GIANFRANCO DE STEFANO

Dottore di ricerca

ciclo: XXXVII



Titolo della tesi: Pathophysiological Mechanisms in Trigeminal Neuralgia - The Impact of Sex, Neurovascular Compression and Nerve Fibre Function

This PhD thesis investigates the pathophysiological mechanisms underlying trigeminal neuralgia (TN), with a focus on how sex, neurovascular compression, and nerve fibre function influence the clinical presentation and neurophysiological characteristics of this unique chronic neuropathic pain disorder. Key findings reveal an association between female sex and idiopathic TN, suggesting the involvement of additional etiological factors beyond neurovascular compression in women, supporting a multi-hit model of disease. This association, along with the poorer tolerability of first-line drugs (carbamazepine and oxcarbazepine) in women, underscores the significant burden TN places on female patients and highlights the need for sex-specific therapeutic approaches. A latency asymmetry exceeding 0.5 ms between the affected and unaffected sides in trigeminal reflexes is predictive of classical TN, likely reflecting the impact of neurovascular compression on large-myelinated nerve fibres. In patients with concomitant continuous pain, reduced C fibre-related laser-evoked potential (LEP) amplitude on the affected side suggests that selective damage to unmyelinated C fibers, potentially reflecting axonal loss, may be the primary mechanism behind this kind of pain. Such axonal loss may result in abnormal activity in anatomically denervated trigeminal nociceptive second- order neurons, a mechanism known as “denervation supersensitivity”. Overall, these findings enhance our understanding of TN pathophysiology and lay the groundwork for more patient-tailored treatment approaches.

Produzione scientifica

11573/1733961 - 2025 - Trigeminal reflex testing abnormalities as a predictive model for distinguishing classical and idiopathic trigeminal neuralgia
De Stefano, Gianfranco; Mollica, Cristina; Leone, Caterina; Galosi, Eleonora; Di Pietro, Giuseppe; Falco, Pietro; Esposito, Nicoletta; Litewczuk, Daniel; Evangelisti, Enrico; Caramia, Francesca; Truini, Andrea; Di Stefano, Giulia - 01a Articolo in rivista
rivista: CLINICAL NEUROPHYSIOLOGY ([S.l.] : Elsevier Science) pp. 61-66 - issn: 1872-8952 - wos: (0) - scopus: 2-s2.0-85216333360 (0)

11573/1734836 - 2025 - Epidermal Transient Receptor Potential Vanilloid 1 innervation is increased in patients with painful diabetic polyneuropathy experiencing ongoing burning pain
Galosi, Eleonora; Falco, Pietro; Di Pietro, Giuseppe; Esposito, Nicoletta; De Stefano, Gianfranco; Evangelisti, Enrico; Leone, Caterina; Litewczuk, Daniel; Tramontana, Lorenzo; Di Stefano, Giulia; Truini, Andrea - 01a Articolo in rivista
rivista: PAIN (Amsterdam : Elsevier Health Sciences) pp. - - issn: 1872-6623 - wos: (0) - scopus: (0)

11573/1711828 - 2024 - An overview of diagnosis and assessment methods for neuropathic pain
De Stefano, Gianfranco; Truini, Andrea - 01g Articolo di rassegna (Review)
rivista: LA PRESSE MÉDICALE (Milano: Masson Italia periodici.) pp. - - issn: 0393-0653 - wos: (0) - scopus: 2-s2.0-85192082572 (2)

11573/1705171 - 2024 - Nerve ultrasound in Friedreich's Ataxia: enlarged nerves as a biomarker of disease severity
Di Pietro, G.; Cioffi, E.; Falco, P.; Galosi, E.; De Stefano, G.; Di Stefano, G.; Leone, C.; Martines, V.; Perotti, S.; Casali, C.; Truini, A. - 01a Articolo in rivista
rivista: CLINICAL NEUROPHYSIOLOGY (Elsevier Science Ireland Limited:PO Box 85, Limerick Ireland:011 353 61 709600, 011 353 61 61944, EMAIL: usinfo-f@elsevier.com, INTERNET: http://www.elsevier.com, Fax: 011 353 61 709114) pp. 75-80 - issn: 1388-2457 - wos: WOS:001187805500001 (3) - scopus: 2-s2.0-85185248895 (3)

