Search Results (104)

Background/Objectives: Impairment in self-awareness (ISA) is one of the common consequences of an acquired brain injury (ABI) and is associated with anosodiaphoria. Collectively, these co-occurring neuropsychological disorders pose significant obstacles in the neurorehabilitation of moderate-to-severe ABI patients. Individuals who recover from ISA may present with anxiety and/or depression as adaptive reactions to the ABI, along with related functional disabilities. The present study investigated whether the level of metacognitive self-awareness (SA) is associated with the presence of anxiety and depression, apathy, or anosodiaphoria in patients with moderate-to-severe ABI. It aimed also at investigating the possible relationship between the severity of disability and both psycho-emotional diseases and the presence of PTSD symptoms in patients with high metacognitive SA. Methods: Sixty patients with moderate-to-severe ABI and different levels of metacognitive SA completed a series of questionnaires, which assessed their self-reported metacognitive SA, anosodiaphoria, anxiety and depression, apathy, and PTSD symptoms. Results: Low-metacognitive-SA patients showed lower levels of anxiety and depression and higher anosodiaphoria than high-metacognitive-SA patients. Patients with high metacognitive SA and high levels of disability showed significant higher states of anxiety and PTSD symptoms than patients with high metacognitive SA and low levels of disability. Conclusions: The neurorehabilitation of individuals with moderate to severe ABI should address, in particular, the complex interaction between ISA and anxiety and depression in patients during the rehabilitation process. Full article

Background/Objectives: Fatigue and cognitive impairment are common issues for People with Multiple Sclerosis (PwMS), affecting over 80% and 40–65%, respectively. The relationship between these two debilitating conditions is complex, with cognitive deficits exacerbating fatigue and vice versa. This study investigates the effects of a multimodal intervention combining cognitive rehabilitation and neuromodulation to alleviate fatigue and enhance cognitive performance in PwMS. Methods: The research employed multiple baselines across the subjects in a Single-Case Experimental Design (mbSCED) with a cohort of three PwMS diagnosed with Relapsing–Remitting MS. The intervention protocol consisted of a baseline phase followed by a four-week treatment involving transcranial direct current stimulation (tDCS) and cognitive training using RehaCom^® software (version 6.9.0). Fatigue levels were measured using the modified Fatigue Impact Scale (mFIS), while cognitive performance was evaluated through standardized neuropsychological assessments. Results: The multimodal protocol exhibited high feasibility and acceptability, with no dropouts. Individual responsiveness outcomes varied, with two PwMS showing significant decreases in fatigue and improvements in cognitive performance, particularly in the trained domains. Their motor performance and quality of life also improved, suggesting that the treatment had indirect beneficial effects. Conclusions: This study provides preliminary evidence for the potential benefits of integrating neuromodulation and cognitive rehabilitation as a personalized therapeutic strategy for managing fatigue and cognitive impairments in MS. Further research is needed to delineate the specific contributions of each intervention component and establish standardized protocols for clinical implementation. The insights gained may lead to more effective, tailored treatment options for PwMS. Full article

Background: Hospitalization during the COVID-19 pandemic has been linked with increased psychological distress, cognitive impairment, and reduced quality of life (QoL). Posttraumatic stress symptoms (PTSS) and rumination may significantly influence QoL outcomes, yet the mechanisms underlying these effects remain poorly understood. Based on the Cognitive Aging Model, this study examines the mediating effects of cognitive and emotional functioning, loneliness, and posttraumatic growth (PTG) on the connection between PTSS/rumination and QoL among patients hospitalized with COVID-19, including the moderator effect of sex, time since discharge, and admission to the intensive care unit (ICU). Methods: A cohort of 258 patients previously hospitalized with COVID-19 as the primary or secondary diagnosis was assessed 6 to 24 months post-discharge. Participants completed validated self-report and neuropsychological assessments of PTSS, rumination, cognitive function, psychological morbidity (depression and anxiety), loneliness, PTG, and QoL. Path analysis and multigroup analysis were employed to assess mediating and moderating effects. Results: PTSS and rumination were associated with reduced physical and mental QoL, primarily via increased psychological morbidity, impaired cognitive functioning, loneliness, and reduced PTG. Rumination showed strong direct and indirect effects on multiple mediators. Only sex and time since discharge significantly moderated pathways, with women showing a strong association between rumination and cognitive impairment/loneliness, while the association between loneliness and mental QoL was significant only in men and in recently discharged patients. Conclusions: PTSS and rumination contribute negatively to QoL in post-discharged patients with COVID-19 through emotional, cognitive, and social pathways, influenced by sex and duration since discharge. The findings underscore the significance of comprehensive long-term care methods focused on cognitive rehabilitation, psychosocial sT, and social reintegration for COVID-19 survivors. Full article

Objective: Obesity represents a health risk and several studies have linked this clinical entity to cognitive deficits. Among the neuropsychological rehabilitation tools, Peak, a digital application, has shown positive results as a therapeutic method. The aim of this work was to measure, for the first time, cognitive deficits and the effects of Peak digital cognitive neurohabilitation therapy in patients diagnosed with obesity. Methods: Peak treatment was offered to the parents who agreed and lasted 6 months, including the neurocognitive evaluation. The patients used Peak five times a day for 20 min. The Neuropsychological Attention and Memory Battery (NEUROPSI) was applied before and after the intervention. Results: The results revealed posttest changes in attention and executive function, memory, and total attention and memory. Significant clinical changes were observed, and the diagnostic range increased from severe to moderate. Conclusions: We concluded that, through an intervention with the Peak app, it is possible to enable attention and memory, which represent the main cognitive deficits in obese pediatric patients. Full article

Background and Objectives: Theory of mind (ToM) deficits in children with ADHD are closely related to social difficulties and problems in interpersonal interactions. Evidence suggests that these cognitive deficits negatively affect the ability to understand and respond to others’ emotions and intentions, thus contributing to social isolation and a lower quality of life. However, the findings across studies vary, indicating that ADHD subtype and comorbidities, such as anxiety and mood disorders, can significantly influence sociocognitive deficits, modulating the extent of social problems. Materials and Methods: This review examines the relationship among ADHD, ToM, and empathy, analyzing studies comparing children with ADHD with peers with typical development or other neurodevelopmental conditions. A search in PubMed, Scopus, and the Cochrane Library prior to January 10, without time restrictions, using “ADHD”, “Cognitive Empathy”, and “Theory of Mind” identified relevant studies assessing these abilities through neuropsychological tests or questionnaires. Results: Of the initial 243 studies, 23 studies met the inclusion criteria. Children with ADHD exhibited significant impairments in ToM and empathy, affecting social cognition and interpersonal understanding. Various assessment tools revealed difficulties in understanding beliefs, emotions, and intentions, with executive function deficits playing a crucial role in shaping these social challenges. Conclusions: This review highlights the need for targeted therapeutic interventions that not only address cognitive deficits but consider emotional and metacognitive aspects, such as emotion regulation and self-awareness. Future research should focus on integrating executive function training with approaches that develop metacognitive and emotional skills, thus providing more comprehensive support. Full article

Background/Objectives: A traumatic brain injury (TBI) is a brain lesion caused by external or internal factors, resulting in cognitive, behavioral, physical, relational, and sensory sequelae, depending on the affected brain area and the severity of the injury. Within neuropsychological rehabilitation (NR), multiple methods have been developed that are aimed at restoring, compensating, and substituting deteriorated cognitive functions resulting from a TBI. This systematic review aimed to identify the state of the scientific literature regarding the efficacy of NR methods in individuals with a TBI. Methods: Articles were analyzed in the SCOPUS and PUBMED databases. Initially, 5347 studies were found. After applying inclusion and exclusion criteria, 17 articles remained and were included in the data extraction process. Results: Of the seventeen included articles, eleven employed randomized or semi-randomized controlled trials, five were clinical studies, and one was a comparative study, in which the percentage of computerized NR methods was 58.82% in the experimental and clinical groups. In contrast, traditional methods constituted 35.3%, and the remaining 5.88% conducted holistic NR. Ninety percent of the methods employed in these investigations showed efficacy. Conclusions: While most of the evaluated NR methods demonstrated efficacy, the analysis of these findings should not be isolated from variables such as the etiology and phase of the TBI, the intervention duration, and the symptoms treated. Furthermore, the NR implementation must be adapted to the specific context of each patient. Full article

