82:373-82 - Danish Headache Centre, Glostrup University Hospital & 4: Sandrini G, Cerbo R, Del Bene E, Ferrari A, Genco S, University of Copenhagen, Denmark (Jes Olesen, Rigmor Grazioli I, Martelletti P, Nappi G, Pinessi L, Sarchielli Jensen); P, Tamburro P, Uslenghi C, Zanchin G. Efficacy of - University of Liège, Belgium (Jean Schoenen); dosing and re-dosing of two oral fixed combinations of - Leids Universitair Medisch Centrum, Leiden, The indomethacin, prochlorperazine and caffeine compared Netherlands (Michel D. Ferrari); with oral sumatriptan in the acute treatment of - University of Helsinki, Finland (Aarne Palotie); multiple migraine attacks: a double-blind, double- - Institute of Neurology, University College London, dummy, randomised, parallel group, multicentre London, UK (Peter Goadsby); study. Int J Clin Pract. 2007 Aug;61(8):1256-69 - University of Duisburg-Essen, Essen, Germany (Hans- Christoph Diener, Zaza Katsarava); 5: Serrao M, Arendt-Nielsen L, Ge HY, Pierelli F, Sandrini G, Farina D. Experimental muscle pain decreases the frequency threshold of electrically elicited muscle 32
  5. 5. cramps. Exp Brain Res. 2007 Sep;182(3):301-8. Epub 2007 Jun 6 6: Versino M, Candeloro E, Tavazzi E, Moglia A, Sandrini G, Alfonsi E. The H reflex from the abductor brevis hallucis muscle in healthy subjects. Muscle Nerve. 2007 Jul;36(1):39-46 7: Dodick DW, Sandrini G, Williams P. Use of the sustained pain-free plus no adverse events endpoint in clinical trials of triptans in acute migraine. CNS Drugs. 2007;21(1):73-82 8: Di Lorenzo C, Sances G, Di Lorenzo G, Rengo C, Ghiotto N, Guaschino E, Perrotta A, Santorelli FM, Grieco GS, Troisi A, Siracusano A, Pierelli F, Nappi G, Casali C. The wolframin His611Arg polymorphism "Headaches in Search of an Author" is a annual influences medication overuse headache. Neurosci photographic competition open to non-health professionals Lett. 2007 Sep 13;424(3):179-84. Epub 2007 Aug 6 affected by headache who are invited to express their disease in a photograph. The winner of the 4rd "Headaches in Search of an Author" competition, in 2007, was ??????? 9: Antonaci F, Chimento P, Diener HC, Sances G, Bono G. who submitted a photograph entitled ???????. Lessons from placebo effects in migraine treatment. J Headache Pain. 2007 Feb;8(1):63-6. Epub 2007 Feb 19 10: Ferrari A, Leone S, Vergoni AV, Bertolini A, Sances G, Coccia CP, Ottani A, Pinetti D, Sternieri E. Similarities and differences between chronic migraine and episodic migraine. Headache. 2007 Jan;47(1):65-72 11: Greco R, Amantea D, Blandini F, Nappi G, Bagetta G, Corasaniti MT, Tassorelli C. Neuroprotective effect University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 of nitroglycerin in a rodent model of ischemic stroke: evaluation of Bcl-2 expression. Int Rev Neurobiol. 2007;82:423-35 Scientific organisations, professional organisations and committees The Italian Linguistic Subcommittee of the International 12: Amantea D, Spagnuolo P, Bari M, Fezza F, Mazzei C, Headache Society (Chairman: prof. G. Nappi) Tassorelli C, Morrone LA, Corasaniti MT, Maccarrone The aims of this subcommittee are to promote the M, Bagetta G. Modulation of the endocannabinoid objectives of the IHS and to support initiatives that pursue system by focal brain ischemia in the rat is involved in these objectives amongst those whose first language is neuroprotection afforded by 17beta-estradiol. FEBS J. Italian; it also aims to increase the involvement of native 2007 Sep;274(17):4464-775. Italian speakers in the activities of the society. The International School on Adaptive Disorders and Other activities Headache (ISADH) Honorary degrees, prizes and other honours “La Settimana della Cefalea” – 5th edition Castrocaro Terme (Forlì), 4-7 october 2006 The 4rd Cluster Headache Award, in 2006, went to the following paper: Study of hypothalamic metabolism in Members of EHF and IHS cluster headache by proton MR spectroscopy Members of the staff of the Pavia Headache Centre are board members of the European Headache Federation Written by: Lodi R, Pierangeli G, Tonon C, Cevoli S, (EHF) and members of the Council of the International Testa C, Bivona G, Magnifico F, Cortelli P, Montagna P, Headache Society (IHS). Barbiroli B.R Members of the staff belong to the EHF “Guidelines for the Standards of the Headache Centre in Europe “ and Appeared in: Neurology. 2006 Apr 25;66(8):1264-6. “Guidelines for Headache Treatment in Primary Care” task forces. Editorial activity 31
