Dementia Research Center IRCCS Mondino Foundation-University of Pavia-IUSS
a) Identification of innovative cognitive markers for early detection of cognitive degenerative diseases
Clinical diagnosis of cognitive neurodegenerative disorders relies on the use of biomarkers that allow the identification of specific clinical phenotypes in order to plan individualized therapeutic actions already at the earliest stages of the disease. In this regard, this Unit presents a line of research aimed at the development and validation of new cognitive tasks for Precise Medicine in dementia field. This area of research includes different objectives calibrated to the needs of single cognitive disorders (e.g. Mild Cognitive Decline, Frontotemporal Dementia, Primary Progressive Aphasias). In particular, the Unit is developing a digital version of an Uniform Neuropsychological Data Set for the early diagnosis of cognitive decline in the Italian population. This project is in collaboration with the National Network of Scientific and Clinical Research Institutes (IRCCS). This research area includes also the validation of a screening tool (Mini Standard Language Examination) for Primary Progressive Aphasias, developed in collaboration with an international group of researchers (St. George University of London and University of Cambridge). The validation of a neuropsychological battery for the early diagnosis of the behavioral variant of frontotemporal dementia and cognitive-behavioral disorder in amyotrophic lateral sclerosis is also underway, based on the identification of specific deficit profiles in executive, language and social cognition skills. Finally, a sub-project within this line of research aims to characterize the selective cognitive vulnerability of subjects affected by Mild Cognitive Decline with prevalent degeneration of medial temporal lobe structures, through the use of a cognitive battery that investigate emotion recognition and socio-emotional processing, as well as episodic memory.
b) Advanced clinical research of dementias with multimodal and machine-learning techniques
Clinical research on neurodegenerative diseases with a precision medicine approach is based on the availability of large dataset containing multimodal information (big data). The availability of clinical, neuropsychological, imaging, neurophysiological and biological data is a necessary condition for both the development of monocentric projects and the participation in multicentric collaborations and clinical trials. Current developments in artificial intelligence applied to precision medicine are only possible through the creation and implementation in clinical settings of data analysis pipelines requiring an adequate IT infrastructure. This line of research is pursued through the active collaboration with the neuroradiology and bioinformatics services of the Mondino IRCCS Foundation, with the aim of developing a large dementia database, potentially applicable to all fields of neurodegenerative pathology. Data analysis using data visualization software and advanced machine-learning and artificial intelligence techniques will allow the creation of predictive models of cognitive degenerative disease (e.g. for the diagnosis of Alzheimer's disease) to be implemented in the clinical setting. This research line is entirely integrated with research line a).
c) Digitization of diagnosis and rehabilitation in the neuropsychological field
The increasing number of people with cognitive deficits and the advancing average age of the general population, as well as the growing need for health personnel to manage high patient flows, imply a complete overhaul of the current way of managing the activities of neuropsychological services. The use of digital technologies represents an opportunity to overcome this impasse. However, the digitization of the healthcare sector is taking place very quickly and is not always adapted to the needs of the cognitively fragile elderly population. This line of research of our Unit is based on collaboration with other academic and research institutions, operating at national and international level, as well as with medical engineering companies with the aim of bringing the neuropsychology of dementias into the age of digital transformation, as already happened for other sectors (e.g. imaging, neurophysiology). This involves a complete innovation of operating procedures, allowing the relocation of care from hospital facilities directly to the patient's home, as well as the introduction of new professional skills, adapting the Italian system to what is already in place in other countries. In this context, the aim is to develop new IT tools for the diagnosis and rehabilitation of dementias to be implemented in the clinical routine. This line of research is entirely integrated with the research line a) thinking about the development of new digitized screening tools that allow to better allocate limited resources and optimize the management of patients at home.
d) Neural correlates of cognitive functions
Using methods of neuroimaging and neurophysiology, and cutting-edge statistical analysis techniques, thanks also to numerous collaborations with national and international research centers, this line of research is characterized by cognitive neuroscience studies aimed at understanding and characterizing the functioning and neural bases of different cognitive processes, with a particular interest in language, semantic memory and social cognition. This research is conducted on healthy subjects and on patients suffering from neurodegenerative diseases. This line of research is integrated with research lines a) and b).
- Stefano Cappa (Full Professor IUSS, Neurology MED/26; Head of Dementia Clinical Research)
- Eleonora Catricalà (Associate Professor IUSS, Psychobiology and Physiological Psychology M-PSI/02)
- Chiara Cerami (Senior Researcher IUSS, Neurology MED/26)
- Francesca Conca (PhD Student IUSS in Neuroscience and Philosophy of Mind)
- Chiara Crespi (Post-doc Research Fellow, Mondino Foundation IRCCS)
- Valentina Esposito (Scholarship Holder, Mondino Foundation IRCCS)
- Neurologists, neuropsychologists, neuroradiologists, neurophysiologists and biostatisticians (Mondino Foundation IRCCS and University of Pavia)