Member PUBLICATIONS

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• Predictors of tumor shrinkage after primary therapy with somatostatin analogs in acromegaly: a prospective study in 99 patients.

  Publication Date: 01/06/2006 on The Journal of clinical endocrinology and metabolism

  by Colao A, Pivonello R, Auriemma RS, Briganti F, Galdiero M, Tortora F, Caranci F, Cirillo S, Lombardi G

  DOI: 10.1210/jc.2005-2110

  Primary treatment with depot octreotide and lanreotide induces tumor shrinkage in newly diagnosed patients with acromegaly.

• Differential sex-independent amygdala response to infant crying and laughing in parents versus nonparents.

  Publication Date: 15/12/2003 on Biological psychiatry

  by Seifritz E, Esposito F, Neuhoff JG, Lüthi A, Mustovic H, Dammann G, von Bardeleben U, Radue EW, Cirillo S, Tedeschi G, Di Salle F

  Animal and human studies implicate forebrain neural circuits in maternal behavior. Here, we hypothesized that human brain response to emotional stimuli relevant for social interactions between infants and adults are modulated by sex- and experience-dependent factors.

• Real-time independent component analysis of fMRI time-series.

  Publication Date: 01/12/2003 on NeuroImage

  by Esposito F, Seifritz E, Formisano E, Morrone R, Scarabino T, Tedeschi G, Cirillo S, Goebel R, Di Salle F

  Real-time functional magnetic resonance imaging (fMRI) enables one to monitor a subject's brain activity during an ongoing session. The availability of online information about brain activity is essential for developing and refining interactive fMRI paradigms in research and clinical trials and for neurofeedback applications. Data analysis for real-time fMRI has traditionally been based on hypothesis-driven processing methods. Off-line data analysis, conversely, may be usefully complemented by data-driven approaches, such as independent component analysis (ICA), which can identify brain activity without a priori temporal assumptions on brain activity. However, ICA is commonly considered a time-consuming procedure and thus unsuitable to process the high flux of fMRI data while they are acquired. Here, by specific choices regarding the implementation, we exported the ICA framework and implemented it into real-time fMRI data analysis. We show that, reducing the ICA input to a few points within a time-series in a sliding-window approach, computational times become compatible with real-time settings. Our technique produced accurate dynamic readouts of brain activity as well as a precise spatiotemporal history of quasistationary patterns in the form of cumulative activation maps and time courses. Results from real and simulated motor activation data show comparable performances for the proposed ICA implementation and standard linear regression analysis applied either in a sliding-window or in a cumulative mode. Furthermore, we demonstrate the possibility of monitoring transient or unexpected neural activities and suggest that real-time ICA may provide the fMRI researcher with a better understanding and control of subjects' behaviors and performances.

• Coordinate and categorical judgements in spatial imagery. An fMRI study.

  Publication Date: 01/01/2002 on Neuropsychologia

  by Trojano L, Grossi D, Linden DE, Formisano E, Goebel R, Cirillo S, Elefante R, Di Salle F

  We aimed at verifying whether the hemispheric specialisation for categorical/coordinate spatial judgements also applies to the spatial imagery domain by the use of whole-brain fMRI. In a block-design experiment we used the "coordinate" mental clock test, contrasting it with a "categorical" task applied to the same clock stimuli; as a control task we used a syllable counting task requiring a verbal-phonological judgement on the same material of the two imagery tasks. Our results showed that categorical and coordinate spatial judgements on imagined stimuli rely on the activation of a set of cortical areas, centred upon the superior parietal lobule (SPL) bilaterally. These regions, together with other parietal and prefrontal areas, showed a pattern of relative lateralization, with the left hemisphere being mainly activated during the categorical task and the right in the coordinate task. These data confirm the strong involvement of the SPL in spatial processing. Moreover, our findings suggest that different interconnected neural networks are activated to comply with specific test requirements, giving rise to functional imaging patterns compatible with psychological theories on hemispheric specialization.

• Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: a prospective study in 110 patients.

  Publication Date: 01/06/2000 on The Journal of clinical endocrinology and metabolism

  by Colao A, Di Sarno A, Landi ML, Scavuzzo F, Cappabianca P, Pivonello R, Volpe R, Di Salle F, Cirillo S, Annunziato L, Lombardi G

  DOI: 10.1210/jcem.85.6.6657

  To investigate whether previous treatment with bromocriptine (BRC) or quinagolide (CV) impairs a subsequent response to long-term cabergoline (CAB) treatment, we prospectively studied 110 patients with macroprolactinoma. Four groups of patients were considered: 1) naive: 26 untreated patients with a mean serum PRL levels of 1013.4 +/- 277.7 microg/L (+/- SEM; range, 185.5-5611 microg/L); 2) intolerant: 19 patients previously shown to be intolerant of BRC treatment with a mean serum PRL level of 539.4 +/- 172.2 microg/L (range, 174-3564 microg/L); 3) resistant: 37 patients shown to be resistant/hyporesponsive to BRC, CV, or both, with a mean serum PRL level of 602.6 +/- 136.8 microg/L (range, 148-3511 microg/L); and 4) responsive: 28 patients previously treated with BRC or CV for 1-5 yr, achieving normoprolactinemia and restoration of gonadal function, but no longer treated with BRC or CV because of poor compliance or because the drug was not available. After a 15- to 30-day washout period, the serum PRL level was 397 +/- 43.1 microg/L (140-978 microg/L). CAB treatment was given at doses ranging 0.25-3.5 mg weekly for 1 yr to 110 patients, for 2 yr to 104 patients, and for 3 yr to 81 patients. Magnetic resonance imaging was performed before and after 12, 24, and 36 months of CAB treatment to evaluate significant tumor shrinkage (>80% reduction of pretreatment tumor volume). Among the 26 naive patients, normoprolactinemia was achieved in 21 (80.8%) after 1-6 months at 0.25-2 mg/week and in 5 patients after 24 months at 0.5-3 mg/week. Tumor volume was reduced from 1431.5 +/- 310.3 to 47.2 +/- 21.5 mm3 (P < 0.0001); average tumor shrinkage was 92.1 +/- 2.9%; significant tumor shrinkage was observed in 92.3% of patients, and tumor mass completely disappeared in 16 patients (61.5%). Among the 19 intolerant patients, normoprolactinemia was achieved in 18 (94.7%) after 1-6 months of CAB treatment at 0.25-1 mg/week. One patient remained mildly hyperprolactinemic. Tumor volume was reduced from 1925 +/- 423.1 to 842.0 +/- 330.7 mm3 (P < 0.001); average tumor shrinkage was 66.2 +/- 6.4%; significant tumor shrinkage was obtained in 42.1% of patients, and tumor mass completely disappeared in 4 patients (21%). Among the 37 resistant patients, normoprolactinemia was achieved in 19 (51.3%) after 6-12 months at 1-2 mg/week and in the remaining 18 patients after 18-24 months at 3-3.5 mg/week. Tumor volume was reduced from 1208.0 +/- 173.7 to 471.2 +/- 87.3 mm3 (P < 0.005); average tumor shrinkage was 58.4 +/- 4.9%; significant tumor shrinkage was obtained in 10 of 33 patients (30.3%), and in no patient did tumor mass completely disappear. Among the 28 responsive patients, normoprolactinemia was achieved in 23 (82.1%) after 1-6 months at 1-2 mg/week and in 5 patients after 12 months at 3 mg/week. Tumor volume was reduced from 1351.3 +/- 181.5 to 757.1 +/- 193.6 mm3 (P < 0.01); average tumor shrinkage was 59.2 +/- 6.2%; significant tumor shrinkage was obtained in 10 of 26 patients (38.4%), and tumor mass completely disappeared in 4 patients (15.4%). Nadir PRL levels and percent tumor shrinkage during CAB treatment in naive patients were significantly lower (P < 0.001) and higher (P < 0.001), respectively, than those in the remaining three groups, and the average weekly dose of CAB in resistant patients was significantly higher (P < 0.001) than that in the remaining three groups. A significant association was found between tumor shrinkage and previous treatments (chi2 = 27.1; P < 0.0001). At the multistep correlation analysis, nadir PRL levels were the strongest predictors of tumor shrinkage (r2 = 0.556; P < 0.0001), followed by CAB dose (r2 = 0.577; P < 0.0001). The tolerability was excellent in 105 patients (95.4%). In conclusion, the prevalence of macroprolactinoma shrinkage after CAB treatment at standard doses for 1-3 yr was higher in naive patients (92.3%) than in intolerant (42.1%), resistant (30.3%), and responsive patients (38.4%). Thus, C

• Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage.

  Publication Date: 01/11/1997 on The Journal of clinical endocrinology and metabolism

  by Colao A, Di Sarno A, Landi ML, Cirillo S, Sarnacchiaro F, Facciolli G, Pivonello R, Cataldi M, Merola B, Annunziato L, Lombardi G

  DOI: 10.1210/jcem.82.11.4368

  Cabergoline (CAB), a long-lasting dopamine-agonist, specific for the D2 receptor, is effective in normalizing serum PRL levels in most patients with microprolactinoma or idiopathic hyperprolactinemia. Because few data are presently available on the effects of CAB treatment in macroprolactinomas, the aim of this open-label study was to investigate whether this drug was effective in producing tumor shrinkage, as well as in normalizing PRL levels. Twenty-three patients with macroprolactinoma entered this study 15 patients had had no treatment, whereas the remaining 8 patients had been previously treated with bromocriptine, which was with-drawn because of intolerance. Three of 23 patients had undergone unsuccessful surgery. Pretreatment serum PRL levels ranged from 100-3860 micrograms/L. CAB was administered at a dose of 0.5-3 mg once or twice a week for 12-24 months. Magnetic resonance imaging (MRI) scans were performed before and 3, 6, 12, and 24 months after the beginning of treatment, to evaluate tumor shrinkage, defined as a decrease of at least 80% of baseline tumor volume. After 3-6 months of treatment with a low dose (0.5-1 mg/week), serum PRL levels normalized in 18 patients. In the remaining 5 patients, whose serum PRL levels were not normalized, the dose was increased to 2-3 mg/week. This schedule caused the normalization of PRL levels in 1 patient, whereas in the remaining 4 patients, PRL levels were reduced to 30-82 micrograms/L. A tumor volume reduction greater than 80% at MRI occurred in 14 of 23 patients (61%) after CAB treatment (from 2609.4 +/- 534.7 to 530.1 +/- 141.3 mm3 at the 12-24th month follow-up, P < 0.001). A volume reduction of 41.8 +/- 3.4% was already evident after 3 months (1436 +/- 285.9 mm3; P < 0.001). The complete disappearance of the tumor mass at MRI occurred after 6 months of treatment with CAB in 1 patient, and in 5 patients after 1 yr of treatment. An improvement of visual field defects was obtained in 9 of the 10 patients presenting visual impairment before CAB treatment. The drug was tolerated well by all patients. Only 1 patient experienced mild nausea, which disappeared spontaneously after the 2nd day of treatment. Long-term, a low dose of the D2 receptor agonist CAB significantly reduced tumor volume and normalized serum PRL levels in a great majority of patients bearing macroprolactinoma. This treatment met with excellent patient compliance. This study suggests that CAB can be used as a first choice drug treatment in macroprolactinomas, as already shown for microprolactinomas and idiopathic hyperprolactinemia.

• Clinical and computerized tomographic study of a case of Schilder's disease.

  Publication Date: 01/02/1982 on Acta neurologica

  by Barbieri F, Filla A, Grossi D, Orefice G, Perretti A, Cirillo S, Buscaino GA

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