University of Pavia Specialty in Radiodiagnostics 2003-2007 Radiology with a special focus of Neuroradiology
University of Pavia Degree in Medicine and Surgery 1998-2003 Medicine, thesis in Neurology
RESEARCH INTERESTS
Neuroncology
Neurodegenerative disease
34
Scopus Publications
Scopus Publications
Cerebrospinal Fluid Biomarkers Profiling in Cerebral Amyloid Angiopathy and Relationship With Disease Phenotypes Mattia Losa, Matteo Cotta Ramusino, Isabella Cama, Lorenzo Gualco, Ilaria Gandoglia, Federico Massa, Andrea Donniaquio, Pierumberto Mortola, Lucia Argenti, Lorenzo Lombardo, Wendy Kreshpa, Virginia Pelagotti, Giulia Bozzo, Beatrice Orso, Pietro Mattioli, Dario Arnaldi, Alessio Cirone, Shahzad Ali, Mehrnaz Hamedani, Martina Pulze, Domenico Plantone, Luigi Lorenzini, Laura Falcitano, Federico Mazzacane, Giulia Perini, Alfredo Costa, Michele Piana, Lucio Castellan, Antonio Uccelli, Angelo Schenone, Mariel Kozberg, Fabrizio Piazza, Massimo Del Sette, Sara Garbarino, Luca Roccatagliata, Lisa Maria Farina, Matteo Pardini Journal of the American Heart Association, 2025 Background Cerebral amyloid angiopathy (CAA) is a heterogeneous small vessel disease that can occur independently or alongside Alzheimer disease (AD). CAA is diagnosed using the Boston Criteria 2.0, integrating clinical and neuroimaging features, whereas the Cerebrospinal Fluid (CSF) role in clinical practice remains under investigation. This study explores whether CSF biomarkers can identify distinct disease phenotypes, supporting hemorrhagic risk stratification. Methods We enrolled probable patients with CAA retrospectively (Boston Criteria 2.0) from 2 institutions, collecting clinical, neuroimaging, and follow‐up data alongside core CSF biomarkers (Aβ40 [amyloid β 1–40], Aβ42 [amyloid β 1–42], p‐Tau181 [phosphorylated Tau], total‐Tau). Patients with CAA were stratified applying the Amyloid Tau Neurodegeneration (ATN) research framework, according to the presence of CSF amyloidosis (A + CAA versus A − CAA) and tauopathy (A + T + CAA versus A + T − CAA), and using unsupervised clustering, which defined CAA subgroups based on CSF biomarker levels only. Kaplan‐Meier and Cox regression analyses assessed the predictive value of CSF‐based subgroups for symptomatic hemorrhages during follow‐up. Results Seventy‐one probable CAA patients (aged 71.77±8.45 years, 66% men, median follow‐up 1.15 years [0.50–2.44]) were enrolled. A + CAA showed a higher prevalence of cortical superficial siderosis than A − CAA (67% versus 25%, P =0.016). A + T − CAA had a greater hemorrhagic risk than A + T + CAA during follow‐up (29 versus 7 events per 100 patient‐years, P =0.010; log‐rank test: P =0.013). Unsupervised clustering identified 2 subgroups, which we defined as pure CAA and CAA‐ADA, with pure CAA presenting more symptomatic hemorrhages during follow‐up (22 versus 0 events per 100 patient‐years, P =0.017; log‐rank test, P =0.011). Conclusions CSF‐based profiling effectively stratifies CAA phenotypes, offering a promising prognostic tool alongside neuroimaging markers. Further validation is needed to confirm its role in identifying patients with CAA with different natural histories.
