Andrea Guzetta

 

Infants at Neurological Risk: Neuroplasticity and Early Intervention
Abstract: During the perinatal period, the nervous system is very vulnerable to insult. At this time, the brain undergoes fast and complex maturational processes such as synaptogenesis, arborization, and apoptosis, and the response to the insult is highly dependent on its exact timing. There is evidence that some of the neuroplastic mechanisms adopted by the young brain after damage are unavailable at a later stage of maturation. This applies, for example, to the reorganization of language, the sensorimotor system, or the visual system.

During the perinatal period, the nervous system is very vulnerable to insult. At this time, the brain undergoes fast and complex maturational processes such as synaptogenesis, arborization, and apoptosis, and the response to the insult is highly dependent on its exact timing. There is evidence that some of the neuroplastic mechanisms adopted by the young brain after damage are unavailable at a later stage of maturation. This applies, for example, to the reorganization of language, the sensorimotor system, or the visual system. Expanding our knowledge on these mechanisms could help the development of early therapeutic interventions aimed at supporting and enhancing functional reorganization at a time of greatest potential brain plasticity.

Dr Andrea Guzzetta Biography
i) I obtained my PhD in Basic and Developmental Neuroscience at the University of Pisa, in 2005, with a thesis entitled: "Development of the human nervous system after early brain damage: maturation and integration of motor and visuo-perceptual functions”.

ii) In the 4 years since completing my PhD I have maintained a full time position as a researcher at the Department of Developmental Neuroscience of the Stella Maris Scientific Institute in Pisa. The Stella Maris hosts Italy’s largest child neurology units with the largest register of patients with congenital brain damage in the country. During my experience as a researcher at the Institute, I have also undertaken study leaves for overall more that 20 months, to perform compound training experiences in some of the most productive European centres in the field, including the Hammersmith Hospital and the Visual Development Unit in London (Great Britain) and the Department of Child Neurology in Tuebingen (Germany).

iii) In the last two years I’ve held a scholarship from the Queensland Cerebral Palsy Research and Rehabilitation Center (QCPRRC), to work full-time research as a Senior Research Fellow at the University of Queensland for 18 months. From the end of 2010 I returned to my position at the Stella Maris Institute in Italy where my activity will be 50% research and 50% clinical work as a child neurologist.

iv) My involvement in the research environment of the Stella Maris Institute, includes being responsible for the Laboratory of Child Neuro-ophthalmology, for the Laboratory of Infant Electrophysiology and head of the clinicians part of of the Laboratory of Neuroimaging. This latter role will be further developed from January 2011, when the Institute will complete the installation of a high-field 7-Tesla magnetic resonance centre, one of the very few in Europe, capable of high-resolution functional imaging.

Research activity and impact in field
Dr Guzzetta main research has focused on the effects of early brain damage on the development of different functions and the underlying neuroplastic mechanisms, with the final aim to improve early intervention paradigms and outcomes. In his still relatively short research career he has provided some significant contribution to a number of research questions in the area, thanks to his compound training experiences in some of the most productive European centres in the field, including the Hammersmith Hospital and the Visual Development Unit in London (Great Britain) and the Department of Child Neurology in Tuebingen (Germany).

His major scientific contributions have been achieved in the following areas.
1. Early prediction of functional outcome in infants with brain damage using neonatal brain imaging.

2. The early assessment of visual functions and diagnosis of cerebral visual impairment.

3. The early neurological assessment in infants at neurological risk.

4. Brain plasticity in congenital lesions.

5. The effect of neurodevelopmental interventions on brain maturation.


Dr. Guzzetta current research focus builds upon these contributions, and includes:

- Advanced brain imaging focused on the study of structural differences in brain reorganization between subjects with congenital brain damage and those with acquired lesions (e.g. DTI, cortical connectivity, etc.). A better understanding of causal pathways to functional impairment is essential for improving early therapies.

- New early interventions, based on the stimulation of the mirror neuron system to activate the motor cortex and thus influence the pattern of cortical reorganization. The theory of mirror neurons can have the power to revolutionize the field of early motor rehabilitation, although the field is still completely unexplored.

- New early interventions, based on the environmental enrichment of preterm born infants. Reducing the risk for neurodevelopmental complications of preterm birth might have enormous social and economical positive consequences.

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