A chat with the expert: Claudio Städler

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The third "Chat with the expert" is scheduled for Saturday, 11 January 2020 at L’Ideatorio, Cadro. The Journey into the complex world that is our brain will bring the audience into the field of neurology with Dr.med Claudio Städler, Head Physician of the Clinic of Neurology, at Neurocentro della Svizzera Italiana (EOC). "When the brain falls ill" is the title of the informal chat proposed by the neurologist, which will be held in Italian.

Unfortunately, there are many diseases that affect the brain and all of them are caused by different factors: "the most frequent are vascular diseases (heart attacks and brain haemorrhages), neurodegenerative diseases (among which the most frequent is Alzheimer’s disease), inflammatory diseases (such as Multiple Sclerosis) and brain tumors," explains Städler. The neurologist’s first step is therefore to identify the pathology, its severity and personal and social implications. But what happens in our brain when it is affected by a neurodegenerative disease? "For such diseases there is often an anomaly in the structure of specific proteins that play an important role in the functioning of neurons or glial brain cells. This, in a cascade mechanism, generally slow and insidious, leads to brain dysfunction and therefore to the appearance of neurological symptoms. Unfortunately, in most cases, when the patient shows the first signs of disease, this degenerative process is already well advanced and it is impossible to arrest it, at least at the current state of knowledge," explains Städler.

Städler earned his doctorate in medicine from the University of Basel in 1988 and was awarded a Swiss specialist title in neurology in 1996. His interest in this field stems from clinical practice: "I worked in the Neurology Service, then directed by a great clinical neurologist, Dr. Carlo Tosi, as part of my training in internal medicine - says Städler - I realised that understanding the origin of a disease in neurological patients, studying their pathophysiological processes and treating them in the acute and chronic phase, was very interesting and stimulating for me". He then decided to undertake training in this field in Lausanne and then in Paris, focusing above all on cerebrovascular and neurodegenerative diseases, in particular in Parkinson’s. Since 2012 he has been head of the Neurology Clinic of the Neurocentro della Svizzera italiana , a multi-disciplinary entity that deals with very diverse fields. "As for Neurology - continues Städler - in order to ensure both clinical and scientific quality, we decided to focus on certain diseases, such as cerebrovascular diseases, movement disorders, neurodegenerative diseases (especially Parkinson’s, Alzheimer’s dementia, vascular dementia and other diseases that involve neuropsychological disorders), Multiple Sclerosis (and other neuroinflammatory diseases) up to sleep disorders and epilepsy.

In the previous chat, Luca Gambardella talked about artificial intelligence (AI): what role does AI play in understanding complex diseases? The relationship between AI and Neuroscience, and its ethical implications, will be discussed during Brain Week 2020, organised by Neurocentro della Svizzera italiana in collaboration with USI L’Ideatorio: "It is now difficult to predict if and when in our clinical activity we will be assisted by robots. Certainly it is no longer science fiction and these issues are also discussed in magazines dedicated to general practice - says Städler - It will be something that will change the way we work, but I’m sure that patients will always need doctors in the flesh and a human medicine in the true sense of the term".

Emiliano Albanese spoke about the important role played by public health in prevention and the personal relationship that should be established with the patient. Such reflections are also true for many neurological diseases. "If we talk about prevention, it is important to move between a general social dimension, and the daily reality of taking care of the patient, in which the personal relationship remains essential". The key word is precisely "relationship", a key element in the therapeutic process, in addition to the technological equipment that evolves rapidly: "we never cure and we will never cure diseases, but sick people" concludes Städler.