Search Results (31)

Reward processing is a vital function for health and survival and is impaired in various psychiatric and neurological disorders. Using a monetary gambling task, the current study aims to elucidate neural substrates in the reward network underlying the evaluation of win versus loss outcomes and their association with behavioral characteristics, such as impulsivity and task performance, and neuropsychological functioning. Functional MRI was recorded in thirty healthy, male community volunteers (mean age = 27.4 years) while they performed a monetary gambling task in which they bet with either 10 or 50 tokens and received feedback on whether they won or lost the bet amount. Results showed that a set of key brain structures in the reward network, including the putamen, caudate nucleus, superior and inferior parietal lobule, angular gyrus, and Rolandic operculum, had greater blood oxygenation level-dependent (BOLD) signals during win relative to loss trials, and the BOLD signals in most of these regions were highly correlated with one another. Furthermore, exploratory bivariate analyses between these reward-related regions and behavioral and neuropsychological domains showed significant correlations with moderate effect sizes, including (i) negative correlations between non-planning impulsivity and activations in the putamen and caudate regions, (ii) positive correlations between risky bets and right putamen activation, (iii) negative correlations between safer bets and right putamen activation, (iv) a negative correlation between short-term memory capacity and right putamen activity, and (v) a negative correlation between poor planning skills and left inferior occipital cortex activation. These findings contribute to our understanding of the neural underpinnings of monetary reward processing and their relationships to aspects of behavior and cognitive function. Future studies may confirm these findings with larger samples of healthy controls and extend these findings by investigating various clinical groups with impaired reward processing. Full article

Background/Objectives: Successful discourse relies not only on linguistic but also on prosodic information. Difficulty recognizing emotion conveyed through prosody (receptive affective aprosodia) following right hemisphere stroke (RHS) significantly disrupts communication participation and personal relationships. Growing evidence suggests that damage to white matter in addition to gray matter structures impairs affective prosody recognition. The current study investigates lesion–symptom associations in receptive affective aprosodia during RHS recovery by assessing whether disruptions in distinct white matter structures impact different underlying affective prosody recognition skills. Methods: Twenty-eight adults with RHS underwent neuroimaging and behavioral testing at acute, subacute, and chronic timepoints. Fifty-seven healthy matched controls completed the same behavioral testing, which comprised tasks targeting affective prosody recognition and underlying perceptual, cognitive, and linguistic skills. Linear mixed-effects models and multivariable linear regression were used to assess behavioral performance recovery and lesion–symptom associations. Results: Controls outperformed RHS participants on behavioral tasks earlier in recovery, and RHS participants’ affective prosody recognition significantly improved from acute to chronic testing. Affective prosody and emotional facial expression recognition were affected by external capsule and inferior fronto-occipital fasciculus lesions while sagittal stratum lesions impacted prosodic feature recognition. Accessing semantic representations of emotions implicated the superior longitudinal fasciculus. Conclusions: These findings replicate previously observed associations between right white matter tracts and affective prosody recognition and further identify lesion–symptom associations of underlying prosodic recognition skills throughout recovery. Investigation into prosody’s behavioral components and how they are affected by injury can help further intervention development and planning. Full article

Mirror movements (MMs) are related to structural alterations of the pyramidal tract or transcallosal pathways, as well as functional impairment of the interhemispheric inhibitory effects on motor planning skills, leading to the inability to perform limb movements independently. On the other hand, white matter bundles that connect distant cortical regions are thought to be the anatomical substrate of seizure propagation in epileptic subjects, and the spread of excitation through intracortical and transcallosal pathways is a well-recognized pathophysiological abnormality in epilepsies. To investigate this possible association, we searched the MEDLINE and Embase electronic databases, and only original articles were considered eligible for inclusion; we found thirteen patients from eleven articles, all of them case study reports. Therefore, epilepsy and MM co-morbidity has rarely been reported in the same subjects, even if changes in interhemispheric modulation are shared by both conditions. However, the study of this co-morbidity may help in elucidating the exact pathophysiological mechanisms of MMs and to better understand the pathological interhemispheric connections in epilepsy patients. Full article

