Neurological Clinic - NeuroMet Metropolitan Network

NeuroMet is an integrated network of skills and care offerings led by the ISNB and belonging to different structures operating within the metropolitan area of Bologna. Established in 2018 by mandate of the General Directorates of the Bologna USL and Sant'Orsola Hospital, and with the approval of the University of Bologna, the network aims to provide an adequate response to the citizens of the area of competence who present neurological diseases, both in emerging-urgent activities and in chronic conditions, through an integrated action between specialist centres of II and III level, between hospital and territory neurologists and General Practitioners, in the logic of PDTA, networks and the definition of the most appropriate settings.

Care activities

Bellaria Hospital Headquarters

- neurological consultancy in emergencies, inpatient and day hospital settings

- clinics oriented towards areas of excellence:

• The Centre for the Study and Treatment of Headaches and Facial Pain is concerned with the diagnosis of primary and secondary headaches by defining Diagnostic-Therapeutic Pathways and proposing personalised conventional, unconventional, advanced (botulinum toxin, neurostimulation of the great occipital nerve) and innovative (monoclonal antibodies, infiltration of the great occipital nerve) therapies for primary and secondary headaches. Particular attention is also paid to patients with high-frequency headaches or rare forms with high diagnostic complexity.
• The Movement Disorders Centre is dedicated to the diagnosis and treatment of Parkinson's disease, Parkinson's syndromes (in particular Multisystem Atrophy, Progressive Supranuclear Palsy, Cortico-Basal Syndrome, Normotensive Hydrocephalus), dystonias, tremors, chorea and tics. The Centre specialises in the differential diagnosis of the various Parkinsonian syndromes and in the specific treatment of early and advanced stages through collaboration with other Centres of the Institute for the proposal of individualised therapies. It is a Reference Centre for the individualised treatment of motor and non-motor symptoms in the early stages and for advanced therapies in Parkinson's disease (botulinum toxin, implantation of neurostimulators, infusion therapies). Doctors participate in international studies on experimental therapies for Parkinson's disease and other movement disorders.
• The Dysautonomia and Syncope Outpatient Clinic is a national reference point for the diagnosis and treatment of alterations in the vegetative nervous system and circadian rhythms, with particular emphasis on the study of neurodegenerative diseases and rare neurological diseases. It plays a key role in the diagnostic and therapeutic process for forms of transient loss of consciousness.
• The Centre for the Study and Treatment of Sleep Disorders is dedicated to the study and treatment of behavioural, motor and respiratory disorders during sleep. The Centre carries out examinations and interviews with patients, and administers questionnaires, rating scales and sleep diaries for diagnosis and treatment. Patients also undergo daytime and night-time polysomnographic examinations with video-monitoring, as well as dynamic-ambulatory examinations with portable instruments (complete dynamic polysomnographies, cardio-respiratory monitoring, actigraphs, pulse oximetry).

- laboratories:

• The Laboratory for Functional Exploration of the Vegetative Nervous System is a national reference for the diagnosis and treatment of alterations in the vegetative nervous system and circadian rhythms. It plays a key role in the diagnostic and therapeutic process for forms of transient loss of consciousness.
• Polysomnography laboratory dedicated to the study of behavioural, motor and respiratory disorders during sleep by means of nocturnal videopolysomnographic recordings under the supervision of a neurophysiopathology technician and/or 24/48-hour dynamic home recordings. In the same laboratory, daytime polygraphic recordings are also performed for the neurophysiological characterisation of movement disorders and for the treatment of respiratory disorders during sleep.
  Particular attention is devoted to the study of neurodegenerative and rare neurological diseases.

Headquarters Sant'Orsola Polyclinic

- neurological consultancy in emergencies, ordinary hospitalisation, Day Hospital, Day Service and for patients entering the Emergency Department
- pathology-oriented clinics:

• Movement disorders dedicated to patients suffering from Parkinson's disease and other movement disorders, organised through a multidisciplinary approach and integrated into dedicated clinical pathways
• Cognitive and behavioural disorders, devoted to the diagnosis and treatment of cognitive decline from early stages to dementia, neurodegenerative, cerebrovascular and internal diseases
• Neuromuscular, dedicated to patients suffering from diseases of the Peripheral Nervous System (SNP), neuromuscular junction and muscle, through a multidisciplinary approach in the context of PDTA dedicated to muscle diseases and myasthenia and myastheniform syndromes
• Sleep medicine with particular reference to the study and treatment of obstructive sleep apnoea syndrome (OSAS), articulated through a multidisciplinary approach and dedicated clinical pathways
• Neurovascular, dedicated to all patients diagnosed with TIA who enter the "fast track TIA" PDTA and the PDTA of patients with cerebral stroke, with particular attention to rare, cryptogenic and juvenile conditions and follow-up after acute reperfusion treatment
• Transplant neurology, devoted to the evaluation of liver, kidney and heart transplant candidates for possible contraindications and neurological complications of transplant patients
• Neurology of CAR-T therapy (ChimericAntigen Receptor T cell therapies) in collaboration with the Seragnoli Institute of Haematology, dedicated to the study of predictors, monitoring and treatment of neurological problems related to the use of CAR-Ts
• biotechnology drug and immunoglobulin therapy centre dedicated to the treatment of patients suffering from rare immune-mediated diseases of the Central Nervous System (CNS) and SNPs

