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Brain Sciences
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Assessment and Rehabilitation of Cognitive Function in Neurological Disorders
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Assessment and Rehabilitation of Cognitive Function in Neurological Disorders

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: 10 September 2026 | Viewed by 3871

Special Issue Editor

Dr. Gilles Naeije

E-Mail Website
Guest Editor
Neurology Department, HUB-Hôpital Erasme, Brussels, Belgium
Interests: functional connectivity; stroke; cerebellar ataxia

Special Issue Information

Dear Colleagues,

Post-stroke cognitive impairment (PSCI) affects nearly half of stroke survivors, yet the mechanisms that drive it remain elusive. Beyond direct cortical injury, diaschisis—remote functional depression following focal damage—may play a pivotal role. Recent studies have highlighted the contribution of thalamic, hippocampal, and cerebellar diaschisis to PSCI, particularly after anterior circulation stroke, where these regions are structurally intact but disconnected from cortical networks.

Insights from cerebellar ataxias underscore the cognitive role of cerebellar posterior lobes, which co-evolved with the prefrontal cortex and maintain dense anatomical and functional connectivity to executive networks. Lesions involving cerebellar posterior lobes are associated with cognitive impairment and prefrontal diaschisis, while neuromodulation studies begin to target these circuits therapeutically.

We especially welcome translational work bridging diaschisis models with clinical rehabilitation, and studies applying frameworks from neurodegenerative or developmental disorders to cerebrovascular disease.

Dr. Gilles Naeije
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • post-stroke cognitive impairment
  • diaschisis
  • cerebellum
  • cortico-cerebellar connectivity
  • neuromodulation
  • transcranial cerebellar stimulation
  • cognitive rehabilitation
  • functional connectivity

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Published Papers (4 papers)

