One of the long-terms goals of the Applied Neurophysiology Lab for Movement Disorders in Genova, Italy is to develop innovative and effective physiotherapy approaches focused on improving gait and balance disturbances and freezing of gait in people with Parkinson’s disease.

Under the leadership of Associate Professor Laura Avanzino, our team studies the mechanisms of sensorimotor integration in young people, in the elderly and in people with movement disorders such as Parkinson’s Disease¹ and Dystonia² with a specific interest in brain plasticity. We also study motor control with Transcranial Magnetic Stimulation (Alessandro Botta, PhD student), and spend time on the analysis of kinematic parameters and gait analysis (Chiara Ponte, PhD student). In addition, we are interested in studying neuro-motor control, motor-cognitive interactions and motor learning mechanisms (Cosentino Carola, PhD students) in clinical populations.

The Applied Neurophysiology lab for Movement disorders current studies investigate sensorimotor integration mechanisms at the basis of motor learning through motor execution, motor imagery and action observation³. Further motor performance changes are also analyzed with the aim of finding novel strategies which can positively impact on every-day activities and quality of life in Parkinson’s disease population.

We are also investigating motor-cognitive-emotional interaction⁴ (Giovanna Lagravinese, lecture) with ad hoc experimental tasks and by combining behavioral paradigm with non-invasive neuroimaging and neuromodulation techniques.

Particular attention is devoted to the role of motor-cognitive-emotional interaction in gait control and in revealing its role in freezing of gait pathophysiology⁵ (Martina Putzolu, PhD student).

Furthermore, in the last year, our laboratory is combining non-invasive neuromodulation techniques (NIBS), such as Transcranial Current stimulation along with High-density EEG to determine the cortical network to target and the oscillation frequency engaged during usual and complex walking, to foster the effect of gait training in people with Parkinson’s disease (Gaia Bonassi, post-Doc fellow). This project entitled “Gait-tailored brain electroceutical therapy in Parkinson's disease” has been funded by the Ministry of Health of Italy in their effort to support junior researchers with “starting grants”.

With the support of Drop (Srls – Velletri, Roma) we recently developed ParkinsonRehab® a free app to support people with Parkinson’s disease in doing every-day exercise at home and to help them be proactive particularly during the COVID-19 pandemic, when it was no longer possible to provide physiotherapy session in our out-patient clinic. While the app is only available in Italian now, we hope to one day to see it in English and find that even the visuals are easily understood by those who don’t speak Italian.

Despite research progresses in the physiotherapy field, there are scientific questions that remain to be answered and gaps that need to be filled. For example, the effect of physiotherapy training on disease progression or which interventions fit the best for each single patient.

We do believe that research can obtain great benefit from listening and involving people with Parkinson’s disease and their caregivers. We look forward to meeting members of the Parkinson’s community to get inspired and to present results of our research at the next WPC in Barcelona

References

1. Pelosin E, Cerulli C, Ogliastro C, Lagravinese G, Mori L, Bonassi G, Mirelman A, Hausdorff JM, Abbruzzese G, Marchese R, Avanzino L. A Multimodal Training Modulates Short Afferent Inhibition and Improves Complex Walking in a Cohort of Faller Older Adults With an Increased Prevalence of Parkinson's disease. J Gerontol A Biol Sci Med Sci. 2020 Mar 9;75(4):722-728. doi: 10.1093/gerona/glz072. PMID: 30874799.

2. Avanzino L, Cherif A, Crisafulli O, Carbone F, Zenzeri J, Morasso P, Abbruzzese G, Pelosin E, Konczak J. Tactile and proprioceptive dysfunction differentiates cervical dystonia with and without tremor. Neurology. 2020 Feb 11;94(6):e639-e650. doi: 10.1212/WNL.0000000000008916. Epub 2020 Jan 14. PMID: 31937622.

3. Abbruzzese G, Avanzino L, Marchese R, Pelosin E. Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson's disease. Parkinsons Dis. 2015;2015:124214. doi: 10.1155/2015/124214. Epub 2015 Oct 1. PMID: 26495150; PMCID: PMC4606219.

4. Lagravinese G, Pelosin E, Bonassi G, Carbone F, Abbruzzese G, Avanzino L. Gait initiation is influenced by emotion processing in Parkinson's disease patients with freezing. Mov Disord. 2018 Apr;33(4):609-617. doi: 10.1002/mds.27312. Epub 2018 Feb 2. PMID: 29392774.

5. Putzolu M, Ogliastro C, Lagravinese G, Bonassi G, Trompetto C, Marchese R, Avanzino L, Pelosin E. Investigating the effects of transcranial direct current stimulation on obstacle negotiation performance in Parkinson disease with freezing of gait: A pilot study. Brain Stimul. 2019 Nov-Dec;12(6):1583-1585. doi: 10.1016/j.brs.2019.07.006. Epub 2019 Jul 12. PMID: 31326366.