CT acquisition protocols by pathology, SIRM position paper part 1: head and neck, brain and spine, chest, cardiovascular Ernesto Di Cesare, Antonio Esposito, Antonio Lo Casto, Maria Antonietta Mazzei, Gabriele Polonara, Nicola Sverzellati, Francesco Arrigoni, Nicoletta Gandolfo, Vittorio Miele, Andrea Giovagnoni, , Maurizio Balbi, Elisa Baratella, Andrea Borghesi, Elisa Bruno, Federico Bruno, Marco Busso, Lucio Calandriello, Emanuele Cerioni, Riccardo Faletti, Lisa Maria Farina, Nicola Galea, Mirko Giannoni, Carlo Liguori, Luigi Lovato, Anna Palmisano, Stefano Palmucci, Pierpaolo Palumbo, Anna Pichiecchio, Silvia Pradella Radiologia Medica, 2025
Neurophysiological Alterations of the Visual Pathway in Posterior Cortical Atrophy: Systematic Review and a Case Series Matteo Cotta Ramusino, Lucia Scanu, Linda Gritti, Camillo Imbimbo, Lisa Maria Farina, Giuseppe Cosentino, Giulia Perini, Alfredo Costa Journal of Alzheimer S Disease, 2024 Background: The clinical features of posterior cortical atrophy (PCA), a rare condition often caused by Alzheimer’s disease, have been recently defined, while little is known about its neurophysiological correlates. Objective: To describe neurophysiological alterations of the visual pathway as assessed using visual field test (VF), visual evoked potentials (VEP), and electroretinogram (ERG) in PCA patients. Methods: Studies reporting VF, VEPs, and ERG in PCA patients were selected according PRISMA method. Of the 323 articles that emerged from the literature, 17 included the outcomes of interest. To these data, we added those derived from a patient cohort enrolled at our clinic. Results: The literature review included 140 patients, half of them (50%) presented with homonymous hemianopia or quadrantanopia. VEPs were available in 4 patients (2 normal findings, 1 decreased amplitude, and 1 increased latency) and ERG in 3 patients (substantially normal findings). Our case series included 6 patients, presenting with homonymous lateral hemianopia in 50% and contralateral cortical atrophy. VEPs showed normal amplitude in 66–83% according to the stimulation check, and increased latency in 67% in absence of myelin damage on MRI. Latency was increased in both eyes in 50% and only on one side in the other 50%. Such alterations were observed in patients with more severe and symmetric atrophy. ERG showed normal findings. Conclusions: Neurophysiological investigations of the visual pathway in PCA are almost absent in literature. Alterations involve both amplitude and latency and can be also monocular. A multiple-point involvement of the optical pathway can be hypothesized.
Retinal and Cortical Visual Processing Dysfunction in a Case of Mild Cognitive Impairment with Lewy Bodies: A Case Report Giulia Perini, Matteo Cotta Ramusino, Francesca Conca, Giuseppe Cosentino, Lisa Maria Farina, Alfredo Costa, Elisabetta Farina Journal of Alzheimer S Disease Reports, 2024 The prodromal stage of Lewy body dementia includes a mild cognitive impairment with visual processing and/or attention-executive deficits. A clinical presentation with progressive visual loss is indeed seldom reported and can be misleading with a posterior cortical atrophy disease. While the neurodegeneration at the occipital cortex can only partially explain the visual disturbances of Lewy body dementia, more recently a retinal dysfunction has been suggested by preliminary optical coherence tomography and autoptic findings. Herein, we present a case of a mild cognitive impairment with Lewy bodies, who presented initially with visual disturbances and signs of both retinal and cortical visual processing dysfunction. A complete neuropsychological, neurophysiological and brain imaging assessment highlighted a prominent ventral visual pathway involvement. This report provides first that the prodromal stage of Lewy body dementia can manifest as a primarily progressive visual loss, second that the involvement of visual pathway, particularly the ventral stream, can be detectable from the retinal to the cortical level.
