Newly established IPiN Neuroimaging Unit has been designed to perform a multi-disciplinary neuroimaging research by means of neuroimaging techniques facility (e.g., functional and structural MRI, Diffusion Tensor Imaging, and Transcranial Magnetic Stimulation) along with neuroscience research, neurology and neuropsychiatry.

The IPiN Neuroimaging Unit collaborates widely with some of the leading neuroscientists and clinicians in this field (e.g., the UK, Germany, Italy, and Canada).

The unit is proud to host a PhD students and research fellows.

PRINCIPAL INVESTIGATORS:
  • Danuta Ryglewicz, MD, PhD
  • Katarzyna Kucharska-Pietura, MD, PhD
  • Renata Poniatowska, MD, PhD
  • Roman Stefański, MD, PhD
  • Piotr Bogorodzki, PhD

    FUNDED PROJECTS:

    Grant No.2011/01/B/NZ5/02838 from the National Science Centre, Cracow, Poland

    Neuropsychological and neuroimaging (fMRI) evaluation of the remediation process of neurocognition and social cognition in patients with thalamic stroke: Efficacy of a newly acquired rehabilitation program - double blind randomized clinical trial.

    Key words: thalamic stroke, social cognition, functional resonance imaging, neurocognitive and social cognitive training

    Project summary While a number of stroke studies have examined both neurocognitive and social cognitive functioning in subcortical lesions, mostly amygdale and basal ganglia, few have attempted to untangle mysterious knot around thalamus role in relation to treatment provided. A stroke occurs within small amount of time only however its consequences can be felt for the rest of life. Undoubtedly, the consequence of a short-term blood interruption in thalamus can result not only in motor impairment but also in neurocognitive and social cognitive impairments. The solution is to offer the patients rehabilitation program immediately while still in hospital. Early cognitive therapy focuses on improving the gross cognitive system including attention, memory, perceptual skills, visual and spatial processing, etc. to help the stroke survivors to achieve the most independent level of functioning as possible. However, it is unlikely that interventions targeting only basic neurocognition will be sufficient to achieve optimal social cognitive functioning. Rapidly growing evidence indicates that impairments in the domain social cognition are important determinants of functional outcome.

    Social cognition has been defined as the mental operations underlying social interactions, and is thought to represent a specialized domain of cognition, which captures affect perception, social cue perception, theory of mind, empathy, and attribution style. Hence, social cognition appears to be more proximal to functional outcome than basic cognition and, for that reason, could be an even better target for stroke rehabilitation.

    The aim of the study is to examine neurocognition and social cognitive functioning in 40 inpatients at early stage of thalamic stroke (2-3 weeks after stroke onset) and after 4 months of treatment including a new 24 session- neurocognitive and social cognitive remediation training. Multidisciplinary approach (neurologist, neuropsychologist, psychiatrist, and therapist) was implemented to adapt our neurocognitive and social cognitive remediation training to stroke patients. The pilot program was delivered individually to individual participants twice weekly for 45 minutes in 12 weeks program (24 sessions) consisted of two modules: 1) neurocognitive remediation (twelve 45 min sessions), 2) social cognition (twelve 45 min sessions).

    Neurocognitive remediation is a cognitive rehabilitation therapy designed to improve neurocognitive abilities such as attention, working memory, cognitive flexibility, and executive functioning. Training material uses existing computer tasks of the software Cogpack Professional (version 5.9; 6.0 j). This program is often used for cognitive rehabilitation in patients with brain injuries.

    Social cognitive training - the first six sessions of social cognitive remediation are designed to improve emotion and social perception. They involve identifying six basic emotions, non-verbal gestures of emotion, and the relationship between emotion, thought and behavior. They also incorporate understanding others emotions in different social settings through photos, dynamic film clips and computerized exercises. The latter six sessions focus on improving theory of mind and social attribution (integrating various social cues to make correct inferences about others mental states, such as sarcasm, humor, or deception etc.).

    40 inpatients will be randomly assigned to a new training (n=20) or a time-matched control condition (treatment as usual TAU, n=20), and will complete pre-and post- neuropsychological assessments. Patients with unilateral thalamic infarction in the territory of the (1) tuberothalamic artery, (2) paramedian artery, (3) inferolateral artery, or (4) posterior choroidal artery, and healthy volunteers will participate in the study.

    Furthermore, the investigators aim to show that combining the fMRI and lesion approaches can help reveal the source of functional modulatory influences between distant but interconnected brain regions. Functional magnetic resonance imaging will be used in to determine whether patients present with functional brain abnormalities and to evaluate how the brain attempts to repair itself through neuroplasticity process with and without training intervention. 30 subjects with unilateral thalamic lesions (15 patients on TAU and 15 on new training program) will undergo three fMRI experiments during two experimental sessions: 1) 2-3 weeks after lesion onset, and 2) after 4 months of treatment. 15 healthy controls will undergo three fMRI experiments once.

    Thus, neuroimaging research applying innovative neuropsychological experiments and novel therapeutic approaches will lead towards development of shared comprehensive diagnostic resources and technologies to increase our understanding about diagnosis, treatment and prognosis of thalamic lesions. The outcome of this multi-disciplinary work will be the integration of up-to-date knowledge about the involvement of the thalamus in key emotional and cognitive processes in the context of efficacy and effectiveness of newly implemented therapy scaffolding on our emerging understanding of neuroplasticity. Additionally, structural and functional connectivity analyses will contribute to our understanding of brain inter-regional associations and how they are impacted by specific thalamic lesions.

    The project will enable the applicants and people from neuroimaging Centers in Poland, to participate, abroad and in Poland, in regular teaching and research seminars in fMRI performed by experts. In addition, we hope that invited experts will attend induction seminars and other teaching events in computer and neuroimaging. They will learn under supervision, how to acquire MRI data; to archive scans; to transfer data for analysis; to carry out sophisticated fMRI analyses, including functional connectivity analysis, and to map activation onto a standard structural template of the human brain. On completion of the study the participants will continue to review and design future projects. In the present project research work plan involves:
  • development of innovative and comprehensive techniques and methods that will increase quality of diagnosis and accuracy of imaging brain structure and function;
  • building collaborative national and international network, which will integrate the research capabilities of a group of research institutes and university departments to provide an infrastructure for the highest quality research in brain disorders;
  • application of innovative methods, which can then be standardized, aimed at improving efficacy and effectiveness of thalamic lesion therapy and relevant rehabilitation programs;
  • exchange of scientific information to be used by the researchers in- and outside the network;
  • training programs of PhD-students, who will influence the future of neuroscience in Europe;
  • "translational research" - getting research into the clinical culture and promoting "evidence based medicine";
  • publications in peer-reviewed journals,
  • Ph.D. thesis