Neuromodulation

A.A. 2021/2022
6
Crediti massimi
40
Ore totali
SSD
MED/26
Lingua
Italiano
Obiettivi formativi
The course will provide insights on the methodological aspects, genetics/epigenetics at the base of neuromodulation, as the number of physical and pharmacological processes modifying neuronal function.
The course will properly address these topics, by discussing the clinical applications and by stimulating students towards a translational vision to be applied in practice.
The Course will also aim to provide students the methods to critically analyze the most recent literature in the field and to identify the most suitable techniques of neuromodulation as a function of different clinical scopes in neuroscience.
Risultati apprendimento attesi
At the end of the Course, the student will achieve the following leaning outcomes:
1. Come into the pathophysiological, genetic/epigenetic and pharmacological aspects of neurobiology to be applied in neuromodulation;
2. Analyze the connections between neuromodulation, neuroimaging and the pathophysiological aspects in neurological disorders as well as in systemic disorders and disturbances;
3. Interpret, with an active attitude to the themes, the scientific literature in the field of neuromodulation and the psychosocial/ethical concerns related to the use of the ongoing and future approaches of neuromodulation.
Programma e organizzazione didattica

Edizione unica

More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Programma
The Course will be scheduled into three parts, in accordance with the learning objectives and the expected learning outcomes:

A) A first part will get into the genetics/epigenetics aspects in neurosciences as well as the techniques of neuromodulation and neuroimaging.
The following contents will be addressed:

-Genetics/epigenetics and pharmacological principles in neurobiology;
-Fundamentals of electrical neuronal stimulation and high-frequency block of neuronal conduction;
-Peripheral neuromodulation: perimedullary neuromodulation, neuromodulation of dorsal ganglia, vagal nerve and sacral nerve;
-Implantable devices and microstimulators; Deep Brain Stimulation (DBS);
-Non-invasive neuromodulation: rTMS and tDCS;
-Intrathecal administration of pharmacological compounds; advanced pharmacological approaches;
-Perspectives of epigenetics: from gene editing to stem cell based reprogramming of the nervous system;
-Neuroimaging for brain and neuronal peripheral areas I (electroencephalography, magnetoencephalography);
-Neuroimaging for brain and neuronal peripheral areas II (TC, structural/functional MRI, PET).

B) A second part will discuss examples of clinical applicability of neuromodulation. The following themes will be introduced:

-Epigenetic neuromodulation of food disorders; the "gut-brain axis"; gastric neuromodulation;
-Epigenetics players of cardiovascular neuromodulation;
-Neuronal and cellular imaging connecting the brain and the heart;
-Neuromodulation in metabolic disorders (diabetes);
-Application of neuromodulation in inflammatory pathologies;
-Genetics studies and clinical trials testing neuromodulation: design and ethical concerns.

C) A third part, will involve an active and critical analysis, in an open discussion mode, of published experimental studies or clinical trials involving neuromodulation.
Prerequisiti
To address the topics of this Course, the main principles and a minimal background of the following aspect is required:
-Genetics and cellular neurobiology;
-Pharmacological mechanisms involved in neurosciences.

Finally, a good or optimal fluency of scientific English, both as writing, reading and speaking is strongly required.
Metodi didattici
According to the structure of the detailed program of the Course:
(A) The first and the second parts will be scheduled as lectures with the use of PowerPoint slides. The slides are uploaded on Ariel platform at the end of each lecture.
(B) The third part will be organized as open panel discussions among students about published paper (either as experimental study or clinical trial) to stimulate interactive discussions about the technical aspects and the clinical, ethical concerns.
Materiale di riferimento
a) "Textbook of Neuromodulation, Ed. I" Knotkova H and Rasche D. ISBN: 978-1-4939-1408-1, 2015 Springer-Verlag New York;
b) "A Systematic Literature Review of Spine Neurostimulation Therapies for the Treatment of Pain". Deer RT et al. Pain Med. 2020 Nov 7;21(7):1421-1432. doi: 10.1093/pm/pnz353.
c) "Neuromodulation interventions for addictive disorders: challenges, promise, and roadmap for future research". Spagnolo PA et al. Brain. 2017 May; 140(5): 1183-1203.
d) "Brain Imaging Technologies: Clinical and Neuronal Applications" Asbury CH, Detre JA. Dana Foundation. https://www.dana.org/wp-content/uploads/2019/09/primer-brain-imaging-te….
e) "Farmacologia - Principi di base e applicazioni terapeutiche, IV Ed." Rossi F, Cuomo V, Riccardi C. ISBN: 978-88-7711-995-7, 2020 Edizioni Minerva Medica S.p.A. Corso Bramante, 83/85 - 10126 Torino;
f) Slides of lectures, personal notes, links to websites and selected documents;
g) Scientific papers, which will be online available through the use of the personal institutional credentials in the library platforms of the University.
Modalità di verifica dell’apprendimento e criteri di valutazione
A final exam will evaluate the competencies that will be acquired and developed during the Course following this schedule:

A) PRESENTATION OF A TOPIC OF NEUROMODULATION. Each student will present, in the form of PowerPoint slides and as open panel discussions with colleagues, a single experimental study or clinical trial.

EVALUATION DURING THE PRESENTATION OF THE TOPIC:
The presentation of the single study will be evaluated according to these criteria:

1) Understanding the rationale, the design, the scientific outputs and the exploitable clinical outcomes of the study;
2) Demonstrating a critical vision of the topic in relation to the knowledge acquired from the lectures;
3) Stimulating interactive discussion with colleagues.

The presentation will be evaluated with a maximum score of 3 points.

B) ORAL EXAMINATION. This examination will test the knowledge and the learnt outcomes achieved from lectures. The oral examination is passed if the student reaches a minimum score of 18; the final exam grade will include the points (up to 3) from the presentation of the topic.
It is mandatory to sign up to the examination through the UNIMIA platform within the predetermined dates for each examination.

EVALUATION OF KNOWLEDGE AND COMPETENCES DURING THE ORAL EXMAINATION:

The oral examination is conceived to evaluate the following knowledge and competences:
1) Acquire the principal mechanisms of neuromodulation;
2) Demonstrate a critical approach to the applicability of the different techniques of neuromodulation for the different disorders;
3) Critically evaluate the translational aspects and ethical consequences in clinical practice and research.
MED/26 - NEUROLOGIA - CFU: 6
Lezioni: 40 ore
Docente/i