Role of fronto-limbic circuit in neuropsychiatric symptoms of dementia: clinical evidence from an exploratory study Matteo Cotta Ramusino, Camillo Imbimbo, Marco Capelli, Raffaella Fiamma Cabini, Sara Bernini, Francesca Paola Lombardo, Laura Mazzocchi, Lisa Maria Farina, Anna Pichiecchio, Giulia Perini, Alfredo Costa Frontiers in Psychiatry, 2024 BackgroundNeuropsychiatric symptoms (NPSs) are a distressful aspect of dementia and the knowledge of structural correlates of NPSs is limited. We aimed to identify associations of fronto-limbic circuit with specific NPSs in patients with various types of cognitive impairment.MethodsOf 84 participants, 27 were diagnosed with mild cognitive impairment (MCI), 41 with Alzheimer’s disease (AD) dementia and 16 with non-AD dementia. In all patients we assessed regional brain morphometry using a region of interest (ROI)-based analysis. The mean cortical thickness (CT) of 20 cortical regions and the volume (V) of 4 subcortical areas of the fronto-limbic system were extracted. NPSs were rated with the Neuropsychiatric Inventory (NPI). We used multiple linear regression models adjusted for age and disease duration to identify significant associations between scores of NPI sub-domains and MRI measures of brain morphometry.ResultsAll significant associations found were negative, except those between irritability and the fronto-opercular regions in MCI patients (corresponding to a 40-50% increase in CT) and between delusions and hippocampus and anterior cingulate gyrus (with a 40-60% increase). Apathy showed predominant involvement of the inferior frontal regions in AD group (a 30% decrease in CT) and of the cingulate cortex in non-AD group (a 50-60% decrease in CT). Anxiety correlated in MCI patients with the cingulate gyrus and caudate, with a CT and V decrease of about 40%, while hallucinations were associated with left enthorinal gyrus and right amygdala and temporal pole. Agitation showed associations in the AD group with the frontal regions and the temporal pole, corresponding to a 30-40% decrease in CT. Euphoria, disinhibition and eating abnormalities were associated in the MCI group with the entorhinal, para-hippocampal and fusiform gyri, the temporal pole and the amygdala (with a 40-70% decrease in CT and V). Finally, aberrant motor behavior reported a significant association with frontal and cingulate regions with a 50% decrease in CT.ConclusionOur findings indicate that specific NPSs are associated with the structural involvement of the fronto-limbic circuit across different types of neurocognitive disorders. Factors, such as age and disease duration, can partly account for the variability of the associations observed.
Cognitive Versus Hemorrhagic Onset in Cerebral Amyloid Angiopathy: Neuroimaging Features Giulia Perini, Matteo Cotta Ramusino, Lisa Maria Farina, Beatrice Dal Fabbro, Isabella Canavero, Marta Picascia, Shaun Muzic, Elena Ballante, Anna Cavallini, Anna Pichiecchio, Alfredo Costa Current Alzheimer Research, 2023 Background: Intracerebral hemorrhage and cognitive decline are typical clinical presentations of cerebral amyloid angiopathy (CAA). Objective: To determine whether magnetic resonance imaging (MRI) features differ between CAA with hemorrhagic versus cognitive onset. Methods: In this retrospective study, sixty-one patients with CAA were classified by onset presentation of the disease: hemorrhage (n = 31) or cognitive decline (n = 30). The two groups were compared for MRI markers of small vessel disease, namely cerebral microbleeds (CMBs), cortical superficial siderosis, white matter hyperintensities (WMHs), enlarged perivascular spaces, cortical microinfarcts, and visual rating scales for cortical atrophy. In the patients with cognitive onset, further exploratory analyses investigated MRI markers according to cerebrospinal fluid (CSF) and neuropsychological profiles. Results: Patients with cognitive onset showed a higher prevalence of CMBs (p < 0.001), particularly in temporal (p = 0.015) and insular (p = 0.002) lobes, and a higher prevalence of WMHs (p = 0.012). Within the cognitive onset group, 12 out of 16 (75%) patients had an Alzheimer’s disease (AD) CSF profile but did not differ in MRI markers from those without AD pathology. Patients with cognitive onset displayed a multidomain profile in 16 out of 23 (70%) cases; patients with this profile showed increased WMHs and CMBs in parietal lobes compared with the amnestic group (p = 0.002) and dysexecutive group (p = 0.032), respectively. Conclusion: Higher burdens of WMHs and CMBs, especially in temporal and insular lobes, are associated with the cognitive onset of CAA. MRI markers could help to shed light on the clinical heterogeneity of the CAA spectrum and its underlying mechanisms.
