Time filter

Source Type

Tessitore A.,The Second University of Naples | Esposito F.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Vitale C.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Santangelo G.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | And 10 more authors.
Neurology | Year: 2012

Objective: Using resting-state (RS) fMRI, we investigated the functional integrity of the defaultmode network (DMN) in cognitively unimpaired patients with Parkinson disease (PD). Methods: RS fMRI at 3 T was collected in 16 cognitively unimpaired patients with PD and 16 ageand gender-matched healthy controls. Single-subject and group-level independent component analysis was used to investigate differences in functional connectivity within the DMN in patients with PD and healthy controls. Statistical analysis was performed using BrainVoyager QX. In addition, we used voxel-based morphometry to test whether between-group differences in RS functional connectivity were related to structural abnormalities. Results: Patients with PD compared with controls showed a decreased functional connectivity of the right medial temporal lobe and bilateral inferior parietal cortex within the DMN. Although patients with PD were cognitively unimpaired, the decreased DMN connectivity significantly correlated with cognitive parameters but not with disease duration, motor impairment, or levodopa therapy. The analysis of regional volume differences did not reveal any differences in local gray matter between patients and controls. Conclusions: Our findings revealed a functional disruption of the DMN in cognitively unimpaired patients with PD, in the absence of significant structural differences between patients and controls. Wehypothesize that a dysfunction of theDMNconnectivitymay have a role in the development of cognitive decline in PD. © 2012 American Academy of Neurology.


Tessitore A.,The Second University of Naples | Amboni M.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Amboni M.,University of Naples Federico II | Esposito F.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | And 13 more authors.
Parkinsonism and Related Disorders | Year: 2012

Background: Freezing of gait is a common cause of disability and falls in patients with Parkinson's disease. We studied brain functional connectivity, by means of resting-state functional magnetic resonance imaging, in patients with Parkinson's disease and freezing of gait. Methods: Resting-state functional magnetic resonance imaging at 3 T was collected in 29 patients with Parkinson's disease, of whom 16 presented with freezing of gait as determined by a validated freezing of gait questionnaire, and 15 matched healthy controls. Single-subject and group-level independent component analysis was used to identify the main resting-state networks differing between Parkinson's disease patients with and without freezing of gait. Statistical analysis was performed using BrainVoyager QX. Results: Between-group differences in resting-state networks revealed that patients with freezing of gait exhibit significantly reduced functional connectivity within both "executive-attention" (in the right middle frontal gyrus and in the angular gyrus) and visual networks (in the right occipito-temporal gyrus) [. p < 0.05 corrected for multiple comparisons]. Freezing of gait clinical severity was significantly correlated with decreased connectivity within the two networks. Consistent with their "executive-attention" network impairment, patients with freezing of gait scored lower on tests of frontal lobe functions (phonemic verbal fluency: p = 0.005; frontal assessment battery: p < 0.001; ten point clock test: p = 0.04). Conclusions: Our findings suggest that a resting-state functional connectivity disruption of "executive-attention" and visual neural networks may be associated with the development of freezing of gait in patients with Parkinson's disease. © 2012 Elsevier Ltd.


Russo A.,The Second University of Naples | Russo A.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Tessitore A.,The Second University of Naples | Esposito F.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | And 11 more authors.
Journal of Neurology | Year: 2012

We explored the functional pattern of the painprocessing network in patients with migraine, in the interictal periods, during trigeminal noxious stimulation. Contact heat evoked potential stimulation induced thermal pain and functional magnetic resonance imaging were used to measure whole-brain activation in 16 patients with episodic migraine without aura and 16 age- and gender-matched healthy controls in response to a severe (53°C) noxious, a moderate (51°C) noxious, and a control (41°C) stimulus applied to the maxillary skin. When comparing the fMRI activation over the entire brain, patients with migraine, with respect to healthy controls, showed a significantly greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral secondary somatosensory cortex at 53°C. A group-by-stimulus interaction analysis revealed a region in the pons showing a divergent response in patients and healthy controls. Correlation analyses demonstrated that the pons activation correlated with higher headache-related disability in patients. Our findings demonstrate increased antinociceptive activity in patients with migraine, which may represent a compensatory reorganization to modulate pain perception at the same intensity of healthy controls. © Springer-Verlag 2012.