  6. 6. functional neurology The journal, founded in 1986, is published in English and indexed in the main international databases of scientific literature: Journal Citation Reports, Neuroscience Citation Index, Science Citation Index-Expanded, Current Advances in Neuroscience, Medline-Index Medicus, Embase-Excerpta Medica, Physicians’ Silverplatter Neurology, PsycINFO, Data Base “Medicine”, Research Alert, The Academy of Sciences of the Russian Federation. THE Editor-in-Chief is Prof. S. Bastianello and the Founding Editor is Prof. G. Nappi. The journal has the following sections: Editorial; Congress organisation Reviews, Mini-Review; Original Articles; Short The staff have been involved in the organisation of Communications; Technical Notes; Forthcoming Events. numerous meetings, Italian and international, chaired many events and sessions, given several invited lectures, and delivered numerous platform or poster presentations. organisation of italian meetings ??????? organisation of international scientific meetings ??????? 5.6 Pre- and postgraduate teaching Various members of the Staff of the Pavia sections hold confinia cephalalgica academic courses at the University of Pavia for the School of Medicine, the Residency in Neurology and The journal focuses on interdisciplinary study of headache Neurophysiology and the School for Neurophysiology and adaptive disorders. The contributions come from Technicians. University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 specialists in the main branches of medicine and other fields Founded by Prof. G. Nappi and Prof. G.C. Manzoni 5.7 Collaboration with scientific organisations The Pavia sections closely collaborates with the following Italian scientific organisations: - Italian Society for the Study of Headache (SISC); - Italian Society of Neurology (SIN); - Italian Society of Neurological Rehabilitation (SIRN); - International Headache Society (IHS); - European Headache Federation (EHF). cefalee today 5.8 Collaboration with lay associations This is an informative bi-monthly newsletter edited by CIRNA Foundation (Centro Italiano Ricerche Neurologiche The Pavia sections closely and actively collaborate with the Applicate; Italian Centre for Applied Neurological Italian lay association Alleanza Cefalalgici (Al.Ce. Group). Research); the newsletter can be consulted online on the Several members of the centre’s staff help, on a voluntary website www.cefalea.it. Its main aim is to cover, in simple basis, to encourage and promote the activities of the Al.Ce. terms, questions on headache and its co-morbidities. The Group. articles are aimed at people with an interest in headache Members of the Pavia Headache Centre staff are board (patients and their families, doctors, nurses, pharmacists, members of the European Headache Alliance (EHA), an the media, pharmaceutical industries, experts on alternative umbrella organisation that groups several European lay medicine); Editor-in-chief: Dr G. Sances. headache organisations. 5.9 Website The UCDAH runs a very active website. The website www.cefalea.it is created by Al.Ce. (Alleanza Cefalalgici) Group - CIRNA Foundation (Italian Centre for Applied Neurological Research), a non-profit organisation, founded in 1999 and made up of volunteers (medical and non- 32
