Elisabetta Signoriello

PhD student of Neurology

Name Elisabetta
Surname Signoriello
Institution Università degli Studi della Campania Luigi Vanvitelli
Telephone +39 081 014 51 87
Mobile +39 338 435 8763
E-Mail elisabetta.signoriello@gmail.com
Address II Division of Neurology & Center fo Rare Diseases Department of Medical Surgical, Neurological, Metabolic Sciences, and Aging, University of Campania Luigi Vanvitelli, Edificio 10 Via Sergio Pansini, 580131 Naples, Italy
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Member PUBLICATIONS

  • Determinants of therapy switch in multiple sclerosis treatment-naïve patients: A real-life study.

    Publication Date: 25/07/2018 on Multiple sclerosis (Houndmills, Basingstoke, England)
    by Saccà F, Lanzillo R, Signori A, Maniscalco GT, Signoriello E, Lo Fermo S, Repice A, Annovazzi P, Baroncini D, Clerico M, Binello E, Cerqua R, Mataluni G, Bonavita S, Lavorgna L, Zarbo IR, Laroni A, Rossi S, Pareja Gutierrez L, La Gioia S, Frigeni B, Barcella V, Frau J, Cocco E, Fenu G, Torri Clerici V, Sartori A, Rasia S, Cordioli C, Di Sapio A, Pontecorvo S, Grasso R, Barrilà C, Russo CV, Esposito S, Ippolito D, Bovis F, Gallo F, Sormani MP,
    DOI: 10.1177/1352458518790390

    With many options now available, first therapy choice is challenging in multiple sclerosis (MS) and depends mainly on neurologist and patient preferences.

  • Migraine as possible red flag of PFO presence in suspected demyelinating disease.

    Publication Date: 15/07/2018 on Journal of the neurological sciences
    by Signoriello E, Cirillo M, Puoti G, Signoriello G, Negro A, Koci E, Melone MAB, Rapacciuolo A, Maresca G, Lus G
    DOI: 10.1016/j.jns.2018.04.042

    To investigate a possible association between isolated white matter lesions suggestive of demyelinating disease in magnetic resonance imaging (MRI) and patent foramen ovale (PFO) evidence in migraine patients, with or without aura.

  • Clinical activity after fingolimod cessation: disease reactivation or rebound?

    Publication Date: 31/05/2018 on European journal of neurology
    by Frau J, Sormani MP, Signori A, Realmuto S, Baroncini D, Annovazzi P, Signoriello E, Maniscalco G, La Gioia S, Cordioli C, Frigeni B, Rasia S, Fenu G, Grasso R, Sartori A, Lanzillo R, Stromillo ML, Rossi S, Forci B, Cocco E,
    DOI: 10.1111/ene.13694

    There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself, or if it is due to the natural course of highly active multiple sclerosis (MS). We aimed to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS.

  • Palatability and oral cavity tolerability of THC:CBD oromucosal spray and possible improvement measures in multiple sclerosis patients with resistant spasticity: a pilot study.

    Publication Date: 01/04/2018 on Neurodegenerative disease management
    by Lus G, Cantello R, Danni MC, Rini A, Sarchielli P, Tassinari T, Signoriello E
    DOI: 10.2217/nmt-2017-0056

    Complaints about Δ-tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex; GW Pharma Ltd, Salisbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects.

  • Fingolimod reduces the clinical expression of active demyelinating lesions in MS.

    Publication Date: 01/02/2018 on Multiple sclerosis and related disorders
    by Signoriello E, Landi D, Monteleone F, Saccà F, Nicoletti CG, Buttari F, Sica F, Marfia GA, Di Iorio G, Lus G, Centonze D
    DOI: 10.1016/j.msard.2018.02.002

    Fingolimod is a modulator of Central and peripheral sphingosine pathways, which is currently approved for treatment of Multiple Sclerosis (MS). In animal models it reduces inflammation, but it is also able to potentiate glutamatergic transmission and synaptic plasticity. We aimed to explore whether Fingolimod is able to modify the clinical expression of new demyelinating lesions with respect to IFNβ-1a in relapsing remitting MS (RRMS) patients suboptimal responders to IFNβ-1a.

  • Diagnostic contribution of magnetic resonance imaging in an atypical presentation of motor neuron disease.

    Publication Date: 01/12/2017 on Quantitative imaging in medicine and surgery
    by Ugga L, Coppola C, Cocozza S, Saracino D, Caranci F, Tuccillo F, Signoriello E, Casertano S, Di Iorio G, Tedeschi E
    DOI: 10.21037/qims.2017.10.06