Background/Objectives: The widespread phenomenon of “brain rot”, named the Oxford Word of the Year 2024, refers to the cognitive decline and mental exhaustion experienced by individuals, particularly adolescents and young adults, due to excessive exposure to low-quality online materials, especially on social media. The present study is exploratory and interpretative in nature, aiming to investigate the phenomenon of “brain rot”, with a focus on its key pillars, psychological factors, digital behaviors, and the cognitive impact resulting from the overconsumption of low-quality digital content. Methods: This study employs a rapid review approach, examining research published between 2023 and 2024 across PubMed, Google Scholar, PsycINFO, Scopus, and Web of Science. It explores the causes and effects of brain rot, focusing on the overuse of social media, video games, and other digital platforms. Results: The findings reveal that brain rot leads to emotional desensitization, cognitive overload, and a negative self-concept. It is associated with negative behaviors, such as doomscrolling, zombie scrolling, and social media addiction, all linked to psychological distress, anxiety, and depression. These factors impair executive functioning skills, including memory, planning, and decision-making. The pervasive nature of digital media, driven by dopamine-driven feedback loops, exacerbates these effects. Conclusions: The study concludes by offering strategies to prevent brain rot, such as controlling screen time, curating digital content, and engaging in non-digital activities. Given the increasing prevalence of digital engagement, it is essential to explore a variety of strategies, including mindful technology use, to support cognitive health and emotional well-being. The results can guide various stakeholders—policymakers, practitioners, researchers, educators, and parents or caregivers—in addressing the pervasive impact of brain rot and promoting a balanced approach to technology use that fosters cognitive resilience among adolescents and young adults. Full article

Executive functions (EFs) are essential cognitive processes involved in concentration, planning, decision-making, and impulse control during adolescence. Executive Dysfunction (ED) can lead to significant academic and socio-emotional difficulties, particularly with impairments in emotion regulation (ER). This study aims to assess a virtual reality (VR) cognitive training intervention on EFs, ER, and internalizing symptoms in adolescents at risk for ED. Thirty-eight adolescents aged 12–14 years, identified as being at moderate to high risk for ED, were randomly assigned to two groups. The experimental group (n = 22) received gamified VR cognitive training, while the control group (n = 16) received VR nature-based relaxation training. Both interventions lasted five weeks, twice a week for 30 min each. Pre- and post-assessments included ER skills, internalizing symptoms, and cognitive performance measures. Two-way mixed ANOVAs showed significant group × time interactions (p < 0.05) in measures of depression and internalizing symptoms. The experimental group showed significant reductions in these symptoms compared with the control group. Significant main effects of time (p < 0.05) were also found on some measures. Both groups experienced reduced anxiety, improved emotional control and cognitive functioning, and VR cognitive training was particularly effective in reducing internalizing symptoms, while both interventions showed promising results in improving some ER skills and cognitive performance. The findings demonstrate the preliminary effects of VR-based cognitive training in improving the psychological and cognitive well-being of adolescents at risk for ED and suggest that integrating VR technologies into educational settings can effectively address the cognitive and emotional challenges faced by these students. Full article

Background-objectives: Multiple dynamic interacting factors contribute to the presence and progression of eating disorders (ED). Empirical research has provided mixed findings regarding the mechanisms explaining the contribution of body mass index (BMI) to the diverse ED endophenotypes. The present study aims to evaluate the underlying processes (direct and indirect effects) contributing to BMI and ED severity, considering the contribution of multiple neuropsychological constructs. Method: Path analysis, implemented through structural equation models (SEM), was applied to a sample of N = 193 ED patients, men and women, aged 17 to 50 years old, and diagnosed with bulimia nervosa, night eating syndrome, binge eating disorder, and other specified feeding. Results: BMI was directly associated with ED severity level. The ED symptom level was also a mediational link into the relationship between BMI with emotion regulation strategies, decision-making capacity, stress levels, and impulsiveness. Multigroup SEM revealed invariance of the structural coefficients by sex, but differences according to the ED subtype. Conclusions: This study provides new empirical evidence on predictors of ED severity, focusing on the role of impaired decision-making and BMI. Our results could contribute to new intervention plans with techniques specifically aimed at improving emotional regulation capacity, decreasing impulsivity levels, and improving reasoning skills. Nutrition education plans may also play a key role for preventing the onset and progression of ED, helping patients understand how food affects their physical and emotional health and how to manage anxiety and fears related to food. Full article