  7. 7. medical) working to educate and to inform people about headache. The website has many interactive options: -“Info UCADH” containing a description of University Centre for Adaptive Disorders and Headache, information on main headache events and book reviews; -information service for patients and doctors; -a list of headache centres classified and accredited by the CIRNA Foundation; -“Cefalee Today”, a bimonthly newsletter. Each issue of the newsletter contains: an article on a general topic in the field of headache; a section called 'Contagocce' containing the latest information on headache taken from press coverage; information on the Al.Ce. Group; and an editorial by an Italian journalist. -the online version of Confinia Cephalalgica; -many articles on headaches; -“Self-help forum”, a headache forum accessible after registration. The clinical activity of the Pavia Headache Centre is supported by the website of the IRCCS C. Mondino http:// www.ccmondino.homestead.com/ccmondino/index.html where patients can found a numbers of information concerning the in and out-patients activity 6. Acknowledgements The research group at the Pavia section of UCADH has received funding from a number of public and private organizations, which include: - MURST; - Italian Ministry of Health; - European Community; - Indena Inc. University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 31
  8. 8. The staff for clinical activities consists of 3 neurologists: dr. S. Colnaghi,dr. E. Marchioni, prof. M, Versino. Research activity The research activity focuses on the same topics of the clinical activity; recently a particular emphasis was put on the revision of the Tolosa Hunt classification criteria. The section is currently involved in an evoked potential habituation study based on auditory stimulation: this study is made in collaboration with the UCADH Varese section. In the next future the section would like to promote a multicenter study on Tolosa-Hunt classification/diagnostic criteria, and a study on the efficacy of vestibular rehabiltaion in the treatment of migraine vertigo. The staff for research activities consists of 4 neurologists SEZIONE DI PAVIA II (dr. S. Colnaghi, dr. E. Marchioni, dr. A. Romani, prof. M, Versino) and 1 physiologist (prof. M. Schieppati). UNIVERSITÀ DEGLI STUDI DI PAVIA Research staff SEZIONE DI NEUROFISIOLOGIA CLINICA Prof. M. Versino, MD, Associate Professor of Neurology RESPONSABILE (Chief) Prof. M. Schieppati, MD, Full Professor of Physiology, Maurizio Versino, PA Dr. S. Colnaghi, MD, neurologist, PhD student Dr. E. Marchioni, MD, Neurologist IRCCS Fondazione Istituto Neurologico “C. Mondino” Dr. A. Romani, MD, Neurologist Via Palestro 3 - 27100 Pavia Publications (2006-2007) Tel.: 0382-380… / 0382-380… / Fax: 0382-380… University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 e-mail: maurizio.versino@unipv.it 1. Marchioni E, Tavazzi E, Bono G, Minoli L, Bastianello S, Sinforiani E, Sances G, Tinelli C, Nappi G. MEMBRI CONSIGLIO SCIENTIFICO Headache attributed to infection: observations on the IHS classification (ICHD-II). Cephalalgia. 2006 Marco Schieppati, Dec;26(12):1427-33 Arrigo Moglia, PO 2. Colnaghi S, Pichiecchio A, Bastianello S, Versino M. IRCCS Fondazione Istituto Neurologico “C. Mondino” SPIR MRI usefulness for steroid treatment management in Tolosa-Hunt syndrome. Neurol Sci. Via Palestro 3 - 27100 Pavia 2006 Jun;27(2):137-9 Tel.: 0382-380209 / 380244 (segr) / Fax: 0382-380286 3. Alfonsi E, Versino M, Merlo IM, Pacchetti C, e-mail: arrigo.moglia@unipv.it Martignoni E, Bertino G, Moglia A, Tassorelli C, Nappi G. Electrophysiologic patterns of oral- pharyngeal swallowing in parkinsonian syndromes. ANNUAL REPORT 2006-2007 Neurology. 2007 Feb 20;68(8):583-9 Clinical activity 4. Bensoussan L, Viton JM, Schieppati M, Collado H, Milhe de Bovis V, Mesure S, Delarque A. Changes in The clinical activity mainly focuses on patients with postural control in hemiplegic patients after stroke migraine vertigo or secondary headache. The section is only performing a dual task. Arch Phys Med Rehabil. 2007 Aug;88(8):1009-15 interested in the Tolosa-Hunt syndrome. The patients are mainly seen in the outpatient centre or in a day hospital 5. Bove M, Brichetto G, Abbruzzese G, Marchese R, regimen, and the diagnostic assessment is made through the Schieppati M. Postural responses to continuous facilities of the C. Mondino Neurological Institute unilateral neck muscle vibration in standing patients Foundation (Echo-DDS, EMG, Evoked potentials, with cervical dystonia. Mov Disord. 2007 Mar Vestibular and Eye movement labs; MRI). 15;22(4):498-503 32
