Orsola Gambini, MD Associate Professor (not confirmed) Psychiatry(MED/25) Dipartimento di Scienze della Salute, Università degli Studi di Milano

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1 CURRICULUM VITAE Orsola Gambini, MD Associate Professor (not confirmed) Psychiatry(MED/25) Dipartimento di Scienze della Salute, Università degli Studi di o Address: DMCO room 807 AO San Paolo Via A. di Rudinì 8, o Italy orsola.gambini@unimi.it Date of Birth: January 10, 1957 Languages: Italian (mother language), English and German Education and Training: School of Medicine, (Italy) Resident in Clinical Psychiatry, School of Medicine, University of (Italy) 1985 Training period at Psychophysiology Laboratory, Chief Prof. J. Gruzelier, Charing-Cross Hospital, London (GB) Fellow in Clinical Neurophysiology, School of Medicine, University of Pavia, (Italy) Fellow, Bioethic Institute, H San Raffaele, (Italy) 1994 Training period at the Harvard Medical School and Mc Lean Hospital, Psychology Laboratory, Chief Prof. P. Holzman (USA) Fellow, Course for Health Management (Regione Lombardia, Italy) Awards: 1985 De Visart Grant in Psychiatry and Neurophysiology, C.N.R. Grant for a training period at the Neuropsychological and Neurophysiological Section (Chief. Prof. J. Gruzepier) at the Charing Cross Hospital, London (GB) Qualifications: 1983 Degree in Medicine (mark: 105/110) 1983 Italy License for the practice of Medicine Specialty in Psychiatry (mark: 70/70 with honors) 1994 Psychotherapy, Italian College of Medicine 1991 Specialty in Clinical Neurophysiology (mark: 45/50) 2001 Certificate in Health Management (Regione Lombardia, Italy) Academic, Teaching and Research Appointments Present Academic Position: Associate Professor in Psychiatry (Sept): Researcher in Psychiatry, 2010: Eligible for Associate Professor in Psychiatry (Decreto Rettorale Università degli Studi di Verona) 2011(Oct)-present: Associate Professor in Psychiatry,

2 Positions Held: : Tutor for MD students and residents in Psychiatry, University of 1998-present: Tutor for MD students and residents in Psychiatry, University of : Adjunct Professor, : Adjunct Professor, : Tutor, Dept. of Psychiatry, : consultation and support for thesis preparation present: Supervisor for MD, Nurse and Physical Therapy theses and specialization theses in Psychiatry, : Multicentric research program PRIN 2005 (ex COFIN) (Italy) Schizotassia: epidemiologia e validazione clinica e neuropsicologica : P.I. (Italy) for the FIRST research program Risk Factors for postoperative depression in subjects treated for drug-resistant focal epilepsy 2006-present: co-p.i. (Italy) for the Deep Brain Stimulation of Nucleus Accumbens for severe drug-resistant Obsessive-Compulsive Disorder project 2009-present : P.I. (Italy) for the PUR research program Psychogenic Non Epileptic Seizures, (PNES): Psichiatric, neurologic, neurophysiologic and neuropsychologic evaluation present: Multicentric research program (Europe) for Deep Brain Stimulation for severe, chronic, drug resistant Obsessive-Compulsive Disorder 2010-present: Multicentric research program (Europe) for Deep Brain Stimulation for severe, chronic, drug resistant Major Depressive Disorder : Tutor for residents in Psychology LIST OF COURSES / TEACHING : Practice Oral Exam Supervision MD students, 1997-present: Practice Oral Exam Supervision MD students, University of 2010-present: Practice Oral Exam Supervision Residents in Psychiatry, : Medical Statistics - (Adjunct Professor) Residents in Psychiatry, : Neurobiology of Mental Disorders (Adjunct Professor) Residents in Medical Psychology : Neurobiology of Mental Disorders (Adjunct Professor) Residents in Psychiatry, : Clinical Psychiatry Residents in Child Neuro-Psychiatry, : Neurobiology of Mental Disorders (Adjunct Professor) Residents in Psychiatry, 2006-present: Neurobiology of Mental Disorders Residents in Psychiatry, : Course of Clinical Psychiatry for MD students at the DMCO and ICH sites of the, School of Medicine : Sociology for Physical Therapy students University pf

