Member PUBLICATIONS

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• Diagnostic accuracy of short-time inversion recovery sequence in Graves' Ophthalmopathy before and after prednisone treatment.

  Publication Date: 01/05/2014 on Neuroradiology

  by Tortora F, Prudente M, Cirillo M, Elefante A, Belfiore MP, Romano F, Cappabianca S, Carella C, Cirillo S

  DOI: 10.1007/s00234-014-1332-4

  In Graves' Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS < 3) from active Graves' Ophthalmopathy (GO) (CAS > 3) subjects and, second, to follow post-steroid treatment disease.

• Motor and extramotor neurodegeneration in amyotrophic lateral sclerosis: a 3T high angular resolution diffusion imaging (HARDI) study.

  Publication Date: 01/12/2013 on Amyotrophic lateral sclerosis & frontotemporal degeneration

  by Trojsi F, Corbo D, Caiazzo G, Piccirillo G, Monsurrò MR, Cirillo S, Esposito F, Tedeschi G

  DOI: 10.3109/21678421.2013.785569

  In amyotrophic lateral sclerosis (ALS), diffusion weighted magnetic resonance imaging (DW-MRI) has produced mounting evidence of a widespread white matter (WM) damage within motor and extramotor pathways. To provide novel information about the degenerative process in ALS, overcoming some of the limitations imposed by diffusion tensor imaging (DTI), we performed a high angular resolution diffusion imaging (HARDI) analysis of DW-MRI data. Generalized fractional anisotropy (GFA) was evaluated in 19 patients with ALS and 19 matched control subjects, and was correlated with clinical scores of disability, pyramidal impairment by upper motor neuron (UMN) score and frontal dysfunction by the Frontal Systems Behaviour (FrSBe) scale. Results demonstrated that ALS patients showed a significant decrease of GFA in the WM tracts underneath the left and right precentral gyri and the body of the corpus callosum (p < 0.05, corrected), where GFA was significantly related to UMN scores (p < 0.001, uncorrected); and in the left superior longitudinal fasciculus (p < 0.05, corrected), where GFA was significantly related to FrSBe scale scores (p < 0.01, uncorrected). In conclusion, this study revealed a pattern of motor and extramotor frontal diffusivity abnormalities (probably related to behavioural and cognitive dysfunctions) showing a spatial distribution similar to what was previously described in ALS - frontotemporal dementia continuum.

• Disrupted default mode network connectivity in migraine without aura.

  Publication Date: 08/11/2013 on The journal of headache and pain

  by Tessitore A, Russo A, Giordano A, Conte F, Corbo D, De Stefano M, Cirillo S, Cirillo M, Esposito F, Tedeschi G

  DOI: 10.1186/1129-2377-14-89

  Resting-state functional magnetic resonance imaging (RS-fMRI) has demonstrated disrupted default mode network (DMN) connectivity in a number of pain conditions, including migraine. However, the significance of altered resting-state brain functional connectivity in migraine is still unknown. The present study is aimed to explore DMN functional connectivity in patients with migraine without aura (MwoA) and investigate its clinical significance.

• Disease activity in Graves' ophthalmopathy: diagnosis with orbital MR imaging and correlation with clinical score.

  Publication Date: 01/10/2013 on The neuroradiology journal

  by Tortora F, Cirillo M, Ferrara M, Belfiore MP, Carella C, Caranci F, Cirillo S

  DOI: 10.1177/197140091302600509

  In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone.

• Trigeminal neuralgia and persistent trigeminal artery.

  Publication Date: 01/12/2012 on Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

  by Conforti R, Parlato RS, De Paulis D, Cirillo M, Marrone V, Cirillo S, Moraci A, Parlato C

  DOI: 10.1007/s10072-012-0942-z

  We report a case of trigeminal neuralgia caused by persistent trigeminal artery (PTA) associated with asymptomatic left temporal cavernoma. Our patient presented unstable blood hypertension and the pain of typical trigeminal neuralgia over the second and third divisions of the nerve in the right side of the face. The attacks were often precipitated during physical exertion. MRI and Angio-MRI revealed the persistent carotid basilar anastomosis and occasionally left parietal cavernoma. After drug treatment of blood hypertension, spontaneous recovery of neuralgia was observed and we planned surgical treatment of left temporal cavernoma.

• Spontaneous regression of syringomyelia in a young patient with Chiari type I malformation.