Purpose: Over the past decade, tele-neurorehabilitation (TNR) has emerged as a vital and effective tool for delivering continuous care to stroke patients, playing a key role in enhancing functional recovery and ensuring consistent access to rehabilitation services. In the field of TNR, various protocols are utilized to ensure effective cognitive stimulation at home. Recent preliminary studies highlight the employment of multidomain cognitive interventions, which would seem to induce more stable and relevant cognitive recovery in stroke patients. A randomized controlled trial (RCT) study was conducted to compare the effectiveness of a TNR multidomain cognitive approach to conventional face-to-face cognitive treatment. Methods: A total of 30 patients with stroke were equally enrolled and randomly assigned to the experimental and control groups. In the experimental group, patients received sessions of home-based cognitive virtual reality rehabilitation system (VRRS) training. The control group underwent traditional face-to-face cognitive multidomain treatment at the hospital. The therapy was given for one hour every day for four weeks in both groups. Specific cognitive domains, including memory, praxis skills, executive functions, and speech therapy, were stimulated in the procedure. Neuropsychological evaluations were performed at three timepoints: at baseline (T0), at the end of TNR (T1), and six months later (T2). Results: The TNR group demonstrated significant improvements in working memory and language abilities, as well as in depressive symptoms and caregiver burden, with an average decrease of 2.07. Most of this improvement persisted 6 months after treatment. The group that received face-to-face cognitive treatment showed improvements (not persisting at T2) after treatment in a task measuring constructive apraxia and alternating attention with the cognitive skill of set-shifting. Conclusions: According to our findings, multidomain cognitive TNR may be useful in enhancing cognitive outcomes in stroke populations (even six months after treatment concludes). TNR may also be a viable way to deliver these interventions since it boosts people’s motivation to train and, consequently, their adherence to treatment while also having a positive effect on caregivers’ distress management. Full article

Background/Objectives: Body representations (BRs) are essential for guiding movements, maintaining spatial awareness, and achieving effective interactions with the environment. Several studies suggest that BRs are frequently impaired following unilateral brain damage, emphasising the need for tailored rehabilitation interventions; however, there is a lack of studies evaluating the effectiveness of training specifically designed to improve different kinds of functional BRs after stroke. Therefore, the present study aimed to present and implement a specific rehabilitation training program for BR alterations and evaluate its effectiveness in a sample of adults with unilateral brain damage. Methods: Nine adults with unilateral brain damage and seven age- and education-matched healthy controls were recruited. Both groups underwent a neuropsychological assessment to evaluate BR (action- and nonaction-oriented). Additionally, functional autonomy and motor functioning were assessed in the patient group. Following an initial assessment (T0), the patients participated in a BR-specific rehabilitation intervention. At the end of the rehabilitation program (T1), both groups were re-evaluated with the same tasks used at T0. Results: At T0, the patient group performed worse on BR tasks than the controls. At T1, a significant improvement in the nonaction-oriented BR and functional autonomy was observed in the patient group. Conclusions: This preliminary study suggests the effectiveness of a targeted rehabilitation intervention for BR in promoting enhanced body boundary awareness and greater accuracy in the perception of body part positions, possibly leading to increased functional autonomy. These findings highlight the importance of incorporating BR training in rehabilitation programs for adults with acquired brain damage, alongside motor rehabilitation. Full article