Virtual brain simulations reveal network-specific parameters in neurodegenerative dementias Anita Monteverdi, Fulvia Palesi, Michael Schirner, Francesca Argentino, Mariateresa Merante, Alberto Redolfi, Francesca Conca, Laura Mazzocchi, Stefano F. Cappa, Matteo Cotta Ramusino, Alfredo Costa, Anna Pichiecchio, Lisa M. Farina, Viktor Jirsa, Petra Ritter, Claudia A. M. Gandini Wheeler-Kingshott, Egidio D’Angelo Frontiers in Aging Neuroscience, 2023 IntroductionNeural circuit alterations lay at the core of brain physiopathology, and yet are hard to unveil in living subjects. The Virtual Brain (TVB) modeling, by exploiting structural and functional magnetic resonance imaging (MRI), yields mesoscopic parameters of connectivity and synaptic transmission.MethodsWe used TVB to simulate brain networks, which are key for human brain function, in Alzheimer’s disease (AD) and frontotemporal dementia (FTD) patients, whose connectivity and synaptic parameters remain largely unknown; we then compared them to healthy controls, to reveal novel in vivo pathological hallmarks.ResultsThe pattern of simulated parameter differed between AD and FTD, shedding light on disease-specific alterations in brain networks. Individual subjects displayed subtle differences in network parameter patterns that significantly correlated with their individual neuropsychological, clinical, and pharmacological profiles.DiscussionThese TVB simulations, by informing about a new personalized set of networks parameters, open new perspectives for understanding dementias mechanisms and design personalized therapeutic approaches.
Ventricular Peritoneal Shunting Using Modified Keen’s Point Approach: Technical Report and Cases Series Elena Virginia Colombo, Daniele Bongetta, Fabio Cofano, Alessandro Versace, Diego Garbossa, Alessandro Bertuccio, Daniele Armocida, Patrizia d’Auria, Lisa Maria Farina, Roberto Assietti, Fulvio Tartara Surgeries Switzerland, 2022 Background: Ventricular peritoneal shunting (VPS) is a frequent procedure in neurosurgery, unfortunately still burdened with a significant rate of complications. The frontal Kocher’s point is the most frequently used landmark for ventricular puncture. Keen’s point (posterior parietal approach) seems to be a valid alternative. We report a newly described access to the lateral ventricle located in posterior temporal area and the results of a large series of adult patients. Methods: Retrospective analysis of a series of 188 cases of VPS performed with this approach. Results: Mean surgical time was 51.5 +/− 13.1 min (range 25–90 min). Twenty-one patients (11.2%) were subjected to revision surgery: eight cases (4.3%) for displacement or malfunction of ventricular catheter, eight cases (4.3%) for abdominal issues, three cases (1.6%) for hardware failure, and two cases (1.1%) for infection. Optimal catheter placement was reached in 90.1%. Conclusions: The modified Keen’s point approach seems to be safe, technically feasible, and reproducible, showing some potential advantages such as short surgical time, precision in ventricular catheter placement, and short tunneling tract. The need for surgical revision is similar to that reported in the literature, while the rate of catheter malpositioning and infections seems to be low; hemorrhages around catheter and seizures were not reported.
