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2023 has been an essential year for the BBHI team. Researchers Maria Redondo, Selma Delgado and María Cabello have defended their doctoral theses, developed within the framework of the initiative and culminating a process that will provide key knowledge for a better understanding of the mechanisms that contribute to a better brain health.

Guttmann Barcelona physiotherapist Maria Redondo Camós defended her thesis in June, entitled Biomarkers of brain health measured with transcranial magnetic stimulation combined with electroencephalography and electromyography and directed by physician Josep Maria Tormos and BBHI principal investigator and professor at the Faculty of Medicine and Health Sciences of the University of Barcelona, David Bartrés-Faz. Bartrés-Faz highlighted the "complexity" of the work, both in terms of the subject of the study and the exhaustive work of collecting the data.

The main objective of the thesis was to characterise new markers of brain health through the application of Transcranial Magnetic Stimulation (TMS) in the prefrontal and motor cortex, and to improve knowledge of the mechanisms of cognition in the healthy adult population.

The results would provide a better understanding of the link between neurophysiology and cognition and could be potential targets for the development of interventions to help monitor or maintain brain health and thus cognitive function. If these markers, which are much more sensitive than those obtained by classical tests, reveal changes, programmes that modulate brain activity using TMS or other neuromodulatory tools could be suggested to reverse these changes.

Brain health and chronic pain

Selma Delgado, a physiotherapist at the Guttmann Barcelona Institute for Brain Health and Neurorehabilitation, defended in September the thesis Cognitive, emotional and neurobiological aspects in the perception of chronic pain, directed by the Institut Guttmann psychologist Dolors Soler and BBHI researcher Gabriele Cattaneo. The latter highlighted the exhaustive data collection, the complexity of the field of research and the PhD student enthusiasm in the development of the work.

Dr. Delgado's thesis offers an innovative contribution on brain, cognitive and emotional functioning in chronic pain patients aged between 40 and 65. Specifically, she analyses the mechanisms of pain functioning, especially how it is perceived, processed and modulated at brain level, and the role played by emotional and cognitive aspects in these stages. Factors such as resilience or cognitive reserve, which promote more effective brain functioning in times of difficulty, could play a key role in helping to break the vicious circle of pain.

Mechanisms of brain resilience

Finally, health engineer specialising in bioinformatics and researcher at the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) María Cabello defended her thesis Brain mechanisms and psychological determinants of resilience in mental health in November. Learning from the COVID-19 pandemic.

The study aimed to study the emotional, social and psychological changes in a healthy adult population in the context of the Covid-19 pandemic, with a special focus on understanding the factors that characterise the most resilient individuals in stressful situations. In general terms, the thesis has identified at-risk populations (individuals living alone, women or young adults) and factors to be promoted to protect them (coping strategies or healthy living habits that promote general and cognitive health). The role of the balance between how different brain networks interconnect and work has also been identified for the first time, which makes a person more or less resilient to a stressor. All this reveals the need to take into account psychological, lifestyle and socio-demographic factors, together with brain mechanisms and with a particular emphasis on their interactions, to fully understand the phenomena of resilience and vulnerability and thus to enhance more effective interventions.