Background/Objectives: Malan syndrome (MALNS) is an ultra-rare genetic disorder caused by aberrations in the NFIX gene, located at chromosome 19p13.2. Key features of MALNS include general overgrowth, a typical facial gestalt, muscle–skeletal abnormalities, speech difficulties and intellectual disability. Additionally, MALNS frequently presents with autism-like behaviour and social challenges. However, characterisation of the cognitive profile of MALNS, including social perception skills, is limited. Methods: Six children and adolescents with MALNS, whose clinical and emotional–behavioural features had been described in previous studies, were assessed by means of a single, co-normed neuropsychological battery covering multiple cognitive domains. Results: Consistent with their intellectual disability, performance was generally weak across all neuropsychological subtests. Nonetheless, memory for faces, visual attention and contextual (non-verbal) theory of mind emerged as relative strengths of the profile, both at group and individual levels. Conversely, tasks requiring verbal reasoning and language comprehension, such as comprehension of instructions and verbal theory of mind, represented weaknesses for all participants. Conclusions: These findings provide a further characterisation of cognitive and social functioning in MALNS, which can inform future research as well as clinical practice and rehabilitation Full article

Objective: Resection of colloid cysts, a rare third ventricle pathology, is accepted clinical practice. Owing to their location proximal to deep gray nuclei and forniceal columns, colloid cysts have been theorized to contribute to cognitive decline. Comprehensive pre- and post-operative cognitive testing, however, has rarely been implemented. Methods: We analyzed formal neuropsychological testing performed in 20 patients undergoing endoscopic cyst resection. Pre- and post-operative performance was compared either for each individual patient or according to aggregated neuropsychological factor scores grouped via expert census. A change in performance was deemed significant if (i) it reached statistical significance and (ii) was greater than 1.5 pre-operative standard deviations. Results: Twenty patients with colloid cysts (average diameter 13.3 ± 1.3 mm) underwent matched pre- and post-operative testing. No patient had a significant change in cognitive performance. Neurocognitive metrics assessing cognitive functions typically subsumed by the temporal (p = 0.35), extratemporal (p = 0.20), occipitoparietal (p = 0.31), or frontal lobes (p = 0.11) did not change post-operatively. Similarly, no differences emerged when factor scores were generated according to composite scores of different neurocognitive domains: attention (p = 0.32), executive function (p = 0.14), language (p = 0.98), and visuospatial function (p = 0.42). Conclusions: Neuropsychological testing allows for the careful monitoring of cognitive status before and after surgery and for the identification of patients who may benefit from pre- and post-operative cognitive rehabilitation. It should also be used as a valuable surgical psychometric marker and adjuvant. No significant cognitive decline was observed in this cohort. Full article

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients’ quality of life. Full article

Purpose: Cognitive dysfunctions are still very common in the chronic phase of stroke when patients are discharged from neurorehabilitation centers. Even individuals who appear to have made a full clinical recovery may exhibit new deficiencies at home. Here, we present evidence of a novel kind of therapy at home aimed at contrasting the heterogenic evolution of stroke patients using a multidomain cognitive approach. Methods: Eighteen ischemic stroke patients were assessed in a within-subject longitudinal design (age 62.33 ± 11.1 years; eight men). Patients underwent the Tele-NeuroRehabilitation (TNR) multidomain cognitive training treatment using the Virtual Reality Rehabilitation System (VRRS) five times a week for 1 h sessions for four consecutive weeks. The protocol included the stimulation of specific cognitive functions, such as logical skills, praxis skills, attention, executive functions, memory, space time orientation and perception, and speech therapy. To determine neuropsychological changes, patients were evaluated before the sessions (T0), at the end of the sessions (T1), and after six months (T2). Results: The multidomain cognitive training induced a significant improvement in the working memory and language abilities as well as depression symptoms and alleviated caregiver burden. Most of this cognitive enhancement persisted after six months (T2), with the exception of depression symptoms. Otherwise, a significant decline in attention abilities was reported, thus demonstrating a lack of effect in this function. Conclusions: Our results suggest that multidomain cognitive TNR is a suitable protocol for reducing some cognitive and behavioral alterations in patients with strokes, with a beneficial impact also on the caregivers’ burden distress management. Further RCTs are warranted to validate this new kind of approach. Full article

