Description

Research on severe brain injury is divided in several aspects:

1. DIAGNOSTIC AND PHARMACOLOGICAL CLINICAL ASPECTS

Strazzer Sandra & Galbiati Sara and Locatelli Federica in collaboration with the Clinical Pharmacology Service (Clementi Emilio and Pozzi Marco) and in collaboration with the Neurophysiology Service (Zucca Claudio).

The management of clinical and pharmacological problems in the field of acquired brain injury in the pediatric age is complex. There are no references to literature and national and international guidelines.

During this period we are monitoring and studying the following issues:

• Endocrinological aspects
• Nephrolithiasis and correlations with enteral feeding
• Epilepsy prophylaxis treatment in TBI
• Evaluation protocol for patients with pharmacoresistant epilepsy
• Monitoring the side effects of drugs
• Management protocol of Tracheostomized patient
• Paroxysmal Sympathetic Hyperactivity in Pediatric Rehabilitation: Clinical Factors and Pharmacological Management
• Description of hospital infections and their management

2. ASSESSMENT AND REHABILITATION PROTOCOL IN PATIENTS WITH DISORDERS OF CONSCIOUSNESS

Colombo Katia & Pastore Valentina, Galbiati Susanna, Recla Monica, Galbiati Sara, Locatelli Federica, Avantaggiato Paolo, Formica Francesca

The low levels of consciousness (vegetative state and minimally conscious state) are still scantly known. Lack of studies and literature leads to a very high diagnostic error. This lack of knowledge is even more relevant in the pediatric field.

Part of our research focuses on these aspects:

• Prognosis Study with Polysomnography and Functional Resonance with Electroencefalographic and Polygraphic Study in Correlation with Functional Scales
• Study of Clinical Assessment Scales in Children in Vegetative State
• Short and long term outcome studies in relation to rehabilitation pathways
• Psychological evaluation on the care givers / brothers

3. ASSESSMENT AND TREATMENT OF BEHAVIORAL ASPECTS AND NEUROPSYCHOLOGICAL DEFICIENCES

Pastore Valentina & Galbiati Susanna with Recla Monica, Colombo Katia, Manfredi Valentina, in collaboration with Bardoni Alessandra and Fedeli Claudia

Patients with acquired severe brain injury always show behavioral, psychological and neuropsychological deficits. Over the years, clinical and rehabilitative paths have been set up to reduce these problems. They are also intended to encourage the social reintegration of the child and his family. These paths are subject to study and research, in particular we are performing:

• outcome evaluations of Neuropsychological and Psychological Treatment
• functional changes through brain fMRI after specific cognitive treatment
• issues in adolescents with acquired severe brain injury (body image and impact of social inclusion)
• Psychological evaluation on the care givers / brothers

4. MOTOR REHABILITATION

Beretta Elena, in collaboration with Clinical Engineering (Biffi Emilia, Cesareo Ambra) and CESNE (Dr. Arrigoni Filippo) and the physiotherapy sector (Panzeri Daniele).

The creation of rehabilitation pathways in the motor field has allowed an assessment of their outcome. In particular we are studying:

• motor and functional outcome
• the outcome after robotic treatment and after virtual reality (gait)
• the effectiveness of traditional treatment vs ARMEO vs. CIMT (upper limb)
• Evaluation of brain network activation after rehabilitation paths
• Innovative orthosis evaluations
• Mechanized Passive Mechanism Activated Assessments on Brain Activation
• Modification of muscle structure after treatment with Lokomat