    Motor neuron disease (MND) is a neurodegenerative disease determining progressive and relentless motor deterioration involving both upper and lower motor neurons (UMN and LMN); several variants at onset are described. Here we describe a case of MND presenting as pure spastic monoparesis in which magnetic resonance imaging (MRI) gave a substantial contribution in confirming the diagnosis and assessing the severity of UMN involvement. An isolated pyramidal syndrome, with complete absence of LMN signs, is a rare phenotype in the context of MND (less than 4% of total cases), especially if restricted to only one limb. Several other elements made this case an unusual presentation of MND: the late age of onset (8th decade), the subacute evolution of symptoms (raising the suspicion of an ischemic or inflammatory, rather than degenerative, etiology), the patient's past medical history (achalasia, erythema nodosum), the increase of inflammatory indices. Conventional MRI showed no focal lesions that could explain the clinical features; therefore, we used advanced MR sequences. Diffusion tensor imaging (DTI) evaluation evidenced bilateral impairment of corticospinal tract (CST) diffusion metrics, with clear right-left asymmetry, pointing to a neurodegenerative etiology, which clinically appeared less likely at that time. Magnetic resonance spectroscopy (MRS) showed a significant reduction of NAA/Cho + Cr ratio in the motor cortex (MC), further supporting the hypothesis of UMN degeneration. In conclusion, in this particular case of MND, whose nosographic framing has not been fully defined, advanced MRI techniques with DTI and MRS proved to be of great usefulness in confirming a diffuse UMN involvement, possibly at a more advanced stage than its clinical expression.

  • Assessing association of comorbidities with treatment choice and persistence in MS: A real-life multicenter study.

    Publication Date: 28/11/2017 on Neurology
    by Laroni A, Signori A, Maniscalco GT, Lanzillo R, Russo CV, Binello E, Lo Fermo S, Repice A, Annovazzi P, Bonavita S, Clerico M, Baroncini D, Prosperini L, La Gioia S, Rossi S, Cocco E, Frau J, Torri Clerici V, Signoriello E, Sartori A, Zarbo IR, Rasia S, Cordioli C, Cerqua R, Di Sapio A, Lavorgna L, Pontecorvo S, Barrilà C, Saccà F, Frigeni B, Esposito S, Ippolito D, Gallo F, Sormani MP,
    DOI: 10.1212/WNL.0000000000004686

    To assess whether the presence of concomitant diseases at multiple sclerosis (MS) diagnosis is associated with the choice and the treatment persistence in an Italian MS cohort.

  • Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis.

    Publication Date: 01/10/2017 on Quantitative imaging in medicine and surgery
    by Schettino C, Caranci F, Lus G, Signoriello E, Eoli M, Anghileri E, Pollo B, Melone MAB, Di Iorio G, Finocchiaro G, Ugga L, Tedeschi E
    DOI: 10.21037/qims.2017.06.09

    We report the case of a young man with sudden onset of diplopia after an upper respiratory tract infection. Based on the first radiological findings acute hemorrhagic leukoencephalitis, a variant of acute disseminated encephalomyelitis, was suspected and treatment with high dose intravenous dexamethasone was started but it was stopped for intolerance. The patient clinically worsened, developing gait instability, ataxia and ophthalmoplegia; brain MRI performed 20 days later showed severe progression of the disease with subependymal dissemination. After brain biopsy of the right temporal lesion the histological diagnosis was glioblastoma. These findings suggest that MRI features of acute hemorrhagic leukoencephalitis may dissimulate the diagnosis of diffuse glioma/glioblastoma. This case underscores the importance of considering diffuse glioma in the differential diagnosis of atypical signs and symptoms of acute hemorrhagic leukoencephalitis and underlines the relevant role of integrating neuroradiologic findings with neuropathology.

  • Sativex in resistant multiple sclerosis spasticity: Discontinuation study in a large population of Italian patients (SA.FE. study).

    Publication Date: 01/08/2017 on PloS one
    by Messina S, Solaro C, Righini I, Bergamaschi R, Bonavita S, Bossio RB, Brescia Morra V, Costantino G, Cavalla P, Centonze D, Comi G, Cottone S, Danni MC, Francia A, Gajofatto A, Gasperini C, Zaffaroni M, Petrucci L, Signoriello E, Maniscalco GT, Spinicci G, Matta M, Mirabella M, Pedà G, Castelli L, Rovaris M, Sessa E, Spitaleri D, Paolicelli D, Granata A, Zappia M, Patti F,
    DOI: 10.1371/journal.pone.0180651

    The approval of Sativex for the management of multiple sclerosis (MS) spasticity opened a new opportunity to many patients. In Italy, the healthcare payer can be fully reimbursed by the involved pharma company with the cost of treatment for patients not responding after a 4 week (28 days) trial period (Payment by Results, PbR), and 50% reimbursed with the cost of 6 weeks (42 days) treatment for other patients discontinuing (Cost Sharing, CS). The aim of our study was to describe the Sativex discontinuation profile from a large population of spasticity treated Italian MS patients.

  • The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests.

    Publication Date: 01/11/2016 on Multiple sclerosis (Houndmills, Basingstoke, England)
    by Saccà F, Costabile T, Carotenuto A, Lanzillo R, Moccia M, Pane C, Russo CV, Barbarulo AM, Casertano S, Rossi F, Signoriello E, Lus G, Brescia Morra V
    DOI: 10.1177/1352458516677592

    Despite cognitive tests have been validated in multiple sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring.