Search Results (118)

Introduction: Cognitive dysfunction (“brain fog”) is a common manifestation of post-acute COVID-19 syndrome (PACS) and may persist long after the acute infection. While cross-sectional studies have described cognitive deficits, longitudinal evidence on recovery trajectories remains limited. Methods: We conducted a longitudinal observational study of neurocognitive performance and neuropsychiatric symptoms in patients with PACS. Participants underwent assessment with 20 standardized tests covering five cognitive domains (memory, attention, language, executive functions, psychomotor processing speed); anxiety, depression, and sleep quality were assessed at three time points. Changes were analysed using the Friedman test. Results: Forty-two patients were included (median age 57 years; 35.7% female) from a predominantly hospitalized cohort (81% hospitalised; 66.7% requiring respiratory support). Patients who completed all three assessments (completers, n = 42) were compared with those who attended the first evaluation but did not complete follow-up (non-completers, n = 544); completers were more severely ill during the acute phase rather than healthier or more motivated. At the group level, statistically significant improvements over time were observed across the whole sample in verbal short-term learning, visuospatial memory, working memory, constructional praxis, phonological verbal fluency, and psychomotor processing speed (all p ≤ 0.05); after Benjamini–Hochberg adjustment across the twenty cognitive outcomes, visuospatial span forward and backward and psychomotor processing speed remained significant (all FDR-adjusted p ≤ 0.013), with the change confined to the first six months. Sleep quality also improved (p < 0.0001). Conclusion: In this cohort, group-level performance improved in six of the twenty tests administered, of which three remained significant after correction for multiple comparisons, while 28 of 42 patients (66.7%) still scored in the impaired range on at least one test at 12 months, and 17 (40.5%) on two or more. These findings highlight the importance of long-term neuropsychological monitoring and integrated cognitive-psychiatric evaluation in post-COVID care. Given the small, predominantly hospitalized sample, improvements should be interpreted cautiously and confirmed in larger controlled studies, although the use of alternate forms for part of the battery makes task-specific learning an incomplete explanation. Full article

Background/Objectives: Dementia is a progressive neurocognitive disorder characterized by decline in cognitive, communicative, and functional abilities. Speech and language therapists (SLTs) play a role in managing communication and cognitive–linguistic impairments while supporting families and caregivers. However, evidence regarding the effectiveness of speech and language therapy interventions remains heterogeneous, and evidence has not integrated cognitive–linguistic and caregiver-related outcomes. This systematic review aimed to synthesize recent evidence regarding the effects of speech and language therapy interventions on cognitive–linguistic functioning in individuals with dementia and caregiver-related outcomes. Methods: The review followed PRISMA guidelines. Studies were retrieved from Google Scholar, PubMed, and ScienceDirect using search terms including “speech therapy,” “language therapy,” and “dementia.” Eligible studies included those published within the last ten years that examined speech and language therapy interventions in individuals with dementia and reported cognitive-linguistic and/or caregiver-related outcomes. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Findings were synthesized narratively due to heterogeneity in study designs, interventions, and outcome measures. Twelve studies met the inclusion criteria. Results: The included studies generally reported improvements in cognitive–linguistic and communicative functioning following speech and language therapy interventions. Fewer studies reported performance stabilization, while none reported deterioration. Several studies also reported positive effects on caregiver communication confidence and interaction quality. Conclusions: Speech and language therapy appears to improve cognitive–linguistic functioning and support caregiver communication and engagement. However, the evidence remains limited due to small sample sizes, heterogeneous intervention protocols, and variability in outcome measures, highlighting the need for further high-quality research. Full article

Background/Objectives: Autism spectrum disorder (ASD) is currently singularly described as a behaviourally defined neurodevelopmental diagnosis with symptoms affecting social communication and social understanding alongside the presence of restricted patterns of behaviour. Wide, and often very personal, variations in symptom intensities and differing developmental trajectories, reflective of large heterogeneity, are an important feature of the label. ASD carries enhanced risks for multiple over-represented, sometimes overlapping, comorbidities spanning behavioural, psychiatric and somatic domains. Said comorbidities often have numerous and far-reaching effects on quality of life by way of their impacts and, in extreme cases, their potential effects on life expectancy. It is of paramount importance that data on the risks of such comorbidities are available and, where possible, screening, preventive and/or treatment options implemented. Methods: In this narrative review, the authors searched databases (PubMed/Medline, ScienceDirect, Google Scholar) for papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism. Results: We present data on the frequency of various somatic (gastrointestinal, immunological, metabolic, neurological, motor-sensory disorders), psychiatric (anxiety, mood, schizophrenia spectrum, personality, substance abuse, trauma, feeding and eating, sleeping, self-harm, neurocognitive disorders) and neurodevelopmental comorbidities (intellectual, attentional, speech and language, motor disorders) that can present alongside a diagnosis of ASD. We provide accompanying data on the magnitude of potential risk and, where available, information on comorbidity risks according to sex and age. Conclusions: This review paper deals with an extremely broad field. Limitations of the narrative review strategy are discussed alongside how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations. Full article