Developmental coordination disorder (DCD) is a lifelong neurological disorder impairing the coordination and planning of motor and sensory tasks. Its functional manifestation includes difficulties in various aspects of daily living, making early diagnosis and management essential. This cross-sectional, questionnaire-based study targeted healthcare providers in Saudi Arabia’s Eastern Province who work with children under the age of 18. The questionnaire was completed through field visit interviews and electronically via social platforms from October 2023 to March 2024, collecting data on demographics, professional experience, familiarity with related disorders, and awareness of dyspraxia symptoms. Of the participants, 21.2% had previously diagnosed at least one child with dyspraxia, with family physicians comprising 30% of those diagnoses. The overall mean knowledge score was 17%, ranging from 8.3% to 23.1%. The most recognized symptom was motor learning difficulties (22.7%), followed by gross and fine motor skill delays (22.3%). Notably, 65.15% of respondents were unsure about the gender distribution of dyspraxia. The findings align with international studies, showing significant knowledge gaps among healthcare providers in the Eastern Province. These findings also emphasize the need for targeted health promotion programs, promotional activities, and media involvement for enhancing public health outcomes, early identification, and better management of DCD. Full article

Introduction: Apraxia is a neurological disorder that is common after a stroke and impairs the planning and execution of movements. In the rehabilitation field, virtual reality (VR) presents new opportunities and offers advantages to both rehabilitation teams and individuals with neurological conditions. Indeed, VR can stimulate and improve cognitive reserve and abilities, including executive function, and enhance the patient’s emotional status. Aim: The objective of this research is to determine the effectiveness of VR in improving praxis skills and behavioural functioning in individuals with severe stroke. Methods: A total of 20 stroke patients were enrolled from February 2022 to March 2023 and divided by the order of their recruitment into two groups: the experimental group (EG: n = 10) received training to improve their praxis skills using VR whereas the control one (CG: n = 10) received the same amount of standard training. All patients underwent an evaluation using a psychometric battery that consisted of the Hamilton Rating Scale for Depression (HRS-D), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Spinnler and Tognoni test, and De Renzi and Faglioni test. Valuations were performed before rehabilitation (T0) and after its completion (T1). Results: Both groups demonstrated significant improvements post-intervention. The EG showed a greater enhancement in their MMSE scores (p = 0.002), and reductions in both ideomotor and constructive apraxia (p = 0.002 for both), compared to the CG. The VR-based training also resulted in significant improvements in their depression symptoms (HRSD scores improved, p = 0.012 in EG vs. p = 0.021 in CG). Conclusions: This pilot study suggests that VR could help reduce cognitive, constructive apraxia and ideomotor apraxia symptoms caused by stroke injury. Full article

Digital audio–tactile maps (DATMs) on touchscreen devices provide valuable opportunities for people who are visually impaired (PVIs) to explore the spatial environment for engaging in travel activities. Existing solutions for DATMs usually require extensive training for the PVIs to understand the feedback mechanism. Due to the shortage of human resources for training specialists, as well as PVIs’ desire for frequent practice to maintain their usage skills, it has become challenging to widely adopt DATMs in real life. This paper discusses the use of large language models (LLMs) to provide a verbal evaluation of the PVIs’ perception, which is crucial for the independent practice of DATM usage. A smartphone-based prototype providing DATMs of simple floor plans was developed for a preliminary investigation. The evaluation results have proven that the interaction with the LLM could help the participants better understand the DATMs’ content and could vividly replicate them by drawings. Full article