Radiological assessment of dementia: the Italian inter-society consensus for a practical and clinically oriented guide to image acquisition, evaluation, and reporting Francesca B. Pizzini, Enrico Conti, Angelo Bianchetti, Alessandra Splendiani, Domenico Fusco, Ferdinando Caranci, Alessandro Bozzao, Francesco Landi, Nicoletta Gandolfo, Lisa Farina, Vittorio Miele, Marco Trabucchi, Giovanni B. Frisoni, Stefano Bastianello Radiologia Medica, 2022 Background Radiological evaluation of dementia is expected to increase more and more in routine practice due to both the primary role of neuroimaging in the diagnostic pathway and the increasing incidence of the disease. Despite this, radiologists often do not follow a disease-oriented approach to image interpretation, for several reasons, leading to reports of limited value to clinicians. In our work, through an intersocietal consensus on the main mandatory knowledge about dementia, we proposed a disease-oriented protocol to optimize and standardize the acquisition/evaluation/interpretation and reporting of radiological images. Our main purpose is to provide a practical guideline for the radiologist to help increase the effectiveness of interdisciplinary dialogue and diagnostic accuracy in daily practice. Results We defined key clinical and imaging features of the dementias (A), recommended MRI protocol (B), proposed a disease-oriented imaging evaluation and interpretation (C) and report (D) with a glimpse to future avenues (E). The proposed radiological practice is to systematically evaluate and score atrophy, white matter changes, microbleeds, small vessel disease, consider the use of quantitative measures using commercial software tools critically, and adopt a structured disease-oriented report. Summary statement In the expanding field of cognitive disorders, the only effective assessment approach is the standardized disease-oriented one, which includes a multidisciplinary integration of the clinical picture, MRI, CSF and blood biomarkers and nuclear medicine.
Acute myelopathies associated to SARS-CoV-2 infection: Viral or immune-mediated damage? Isabella Canavero, Francesca Valentino, Elena Colombo, Diego Franciotta, Delfina Ferrandi, Marco Mussa, Rodolfo Schizzi, Kalliopi Marinou, Carla Zanferrari, Pietro Businaro, Sabrina Ravaglia, Paolo Prunetti, Giuseppe Cosentino, Lisa Maria Farina, Elisa Rognone, Anna Pichiecchio, Giuseppe Micieli Travel Medicine and Infectious Disease, 2021
Brain MR findings in patients treated with particle therapy for skull base tumors Gisela Viselner, Lisa Farina, Federica Lucev, Elena Turpini, Luca Lungarotti, Ana Bacila, Alberto Iannalfi, Emma D’Ippolito, Barbara Vischioni, Sara Ronchi, Enrico Marchioni, Francesca Valvo, Stefano Bastianello, Lorenzo Preda Insights into Imaging, 2019
Cortical malformations and COL4A1 mutation: Three new cases G. Vitale, A. Pichiecchio, F. Ormitti, D. Tonduti, A. Asaro, L. Farina, B. Piccolo, A. Percesepe, S. Bastianello, S. Orcesi, P. Accorsi, D. Battaglia, C. Cereda, P. Martelli, M. Mine, L. Pinelli, T. Tartaglione, T. Ghi, E. Parrini, O. Zuffardi European Journal of Paediatric Neurology, 2019
Stroke-like events after brain radiotherapy: a large series with long-term follow-up A. L. Di Stefano, G. Berzero, F. Ducray, M. Eoli, A. Pichiecchio, L. M. Farina, V. Cuccarini, M. C. Brunelli, L. Diamanti, S. Condette Auliac, A. Salmaggi, A. Silvani, B. Giometto, A. Pace, A. Vidiri, F. Bourdain, S. Bastianello, M. Ceroni, E. Marchioni European Journal of Neurology, 2019
Herpes simplex encephalitis in glioma patients: A challenging diagnosis Giulia Berzero, Anna Luisa Di Stefano, Caroline Dehais, Marc Sanson, Paola Gaviani, Antonio Silvani, Andrea Salmaggi, Paolo Vitali, Luca Diamanti, Fausto Baldanti, Lisa Maria Farina, Mauro Ceroni, Enrico Marchioni Journal of Neurology Neurosurgery and Psychiatry, 2015
Meningeal melanomatosis: A challenge for timely diagnosis Giulia Berzero, Luca Diamanti, Anna Luisa Di Stefano, Paola Bini, Diego Franciotta, Ilaria Imarisio, Paolo Pedrazzoli, Lorenzo Magrassi, Patrizia Morbini, Lisa Maria Farina, Stefano Bastianello, Mauro Ceroni, Enrico Marchioni Biomed Research International, 2015