Alzheimer’s disease is biologically defined by beta-amyloid and tau pathology, yet the mechanisms through which molecular and network alterations become expressed as the progressive loss of meaningful behaviour remain incompletely understood. This perspective proposes a neurocognitive framework in which apraxia provides a particularly informative clinical window onto the deterioration of functional integration. The model assigns a central organisational role to interhemispheric communication within distributed frontoparietal, temporal, language, memory, and default mode networks. It interprets recognised apraxic syndromes as clinically distinct disturbances that expose complementary requirements of meaningful action, including action knowledge, bodily configuration, sequencing, spatial organisation, object use, fine motor control, and interhemispheric transfer. The framework further examines whether partially convergent impairments of gesture, connected speech, autobiographical construction, and perspective coordination may reflect declining capacity to integrate specialised representations within coherent behaviour. Its original theoretical component proposes that conscious proprioceptive organisation contributes to maintaining body-centred reference frames through which heterogeneous information is coordinated during action and perspective transformation. Evidence for Alzheimer-related connectivity alterations and impairments of praxis, discourse, and autobiographical memory is reviewed separately from the proposed integrative mechanism, which requires direct testing. The framework predicts that longitudinal changes across these behavioural domains will covary with deterioration in interhemispheric and large-scale network connectivity and provide explanatory information beyond global cognitive severity and regional atrophy. Multimodal longitudinal studies combining molecular biomarkers, neuroimaging, apraxia assessment, connected-speech analysis, and autobiographical tasks are proposed to evaluate, delimit, or reject these predictions. Full article

Foreign language reading comprehension is a critical indicator of university students’ academic cognitive ability and global competence, yet effectively assessing their latent learning potential remains a major challenge. Therefore, from a neurocognitive perspective, this study combined functional near-infrared spectroscopy (fNIRS) with dynamic assessment (DA) to investigate the activation characteristics of the left frontal and temporal regions in non-English majors during reading tasks across two difficulty levels (CET-4/CET-6) and two assessment conditions (static/dynamic testing). The results showed that reading tasks activated the dorsolateral prefrontal cortex and middle temporal gyrus. Compared with CET-4, the more difficult CET-6 task showed a broader descriptive cortical activation pattern. Notably, mediated prompts were associated with different behavioral and activation-frequency patterns across task difficulty levels: in the CET-4 task, dynamic assessment showed higher normalized activation-frequency values than static assessment in areas corresponding to the middle and inferior frontal gyrus, accompanied by rising prompt scores; however, the CET-6 task exhibited the opposite pattern. These findings suggest that mediated prompts may be more effective in stimulating learning potential when task difficulty aligns with the learner’s zone of proximal development. Overall, by considering behavioral dynamic-assessment indicators in foreign-language reading together with fNIRS-based cortical activation patterns, this exploratory study offers preliminary insights into learning potential, personalized instructional interventions, and academic cognitive assessment. Full article

Developmental and/or epileptic encephalopathy with spike-wave activation in sleep (D/EE-SWAS), previously described as continuous spike-wave during slow-wave sleep (CSWS) or electrical status epilepticus in sleep (ESES), is a childhood-onset disorder characterized by cognitive, language, behavioral, and/or motor regression or stagnation associated with marked activation of epileptiform discharges during non-rapid eye movement sleep. Three themes are central to the evolving understanding of D/EE-SWAS. First, it is a network disorder in which thalamocortical dysfunction, impaired sleep-dependent synaptic homeostasis, and potentially neuroinflammatory mechanisms contribute to neurodevelopmental deterioration. Second, increasing recognition of its genetic and structural heterogeneity is reshaping diagnostic evaluation. Monogenic etiologies are identified in up to one-third of cases, with a higher yield in the developmental and epileptic encephalopathy subtype, supporting early genomic testing alongside prolonged sleep EEG, MRI, and serial neuropsychological assessment. Third, treatment remains empiric and constrained by limited comparative evidence. Corticosteroids retain the strongest evidence base for cognitive improvement, although the overall certainty of this evidence remains low to moderate. Benzodiazepines are commonly used alternatives, and epilepsy surgery can provide substantial benefit in appropriately selected patients with focal structural abnormalities. Emerging etiology-directed therapies, including L-serine for selected GRIN loss-of-function variants and primidone for TRPM3-related disease, illustrate a broader transition from syndrome-based to precision management. However, no pharmacological therapy is specifically approved for D/EE-SWAS, long-term neurodevelopmental morbidity remains common, and adequately powered trials using standardized EEG and neurocognitive outcomes are urgently needed. Full article