Background: Patients suffering from osteoarthritis particularly complain about pain during day and night as well as loss of function. This consequently leads to impaired quality of life and therefore psychological stress. The surgical therapy of choice is joint replacement. Regarding the outcome after operation, expectations might differ between the patient and the surgeon. This can lead to dissatisfaction on both sides. This study aimed to document patients’ expectations of a planned shoulder joint replacement. The results were compared with assessments made by shoulder surgeons. Methods: In total, 50 patients scheduled for operative shoulder joint replacement were included in this study, as well as 10 shoulder surgeons. Patients were requested to fill out questionnaires preoperatively to provide sociodemographic data, PROMS (Patient-Reported Outcome Measures) with regard to the pathology and their expectations about surgery in terms of pain relief, gain of range of motion, strength as well as the impact on activities of daily and professional life and sports. In addition, surgeons were asked what they thought their patients expect. Results: The most important goal to achieve for patients was to relieve daytime pain, followed by improvement of self-care and the ability to reach above shoulder level. The most important factors for patients to achieve after operation were ‘pain relief’ in first place, ‘movement’ in second and ‘strength’ in third. This also applied to shoulder surgeons, who ranked ‘pain relief’ first, followed by ‘movement’ and ‘strength’. When patients where asked what is most important when it comes to choosing their surgeon, 68% voted for ‘surgical skills’, 28% for ‘age/experience’, followed by ‘empathy’, ‘sympathy’ and ‘appearance’. For surgeons, ‘age/experience’ obtained rank one, ‘surgical skills’ was ranked second, followed by ‘sympathy’, ‘empathy’ and ‘appearance’. Surgeons significantly underrated the factor ‘empathy’ in favor of ‘sympathy’. Conclusions: This study shows that patients’ expectations for shoulder joint replacement and surgeons’ assessments do not differ significantly. Relief from pain and better shoulder movement were crucial for patients to achieve after operation, which was in line with surgeons’ expectations. The most important factor for choosing the surgeon was ‘surgical skills’ for patients, while surgeons thought they would care more about ‘age and experience’. This underlines that patients’ expectations should be taken into account within the preoperative medical interview. This might allow an optimization of compliance of the patients and lead to a better satisfaction on both sides. Full article

Advances in technology and artificial intelligence (smart healthcare) open up a range of possibilities for precision intervention in the field of health sciences. The objectives of this study were to analyse the functionality of using supervised (prediction and classification) and unsupervised (clustering) machine learning techniques to analyse results related to the development of functional skills in patients at developmental ages of 0–6 years. We worked with a sample of 113 patients, of whom 49 were cared for in a specific centre for people with motor impairments (Group 1) and 64 were cared for in a specific early care programme for patients with different impairments (Group 2). The results indicated that in Group 1, chronological age predicted the development of functional skills at 85% and in Group 2 at 65%. The classification variable detected was functional development in the upper extremities. Two clusters were detected within each group that allowed us to determine the patterns of functional development in each patient with respect to functional skills. The use of smart healthcare resources has a promising future in the field of early care. However, data recording in web applications needs to be planned, and the automation of results through machine learning techniques is required. Full article

In recent years, there has been an increase in the prevalence of comorbidity between ASD and epilepsy in the pediatric population. Children with ASD and epilepsy often exhibit greater impairments in executive functions such as cognitive flexibility, planning, inhibition, and emotional control, as well as in language dimensions such as phonology, semantics, morphosyntax, and pragmatics. These impairments can significantly impact their maturation and development. The aim of this study was to assess and compare the executive functioning and language skills of 150 participants, divided into three groups: one with ASD only, another with epilepsy only, and the third group with both ASD and epilepsy. The study utilized the Behavior Rating Inventory of Executive Function (BRIEF-2) and Neuropsychological Evaluation of Executive Functions in Children (ENFEN) to assess executive functions, and Clinical Evaluation of Language Fundamentals 5 (CELF-5) to evaluate language skills. The results indicated that participants with this comorbidity had lower scores in both executive functioning and language skills compared to children with only ASD or epilepsy. The presence of epilepsy significantly limits the executive and linguistic performance of children with ASD, negatively affecting language acquisition, functionality, and the ability to carry out basic life activities independently. Full article

