Member PUBLICATIONS

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• Interaction between aging and neurodegeneration in amyotrophic lateral sclerosis.

  Publication Date: 01/05/2012 on Neurobiology of aging

  by Tedeschi G, Trojsi F, Tessitore A, Corbo D, Sagnelli A, Paccone A, D'Ambrosio A, Piccirillo G, Cirillo M, Cirillo S, Monsurrò MR, Esposito F

  DOI: 10.1016/j.neurobiolaging.2010.07.011

  We assessed the spontaneous blood-oxygen-level-dependent signal fluctuations in the resting-state brain networks of amyotrophic lateral sclerosis patients and their relation to physiologically sensitive and disease modified functional magnetic resonance imaging parameters. Resting-state functional magnetic resonance imaging was performed at 3 Tesla on 20 amyotrophic lateral sclerosis patients with minimal frontal cognitive dysfunction and 20 age- and sex-matched healthy volunteers. Resting-state network maps were extracted with independent component analysis and group-level statistical analyses were performed to detect disease and disease-by-age interaction effects. Whole-brain global and regional atrophy measures were obtained from same-session structural scans. The sensori-motor network showed significant disease effects, with signals suppressed in patients bilaterally in the primary motor cortex. The default-mode network showed a significant disease-by-age interaction in the posterior cingulate cortex, where signals correlated with age positively in patients and negatively in controls. Both disease and disease-by-age interaction effects were detected in the right fronto-parietal network. Although global atrophy did not show significant differences, regions of reduced gray matter volume were detected in patients compared with controls adjacent to regions of reduced functional connectivity. Our results confirm that resting-state functional magnetic resonance imaging signals in the sensori-motor network are suppressed in amyotrophic lateral sclerosis. A similar suppression is evident in the right fronto-parietal network, possibly reflecting the patients' frontal dysfunction and right-lateralized patterns of regional atrophy. The interaction between disease and aging in the default-mode network unravels a possible mechanism of compensation between motor and extramotor systems emerging as a supplementary functional push to help motor disturbances.

• Spontaneous regression of dilated virchow-robin spaces. A case report.

  Publication Date: 01/03/2012 on The neuroradiology journal

  by Tortora F, Cirillo M, Belfiore MP, Pepe D, Pezzullo F, Barbarisi M, Cirillo S

  DOI: 10.1177/197140091202500106

  We describe a 28-year-old woman with a dilated perivascular spaces in the right pre-rolandic district. The purpose of this article is to provide an in-depth overview of the MR imaging features of VR spaces and to describe magnetic resonance imaging evidence of complete regression of dilated perivascular spaces (2).

• Interictal cortical reorganization in episodic migraine without aura: an event-related fMRI study during parametric trigeminal nociceptive stimulation.

  Publication Date: 01/05/2011 on Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

  by Tessitore A, Russo A, Esposito F, Giordano A, Taglialatela G, De Micco R, Cirillo M, Conte F, d'Onofrio F, Cirillo S, Tedeschi G

  DOI: 10.1007/s10072-011-0537-0

  The aim of our study was to explore the pain processing network in patients with migraine during trigeminal nociceptive stimulation. Sixteen patients with episodic migraine without aura and 16 healthy controls performed functional magnetic resonance imaging during thermal stimuli (at 41, 51 and 53°C). Patients with migraine showed a greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral somatosensory cortex at 53°C compared to healthy controls. There were no differences in experimental pain perception between groups. Our findings demonstrate a functional reorganization of cerebral areas known to be involved in pain processing in patients with migraine.

• DWI Reversibility after Intra-Arterial Thrombolysis. A Case Report and Literature Review.

  Publication Date: 01/12/2010 on The neuroradiology journal

  by Tortora F, Cirillo M, Ferrara M, Manto A, Briganti F, Cirillo S

  DOI: 10.1177/197140091002300618

  We report our case and review the literature on reversal DWI lesions, ADC thresholds and correlation between DWI lesion and outcome measured with clinical scales. A 30-years old woman was admitted to our hospital 18 hours after stroke onset. Considering the absence of alterations on CT and the worsening of symptomatology, the patient underwent MRI, which showed a slightly hyperintense signal in FLAIR images in the left portion of the pons and midbrain and a more evident bilateral DWI hyperintensity of the pons. The patient was treated with mechanical and pharmacological intra-arterial thrombolysis. The patient showed a rapid improvement of symptoms. Two weeks after the treatment her clinical conditions were characterized by a residual right hemiparesis and complete recovery of right motility, respiratory and swallowing difficulties. MR examination demonstrated a slight signal alteration of the pons left hemiportion and a disappearance of the mesencephalic signal alteration and of the right portion of the pons. DWI lesions represent irreversibly damaged tissue but new evidence suggests that DWI lesions may be reversible, especially with reperfusion, by now well demonstrated in animal models. Therefore acute DWI lesions probably contain not only irreversibly injured tissue but also parts of the penumbra. The debate on the capability of ADC maps to discriminate irreversibly from reversibly damaged tissue is a matter of controversy. ADC values in human stoke are not an independent indicator of tissue viability. The use of thresholds may improve reproducibility but not validity.

• Role of Magnetic Resonance Imaging in Duane's Retraction Syndrome: Presence of the Abducens Nerve Depending on Type. A Clinical-Anatomical Study.

