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Prism adaptation (PA) is both a visuomotor learning task and potential treatment for spatial neglect after stroke. While PA's aftereffects can improve neglect symptoms, therapeutic benefits vary across individuals, possibly due to differences in neglect subtypes. Neglect symptoms can be described along an information processing pathway, yielding perceptual (input) and premotor (output) neglect subtypes. There is some evidence that PA mainly benefits persons with premotor neglect. We investigated whether PA modulates the premotor stage of information processing by examining whether PA could induce a premotor bias in healthy adults. We measured perceptual and premotor biases using a speeded reach task that compares the initiation time of leftward and rightward reaches to lateralized targets from different hand start positions. Using a randomized mixed experimental design, 30 right-handed healthy adults completed this speeded reach task before and after either left-shifting (n = 15) or right-shifting (n = 15) PA. As hypothesized, left-shifting PA speeded initiation time specifically for reaches in the rightward direction, regardless of target location (p =.02, ηp2 =.18), suggesting that PA induced a premotor bias in the direction of the prism aftereffect. These findings have implications for PA's underlying mechanisms, which can inform visuomotor learning theories and PA's use as a treatment for spatial neglect. [ABSTRACT FROM AUTHOR]

Cognitive activity questionnaires could provide insight into neurocognitive reserve. The Lifetime Cognitive Activities Questionnaire (LCAQ) assesses cognitive activities at four stages of life. The Modified Current Cognitive Activities Questionnaire (CCAQ) assesses current cognitive activities. We examined the construct validity, internal consistency, test-retest reliability, and stability of these questionnaires throughout the Brain in Motion (BIM) study and their relationship with cognitive performance. The LCAQ, Montreal Cognitive Assessment (MoCA), and neuropsychological battery were administered at the initial pre-intervention and six-year follow-up. The CCAQ was administered at five timepoints. Construct validity of the CCAQ/LCAQ was assessed using proxies of cognitive engagement (educational attainment and the North American Adult Reading Test [NAART]). Cronbach alpha analysis determined internal consistency. LCAQ reliability was established by comparing the pre-intervention and six-year follow-up. CCAQ reliability was determined by comparing both pre-intervention assessments, correlations throughout BIM determined stability. A multiple linear regression investigated the associations between cognitive engagement and cognitive domains derived from a principal component analysis. MoCA scores at the initial pre-intervention (27.49 ± 1.46) and six-year follow up (26.53 ± 2.08). The LCAQ and CCAQ correlated with educational attainment and the NAART. The LCAQ (n = 266) produced an alpha of 0.90 (20 items). The CCAQ (n = 261) resulted in an alpha of 0.71 (25 items). LCAQ scores (n = 94) at the initial pre-intervention and six-year follow-up were correlated. CCAQ (n = 94) scores at the initial pre-intervention correlated with scores at all five other timepoints. The multiple linear regression revealed associations between the CCAQ and verbal memory/attention. The NAART was associated with processing speed, concept formation, and verbal memory/attention. In the absence of cognitive decline, these questionnaires exhibit significant construct validity, internal consistency, test-retest reliability, and the CCAQ displayed stability. The NAART and CCAQ were associated with neuropsychological performance. Our findings support future use of these questionnaires and exemplify the neuroprotective role of cognitive engagement. [ABSTRACT FROM AUTHOR]

Normal observers demonstrate a bias to process the left sides of faces during perceptual judgments about identity or emotion. This effect suggests a right cerebral hemisphere processing bias. To test the role of the right hemisphere and the involvement of configural processing underlying this effect, young and older control observers and patients with right hemisphere damage completed two chimeric faces tasks (emotion judgment and face identity matching) with both upright and inverted faces. For control observers, the emotion judgment task elicited a strong left-sided perceptual bias that was reduced in young controls and eliminated in older controls by face inversion. Right hemisphere damage reversed the bias, suggesting the right hemisphere was dominant for this task, but that the left hemisphere could be flexibly recruited when right hemisphere mechanisms are not available or dominant. In contrast, face identity judgments were associated most clearly with a vertical bias favouring the uppermost stimuli that was eliminated by face inversion and right hemisphere lesions. The results suggest these tasks involve different neurocognitive mechanisms. The role of the right hemisphere and ventral cortical stream involvement with configural processes in face processing is discussed.