- labs

• Laboratory of Electroencephalography, Evoked Potentials and sleep study.
  Electroencephalographic recording in wakefulness or after sleep deprivation with video is dedicated to the study of patients with suspected epilepsy, disturbance of vigilance, and metabolic/atrogenic encephalopathy as well as for the assessment of brain death.
  Evoked potentials are used to study alterations in somatosensory, auditory and visual
  pathways and for prognostic purposes in post-anoxic coma. Polysomnographic
  recordings are aimed at diagnosing sleep disorders. Among respiratory sleep disorders, the laboratory is mainly concerned with the management of OSAS also with autoCPAP.
• Electromyography and electroneurography laboratory dedicated to the study of suspected motor neuron, peripheral nerve, neuromuscular junction or muscle disorders.
• Neuropsychology laboratory dedicated to the assessment of cognitive disorders with specific test batteries for the different functions to be explored and cognitive stimulation/rehabilitation of selected pathologies. It also provides psychological counselling to patients and caregivers.

NeuroMet collaborates with the other centres and laboratories of the Institute to enable an integrated assessment of these pathologies.

Research activities

The Metropolitan Network NeuroMet Neurology Clinic carries out research activities in line with the research objectives of the IRCCS Istituto delle Scienze Neurologiche. It collaborates with researchers of the Department of Biomedical and Neuromotor Sciences (DIBINEM) of the University of Bologna and of other University Departments in the development of research projects and programmes and in the training of students attending lectures and internships for several degree courses and Specialisation Schools.

In addition, it collaborates with national and international research centres and participates in clinical trials for the evaluation of experimental therapies for relevant pathologies.

The research activity of the Movement Disorders Centre is aimed at studying the clinical, diagnostic and therapeutic aspects of these diseases. Particular attention is paid to the study of the predictive, diagnostic and prognostic value of sleep alterations, cardiovascular reflexes, neuropsychological tests, plasma biomarkers and neuroradiological/functional aspects of movement disorders.

The research activity of the Centre for the Study and Treatment of Headache and Facial Pain is aimed at studying the physiopathological and genetic bases of the main forms of primary headache. Particular attention is paid to the study of clinical, psychophysiological, diagnostic and therapeutic aspects of headaches and their chronicity.

The research activity of the Laboratory of Functional Exploration of the Vegetative Nervous System is mainly aimed at studying the vegetative control of the cardiovascular system and the circadian rhythm of blood pressure, heart rate, temperature and the main hormones in neurodegenerative diseases.

The research activity in the field of Sleep Medicine is mainly devoted to the study of behavioural, motor and respiratory disorders during sleep in search of prognostic markers predictive of the evolution of different diseases.

The research activity of the Neuromet office at the Sant'Orsola Hospital in the field of neurovascular pathology is mainly focused on the clinical and prognostic aspects of TIA and related organisational-assistance models.

Research activity related to neuromuscular pathology is mainly devoted to the study and treatment of severe gastrointestinal dysmotility with a focus on MNGIE.
Research in the field of cognitive-behavioural disorders is particularly dedicated to the study of the early stages of dementia, possible predictors and non-pharmacological treatments that could change the course of the disease.

Publications

See the list of the most representative publications of this Unit.

Staff

Bellaria Hospital Headquarters

Prof. Pietro Cortelli, MD, PhD, Neurologist, Full Professor, with integration of care, Director U.O.C. Clinica Neurologica Rete Metropolitana NEUROMET

Dr Federica Provini MD, PhD, Neurologist, Confirmed Researcher with Integration of Care

Dr Giulia Pierangeli MD, PhD, Neurologist, Confirmed Researcher with Integration of Care

Dr. Giovanna Calandra Buonaura MD, PhD, Neurologist, Researcher on fixed-term type b (senior), with integration of assistance

Dr Sabina Cevoli MD, PhD, Neurologist, Medical Officer

Dr. Pietro Guaraldi MD, PhD Neurologist, contracted outpatient specialist

Dr. Valentina Favoni, MD, Neurologist, contracted outpatient specialist

Dr Stefania Alessandra Nassetti MD, PhD, Neurologist, Co.co.Co.

Dr Francesca Baschieri, MD, Neurologist, PhD student

Dr Giulia Giannini MD, Neurologist, PhD student

Dr Luciano Romano, Psychologist, Research Fellow

Dr Luisa Sambati MD, PhD, Neurologist, Research Fellow

Giorgio Barletta, Laboratory Technician

Solieri Laura, Laboratory Technician

Anna Grazia Cecere, Laboratory Technician

Francesco Mignani, Laboratory Technician

Rosalia Cilea, Laboratory Technician

Sant'Orsola Hospital
Dr. Maria Guarino, MD, Neurologist, Medical Director, Head of Simple Neurology Structure - AOU, Policlinico S.Orsola-Malpighi

Dr. Roberto D'Angelo, MD, Neurologist, Medical Director

Dr Marianna Nicodemo, MD, Neurologist, Medical Officer

Dr Susanna Mondini MD, Neurologist, Medical Officer

Dr Rita Rinaldi, MD, Neurologist, Medical Officer

Dr Francesca Rondelli, MD, Neurologist, Medical Officer

Francesco Casano, Neurophysiopathology Technician

Silvia Malservisi, Neurophysiopathology Technician

Maria Rosaria Parente, Neurophysiopathology Technician

Rita Signorelli, Neurophysiopathology Technician

Lino Trentin, Neurophysiopathology Technician

Rossella Santoro, Psychologist, Neuropsychologist

Lucia Cretella, Psychologist, Neuropsychologist