Alberto Priori | |
---|---|
Born | |
Nationality | Italian |
Occupation(s) | Neurologist, academic, and author |
Academic background | |
Education | Degree in Medicine and Surgery Specialization in Neurology Doctor of Philosophy (PhD) |
Alma mater | University of Rome “La Sapienza” |
Academic work | |
Institutions | University of Milan |
Alberto Priori (born November 19,1962) is an Italian neurologist,academic,and author. He is a Professor of Neurology at the University of Milan,Director of Neurology 1 Unit at San Paolo Hospital, [1] and the Founder and Coordinator of Aldo Ravelli Center (Coordinated Research Center) of the University of Milan. He also serves as President of the Neurophysiopatology Techniques Course,and Professor of Postgraduate Schools - Medicine,Healthcare,Dental Medicine at the same University. [2]
Priori is internationally recognized for his wide-ranging research on the pathophysiological mechanisms that underlie diseases of the brain and of the peripheral nervous system. He developed innovative technologies for the treatment of neuropsychiatric disorders,and has also pioneered the implementation of several neuromodulation techniques. [3] In 2008,he founded the Newronika SpA a spin-off company of the University of Milan and Fondazione IRCCS Ca’Granda in Milan,Italy. The company is dedicated to the development of neurotechnological devices for the treatment of neurological disorders. [4]
Priori was born in Turin,Italy in 1962. He studied at the University of Rome "La Sapienza",and got his Degree in Medicine and Surgery in 1987,specialization in Neurology in 1991,and a Doctoral degree in 1995. His dissertation on the non-invasive study of the inhibitory mechanisms in the human cerebral cortex,was supervised by Alfredo Berardelli and Mario Manfredi. [5] From 1997 till 1998,Priori was a Postdoctoral fellow at the University of Rome "La Sapienza." [2]
Priori began his career in 1990,with an appointment as a Research Registrar of Human Movement and Balance Unit dell’Institute of Neurology at the University of London in the period 1989-1991. From 1992 till 1998,he was appointed as an Attending physician in the Department of Neurology of Ospedale Mellino Mellini di Chiari (BS). Following this,he joined Fondazione IRCCS CàGranda - Ospedale Maggiore Policlinico of Milan,and served there as a Neurologist from 1998 till 2015,and as a Director from 2008 till 2015. During this time period,he also held a concurrent appointment as an Army Medical Corps Captain. [6]
Priori's research spans the fields of clinical and experimental neurosciences with particular attention on movement disorders and their pathophysiology,clinical and experimental neurophysiology, [7] [8] behavioral neurology,and neuromodulation. With collaboration of clinical neuroscientists,he works extensively to develop technologies for the treatment of neuropsychiatric disorders. He has published over 300 papers. [9] For his research in the field,he has also received several competitive research grants provided by national and international institutes. [10]
Priori led the group who developed,in 2004,and eventually patented,the adaptive Deep Brain Stimulation technique. This technology has been licensed to Newonika. [11] Along with discussing the efficacy of deep brain stimulation (DBS) in terms of treating neurological disorders,Priori has presented a review on the evidences regarding the advantages of neurosignal-controlled aDBS that uses local field potentials (LFPs) as a control variable. His research highlighted how DBS systems automatically adjust stimulation by analyzing the individual patient's condition,and then improve control over parkinsonian disturbances. [12] In 2017,he presented a report on the possible pathways for the clinical translation of aDBS with its benefits,limitations and unsolved issues. [13] He also developed and validated an external portable aDBS system prototype with an application to promote clinical investigations in Parkinson's Disease. [14] Moreover,he discussed the implications of aDBS in the context of providing effective treatment method for the management of clinical fluctuations, [15] as well as controlling levodopa‐induced side effects in Parkinsonian patients. [16]
In 2021,he conducted a comparative analysis of the impacts occurred on motor symptoms as a result of conventional deep brain stimulation (cDBS) and closed-loop adaptive deep brain stimulation (aDBS) in patients with Parkinson's Disease. [17] He also presented an implantable closed-loop clinical neural interface,and described its first application in Parkinson's disease. [18]
Priori is the first to describe a technique now known as transcranial direct current stimulation (tDCS). Lately,he has implemented this technique by developing the methodology for stimulating with non-invasive DC,the cerebellum and the spinal cord. In 2008,he provided the state of the art for tDCS,while highlighting the applications of tDCS in terms of inducing beneficial effects in brain disorders. He regarded brain stimulation with weak direct currents as a promising tool in the context of human neuroscience and neurobehavioral research. [19] In a later study,he presented a comprehensive review to discuss the key challenges that occur in the process of conducting clinical research with transcranial direct current stimulation (tDCS). [20] Having discussed the challenges,he described the evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS), [21] [22] and low intensity transcranial electric stimulation (TES). [23]
Priori focused his study to explore the long-lasting cognitive abnormalities that can occur in the COVID-19 patients in the months after hospital discharge. [24] [25] In 2020,he provided justifications regarding "The international European Academy of Neurology survey on neurological symptoms in patients with COVID-19 infection." He is of the view that the survey serves to set up a prospective registry to better capture the prevalence of patients with neuro COVID-19,neurological disease characteristics and the contribution of neurological manifestations to outcome. [26] While discussing the psychological implications of the first outbreak of COVID-19 in the context of Italy,he offered several ways to minimize the impact in daily life activities,such as sexuality and nutrition. [27] [28]
Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to induce an electric current at a specific area of the brain through electromagnetic induction. An electric pulse generator, or stimulator, is connected to a magnetic coil connected to the scalp. The stimulator generates a changing electric current within the coil which creates a varying magnetic field, inducing a current within a region in the brain itself.
