Search Results (134)

This exploratory case study investigates the implementation and educational impact of a Virtual Reality (VR)- and Augmented Reality (AR)-based assistive technology developed to support learners with dyslexia. The intervention, delivered via mobile devices and VR headsets, incorporated gamified and interactive content aimed at enhancing cognitive skills such as attention, inhibition, narrative memory, and phonological awareness. Two in-depth case studies were conducted with primary school students formally diagnosed with dyslexia. Cognitive performance was assessed using the NEPSY-II neuropsychological battery, and user experience was evaluated using the Technology Acceptance Model (TAM). The results showed positive trends in executive function and language-related skills, as well as high motivation and satisfaction. While these findings suggest promising benefits of immersive educational technologies in dyslexia intervention, conclusions regarding efficacy cannot be drawn due to the limited sample size. Further research with larger and controlled designs is needed to validate these initial observations. Full article

Background: Cognitive heterogeneity in Parkinson’s disease (PD) remains a diagnostic and prognostic challenge, particularly in early stages. In this cross-sectional study, we aimed to identify clinically relevant cognitive subtypes in early PD by integrating neuropsychological profiles with regional brain atrophy assessed via visual MRI scales. Methods: Eighty-one de novo PD patients (≤36 months from diagnosis) and twenty healthy controls underwent 3T MRI with visual atrophy ratings and completed an extensive neuropsychological battery. Results: Using a mixed a priori–a posteriori approach, we defined eight anatomocognitive subtypes reflecting distinct patterns of regional vulnerability: frontosubcortical, posterior cortical, left/right hippocampal, global, and preserved cognition. Specific MRI markers correlated with cognitive deficits in executive, visuospatial, memory, and language domains. Cluster analyses supported subtype validity (AUC range: 0.68–0.95). Conclusions: These results support a practical classification model linking cognitive performance to brain structural changes in early PD. This scalable approach may improve early patient stratification and guide personalized management strategies. Longitudinal studies are needed to assess progression patterns and therapeutic implications. Full article

Background/Objectives: Neuropsychological assessment tools adapted for digital formats are crucial to expanding access and improving cognitive evaluation in post-stroke patients. This study aimed to examine the reliability, convergent validity, and criterion-related validity (concurrent and known-groups) of TRIACOG-Online, a computerized cognitive screening tool designed to assess multiple domains in post-stroke adults in person or remotely. Methods: 98 participants (47 neurologically healthy adults and 51 post-stroke patients) completed a sociodemographic questionnaire, the Mini-Mental State Examination—MMSE, G-38—Nonverbal Intelligence Test, and the TRIACOG-Online assessment. Evaluations were conducted in person, computer mediated. Results: TRIACOG-Online demonstrated high internal consistency (Cronbach’s α = 0.872; McDonald’s ω = 0.923). Statistically significant differences were found between groups in episodic memory, attention, executive functions, and numerical processing, with healthy individuals outperforming post-stroke participants. Effect sizes were medium to large in several domains, especially for visual memory. Validity evidence based on the relationship with external variables was supported by negative correlations with age and positive correlations with education and reading and writing habits, particularly in the clinical group. Educational level showed stronger associations with verbal memory and language, suggesting a protective role in post-stroke cognitive performance. TRIACOG-Online scores demonstrated evidence of convergent validity with MMSE and G-38. Conclusions: TRIACOG-Online shows strong psychometric properties for the cognitive assessment of post-stroke adults. Its computerized format represents a promising tool for clinical and research use in neuropsychology, especially for bedside applications. Full article