  9. 9. 6. Courtine G, De Nunzio AM, Schmid M, Beretta MV, Schieppati M. Stance- and locomotion-dependent processing of vibration-induced proprioceptive inflow from multiple muscles in humans. J Neurophysiol. 2007 Jan;97(1):772-9 7. De Nunzio AM, Nardone A, Schieppati M. The control of equilibrium in Parkinson's disease patients: delayed adaptation of balancing strategy to shifts in sensory set during a dynamic task. Brain Res Bull. 2007 Sep 28;74(4):258-70 8. De Nunzio AM, Schieppati M. Time to reconfigure balancing behaviour in man: changing visual condition while riding a continuously moving platform.Exp Brain Res. 2007 Mar;178(1):18-36 9. Nardone A, Galante M, Pareyson D, Schieppati M. Balance control in Sensory Neuron Disease. Clin Neurophysiol. 2007 Mar;118(3):538-50 10. Schmid M, Nardone A, De Nunzio AM, Schmid M, Schieppati M. Equilibrium during static and dynamic tasks in blind subjects: no evidence of cross-modal plasticity. Brain. 2007 Aug;130(Pt 8):2097-107 11. Versino M, Candeloro E, Tavazzi E, Moglia A, Sandrini G, Alfonsi E. The H reflex from the abductor brevis hallucis muscle in healthy subjects.Muscle Nerve. 2007 Jul;36(1):39-46 12. Zanetti C, Schieppati M. Quiet stance control is University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 affected by prior treadmill but not overground locomotion.Eur J Appl Physiol. 2007 Jun;100(3):331-9 13. Versino M, Ranza L, Colnaghi S, Alloni R, Callieco R, Romani A, Bergamaschi R, Pichiecchio A, Bastianello S, Cosi V. The N3 potential compared to sound and galvanic vestibular evoked myogenic potential in healthy subjects and in multiple sclerosis patients. J Vestib Res. 2007;17(1):39-46. 31
  10. 10. Neurobiological correlates of alcoholism and other addictions Neurobiological correlates of mood and anxiety disorders Neurobiological markers of cognitive disorders Neurobiological correlates of eating disorders in elderly and demented patients Neurological correlates of glycogenosis type II Research Projects 2006-2007 Neurobiological correlates of eating disorders in elderly SEZIONE DI PAVIA III and demented patients Neurochemical markers in the diagnosis of dementia UNIVERSITÀ DEGLI STUDI DI PAVIA Neuroimaging in dementia syndromes Neurological assessment of glycogenosis type II under SEZIONE DI NEUROPSICHIATRIA enzyme replacement treatment (ERT). BIOLOGICA Research staff Prof. A. Costa, MD, Aggregate Professor (Chief) RESPONSABILE Prof. M. Rossi, Biologist, Aggregate Professor Alfredo Costa, R Dr. S. Ravaglia, MD, PhD IRCCS Fondazione Istituto “C. Mondino” Dr. P. Bini, MD, Fully trained Neurologist, PhD Applicant Via Palestro, 3 – 27100 Pavia Dr. F. Casoni, MD, Training Neurophysiopathologist Tel.: 0382-380… / 0382-380… / Fax: 0382-380… e-mail: Research and clinical collaborations ANNUAL REPORT 2006-2007 National Collaborations Clinical Activity Prof. P. Navarra, Institute of Pharmacology, Catholic University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 University of Rome The outpatient headache service consists of 3 outpatient Prof. C. Danesino, Institute of Medical Genetics, University clinics /week, for about 20 pts/week of Pavia Physicians staffing the outpatients clinics Prof. L. Manzo, Dept. of Medical Toxicology, University n. 1 (Prof. A. Costa) of Pavia, IRCCS S. Maugeri, Pavia Prof. E. Sternieri, Institute of Pharmacology, University of The inpatient headache service consists of about 10 Modena patients /months Inpatients service staff International Collaborations n. 3 Physicians (Prof. A. Costa, Dr. F. Casoni, Dr. P. Bini) Prof. A. Grossman, Dept. of Endocrinology, St. Bartholomew’s Hospital, London Facilities Other activities Protocols of withdrawal of drug and other substance in cases of abuse or dependence; Pre- and postgraduate teaching Teaching of several medical students and training Instrumental diagnostic tools (CT, MRI, EEG, EMG, neurologists; ECHO-DDS, Psychodiagnostic testing, neuroendocrine assessment). Collaboration with scientific organisations Research activity Collaborations with SISC, EHF and SIN Historical lines of research Neuroendocrinology and neuropharmacology of headache disorders Neuroendocrine correlates of headache drug abuse / dependence 32