Background/Objective: Over the past two decades, the utilization of virtual care in rehabilitation has witnessed a significant surge; this is owing to the widespread availability of technological tools and the global impact of the COVID-19 pandemic. As a result, discussions surrounding the relevance and benefits of telerehabilitation have gained prominence among practitioners, who continually seek to enhance patient care while maintaining high standards of quality. Associated with these discussions are concerns over being able to provide care in an ethical way, as well as addressing equity issues that might be hindered or improved via telerehabilitation. To address the ethical and equity concerns around telerehabilitation, a series of five parallel rapid reviews of the scientific literature were conducted, focusing on different rehabilitation fields: physiotherapy and occupational therapy (1); speech therapy and audiology (2); psychology and neuropsychology (3); and in two age groups: older adults (4); and pediatrics and young adults (5). The objective of this series of rapid reviews is to evaluate the evidence presented regarding telerehabilitation; identifying and recommending best practices especially in the realm of ethics and equity. Methods: Medline; CINAHL; and EMBASE were searched between 2010 and 2023 for English or French-language reviews (2010–2020) and individual studies (2020–2023) pertaining to telerehabilitation and these fields of interest. Data were extracted following a standardized form focusing on: outcomes; findings; quality assessment/biases; limitations; and discussion of ethical and equity concerns. Results: The results are presented according to the most relevant themes, which include: findings; strengths; limitations; and ethical/equity considerations. Conclusions: This research presents a methodology rarely published before, on how to conduct multiple parallel rapid reviews on the theme of telerehabilitation, based on different rehabilitation fields and age groups. This research will shape future guidelines and standards in applying ethical and equity standards in telerehabilitation. Full article

The growing number of stroke survivors face physical, cognitive, and psychosocial impairments, making stroke a significant contributor to global disability. Various factors have been identified as key predictors of post-stroke outcomes. The aim of this study was to develop a standardized predictive model that integrates various demographic and clinical factors to better predict post-stroke cognitive recovery and depression in patients with ischemic stroke (IS). We included IS patients during both the acute phase and six months post-stroke and considered neuropsychological measures (screening scales, individual tests, functional cognitive scales), stroke severity and laterality, as well as functional disability measures. The study identified several key predictors of post-stroke cognitive recovery and depression in IS patients. Higher education and younger age were associated with better cognitive recovery. Lower stroke severity, indicated by lower National Institutes of Health Stroke Scale (NIHSS) scores, also contributed to better cognitive outcomes. Patients with lower modified Rankin Scale (mRS) scores showed improved performance on cognitive tests and lower post-stroke depression scores. The study concluded that age, education, stroke severity and functional status are the most critical predictors of cognitive recovery and post-stroke emotional status in IS patients. Tailoring rehabilitation strategies based on these predictive markers can significantly improve patient outcomes. Full article

Background/Objectives: This systematic review of neuropsychological rehabilitation strategies for primary progressive aphasia will consider recent developments in cognitive neuroscience, especially neuroimaging techniques such as EEG and fMRI, to outline how these tools might be integrated into clinical practice to maximize treatment outcomes. Methods: A systematic search of peer-reviewed literature from the last decade was performed following the PRISMA guidelines across multiple databases. A total of 63 studies were included, guided by predefined inclusion and exclusion criteria, with a focus on cognitive and language rehabilitation in PPA, interventions guided by neuroimaging, and mechanisms of neuroplasticity. Results: Integration of neuroimaging techniques contributes to the increase in the efficacy of interventions with critical information about the neural mechanisms underlying language deficits in the aphasias. Traditional rehabilitation strategies, technology-assisted interventions, and non-invasive brain stimulation techniques hold considerable promise for language improvement. Neuroimaging was also found to be necessary in subtype-specific differentiation toward tailoring therapeutic intervention. Evidence also shows that directed and sustained interventions using neuroplasticity can have long-term effects in managing the symptoms of PPA. Conclusions: The present review underlines the necessity of including cognitive neuroscience techniques within neuropsychological rehabilitation to enhance therapeutic outcomes in PPA. In addition, neuroimaging modalities such as EEG and fMRI are also of great importance in understanding the underlying neurobiology of language disturbances and guiding tailored interventions. Long-term benefits of these approaches should be evaluated, including their applicability in routine clinical practice. Full article