Luigi Trojano

Professor of Neuropsychology

Name Luigi
Surname Trojano
Institution Università degli Studi della Campania Luigi Vanvitelli
Address Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100 Caserta, Italy


  • Affective saliency modifies visual tracking behavior in disorders of consciousness: a quantitative analysis.

    Publication Date: 01/01/2013 on Journal of neurology
    by Trojano L, Moretta P, Loreto V, Santoro L, Estraneo A
    DOI: 10.1007/s00415-012-6717-x
  • Mapping correspondence between facial mimicry and emotion recognition in healthy subjects.

    Publication Date: 01/12/2012 on Emotion (Washington, D.C.)
    by Ponari M, Conson M, D'Amico NP, Grossi D, Trojano L
    DOI: 10.1037/a0028588

    We aimed at verifying the hypothesis that facial mimicry is causally and selectively involved in emotion recognition. For this purpose, in Experiment 1, we explored the effect of tonic contraction of muscles in upper or lower half of participants' face on their ability to recognize emotional facial expressions. We found that the "lower" manipulation specifically impaired recognition of happiness and disgust, the "upper" manipulation impaired recognition of anger, while both manipulations affected recognition of fear; recognition of surprise and sadness were not affected by either blocking manipulations. In Experiment 2, we verified whether emotion recognition is hampered by stimuli in which an upper or lower half-face showing an emotional expression is combined with a neutral half-face. We found that the neutral lower half-face interfered with recognition of happiness and disgust, whereas the neutral upper half impaired recognition of anger; recognition of fear and sadness was impaired by both manipulations, whereas recognition of surprise was not affected by either manipulation. Taken together, the present findings support simulation models of emotion recognition and provide insight into the role of mimicry in comprehension of others' emotional facial expressions.

  • Quantitative assessment of visual behavior in disorders of consciousness.

    Publication Date: 01/09/2012 on Journal of neurology
    by Trojano L, Moretta P, Loreto V, Cozzolino A, Santoro L, Estraneo A
    DOI: 10.1007/s00415-012-6435-4

    The study of eye behavior is of paramount importance in the differential diagnosis of disorders of consciousness (DoC). In spite of this, assessment of eye movement patterns in patients with vegetative state (VS) or minimally conscious state (MCS) only relies on clinical evaluation. In this study we aimed to provide a quantitative assessment of visual tracking behavior in response to moving stimuli in DoC patients. Nine VS patients and nine MCS patients were recruited in a Neurorehabilitation Unit for patients with chronic DoC; 11 matched healthy subjects were tested as the control group. All participants under went a quantitative evaluation of eye-tracking pattern by means of a computerized infrared eye-tracker system; stimuli were represented by a red circle or a small color picture slowly moving on a PC monitor. The proportion of on- or off-target fixations differed significantly between MCS and VS. Most importantly, the distribution of fixations on or off the target in all VS patients was at or below the chance level, whereas in the MCS group seven out of nine patients showed a proportion of on-target fixations significantly higher than the chance level. Fixation length did not differ among the three groups significantly. The present quantitative assessment of visual behaviour in a tracking task demonstrated that MCS and VS patients differ in the proportion of on-target fixations. These results could have important clinical implications since the quantitative analysis of visual behavior might provide additional elements in the differential diagnosis of DoC.

  • Chronic somatoparaphrenia: a follow-up study on two clinical cases.

    Publication Date: 01/06/2012 on Cortex; a journal devoted to the study of the nervous system and behavior
    by Cogliano R, Crisci C, Conson M, Grossi D, Trojano L
    DOI: 10.1016/j.cortex.2011.08.008

    Somatoparaphrenia consists in abnormal or bizarre verbal reports about some parts of the body. Such a pathological condition usually lasts for days or weeks and is variably associated with other cognitive defects. In the present paper we describe exceptionally long-lasting somatoparaphrenia in two focal brain-damaged patients: GA who had a right hemorrhagic fronto-parieto-temporal stroke and AC who developed a left ischemic parieto-occipital lesion. The presence and severity of somatoparaphrenia did not change in either patient during a 2-year follow-up, whereas the two patients showed different evolution of anosognosia for motor disorders, severity of extrapersonal neglect and cognitive impairments. Moreover, impairment of position sense was associated with somatoparaphrenia in one patient only; neither patient showed personal neglect. The reported clinical observations suggest that somatoparaphrenia can be observed as a body-related chronic disorder and can outlast other cognitive defects, even if it arose in conjunction with them.

  • Executive functions are impaired in heterozygote patients with oculopharyngeal muscular dystrophy.

    Publication Date: 01/05/2012 on Journal of neurology
    by Dubbioso R, Moretta P, Manganelli F, Fiorillo C, Iodice R, Trojano L, Santoro L
    DOI: 10.1007/s00415-011-6255-y

    Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant disorder caused by a small expansion of a short polyalanine tract in poly(A) binding protein nuclear 1 (PABPN1). It presents with adult onset of progressive eyelid drooping, swallowing difficulties and proximal limb weakness, usually without involvement of central nervous system (CNS). However, cognitive decline with relevant behavioural and psychological symptoms has been recently described in homozygous patients. In this study, we performed for the first time an extensive neuropsychological and neuropsychiatric evaluation on 11 OPMD heterozygote patients. We found that they were less efficient than a matched control sample on several tests, particularly those tapping executive functions. Moreover, the presence of negative correlation between GCN expansion size and some neuropsychological scores raises the issue that CNS involvement might be linked to the genetic defect, being worse in patients with larger expansion. Our results might be consistent with the toxic gain-of-function theory in the pathogenesis of OPMD and hint at a possible direct role of PABPN1 in the CNS also in heterozygote patients.