Trojsi F.,The Second University of Naples | Esposito F.,The Second University of Naples | Esposito F.,University of Salerno | de Stefano M.,The Second University of Naples | And 9 more authors.
Neurobiology of Aging | Year: 2015

Amyotrophic lateral sclerosis (ALS) and behavioral variant frontotemporal dementia (bvFTD) lie on a clinical, pathologic, and genetic continuum. Neuroimaging techniques have proven to be potentially useful to unravel the shared features of these syndromes. Using resting-state functional magnetic resonance imaging (RS-fMRI), we investigated functional connectivity of brain networks in 15 ALS and 15 bvFTD patients in early stages of disease and 15 healthy controls, looking expressly for connectivity pattern divergence or overlap between the 2 disorders. Compared with controls, we found decreased RS-fMRI signals within sensorimotor, right frontoparietal, salience, and executive networks in both patient groups. Within the default mode network (DMN), divergent connectivity patterns were observed, with RS-fMRI signals in the posterior cingulate cortex enhanced in bvFTD patients and suppressed in ALS patients. Our findings confirm that ALS and bvFTD not only broadly share common RS-fMRI connectivity patterns, probably representing different phenotypical expressions of the same neurodegenerative process, but also differ in the DMN, probably reflecting a different stage of neurodegeneration. © 2015 Elsevier Inc.


Caiazzo G.,The Second University of Naples | Corbo D.,The Second University of Naples | Corbo D.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Trojsi F.,The Second University of Naples | And 7 more authors.
Journal of Neurology | Year: 2014

Diffusion tensor imaging (DTI) has become a useful tool for investigating early white matter (WM) abnormalities in motor neuron disease. Furthermore, fiber tracking packages that apply multi-tensorial algorithms, such as q-ball imaging (QBI), have been proposed as alternative approaches to overcome DTI limitations in depicting fiber tracts with different orientations within the same voxel. We explored motor and extra-motor WM tract abnormalities in phenotypically heterogeneous amyotrophic lateral sclerosis (ALS) cases aiming to establish a consistent QBI-based WM signature of disease. We performed a whole-brain, QBI tract-based spatial statistics analysis with deterministic tractography of genu, body and splenium of corpus callosum (CC) and corticospinal tracts (CST) in 20 ALS patients (12 classical and 8 lower motor neuron variants) compared to 20 healthy controls. Mean tract length, fiber volume and density, and generalized fractional anisotropy were extracted and related to clinical indices of pyramidal impairment (upper motor neuron score), disease disability (ALS functional rating scale-revised) and progression. ALS patients showed significantly decreased fiber density and volume, and increased tract length in all regions of CC and left CST (p < 0.05, corrected). In CC body, pyramidal impairment was inversely correlated to fiber density (p = 0.01), while in CC splenium, clinical disability (p = 0.01) and progression (p = 0.02) were inversely correlated to tract length. Our findings further suggest that QBI tractography might represent a promising approach for investigating structural alterations in neurodegenerative diseases and confirm that callosal involvement is a consistent feature of most ALS variants, significantly related to both pyramidal dysfunction and disease disability. © 2013 Springer-Verlag Berlin Heidelberg.


PubMed | University of Salerno, The Second University of Naples and Neurological Institute for Diagnosis and Care Hermitage Capodimonte
Type: | Journal: European journal of neurology | Year: 2016

In multiple sclerosis (MS), depression is a common disorder whose pathophysiology is still debated. To gain insights into the pathophysiology of depression in MS, resting-state (RS) functional connectivity (FC) changes of the default mode network (DMN), salience network (SN) and executive control network (ECN) were assessed in a group of depressed MS (D-MS) patients and in appropriately matched control groups.Sixteen D-MS patients, 17 non-depressed MS (ND-MS) patients, 17 non-depressed healthy controls and 15 depressed subjects (D-S), age, sex and education matched, cognitively preserved and non-fatigued, were enrolled. All participants underwent a neuropsychological evaluation and RS functional magnetic resonance imaging study.Comparing D-MS patients with D-S, within the DMN, a significant RS-FC suppression was found in the posterior cingulate cortex (PCC); comparing D-MS with ND-MS, FC was significantly increased in the anterior cingulate cortex and significantly reduced in the PCC. Within the SN increased FC in the right supramarginal gyrus and right middle frontal gyrus was found in D-MS patients compared to D-S and to ND-MS; within the ECN increased FC in the right inferior parietal cortex was found in D-MS patients compared to ND-MS patients.In cognitively preserved D-MS patients, FC derangement occurs in the SN, ECN and DMN. In the latter, changes occurring both in the anterior cingulate cortex and PCC suggest that depression in MS may be linked to MS itself and, in particular, to a peculiar pattern of network abnormalities favored by MS pathology through disconnection mechanisms. Reduced FC in the PCC, similar to MS patients with cognitive impairment, suggests a functional link between depression and cognitive impairment in MS.