Selected publications

• Pozzi M, Galbiati S, Locatelli F, Granziera M, Santi M, Colombo D, Pellegrino P, Radice S, Clementi E, Strazzer S. Prevention of respiratory infections in tracheostomized patients of a pediatric long-term rehabilitation setting. Am J Infect Control. 2015 Feb 8.
• Beretta E, Romei M, Molteni E, Avantaggiato P, Strazzer S. Combined robotic-aided gait training and physical therapy improve functional abilities and hip kinematics during gait in children and adolescents with acquired brain injury. Brain Inj. 2015 Apr 27:1-8. [Epub ahead of print] PubMed PMID: 25915458.
• Pastore V, Colombo K, Maestroni D, Galbiati S, Villa F, Recla M, Locatelli F, Strazzer S. Psychological problems, self-esteem and body dissatisfaction in a sample of adolescents with brain lesions: A comparison with a control group. Brain Inj. 2015 May 7:1-9. [Epub ahead of print] PubMed PMID: 25950267.
• Avantaggiato P, Molteni E, Formica F, Gigli GL, Valente M, Lorenzut S, de Biase S, Arcieri S, Locatelli F, Strazzer S. Polysomnographic Sleep Patterns in Children and Adolescents in Unresponsive Wakefulness Syndrome. J Head Trauma Rehabil. 2015 Sep-Oct;30(5):334-46.
• Pozzi M, Conti V, Locatelli F, Galbiati S, Radice S, Citerio G, Clementi E, Strazzer S. Paroxysmal Sympathetic Hyperactivity in Pediatric Rehabilitation: Clinical Factors and Acute Pharmacological Management. J Head Trauma Rehabil. 2015 Sep-Oct;30(5):357-363.
• Pozzi M, Locatelli F, Galbiati S, Clementi E, Strazzer S. Re: "Paroxysmal Sympathetic Hyperactivity: A New Era for Diagnosis and Treatment". J Head Trauma Rehabil. 2015 Sep-Oct;30(5):366-7.
• Dilena R, Strazzer S, Esposito S, Paglialonga F, Tadini L, Barbieri S, Giannini A. Locked-in-like fulminant infantile Guillain-Barré syndrome associated with herpes simplex virus 1 infection. Muscle Nerve. 2015 Sep 15.
• Strazzer S, Rocca MA, Molteni E, De Meo E, Recla M, Valsasina P, Arrigoni F, Galbiati S, Bardoni A, Filippi M. Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury. Neural Plast. 2015;2015:104282.
• Molteni E, Beretta E, Altomonte D, Formica F, Strazzer S. Combined robotic-aided gait training and 3D gait analysis provide objective treatment and assessment of gait in children and adolescents with Acquired Hemiplegia. ConfProc IEEE Eng Med Biol Soc. 2015 Aug;2015:4566-9. doi: 10.1109/EMBC.2015.7319410. PubMed PMID: 26737310.
• Garavaglia L, Molteni E, Beretta E, Vassena E, Strazzer S, Pittaccio S. Pilot study of the cortical correlates and clinical effects of passive ankle mobilisation in children with upper motorneuron lesions. Conf Proc IEEE Eng Med Biol Soc. 2015 Aug;2015:6614-7. doi: 10.1109/EMBC.2015.7319909. PubMed PMID:26737809.
• Biffi E, Beretta E, Diella E, Panzeri D, Maghini C, Turconi AC, Strazzer S, Reni G. Gait rehabilitation with a high tech platform based on virtual realityconveys improvements in walking ability of children suffering from acquired brain injury. Conf Proc IEEE Eng Med Biol Soc. 2015 Aug;2015:7406-9. doi: 10.1109/EMBC.2015.7320103. PubMed PMID: 26738003.
• Strazzer S, Pozzi M, Avantaggiato P, Zanotta N, Epifanio R, Beretta E, Formica F, Locatelli F, Galbiati S, Clementi E, Zucca C. Late Post-traumatic Epilepsy in Children and Young Adults: Impropriety of Long-Term Antiepileptic Prophylaxis and Risks in Tapering. Paediatr Drugs. 2016 Feb 25. [Epub ahead of print] PubMed PMID: 26913859.
• Molteni E, Avantaggiato P, Formica F, Pastore V, Colombo K, Galbiati S, Arrigoni F, Strazzer S. Sleep/Wake Modulation of Polysomnographic Patterns has Prognostic Value in Pediatric Unresponsive Wakefulness Syndrome. J Clin Sleep Med. 2016 May 3. pii: jc-00048-16. [Epub ahead of print] PubMed PMID: 27166297.
• Pozzi M, Conti V, Locatelli F, Galbiati S, Radice S, Clementi E, Strazzer S. Paroxysmal Sympathetic Hyperactivity in Pediatric Rehabilitation: Pathological Features and Scheduled Pharmacological Therapies. J Head Trauma Rehabil. 2017 Mar/Apr;32(2):117-124.
• Molteni E, Rocca MA, Strazzer S, Pagani E, Colombo K, Arrigoni F, Boffa G, Copetti M, Pastore V, Filippi M. A diffusion tensor magnetic resonance imaging study of paediatric patients with severe non-traumatic brain injury. Dev Med Child Neurol. 2017 Feb;59(2):199-206.
• Biffi E, Beretta E, Cesareo A, Maghini C, Turconi AC, Reni G, Strazzer S. An Immersive Virtual Reality Platform to Enhance Walking Ability of Children with Acquired Brain Injuries. Methods Inf Med. 2017 Mar 23;56(2):119-126.
• Galbiati S, Pastore V, Locatelli F, Recla M, Galbiati S, Mansi G, Arrigoni F, Scandroglio AM, Beretta L, Strazzer S. Neurocognitive and behavioral outcomes in a nearly drowned child with cardiac arrest and hypothermia resuscitated after 43min of no flow-time: A case study. Resuscitation. 2017 Sep;118:e3-e4.
• Beretta E, Molteni E, Galbiati S, Stefanoni G, Strazzer S. Five-year motor functional outcome in children with acquired brain injury. Yet to the end of the story? Dev Neurorehabil. 2017 Aug 17:1-8.