  Publication Date: 01/11/2012 on The neuroradiology journal

  by Tortora F, Napoli M, Caranci F, Cirillo M, Pepe D, Cirillo S, Briganti F

  DOI: 10.1177/197140091202500513

  Syringomyelia is a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called syrinx, can expand and elongate over time, destroying the spinal cord. We describe the case of a young patient with partial spontaneous regression of syringomyelia in Chiari I malformation, confirmed by magnetic resonance imaging three years after the diagnosis. During this period the patient did not experience any clinical symptoms. Although described in literature, spontaneous regression is an unusual event and very few cases have been reported. This case report supports the belief that conservative management together with both clinical and imaging periodic controls should be preferred in stable mild-symptomatic patients.

• Visual resting-state network in relapsing-remitting MS with and without previous optic neuritis.

  Publication Date: 02/10/2012 on Neurology

  by Gallo A, Esposito F, Sacco R, Docimo R, Bisecco A, Della Corte M, D'Ambrosio A, Corbo D, Rosa N, Lanza M, Cirillo S, Bonavita S, Tedeschi G

  DOI: 10.1212/WNL.0b013e31826d5eea

  To investigate functional connectivity of the visual resting-state network (V-RSN) in normal-sighted relapsing-remitting multiple sclerosis (RRMS) patients with and without previous optic neuritis (ON).

• Paget's Disease. A Case Report.

  Publication Date: 01/09/2012 on The neuroradiology journal

  by Conforti R, Galasso R, Marrone V, Urciuoli L, Cirillo S

  DOI: 10.1177/197140091202500410

  Paget's disease (PD) is a common focal progressive osteometabolic disorder characterised by a disturbance in bone modelling and remodelling, because of an increase in osteoblastic and osteoclastic activity. It is a condition of unknown aetiology affecting approximately 3% of the population over 40 years of age and, approximately 10% of those over the age of 85 years. It is most common in Northern Europe and Australia and is rare in Asia and Africa. We describe the case of a 71-year-old man diagnosed with PD confined to the sacrum. After laboratory test, an imaging study with radiography, scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI) was performed disclosing findings compatible with Paget's disease in middle pathologic phase. The diagnosis was confirmed at biopsy. The structural modification of the sacrum with spongiosa rarefaction, thickening of bone and intact bone cortical, confirmed by CT, are tipical of an intermediate phase of PD. This was also supported by signal MRI changes showing substitution of the red by the fat medulla, visualized by FS sequences. Once the treatment for the bone disease was established, the patient no longer complained of pain. Special attention should be paid to male and elderly patients with pain in the lumbar spine because of the potential risk cancer development (21). The radiologist must be attentive to the possible presentations and complications of PD, even in uncommon sites, trying whenever possible to correlate the radiological features with the patient's clinical symptoms.

• Giant dilatations of virchow-robin spaces in the midbrain. MRI aspects and review of the literature.

  Publication Date: 01/09/2012 on The neuroradiology journal

  by Algin O, Conforti R, Saturnino PP, Ozmen E, Cirillo M, Di Costanzo A, De Cristofaro M, Rotondo M, Cirillo S

  DOI: 10.1177/197140091202500404

  Virchow-Robin spaces are lesions often seen in the brain parenchyma but their etiopathogenesis remains unsettled. Giant Virchow-Robin spaces placed in the midbrain are extremely rare. We describe three patients with a diagnosis of giant Virchow-Robin spaces in the midbrain, and their clinical and radiologic findings. We reviewed the literature in terms of the etiopathology, anatomic and radiologic appearance and differential diagnosis of the giant Virchow-Robin spaces. The diagno-stic role of the high Tesla magnetic resonance devices and new sequences techniques such as three dimensional isotropic acquisition and diffusion tensor imaging were also evaluated in this case series.

• Widespread microstructural white matter involvement in amyotrophic lateral sclerosis: a whole-brain DTI study.

  Publication Date: 01/06/2012 on AJNR. American journal of neuroradiology

  by Cirillo M, Esposito F, Tedeschi G, Caiazzo G, Sagnelli A, Piccirillo G, Conforti R, Tortora F, Monsurrò MR, Cirillo S, Trojsi F

  DOI: 10.3174/ajnr.A2918

  The extensive application of advanced MR imaging techniques to the study of ALS has undoubtedly improved our knowledge of disease pathophysiology, even if the actual spread of the neurodegenerative process throughout the central nervous system is not fully understood. The present study aimed to detect WM patterns of microstructural abnormalities to better investigate the pathologic process in ALS, within but also beyond CSTs, in a whole-brain analysis.

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