Deep brain stimulation (DBS) is a surgical procedure that implants a neurostimulator and electrodes which sends electrical impulses to specified targets in the brain responsible for movement control. The treatment is designed for a range of movement disorders such as Parkinson's disease, essential tremor, and dystonia, as well as for certain neuropsychiatric conditions like obsessive-compulsive disorder (OCD) and epilepsy. The exact mechanisms of DBS are complex and not entirely clear, but it is known to modify brain activity in a structured way.
Neurotechnology encompasses any method or electronic device which interfaces with the nervous system to monitor or modulate neural activity.
A minimally conscious state or MCS is a disorder of consciousness distinct from persistent vegetative state and locked-in syndrome. Unlike persistent vegetative state, patients with MCS have partial preservation of conscious awareness. MCS is a relatively new category of disorders of consciousness. The natural history and longer term outcome of MCS have not yet been thoroughly studied. The prevalence of MCS was estimated to be 9 times of PVS cases, or between 112,000 and 280,000 in the US by year 2000.
Hypokinesia is one of the classifications of movement disorders, and refers to decreased bodily movement. Hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Hypokinesia is a symptom of Parkinson's disease shown as muscle rigidity and an inability to produce movement. It is also associated with mental health disorders and prolonged inactivity due to illness, amongst other diseases.
Neurohacking is a subclass of biohacking, focused specifically on the brain. Neurohackers seek to better themselves or others by “hacking the brain” to improve reflexes, learn faster, or treat psychological disorders. The modern neurohacking movement has been around since the 1980s. However, herbal supplements have been used to increase brain function for hundreds of years. After a brief period marked by a lack of research in the area, neurohacking started regaining interest in the early 2000s. Currently, most neurohacking is performed via do-it-yourself (DIY) methods by in-home users.
Transcranial direct current stimulation (tDCS) is a form of neuromodulation that uses constant, low direct current delivered via electrodes on the head. It was originally developed to help patients with brain injuries or neuropsychiatric conditions such as major depressive disorder. It can be contrasted with cranial electrotherapy stimulation, which generally uses alternating current the same way, as well as transcranial magnetic stimulation.
In the management of Parkinson's disease, due to the chronic nature of Parkinson's disease (PD), a broad-based program is needed that includes patient and family education, support-group services, general wellness maintenance, exercise, and nutrition. At present, no cure for the disease is known, but medications or surgery can provide relief from the symptoms.
Responsive neurostimulation device is a medical device that senses changes in a person's body and uses neurostimulation to respond in the treatment of disease. The FDA has approved devices for use in the United States in the treatment of epileptic seizures and chronic pain conditions. Devices are being studied for use in the treatment of essential tremor, Parkinson's disease, Tourette's syndrome, depression, obesity, and post-traumatic stress disorder.
Ablative brain surgery is the surgical ablation by various methods of brain tissue to treat neurological or psychological disorders. The word "Ablation" stems from the Latin word Ablatus meaning "carried away". In most cases, however, ablative brain surgery does not involve removing brain tissue, but rather destroying tissue and leaving it in place. The lesions it causes are irreversible. There are some target nuclei for ablative surgery and deep brain stimulation. Those nuclei are the motor thalamus, the globus pallidus, and the subthalamic nucleus.
