Cognitive rehabilitation

Riabilitazione cognitiva

One of the aspects that characterize Huntington's disease (HD) is the impairment of cognitive functions, including for example attention, the ability to make decisions and to recognize emotions and memory. Cognitive disorders may also occur before the onset of motor and behavioral symptoms and before the clinical diagnosis of disease. Our research projects in the cognitive area aim to identify indicators of potential cognitive decline and evaluate cognitive functions - especially executive and attentional ones - through the implementation of new methods that combine the basic knowledge of neuropsychology and cognitive neuroscience with engineering and information technology expertise. A further field of study and interest concerns brain plasticity, cognitive reserve and brain stimulation methods for diagnostic and rehabilitative purposes.

COGNITIVE RESEARCH PROJECTS

Beyond movement disorders: Evaluation of subcortical functions in patients with presymptomatic Huntington's disease

(concluded and published)

Task-switching is the ability to quickly switch between tasks as environmental conditions change.  The ability to take financial decisions, weighing the risks and benefits of your choice, is at the basis of personal and professional success and is related to the ability to modulate the perception of the benefit or damage related one’s choices. We have analyzed these two abilities in pre-symptomatic subjects and came to some interesting conclusions.Read more

Evaluation of the skills of mind theory in subjects in the presymptomatic phase of disease

(concluded and published)

The aim of the study is to evaluate subjects with positive genetic testing but without clinical signs of disease: 1) the abilities to recognize the mental state of others, such as beliefs, thoughts or desires; 2) the influence on these abilities of some characteristics of the stimulus to be recognized (gender: male or female; emotional value: positive, negative, neutral). This is a social and communicative competence that allows us to understand the behaviour of others, attaching a meaning to observed actions, when these behaviours are not directly explained to us.Read more

Eye movements during an emotional recognition tasko

(completed - in the data processing stage)

The aim of the study is to evaluate the visual scanning ability (visual search eye movements for the fixation, tracking and processing of the characteristics of an object) during a task that involves the recognition of basic emotions (anger, disgust, sadness, fear, joy). It is assumed that an alteration of visual scanning can negatively affect emotional recognition skills.

Analysis of cognitive reserve in Huntington's disease and possible correlations with the natural history of the disease

(completed - in the data processing stage)

The term "cognitive reserve" indicates the resilience of the brain to brain damage: it describes the mental ability of an individual to resist and recover their cognitive and mental abilities as a result of brain damage (eg: neuro-degeneration). The cognitive reserve is the result of experiences gained throughout one's life (schooling, hobbies, work). The aim of the study is to evaluate the degree of cognitive reserve in a sample of patients suffering from Huntington's disease through a standardized questionnaire; the relationships between the level of cognitive reserve, the clinical manifestations of the disease (motor, cognitive, behavioural) and their evolution over time will also be evaluated.

Validation of a self-administered questionnaire for the detection of cognitive deficit

(completed - in the data processing stage)

To date, there are no tools to assess the perception of cognitive difficulties by the patient and the family member. The aim of our study is to validate a tool aimed at the perception of the cognitive disorder in order to identify patients at high risk of neuropsychological deficit who may need a more thorough neuropsychological assessment.

Computerized cognitive rehabilitation at home in patients at an early stage of illness

(Starting on September 2019)

The endpoint of the study is to implement a computerized cognitive rehabilitation protocol for patients in the early stages of illness by assessing the effects on the course of the clinical picture. The study envisages: 1) an initial evaluation of the cognitive, behavioural and motor status; 2) six weeks of computerized cognitive stimulation at home, five days a week, 40 minutes a day; 3) a clinical re-evaluation at the end of treatment and a follow-up at 3/6 months in order to evaluate the effects of treatment over time.

Irritability and disturbance of executive functions: a correlational study

(completed - in the data processing stage)

The study involves the analysis of the traits of the behavioural disorder (in particular of aggression and irritability) and of the possible correlation with executive functions (for example, the inhibition of automatic behaviours, cognitive flexibility and the planning of behaviours for a purpose). It is possible to assume that reactive behaviours are amplified by difficulties in the executive functions. If confirmed, these data could be used to implement cognitive training programs aimed at strengthening the executive functions so as to have greater control over emotions and impulsive responses.

JHUMP – Juvenile HUntington Modular Project

(In progress)

Implementation of a new clinical assessment method in patients with juvenile onset of Huntington's disease (JHD). The aim of the study is to bridge the gap in assessment methods in patients with juvenile onset of Huntington's disease. Our goal is to build a new method for assessing motor and cognitive symptoms using engineering systems applied to the knowledge base of Huntington neuroscience.

Validation of the Huntington’s Disease Cognitive Rating Scale (HDCRS) - The Cognitive Phenotype Working Group of the European Huntington’s Disease Network

(completed - in the data processing stage)

Evaluation of the psychometric properties of a new screening battery of neuropsychological tests for the assessment of cognitive deficits in subjects in the pre-symptomatic phase and patients in the early and moderate phase of disease.

Edinburgh Cognitive and Behavioural ALS Screen (ECAS)

(completed - in the data processing stage)

The ECAS screening battery for neuropsychological deficit assessment is an instrument used with patients affected by Amyotrophic Lateral Sclerosis (ALS). Given the excellent psychometric properties of the instrument, the purpose of the study is to assess its sensitivity in subjects in the pre-symptomatic phase and patients in the early and moderate stage of disease in order to ascertain its usefulness in detecting cognitive deficits and changes in the neuropsychological picture over time.