Valeria Di Stefano

Dr. Valeria Di Stefano

orcid

Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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31 January 2025 in Neuroscience & Biobehavioral Reviews
Verified
Journal Article
Open access
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
MDMartina D’Angelo
Martina D’Angelo
FMFrancesco Monaco
Francesco Monaco
VSValeria Di Stefano
Valeria Di Stefano
Bipolar disorder (BD) is characterized by a complex constellation of emotional, cognitive, and psychomotor disturbances, each deeply intertwined with underlying dysfunctions in large-scale brain networks and neurotransmitter systems. This manuscript integrates recent advances in neuroimaging, neuromodulation, and pharmacological research to provide a comprehensive view of BD's pathophysiology, emphasizing the role of network-specific dysfunctions and their clinical manifestations. We explore how dysregulation within the fronto-limbic network, particularly involving the prefrontal cortex (PFC) and amygdala, underpins the emotional instability that defines both manic and depressive episodes. Additionally, impairments in the central executive network (CEN) and default mode network (DMN) are linked to cognitive deficits, with hyperactivity in the DMN driving rumination and cognitive inflexibility, while CEN underactivity contributes to attentional lapses and impaired executive function. Psychomotor symptoms, which oscillate between hyperactivity in mania and retardation in depression, are closely associated with imbalances in neurotransmitter systems, particularly dopamine and serotonin, within the basal ganglia-thalamo-cortical motor pathway. Recent studies indicate that these psychomotor disturbances are further exacerbated by disruptions in network connectivity, leading to impairments in both motor control and emotional regulation. Emerging therapeutic strategies are discussed, with a focus on neuromodulation techniques such as transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS), which show promise in restoring balance within these critical networks. Furthermore, pharmacological interventions that modulate synaptic functioning and neuronal plasticity offer potential for addressing both the emotional and motor symptoms of BD. This manuscript underscores the need for an integrative treatment approach that simultaneously targets neural circuits and neurotransmitter systems to address the full spectrum of symptoms in BD. Drawing on recent advancements in neurobiological models and therapeutic frameworks, this proposal outlines a pathway for the development of precision-tailored interventions. These approaches are designed to optimize cognitive, emotional, and psychomotor outcomes, ultimately striving to elevate the quality of life for individuals living with bipolar disorder (BD), while remaining firmly grounded in the latest empirical evidence and theoretical insights.

22 May 2025 in Biomedicines
Verified
Journal Article
Open access
PDF file
VSValeria Di Stefano
Valeria Di Stefano
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
MDMartina D’Angelo
Martina D’Angelo
FMFrancesco Monaco
Francesco Monaco
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
Palmitoylethanolamide (PEA) is an endogenous lipid mediator belonging to the N-acyl-ethanolamine family, widely recognized for its multifaceted effects on neuroprotection, chronic pain management, and immune modulation. As a naturally occurring compound, PEA plays a crucial role in maintaining homeostasis under conditions of cellular stress and inflammation. Its pharmacological effects are primarily mediated through peroxisome proliferator-activated receptor-alpha (PPAR-α) activation, alongside indirect modulation of cannabinoid receptors CB1 and CB2, as well as interactions with novel targets such as GPR55 and TRPV1. These molecular mechanisms underpin its broad therapeutic potential, particularly in the management of neuroinflammatory and neurodegenerative disorders, pain syndromes, and immune dysregulation. A major advancement in PEA research has been the development of ultramicronized palmitoylethanolamide (umPEA), which significantly enhances its bioavailability and therapeutic efficacy by facilitating better tissue absorption and interaction with key molecular pathways. Preclinical and clinical studies have demonstrated that umPEA is particularly effective in reducing neuroinflammation, stabilizing mast cells, and enhancing endocannabinoid system activity, making it a promising candidate for integrative approaches in neuropsychiatric and chronic inflammatory diseases. Given its well-established safety profile, umPEA represents an attractive alternative or adjunct to conventional anti-inflammatory and analgesic therapies. This communication provides a comprehensive overview of the mechanisms of action and therapeutic applications of both PEA and umPEA, emphasizing their emerging role in clinical practice and personalized medicine.

16 January 2025 in Brain Sciences
Verified
Journal Article
Open access
PDF file
AVAnnarita Vignapiano
Annarita Vignapiano
FMFrancesco Monaco
Francesco Monaco
EPErnesta Panarello
Ernesta Panarello
SLStefania Landi
Stefania Landi
BGBenedetta Di Gruttola
Benedetta Di Gruttola
GCGiulio Corrivetti
Giulio Corrivetti
Background: The integration of digital health technologies has transformed mental healthcare, particularly for young adults with First-Episode Psychosis (FEP). Digital interventions, such as telepsychiatry and mobile applications, address barriers like social stigma, restricted access to services, and the urgency of timely care. Methods: A systematic literature review was conducted using PubMed and APA PsycINFO. Included studies focused on randomized controlled trials, cohort studies, and open studies of digital interventions for FEP rehabilitation. Exclusion criteria included meta-analyses, reviews, and irrelevant studies. Results: Smartphone applications like Horyzons-Canada facilitated peer support and symptom management, while tools such as My Journey 3 emphasized the need for better user engagement. Digital innovations, including Cognitive Behavioral Therapy for insomnia (CBT-I) and telepsychiatry, demonstrated improvements in recovery and treatment adherence. Discussion: Digital interventions significantly enhance the accessibility and quality of FEP care, supporting functional recovery and patient engagement. Future research should prioritize longitudinal studies, user engagement strategies, and advanced analytics to develop personalized, scalable solutions.

