87464 - Semeiotics and Differential Diagnosis in Neuropsychology

Learning outcomes

At the end of the training activity, the student: - has advanced knowledge on the functional anatomy of the central nervous system; - knows the symptoms, clinical signs and neuroanatomical correlates of the main cognitive disorders and their differential diagnosis; - knows the neuropsychological profiles and is able to make a differential diagnosis of different types of cognitive impairment.

Course contents

The course is articulated in 4 modules.

Module 1

This module aims to provide advanced knowledge on the functional anatomy of the central nervous system, and on the etiology and clinical-radiological aspects of the main neurological pathologies relevant for neuropsychological semeiotics and diagnosis. The module will cover the following topics:

1) Functional neuroanatomy of cerebral hemispheres, diencephalon and basal ganglia, brain stem (midbrain, pons and medulla), cerebellum and spinal cord;

2) Localization of major cortical and subcortical nervous structures, in horizontal, sagittal and coronal sections of the brain, and in MRI and CT images;

3) Main etiologies, and clinical-radiological aspects of neurological diseases associated with neuropsychological disorders.

Module 2, 3 and 4

The modules 2-4 aim to provide knowledge on the cognitive mechanisms, neural bases, and neuropsychological disorders affecting various cognitive processes, including:

• Attention

• Executive control

• Perception

• Memory

• Imagination

• Emotion

• Movement

• Consciousness

• Language

For each cognitive domain, we will cover the relevant theoretical models and the main mechanisms of impairment, with particular emphasis on the clinical presentation and the diagnostic elements of the various cognitive disorders (symptoms reported by the patient, clinical signs detectable by collection of anamnestic and data and the results in neuropsychological tests) and on the differential diagnosis between cognitive disorders.

Readings/Bibliography

For Module 1 the materials and slides provided by the professor and, optional, the textbook: Sobotta Atlas of Human Anatomy, Vol. 3, 15th ed., English/Latin: Head, Neck and Neuroanatomy. Authors: Friedrich Paulsen & Jens Waschke. Publisher: Urban & Fischer, Elsevier; 15th edition (2013).

For Module 2-4, the materials and slides provided by the professors, and, as a support for learning, the textbook: Denes, Pizzamiglio, Guariglia, Cappa, Grossi, Luzzatti (2019) Handbook of Neuropsychology. Bologna, Zanichelli.

Teaching methods

Lectures, presentation of scientific articles, discussion of cases, practical exercises.

Assessment methods

Learning will be assessed through a final exam testing the acquisition of the expected knowledge through performance of two written tests, relating to Module 1 and Module 2-4, respectively.

Module 1
There will be a written test lasting 30 minutes. The test consists in naming brain regions and structures and identifying pathological pictures in CT and MRI images on 10 anatomical tables of the central nervous system.

Module 2-4
There will be a written test lasting 1 hour and consisting of 3 open-ended questions (1 question for each of the Module 2, 3 and 4, respectively). This test will help evaluate both the students’ theoretical knowledge and ability to reason on a clinical case in order to formulate a possible diagnosis starting from anamnestic and/or lesion data.

Partial exam

Students can take a partial exam relating to Module 1 (functional neuroanatomy) immediately before the end of the course, approximately in May 2024. The grade in the partial exam will be added to that relating to Module 2-4 which will be acquired in one of the official exam sessions.

At each session it is still possible to take the total exam (Module 1 + Module 2-4).

Evaluation criteria

Module 1: 1 point for each of the 10 correctly named anatomical tables; the vote will be expressed on a scale of 0 to 10 points. A score of 6/10 is considered sufficient.

Module 2-4: the written exam will evaluate the students’ theoretical knowledge of cognitive functions and their impairment, and the ability to analyse individual cases that require interpretation and differential diagnosis of cognitive disorders. In assigning the score, the degree of knowledge of both areas (theoretical and applied) is considered. The mark of this second part will be expressed on a scale of 0 to 20 points. A score of 12/20 is considered sufficient.

The final evaluation grade will be determined by the sum of the scores at the two tests, assuming that both are sufficient. If at least one is insufficient, the student will have to repeat the exam entirely.

To take the exam, registration via the Almaesami application is required, in observance of the established deadlines. Those who are unable to enroll due to technical problems by the scheduled date are required to promptly communicate the problem to the teaching secretariat (and in any case before the official closure of the enrollment lists) and send an email to Prof. di Pellegrino. It will be his faculty to admit them to take the test.

Teaching tools

Presentation of slides, neuroanatomical atlases, neuroradiological images, video clips of clinical cases.

Office hours

See the website of Giuseppe Di Pellegrino

See the website of Silvia Gambino

See the website of Maria Angela Molinari