Wednesday, 14 June 2017

CeRiN: Cognitive rehabilitation in Trentino

Intense work at the University research centre in Rovereto - part of CIMeC - that studies language and cognitive disorders

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The Center for Neurocognitive Rehabilitation (CeRiN) of the University of Trento, based in Rovereto, has been working for years on the diagnosis and rehabilitation of patients with language and cognitive disorders caused by brain injuries. 

The Center, which is part of the Center for Mind/Brain Sciences (CIMeC), carries out research and offers education and training, but is also a clinical point of reference to diagnose and treat adult patients with cognitive and motor disorders due to brain injuries. 

Among the cognitive disorders treated at CeRIN are, for example, language, memory, attention deficits, deficits in visuo-spatial processing, the use of numbers and computing, operational functions, the control of complex movements.

The Centre operates in close collaboration with the Provincial Healthcare Service (APSS) and in agreement with the National Health Service. In the first months of 2017 (between February and May), 142 people were treated, for the most part patients from the departments of neurology and geriatrics of the Trento and Rovereto hospitals, but also from other hospitals and, for a small part, from neighbouring regions. And the number can increase further.

The work of CeRIN and its possible future development were presented yesterday in a meeting that took place at the Trade Center in Rovereto, attended by medical practitioners, executives and health professionals.

The purpose of the meeting was to strengthen the relationships with local institutions to take advantage of the full potential of the Center, which combines research and clinical practice to the benefit of public health.

Costanza Papagno, new clinical director who has been recently appointed to lead CeRIN in Rovereto, was the first to take the floor, together with Carlo Miniussi, director of CiMeC. Paolo Collini, Rector of the University of Trento, gave a short welcome speech and introduced Luca Zeni, Provincial Councilman for Health and Social policies, and the many medical practitioners attending.

Giorgio Rossi, chief of Neurology at the Rovereto hospital, Maurizio Amichetti, director of the Proton Therapy Center in Trento, medical executives from the Neurology department of the Trento hospital, Franco Chioffi, chief of Neurosurgery in Trento, and Nunzia Mazzini, chief of staff at Villa Rosa, also addressed the audience. In the audience were Paolo Bordon, director-general of APSS, Claudio Dario, health director of APSS, Bruno Giometto, chief of Neurology at the Trento hospital, Giovanni Maria Guarrera, head of the Service of Clinical Governance of APSS, and Silvio Fedrigotti, director of the Department of Health and Social Solidarity.

The objective of the center is threefold: to provide basic clinical services to the community; to prepare professionals in the clinical disciplines of cognitive neuroscience; and to carry out research in neuroscience, studying the mechanisms responsible for neurocognitive disorders and the patients’ recovery through neurorehabilitative intervention.
Its strength lies in the coexistence of clinical services, education and training activities and (clinical and basic) research in cognitive neuroscience, as these ensure the constant innovation of clinical practice. The activities are performed by researchers, medical practitioners and health professionals, administrative personnel and technicians. 

A community service - CeRiN treats a number of conditions caused by neurological disorders due to vascular damage, degeneration or trauma. In particular, the center is specialized in focal brain injuries in the subacute or post-acute stage in patients in stable conditions who do not need hospitalization; patients with focal brain injuries who have completed the rehabilitation program of the acute stage; patients with suspected or known degenerative conditions. They are referred to the Center by a neurologist, a physical therapist or a geriatric physician who practice in agreement with APSS. 
The purpose of diagnostic is to identify any language and cognitive impairments caused by brain injuries and to assess to what extent they compromise the patients’ communication skills and their ability to perform everyday tasks and to live independently. Through diagnostics, medical professionals can identify a rehabilitation program and the necessary criteria to implement it. In this context, patients carry out the tasks that allow medical professionals to establish whether there is a cognitive impairment and how serious that is. The team working on a diagnosis is composed of a neurologist, a neurophychologist and one or more therapists (speech therapists, physical therapists).

Research - CeRiN is, more than anything else, a research institute. As part of the Center for Mind/Brain Sciences (CIMeC), it is involved in research studies on language and cognitive disorders that take place in Rovereto and in the Mattarello laboratories. Patients who are diagnosed or are following a cognitive rehabilitation program at CeRIN may participate in on-going research protocols on a voluntary basis, after signing an informed consent form. Research projects investigate brain functioning during cognitive activities, and the effects of rehabilitation in patients recovering from cognitive disorders caused by brain injuries.
Clinical research explores the development and harmonization of diagnostic tools for neuro-cognitive disorders and new neuro-rehabilitation techniques, including neuromodulation. Basic research studies language processing, active perception, learning processes and plasticity. More in detail, the center investigates the neural mechanisms that are responsible for specific cognitive processes, in particular noun and verb processing, speech, writing, and visuo-spatial analysis.  The center also aims to improve the early diagnosis of dementia by collecting multi-level data from patients with mild cognitive impairments and dementia.  To conclude, the center also studies the neural mechanisms that are crucial to restore the patients’ cognitive abilities, using fMRI, tDCS, and rTMS. Research is conducted by CeRIN staff, researchers from other CIMeC laboratories, and personnel from the ITT - Italian Institute of Technology.

Education and training - Education and training activities are targeted to medical professionals and paramedics, young neuroscience researchers, bachelor and master students of the University of Trento. The Centre organizes training courses and CEM (Continuing Medical Education) courses with CIMeC members. In the framework of the project "Valutazione, diagnosi e riabilitazione del paziente neurologico 2017” (Assessment, diagnosis and rehabilitation of neurological patients 2017), CeRiN is also organizing a series of seminars – with credit points for physical therapists, speech therapists, psychologists, medical doctors, neurologists, and nurses – to present and discuss clinical cases that are interesting in a neuro-psychological and rehabilitation perspective. APSS personnel attend free of charge.