  11. 11. The inpatient headache service has about 40 ordinary admissions a year with an average length of stay of one week. The outpatient headache service provides approximately 1000 outpatient evaluations per year (500 first-time visits and 500 follow-up evaluations). Appointments are typically scheduled by phone. Referrals are received from primary care physicians, schools, family members and outside providers. SEZIONE DI PAVIA IV The referred children and adolescents represent a wide range of regional and extraregional patients of different UNIVERSITÀ DEGLI STUDI DI PAVIA socioeconomic and increasingly racial groups. The clinic staff consists of staff child neuropsychiatrist and SEZIONE DI STUDIO E TERAPIA DELLA trainees in child and adolescent neuropsychiatry with CEFALEA IN ETÀ EVOLUTIVA specific expertise in assessing and managing headache in children and adolescents Umberto Balottin , MD ( Director of the Unit ) RESPONSABILE Cristiano Termine , MD Umberto Balottin , PO Fausta Piazza, MD IRCCS Fondazione Istituto “C. Mondino” Maura Rossi, MD, PhD Via Mondino,2 – 27100 Pavia Enrico Alfei, MD Tel.: 0382-380211/ 0382-380280/ Fax: 0382-380286- Tiziana Carigi, MD mail: umberto.balottin@unipv.it Francesca Assandri, MD Sara Malgesini, MD Chiara Cortesi, MD Section Research and therapy of childhood headache and migraine Pavia Research activity Our research programs focus on the pathogenesis, ANNUAL REPORT 2006-2007 phenotypic characterization, course and clinical and University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 Member of Scientific Council pharmacological treatment of different childhood and Fazzi Elisa, PA adolescent headache subtypes, according to ICHD – II IRCCS Fondazione Istituto “C. Mondino” edition (2004) criteria. Via Mondino,2 – 27100 Pavia The historical lines of research include studies and Tel.: 0382-380222 0382-380280 Fax: 0382-380286, publications focusing on: e-mail: elisa.fazzi@mondino.it -Pathogenesis of idiopathic headache in children and adolescents Veggiotti Pierangelo, … -Personality traits and psychiatric comorbidity in childhood IRCCS Fondazione Istituto “C. Mondino” and adolescents headache Via Mondino,2 – 27100 Pavia - Phenotypic characterization and course of migraine and Tel.: 0382-380344/ 0382-380280/ Fax: 0382-380286- tension type headache in children mail: pierangelo.veggiotti@mondino.it - The prevalence of vascular disorders in the relatives of children and adolescents with migraine Clinical Activity - The evolution of migraine aura in children and The department has an active clinical program devoted to adolescents ( follow-up studies) providing high quality clinical care through the development - The therapeutic approach to the migraine patient-headache of appropriate diagnosis, treatment and management plans in children and adolescents, with a particular emphasis on according to written evidence-based specific specialty the effectiveness of hospitalisation and alternatives protocols. therapies in the treatment of paediatric idiopathic headache As a tertiary care center, the inpatient program provides patients and on evidence-based migraine prophylactic comprehensive diagnostic evaluation and specialized treatments. treatments for the most severe forms of migraine and tension type headache in children and adolescents. Research Projects 2006-2007 31
