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.