Spasticity following a stroke often leads to severe motor impairments, necessitating comprehensive and personalized rehabilitation protocols. This paper presents Rehabotics, an innovative rehabilitation platform incorporating a multi-component design for the rehabilitation of patients with post-stroke spasticity in the upper limbs. This system incorporates a sensor-equipped soft glove, a robotic exoskeleton hand, and an augmented reality (AR) platform with serious games of varying difficulties for adaptive therapy personalization. The soft glove collects data regarding hand movements and force exertion levels when the patient touches an object. In conjunction with a web camera, this enables real-time physical therapy using AR serious games, thus targeting specific motor skills. The exoskeleton hand, facilitated by servomotors, assists patients in hand movements, specifically aiding in overcoming the challenge of hand opening. The proposed system utilizes the data collected and (in combination with the clinical measurements) provides personalized and refined rehabilitation plans and targeted therapy to the affected hand. A pilot study of Rehabotics was conducted with a sample of 14 stroke patients. This novel system promises to enhance patient engagement and outcomes in post-stroke spasticity rehabilitation by providing a personalized, adaptive, and engaging therapy experience. Full article

(1) Background: chronic alcohol use is consistently associated with impaired executive functioning, but its profile across the spectrum from mild to major alcohol-related cognitive impairment is, to date, unclear. This study aims to compare executive performances of patients with alcohol-induced neurocognitive disorder, including Korsakoff’s syndrome (KS), by using a computerized assessment battery allowing a fine-grained and precise neuropsychological assessment; (2) Methods: performances of 22 patients with alcohol-related cognitive impairment (ARCI) and 20 patients with KS were compared to those of 22 matched non-alcoholic controls. All participants were diagnosed in accordance with DSM-5-TR criteria and were at least six weeks abstinent from alcohol prior to assessment. Executive function was evaluated using four subtests of Cambridge Neuropsychological Test Automated Battery (CANTAB^®); (3) Results: significant differences between groups were found on spatial working memory (updating), sustained attention and inhibitory control, set shifting, and planning. Healthy controls performed significantly better than both patient groups (Games-Howell post hoc; p < 0.05), but no differences in performance were found between the ARCI and KS group; (4) Conclusions: ARCI and KS patients showed significant executive impairments, most prominent in updating, set-shifting and general planning abilities. Findings suggest equivalent levels of executive function in ARCI and KS patients. Our results highlight executive function as a significant hallmark of alcohol-induced neurocognitive disorder and stipulate the importance of early assessment and evaluation of skills to guide treatment. Full article

Background: Patients with major depressive disorder (MDD) are characterized by neurocognitive impairments and show deficits in various cognitive performance indicators, including executive function. We examined whether sustained attention and inhibitory control differ between patients with MDD and healthy controls, and whether differences exist between patients with mild, moderate, and severe depression. Methods: Clinical in-patients (N = 212) aged 18–65 years with a current diagnosis of MDD and 128 healthy controls were recruited. Depression severity was assessed using the Beck Depression Inventory, and sustained attention and inhibitory control were assessed using the oddball and flanker tasks. The use of these tasks promises insights into executive function in depressive patients that are not biased by verbal skills. Group differences were tested via analyses of covariance. Results: Patients with MDD showed slower reaction times in both the oddball and flanker task, independent of the executive demands of the trial types. Younger participants achieved shorter reaction times in both inhibitory control tasks. After correcting for age, education, smoking, BMI, and nationality, only differences in reaction times in the oddball task were statistically significant. In contrast, reaction times were not sensitive to the symptom severity of depression. Conclusion: Our results corroborate deficits in basic information processing and specific impairments in higher-order cognitive processes in MDD patients. As difficulties in executive function underlie problems in planning, initiating, and completing goal-directed activities, they may jeopardize in-patient treatment and contribute to the recurrent nature of depression. Full article