Trojsi F.,The Second University of Naples | Trojsi F.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Trojsi F.,Magnetic Resonance Imaging Center | Monsurr M.R.,The Second University of Naples | And 6 more authors.
Neural Plasticity | Year: 2012

Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease principally affecting motor neurons. Besides motor symptoms, a subset of patients develop cognitive disturbances or even frontotemporal dementia (FTD), indicating that ALS may also involve extramotor brain regions. Both neuropathological and neuroimaging findings have provided further insight on the widespread effect of the neurodegeneration on brain connectivity and the underlying neurobiology of motor neurons degeneration. However, associated effects on motor and extramotor brain networks are largely unknown. Particularly, neuropathological findings suggest that ALS not only affects the frontotemporal network but rather is part of a wide clinicopathological spectrum of brain disorders known as TAR-DNA binding protein 43 (TDP-43) proteinopathies. This paper reviews the current state of knowledge concerning the neuropsychological and neuropathological sequelae of TDP-43 proteinopathies, with special focus on the neuroimaging findings associated with cognitive change in ALS. Copyright © 2012 Francesca Trojsi et al.


Trojsi F.,The Second University of Naples | Trojsi F.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Monsurro M.R.,The Second University of Naples | Monsurro M.R.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | And 2 more authors.
International Journal of Molecular Sciences | Year: 2013

There is a broad scientific consensus that amyotrophic lateral sclerosis (ALS), a fatal neuromuscular disease, is caused by gene-environment interactions. In fact, given that only about 10% of all ALS diagnosis has a genetic basis, gene-environmental interaction may give account for the remaining percentage of cases. However, relatively little attention has been paid to environmental and lifestyle factors that may trigger the cascade of motor neuron degeneration leading to ALS, although exposure to chemicals-including lead and pesticides-agricultural environments, smoking, intense physical activity, trauma and electromagnetic fields have been associated with an increased risk of ALS. This review provides an overview of our current knowledge of potential toxic etiologies of ALS with emphasis on the role of cyanobacteria, heavy metals and pesticides as potential risk factors for developing ALS. We will summarize the most recent evidence from epidemiological studies and experimental findings from animal and cellular models, revealing that potential causal links between environmental toxicants and ALS pathogenesis have not been fully ascertained, thus justifying the need for further research. © 2013 by the authors; licensee MDPI, Basel, Switzerland.


Russo A.,The Second University of Naples | Russo A.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Tessitore A.,The Second University of Naples | Giordano A.,The Second University of Naples | And 10 more authors.
Cephalalgia | Year: 2012

Background: Converging neuropsychological evidence suggests that in migraine executive functions (EF) may be affected during interictal periods.Objective: To evaluate the functional connectivity of the fronto-parietal networks (FPN) known to be associated with EF, in migraine without aura (MwoA) patients, in the interictal period, in comparison to healthy controls (HC).Methods: Using resting-state functional MRI (RS-fMRI), we compared functional connectivity within the FPN in 14 patients with MwoA versus 14 sex- and age-matched HC, and assessed the correlation between functional connectivity within FPN, clinical features of MwoA patients, and EF. We used voxel-based morphometry to assess whether between-group differences in functional connectivity were dependent on structural differences.Results: Neuropsychological data revealed no significant executive dysfunction in MwoA patients. RS-fMRI showed that MwoA patients, compared to HC, had significant functional connectivity reduction within the right FPN and specifically in the middle frontal gyrus (MFG) and the dorsal anterior cingulate cortex. In addition, we found that MFG reduced connectivity was negatively correlated with the pain intensity of migraine attacks. There were no structural differences between the two groups.Conclusions: Our data suggest that, even in the absence of clinically evident EF deficits, MwoA is associated with reduced FPN functional connectivity. This study provides further insights into the complex scenario of migraine mechanisms. © International Headache Society 2012.


Tedeschi G.,The Second University of Naples | Tedeschi G.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Russo A.,The Second University of Naples | Russo A.,Neurological Institute for Diagnosis and Care Hermitage Capodimonte | Tessitore A.,The Second University of Naples
Expert Review of Neurotherapeutics | Year: 2013

Advances in imaging have provided further insights into the complex migraine pathophysiology. Functional neuroimaging by means of PET and functional MRI studies have addressed crucial migraine-related issues, improving our understanding of the circuitry that may be involved in the generation, maintenance and recurrence of pain symptoms in migraine. In the last few years, a growing body of imaging literature has also explored pathophysiology of associated migraine symptoms. Of great interest will be the use of advanced imaging techniques to elucidate neural correlates of migraine prodromal, in order to identify clinical subgroups of migrainous subjects. However, the interpretation of the biological significance of these various functional changes could remain incomplete without a combination of expanding genomic information about neurochemical pathways and genetic polymorphisms linked to specific migraine subtypes. Hopefully, a more detailed picture of the migraine neurobiology will emerge from future neuroimaging studies, which may eventually lead to better and more rational treatments. © 2013 Expert Reviews Ltd.

Loading Neurological Institute for Diagnosis and Care Hermitage Capodimonte collaborators
Loading Neurological Institute for Diagnosis and Care Hermitage Capodimonte collaborators