  Publication Date: 01/12/2010 on The neuroradiology journal

  by Taglialatela G, Conforti R, Notaro M, Cotticelli L, Caranci F, Cirillo S

  DOI: 10.1177/197140091002300610

  This study correlated anatomical findings and clinical evidence in Duane's Retraction Syndrome using brain MRI. The study included 11 patients with different types of Duane's Retraction Syndrome (DRS). Each patient underwent brain MRI. The VI(th) nerve was absent in all patients with DRS-I, present in all patients with DRS-II, while findings varied in patients with DRS-III. Our study confirms the literature on the usefulness of brain MRI in diagnosis of Duane's Retraction Syndrome in children.

• Spontaneous resolution of eosinophilic granuloma in a patient with a psychotic disorder.

  Publication Date: 01/09/2010 on The neuroradiology journal

  by Conforti R, Porto A, Cirillo M, Sgambato A, Galderisi S, Cirillo S

  DOI: 10.1177/197140091002300412

  A 16-year-old female who manifested psychotic symptoms underwent CT and MRI for the evaluation of an incidentally discovered asymptomatic palpable mass of the right occipital region of the skull. The correlation between clinical and radiological data and biopsy data led to the diagnosis of eosinophilic granuloma. The radiological finding is discussed and reviewed in relation to clinical aspects and literature data.

• Hippocampal asymmetry with hippocampal sulcus remnants in a patient with mild cognitive impairment. A case report.

  Publication Date: 01/09/2010 on The neuroradiology journal

  by Conforti R, Ronza FM, Di Costanzo A, De Cristofaro M, Cirillo M, Cirillo S

  DOI: 10.1177/197140091002300402

  A 65-year-old woman underwent MRI for a mild cognitive impairment (MCI) at Mini-Mental State Examination (MMSE). MRI showed hippocampal sulcus remnants bilaterally, although they were larger on the right, and left hippocampal atrophy with increased left fimbriosubicular distance (right side: 1.2 mm; left side: 2.0 mm). The meaning of these findings in relation to clinical aspects is discussed and reviewed according to data from the literature.

• Non-Alcoholic Wernicke Encephalopathy: MR Imaging and Review of the Literature.

  Publication Date: 01/04/2010 on The neuroradiology journal

  by Saturnino PP, Conforti R, Amoroso V, D'Agostino V, Ferrara M, Cirillo S

  DOI: 10.1177/197140091002300202

  We describe a patient with non-alcoholic Wernicke's encephalopathy caused by long-term parenteral nutrition. The diagnosis is based on clinical and magnetic resonance findings. We also reviewed the literature review in typical and atypical findings at MR examination.

• Lung cancer single intramedullary metastasis vs delayed radionecrosis. A case report.

  Publication Date: 29/08/2009 on The neuroradiology journal

  by Conforti R, Tagliatatela G, De Cristoforo M, Di Costanzo A, Scuotto A, Sanpaolo S, Dericoloso A, Cirillo S

  DOI: 10.1177/197140090902200417

  Intramedullary metastases are rare, accounting for 0.9-5% of spinal metastases. Radiation myelopathy is considered one of the most distressing complications of radiotherapy. In both cases symptoms are aspecific, and there are no characteristic neuroradiologic findings. We describe a case of single intramedullary metastasis from lung microcytoma in a 55-year-old man with a history of malignancy, treated by radiotherapy five years previously. The patient returned to our observation complaining of pain and paraesthesia in the left C7 area. Spinal MRI and rachicentesis findings were aspecific. Ten days later a new MRI showed that the lesion size had increased, and neoplastic cells were found in CSF. Intramedullary metastases are extremely rare, accounting for 0.1-0.4% of all CNS tumors. The risk of developing delayed radionecrosis varies with the total dose administered. In both cases diagnosis is histological, while contrast-enhanced MRI is highly sensitive and specific in identifying and characterizing the lesion. In case of metastatic lesions the prognosis is unfavorable. Differential diagnosis is important because it has a strong effect on patient management.

• Does the default-mode functional connectivity of the brain correlate with working-memory performances?

  Publication Date: 01/03/2009 on Archives italiennes de biologie

  by Esposito F, Aragri A, Latorre V, Popolizio T, Scarabino T, Cirillo S, Marciano E, Tedeschi G, Di Salle F

  The "default-mode" network is an ensemble of cortical regions that are typically deactivated during demanding cognitive tasks in functional magnetic resonance imaging (fMRI) studies. Using functional connectivity analysis, this network can be studied as a "stand-alone" brain system whose functional role is supposed to consist in the dynamic control of intrinsic processing activities like attention focusing and task-unrelated thought generation and suppression. Independent component analysis (ICA) is the method of choice for generating a statistical image of the "default-mode" network (DMN) using a task- and seed-independent distributed model of fMRI functional connectivity without prior specification of node region extent and timing of neural activation. We used a standard graded working-memory task (n-back) to induce fMRI changes in the default-mode regions and ICA to evaluate to DMN functional connectivity in nineteen healthy volunteers. Based on the known spatial variability of the ICA-DMN maps with the task difficulty levels, we hypothesized the ICA-DMN may also correlate with the subject performances. We confirmed that the relative extent of the anterior and posterior midline spots within the DMN were oppositely (resp. positively in the anterior and negatively in the posterior cingulate cortex) correlated with the level of task difficulty and found out that the spatial distribution of DMN also correlates with the individual task performances. We conclude that the working-memory function is related to a spatial re-configuration of the DMN functional connectivity, and that the relative involvement of the cingulate regions within the DMN might function as a novel predictor of the working-memory efficiency.

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