  12. 12. Our current multidisciplinary research programs, 4. Balottin U, Ferri M, Termine C. Evidence-based developed through national and international collaborations, medicine in migraine prophylactic treatment in focus on : childhood and adolescence Drug Development The quality of life of headache patients and their relatives Research 2007; 68 (7): 461– 468 compared to healthy controls The prevalence and characterization of comorbid psychiatric Books disorders in headache patients and their parents compared G. Lanzi, S. D’Arrigo, O. Ferrari Ginevra, C. Termine to healthy controls Emicrania e cefalea tensiva in età evolutiva The analysis of different neurophysiological measures in Franco Angeli Edizioni, a cura delle Fondazione Pierfranco order to understand if psychiatric comorbidity influences e Luisa Mariani (MI) the cortical responses of juvenile headache sufferers. Research staff : Congress Proceedings Umberto Balottin, MD ( Director of the Unit ) -Balottin U., Termine C., Racca M., Rossi M., Ferri M., Cristiano Termine ,MD Rossi G., Lanzi G. Fausta Piazza ,MD -Emicrania e cefalea tensiva in età evolutiva: la psicoterapia Maura Rossi ,MD, PhD è più o meno efficace della terapia neuropsichiatria Enrico Alfei, MD tradizionale? Uno studio pilota controllato. Tiziana Carigi, MD -XXXIII Congresso Nazionale SINPIA “Ospedale e Francesca Assandri , MD Territorio: spazi e modalità di cura del bambino e Chiara Cortesi, MD dell’adolescente” , Abano Terme 25/28 ottobre 2006 Sara Malgesini, MD Research and clinical collaborations National Collaborations : Department of Developmental Neurology and Psychiatry, University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 University of Rome ‘‘La Sapienza’’ – Director Prof. Guidetti International Collaborations: Headache Outpatient Centre, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria – Prof. Wober-Bingol Publications (2006-2007) 1. Balottin U, Nicoli F, Pitillo G, Ferrari Ginevra O, Borgatti R, Lanzi G. Migraine and tension headache in children under 6 years of age. European Journal of Pain 8 (2004) 307-314 2. Piccinelli P, Borgatti R, Nicoli F, Calcagno P, Bassi MT,Quadrelli M, Rossi G, Lanzi G, Balottin U. Relationship between migraine and epilepsy in pediatric age. Headache 2006 Mar;46(3):413-21. 3. Lanzi G, D'Arrigo S, Termine C, Rossi M, Ferrari- Ginevra O, Mongelli A, Millul A, Beghi E. The effectiveness of hospitalization in the treatment of paediatric idiopathic headache patients. Psychopathology. 2007;40(1):1-7. 32
  13. 13. Co-opted members Dr Anna Ambrosini (Headache Clinic INM Neuromed) Dr Armando Perrotta (Headache Clinic INM Neuromed) Dr Filippo Maria Santorelli (Bambino Gesù Children's Research Hospital, Rome, Italy) SEZIONE DI ROMA “LA SAPIENZA” Clinical Activity UNIVERSITÀ DI ROMA “LA SAPIENZA” The clinical activity is based on the presence of outpatient and inpatient facilities and is always carried out in parallel SEZIONE DI CEFALEE PRIMARIE: with clinical and pre-clinical research. NEUROGENETICA E NEUROFISIOLOGIA The outpatient and inpatient headache service consist in one RESPONSABILE day for general headache consultation and clinic for specific Pierelli, Francesco PO disorders, such as chronic headache with or without Dip di Neurologia Clinica, Otorinolaringoiatria, medication overconsumption. For both general and specific Viale dell'Università, 30 - BOX 53 - Agenzia Roma - headache clinics we have several facilities, such as Succ.le 62 neuroimagings (MRI, Angio-MRI, multilayer CT-scan), Tel: 06-49914497 Fax: 064454294 neurophysiological (EEG, EMG, evoked potentials, blink- e-mail: pierelli@neuromed.it reflex) and neuropsychological tests. Francesco.Pierelli@uniroma1.it ANNUAL REPORT 2006-2007 Physicians staffing the outpatients clinics Prof. Francesco Pierelli, Headache Clinic – U.O.C. Neuroriabilitazione, I Facoltà Dr. Gianluca Coppola, Medicina e Chirurgia, Università “La Sapienza” - Polo Dr. Cherubino di Lorenzo. Pontino- I.C.O.T. Research activity The inpatient headache service University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 We schedule the patient’s hospitalization only in case of Historical lines of research differential diagnosis with a secondary headache’s form, with the scope to perform more specific diagnostic - Genetics and neurophysiology of