The impact of cognitive rehabilitation with RehaCom software on attention improvement in patients with traumatic brain impairment

Background & Objective: During the past 3 decades, numerous neurophysiological, neuroimaging, experimental and clinical studies have evidenced a crucial role for the cerebellum in cognitive, affective and behavioral functions. As a result of the acknowledged modulatory role of the cerebellum upon remote structures such as the cerebral cortex, cerebellar injury may give rise to a constellation of behavioral, affective and cognitive symptoms (Schmahmann's Syndrome). In sharp contrast to the wide range of therapeutic interventions to treat cognitive and affective disorders following cerebral cortical lesions and despite the consequences of Schmahmann’s syndrome upon daily life activities, the literature is surprisingly only scantly documented with studies investigating the impact of cognitive therapies on cerebellar induced cognitive and affective disorders. This survey aims to present an overview of the therapeutic interventions available in the literature as a possible treatment for Schmahmann’s Syndrome after cerebellar injury, after posterior fossa surgery in children, and in children with neurodevelopmental disorders. Although systematical studies are clearly warranted, available evidence suggests that cerebellar-induced cognitive and affective disorders should be treated in a specific way. Approaches where the patients are explicitly made aware of their deficits and are considered to act as an “external cerebellum” are the most promising. Conclusion: The study of the anatomical connectivity of the cerebellar microcomplexes involved in cognitive/affective deficits is likely to play a major-role in the future.

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The impact of patient and partner personality traits on learning success for a cognitive rehabilitation intervention for patients with MCI

Neuropsychological Rehabilitation ◽

10.1080/09602011.2021.1948872 ◽

2021 ◽

pp. 1-13

Author(s):

Renata Khayoun ◽

Katrina L. Devick ◽

Melanie J. Chandler ◽

Anne L. Shandera-Ochsner ◽

Liselotte De Wit ◽

...

Keyword(s):

Personality Traits ◽

Cognitive Rehabilitation ◽

Rehabilitation Intervention ◽

Learning Success ◽

The Impact

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Validation of Cognitive Rehabilitation as a Balance Rehabilitation Strategy in Patients with Parkinson’s Disease: Study Protocol for a Randomized Controlled Trial

Medicina ◽

10.3390/medicina57040314 ◽

2021 ◽

Vol 57 (4) ◽

pp. 314

Author(s):

Aida Arroyo-Ferrer ◽

Francisco José Sánchez-Cuesta ◽

Yeray González-Zamorano ◽

María Dolores del Castillo ◽

Carolina Sastre-Barrios ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Therapy ◽

Cognitive Processing ◽

Processing Speed ◽

Cognitive Rehabilitation ◽

Neurodegenerative Disorder ◽

Control Group ◽

Motor Symptoms ◽

The Impact

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. This disease is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity. Although balance impairment is characteristic of advanced stages, it can be present with less intensity since the beginning of the disease. Approximately 60% of PD patients fall once a year and 40% recurrently. On the other hand, cognitive symptoms affect up to 20% of patients with PD in early stages and can even precede the onset of motor symptoms. There are cognitive requirements for balance and can be challenged when attention is diverted or reduced, linking a worse balance and a higher probability of falls with a slower cognitive processing speed and attentional problems. Cognitive rehabilitation of attention and processing speed can lead to an improvement in postural stability in patients with Parkinson’s. Methods: We present a parallel and controlled randomized clinical trial (RCT) to assess the impact on balance of a protocol based on cognitive rehabilitation focused on sustained attention through the NeuronUP platform (Neuronup SI, La Rioja, Spain) in patients with PD. For 4 weeks, patients in the experimental group will receive cognitive therapy three days a week while the control group will not receive any therapy. The protocol has been registered at trials.gov NCT04730466. Conclusions: Cognitive therapy efficacy on balance improvement may open the possibility of new rehabilitation strategies for prevention of falls in PD, reducing morbidity, and saving costs to the health care system.

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The Effect of Smartphone-Based Cognitive Training on the Functional/Cognitive Markers of Schizophrenia: A One-Year Randomized Study

Journal of Clinical Medicine ◽

10.3390/jcm9113681 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3681

Author(s):

Marek Krzystanek ◽

Krzysztof Krysta ◽

Mariusz Borkowski ◽

Katarzyna Skałacka ◽

Jacek Przybyło ◽

...