Electrical brain stimulation (EBS), also referred to as focal brain stimulation (FBS), is a form of electrotherapy used as a technique in research and clinical neurobiology to stimulate a neuron or neural network in the brain through the direct or indirect excitation of its cell membrane by using an electric current. EBS is used for research or for therapeutic purposes.
Neurostimulation is the purposeful modulation of the nervous system's activity using invasive or non-invasive means. Neurostimulation usually refers to the electromagnetic approaches to neuromodulation.
Neurodegeneration with brain iron accumulation is a heterogenous group of inherited neurodegenerative diseases, still under research, in which iron accumulates in the basal ganglia, either resulting in progressive dystonia, parkinsonism, spasticity, optic atrophy, retinal degeneration, neuropsychiatric, or diverse neurologic abnormalities. Some of the NBIA disorders have also been associated with several genes in synapse and lipid metabolism related pathways. NBIA is not one disease but an entire group of disorders, characterized by an accumulation of brain iron, sometimes in the presence of axonal spheroids in the central nervous system.
The temporal dynamics of music and language describes how the brain coordinates its different regions to process musical and vocal sounds. Both music and language feature rhythmic and melodic structure. Both employ a finite set of basic elements that are combined in ordered ways to create complete musical or lingual ideas.
Restorative neurology is a branch of neurology dedicated to improving functions of the impaired nervous system through selective structural or functional modification of abnormal neurocontrol according to underlying mechanisms and clinically unrecognized residual functions. When impaired, the body naturally reconstructs new neurological pathways and redirects activity. The field of restorative neurology works to accentuate these new pathways and primarily focuses on the theory of the plasticity of an impaired nervous system. Its main goal is to take a broken down and disordered nervous system and return it to a state of normal function. Certain treatment strategies are used to augment instead of fully replace any performance of surviving and also improving the potential of motor neuron functions. This rehabilitation of motor neurons allows patients a therapeutic approach to recovery opposed to physical structural reconstruction. It is applied in a wide range of disorders of the nervous system, including upper motor neuron dysfunctions like spinal cord injury, cerebral palsy, multiple sclerosis and acquired brain injury including stroke, and neuromuscular diseases as well as for control of pain and spasticity. Instead of applying a reconstructive neurobiological approach, i.e. structural modifications, restorative neurology relies on improving residual function. While subspecialties like neurosurgery and pharmacology exist and are useful in diagnosing and treating conditions of the nervous system, restorative neurology takes a pathophysiological approach. Instead of heavily relying on neurochemistry or perhaps an anatomical discipline, restorative neurology encompasses many fields and blends them together.
Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function. Neuromodulation is an evolving therapy that can involve a range of electromagnetic stimuli such as a magnetic field (rTMS), an electric current, or a drug instilled directly in the subdural space. Emerging applications involve targeted introduction of genes or gene regulators and light (optogenetics), and by 2014, these had been at minimum demonstrated in mammalian models, or first-in-human data had been acquired. The most clinical experience has been with electrical stimulation.
Gait variability seen in Parkinson's Disorders arise due to cortical changes induced by pathophysiology of the disease process. Gait rehabilitation is focused to harness the adapted connections involved actively to control these variations during the disease progression. Gait variabilities seen are attributed to the defective inputs from the Basal Ganglia. However, there is altered activation of other cortical areas that support the deficient control to bring about a movement and maintain some functional mobility.
Non-invasive cerebellar stimulation is the application of non-invasive neurostimulation techniques on the cerebellum to modify its electrical activity. Techniques such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) can be used. The cerebellum is a high potential target for neuromodulation of neurological and psychiatric disorders due to the high density of neurons in its superficial layer, its electrical properties, and its participation in numerous closed-loop circuits involved in motor, cognitive, and emotional functions.
Friedhelm Christoph Hummel is a German neuroscientist and neurologist. A full professor at École Polytechnique Fédérale de Lausanne, he is the Defitech Chair of Clinical Neuroengineering, and the head of the Hummel Laboratory at EPFL's School of Life Sciences. He also is an associate professor of clinical neuroscience at the University of Geneva.
Adaptive Deep Brain Stimulation (aDBS), also known as Closed Loop Deep Brain stimulation (clDBS), is a neuro-modulatory technique currently under investigation for the treatment of neurodegenerative diseases.
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