Partnerships

• Emilio Clementi - University of Milan, Milano- Department of Biomedical and Clinical Sciences "Luigi Sacco"
• Dr.ssa Sonia Radice - Servizio Farmacovigilanza, unità di Farmacologia clinica ASST FBF-Sacco, Milano.
• Erika Molteni Associate Researcher - University College London, London - Department of Medical Physics and Bioengineering
• Simone Pittaccio, Researcher - Italian National Research Council, Rome - Institute for Energetics and Interphases IENI
• Giovanna Rizzo, Senior Researcher -Italian National Research Council, Rome - Institute of Molecular Bioimaging and Physiology IBFM
• Enrico Castelli, Director, Pediatric Neurorehabilitation Units - Ospedale Pediatrico Bambino Gesù, Rome - Department of Neurosciences and Neurorehabilitation

Description

Rehabilitation of brain tumor survivors is a complex process drawing on multidisciplinary expertise and integrated knowledge.

The main research focus in this area consists in the assessment of functional outcomes in order to establish rehabilitation needs as well as evaluate outcomes based on a number of international and national management protocols.

Research activity

• “Cerebellar lesions and cognitive-behavioral disorders: A study of posterior fossa tumors in children and adolescents” (2001-2004). Current research authorized by the Italian Ministry of Health
• “Comprehensive diagnosis and treatment for intracranial pediatric ependymoma”. A multicenter collaborative project with E. Medea Institute acting as lead for assessment and neuropsychological outcomes (Research Unit: Neuropsychological evaluation/Observation and psychological intervention/Intensive rehabilitation) (2005-2008). Research approved by AIRC (Associazione Italiana per la Ricerca sul Cancro)
• “Brain tumors in children: Supporting parent-child communication about the disease” (2010-11). Research sponsored by Fondazione Berlucchi
• “A diffusion-tensor study of radiation-induced brain damage correlated to possible cognitive deficits in the pediatric population” (2011-13). Research funded by Lombardy Region:
• “Retrospective and prospective study of late radiation damages after focal radiotherapy for childhood brain tumors”. Research approved by AIRC (Associazione Italiana per la Ricerca sul Cancro) for the 2014-2016 period. This multicenter research saw the collaboration of INT-Milan and the Neuro-Oncology Rehabilitation Unit and the Neuroradiology Unit of E. Medea Institute.

