Scientific Coordinator: Prof. Tiziano Agostini
EFFICACY OF COMBINED COGNITIVE AND EXERCISE TREATMENT ON NEUROPHYSIOLOGICAL AND CLINICAL OUTCOMES IN CHRONIC MIGRAINE
In the physiopathology of migraine two opposing processes, depression (habituation) and facilitation (sensitization), determine the final behavioral outcome after a sequence of repetitive stimuli. Sensitization is a behavioral increase response to repeated stimulation. It has been associated with a dysfunction in descending pain inhibition. Habituation is a behavioral decreased response to repeated stimulation. It has been associated with a dysfunction in information processing. The purpose of this study is first to compare a non-pharmacological treatment such as physical therapy, with a specific dual task protocol of active exercise with concomitant cognitive tasks, with the pharmacological prophylactic Topiramate treatment, in relation to the modification of P300 wave. The second aim is to correlate the improve in headache parameters (such as intensity of pain, duration of attacks and frequency of pain registered with ad hoc diary) and in the headache-related disability (using Migraine disability assessment scale-MIDAS) with the recording of Event-related potentials. A Randomized Controlled Trial will be conducted on three groups of patients with chronic migraine. Patients will be recruited and randomized by the Headache Centre (University of Trieste in the Department of Medical, Surgical, and Health Sciences), diagnosing migraine after a neurologic visit (diagnostic criteria of ICDH3-beta). Two types of oddball paradigms will be presented (T1), auditory and visual oddball. Electroencephalogram will be recorded and Evoked responses will be analyzed. The Migraine disability assessment scale (MIDAS) will be performed. Finally, after three months of each treatment, the final visit will be performed (T2) with clinical re-evaluation of the patients and analysis of the cephalic parameters reported in the diary, the amplitude of P300 with EEG and the headache-related disability with MIDAS. All patients will be reexamined at 6 months follow up (T3) with the diary, EEG and MIDAS.
Candidate: Manuela Deodato
FUNCTIONAL ANALYSIS OF COUNTERFACTUAL THINKING: DEVELOPMENT PATHS AND APPLICATIONS
Counterfactual reasoning (CFR) involves mentally representing what the world would be like now if things had been different in the past (Rafetseder, & Perner, 2014). Counterfactual reasoning has an important role in evaluation, planning, and emotion management. This Ph.D. project aims to investigate counterfactual thinking as an autonomous form of thinking and as a way to improve flexible thinking and minimize cognitive biases in evaluation and decision-making.
First, it will be analyzed the underlying cognitive mechanisms of counterfactuals by identifying characteristics in contrast with other mental simulations. Secondly, two fields of application will be examined: educational-healthcare and organizational-work. People with autistic spectrum disorders (ASD) have counterfactual processing abilities (Ferguson et al. 2020). The aim is to promote ASD flexible thinking. It will be verified whether training counterfactual abilities, people with ASD will improve their general abilities of thinking and decrease their rigid thinking. The second area of application concerns the prevention of accidents in the workplace. Counterfactual thinking is important because it facilitates people to move from active to latent failures in assessing the case of an accident (Rizzo et al 1992). The aim will be to use methods and tools to integrate causal analysis with counterfactual evaluation.
Candidate: Angela Faiella
STRUCTURE-FUNCTION RELATIONSHIP ANALYSIS IN MACULAR DISEASES
The relationship between anatomical structure and output function is a crucial topic in neuroscience. With the new imaging techniques introduced in Ophthalmology, this relationship can be easily analyzed in retinal and macular diseases. The Optical Coherence Tomography (OCT) is a non-invasive diagnostic technique based on interferometry that renders an in vivo cross-sectional view of the retina with 5-7 microns resolution with approximately 20.000-40.000 scans per second. The increased scans rate allows a 3D reconstruction of all retinal layers, from the Internal Limiting Membrane to the Retinal Pigment Epithelium.
The research project aims to enroll patients with a monocular or binocular macular disease who present metamorphopsia as the main symptom. Patients with age-related macular degeneration (AMD), diabetic macular edema (DME), or pathologies of the retinal interface, such as epiretinal membrane (ERM) or vitreomacular traction (VMT), will be included in the study. These macular diseases are characterized by the involvement of different structural loci in the retina. In particular, in AMD an early involvement of the outer retinal layers from the RPE to the outer plexiform layer (OPL) is reported. The DME develops first in the intermediate layers, from the internal plexiform layer (IPL) to the external limiting membrane (ELM), and ERM and VMT promote an early distortion of the inner retinal layers, from the internal limiting membrane to the internal nuclear layer (INL).
At baseline and during the follow-up, all patients included in the research will undergo evaluation and quantification of the degree of metamorphopsia. Horizontal and vertical metamorphopsia scores will be tested using M-charts, a diagnostic tool to objectively quantify the degree of metamorphopsia. These results will be correlated to the in vivo analysis of the different retinal layers' involvement using the OCT cross-sectional analysis.
Candidate: Marco Rocco Pastore
Pastore MR, De Giacinto C, Cirigliano G, DʼAloisio R, Addobbati R, Agostinis C, Radillo O, Di Martino G, Di Nicola M, Cecchini P, Tognetto D. Vitreous prostaglandin E2 changes after topical administration of diclofenac 0.1%, indomethacin 0.5%, nepafenac 0.3%, and bromfenac 0.09%. Retina. 2020 Sep;40(9):1838-1845. doi: 10.1097/IAE.0000000000002674.PMID: 31800462
Pastore MR, De Giacinto C, Cirigliano G, Turco G, Borelli M, Tognetto D. Comparative analysis of 23-, 25-, and 27-gauge forceps stiffness and related displacement. Eur J Ophthalmol. 2020 May 27:1120672120926861. doi: 10.1177/1120672120926861. PMID: 32460546
Tognetto D, Pastore MR, De Giacinto C, Cecchini P, Agolini R, Giglio R, Vinciguerra AL. Managing ophthalmic practices in a referral emergency COVID-19 hospital in north-east Italy. Acta Ophthalmol. 2020 Jun 1:10.1111/aos.14488. doi: 10.1111/aos.14488. PMID: 3248392
De Giacinto C, Porrelli D, Turco G, Pastore MR, D'Aloisio R, Tognetto D. Surface properties of commercially available hydrophobic acrylic intraocular lenses: Comparative study. J Cataract Refract Surg. 2019 Sep;45(9):1330-1334. doi: 10.1016/j.jcrs.2019.04.011. PMID: 31371148