Background/Objectives: Cognitive impairment often occurs in various parkinsonian syndromes. The course of deficits in cognitive functions ranges from mild cognitive decline to severe deterioration. Affected cognitive domains are also variable. The genetic background of patients exhibiting parkinsonism with concomitant cognitive decline is still elusive. A significant part of current research in Parkinson’s disease and other parkinsonian syndromes is targeted towards the genetic aspects of these disorders. The aim of the present review was to summarize existing studies focusing on the investigation of the interplay between genetic data in parkinsonism and associated cognitive symptoms. Methods: A review of English-language articles published between 2000 and 2024 was conducted, focusing on genetic studies of Parkinson’s disease and atypical parkinsonian syndromes with cognitive decline, using the databases PUBMED, SCOPUS, and EMBASE. Results: We have selected a clinical phenotype-wise assessment of parkinsonian conditions with cognitive deficits, including typical or early-onset Parkinson’s disease, dementia with Lewy bodies, Corticobasal Syndrome, Progressive Supranuclear Palsy, and frontotemporal dementia with parkinsonism. Both typical and atypical parkinsonian syndromes with concomitant cognitive decline were explored. Conclusions: Genetic background likely contributes to the heterogeneity of cognitive impairment in parkinsonian syndromes, with specific mutations linked to distinct cognitive symptoms. The integration of genetic data and a more thorough neuropsychological assessment with clinical, imaging, and biomarkers may enhance diagnosis and enable personalized therapies. Full article

Background: The prevalence of HIV-associated neurocognitive disorders (HAND) remains high despite antiretroviral treatment (ART). Changes in gut microbiota and persistent immune activation have been suggested as possible causes, while the role of probiotic supplementation remains controversial. Methods: We included subjects with mild HAND and successful ART. They were randomized to receive either 6 months of high-dose probiotic supplementation or to continue with only ART. Immune activation markers and neuropsychological testing were performed at baseline and the end of follow-up. Neuropsychological testing assessed learning, episodic memory, attention/concentration, executive functions, language, information processing speed, and motor skills. Z- and T-scores were calculated for all domains but motor skills, allowing the measurement of the global deficit score (GDS). The trajectories of neuropsychological performances and immune activation markers were compared between groups. Results: From September 2020 to July 2021, 31 PWHs were included (median age 62, 73% men, CD4 744 cc/mm³), and 28 completed the 6-month follow-up. The characteristics of the subjects and their neuropsychological performance at baseline in the two groups were similar. At the end of follow-up, probiotics did not have any impact on immune activation markers, while they were associated with better improvement in GDS (T-score 0.0 in controls vs. −0.3 in probiotics, p = 0.048) and the attention/concentration test (Z-score 0.4 in controls vs. 1.2 in probiotics, p = 0.035). Conclusions: Oral supplementation with high-dose probiotics for 6 months did not affect systemic immune activation but was associated with improved neurocognitive performance, suggesting benefits from probiotic supplementation for mild HAND. Full article

Epilepsy is widely known as a network disease. Ictal and interictal activities are generated and spread within the existing networks involving different regions of the brain. Network alterations affect both grey and white matter, deep brain nuclei, including those of the ascending reticular formation. These structures may be involved in a disorganized connectome associated with epilepsy. A growing body of neuroimaging and neuropsychological findings suggests that global and focal network aberrations are closely linked to cognitive deficits in epilepsy patients. This evidence relates equally to focal epilepsies, such as temporal lobe epilepsy or extra-temporal lobe epilepsy, as well as generalized epilepsies, such as juvenile myoclonic epilepsy. Network abnormalities have been associated with a broad range of cognitive impairments, including language, memory, and executive functions, as well as sensory and motor functions. Whole-brain structural connectome models help in the understanding of seizure generation and spread. Identifying key nodes of seizure propagation may help in planning surgical procedures in individual patients by simulating epilepsy surgery on virtual models. Functional connectomic profiles may predict seizure outcomes in patients who undergo deep brain stimulation due to intractable seizures. Therefore, individualized interventional strategies could be developed based on connectome characteristics. Full article