primary headaches confirmations. We reserve Day Hospital beds for detoxication’s Research Projects 2006-2007 procedures in patients with medication overuse headache. This detoxication’s program consists of pharmacological - Genetic basis of responses to preventive treatment with intervention in conjunction with cervical massages and high dose of riboflavin; kinesic treatment. Patients are daily monitored by means of - Mitochondrial genetic basis of migraine disease; scheduled clinical visits and headache diary observation. At - Visual evoked gamma band oscillations in a subgroups of the end of at least one month detoxication’s period, a migraine with aura patients; proper prophylactic treatment will be establish. - Trigeminal reflexes (blink and trigemino cervical) in primary headaches; - Trigeminal evoked potentials in migraine and chronic Inpatients service staff headaches (with or without medication overuse); Prof. Francesco Pierelli, - Thalamo-cortical activity and its relationship with lack of Dr. Mariano Serrao, habituation in migraine. Dr. Gianluca Coppola. Research staff Facilities Prof. Francesco Pierelli In January 2005 a peace of Neurology Clinic of “La Dr. Mariano Serrao Sapienza” University moved to city of Latina, located 60 Dr. Gianluca Coppola kilometres from Rome. The hospital rooms and clinics are Dr. Di Lorenzo Cherubino of the highest standard. In addition, we have the 31
  14. 14. neuroimaging, biochemical and neurophysiological research 6. Di Lorenzo C, Sances G, Di Lorenzo G, Rengo C, laboratories grouped in a new hospital site. Ghiotto N, Guaschino E, Perrotta A; Santorelli FM, Grieco GS, Tessa A, Troisi A, Siracusano A, Research and clinical collaborations Pierelli F, Sandrini G, Nappi G, Casali C. The Wolframin His611Arg polymorphism influences Medication Overuse Headache. Neurosci Lett, 2007 National Collaborations Sep 13;424(3):179-84 - Centro Interuniversitario per lo Studio delle Cefalee e dei 7. Coppola G, Pierelli F, Schoenen J. Is the cerebral Disordini Adattativi (UCADH), IRCCS Mondino, cortex hyperexcitable or hyperresponsive in migraine? Università degli Studi di Pavia – Prof. Giorgio Sandrini Headache Currents (Cephalalgia) 2007; 27: 1429– - Fondazione per l’Oftalmologia “G.B. Bietti”, IRCSS, 1439 Roma – Dott. Vincenzo Parisi; - IRCSS INM Neuromed, Headache Clinic, Pozzilli (IS) – 8. Magis D, Ambrosini A, Bendtsen L, Ertas M, Kaube Dr. Anna Ambrosini. Dr Armando Perrotta H, Schoenen J; EUROHEAD Project. Evaluation and proposal for optimalization of neurophysiological tests in migraine: part 1--electrophysiological tests. International Collaborations Cephalalgia. 2007 Dec;27(12):1323-38 - Headache Research Unit, CHR Citadelle Hospital, 9. Ambrosini A. Occipital nerve stimulation for University of Liège, Liegi (Belgio); intractable cluster headache. Lancet. 2007 Mar 31;369(9567):1063-5 - Center for Sensory-Motor Interaction, Aalborg University (Danimarca). 10. Magis D, Ambrosini A, Sándor P, Jacquy J, Laloux P, Schoenen J. A randomized double-blind placebo- controlled trial of thioctic acid in migraine Publications 2006-2007 prophylaxis. Headache. 2007 Jan;47(1):52-7. 1. Pierelli F, Grieco GS, Pauri F, Pirro C, Fiermonte G, Other activities Ambrosini A, Costa A, Buzzi MG, Valoppi M, Caltagirone C, Nappi G, Santorelli FM. A novel University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 ATP1A2 mutation in a family with FHM type II. Scientific organisations, professional organisations and Cephalalgia 2006; 26:324–328 committees: - ECM organization entitled “Emicrania: aspetti clinici e 2. Coppola G, Di Clemente L, Fumal A, Magis D, De terapeutici”. Ordine dei Medici di Latina, 10 February 2007 Pasqua V, Pierelli F, Schoenen J. Inhibition of the nociceptive R2 blink reflex after supraorbital or index Honorary degrees, prizes and other honours: finger stimulation is normal in migraine without aura between attacks. Cephalalgia 2007; 27: 803-8 • The poster entitled “The Nociceptive Trigemino- 3. Cricchi F, Di Lorenzo C, Grieco GS, Rengo C, Cervical-Reflexes (TCRs) in healthy subjects” Cardinale A, Racaniello M, Santorelli FM, Nappi G, won as better poster presentation in its session Pierelli F, Casali C. Early-onset progressive ataxia and was converted to oral presentation at the associated with the first CACNA1A mutation Congress of the Italian Clinical identified within the I-II loop. J Neurol Sci. 2007; Neurophysiological Society (SINC) 2007, 254(1-2):69-71 Palermo 24-26 May 2007; • The project entitled “Modulation of Visual 4. Currà A, Pierelli F, Coppola G, Barbanti P, Buzzi MG, Evoked Potentials by Diffuse Noxious Inhibitory Galeotti F, Serrao M, Truini A, Casali C, Pauri F, Control (DNIC) in migraine patients between Cruccu G. Shortened cortical silent period in facial attacks” won the prize Franco Michele Puca muscles of patients with migraine. Pain 2007; Award 2007, Pavia 29 September, SISC. 132(1-2):124-31 Editorial activity 5. Coppola G, Parisi V, Fiermonte G, Restuccia R, - Two chapters of the new “Trattato delle Cefalee” (Edited Pierelli F. Asymmetrical distribution of visual evoked by: A.Pini, P. Sarchielli, G.Zanchin) potentials in patients with migraine with aura during the interictal phase. Eur J Ophtalmol 2007; Collaboration with scientific organisations: 17(5):828-35 32
  15. 15. • Prof. Pierelli is member of the main council of the Historical lines of research Italian Society of the study of Headache (SISC); - Cluster headache (classification, epidemiology and • Dr. Coppola is member of the main council of the clinical picture) regional section (Lazio/Molise) of the Italian Society of the study of Headache (SISC); - Migraine with aura (epidemiology, comorbidity, clinical pictures) • Dr. Coppola is member of the Sub-commission - Chronic daily headache (classification Traines of the International Headache Society epidemiology, comorbidity, clinical picture) (HIS). - Tension-type headache( Pathogenetical aspects) SEZIONE DI PARMA UNIVERSITÀ DI PARMA Research projects 2006-2007 SEZIONE DI NEUROEPIDEMIOLOGIA - Study of the prevalence of the major primary APPLICATA headache forms in the general population - Head injury and cluster headache - Smoking and cluster headache RESPONSABILE - Migraine with aura and interatrial sectum defects Manzoni, Giancamillo, PO - Comorbidity between migraine and epilepsy Centro cefalee, sez di neurologia Dipartimento di - comorbidity between migraine and psychiatric Neuroscienze, c/o Ospedale maggiore, padiglione barbieri, disease via Gramsci, 14 - 43100 Parma - Healthcare provision to primary migraine patients tel 0521-704126 fax 0521-704105 e-mail: in the Parma province manzoni@ipruniv.cce.unipr.it - Validation of a diagnostic headache questionnaire to use in the general population ANNUAL REPORT 2006-2007 Clinical trials Clinical activity Botulinum toxin in the detoxification of chronic medication overuse headache University Centre for Adaptive Disorders and Headache (UCADH) | 18/07/2008 Out-patient activity Research staff 2,000 medical visits per year (including first-time visits and follow-up visits) Prof. Gian Camillo Manzoni Prof. Paola Torelli Medical staff for the out-patient service Dr. Paola Castellini Prof. Gian Camillo Manzoni Dr. Giorgio Lambru Prof. Paola Torelli Dr. Tullia Ferrante Dr. Paola Castellini Dr. Giorgio Lambru Clinical research and co-operation Dr. Massimiliano Devetak Dr. Tullia Ferrante National Mondino Institute, Pavia In-patient activity Mario Negri Institute, Milan 2 patients per month International Glostrup Headache Centre, Copenhagen (Denmark) Medical staff for the in-patient service Publications 2006-2007 Prof. Gian Camillo Manzoni Prof. Paola Torelli 1. Manzoni GC, Lambru G, Torelli P. Head trauma and Dr. Paola Castellini cluster headache. Curr Pain Head Rep Dr. Giorgio Lambru 2006;10:130-136 Dr. Massimiliano Devetak Dr. Tullia Ferrante 2. Cucurachi L, Devetak M, Torelli P, Lambru G, Manzoni GC. Gendere ratio of migraine without aura: Research activity observations over time. Neurol Sci 2006;27:47-50 31

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