RADRL: Prof. Massimo Leandri/Prof. Lucio Marinelli/Prof.ssa Marina Grandis
Sede: Neurological clinic, 1st floor
Rooms sited at the first floor of the Clinica Neurologica building
- Floor plan #32/31. Nociceptive Evoked Potentials, Somatosensory Evoked Potentials, Movement Related Evoked Potentials, Visual Event Related Evoked Potentials, Stabilometry (now in #21)
- Floor plan #30. Hardware design, development and testing (collaboration with Vertigo firm)
- Floor plan #29. Software design, development and testing
- Floor plan #26. Study of Autonomic System. Peripheral vascular laser doppler, Quantitative sensory Testing, Near Nerve and Interfascicular Neurography.
The Laboratory of Clinical and Experimental Electrophysiology started in 2016, taking over the activity of the Interuniversity Centre for the Study of Pain Neurophysiology (CIND), (dismissed after 23 years of successful endeavour which included leading coordination of the European project “Mechanisms of Trigeminal Pain”), when Professor M Leandri, its director, moved to DINOGMI and facilities were transferred to the new site. Here, the research of CIND, addressing pathophysiology of neuropathic pain, integrating the clinical activity of the DIMOGMI Peripheral Nerve Unit, directed by Professor A. Schenone. Professors L. Marinelli and M. Grandis also joined in.
The Nociceptive Evoked Potentials and the small fibre study.
Aim of the research has been, and still is now, the development of a new chapter in neurophysiology leading to the instrumental assessment of the thinly myelinated and unmyelinated fibres of the peripheral nerves, very poorly tested with the traditional methods. A significant discovery in this field was the micropatterned selective electrode developed and patented at our laboratory. The electrode selectively activates the intraepidermal endings of thin fibres, thus allowing the assessment of the whole nociceptive pathway from skin to the brain sensory cortex. In consequence of this, a new kind of evoked potential, the Nociceptive Evoked Potential has been introduced as a diagnostic tool in our outpatient clinic, mainly to investigate hereditary neuropaties.
Further instruments to study the conduction of peripheral nerves have recently been made available, with particular attention to autonomic functions like the vascular response to various stimuli evaluated by a laser doppler and sudomotor skin reflex.
A revision of the near nerve recording technique to perform direct recordings from the peripheral nerve (interfascicular recording) is now under development, with a newly designed needle electrode derived from microneurography electrodes. This technique, suitable for superficial nerve trunks, allows to record a vast spectrum of fibre activity, much more extensive than the usually employed method of ortho and antidromic assessments. The resulting information is expected to shed new light onto the discrepancies often found between clinical signs/symptoms and neurophysiological findings.
The Quantitative Thermal Sensory Testing
Aside to the electrophysiological tests, the laboratory has now developed a specially designed equipment to assess the sensory threshold of thermal perception (hot and cold thresholds) with probes of various sizes that can be attached to any site of the body surface, different from the bulky devices commercially available.
The Somatosensory Evoked Potentials
The traditional somatosensory evoked potentials are also studied for research purposes aside to the small fibre study.
The Movement Related Potentials and the Visual Event Related Potentials
This research has started because of the peculiar facilities offered by our software and hardware laboratories. The Department of Design and Architecture (dAD) had asked us for experiments involving the EEG recording of endogenous potentials related to the creation and visualisation of images. So a dedicated instrumentation has been set up to record the EEG activity preceding movements of drawing, and following visualization of images with a presumed emotionally relevant content in healthy individuals. This activity has brought a new line of experimental evidence in the field of neuroarchitecture and is expected to grow with the dissemination of the results.
Stabilometry, static and dynamic, for balance assessment and rehabilitation.
Two platforms have been developed in collaboration with the Vertigo Company (Genova). These devices are syncronised with dedicated electromyography amplifiers so the relationship between centre of balance on one side and amplitude/timing of muscle activity on the other can be assessed to evaluate the pathophysiology of balance in various conditions. A study on movement impaired CMT patients is currently being performed. The patient motor performance on the device can be used in a rehabilitation programme, where also a longitudinal monitoring of the progress made is available.
Development of dedicated software and hardware
This is a key and unique feature of our laboratory, which allows the design and implementation of equipment and data analysis according to the needs of each experiment or line of research. A large laboratory with all the necessary electronic facilities is available and is run with the collaboration with Vertigo Company. Almost all the signal and data handling procedures are performed by software developed in the graphical language LabView, which allows excellent flexibility and interfacing with the whole range of industry and medical standard boards by National Instruments.
Laboratory Personnel:
Grandis, Prof. Marina. Professore Associato of Neurologia at DINOGMI
Leandri, Prof. Massimo former Professore Associato of Neurologia at DINOGMI, former Direttore del CIND, retired, participates activities of the laboratory under a research agreement with DINOGMI
Marinelli, Prof. Lucio. Professore Associato of Neurologia at DINOGMI