Selected publications

• Geraldina Poggi, Annarita Adduci, Lorenza Gandola, Susanna Galbiati, Alessandro Degrate, Elena Sironi, Sandra Strazzer, Maura Massimino  Cognitive and Psychological Outcomes in younger vs. Older Children with Subtentorial /Supratentorial Ependymoma after radiation Therapy. Journal of Behavioral and Brain Science , 2011, 1, 87-93. 
• Massimino M, Cefalo G, Riva D, Biassoni V, Spreafico F, Pecori E, Poggi G, Collini P, Pollo B, Valentini L, Potepan P, Seregni E, Casanova M, Ferrari A, Luksch R, Polastri D, Terenziani M, Pallotti F, Clerici CA, Schiavello E, Simonetti F, Meazza C, Catania S, Podda M, Gandola L. Long-term results of combined preradiation chemotherapy and age-tailored radiotherapy doses for childhood medulloblastoma. Neurooncol. 2012 May;108(1):163-71.
• Adduci A, Jankovic M, Strazzer S, Massimino M, Clerici C, Poggi G. Parent-child communication and psychological adjustment in children with a brain tumor. Pediatr Blood Cancer. 2012 Aug;59(2):290-4.
• Pastore V, Colombo K, Villa F, Galbiati S, Adduci A, Poggi G, Massimino M, Recla M, Liscio M, Strazzer S. Psychological and adjustment problems due to acquired brain lesions in pre-school-aged patients. Brain Inj. 2013 Jun;27(6):677-84.
• Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Pecori E, Vajna De Pava M, Modena P, Antonelli M, Giangaspero F.  Evolving of therapeutic strategies for CNS-PNET.  Pediatr Blood Cancer. 2013 Dec; 60 (12): 2031-5. 
• Geraldina Poggi, Maura massimino, Carlo Alfredo Clerici, Marta Tettamanti, Veronica Biassoni, Annarita Adduci. Brain Tumors in Children: A Support Tool for Parent-Child Communication About The Disease. Psycho-Oncology. 2013 Nov; 22(Suppl.3):124-362.
• Câmara-Costa H, Resch A, Kieffer V, Lalande C, Poggi G, Kennedy C, Bull K, Calaminus G, Grill J, Doz F, Rutkowski S, Massimino M, Kortmann RD, Lannering B, Dellatolas G, Chevignard M; Quality of Survival Working Group of the Brain Tumour Group of SIOP-Europe. Neuropsychological Outcome of Children Treated for Standard Risk Medulloblastoma in the PNET4 European Randomized Controlled Trial of Hyperfractionated Versus Standard Radiation Therapy and Maintenance Chemotherapy. Int J Radiat Oncol Biol Phys. 2015 Aug 1;92(5).
• Massimino M, Biassoni V, Gandola L, Garrè ML, Gatta G, Giangaspero F, Poggi G, Rutkowski S. Childhood medulloblastoma. Crit Rev Oncol Hematol. 2016 Sep;105:35-51. Review.
• Indini A, Schiavello E, Biassoni V, Bergamaschi L, Magni MC, Puma N, Chiaravalli S, Pallotti F, Seregni E, Diletto B, Pecori E, Gandola L, Poggi G, Massimino M. Long-term safety of growth hormone replacement therapy after childhood medulloblastoma and PNET: it is time to set aside old concerns. J Neurooncol. 2017 Jan;131(2):349-357.
• Veneroni L, Boschetti L, Barretta F, Clerici CA, Simonetti F, Schiavello E, Biassoni V, Spreafico F, Gandola L, Pecori E, Diletto B, Poggi G, Gariboldi F, Sensi R, Massimino M. Quality of life in long-term survivors treated for metastatic medulloblastoma with a hyperfractionated accelerated radiotherapy (HART) strategy. Childs Nerv Syst. 2017.
• Camara-Costa Hugo, Bull Kim, Kennedy Colin, Wiener Andreas, Calaminus Gabriele, Resch Anika, Kieffer Virginie, Lalande Clemence, Poggi Geraldina, Von Hoff Katja, Grill Jacques, Doz Francois, Rutkowski Stefan, Massimino Maura, Kortmann Rolf-Dieter, Lannering Birgitta, Dellatolas Georges, Chevignard Mathilde, on behalf of Quality of Survival Working Group of the Brain Tumour Group SIOP Europe (2017); QUALITY OF SURVIVAL AND COGNITIVE PERFORMANCE IN CHILDREN TREATED FOR MEDULLOBLASTOMA IN THE PNET 4 RANDOMIZED CONTROLLED TRIAL; Neuro-Oncology Practice, 4(3):161-170.