Background/Objectives: The present review addresses and systematically analyses the most frequently reported neuropsychological and functional connectivity (FC) alterations in individuals with dyslexia compared to controls. By synthesizing extant evidence, this work aims to clarify dyslexic connectivity profiles and provide a foundation for future research and clinical translation. Methods: This systematic review analyzed publications from the last 10 years in two scientific databases, focusing on individuals with dyslexia, without previous injuries, who underwent resting-state functional magnetic resonance imaging (rs-fMRI) assessments, comparing them with typical readers. Results: This review revealed that most dyslexia studies on brain FC using rs-fMRI focused on children (92%), underscoring a gap in research on adults and limiting our understanding of brain maturation processes and neuroplasticity across the lifespan. FC alterations primarily involved ipsilateral connections (60%), with reduced connectivity mainly in the left hemisphere (40%), particularly in posterior regions, aligning with the neurobiological hypothesis of phonological and visual–phonological dysfunctions in dyslexia. Conversely, increased connectivity in the right hemisphere (20%) may indicate the engagement of an alternative network and highlight the complexity of neural adaptations in dyslexia. Conclusions: The findings highlight a significant gap in the study of adult dyslexia and suggest that FC alterations predominantly affect the left hemisphere, with possible compensatory mechanisms in the right hemisphere. Reading fluency improvements in dyslexia may be linked to connectivity changes across multiple brain networks rather than the classical reading circuitry alone. Increased and decreased connectivity in various regions related to executive function, language, and salience processing indicate that broader cognitive mechanisms play a key role in reading performance. Full article

Introduction: Epilepsy is a chronic neurological disorder, with cognitive impairment being one of its most significant comorbidities. While the majority of individuals with epilepsy maintain regular intellectual abilities, they are more likely to experience cognitive impairment compared to a healthy control group of the same age and educational level. Aim: This study aimed to assess cognitive impairment during epilepsy, particularly temporal lobe epilepsy, and to evaluate the effectiveness of using the Montreal Cognitive Assessment (MoCA) test for cognitive screening in individuals with epilepsy. Materials and methods: One hundred and fifty subjects were included between 2022 and 2023, which were divided into 50 people diagnosed with temporal lobe epilepsy (TLE), 50 people with other types of epilepsy according to the International League Against Epilepsy (ILAE), and 50 healthy controls without epilepsy (HC). Results: Significant differences were found in the total mean scores of the MoCA between TLE, other types of epilepsy, and healthy control groups (p = 0.000), particularly in visuospatial orientation, concentration, memory recall, abstraction, and language skills. Conclusions: Evaluating cognitive impairment in epilepsy involves comprehensive neuropsychological assessments, which have significantly advanced in recent years. Nevertheless, we consider the Montreal Cognitive Assessment (MoCA) test to be an appropriate initial screening tool for assessing cognitive impairment in epilepsy. Full article

Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article

The multi-faceted nature of Selective Mutism (SM), and its comorbidity with other disorders, necessitates a comprehensive assessment process. However, evaluating children with SM presents significant challenges, including difficulties in building rapport, establishing an accurate diagnosis, and conducting formal psychological and neuropsychological assessments. This paper explores the key obstacles in assessing children with SM and provides practical recommendations for overcoming these challenges. Effective strategies for reducing anxiety during assessments include extended rapport-building phases, playful and engaging interactions, and the strategic use of parental involvement. Additionally, given the variability in SM symptoms across different settings, a multi-informant and multi-method assessment approach—including clinical observation, structured interviews, and standardized parent- and teacher-report measures—is recommended. This paper also discusses adaptations for formal testing, particularly in cognitive, language, and neurodevelopmental assessments, where SM-related speech avoidance can interfere with standardized evaluations. Nonverbal assessment tools, modifications to testing environments, and alternative response formats are proposed as potential solutions. Furthermore, we highlight the importance of differentiating SM from overlapping conditions, such as autism spectrum disorder and language impairments, to ensure accurate diagnosis and intervention planning. By implementing tailored assessment strategies, clinicians and researchers can improve diagnostic accuracy and better understand the unique needs of children with SM. This, in turn, can inform individualized treatment plans, enhance educational placement decisions, and support the overall well-being of children with SM. Full article