3 2007-present: Psychiatry for Physical Therapy students 2007-present: Psychiatry for Nurse students : Courses of Clinical Psychiatry for General Practitioners (ECM) and Nurses (ECM) Principal Clinical and Hospital Services Responsibilities Psychiatrist, Dept. of Neuropsychiatry, Military Hospital of Piacenza Clinical Psychiatrist, Dept. of Neuroscience, H. San Raffaele, o; In-patient and outpatient clinic, mainly for subjects with schizophrenia and neuropsychiatric disorders Vice-Head Psychiatrist, Dept. of Neuroscience, H. San Raffaele, ; In-patient and outpatient clinic, mainly for subjects with schizophrenia and HIV neuropsychiatric disorders Clinical Psychiatrist, San Paolo Hospital, ; In-patients clinic and psychiatric emergency service 1997 Vice-Head Psychiatrist, Dept. of Neuroscience, H. San Raffaele, Psychiatrist, San Paolo Hospital, ; In-patient and outpatient clinic, mainly for subjects with schizophrenia and HIV neuropsychiatric disorders Clinical Psychiatrist, USSL 11, AO Ospedale Treviglio Caravaggio ; out patient service, mainly for subjects with schizophrenia and affective disorders Clinical Psychiatrist, San Paolo Hospital, Clinical Psychiatrist at the Casa Circondariale of Opera Vice-Head Psychiatrist, In-patient clinic, San Paolo Hospital, Vice-Head Psychiatrist, Psychiatric Day-Hospital, San Paolo Hospital, Vice-Head Psychiatrist, In-patient and Psychiatric Day-Hospital, San Paolo Hospital, Vice-Head Psychiatrist, Psychiatric Day-Hospital, San Paolo Hospital, 2009-present Vice-Head Psychiatrist, Lieson Psychiatry, San Paolo Hospital, 2007-present Lieson Psychiatry at Istituto Neurologico Besta, Lieson Psychiatry at Istituto Clinico Humanitas, Other Working Experiences Assistant to statistical data analysis at Medinfor - o Academic History 1. Research Endeavors Since 1981, the major research interests have been focused on Psychiatric and Neuropsychiatric Disorders, in different areas of investigations: A) 1981 present: Schizophrenia: neurophysiological, neuropsychological and psychopathology studies B) present: Obsessive-Compulsive Disorders: neurophysiological and neuropsychological studies, Deep Brain Stimulation

4 C) present: Psychiatric and Neuropsychiatric Disorders in Epilepsy D) present: Psychiatric issues in HCV patients A. Schizophrenia A.1 Neuropsychological and Neurophysiological studies. Schizophrenia is an inherited, likely complex genetic disorder and the single best predictor for developing the illness is having an affected first-degree relative. However, most affected individuals lack a family history, leaving open the question of how risk is acquired in such cases. Because the pathophysiology of schizophrenia remains unknown, there are presently no laboratory tests or biological markers definitively related to the illness. Biological markers are disease-specific indicators of the presence or severity of the biological process directly linked to the clinical manifestations and outcome of a particular disorder. Therefore, researches for endophenotypes in patients and first-degree relatives have been done since more than 15 years. Our studies examined neuropsychological and neurophysiological functioning of subjects with schizophrenia and their relatives most with Wisconsin Card Sorting Test and Smooth Pursuit Eye Movements. Our results were mostly consistent with literature hypothesis of deficits in left dorsolateral prefrontal area in schizophrenic subjects. A.2 Psychopathology Many clinical schizophrenic symptoms can be re-interpreted as a disturbance of the self monitoring capacity. Impaired monitoring ability in schizophrenic patients can lead to serious problems in understanding subtle, contextdependent changes in the content and significance of communication. Lack of insight is a common symptom in schizophrenia and can be considered a critical manifestation of impaired Theory of Mind abilities. In our first study on Theory of Mind, we found that the shift from first to third person perspective improved insight into delusions in some subjects with schizophrenia. In a more extended sample, we found that the gain on insight is not dependent on the diagnosis of schizophrenia, but on the severity of delusions in schizophrenia, delusional disorder, psychotic depression and psychotic manic episode. B. Obsessive-Compulsive Disorders: Deep brain stimulation (DBS) became a widely accepted procedure in the nineties, when it was introduced for the treatment of advanced and drugrefractory Parkinson s disease and other primary or symptomatic movement disorders. More recently, DBS has been considered a therapeutic option for severe, chronic, drug resistant obsessive-compulsive disorder. Many data point to a neurobiological basis for OCD: the evidence for a genetic component in its pathogenesis, the differences in brain regional activity detected by neuroimaging between OCD patients and normal subjects, neurophysiological and neuropsychological data, the occurrence of the disease in children after streptococcal infection inducing autoimmunity with subsequent basal ganglia damage. The first protocol in Italy, for DBS of the Nucleus Accumbens in subjects with obsessive-compulsive disorders, begun in A multicentric

5 European study for DBS in Obsessive-Compulsive subjects started in C. Psychiatric and Neuropsychiatric disorders in Epilepsy C. Psychiatric and Neuropsychiatric disorders in Epilepsy are present in high percentage of patients. Our studies address two main topics. The first is to identify risk factors for post-surgical psychiatric disorders in subjects operated on for drug-resistant epilepsy. Post-surgical psychiatric disorders, first of all, depressive disorders, arise in several subjects with good surgery outcome. The identification of risk factors for post-surgical psychiatric disorders, is essential in order to prevent or to cure as early as possible, a psychiatric disorder. The second topic, is the clinical, neurophysiological and neuropsychological evaluation of subjects with Psychogenic Non Epileptic Seizures (PNES). Identification of PNES vs Epilepsy is essential, in order to provide the best treatment programs and in order to avoid un-necessary treatments. D. Psychiatric issues in HCV patients Patients with HCV chronic hepatitis are frequently treated with IFN, which in several cases induces neuropsychiatric adverse effects. Most frequent are depressive syndromes, less frequent are manic like reactions or acute confusional states. Therapeutic approaches to neuropsychiatric symptoms and syndromes induced by INF, include therapies of acute clinical pictures and prevention of depressive syndromes in subjects who have a personal history for depression. Referee per: The Journal of Headache and Pain Therapeutic Advances in Neurological Disorders BMC Psychiatry European Journal of Neurology Seizure Journal of Neuroscience in Rural Practice General Hospital Psychiatry