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Research

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12 pages, 1072 KB  
Article
Peripheral Sensory Stimulation for Long-Term Improvement in Mild Cognitive Decline: A Prospective Interventional Study
by Tom Zhang, Fei Sun, Andre Stang and George Ayoub
Brain Sci. 2026, 16(3), 265; https://doi.org/10.3390/brainsci16030265 - 27 Feb 2026
Viewed by 398
Abstract
Background: Despite recent breakthroughs in pharmacological treatment for Alzheimer’s disease, high costs and the complex procedure to monitor safety have limited access for many patients. Less invasive and more accessible non-pharmacological therapies that support neuroplasticity and slow cognitive decline are needed. Processing Inner [...] Read more.
Background: Despite recent breakthroughs in pharmacological treatment for Alzheimer’s disease, high costs and the complex procedure to monitor safety have limited access for many patients. Less invasive and more accessible non-pharmacological therapies that support neuroplasticity and slow cognitive decline are needed. Processing Inner Strength Toward Actualization (PISTA) stimulation applies structured tactile input to promote cortical–subcortical activation. This study evaluated the long-term effects of PISTA on cognition and pain in older adults with mild cognitive impairment or early dementia. Methods: This single-arm, prospective trial enrolled 100 outpatients aged 47–70 years at outset (50 women, 50 men) with no control group. Participants received clinician-supervised PISTA stimulation three times weekly for 48 months. Each 30 min session delivered rhythmic tactile input calibrated to individual sensory thresholds. Cognitive performance was assessed monthly using the Mini-Mental State Examination (MMSE). Perceived pain was measured monthly with the Numeric Pain Rating Scale. Outcomes were analyzed using ANCOVA, adjusting for age, sex, and baseline cognitive status. Results: Cognitive scores improved significantly across all age strata, with a mean annual MMSE increase of 0.75 points (95% CI: 0.26–1.21; p < 0.0025). Pain intensity decreased in parallel (mean reduction: 0.56 points; 95% CI: 0.34–0.78; p < 0.001). Improvements in cognition and pain were moderately correlated (r = 0.38). The greatest combined benefits occurred in participants aged 55–62 years. No serious adverse events were observed during the 48-month trial. Conclusions: PISTA stimulation produced sustained improvement in cognition and reduced perceived pain, supporting its promising role as a safe, non-invasive adjunct for neurodegenerative cognitive decline. These findings suggest peripheral sensory activation as a promising driver of functional neuroplasticity and warrant verification in randomized, controlled trials. Full article
(This article belongs to the Special Issue Assessment and Rehabilitation of Cognitive Function in Neurological Disorders)
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14 pages, 482 KB  
Article
Targeting Cognition and Behavior Post-Stroke: Combined Emotional Music Stimulation and Virtual Attention Training in a Quasi-Randomized Study
by Rosaria De Luca, Federica Impellizzeri, Francesco Corallo, Andrea Calderone, Rosalia Calapai, Alessio Mirabile, Lilla Bonanno, Maria Grazia Maggio, Angelo Quartarone, Irene Ciancarelli and Rocco Salvatore Calabrò
Brain Sci. 2025, 15(11), 1168; https://doi.org/10.3390/brainsci15111168 - 29 Oct 2025
Viewed by 939
Abstract
Background: Emotionally salient music may enhance attention-focused rehabilitation, yet concurrent music plus virtual-reality programs in chronic stroke are largely untested. We assessed whether personalized emotional music stimulation (EMS) layered onto a standardized virtual reality rehabilitation system (VRRS) augments cognitive, affective, physiological, and [...] Read more.
Background: Emotionally salient music may enhance attention-focused rehabilitation, yet concurrent music plus virtual-reality programs in chronic stroke are largely untested. We assessed whether personalized emotional music stimulation (EMS) layered onto a standardized virtual reality rehabilitation system (VRRS) augments cognitive, affective, physiological, and functional outcomes. Methods: In a quasi-randomized outpatient trial, 20 adults ≥ 6 months post-ischemic stroke were allocated by order of recruitment to VRRS alone (control, n = 10) or VRRS+EMS (experimental, n = 10). Both groups performed 45 min of active VRRS cognitive training (3×/week, 8 weeks), while the EMS group received approximately 60 min sessions including setup and feedback phases. Primary outcomes were cognition and global function; secondary outcomes were intrinsic motivation, depression, anxiety, and heart rate. Non-parametric tests with effect sizes and Δ-scores were used. Results: The experimental group improved across all domains: cognition (median +4.5 points), motivation (median +54 points), depression (median −3.5 points), anxiety (median −4.0 points), heart rate (median −6.35 beats per minute), and disability (median one-grade improvement), each with large effects. The control group showed smaller gains in cognition and motivation and a modest heart-rate reduction, without significant changes in mood or disability. At post-treatment, the music group outperformed controls on cognition, motivation, and disability. Change-score analyses favored the music group for every endpoint. Larger heart-rate reductions correlated with greater improvements in depression (ρ = 0.73, p < 0.001) and anxiety (ρ = 0.58, p = 0.007). Conclusions: Adding personalized emotional music to virtual-reality attention training produced coherent, clinically relevant gains in cognition, mood, motivation, autonomic regulation, and independence compared with virtual reality alone. Full article