Keyword(s):

Cognitive Function ◽

Cognitive Training ◽

Cognitive Rehabilitation ◽

Reference Group ◽

Paranoid Schizophrenia ◽

Randomized Study ◽

Functional Markers ◽

Open Label ◽

Antipsychotic Therapy ◽

The Impact

Background: Cognitive impairment is associated with long-term disability that results in the deterioration of both the social and professional status of individuals with schizophrenia. The impact of antipsychotic therapy on cognitive function is insufficient. Cognitive training is therefore proposed as a tool for cognitive rehabilitation in schizophrenia. In this study we investigated the effect of self-administered cognitive training using a smartphone-based application on the cognitive function of paranoid schizophrenia patients focusing on response time, correct answer rate, incorrect answer rate, and fatigability to check, if these functions can be functional markers of successful cognitive-smartphone rehabilitation. Methods: 1-year multicenter, open-label randomized study was conducted on 290 patients in a state of symptomatic remission. 191 patients were equipped with the full version of the application and conducted cognitive training twice a week. Reference group (n = 99) was provided with a version of the application having only limited functionality, testing the cognitive performance of patients every 6 months. Results: Statistically significant improvement was observed in both the rate of correct answers (by 4.8%, p = 0.0001), and cognitive fatigability (by 2.9%, p = 0.0001) in the study group, along with a slight improvement in the rate of incorrect answers (by 0.9%, p = 0.15). In contrast, the reference group, who performed cognitive training every 6 months, demonstrated no significant changes in any cognitive activities. Conclusions: Cognitive trainings facilitated by a smartphone-based application, performed regularly for a longer period of time are feasible and may have the potential to improve the cognitive functioning of individuals with schizophrenia. Correct answers and cognitive fatigability have potential to be functional markers of successful smartphone-based psychiatric rehabilitations in schizophrenia patients.

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Towards Personalized Web-based Cognitive Rehabilitation for Patients with Ischemic Stroke: An Elo Rating Approach (Preprint)

10.2196/preprints.28090 ◽

2021 ◽

Author(s):

Alejandro Garcia-Rudolph ◽

Jaume Lopez ◽

Eloy Opisso ◽

Josep Maria Tormos ◽

Vince I. Madai ◽

...

Keyword(s):

Ischemic Stroke ◽

Verbal Memory ◽

Cognitive Rehabilitation ◽

Treated Patient ◽

Inpatient Rehabilitation ◽

Operating Characteristics ◽

Web Based ◽

Rehabilitation Outcomes ◽

Number Of Patients ◽

The Impact

BACKGROUND Stroke is a worldwide cause of disability, 40% of stroke survivors sustain cognitive impairments, most of them follow inpatient rehabilitation at specialized clinical centers. Web-based cognitive rehabilitation tasks are already integrated into clinical settings. The impact of a task execution depends on the ratio between the skills of the treated patient and the challenges imposed by the task itself. Thus, treatments personalization requires a trade-off between patients’ skills and tasks difficulties, which is still an open issue. In this work we propose Elo ratings to support clinicians in representing patients’ skills and supporting tasks assignations to optimize rehabilitation outcomes. OBJECTIVE i) perform a stratification of patients with ischemic stroke at early stage of rehabilitation in three levels according to their Elo rating ii) show the relationships between the Elo rating levels, tasks difficulty levels and rehabilitation outcomes iii) determine if Elo rating obtained at early stages of rehabilitation is a significant predictor of rehabilitation outcomes. METHODS The PlayerRatings R library was used to obtain the Elo rating for each patient. Working memory was assessed using the DIGITS subtest of Test Barcelona and the Rey Auditory Verbal Memory Test (RAVLT) was used to assess verbal memory. The three subtests of RAVLT were used: RAVLT learning (RAVLT075), free-recall memory (RAVLT015) and recognition (RAVLT015R). Memory predictors were identified using forward stepwise selection to add covariates to the models which were evaluated by assessing discrimination using the area under the receiver operating characteristics curve (AUC) for logistic regressions and adjusted R2 for linear regressions. RESULTS Three Elo levels (Low, Mid and High) with the same number of patients (n=96) in each Elo group, were obtained using the 50 initial tasks executions (from a total of 38,177) for n=288 adult patients consecutively admitted for inpatient rehabilitation in a clinical setting. The highest proportion of patients that improved in all 4 memory items were from Mid Elo level: 56.7% of them improved in DIGITS, 67.1% in RAVLT075, 58.8% in RAVLT015 and 53.7% in RAVLT015R (p < 0.001). The proportion of patients from the Mid Elo level that performed tasks at difficulty levels #1, #2 and #3 were: 32.1%, 31.0% and 36.9% (p < 0.001) respectively, showing the highest match between skills (represented by Elo level) and tasks difficulties, considering the set of 38,177 tasks executions. Elo ratings were significant predictors in 3 of the 4 models and quasi-significant in the other. When predicting RAVLT075 and DIGITS at discharge we obtained R2=0.54 and R2=0.43 respectively, meanwhile in RAVLT075 and DIGITS improvement predictions we obtained AUC= 0.73, 95% CI(0.64-0.82) and AUC= 0.81 95%CI(0.72-0.89). CONCLUSIONS Elo ratings can support clinicians at early rehabilitation stages in identifying cognitive profiles that can be used to assign tasks’ difficulty levels.

