One of the main goals of the Casa di Cura Privata del Policlinico (CCPP) is to create the ideal environment to promote clinical, applied, and translational research in the field of Cerebrovascular and Neurodegenerative Diseases. This objective is strived for in order to facilitate the rapid transfer of knowledge gained in basic research and in technology to the present reality of clinical care.
Several different lines of research are under the subject area of the Neurological Sciences, which specifically concern the study, and treatment of disorders resulting from brain injury, spinal cord and neuromuscular disorders.
Some studies aim at the clinical characterization and treatment of cognitive deficits in patients with focal hemispheric lesions following a stroke or neurosurgical procedures. The language disorder (aphasia), in its different modes of clinical expression, once suitably qualified is tested or treated with different techniques that include the use of a transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS). The study of visual-spatial deficit involves the application of computerized experimental models with which we analyze the variations in visual processing. Several research protocols have been finalized in this context in order to create assessment tools for the differential diagnosis between attention deficits and sensory deficits. Studies are underway to assess the aspects of motor planning in patients with brain lesions of the primary and associative motor areas through motion analysis techniques and functional neuroimaging.
Conversely, research on Neurodegenerative Diseases deals with the residual capacity of patients, with specific reference to motor and cognitive functions. Moreover, in this context, our Centre is actively involved in clinical and pre-clinical research programs, which include the analysis of putative biomarker, genetic studies and the evaluation of new experimental therapies in affected patients.
The research conducted in CCP involves the active participation of researchers of the Clinic in collaboration with other researchers working for other national or international entities, laboratories and university departments.
The research area of Neurorehabilitation Science occupies a place of special importance in the context of our scientific activity. The studies already initiated range from the application of rehabilitation protocols, like the mirror therapy, to the introduction of instruments modulation brain, like the tDCS (transcranial direct current stimulation).
We also initiated a series of research lines on retrospective data collected in recent years. The main goal of this process is to analyze the variation of efficacy in motor rehabilitation treatments on patients who present different cognitive deficits and therefore optimize the multidisciplinary strategies of treatment for our patients.
The neurorehabilitation patients often present neurogenic dysphagia, therefore in this area we have initiated research projects for the validation of more sensitive instruments in detecting impairment of swallowing, and the application of new rehabilitation protocols in dysphagic subjects with difficulty in learning the techniques of compensation.
Aspiring to the principle of personalized care, interesting individual cases showing peculiar clinical characteristics may be worthy of in depth studies and the implementation of specific rehabilitation programs, which could then eventually be applied, if effective, to other similar patients.
From 2014 we initiated the project proposals within the European network finalized at the realization of applied research to the Ambient Assisted Living and Personalizing Health and Care (Horizon 2020). More precisely, in addition to interest in clinical research, CCP promotes the implementation of new technologies for neuromotor rehabilitation (e.g. wearable robotic, brain computer interface, serious gaming, etc.).
Quality of life
While taking charge of rehabilitation it becomes essential to consider one of the key aspects so the person can live the recent change in his state of health, the long period of hospitalization and return to everyday life in the home environment, in the best possible way. For this reason, CCP is developing new areas of research concerning the study of Quality of Life in the hospital setting.
The current definition of “health” given from the World Health Organization (WHO) states the equivalence of such a concept is no longer with that of “absence of disease” but rather with that of “physical, mental and social well-being”. This definition implies that the quantification of the state of health must also take into account aspects of mental, cognitive, affective, emotional, social and economic well-being and not rely merely on biological outcomes.
The introduction of the concept of “Quality of Life” has therefore focused its attention on the centrality of the sick person, his role, his subjectivity and the processes of involvement and participation concerning him.
Over the last few years, previous research has been conducted on the role of “Green” factor and contact with nature concerning the increased physical and psychological wellbeing for people who require periods of prolonged care. This specific research interest is now actively represented at CCPP starting with the application protocols of Horticultural-therapy for post stroke patients undergoing rehabilitation.
The sensibility on the issue of “attention to the person” also promotes enquiries on the Italian adaptation and validation of tools to assess the quality of life and the levels of motivation in people suffering from various neurological diseases, striking both in adulthood and in developmental years, who are hospitalized at our Centre.