Books

I bambini e il tumore. Strategie di supporto in ambito clinico, familiare e scolastico. Annarita Adduci, Geraldina Poggi. Franco Angeli, 2011.

Ritorno a scuola. Accoglienza , gestione e supporto del bambino con tumore cerebrale nel suo ritorno in classe. Geraldina Poggi, Annarita Adduci, Maria Chiara Oprandi, 2015 www.emedea.it/ritornoascuola.

Una sfida possibile. La riabilitazione del paziente con diagnosi di tumore cerebrale in età evolutiva. Geraldina Poggi, Maria Chiara Oprandi, 2017  www.emedea.it/editoria

Book chapters

The Medulloblastoma Book .Editors: Dimitris Kombogiorgas - Capitolo 13. Neurocognitive sequelae: Personal Experiences. Geraldina Poggi, Annarita Adduci, Unit of Acquired Brain Injury, Scientific Institute E. Medea – Bosisio Parini (Lecco), Italy, and others, 2014.

Partnerships

National partnerships

• AIEOP (Associazione Italiana di Emato-Oncologia Pediatrica)
• Neuropsychology working group involving many Italian centers, with E. Medea Institute acting as coordinating center
• Psycho-social coordinating group with active participation in meetings
• AIEOP Multidisciplinary working group on brain tumors. E. Medea Institute is the coordinating center for cognitive, neuropsychological and rehabilitation outcomes

International partnerships

• Participation in SIOP activities – Europe Brain Tumors Group, specifically
  • Quality of Survival group, for the development of protocols targeted to specific types of tumors;
  • “SIOP Intracranial Ependymoma” – Prospective trial for the diagnosis and treatment of children, adolescents and young adults with Intracranial Ependymoma - European study on clinical and functional outcomes.

Description

Cerebral Palsy (CP) is a group of permanent but not unchangeable disorders of movement and posture that cause a limitation of activities, attributed to events occurring before the brain has completed its development in fetus, newborn or infant.
Motor disturbances are prevalent but not exclusive and can accompany problems of sensory-perceptions, cognition, communication, behavior, critical phenomena and secondary skeletal muscle problems. CP is therefore a condition due to central nervous system changes due to pre-, post- or post-natal causes before it completes growth and development, extremely heterogeneous in terms of etiology, type and severity of the disorder itself. Classification systems allow the functional framing of the patient and a common language recognized at international level, in particular:
GMFCS for the evaluation of gross-motor skills
MACS for Bimanual Skills Assessment
CFCS for assessing the effectiveness of communication
EDACS for assessing the ability in eating and drinking
VFCS for evaluating the use of visual function
Instrumental examinations can be performed for complex motor evaluations: isokinetics, surface EMG, stabilometry, Gait analysis, oxygen consumption.
The rehabilitation approach should respect the child's centrality and provide for customized functional activities while safeguarding the emotional dimension of the child
The treatment, aimed at building adaptive functions, is the result of an integrated process, not only motor but also perceptual, visual, cognitive, praxic-manipulative. It is therefore necessary to provide a multidisciplinary approach that should be premature and of high intensity with the involvement of the family.
These include early integrated treatment and constraint induced movement therapy (CIMT) consisting in the therapeutic penalization of the limb maintained and directed to patients with hemiplegia.
Robotic rehabilitation is considered a therapeutic option in treating patients with motor impairment with neurological aetiology.
Robotic systems are particularly well suited to training motor functions because they allow to produce and control with high precision different forces, allowing for personalization of rehabilitation and stimulation of tactile, perceptual and visual sensory systems.
The main devices used in this field are the DGO (Driven Gait Orthosis) (Lokomat) for the robotic gait rehabilitation and the Armeo for upper limb treatment. It is currently considered that the use of robotic systems is an integral part of the rehabilitation program. In experimental projects, a rehabilitation system was also introduced through immersive virtual reality.

