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


  • Anxiety in Multiple Sclerosis: psychometric properties of the State-Trait Anxiety Inventory.

    Publication Date: 01/12/2016 on Acta neurologica Scandinavica
    by Santangelo G, Sacco R, Siciliano M, Bisecco A, Muzzo G, Docimo R, De Stefano M, Bonavita S, Lavorgna L, Tedeschi G, Trojano L, Gallo A
    DOI: 10.1111/ane.12564

    The aims of the present study were to examine psychometric properties of the Spielberger State-Trait Anxiety Inventory (STAI-Y-1 and STAI-Y-2, respectively) in a Multiple Sclerosis (MS) population and to identify a cut-off score to detect those MS patients with high level of state and/or trait anxiety who could be more vulnerable to development of depression and/or cognitive defects.

  • Cognitive dysfunctions and psychological symptoms in migraine without aura: a cross-sectional study.

    Publication Date: 01/12/2016 on The journal of headache and pain
    by Santangelo G, Russo A, Trojano L, Falco F, Marcuccio L, Siciliano M, Conte F, Garramone F, Tessitore A, Tedeschi G
    DOI: 10.1186/s10194-016-0667-0

    The occurrence of cognitive dysfunctions and psychological symptoms, as well as their mutual relationships, in migraine patients are still debated. The aim of the study was to characterize the cognitive profile and psychological symptoms (i.e. depression, anxiety and apathy) in drug-naïve migraine without aura (MwoA) patients.

  • The role of the dorsolateral prefrontal cortex in early threat processing: a TMS study.

    Publication Date: 01/12/2016 on Social cognitive and affective neuroscience
    by Sagliano L, D'Olimpio F, Panico F, Gagliardi S, Trojano L
    DOI: 10.1093/scan/nsw105

    Previous studies demonstrated that excitatory (high frequency) offline transcranial magnetic stimulation (TMS) over the left and right dorsolateral prefrontal cortex (DLPFC) modulates attention allocation on threatening stimuli in non-clinical samples. These studies only employed offline TMS protocol that did not allow investigating the effect of the stimulation on the early stage of threat processing. In this study, the role of the right and left dorsolateral prefrontal cortex in early threat processing was investigated in high and low anxious individuals by means of an inhibitory single-pulse online TMS protocol. Our results demonstrated the role of the left DLPFC in an early stage of threat processing and that this effect is modulated by individuals' anxiety level. The inhibitory stimulation of the left DLPFC determined a disengagement bias in high anxious individuals, while the same stimulation determined an attentional avoidance in low anxious individuals. The findings of the present study suggest that right and left DLPFC are differently involved in early threat processing of healthy individuals.

  • Closing-in is Related to Daily Living Functioning in Patients With Mild-to-Moderate Alzheimer Disease.

    Publication Date: 04/11/2016 on Alzheimer disease and associated disorders
    by De Lucia N, Grossi D, Trojano L
    DOI: 10.1097/WAD.0000000000000165
  • Eye movements reveal mechanisms underlying attentional biases towards threat.

    Publication Date: 01/11/2016 on Cognition & emotion
    by Sagliano L, D'Olimpio F, Taglialatela Scafati I, Trojano L
    DOI: 10.1080/02699931.2015.1055712

    Mechanisms underlying attentional biases towards threat (ABTs), such as attentional avoidance and difficulty of disengagement, are still unclear. To address this issue, we recorded participants' eye movements during a dot detection task in which threatening or neutral stimuli served as peripheral cues. We evaluated response times (RTs) in trials where participants looked at the central fixation cross (not at the cues), as they were required, and number and duration of (unwanted) fixations towards threatening or neutral cues; in all analyses trait anxiety was treated as a covariate. Difficulty in attentional disengagement (longer RTs) was found when peripheral threatening stimuli were presented for 100 ms. Moreover, we observed significantly shorter (unwanted) fixations on threatening than on neutral peripheral stimuli, compatible with an avoidance bias, for longer presentation times. These findings demonstrate that, independent of trait anxiety levels, disengagement bias occurs without eye movements, whereas eye movements are implied in threat avoidance.

  • The influence of interoceptive awareness on functional connectivity in patients with irritable bowel syndrome.

    Publication Date: 04/10/2016 on Brain imaging and behavior
    by Longarzo M, Quarantelli M, Aiello M, Romano M, Del Prete A, Cimminiello C, Cocozza S, Olivo G, Loguercio C, Trojano L, Grossi D
    DOI: 10.1007/s11682-016-9595-5

    Irritable bowel syndrome (IBS) is characterized by visceral hypersensitivity likely related to altered processing of sensory stimuli along the brain-gut axis. Previous neuroimaging studies demonstrated structural and functional alteration of several brain areas involved in bodily representation, e.g. the insula, in patients with IBS. By means of resting-state functional magnetic resonance imaging (rs-fMRI) we searched for alteration of functional connectivity within the network involved in self-bodily consciousness. We found significant inverse correlation between hypochondriasis assessed through a clinical questionnaire and connectivity between posterior cingulate cortex and left supramarginal gyrus, extending into the adjacent superior temporal gyrus. Moreover, we observed a significant and positive correlation between a clinical questionnaire assessing interoception and connectivity between left anterior ventral insula and two clusters located in supramarginal gyrus bilaterally.Our findings highlight an "abnormal network synchrony" reflecting functional alteration, in the absence of structural and micro-structural changes, which might represent a possible therapeutic target for Irritable Bowel Syndrome.