11573/1694131 - 2024 - Predicting value for incomplete recovery in Bell's palsy of facial nerve ultrasound versus nerve conduction study
Di Pietro, Giuseppe; Falco, Pietro; D’Elia, Chiara; Cavalcanti, Luca; Di Stefano, Giulia; De Stefano, Gianfranco; Fabiano, Enrica; Galosi, Eleonora; Leone, Caterina; Vicenzini, Edoardo; Truini, Andrea; Mancini, Patrizia - 01a Articolo in rivista
rivista: CLINICAL NEUROPHYSIOLOGY (Elsevier Science Ireland Limited:PO Box 85, Limerick Ireland:011 353 61 709600, 011 353 61 61944, EMAIL: usinfo-f@elsevier.com, INTERNET: http://www.elsevier.com, Fax: 011 353 61 709114) pp. 35-42 - issn: 1388-2457 - wos: WOS:001149576100001 (2) - scopus: 2-s2.0-85182216543 (5)

11573/1710995 - 2024 - Small fibre neuropathy frequently underlies the painful long-COVID syndrome
Falco, Pietro; Litewczuk, Daniel; Di Stefano, Giulia; Galosi, Eleonora; Leone, Caterina; De Stefano, Gianfranco; Di Pietro, Giuseppe; Tramontana, Lorenzo; Ciardi, Maria Rosa; Pasculli, Patrizia; Zingaropoli, Maria Antonella; Arendt-Nielsen, Lars; Truini, Andrea - 01a Articolo in rivista
rivista: PAIN (Elsevier BV:PO Box 211, 1000 AE Amsterdam Netherlands:011 31 20 4853757, 011 31 20 4853642, 011 31 20 4853641, EMAIL: nlinfo-f@elsevier.nl, INTERNET: http://www.elsevier.nl, Fax: 011 31 20 4853598) pp. 1-9 - issn: 0304-3959 - wos: WOS:001293723900010 (2) - scopus: (0)

11573/1716172 - 2024 - Clinical, histologic, and immunologic signatures of Small Fiber Neuropathy in Systemic Lupus Erythematosus
Galosi, E.; Pirone, C.; Ceccarelli, F.; Esposito, N.; Falco, P.; Leopizzi, M.; Di Maio, V.; Tramontana, L.; De Stefano, G.; Di Pietro, G.; Di Stefano, G.; Garufi, C.; Leone, C.; Natalucci, F.; Orefice, V.; Alessandri, C.; Spinelli, F. R.; Truini, A.; Conti, F. - 01a Articolo in rivista
rivista: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM (MALDEN ,USA :WILEY-BLACKWELL PUBLISHING, INC- 2006 New York, NY: Woodland Publications) pp. - - issn: 1529-8027 - wos: WOS:001268085700001 (0) - scopus: 2-s2.0-85197756537 (1)

11573/1689600 - 2023 - Considerations ehen using gabapentinoids to treat trigeminal neuralgia: a review
De Stefano, Gianfranco; Di Pietro, Giuseppe; Truini, Andrea; Cruccu, Giorgio; Di Stefano, Giulia - 01g Articolo di rassegna (Review)
rivista: NEUROPSYCHIATRIC DISEASE AND TREATMENT (Auckland, N.Z. : Dove Medical Press, c2005-c2008.) pp. 2007-2012 - issn: 1176-6328 - wos: WOS:001072715000001 (2) - scopus: (0)

11573/1685027 - 2023 - Sex differences in trigeminal neuralgia: a focus on radiological and clinical characteristics
De Stefano, Gianfranco; Litewczuk, Daniel; Mollica, Cristina; Di Pietro, Giuseppe; Galosi, Eleonora; Leone, Caterina; Falco, Pietro; Tullo, Maria Giulia; Caramia, Francesca; Truini, Andrea; Di Stefano, Giulia - 01a Articolo in rivista
rivista: NEUROLOGICAL SCIENCES (-Springer-Verlag Italia -Masson SPA:via Flli Bressan 2, I 20126 Milan Italy:011 39 02 27074286, EMAIL: aboonamenti@masson.it, INTERNET: http://www.masson.it, Fax: 011 39 02 27074210) pp. - - issn: 1590-1874 - wos: WOS:001028466400001 (8) - scopus: 2-s2.0-85164503659 (6)

