Program Manager: Luana Salerno ― Psychologist
The diagnostic procedure structured by the Istituto di Neuroscienze for the evaluation of Autism Spectrum Disorders involves an integrated analysis of data obtained through:
Specialist Psychiatric Examination
Specific Psychodiagnostic Evaluation
Microbiota Assessment and organization of the Gut Screening
As experts in the field of Autism Spectrum Disorders, we provide our patients and their families with the most up-to-date diagnostic information to help them understand the patient's strengths and needs.
In accordance with our philosophy that supports the need for personalized medicine, great importance is placed on the assessment process, which includes cutting-edge diagnostic testing and also consideration of the immune profile, brain inflammation status, and microbiome.
At Dr. Stefano Pallanti's Istituto di Neuroscienze, the treatment intake for Autism Spectrum Disorders follows a multimodal and multidisciplinary approach that includes:
Neuromodulation Therapy: EEG-guided TMS and tDCS;
Verbal and augmentative communication treatment;
Mentalization-based Group Psychotherapy: mixed online and in-person meetings for 4-6 subjects led by Dr. Gilla Cauli;
Social skills and emotion recognition programs;
Family support service;
Psychoeducation to patient and family members;
Psychological support to patient and family members.
Guided by evidence from scientific research, our clinical programs our patients with the most innovative therapies available. Consistent with our goal of individualized psychiatry, the presence of one or more comorbid disorders may guide the selection of treatment options, but interventions are alwayscombined according to individual needs.
A personalized approach
Autism Spectrum Disorders are conditions that severely reduce the quality of life of those with the condition and result in a significant workload and financial burden for families. To promote continuity of care and to meet the needs of our patients and their families, at the Istituto di Neuroscienze we use novel treatments that can be easily integrated into patients' daily lives: these include remote care (tele-mental health) offered via web platforms and the use of special tools that allow patients to be treated directly at home, under the supervision of clinicians who supervise them remotely. This can reduce travel and living expenses while, at the same time, increasing treatment compliance.
Transcranial Magnetic Stimulation
Psychiatric and neurodevelopmental disorders are brain circuit disorders, and neuromodulation techniques are privileged tools to act on them. Transcranial Magnetic Stimulation (TMS) is a noninvasive treatment method that allows to reach brain cortical areas of interest to modify their electrical activity in order to be able to reduce symptomatology and promote neuronal plasticity. The use of repetitive TMS (rTMS) has received approval from the Food and Drug Administration (FDA) for the treatment of drug-resistant forms of major depression, but the latest scientific evidence agrees on the effectiveness of TMS with autistic subjects.
There is a particular Transcranial Magnetic Stimulation protocol, called Theta Burst (TBS), which enables shorter times for each therapy session and induces long-lasting clinical effects.
Transcranial Direct-Current Stimulation (tDCS)
There is another neuromodulation technique that has shown to be effective in producing improvement in autistic symptomatology and associated problems. It is called Transcranial Direct Current Stimulation (tDCS), which uses weak electrical currents (1 mA or 2 mA) that that pass through the scalp going to enhance intra- and inter-hemispheric connectivity. During the treatment session, the patient wears a practical headset and experiences mild itching, which tends to gradually fade and be present only when the stimulation device is turned on and off.
Since Autism Spectrum Disorders have been recognized as disorders characterized by impaired neural connectivity, tDCS emerges as a tool with excellent treatment potential. The tDCS treatment protocol involving electrical stimulation on the dorsolateral prefrontal cortex (DLPFC) has been shown to result in improved autistic symptoms and syntax acquisition, while applied on the temporo-parietal junction (TPJ), considered the key region of the social brain, has been shown to improve cognition and social interaction.
At the Istituto di Neuroscienze, we are also equipped with special equipment that allows patients to perform tDCS at home, after appropriate training at our center and under clinical supervision, carried out remotely via web platform during the neuromodulation session.
Vagus Nerve Stimulation
This technique enables lower travel and accommodation costs, and encourages greater treatment compliance while increasing treatment benefits due to the cumulative effect of stimulation.
Transcranial Magnetic Stimulation (TMS)
The different types of Transcranial Magnetic Stimulation (TMS) represent non-invasive and non-pharmacological therapies that use magnetic field to stimulate or inhibit specific brain areas, proving to be highly effective for the treatment of many disorders, including Resistant Depression and Obsessive-Compulsive Disorder (OCD).
Transcranial Direct-Current Stimulation (tDCS)
tDCS is a completely painless neuromodulation therapy that is particularly suitable for children because of the high degree of freedom of movement it allows, used in numerous treatment and rehabilitation settings.
Non-invasive Vagus Nerve Stimulation (VNS)
Non-invasive Vagus Nerve Stimulation (VNS) activates the nerve that connects several neurophysiological pathways that regulate neuroinflammation processes, enabling the improvement of essential body functions.
Oxytocin and Autism Spectrum Disorders
Oxytocin is a hormone involved in the brain mechanisms that enable social bonding that has proven to produce beneficial effects in people with Autism Spectrum Disorders. It can be administered as a nasal spray and has been shown to improve social interaction. In addition, by acting to decrease nerve signaling in the amygdala (the emotional brain), it reduces anxiety and apprehension by promoting easier social communication.
Oxytocin treatment can be accessed at the Istituto di Neuroscienze. No adverse effects have ever been reported.
Social cognition and emotion recognition training
Since an impaired processing of emotions negatively affects social interaction and communication skills – abilities that are severely impaired in Autism Spectrum Disorders – we have developed special emotion recognition software that is used during neuromodulation sessions. By using the software during neuromodulation therapies and participating in group and/or individual sessions, faster improvement in these areas is possible, thus promoting greater adaptation by the individual to the social environment.
Music Therapy and Autism Spectrum Disorders
Music therapy is known to reduce anxiety, social isolation, alleviate frustration, and there is scientific evidence to support a beneficial effect on both verbal and nonverbal communication skills.
At Dr. Pallanti's Istituto di Neuroscienze, we dispose of a special pillow that allows one to listen to music pieces specifically designed to elicit particular emotions and feelings, which can be shared with the psychologist assisting during the session. This particular method makes it possible for the patient to relax and at the same time promotes a reduction in repetitive behavior and the development of expressive skills and creativity.
The special listening experience allows the clinician to guide the exploration of emotions and feelings and the condivision of emotional experience.