Foto del docente

Federica Provini

Assistant professor

Department of Biomedical and Neuromotor Sciences

Academic discipline: MED/26 Neurology

Research

Keywords: Sleep Related Movement Disorders Sleep related eating disorders Restless Legs Syndrome sleep onset Adult Parasomnias Sleep-walking

Areas of particular interest and expertise:

- Epilepsy, in particular Nocturnal Frontal Lobe Epilepsy

- Sleep Medicine, in particular movement disorder during sleep (propriospinal myoclonus, restless legs syndrome, sleep-related eating disorders)

Dr. Provini's main research activities focus on sleep medicine, including the characterization of movement disorders during sleep and the description of sleep features in neurological diseases (in particular neurodegenerative diseases). Using an integrated approach combining clinical observation and video-polysomnographic recording of electroencephalographic, motor and autonomic parameters during wake and sleep, she collected original data in different pathological conditions (e.g.: Vetrugno, Provini, et al, Sleep Med 2004; Calandra-Buonuara, Provini et al, Sleep Med 2014; Chiaro, Provini et al Sleep Med 2016; Antelmi, Provini et al, Sleep 2017).

In particular, she described in detail the clinical and video-polysomnographic characteristics of a sleep-related nocturnal epileptic syndrome (Nocturnal Frontal Lobe Epilepsy). The publications on this topic are a point of reference for the specific diagnostic criteria of this disease, given the large number of cases observed (the largest series in the world) and the accuracy of the clinical analysis conducted (Provini et al, Brain 1999; Provini et al, Sleep Med Rev 2000; Tinuper, Provini et al, Sleep Med Rev 2007; Nobili, Provini et al, Curr Neurol Neurosci Rep 2014;Tinuper, Provini et al, Neurology 2016).

Following the tradition of the work developed in the Sleep Laboratory at the University of Bologna Department of Neurological Sciences, Dr. Provini has made original observations on Restless Legs Syndrome (RLS). She characterized the motor pattern of periodic movements during sleep in patients with RLS (Provini  et al, Neurology 2001 among the selected papers list) and took an active part in the international validation of a scale for the diagnosis of the RLS (Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome, Sleep Med 2003). This scale is currently used worldwide for RLS diagnosis.

Dr. Provini is actively involved in international studies on the search for genes associated with RLS (see Neurogenetics, 2008) and from 2005 to 2008 she took part in six international pharmacological clinical and polygraphic trials designed to assess the efficacy and tolerability of  dopaminergic drugs (Rotigotine and Ropinirole) in RLS. The results of these studies were published in peer-reviewed journals.

More recently she opened new frontiers describing for the first time new aspects of the behaviour of RLS patients: the undescribed association with sleep-related eating and smoking disorders (Vetrugno and Provini, Sleep 2006; Provini et al, Mov Disord 2009; Provini et al, Sleep Med 2010;Antelmi, Provini et al, Sleep Med 2014; Marconi, Provini et al, J Neural Transm 2015) and the description of atypical cases (Turrini, Provini et al, Sleep Med Rev 2017).

Dr. Provini described a new nosological entity: propriospinal myoclonus at sleep onset. She demonstrated that this particular form of spinal myoclonus, strictly confined to the pre-dormitum, causes a severe chronic insomnia; she contributed to the inclusion of this new entity in the latest International Classification of Sleep Disorders (Vetrugno, Provini, et al, Sleep 2001; Antelmi and Provini, Sleep Med Rev 2015).

She has also collected original detailed data on the clinical and neurophysiological features of Fatal Familial Insomnia, Morvan Syndrome and Delirium Tremens, establishing their phenomenological similarities. She contributed to the development of the concept of "agrypnia excitata" as a nosological category defining a peculiar clinical condition characterized by loss of slow-wave sleep, oneiric stupor, motor and sympathergic activation (Lugaresi and Provini, Sleep Med Rev 2001; Guaraldi and Provini, Sleep Med 2011; Lanuzza, Provini et al Sleep Med 2012; Geminiani, Provini et al, Sleep Med 2012; Baiardi, Provini et al, Neurology 2015). This concept led to a radical revision of hitherto accepted theories on the mechanisms regulating the sleep-wake cycle and other circadian rhythms.

Resuming a line of research started during her PhD, Dr Provini has is currently involved in an in-depth study of slow eye movements (SEMs). SEMs are typical of the sleep onset period and are a good and simple marker of sleepiness, matching with other validated tests (Fabbri, Provini et al, 200 among the selected papers list). The goal of the research is to validate a new technology to detect involuntary sleep attacks or reductions of vigilance level during daily-life activities, especially among workers requiring a high level of alertness for prolonged periods of time(e.g. lorry driving).

      

Research Production and Impact

Dr. Provini's research activity has led to more than 200 scientific papers of which 163 have been published in international peer-reviewed journals.         

Dr. Provini contributed to 40 chapters on sleep disorders and epilepsy published in international textbooks by leading publishing houses including Saunders Elsevier Inc, Lippincott Williams & Wilkins and Cambridge University Press.

She is co-author of a chapter of the Handbook of Neurology (Vetrugno R, Provini F, Montagna P. Isolated motor phenomena and symptoms of sleep. Handb Clin Neurol 2011;99:883-899) which for the first time has included two volumes devoted to sleep disorders.

In 2006, together with Elio Lugaresi Dr. Provini wrote an invited chapter on Sleep Medicine for the Book of the year of the prestigious Italian encyclopedia TRECCANI 2006, documenting the large and growing cultural interest in sleep medicine in recent years.