Client Interview: MindLenses in Tuscany’s local health services

The local public health authority of the north-west region of Tuscany started using MindLenses in several hospitals. We interviewed doctor Ferroni, physiatrist, about her experience with the device so far

Lucia Ferroni, MD

Dr. Lucia Ferroni, a physiatrist at the local health hub of the Tuscany North-West region (USL Toscana Nord-Ovest) in Italy, is a specialist in neuropsychological rehabilitation. Beyond her clinical duties in the hospitals of Lucca, Serchio Valley, and Versilia, Dr. Ferroni serves as the scientific representative of the Tuscany chapter of the Aphasia Patient Association. She also organizes various awareness initiatives, focusing on aphasia and other neurocognitive disorders, with the goal of sharing best practices among healthcare professionals in the field.

Dr. Ferroni’s team has integrated MindLenses Professional into the treatment of some of her post-stroke and head trauma patients. The purchase y was made possible through the support of local directors and coordinators Dr. Federico Posteraro and Dr. Ivano Maci. MindLenses Professional is now one of the tools used by the local health hub for adult neuropsychological rehabilitation service.

Dr. Ferroni agreed to share her experience and clinical findings with MindLenses one summer morning before her workday commenced. Let’s delve into her insights.

Dr. Ferroni, how did you first learn about MindLenses Professional?

I stumbled upon it almost serendipitously. A member of the Tuscany Aphasic Association alerted me to a forthcoming meeting on neuropsychological rehabilitation in Florence [this was an event organized by Restorative Neurotechnologies]. Coincidentally, a colleague of mine, who is a speech therapist, learned of the event through her local chapter of the speech therapists association. We attended the event together with another colleague, who also happens to be the president of the Tuscany Aphasic Association. At the event, we were intrigued by Professor Oliveri’s keynote speech about the recent scientific advancements in neuromodulation through prismatic adaptation. It sounded like a very interesting tool, so we set things into motion in order to have it in our hospitals.

What aspect of the therapy intrigued you the most?

The prismatic adaptation glasses of MindLenses Professional are a crucial part of the therapy. They are used to stimulate the brain of the patient in a non-invasive way, making the following rehabilitation exercises much more efficient.

As a rehabilitation physician, I was particularly drawn to the non-invasive nature of MindLenses and its ability to influence neuronal plasticity. Prismatic lenses [one of the components of MindLenses] offer a way to stimulate brain activity in a way that is very similar to more invasive modalities like Transcutaneous Electrical Nerve Stimulation, but at a fraction of the cost for the hospital, and much less invasively.

Due to my previous clinical activity, I was partially familiar with prismatic adaptation’s applications in visuospatial deficits. I was intrigued by the potential to extend its benefits across broader cognitive domains. Prof. Oliveri’s presentation in Florence reignited my interest, especially considering the recent research findings on sustained brain activation even long after prismatic adaptation is performed.

Could you share your experience about integrating MindLenses in your patients’ rehabilitation journeys?

[Laughs politely] Cognitive rehabilitation has been my terrain since college, offering invaluable assistance to those in need, so I was excited to start. I had no significant reservations about MindLenses’ reception, given its minimal invasiveness. This said, although I knew it rested on solid scientific background, I still had to see with my own eyes whether it really was effective – after all, we were venturing into uncharted territory.

My team of speech therapists is really close knit and well-adjusted to working together and experimenting a little. It was easy for them to adopt MindLenses. Individual enthusiasm perhaps varied – I think it’s normal – but the novelty was generally well-received.

My team of speech therapists is really close knit and well-adjusted to working together and experimenting a little. It was easy for them to adopt MindLenses

[Laughs again] If I were to pinpoint a challenge, my limited tech savviness posed some initial difficulty navigating the tablet interface. Nonetheless, with the assistance of younger colleagues and remote support from Restorative team, we swiftly overcame these hurdles!

How do you utilize MindLenses in your rehabilitation department?

Part of the MindLenses Professional rehabilitation protocol, which require the patient to follow a moving target on a tablet screen.

We employ MindLenses primarily for post-stroke and post-head trauma cases with mild to moderate neuropsychological deficits. Patients should have the ability to execute arm movements along specified trajectories, and grasp the importance of “spontaneity over perfection” during therapy sessions. In our hospitals, MindLenses serves as a additional tool for refining the cognitive rehabilitation work. Of course we do not use it in the most severe cases, such as in patients in a vegetative state.

What aspect of the device resonated most with your patients?

Patients who are capable of cooperation generally like MindLenses, actively engaging in therapy sessions. Overall, patient compliance has been commendable.

As a company committed to innovation, we value feedback from practitioners like yourself. Are there any improvements or additional functionalities you’d like to see in MindLenses?

Dr. Ferroni’s insights regarding potential enhancements primarily revolve around expanding MindLenses’ scope beyond neuropsychological rehabilitation to also support physical and motor rehabilitation. Additionally, she suggested exploring variations in protocol intensity and duration to optimize clinical outcomes; and maximizing the therapeutic window by integrating more exercises to do post-prismatic adaptation.

Dr. Ferroni also emphasized the importance of disseminating knowledge about new methodologies like MindLenses among fellow clinicians.

Prismatic lenses are well-known among cognitive rehabilitation professionals for treating neglect, but their use in MindLenses Professional is new to many. How can we better inform clinicians about clinical innovation and research progress?

Well, it’s impossible for those who do rehabilitation to have never heard of neglect – but in fact I think it is possible they haven’t heard of prismatic lenses. This is despite the fact that in the guidelines of scientific societies, for example in the CICERONE Consensus Conference, the use of lenses in neglect is explicitly mentioned as a procedure that works. Therefore, if my colleagues know that “we have already used it in neglect” and it works, in my opinion many fears about the expansion of clinical practice to other cognitive domains in addition to the visuospatial one begin to disappear.

MindLenses also brings improvements to the clinical practice of classic prismatic adaptation, which any clinician will certainly appreciate [dr Ferroni is referring to the digitalization of the pointing movement]. For example, in the classic use, prismatic lenses were always worn for the entire duration of the rehabilitation session, which could cause slight nausea. Instead, in MindLenses protocol the time the patient keeps the lenses in is very short, which is much better. These are all aspects that can be communicated and support adoption.

In short, in my opinion it is worth highlighting the fact that the technology behind a device like MindLenses did not spring out of the blue, but is the result of well-grounded scientific advances that have discovered new aspects of an already safe and widespread technique.

[MindLenses] is the result of well-grounded scientific advances that have discovered new aspects of an already safe and widespread technique.

Rehabilitation is a highly individualized process: we will never have uniformity of treatment, so it is usually very difficult to demonstrate that a therapy “works”. When, as in the case of MindLenses, the treatment is short and very specific, this variability is reduced, and it is easier to observe beneficial clinical effects. We have to obtain solid scientific evidence, without sacrificing the complexity of an holistic and individual approach. MindLenses is an example of a therapy that goes in that direction.