Periodic Reporting for period 1 - MemoMCI (Targeting reconsolidation to strengthen memories in individuals with Mild Cognitive Impairment)
Periodo di rendicontazione: 2016-09-01 al 2018-08-31
The aim of this study was twofold: 1) To determine whether active relative to sham/placebo tDCS applied over the PFC after a memory reactivation would enhance episodic memory performance in older adults with aMCI; 2) To identify aMCI individuals who can benefit the most from this tDCS intervention based on gray matter and white matter integrity assessed using magnetic resonance imaging (MRI), or presence of specific genetic polymorphisms (BDNF, SNAP-25) associated to memory.
To accomplish his career goal of becoming an independent researcher, the fellow's training objectives were: 1) To develop a strong knowledge in neuropsychological evaluations, mechanisms of rehabilitation and recovery, and cognitive rehabilitation interventions tailored to meet individuals' specific needs using an interdisciplinary approach; 2) To develop additional technical skills in MRI; 3) To familiarize himself with molecular genotyping; 4) To enhance his teaching experience.
Although a larger sample size is needed in order to make reliable conclusions, the lack of a behavioural effect might be due to the fact that MCI is a heterogeneous population. In addition, patients with aMCI were diagnosed on the basis of clinical criteria without assessing the accumulation of amyloid plaques in the brain, one of the hallmarks of AD. Therefore, it was not possible to determine if the patients enrolled were MCI due to AD.
To achieve his training objectives the fellow performed neuropsychological assessments, observed clinical activities and cognitive interventions in patients with neurological disorders. He attended clinical rounds, journal clubs and seminars about neurological cases, novel interventions and their mechanism of action. He acquired skills in MRI analysis to map the structural changes associated with neurological disorders in order to better understand the pathological processes and to monitor the effects of treatment interventions on brain structure. He also observed the basic procedures to perform analysis of specific genetic polymorphisms. Finally, he gave lectures at high schools and universities using a research-based teaching approach. He presented his research on human memory and the MemoMCI project at different universities and research institutions in Italy (n=2: Padova, Milan), UK (n=4, London) and US (n=1). He also participated as a speaker in workshops and conferences regarding neurorehabilitation (n=5). Furthermore, he presented preliminary data of the MemoMCI project at an event about memory and dementia organized by the host institution exclusively dedicated to general practitioners. In collaboration with the Scientific Director, Dr. Massimo Corbo, the fellow wrote an opinion article about the possibility to modulate reconsolidation with non-invasive brain stimulation, and organized a workshop at CCP about the use of tDCS as an adjuvant strategy for rehabilitation of motor and cognitive deficits. From this workshop emerged that further investigations on extensive case studies, through neuroimaging and neurophysiological techniques, are indispensable to better clarify the complex mechanisms of basic action and determine the duration of the tDCS-induced effects.
The findings of this project suggest that the white matter microstructure of the left UF might be an important factor in predicting episodic memory performance, confirming as in previous’ studies the presence of early and significant structural changes in prodromal AD. In addition, neuroimaging and genetic analysis at baseline could become a valuable tool to predict which patients will respond positively to memory-targeted tDCS interventions. Therefore, patient’s precise characterization is necessary to individualize the appropriate treatment. It will then be possible to propose useful guidelines on the parameters to be applied also in interaction with classical rehabilitation techniques and to validate protocols aimed at the individualized treatment for patients with memory impairment. Thus, the PI and the host institution will collaborate and continue to recruit aMCI patients, because a larger sample size is critical to better understand the effects of tDCS on this population at risk of developing AD, an issue of potential clinical impact. The fellow’s future plan is to present the research findings of MemoMCI at neuroscience conferences and to write a manuscript for a high-impact journal.