11573/1679817 - 2023 - Anti-LGI1 encephalitis: A family affair
De Stefano, Gianfranco; Pulitano, Patrizia; Di Bonaventura, Carlo; Zuliani, Luigi; Morano, Alessandra - 01i Case report
rivista: JOURNAL OF NEUROIMMUNOLOGY (Amsterdam ; Lausanne ; New York ; Oxford ; Shannon ; Tokyo : Elsevier) pp. 578084- - issn: 0165-5728 - wos: WOS:000981907900001 (0) - scopus: 2-s2.0-85151753325 (0)

11573/1689588 - 2023 - Pain associated with COVID-19 vaccination is unrelated to skin biopsy abnormalities
Di Stefano, G.; Falco, P.; Galosi, E.; De Stefano, G.; Di Pietro, G.; Leone, C.; Litewczuk, D.; Tramontana, L.; Strano, S.; Truini, A. - 01a Articolo in rivista
rivista: PAIN REPORTS (Baltimore, MD : Wolters Kluwer, 2016.) pp. - - issn: 2471-2531 - wos: WOS:001047253700002 (0) - scopus: 2-s2.0-85168481001 (1)

11573/1686144 - 2023 - Autonomic small-fiber pathology in patients with fibromyalgia
Falco, Pietro; Galosi, Eleonora; Di Stefano, Giulia; Leone, Caterina; Di Pietro, Giuseppe; Tramontana, Lorenzo; De Stefano, Gianfranco; Litewczuk, Daniel; Esposito, Nicoletta; Truini, Andrea - 01a Articolo in rivista
rivista: THE JOURNAL OF PAIN (W B Saunders Company:Fulfillment Department, The Curtis Center, Independence Square West:Philadelphia, PA 19106:(800)654-2452, (215)238-7800, EMAIL: wbspcs@harcourt.com, INTERNET: http://elsevierhealth.com, Fax: (215)238-6445) pp. - - issn: 1526-5900 - wos: WOS:001140091600001 (5) - scopus: 2-s2.0-85171333403 (5)

11573/1691487 - 2023 - Trigeminal neuropathy presenting secondary to SARS-CoV-2 infection
O’Neill, Francis; De Stefano, Gianfranco; Pridgeon, Mike; Bhargava, Deepti; Marshall, Anne; Marshall, Andrew; Frank, Bernhard - 01i Case report
rivista: PAIN REPORTS (Baltimore, MD : Wolters Kluwer, 2016.) pp. - - issn: 2471-2531 - wos: WOS:001087858400001 (2) - scopus: 2-s2.0-85178039229 (2)

11573/1679820 - 2023 - A lightning in the face
Truini, Andrea; De Stefano, Gianfranco - 02a Capitolo o Articolo
libro: Neuropathic Pain - (0197616348; 9780197616345; 9780197616376)

11573/1654326 - 2022 - Unravelling the role of unmyelinated nerve fibres in trigeminal neuralgia with concomitant continuous pain
De Stefano, Gianfranco; Leone, Caterina; Di Pietro, Giuseppe; Esposito, Nicoletta; Falco, Pietro; Galosi, Eleonora; Litewczuk, Daniel; Mollica, Cristina; Truini, Andrea; Di Stefano, Giulia - 01a Articolo in rivista
rivista: CLINICAL NEUROPHYSIOLOGY (Elsevier Science Ireland Limited:PO Box 85, Limerick Ireland:011 353 61 709600, 011 353 61 61944, EMAIL: usinfo-f@elsevier.com, INTERNET: http://www.elsevier.com, Fax: 011 353 61 709114) pp. 52-58 - issn: 1388-2457 - wos: WOS:000860711800007 (11) - scopus: 2-s2.0-85135792041 (11)