Background and Objectives: The neurocognitive sequelae of COVID-19 have attracted attention as part of post-COVID condition (PCC), yet standardized tools for screening and quantifying PCC-related cognitive impairment remain scarce. The present study aimed to develop and validate the Screening for Neurocognitive Abilities Post-COVID (SNAP-COVID), a self-report questionnaire designed to capture current symptom burden and perceived changes in cognitive functioning relative to pre-COVID status in a Greek-speaking sample. Materials and Methods: Data collection occurred in three phases between August 2024 and February 2025. Dataset A (N = 27) was used for test–retest reliability. Dataset B (N = 300) was used for exploratory factor analysis (EFA), reliability testing, and convergent validity analyses with the Brain Fog Scale (BFS). Dataset C (N = 317) was used for independent validation through confirmatory factor analysis (CFA). Results: Initial EFA of the 30-item SNAP-COVID scale suggested a four-factor model, yet further item refinement yielded a robust three-factor, 24-item solution: (1) General Cognitive Functions (17 items, α = 0.948), (2) Sensory Hypersensitivity (4 items, α = 0.829), and (3) Language and Communication (3 items, α = 0.950). The total scale demonstrated excellent internal consistency (α = 0.95). Convergent validity was evident by significant correlations between SNAP impact scores and BFS scores (r = −0.442, p < 0.001). CFA confirmed the three-factor structure with acceptable fit indices (χ²(249) = 677.29, p < 0.001; CFI = 0.882; TLI = 0.869; RMSEA = 0.074; SRMR = 0.032). Conclusions: The SNAP-COVID scale is a reliable and valid instrument. Its multidimensional structure captures global and domain-specific difficulties, addressing a critical gap in post-infectious cognitive assessment. Full article

Migraine affects over one billion individuals worldwide and is increasingly recognized as a systemic disorder with broad cardiovascular comorbidities extending beyond its neurological profile. Despite growing epidemiological evidence, the intersections of migraine with cardiovascular risk stratification, stroke mechanisms, endothelial dysfunction, neuroimaging findings, and neurocognitive profiles remain incompletely mapped. Following the PRISMA-ScR framework, we searched PubMed/MEDLINE for recent (2015–2025) English-language human studies with large sample sizes (≥400) examining cardiovascular outcomes, vascular biomarkers, neuroimaging, or endothelial function in adult migraine populations. The protocol was preregistered on OSF. Forty-three studies encompassing more than 1,500,000 participants across seven thematic domains were included. Migraine with aura was consistently associated with increased ischemic stroke risk in a non-atherosclerotic pattern, with evidence suggesting potential cardioembolic mechanisms including patent foramen ovale and atrial fibrillation. Active episodic migraine paradoxically showed inverse associations with traditional cardiovascular risk scores, while inflammatory biomarkers such as high-sensitivity C-reactive protein and fibrinogen remained interictally elevated, and white matter hyperintensity burden was substantially higher than controls, though available evidence did not indicate increased dementia risk. Cardiovascular disease may represent a clinically relevant comorbidity of migraine, warranting integrated multidisciplinary management. Future studies should prioritize sex-stratified longitudinal designs with aura-specific risk modeling and cerebral endothelial assessment. Full article

Research on sex-related differences in child and adolescent neurocognitive development has often been framed around whether boys and girls differ and which group performs better. This framing is increasingly inadequate because it treats developmental timing, observable phenotypes, and clinical recognition as interchangeable forms of evidence. Drawing on developmental neuroscience, cognitive development, research on gendered experience, and clinical studies of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), this integrative narrative review proposes a developmental-visibility framework. The framework interprets sex-related differences across three analytically distinct layers: developmental timing, phenotypic expression, and clinical recognition. Developmental timing refers to age-related trajectories, pubertal coupling, maturation tempo, and variability. Phenotypic expression refers to how developmental differences may appear in language, executive function, emotion, and social cognition under specific task and measurement conditions. Clinical recognition refers to how informants, referral thresholds, compensatory or camouflaging behavior, and diagnostic tools influence which difficulties are identified. ASD and ADHD illustrate the clinical-recognition layer because less externally disruptive or more compensated presentations may remain underrecognized despite meaningful developmental burden. The framework helps explain why modest average effects, inconsistent behavioral findings, and unequal clinical recognition can coexist. It shifts the field from asking whether sex-related differences exist to asking when, how, and under what social and clinical conditions they become visible. Full article