(This article belongs to the Special Issue Assessment and Rehabilitation of Cognitive Function in Neurological Disorders)
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26 pages, 2410 KB  
Study Protocol
In-Phase Bilateral Upper Limb Exercises Improve Cognitive and Motor Functions in Progressive Multiple Sclerosis: A Pilot Randomized Controlled Trial
by Dimitris Sokratous, Charalambos Costa Charalambous, Marios Pantzaris, Kyriaki Michailidou and Nikos Konstantinou
Brain Sci. 2026, 16(2), 191; https://doi.org/10.3390/brainsci16020191 - 5 Feb 2026
Viewed by 556
Abstract
Background and Purpose: Progressive multiple sclerosis impairs cognitive and motor functions and reduces quality of life. Complex goal-directed movements are challenging due to cognitive deficits, whereas in-phase bilateral exercises require less attentional demand and cognitive effort. This type of exercise may therefore improve [...] Read more.
Background and Purpose: Progressive multiple sclerosis impairs cognitive and motor functions and reduces quality of life. Complex goal-directed movements are challenging due to cognitive deficits, whereas in-phase bilateral exercises require less attentional demand and cognitive effort. This type of exercise may therefore improve both cognitive and motor functions. Previous studies in people with progressive multiple sclerosis suggested a strong association between cognitive and upper limb functions; however, the effects of in-phase bilateral exercises remain unclear. Objectives: To evaluate the effects of in-phase bilateral upper limb exercise on cognitive processing, motor functions, and quality of life in people with progressive multiple sclerosis. Methods: Twenty participants (11 females, mean age = 55.8 years) were randomized (1:1) to an experimental or active control group for a 12-week intervention. The experimental group performed in-phase bilateral upper limb exercises while the active control group performed conventional exercises. ANOVA was conducted to determine the effect of intervention on information processing speed, motor function, fatigue, and quality of life. Results: Post hoc analyses revealed that the experimental group demonstrated significantly greater improvements than the active control group in information processing speed (t(18) = 8.6, p < 0.05), as well as across all exploratory secondary outcome measures (all p < 0.05). Conclusions: This pilot randomized controlled trial suggests that in-phase bilateral exercises, which demand less cognitive effort than other forms of bilateral coordination, are associated with improvements in information processing speed, motor functions, fatigue, and quality of life in people with progressive multiple sclerosis. Full article
(This article belongs to the Special Issue Assessment and Rehabilitation of Cognitive Function in Neurological Disorders)
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8 pages, 351 KB  
Brief Report
Screening for Post-Stroke Cognitive Impairment in Sub-Saharan Africa: A Good IDEA?
by Fode Abass Cissé, Yannick Fogoum Fogang, Male Dore and Gilles Naeije
Brain Sci. 2025, 15(6), 543; https://doi.org/10.3390/brainsci15060543 - 22 May 2025
Cited by 1 | Viewed by 1567
Abstract
Background: Post-stroke cognitive impairment (PSCI) remains under-recognized in Sub-Saharan Africa (SSA), in part due to the lack of validated cognitive screening tools adapted to low-literacy populations. We aimed to validate the Identification of Dementia in Elderly Africans (IDEA) cognitive screen in SSA and [...] Read more.
Background: Post-stroke cognitive impairment (PSCI) remains under-recognized in Sub-Saharan Africa (SSA), in part due to the lack of validated cognitive screening tools adapted to low-literacy populations. We aimed to validate the Identification of Dementia in Elderly Africans (IDEA) cognitive screen in SSA and assess its utility for detecting PSCI in Guinea and Cameroon. Methods: Normative IDEA scores were derived from a control cohort of healthy older adults in Conakry (Guinea) and Bafoussam (Cameroon). The tool was then applied to consecutive stroke patients from the same hospitals within one month of stroke onset. Demographic, clinical, and vascular risk profiles were collected. Between-group comparisons were performed using Welch’s t-tests and chi-square tests. Results: Among 91 healthy controls (median age: 64), the mean IDEA score was 12 ± 2.4. A cut-off of ≤7 (2 standard deviations below the mean) was defined for cognitive impairment. Among 111 stroke patients (median age: 65; mean NIHSS: 9.9 ± 5.8), the mean IDEA score was 9.6 ± 3.2, and 31 patients (28%) had scores ≤ 7. Stroke patients had significantly higher rates of hypertension and diabetes compared to controls. Conclusions: The IDEA screen appears to be a feasible and effective tool for detecting PSCI in SSA clinical settings. The 28% prevalence of cognitive impairment aligns with data from high-income countries, supporting the broader use of the IDEA to strengthen cognitive care pathways in SSA stroke populations. Full article
(This article belongs to the Special Issue Assessment and Rehabilitation of Cognitive Function in Neurological Disorders)
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