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A-133 Emotion Regulation Strategy Use in Veterans with Subjective Cognitive Complaints in a Neuropsychology Clinic

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.151 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1184-1184

Author(s):

Tara Austin ◽

Shawneen Pazienza ◽

Crystal Lantrip

Keyword(s):

Emotion Regulation ◽

Cognitive Rehabilitation ◽

Psychological Intervention ◽

Cognitive Strategies ◽

Cognitive Complaints ◽

Modifiable Factors ◽

Regulation Strategies ◽

Participant Understanding ◽

The Impact ◽

Subjective Cognitive Complaints

Abstract Objective Neuropsychological evaluations reveal individuals with both objective and subjective cognitive complaints. Subjective cognitive complaints (SCC) are often related to potentially modifiable factors, such as mood. One proposed treatment for cognitive complaints is to focus on emotion regulation rather than cognitive rehabilitation. This project examines acceptability and feasibility from the perspective of participants, and determines participant understanding of the relationship between mood and cognition following a brief, one session emotion regulation intervention. Method Two study authors interviewed a subgroup of participants enrolled in a larger longitudinal intervention study about their understanding of the impact of mood on cognitive functioning, the acceptability of the intervention, and ease of using the provided strategies. Study authors then used inductive coding to identify common themes in participants’ responses. Results Preliminary results reveal the following themes: 1. Participant understanding that current cognitive concerns are related to modifiable factors (e.g., sleep, pain, emotional distress) rather than damage to brain structures or a neurodegenerative process. 2. Participants’ need for attentional and memory strategies to consistently use emotional regulation strategies day to day as well as participate fully in adjunctive psychological treatment. 3. Post-intervention awareness of high levels of everyday rumination. Conclusion Individuals with SCCs are amenable to psychological intervention, particularly when delivered with a brain-behavior explanation of how modifiable factors contribute to cognitive difficulties. In order to most successfully apply these strategies, participants may also benefit from targeted cognitive strategies to improve their use of emotion regulation strategies.

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The Impact of Mild Stroke on Participation in Physical Fitness Activities

Stroke Research and Treatment ◽

10.1155/2012/548682 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Mary Hildebrand ◽

Megan Brewer ◽

Timothy Wolf

Keyword(s):

High Intensity ◽

Cognitive Rehabilitation ◽

Leisure Activities ◽

Leisure Activity ◽

Physical Activities ◽

High Demand ◽

Before And After ◽

Intensity Physical Activity ◽

Mild Stroke ◽

The Impact

Objective. To compare participation in moderate to high intensity physical activities in persons before and after a mild stroke.Methods. We used data from the Cognitive Rehabilitation and Research Group to examine changes in moderate to high intensity physical activity participation in persons who had a mild stroke as defined by an NIH Stroke Scale score of less than 6 (N=127). Using the Activity Card Sort, we compared the participants' high-demand leisure activity (leisure activities that are moderate to high intensity physical activities) participation at 6-months after stroke with their prestroke level.Results. We found a significant decrease in numbers of high-demand leisure activities in all participants and in each demographic group after mild stroke.Conclusion. These results suggest that persons after mild stroke are not retaining the high-demand leisure activities they were doing prior to their stroke. Health professionals must promote participation in high-demand leisure activities in patients with mild stroke as a tool to enhance health and fitness.

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Impact of expressive writing on everyday memory functioning

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2057 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S557-S557

Author(s):

B. Abuhamda ◽

A. Soliman

Keyword(s):

Cognitive Functioning ◽

Expressive Writing ◽

Cognitive Rehabilitation ◽

Memory Performance ◽

Control Group ◽

Everyday Memory ◽

Memory Functioning ◽

Study Results ◽

Competing Interest ◽

The Impact

IntroductionThe suppression of negative feelings and traumatic events has detrimental effect on mental and physical health. One of the promising techniques to reduce stress related to trauma is expressive writing. Expressive writing has been found successful with different types of maladaptive behaviors e.g., pain, depression, anxiety and cognitive dysfunctioning.ObjectivesThis study investigates the impact of different categories of expressive writing on improving every day memory performance and cognitive functioning.AimsExamining the impact of cognitive functioning and everyday memory.MethodsA sample of 90 participants took part in this study. The participants aged (21 and 65 yrs.) 47 of them are females aged between average of (21.64 yrs.), and 43 males aged between average of (21, 49 yrs.). The participants were classified randomly into three groups (a control group, and two experimental groups [pen and oral writing]). The three groups were administered the Every Memory Questionnaire and Taranto Alexithymia Scale.ResultsThe results showed that there were no significant differences among the three groups in each of the Alexithymia and Everyday memory, which indicates random distribution of the three groups. The results showed that both of the experimental groups were improved on everyday memory functioning. More importantly, the results indicated that there were no significant differences between using pen or figures in expressive writing to improve Everyday memory.ConclusionStudy results showed the significant impact of expressive writing on every day memory functioning, furthermore, the study results are used to empathize on the cognitive rehabilitation of the individuals as well as to improve self-esteem on general psychological individual cases.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm9103115 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3115

Author(s):

Marianna Avola ◽

Giulia Rita Agata Mangano ◽

Gianluca Testa ◽

Sebastiano Mangano ◽

Andrea Vescio ◽

...