27 November 2024 in Brain Sciences
Verified
Journal Article
Open access
PDF file
VSValeria Di Stefano
Valeria Di Stefano
MDMartina D’Angelo
Martina D’Angelo
FMFrancesco Monaco
Francesco Monaco
AVAnnarita Vignapiano
Annarita Vignapiano
VMVassilis Martiadis
Vassilis Martiadis
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
Schizophrenia, a highly complex psychiatric disorder, presents significant challenges in diagnosis and treatment due to its multifaceted neurobiological underpinnings. Recent advancements in functional magnetic resonance imaging (fMRI) and artificial intelligence (AI) have revolutionized the understanding and management of this condition. This manuscript explores how the integration of these technologies has unveiled key insights into schizophrenia’s structural and functional neural anomalies. fMRI research highlights disruptions in crucial brain regions like the prefrontal cortex and hippocampus, alongside impaired connectivity within networks such as the default mode network (DMN). These alterations correlate with the cognitive deficits and emotional dysregulation characteristic of schizophrenia. AI techniques, including machine learning (ML) and deep learning (DL), have enhanced the detection and analysis of these complex patterns, surpassing traditional methods in precision. Algorithms such as support vector machines (SVMs) and Vision Transformers (ViTs) have proven particularly effective in identifying biomarkers and aiding early diagnosis. Despite these advancements, challenges such as variability in methodologies and the disorder’s heterogeneity persist, necessitating large-scale, collaborative studies for clinical translation. Moreover, ethical considerations surrounding data integrity, algorithmic transparency, and patient individuality must guide AI’s integration into psychiatry. Looking ahead, AI-augmented fMRI holds promise for tailoring personalized interventions, addressing unique neural dysfunctions, and improving therapeutic outcomes for individuals with schizophrenia. This convergence of neuroimaging and computational innovation heralds a transformative era in precision psychiatry.

28 February 2024 in Medicina
Verified
Journal Article
Open access
PDF file
MDMartina D’Angelo
Martina D’Angelo
MVMarta Valenza
Marta Valenza
AIAnna Maria Iazzolino
Anna Maria Iazzolino
GLGrazia Longobardi
Grazia Longobardi
VSValeria Di Stefano
Valeria Di Stefano
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
Background and Objectives: Traumatic events adversely affect the clinical course of obsessive–compulsive disorder (OCD). Our study explores the correlation between prolonged interpersonal trauma and the severity of symptoms related to OCD and anxiety disorders. Materials and Methods: The study follows a cross-sectional and observational design, employing the International Trauma Questionnaire (ITQ) to examine areas linked to interpersonal trauma, the Hamilton Anxiety Rating Scale (HAM-A), and the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) to assess anxious and obsessive–compulsive symptoms, respectively. Descriptive analysis, analysis of variance (ANOVA), and logistic regression analyses were conducted. Results: We recruited 107 OCD-diagnosed patients, categorizing them into subgroups based on the presence or absence of complex post-traumatic stress disorder (cPTSD). The ANOVA revealed statistically significant differences between the two groups in the onset age of OCD (p = 0.083), psychiatric familial history (p = 0.023), HAM-A, and Y-BOCS (p < 0.0001). Logistic regression indicated a statistically significant association between the presence of cPTSD and Y-BOCS scores (p < 0.0001). Conclusions: The coexistence of cPTSD in OCD exacerbates obsessive–compulsive symptoms and increases the burden of anxiety. Further advancements in this field are crucial for mitigating the impact of early trauma on the trajectory of OCD and associated anxious symptoms.

24 January 2024 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
AIAnna Maria Iazzolino
Anna Maria Iazzolino
MVMarta Valenza
Marta Valenza
MDMartina D’Angelo
Martina D’Angelo
GLGrazia Longobardi
Grazia Longobardi
VSValeria Di Stefano
Valeria Di Stefano
Luca Steardo Jr.Luca Steardo Jr.
Luca Steardo Jr.
Background: Patients with bipolar disorder (BD) are more likely than the general population to experience traumatic events, particularly during childhood, and these may predict and be a risk factor for the development of complex PTSD (cPTSD). The presence of multiple traumas plays a relevant role from a psychopathological point of view, but little is known about the effect this may have on suicide attempts in patients with BD. Methods: A cross-sectional study was conducted comparing socio-demographic and clinical characteristics, recruiting 344 patients diagnosed with BD I and II, screened for the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ). Suicide attempts were assessed directly during the clinical interview and from the patient’s medical record. Results: The results emerging from the study indicate that cPTSD can be considered a risk factor for suicide attempts in patients with BD. Furthermore, evidence is provided to support the idea that cPTSD is highly prevalent in patients with BD and is related to a higher psychopathological burden. Conclusions: The results recommend an urgent and comprehensive assessment of suicidal risk in patients with comorbidity of both bipolar disorder and cPTSD. There is a crucial demand for early intervention initiatives and proactive prevention strategies to address the intricate intersection of these mental health challenges.