The Askisi-Spelling Deficits (SD) neuropsychological web-based screener was developed to assess cognitive and spelling abilities in children, with an emphasis on the early detection of spelling disorders. This tool incorporates six tasks that evaluate cognitive domains, such as visual and auditory working memory, response inhibition, and spelling processing, providing a comprehensive framework for assessment. A study conducted with 264 Greek children, including 132 children with spelling deficits and 132 typically developing controls, aimed to implement this screening tool. Results indicated that the screener was effective, as children with spelling deficits showed significantly lower performance and longer response times across all tasks. The tool’s internal consistency was supported by split-half correlations (r = 0.64) and Spearman–Brown coefficients (r = 0.78). Nonetheless, certain limitations were identified, including the absence of latency data for specific tasks (Go/No-Go and working memory), as well as the screener’s cultural specificity, which might limit its applicability to other linguistic and orthographic systems. Future iterations should prioritize the inclusion of timing mechanisms for more detailed assessments and consider adaptations for use in languages with varying orthographic complexities. Expanding the demographic reach and conducting longitudinal validation studies would further improve its utility and generalizability. The web-based nature of the screener enables scalable and standardized administration, making it a practical and efficient tool for the early identification of spelling difficulties in children. Full article

Background/objectives: A child’s working memory needs to be efficient in order to perform well at school, because its manipulative function needs to work properly in order to compose and decompose words, a skill that is necessary for reading. Therefore, if a child with an alteration in this type of memory reads a more complex sentence, they will have difficulty storing it until other cognitive processes involved in language comprehension and production take place, leading to impaired reading comprehension. The aim of this study was to develop and verify the applicability of a remediation program for working memory and reading in students with learning difficulties from the third to fifth grades of primary school. Methods: The study was carried out in two phases: phase 1 developed the program on the basis of a literature review, and phase 2 verified the applicability of the program in a pilot study with 21 schoolchildren divided into two groups. The subjects were subjected to tests of metalinguistic and reading skills and the Brief Child Neuropsychological Assessment Instrument. Results: The working memory and reading remediation program consisted of 11 tasks developing phonological and visuospatial working memory. From the results of the application of the Remediation Program With Working Memory and Reading (RP-WMR) in a pilot study, it was possible to verify the applicability of the program; in other words, the strategies developed for students with learning difficulties can be generalised and applied to students who have deficits in working memory and reading. Conclusions: The result of this research indicates that the structured program for remediation of working memory difficulties has proven to be applicable and can help education professionals as a tool for intervening in working memory deficits and reading decoding skills presented by students with learning difficulties. Full article

Objectives: The main objective of this cross-sectional study was to investigate if there are significant differences in cognition between a group of older adults with subjective cognitive decline (SCD) and cognitively intact controls. Methods: An initial sample of 132 older people underwent an extensive neuropsychological evaluation (memory, executive functions, and language) and were classified according to diagnostic criteria. Two groups of 33 subjects each, controls and SCD, were formed using an a priori case-matching procedures in different variables: age, biological sex, years of education, cognitive reserve, and Mini-Mental State Exam. Results: The mean age and standard deviation in the control group were equal to 70.39 ± 4.31 years, while in the SCD group, they were 70.30 ± 4.33 years. The number of males (n = 9) and females (n = 24) was equal in both groups; the means of years of education were also quite similar. SCD participants have a significantly lower mood than the controls. Significant differences between groups were obtained in delayed recall, inhibitory control, and comprehension of sentences not fitted to canonical word order in Spanish. A logistic regression revealed that a lower score on the Stroop’s interference condition is associated with a higher likelihood of having SCD. Finally, ROC analysis provided a model that performs better than random chance, and a cut-off score in Stroop’s interference condition equal to 49 was suggested for clinically differentiating the two groups. Conclusions: This study highlights that, compared to a matched control group, participants with SCD showed subtle but significant neuropsychological differences. Full article

Background: 22q11.2 deletion syndrome is considered as a rare disease. It is considered one of the most prevalent genetic disorders with multiple systemic and neuropsychological alterations. At present, there are few studies that define the linguistic profile in Spanish of children with this syndrome. Objectives: Therefore, the aim of the present study was to define the phonemic–phonological characteristics of people with 22q11.2 Syndrome. Method: Eight boys and girls between 5 and 16 years old participated in an evaluation using the following tests: Induced Phonological Register and Laura Bosh’s Phonological Assessment and Children’s Speech. Results: After analyzing the results obtained, it was observed that more than half of the participants presented a delay in the acquisition of phonemes. Conclusions: The conclusion of this study points out the importance of working on language, especially the phonetic-phonological area, throughout the development of people with 22q11.2 Syndrome. 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