Keyword(s):

Physical Therapy ◽

Femoral Neck ◽

Cognitive Rehabilitation ◽

Femoral Neck Fractures ◽

Postoperative Rehabilitation ◽

Randomized Controlled ◽

New Methods ◽

Rehabilitation Protocols ◽

Neck Fracture ◽

The Impact

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It has been identified as one of the most common comorbidities associated with femoral neck fracture (FNF). The aim of this review was to evaluate the impact of physical therapy on FNF patients’ function and rehabilitation. The selected articles were randomized controlled trials (RCTs), published in the last 10 years. Seven full texts were eligible for this review: three examined the impact of conventional rehabilitation and nutritional supplementation, three evaluated the effects of rehabilitation protocols compared to new methods and a study explored the intervention with erythropoietin (EPO) in sarcopenic patients with FNF and its potential effects on postoperative rehabilitation. Physical activity and dietary supplementation are the basic tools of prevention and rehabilitation of sarcopenia in elderly patients after hip surgery. The most effective physical therapy seems to be exercise of progressive resistance. Occupational therapy should be included in sarcopenic patients for its importance in cognitive rehabilitation. Erythropoietin and bisphosphonates could represent medical therapy resources.

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Past, Present, and Future of Non-invasive Brain Stimulation Approaches to Treat Cognitive Impairment in Neurodegenerative Diseases: Time for a Comprehensive Critical Review

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2020.578339 ◽

2021 ◽

Vol 12 ◽

Author(s):

Clara Sanches ◽

Chloé Stengel ◽

Juliette Godard ◽

Justine Mertz ◽

Marc Teichmann ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Neurodegenerative Diseases ◽

Brain Stimulation ◽

Critical Review ◽

Cognitive Rehabilitation ◽

Financial Burden ◽

Cortical Atrophy ◽

Non Invasive ◽

The Impact

Low birth rates and increasing life expectancy experienced by developed societies have placed an unprecedented pressure on governments and the health system to deal effectively with the human, social and financial burden associated to aging-related diseases. At present, ∼24 million people worldwide suffer from cognitive neurodegenerative diseases, a prevalence that doubles every five years. Pharmacological therapies and cognitive training/rehabilitation have generated temporary hope and, occasionally, proof of mild relief. Nonetheless, these approaches are yet to demonstrate a meaningful therapeutic impact and changes in prognosis. We here review evidence gathered for nearly a decade on non-invasive brain stimulation (NIBS), a less known therapeutic strategy aiming to limit cognitive decline associated with neurodegenerative conditions. Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation, two of the most popular NIBS technologies, use electrical fields generated non-invasively in the brain to long-lastingly enhance the excitability/activity of key brain regions contributing to relevant cognitive processes. The current comprehensive critical review presents proof-of-concept evidence and meaningful cognitive outcomes of NIBS in eight of the most prevalent neurodegenerative pathologies affecting cognition: Alzheimer’s Disease, Parkinson’s Disease, Dementia with Lewy Bodies, Primary Progressive Aphasias (PPA), behavioral variant of Frontotemporal Dementia, Corticobasal Syndrome, Progressive Supranuclear Palsy, and Posterior Cortical Atrophy. We analyzed a total of 70 internationally published studies: 33 focusing on Alzheimer’s disease, 19 on PPA and 18 on the remaining neurodegenerative pathologies. The therapeutic benefit and clinical significance of NIBS remains inconclusive, in particular given the lack of a sufficient number of double-blind placebo-controlled randomized clinical trials using multiday stimulation regimes, the heterogeneity of the protocols, and adequate behavioral and neuroimaging response biomarkers, able to show lasting effects and an impact on prognosis. The field remains promising but, to make further progress, research efforts need to take in account the latest evidence of the anatomical and neurophysiological features underlying cognitive deficits in these patient populations. Moreover, as the development of in vivo biomarkers are ongoing, allowing for an early diagnosis of these neuro-cognitive conditions, one could consider a scenario in which NIBS treatment will be personalized and made part of a cognitive rehabilitation program, or useful as a potential adjunct to drug therapies since the earliest stages of suh diseases. Research should also integrate novel knowledge on the mechanisms and constraints guiding the impact of electrical and magnetic fields on cerebral tissues and brain activity, and incorporate the principles of information-based neurostimulation.

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