Selected publications

• Effects of dose and duration of Robot-Assisted Gait Training on walking ability of children affected by cerebral palsy. Peri E, Turconi AC, Biffi E, Maghini C, Panzeri D, Morganti R, Pedrocchi A, Gagliardi C. Technol Health Care. 2017 Aug 9;25(4):671-681. doi: 10.3233/THC-160668.2.
• Family-centred care for children and young people with cerebral palsy: results from an Italian multicenter observational study. Molinaro A, Fedrizzi E, Calza S, Pagliano E, Jessica G, Fazzi E; GIPCI Study Group. Child Care Health Dev. 2017 Jul;43(4):588-597. doi: 10.1111/cch.12449. Epub 2017 Mar 9. No abstract available
• An Immersive Virtual Reality Platform to Enhance Walking Ability of Children with Acquired Brain Injuries. Biffi E, Beretta E, Cesareo A, Maghini C, Turconi AC, Reni G, Strazzer S.Methods Inf Med. 2017 Mar 23;56(2):119-126. doi: 10.3414/ME16-02-0020. Epub 2017 Jan 24
• Whole-Brain DTI Assessment of White Matter Damage in Children with Bilateral Cerebral Palsy: Evidence of Involvement beyond the Primary Target of the Anoxic Insult. Arrigoni F, Peruzzo D, Gagliardi C, Maghini C, Colombo P, Iammarrone FS, Pierpaoli C, Triulzi F, Turconi AC. AJNR Am J Neuroradiol. 2016 Jul;37(7):1347-53. doi: 10.3174/ajnr.A4717. Epub 2016 Mar 17
• Gait rehabilitation with a high tech platform based on virtual reality conveys improvements in walking ability of children suffering from acquired brain injury. Biffi E, Beretta E, Diella E, Panzeri D, Maghini C, Turconi AC, Strazzer S, Reni G. Conf Proc IEEE Eng Med Biol Soc. 2015;2015:7406-9. doi: 10.1109/EMBC.2015.7320103.
• An ecological evaluation of the metabolic benefits due to robot-assisted gait training. Peri E, Biffi E, Maghini C, Marzorati M, Diella E, Pedrocchi A, Turconi AC, Reni G. Conf Proc IEEE Eng Med Biol Soc. 2015 Aug;2015:3590-3. doi: 10.1109/EMBC.2015.7319169.
• Quantitative Evaluation of Performance during Robot-assisted Treatment. Peri E, Biffi E, Maghini C, Servodio Iammarrone F, Gagliardi C, Germiniasi C, Pedrocchi A, Turconi AC, Reni G. Methods Inf Med. 2016;55(1):84-8. doi: 10.3414/ME14-01-0126. Epub 2015 Dec 7
• Can new technologies improve upper limb performance in grown-up diplegic children? Turconi AC, Biffi E, Maghini C, Peri E, Servodio Iammarone F, Gagliardi C. Eur J Phys Rehabil Med. 2016 Oct;52(5):672-681. Epub 2015 Nov 10
• SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.Benedetti MG, Beghi E, De Tanti A, Cappozzo A, Basaglia N, Cutti AG, Cereatti A, Stagni R, Verdini F, Manca M, Fantozzi S, Mazzà C, Camomilla V, Campanini I, Castagna A, Cavazzuti L, Del Maestro M, Croce UD, Gasperi M, Leo T, Marchi P, Petrarca M, Piccinini L, Rabuffetti M, Ravaschio A, Sawacha Z, Spolaor F, Tesio L, Vannozzi G, Visintin I, Ferrarin M. Gait Posture. 2017 Aug 5;58:252-260
• Kinematic analysis of upper limb during walking in diplegic children with Cerebral Palsy.  Galli M, Cimolin V, Albertini G, Piccinini L, Turconi AC, Romkes J, Brunner R. Eur J Paediatr Neurol. 2014 Mar;18(2):134-9. doi: 10.1016/j.ejpn.2013.09.007. Epub 2013 Oct 11.
• Comparison of two pelvic positioning belt configurations in a pediatric wheelchair. Cimolin V, Avellis M, Piccinini L, Corbetta C, Cazzaniga A, Turconi AC, Galli M. Assist Technol. 2013 Winter;25(4):240-6
• The effects of femoral derotation osteotomy in cerebral palsy: a kinematic and kinetic study. Cimolin V, Piccinini L, Portinaro N, Turconi AC, Albonico S, Crivellini M, Galli M. Hip Int. 2011 Nov-Dec;21(6):657-64. doi: 10.5301/HIP.2011.8758
• Constraint-induced movement therapy for children with hemiplegia after traumatic brain injury: a quantitative study. Cimolin V, Beretta E, Piccinini L, Turconi AC, Locatelli F, Galli M, Strazzer S. J Head Trauma Rehabil. 2012 May-Jun;27(3):177-87. doi: 10.1097/HTR.0b013e3182172276
• Are knee kinematic anomalies in swing due to rectus femoris spasticity different from those due to femoral anteversion in children with cerebral palsy? A quantitative evaluation using 3D gait analysis.Cimolin V, Piccinini L, Turconi AC, Crivellini M, Galli M.J Pediatr Orthop B. 2010 May;19(3):221-5. doi: 10.1097/BPB.0b013e32833390ca
• 3D-Quantitative evaluation of a rigid seating system and dynamic seating system using 3D movement analysis in individuals with dystonic tetraparesis.Cimolin V, Piccinini L, Avellis M, Cazzaniga A, Turconi AC, Crivellini M, Galli M. Disabil Rehabil Assist Technol. 2009 Nov;4(6):422-8. doi: 10.3109/17483100903254553
• Relationship between kinematic knee deviations and femoral anteversion in children with cerebral palsy. Piccinini L, Cimolin V, Turconi AC, Galli M.