Background: Proficient second language (L2) reading relies on complex neurocognitive processes. Neuroimaging studies have identified key brain regions recruited during L2 reading, including the left inferior parietal lobule (LIPL) and the calcarine cortex (CAL). The LIPL has been suggested to be involved in phonological decoding during L2 reading, whereas the CAL has been implicated in early-stage visual processing. However, given the correlational nature of neuroimaging techniques, it remains unclear whether these regions play causal roles in L2 reading or are merely epiphenomenal. Methods: To address this issue, the present study used transcranial magnetic stimulation (TMS) to modulate neural activity in these regions and eye-tracking technology to assess subsequent reading performance in Chinese–English bilinguals. Specifically, ninety-seven participants were randomly assigned to one of three offline TMS conditions: LIPL, CAL or vertex (as a control site) stimulation, after which they performed a natural sentence reading task in English. Results: The results showed that, compared to the control condition, TMS over the LIPL significantly reduced first fixation duration, whereas no significant effects emerged on gaze duration, regression path reading time, or total reading time. TMS over the CAL produced no significant effects on any eye-movement measures. Conclusions: These findings suggest that the LIPL plays a causal role in L2 reading for early-stage lexical processing through phonological decoding. Overall, this study is the first to employ TMS and eye-tracking to investigate the neural mechanisms underlying natural L2 reading. Full article

A growing body of empirical study recognises a tendency for users to form (para)social bonds with Large Language Models, even when users know explicitly that these systems lack interiority or personhood. This contribution argues that such attachments arise from evolved human capacities to attribute being, moral status and, in some ways, ‘soul’ to nonhuman others—and that this capacity now operates without the belief-systems that have historically mediated it. When users encounter helpful, patient, emotionally available behaviour in conversational agents, they project the interior states that would produce those behaviours in themselves: authentic interiority and phenomenal consciousness. Humans have been making such assessments throughout our cultural history, developing ontologies and theologies for managing our relations with nonhuman, mythic and spiritual others. By contrast, modernity has disenchanted its landscapes, dismantling these cultural models even as the ‘ensouling architecture’ of our social and semiotic cognition remained unchanged. Contemporary users thus encounter machine others through the same neurocognitive lens as their ancestors did with spirits and animals on enchanted, animate landscapes, but without the mediation of culture, norm and taboos which place a premium on appropriate conduct, reciprocity and moderation. The resulting condition—a ‘Turing Animism’—leads users to ‘feel soul’ where there is only simulacrum. Full article

Background: Posttraumatic stress disorder (PTSD) in ages 3–18 is associated with disturbances in attention, working memory, processing speed, and executive control, as well as persistent difficulties in affect regulation. These neuropsychological vulnerabilities might interfere with learning, peer relationships, and the consolidation of age-appropriate developmental skills. Methods: We conducted a narrative review informed by a structured literature search in PubMed, Scopus, PsycINFO, Embase, EBSCOhost, Web of Science, and Google Scholar. English-language publications from 1990 to 2025 were considered if they examined (1) neuropsychological outcomes of trauma exposure or PTSD in youth and/or (2) interventions with potential to modify neurocognitive or affective functioning, including trauma-focused cognitive behavioral therapy (TF-CBT), mindfulness-based interventions, cognitive rehabilitation strategies, and biofeedback/neurofeedback. Results: Across study designs, trauma exposure and PTSD in youth are consistently linked to impairments in attentional control and executive functioning, with downstream effects on everyday memory and academic performance. Neurobiological studies commonly implicate altered reactivity within amygdala-centered threat circuits and reduced top-down modulation by prefrontal networks, although findings vary with trauma type, developmental stage, and comorbidity. TF-CBT remains the best-supported intervention for pediatric PTSD symptoms; however, neurocognitive outcomes are measured less frequently. Mindfulness-based programs show promise for strengthening attention and emotion regulation when carefully adapted for trauma-exposed youth. Neurofeedback and targeted cognitive rehabilitation represent emerging approaches with preliminary evidence, but the literature remains heterogeneous. Conclusions: An intervention strategy that combines symptom-focused trauma therapy with explicit targeting of executive control, memory processes, and affect regulation may represent a developmentally informed clinical framework for trauma-exposed youth. Future trials need to incorporate standardized neuropsychological endpoints and examine moderators that inform treatment matching. Full article

