British Society for Clinical Neurophysiology

...to promote and encourage for the public benefit the science and practice of clinical neurophysiology and related sciences

Lecture Details

Invasive and non-Invasive brain Stimulation: novel advances towards the Neuroprotection
Dr Tommaso Bocci

As a neurologist and a clinical neurophysiologist, my activity is mainly focused on the study of bases and mechanisms of action underlying the effects of both invasive (DBS) and non-invasive brain stimulation (NIBS: tDCS, rTMS) techniques, ranging from molecular effects of non-invasive brain stimulation methods, their current distribution and modeling, to the analysis of basal ganglia Local Field Potentials (LFPs) in patients with Parkinson’s Disease (PD) and other movement disorders, searching for novel neurophysiological markers possibly guiding adaptive approaches. I am the Author of 68 peer-reviewed papers, as indexed in Scopus/Web of Science (33 as First/Corresponding Author; H-index = 18; total citations = 976), 10 book chapters and over 100 conference proceedings, presented both at Italian and International congresses (31 of whom accepted as oral presentations).
In particular, recently my research has been devoted to the evaluation of neurophysiological biomarkers underlying the pathogenesis of movement disorders, ranging from Parkinson’s Disease to dystonia, thus supporting the safety and effectiveness of adaptive stimulation compared to traditional cDBS, both in terms of motor performance and side effects, including gait and speech disturbances.

Deep Brain Stimulation (DBS) is a well-known procedure for the treatment of a wide range of neuropsychiatric disorders, comprising advanced Parkinson’s Disease (PD), Dystonias, Alzheimer’s Disease (AD) and Dementias, as well as drug-resistant major depressive disorder and Schizophrenia. A number of anatomical targets have been proposed, strictly depending on the underlying disease and its clinical features. Moreover, novel biomarkers have been recently identified, as the subthalamic (STN) beta oscillations in PD, possibly guiding new adaptive (closed-loop) devices. Nonetheless, whether DBS may exert a neuroprotective and disease-modifying effect, rather than being a purely symptomatic treatment, is still a matter of debate. Pre-clinical data in animals have recently shown that DBS may prevent both the lateral ventricle enlargement and the mal-development of serotoninergic and noradrenergic transmission in psychotic disorders. In AD, studies in rodents have proved that increase of cholinergic neurotransmitters, hippocampal neurogenesis and reduction of amyloid plaques are associated with DBS. Also for non-invasive Brain Stimulation (NIBS) techniques, such as transcranial Direct Current Stimulation (tDCS), a growing body of the literature has recently shown a “neuroprotective” effect, regarding both in vivo and in vitro models. The demonstration of a neuroprotective effect is of key importance for the patients’ selection, as well as for the choice of anatomical targets, and may help to identify novel electrophysiological markers to guide invasive and non-invasive approaches.