The project MAINSTREAM

Primary Progressive Aphasia (PPA) is a group of neurodegenerative disorders that primarily affects language and is characterized as a progressive decline in expressing wants and needs and/or comprehending others. Significant impairments in social communication have also been noted to impact participation in daily life activities and ability to form and sustain interpersonal relationships. The clinical trajectory of PPA denotes cognitive deficits emerging as the disease progresses and can evolve to a Dementia diagnosis.

Currently there are no curative pharmacological treatments available for PPA due to the variability of the pathogenic mechanisms of the disorder. Due to the clinical and social impact of the disease, it is fundamental that individuals impacted by this disorder have access to rehabilitative interventions targeting cognitive and language deficits. With recent years, there has been an increased use of noninvasive cerebral stimulation techniques for cognitive rehabilitation.

The Center for cognitive disturbances and dementia (CDCD) of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano is participating in the research project MAINSTREAM (“A Multimodal Approach for Clinical Diagnosis and Treatment of Primary Progressive Aphasia”). This innovative study is financed by the Regional Foundation for Biomedical Research (FRRB) in response to “Unmet Medical Needs” and coordinated by Dr. Maria Cotelli of the IRCCS San Giovanni Center di Dio Fatebenefratelli Institute of Brescia. The purpose of the study is to develop a regional network to diagnose and treat PPA.

The project MAINSTREAM – will be coordinated by Dr. Tiziana Carandini from the “Centro Dino Ferrari” at the Policlinico of Milan. The study will be followed by a multidisciplinary team at CDCD composed of neurologists, neuropsychologists, speech language pathologists, neurophysiologists and biologists. The project aims to improve the understanding of the mechanisms of neurodegenerative disorders involved in PPA for early diagnosis. Furthermore, the study will evaluate the effectiveness of novel nonpharmacological therapies which constitutes of the application of transcranial direct current stimulation (tDCS) paired with individualized speech language therapy in outpatient care or telehealth. The rehabilitative treatment will be “personalized” to every patient with PPA, adapting the modality of the intervention based on specific language deficits of the individual. Lastly, the most important objective is evaluate the clinical practice of interventions through the generalizability of the proposed treatments to the real world.

Assistance will also be provided to relatives of patients, targeted through a strong partnership with the Italian Association of Frontotemporal Dementia (AIMFT). AIMFT is a nonprofit organization founded in 2010 in Brescia which supports people affected by Frontotemporal Dementia and their families. This relationship was built and maintained by the IRCCS Fatebenefratelli coordinator and IRCCS partner of the project MAINSTREAM.

For more information on patient enrollment contact: centro.alzheimer@policlinico.mi.it

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