11573/1669494 - 2022 - The diagnostic accuracy of the small fiber neuropathy symptoms inventory questionnaire (SFN-SIQ) for identifying pure small fiber neuropathy
Galosi, E.; Falco, P.; Di Pietro, G.; Leone, C.; Esposito, N.; De Stefano, G.; Di Stefano, G.; Truini, A. - 01a Articolo in rivista
rivista: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM (MALDEN ,USA :WILEY-BLACKWELL PUBLISHING, INC- 2006 New York, NY: Woodland Publications) pp. 283-290 - issn: 1529-8027 - wos: WOS:000863932600001 (11) - scopus: 2-s2.0-85139209382 (13)

11573/1474765 - 2021 - Real-world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia
Di Stefano, Giulia; De Stefano, Gianfranco; Leone, Caterina Maria; Di Lionardo, Andrea; Di Pietro, Giuseppe; Sgro, Emanuele; Mollica, Cristina; Cruccu, Girogio; Truini, Andrea - 01a Articolo in rivista
rivista: EUROPEAN JOURNAL OF PAIN (Harcourt Publishers Limited:Foots Cray High Street, Sidcup Kent DA14 5HP United Kingdom:011 44 20 83085700, EMAIL: journals@harcourt.com, INTERNET: http://www.harcourt-international.com, Fax: 011 44 20 83085876) pp. 1064-1071 - issn: 1090-3801 - wos: WOS:000613663200001 (22) - scopus: 2-s2.0-85100098452 (30)

11573/1670912 - 2021 - General approach to diagnosis and assessment of the facial pain patient
Zakrzewska, J; Nurmikko, T; Hodaie, M; Davis, Kd; De Stefano, G; Truini, A - 02a Capitolo o Articolo
libro: Trigeminal Neuralgia and Other Cranial Neuralgias: A Practical Personalised Holistic Approach - (9780191914485)

11573/1472688 - 2020 - Concomitant continuous pain in patients with trigeminal neuralgia is associated with trigeminal nerve root atrophy
Di Stefano, G.; De Stefano, G.; Leone, C.; Cruccu, G.; Tardioli, S.; Cartocci, G.; Fiorelli, M.; Truini, A.; Caramia, F. - 01a Articolo in rivista
rivista: CEPHALALGIA (-Attuale:BLACKWELL PUBLISHING, 9600 GARSINGTON RD, OXFORD, ENGLAND, OXON, OX4 2DQ -Scandinavian University Press:PO Box 508, Sentrum, 0105 Oslo Norway:011 47 24 147500, INTERNET: http://www.universitsforlaget.no, Fax: 011 47 24 147501) pp. 1502-1510 - issn: 0333-1024 - wos: WOS:000559713500001 (23) - scopus: 2-s2.0-85089366585 (30)

11573/1572546 - 2020 - Pharmacotherapeutic Options for Managing Pain in Multiple Sclerosis
Di Stefano, Giulia; De Stefano, Gianfranco; Di Lionardo, Andrea; Cruccu, Giorgio; Truini, Andrea - 01g Articolo di rassegna (Review)
rivista: CNS DRUGS (Adis International Limited:Private Bag 65901, Mairangi Bay, Auckland 1311 New Zealand:011 64 9 4770741, EMAIL: subs@adis.com, david.herrick@adis.co.nz, INTERNET: http://www.adis.com, Fax: 011 64 9 4770766) pp. 749-761 - issn: 1172-7047 - wos: WOS:000531140600001 (3) - scopus: 2-s2.0-85084448399 (5)

11573/852378 - 2015 - Adverse psychiatric effects associated with herbal weight-loss products
Coviello, Marialuce; Imperatori, Claudio; Francesconi, Marta; Hough, Christina M.; Valeriani, Giuseppe; Bolzan Mariotti Posocco, Flaminia; Santacroce, Rita; Minichino, Amedeo; Bersani, Francesco Saverio; De Stefano, Gianfranco; Corazza, Ornella - 01g Articolo di rassegna (Review)
rivista: BIOMED RESEARCH INTERNATIONAL ([London]: [Hindawi] Cairo: Hindawi Publishing Corporation) pp. - - issn: 2314-6133 - wos: WOS:000361996700001 (24) - scopus: 2-s2.0-84942805854 (35)

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