Eleven autistic children, age 8-19, were administered a variation of the Stroop task which involved comprehending single words that differed along a concrete-abstract dimension and that exhibited varying amounts of interference. Both concrete and abstract words appeared as meaningful to autistic children as to reading-matched controls. (Author/JDD)

Aging is a very diverse process: successful agers retain most cognitive functioning, while others experience mild to severe cognitive decline. This decline may eventually negatively impact one's everyday activities. Therefore, scientists must develop approaches to counteract or, at least, slow down the negative change in cognitive performance of aging individuals. Combining cognitive training and transcranial direct current stimulation (tDCS) is a promising approach that capitalizes on the plasticity of brain networks. However, the efficacy of combined methods depends on individual characteristics, such as the cognitive and emotional state of the individual entering the training program. In this report, we explored the effectiveness of working memory training, combined with tDCS to the right dorsolateral prefrontal cortex (DLPFC), to manipulate working memory performance in older individuals. We hypothesized that individuals with lower working memory capacity would benefit the most from the combined regimen. Thirty older adults took part in a 5-day combined regimen. Before and after the training, we evaluated participants' working memory performance with five working memory tasks. We found that individual characteristics influenced the outcome of combined cognitive training and tDCS regimens, with the intervention selectively benefiting old-old adults with lower working memory capacity. Future work should consider developing individualized treatments by considering individual differences in cognitive profiles. [ABSTRACT FROM AUTHOR]

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The Simon effect refers to the performance advantage for responding to the nonspatial identity of the target when the target's irrelevant location corresponds with the relative location of the response. The present study is a parametric examination of the magnitude of the Simon effect across visual space. Response keys were arranged along vertical, horizontal, and two diagonal axes, and stimuli were arranged in two concentric circles (near and far from fixation) along the same axes. The results show that the Simon effect is of similar magnitude regardless of stimulus-responseaxis. In contrast to findings from stimulus-response compatibility paradigms, there was no evidence in this study for the presence of an orthogonal compatibility effect or left-right prevalence effect, suggesting that these effects only arise when response location is relevant. The results demonstrate the robust generalizability of the Simon effect under different spatial conditions and thus broaden the relevance of the Simon effect to a variety of applications.

Spatial neglect has profound implications for quality of life after stroke, yet we lack consensus for screening/diagnosing this heterogeneous syndrome. Our first step in a multi-stage research programme aimed to determine which neglect tests are used (within four categories: cognitive, functional, neurological and neuroimaging/neuromodulation), by which stroke clinicians, in which countries, and whether choice is by professional autonomy or institutional policy. 454 clinicians responded to an online survey: 12 professions (e.g., 39% were occupational therapists) from 33 countries (e.g., 38% from the UK). Multifactorial logistic regression suggested inter-professional differences but fewer differences between countries (Italy was an outlier). Cognitive tests were used by 82% (particularly by psychologists, cancellation and drawing were most popular); 80% used functional assessments (physiotherapists were most likely). 20% (mainly physicians, from Italy) used neuroimaging/ neuromodulation. Professionals largely reported clinical autonomy in their choices. Respondents agreed on the need for a combined approach to screening and further training. This study raises awareness of the translation gap between theory and practice. These findings lay an important foundation to subsequent collaborative action between clinicians, researchers and stroke survivors to reach consensus on screening and diagnostic measures. The immediate next step is a review of the measures' psychometric properties. [ABSTRACT FROM AUTHOR]

