Daria Riva

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Italy

 

Biography

Daria Riva, MD is presently the Scientific Director of the Foundation Together to go of Milan, devoted to the rehabilitation of children with complex neurological diseases.

She is a member of the Scientific Committee of the Mariani Foundation for Child Neurology in Milan and is responsible for the Developmental Cognitive Neuroscience Courses and its related books.

Dr. Riva teaches Cognitive Neurology at the Specialization School of Child Neuropsychiatry at the University of Milan/Medical School and at the University of Pavia/Medical School.

She graduated in Medicine and Surgery at the University of Milan/Medical School (1973), obtained the specialization in Child Neuropsychiatry at the same University (1976) and in Adult Neurology at the University of Parma (1978). He spent a period of fellowship at the Neuropsychology Laboratory headed by Rita Rudell (Department of Child Neurology, directed by D. De Vivo) at Columbia University in New York (1983).

From 1980 to 2016 she worked at the Clinical/Scientific Foundation of Carlo Besta Neurological Institute in Milan. From 2000 to 2016 she was the head of the Developmental Neurology Division and from 2010 to 2016 she was the head of the Pediatric Neuroscience Department. She has developed research activity and has published extensively in the areas of child neurology and developmental cognitive neuroscience.

In 1990, she organized a clinical and research laboratory focused on the cognitive and neuropsychological evaluation of children with different types of neurological diseases (neurodevelopmental disorders, tumors, epilepsy, neurodegenerative diseases etc.) and on the definition of appropriate functional evaluation methods (dichotic listening, transcranial eco doppler etc.).

Particularly in the context of neuro-oncology, she introduced the criterion that the longitudinal cognitive and neuropsychological assessment of these patients should be considered as a key parameter in the treatment definition together with the other clinical, radiological and histological parameters and should be fully entered into the remodeling of the chemo and radiological protocols and guide neuropsychological rehabilitation.

 

Conference Presentation

Keynote Lecture: Long-Term Neurocognitive Outcome in Children with Brain Tumors 

As survival rates among children treated for brain tumours continue to improve, ever greater interest is being focused on the long-term effects of cancer treatment. Brain tumors represent the second most common cancers in children and can have significant physical, behavioral, cognitive, and psychosocial long-term effects on children’s quality of life.

Specifically, neurocognitive and neuropsychological outcome decline has been associated to 3 types of risk variables which are of course intrinsically linked.

Developmental variables concerning the patient’s chronological age and his developmental level, measured both at the time of diagnosis/treatment and at the time of the final outcome.

Biological variables involve the presence of hydrocephalus, the brain tumour anatomical localization, the type of surgical procedure and the effects of adjuvant treatments such as chemotherapy and/or different type of cranial radiotherapy.

The third set of variables is linked to cognitive reserve and to rehabilitation. Cognitive reserve refers to the brain’s capability to enhance performance or to compensate the effect of brain damage; this explains the observed disparity between the degree of brain pathology or damage and its clinical manifestation. Cognitive reserve seems to reflect the individual’s pre-illness cognitive capacity, genetics, and educational background.

A rehabilitation approach that is multi-faceted, and structured considering all the risk variables mentioned above is highly recommended for both motor impairments and for cognitive and social disorders, despite it is not much implemented so far. Ecological and environmental interventions involving the patient’s family context and at times psychotherapeutic counseling should also be considered; however, these types of interventions are again scarcely used, and little is known about whether and how intervention can improve the cognitive morbidity of brain tumors and their treatment.
From the methodological point of view multidisciplinary examinations by specialists over a long follow-up period taking into consideration the variables cited are recommended. Furthermore, these follow-up assessments should be considered in the remodeling of treatment protocols as well as in guiding rehabilitation programs.

 

 

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