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Physiotherapy, Rehabilitation and Sport medicine

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Cognitive Rehabilitation

Neuro-Cognitive Disorders (NCDs) are a new diagnostic category that incorporates Mild Cognitive Impairment (MCI) and Cognitive Impairment No Dementia (CIND). These are subjects without dementia, with subjective cognitive disorders, objective deficit of memory, without any impairment in daily work or social activities. The prevalence of such disorders, as well as real-cognitive decline, such as in Alzheimer’s Disease or Vascular Dementia, exponentially increases with age, affecting 40% of subjects over the age of 80. Mild cognitive disorders may represent an intermediate stage towards a state of confirmed dementia with different conversion rates depending on the various literature studies. Their treatment is a major challenge with significant clinical, social, political and ethical perspectives.

Therapeutic approaches towards Neurocognitive Disorders are very diverse, ranging from waiting attitudes to drug therapy proposals (acetylcholinesterase inhibitors, gingko-biloba, generically neuro stimulants) that have not provided a definitive proof of effectiveness.

Although the data in literature are quite varied, there is agreement on the need to intervene on Neuro-Cognitive Disorders through cognitive rehabilitation that pivots around neuronal plasticity, as the basis of any structural and functional reorganization of the central nervous system.

The results of the studies concerning this neuro cognitive stimulation are very stimulating and have yielded positive results. Cognitive Rehabilitation Techniques are varied and in recent years techniques generically called Individualized Computerized Tasks have appeared. Very recently, non-invasive brain stimulation techniques such as transcranial Direct Current Stimulation (tDCS) are rapidly catching on. This is a non-invasive cortical stimulation procedure in which weak electrical currents (0.5 – 2 mA) are used to depolarize specific cortical areas. With the current from one electrode to the other, this technique modifies the neuron membrane potential by modulating the excitability of the cerebral cortex and hence the neuronal activity of the brain, by increasing or decreasing the functionality of the stimulated area, whilst the cathode stimulation hyper-polarizes neurons with inhibitory effects. If the stimulation is repeated several times it is possible to make these changes more stable and long lasting (Bolognini et al. 2009). The method offers many benefits compared to Cerebral Magnetic Stimulation in particular: it is really a non-invasive technique, it does not cause muscle contractions, no epileptic seizures are reported, it is relatively inexpensive, and can be used in conjunction with a variety of neuro-psychological and motor rehabilitation methods.

The IRR Rehabilitation Institute provides a specific rehabilitative proposal in the field of Cognitive Disorders: BRAINER® Cognitive Stimulation in conjunction with Transcranial Electric Stimulation with the work of a multi-professional and interdisciplinary team (Neurologists, Rehabilitation Therapists, Psychologists). These professional figures have a specific neuro rehabilitative training and use sophisticated neurophysiology, neuroimaging and neurosonology tools.

According to the latest literature, the combination of Cognitive Rehabilitation with tDCS Cerebral Stimulation produces a significant enhancement of specific cognitive functions, both in physiological ageing with “memory loss”, and in cognitive decline in its various clinical forms.

Neuro-Rehabilitative Treatment Protocol for NEURO-COGNITIVE DISORDERS

  1. Neurology Visit:
    Diagnostic Definition of Neuro-Cognitive Disorders and exclusion of a confirmed dementia condition
  2. Development of a tailored neuro-rehabilitative plan
  3. Application and administration of Transcranial Electric Stimulation and Computerized Cognitive Rehabilitation in association, under the guidance of a Neuropsychologist.