Today we present you an interview with one of the most expert figures at a clinical and scientific level of neuropsychology in Italy. We remind you that if you want to have a closer look to MindLenses Professional, which we will talk about in the interview, you can book a meeting here.
Gabriella Bottini is a key figure in the world of neurology and neuropsychology in Italy.
Neurologist, Full Professor of Clinical and Forensic Neuropsychology and Cognitive Rehabilitation at the University of Pavia, where she directs the Cognitive and Forensic Neuropsychology Lab and the Neuroscience and Society Lab, she is also responsible for the Cognitive Neuropsychology Center at hospital ASST – Grande Ospedale Metropolitano Niguarda di Milano – a group that, as we will see later, we know well here at Restorative!
She is an expert in neurocognitive disorders – in particular, she has dealt with cognitive rehabilitation following strokes and dementia.
Prof. Bottini is a member of the Scientific Committee of Restorative Neurotechnologies, an impartial body composed of internationally renowned doctors and scientists responsible for advising our company and expressing opinions on all initiatives regarding the scientific activities behind our products.
We contacted the Professor to get her opinion not only on MindLenses Professional, but also on what is going on in the world of innovative therapies in the field of neurology, neuropsychology and neurocognitive rehabilitation.
Prof. Bottini, we would like to start by asking you a terminological question and “ancestral question” on which, at times, there is a bit of confusion. Can you explain once and for all the difference between neurological rehabilitation and cognitive rehabilitation?
I think that the distinction between neurological rehabilitation and cognitive rehabilitation is a semantic dilemma that we should overcome. The rehabilitation of brain lesions, of whatever origin, requires a complex approach of intervention on both sensorimotor and cognitive functions. If we take things with this approach, the difference ceases to be truly significant.
In your opinion, is it correct to say that cognitive rehabilitation is a bit like “physiotherapy for the mind”?
I appreciate explanatory metaphors and I do not reject this comparison. I often use it myself to explain to my patients what is meant by the rehabilitation of cognitive processes that concern, for example, attention and memory.
Do your patients (or their caregivers) understand when you talk about “cognitive functions”? Or do you have the impression that the “cognitive” aspect is less known than the “neurological” aspect?
It is true that, in general, the rehabilitation of the movement or of the aspects of perception (for example, being able to follow a moving target with your eyes) are easier to understand. Being able to explain that, for example, also memory needs training is certainly more complex. In general, however, I would say that we are starting to be more sensitive to the fact that we need to be efficient in a global way, even with our strategic functions. The meaning of “cognitive“, understood as an adjective that has to do with the possibility of living life to the fullest without encountering difficulties in adaptation, has yet to enter everyday culture.
Let’s talk about neurodevelopment. Is it correct to talk about “cognitive rehabilitation” for those spectrum conditions like ADHD or Specific Learning Disorders?
Sure. Learning or attention disorders are also characterized by more specific deficits in individual cognitive functions, such as short-term memory or attention in some of its components. Therefore, thinking about a cognitive rehabilitation of these functions seems more than appropriate to me.
You have a very long experience in the field of cognitive rehabilitation. Have there been, in these years, technologies or clinical-scientific progresses that have particularly excited you?
Yes. One of these is the possibility of accompanying the so-called “traditional” cognitive rehabilitation, or behavioral [where the patient performs exercises without the application of external stimulation, ed.], with tools that are also easy to use, such as neuromodulation through prismatic lenses and brain stimulation. These techniques have opened up a completely new scenario that combines the clinical approach with the research, approached with a rigorous and modern methodology.
In your clinical experience, what are the most crucial aspects for the success of a therapeutic path of cognitive rehabilitation, in particular for post-stroke?
The use of a methodology that, while respecting the standards of clinical rehabilitation, therefore the application of standardised protocols, does not forget the importance of ad hoc experimental pathways, to verify new treatment hypotheses even in acute forms, such as the immediate post-stroke phase.
Could you briefly tell us about the importance of early intervention of cognitive rehabilitation even in the acute phase post-stroke? Can cognitive rehabilitation be done in a stroke unit?
Not only it can be done, but it should always be done. Cognitive treatment must be considered in the acute post-stroke phase, because some cognitive deficits, such as alterations in space exploration and body representation, typically affect the clinical picture in the phase immediately after the event. Ignoring their presence and postponing the rehabilitation phase to an indefinite “later” can seriously compromise the ability to recover functional autonomy.
Niguarda Hospital, where you work, is the site of a study that uses MindLenses Professional in the intervention on Mild Cognitive Impairment (or mild cognitive disorder), which we know can be a precursor to forms of dementia such as Alzheimer’s. Can you tell us what you are most passionate about this project?
This project is very interesting because it uses digital rehabilitation with MindLenses alongside the targeted behavioral rehabilitation we usually perform with exer-games [a type of exercise based on technologies that detect body movements and help the patient correct them thanks to visual feedback, ed.]. But even more interesting from a scientific point of view is that the digital approach explores a completely new neurophysiological hypothesis. The prismatic adaptation contained in the MindLenses clinical protocol is a technique typically used for the stimulation of neural systems that control the perception, the exploration and the representation of space. In this case, we hypothesize that the same technique can also stimulate the neural systems responsible for controlling the interaction between memory and attention, which unfortunately are compromised in the early stages of cognitive deterioration. To me, this is a typical example in which the experimental approach of a “standardized” path can give truly effective results.
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We thank Professor Bottini for her availability. To learn more about MindLenses Professional you can take an appointment here.