  • Long-term outcome of patients with disorders of consciousness with and without epileptiform activity and seizures: a prospective single centre cohort study.

    Publication Date: 01/10/2016 on Journal of neurology
    by Pascarella A, Trojano L, Loreto V, Bilo L, Moretta P, Estraneo A
    DOI: 10.1007/s00415-016-8232-y

    Brain-injured patients can experience epileptic seizures beyond 1 week from injury (unprovoked remote symptomatic epileptic seizures). In our longitudinal observational study, we analysed occurrence of unprovoked remote epileptic seizures and interictal epileptiform activity in 130 traumatic, vascular or anoxic inpatients with disorders of consciousness (DOC), with a clinical diagnosis of vegetative state (n = 97) or minimally conscious state (n = 33). We also investigated impact of epileptic seizures and epileptiform activity on clinical outcome (30 months post-onset). Epileptic seizures occurred in 35/130 patients (26.9 %), epileptiform activity in 61/130 (46.9 %) patients, without significant differences related to clinical diagnosis or aetiology. Among patients with epileptiform activity, only 26/61 (42.6 %) developed clinically evident seizures. Mortality at 30 months was not significantly influenced by the presence of seizures or epileptiform activity. The proportion of patients who recovered at long-term follow-up was higher in patients without than in patients with epileptic seizures, but was similar in patients with or without epileptiform activity. The presence of epileptic seizures but not of epileptiform activity, significantly affected the level of responsiveness at final outcome. In conclusion, seizures were detected in about one third of the whole sample, and in about a half of patients with epileptiform activity, regardless of clinical diagnosis or aetiology. Although epileptic seizures or epileptiform activity did not significantly affect mortality rate, we demonstrated that epileptic seizures could hamper recovery of consciousness. Epileptic seizures thus qualify as one of the factors largely undetermined at the moment which can influence prognosis in DOC patients.

  • Mental simulation of drawing actions enhances delayed recall of a complex figure.

    Publication Date: 01/10/2016 on Experimental brain research
    by De Lucia N, Trojano L, Senese VP, Conson M
    DOI: 10.1007/s00221-016-4696-3

    Motor simulation implies that the same motor representations involved in action execution are re-enacted during observation or imagery of actions. Neurofunctional data suggested that observation of letters or abstract paintings can elicit simulation of writing or drawing gestures. We performed four behavioural experiments on right-handed healthy participants to test whether observation of a static and complex geometrical figure implies re-enactment of drawing actions. In Experiment 1, participants had to observe the stimulus without explicit instruction (observation-only condition), while performing irrelevant finger tapping (motor dual task), or while articulating irrelevant verbal material (verbal dual task). Delayed drawing of the stimulus was less accurate in the motor dual-task (interfering with simulation of hand actions) than in verbal dual-task and observation-only conditions. In Experiment 2, delayed drawing in the observation only was as accurate as when participants encoded the stimulus by copying it; in both conditions, accuracy was higher than when participants were instructed to observe the stimulus to recall it later verbally (observe to recall), thus being discouraged from engaging motor simulation. In Experiment 3, delayed drawing was as accurate in the observation-only condition as when participants imagined copying the stimulus; accuracy in both conditions was higher than in the observe-to-recall condition. In Experiment 4, in the observe-only condition participants who observed the stimulus with their right arm hidden behind their back were significantly less accurate than participants who had their left arm hidden. These findings converge in suggesting that mere observation of a geometrical stimulus can activate motor simulation and re-enactment of drawing actions.

  • The relationships between apathy and executive dysfunction in multiple sclerosis.

    Publication Date: 01/09/2016 on Neuropsychology
    by Raimo S, Trojano L, Spitaleri D, Petretta V, Grossi D, Santangelo G
    DOI: 10.1037/neu0000279

    Neuropsychiatric symptoms are common in multiple sclerosis (MS). Among these, apathy is relatively frequent but its relationships with cognitive dysfunctions have been poorly investigated.

  • Neuropsychological correlates of Pisa syndrome in patients with Parkinson's disease.

    Publication Date: 01/08/2016 on Acta neurologica Scandinavica
    by Vitale C, Falco F, Trojano L, Erro R, Moccia M, Allocca R, Agosti V, Santangelo F, Barone P, Santangelo G
    DOI: 10.1111/ane.12514

    A complex relationship exists between postural control and cognition in the elderly. Namely, neural mechanisms that are required for the regulation of posture have been variably associated with cognitive dysfunctions. Parkinson's disease (PD) is the second most common neurodegenerative disease among the elderly, and it has been associated with both cognitive and postural abnormalities such as Pisa syndrome (PS). Although its onset has been considered to be multifactorial, the pathophysiological mechanisms underpinning PS are still not fully explained. Until now, no study investigated the possible contribution of cognitive dysfunction to occurrence of PS in PD.