Partnership

• Neurological Institute “C. Besta”- Milan
• Italian Group for Cerebral Palsy (GIPCI)
• Gillette Children’s Specialty Healthcare – Saint Paul – MN – USA
• Karolinska Institutet - Ann-Christin Eliasson – Stockolm
• Kinderspital – Zurich – Andreas Meyer
• Hokoma – Motek Force – Floris Morang

Description

Although the core features of Autism Spectrum Disorder (ASD) are persistent deficits in social communication and interaction and the presence of restricted, repetitive patterns of behavior, interests, or activities, it is of great importance not to ignore the motor impairments associated with ASD as they are highly prevalent and can have a significant impact on social development. A refined characterization of motor profile of children with ASD could identify a well-defined subset of patients, reducing the clinical heterogeneity within the broad behavioral phenotype. This may guide further exploration of the neural mechanisms underlying motor development in children with ASD using different techniques.

Experimental techniques: kinematic analysis, magnetic resonance, genetic analysis.

Selected publications

• Piccin S, Crippa A, Nobile M, Hardan AY & Brambilla P. (2017). Video Modeling for the development of personal hygiene skills in youth with Autism Spectrum Disorder. Epidemiology and Psychiatric Sciences, Epub ahead of print.
• Crippa A, Del Vecchio G, Busti Ceccarelli S, Nobile M, Arrigoni F & Brambilla P (2016) Cortico-Cerebellar Connectivity in Autism Spectrum Disorder: What Do We Know So Far? Frontiers in Psychiatry 7:20.
• Crippa A, Salvatore C, Perego P, Forti S, Nobile M, Molteni M & Castiglioni I. (2015). Use of machine learning to identify children with autism and their motor abnormalities. Journal of Autism and Developmental Disorders; 45(7):2146-2156.
• Crippa A, Forti S, Perego P & Molteni M. (2013). Eye-Hand Coordination In Children With High Functioning Autism and Asperger’s Disorder Using A Gap-Overlap Paradigm. Journal of Autism and Developmental Disorders; 43(4):841-50.
• Forti S, Valli A, Perego P, Nobile M, Crippa A & Molteni M. (2011). Motor Planning and Control in Autism. A Kinematic Analysis of Preschool Children. Research in Autism Spectrum Disorders; 5(2):834-842.

Partnerships

• Prof. Gian Marco Marzocchi, Department of Psychology, University of Milano-Bicocca
• Prof. Paolo Brambilla, Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan
• Dr. Isabella Castiglioni, Institute of Molecular Imaging and Physiology, National Research Council, Segrate – Milano