  • Neuropsychological correlates of theory of mind in patients with early Parkinson's disease.

    Publication Date: 01/01/2012 on Movement disorders : official journal of the Movement Disorder Society
    by Santangelo G, Vitale C, Trojano L, Errico D, Amboni M, Barbarulo AM, Grossi D, Barone P
    DOI: 10.1002/mds.23949

    The theory of mind is the ability to attribute mental states to oneself and others and to understand that others have beliefs, desires and intentions different from one's own. The aim of the study was to explore the neuropsychological correlates of theory of mind in patients affected by early Parkinson's disease (PD). Thirty-three PD patients and 33 age-, sex-, and education-matched control subjects underwent the Frontal Assessment Battery, as well as tasks assessing "cognitive" and "affective" theory of mind, and memory abilities; questionnaires evaluating behavioral disorders and quality of life were also administrated. Although the 2 groups did not differ on neuropsychological tasks, PD patients' performance on tasks assessing cognitive and affective theory of mind was significantly worse than controls. Moreover, PD patients had more behavioral disorders and worse quality of life than controls. After covarying for behavioral and quality of life scores, the differences between patients and controls on theory of mind tasks remained significant. "Cognitive" theory of mind was associated with Frontal Assessment Battery score and 2 domains of quality of life scale, whereas "affective" theory of mind scores correlated only with behavioral scales such as the Frontal Behavioral Inventory and Apathy Evaluation Scale. The results demonstrate that both affective and cognitive aspects of theory of mind are simultaneously impaired in early PD and suggest that deficits in the 2 subcomponents of theory of mind may be linked to dysfunction of different frontosubcortical circuitries in early PD.

  • Comparative neuropsychological profile of pathological gambling, hypersexuality, and compulsive eating in Parkinson's disease.

    Publication Date: 01/04/2011 on Movement disorders : official journal of the Movement Disorder Society
    by Vitale C, Santangelo G, Trojano L, Verde F, Rocco M, Grossi D, Barone P
    DOI: 10.1002/mds.23567

    Impulse control disorders (ICDs), in particular pathological gambling, hypersexuality, and compulsive eating, are being increasingly identified in Parkinson's disease (PD) patients. Pathological gambling has been associated with frontal/executive dysfunctions, whereas hypersexuality and compulsive eating, and their relation with cognitive dysfunctions, have not been investigated in PD.

  • Selective and integrated rehabilitation programs for disturbances of visual/spatial attention and executive function after brain damage: a neuropsychological evidence-based review.

    Publication Date: 01/03/2011 on European journal of physical and rehabilitation medicine
    by Zoccolotti P, Cantagallo A, De Luca M, Guariglia C, Serino A, Trojano L

    The present evidence-based review systematically examines the literature on the neuropsychological rehabilitation of attentional and executive dysfunctions in patients with acquired brain lesions. Four areas are considered: 1) neuropsychological rehabilitation of attentional disorders; 2) neuropsychological rehabilitation of neglect disorders; 3) neuropsychological rehabilitation of dysexecutive disorders and 4) rehabilitation trainings for patients with mild traumatic brain injury (TBI). In each area, search and selection of papers were performed on several databases and integrated by crosschecking references from relevant and recent reviews. The literature up to 2007 was examined (in some areas the search was limited from 2000 to 2007). Class of evidence for each selected study was evaluated according to the SPREAD (2010) criteria. Based on this analysis, recommendations on the effectiveness of rehabilitation trainings are proposed separately for each rehabilitation method in each of the four areas considered. Information on follow-up data and impact on activities of daily living is provided whenever available.

  • Drawing with oblique coordinates: on a single case.

    Publication Date: 01/01/2011 on Behavioural neurology
    by Grossi D, Santangelo G, Carbone G, Giordano F, Angelillo VG, Trojano L
    DOI: 10.3233/BEN-2011-0333

    We describe a patient with right hemisphere damage affected by mild left visuo-spatial neglect and constructional apraxia. During the rehabilitation, he failed to draw a draught-board using horizontal and vertical trajectories, but he performed it successfully using oblique trajectories. These observations suggested an impairment of vertical/horizontal spatial coordinates system. In copying tasks including figure elements in different orientations he drew more accurately components in oblique orientation, whereas failed to reproduce components in horizontal orientation. The patient performed visuospatial perceptual and perceptual-imaginative tasks successfully. From these findings, it is possible to suggest that the oblique coordinate system of reference operates independently of vertical and horizontal coordinate systems in building a complex figure and that, therefore, cardinal orientation do not constitute a reference norm to define oblique orientation, as previously suggested.

  • Cognitive rehabilitation in non-communicative brain-damaged patients.

    Publication Date: 01/01/2011 on Functional neurology
    by Trojano L, Moretta P, Cozzolino A, Saltalamacchia A, Estraneo A

    Conscious patients with severe motor and speech disorders have great difficulty interacting with the environment and communicating with other people. Several augmentative communication devices are now available to exploit these patients' expressive potential, but their use often demands considerable cognitive effort. Non-communicative patients with severe brain lesions may have, in addition, specific cognitive deficits that hinder the efficient use of augmentative communication methods. Some neuropsychological batteries are now available for testing these patients. On the basis of such cognitive assessments, cognitive rehabilitation training can now be applied, but we underline that this training must be tailored to single patients in order to allow them to communicate autonomously and efficiently.