The nonfluent/agrammatic variant of primary progressive aphasia (nfav-PPA) and primary progressive apraxia of speech (PPAOS) are neurodegenerative syndromes that raise diagnostic challenges related to several issues. First, there are two divergent conceptions, one stipulating that (i) nfav-APP and PPAOS are distinct entities, and the other (ii) that PPAOS has to be integrated into the nfav-APP spectrum. A second related issue concerns the consideration of phonological dimensions, lying at the language interface with speech, which could potentially help overcome the nfva-PPA/PPAOS controversy. Third, there is a lack of internationally validated clinical tests assessing apraxia of speech and syntactic abilities with sufficient specificity and sensitivity. This narrative review discusses these issues taking into account clinical, neurocognitive and neurobiological dimensions. It proposes a conceptual-integrative framework conciliating competing nfav-APP/PPAOS accounts while suggesting a graded continuum with subdivisions, related to neurodegenerative expansion throughout language/speech production systems, ranging from syntactic to phonological to phonetic-articulatory impairments. A second controversy in the field of PPA arises from divergent conceptions of semantic PPA (sv-PPA), defined by primary damage to verbal semantics, and of semantic dementia (SD) characterized by multimodal semantic impairments. The current consensus criteria of PPA have deconstructed the initial SD conception by absorbing it into sv-PPA, hence leaving mixed and some non-verbal semantic phenotypes nosologically orphaned. Again, the article proposes a conceptual and integrative model, built on findings from clinical research and cognitive neuroscience, suggesting a graded continuum with subdivisions spanning from verbal to different non-verbal semantic impairments including social-semantic/behavioral phenotypes. Full article

Background: Language impairment is a core feature of Major Neurocognitive Disorder (MND), yet the domain-specific relationship between language functioning and everyday functional status remains insufficiently characterized. Methods: We conducted a retrospective observational study in 125 older adults diagnosed with MND according to DSM-5 criteria with mild-to-moderate cognitive impairment measured with Mini-Mental State Examination (MMSE). Language performance was assessed using semantic, phonemic verbal fluency and confrontation naming. Functional status was evaluated using basic (BADL) and instrumental activities of daily living (IADL). Ordinal logistic regression models examined associations between language domains and functional outcomes, adjusting for global cognitive status (MMSE), demographic variables, multimorbidity, and depressive symptoms. Model fit was evaluated using the Akaike Information Criterion. Results: Semantic fluency emerged as the best-performing predictor of BADL across all hierarchical models, remaining statistically significant after full adjustment for MMSE and clinical covariates (β ≈ 0.60, p < 0.05). Phonemic fluency showed the most robust association with IADL, with a stable effect across models, reaching a trend toward statistical significance in the fully adjusted analyses (β ≈ 0.22–0.27, p = 0.069). Naming ability did not influence functional outcomes. All observed associations persisted after controlling for MMSE, demographic variables, multimorbidity, and depressive symptoms. Conclusions: Language abilities showed differential associations across language domains with functional status in this sample of patients with MND. Semantic fluency was associated with basic self-care, while phonemic fluency showed a trend toward association with instrumental daily activities. These relationships remained observable after adjustment for global cognitive impairment, suggesting verbal fluency as a potentially sensitive marker of functional vulnerability. Full article

This study examines the evolution of the scientific literature on mining and heavy metals, with a particular focus on biosanitary risks associated with childhood exposure. The research integrates a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, combined with a bibliometric analysis of Scopus-indexed publications, international epidemiological data, and an evaluation of the socio-environmental context in Ecuadorian mining regions. The PRISMA-based screening process was applied to identify, filter, and select relevant peer-reviewed studies, enabling the delimitation of a focused corpus of literature, with particular attention given to scientific contributions produced by Latin American researchers and institutions. The results reveal a significant concentration of knowledge production among a limited number of countries and institutions, the dominance of English as the main language of scientific communication, and the centrality of journals in environmental sciences and toxicology. While notable progress has been made in identifying contaminants and exposure pathways, governance structures, territorial disparities, and policy implementation processes remain insufficiently explored. In Ecuador, the rapid growth of mining concessions in ecologically sensitive zones presents potential threats to children’s neurocognitive development, highlighting the urgent need for ongoing surveillance, biomonitoring programs, and preventive public health measures. The study emphasizes the importance of strengthening regional research capacity and fostering more equitable international scientific collaborations to ensure that knowledge production is responsive to local contexts and effectively safeguards vulnerable populations. Full article