Cognitive-motor interference, as measured by dual-task walking (performing a mental task while walking), affects many clinical populations. Ankle-foot orthoses (AFOs) are lower-leg splints prescribed to provide stability to the foot and ankle, as well as prevent foot drop, a gait deficit common after stroke. AFO use has been shown to improve gait parameters such as speed and step time, which are often negatively impacted by dual-task walking. Our objective was to establish whether AFOs could protect against cognitive-motor interference, as measured by dual-task walking, following post-stroke hemiplegia. A total of 21 individuals with post-stroke hemiplegia that use an AFO completed a dual-task walking paradigm in the form of a 2 (walking with vs. without a concurrent cognitive task) by 2 (walking with vs. without an AFO) repeated-measures design. Changes to both motor and cognitive performance were analyzed. The results suggest that the use of an AFO improves gait overall in both single- and dual-task walking, particularly with respect to stride regularity, but there were no interactions to suggest that AFOs reduce the cognitive-motor dual-task costs themselves. A lack of differences in cognitive performance during dual-task walking with and without the AFO suggests that the AFO's benefit to motor performance cannot be attributed to task prioritization. These data support the use of AFOs to improve certain gait parameters for post-stroke hemiplegia, but AFOs do not appear to protect against cognitive-motor interference during dual-task walking. Future research should pursue alternate therapeutics for ameliorating task-specific declines under cognitively demanding circumstances. [ABSTRACT FROM AUTHOR]

BACKGROUND: While prism adaptation (PA) has been recognized as a promising tool for treating spatial neglect, implementation as a standard treatment in clinical care has been lagging. Limited evidence for the generalization of after-effects to everyday activities has been a barrier towards implementation. OBJECTIVES: This study examined whether a home-friendly standardized PA protocol (Peg-the-Mole, PTM) induces after-effects that can transfer to wheelchair maneuvering. We also examined the impact of using constant (1 starting hand position) or variable (3 starting hand positions) training conditions on the transfer of after-effects to wheelchair maneuvering. METHODS: Sixty participants were randomly assigned to one of four PTM conditions: 1) prisms/constant training; 2) prisms/variable training; 3) sham goggles/constant training; 4) sham goggles/variable training. RESULTS: The use of PTM with rightward shifting prisms induced after-effects on proprioceptive and visual pointing outcome tasks. Groups using PTM with prism goggles showed a leftward shift in their position within a wheelchair course and a reduction in the number of right-sided collisions. The training condition did not have an impact on the transfer of after-effects to wheelchair driving. CONCLUSION: PTM is a clinically appealing PA protocol that induces after-effects that can transfer to an everyday activity relevant to patients with neglect. [ABSTRACT FROM AUTHOR]

Abstract Background Despite lack of outward signs, most individuals after non-disabling stroke (NDS) and transient ischemic attack (TIA) have significant cardiovascular and cerebrovascular disease and are at high risk of a major stroke, hospitalization for other vascular events, or death. Most have multiple modifiable risk factors (e.g., hypertension, physical inactivity, hyperlipidaemia, diabetes, tobacco consumption, psychological stress). In addition, accelerated rates of depression, cognitive decline, and poor quality of sleep have been reported following TIA, which correlate with poor functional outcomes and reduced quality of life. Thus, NSD and TIA are important warning signs that should not be overlooked. The challenge is not unlike that facing other 'silent' conditions - to identify a model of care that is effective in changing people's current behaviors in order to avert further morbidity. Methods/Design A single blind, randomized controlled trial will be conducted at two sites to compare the effectiveness of a program of rehabilitative exercise and education versus usual care in modifying vascular risk factors in adults after NDS/TIA. 250 adults within 90 days of being diagnosed with NDS/TIA will be randomly allocated to a 12-week program of exercise and education (PREVENT) or to an outpatient clinic assessment and discussion of secondary prevention recommendations with return clinic visits as indicated (USUAL CARE). Primary outcome measures will include blood pressure, waist circumference, 12-hour fasting lipid profile, and 12-hour fasting glucose/hemoglobin A1c. Secondary measures will include exercise capacity, walking endurance, physical activity, cognitive function, depression, goal attainment and health-related quality of life. Outcome assessment will be conducted at baseline, post-intervention, and 6- and 12-month follow-ups. Direct health care costs incurred over one year by PREVENT versus USUAL CARE participants will also be compared. Ethical approval for the trial has been obtained from the relevant Human Research Ethics Boards. Discussion Whether timely delivery of an adapted cardiac rehabilitation model is effective in attaining and maintaining vascular risk reduction targets in adults after NDS/TIA is not yet known. We anticipate that the findings of this trial will make a meaningful contribution to the knowledge base regarding secondary stroke prevention. Trial registration This trial is registered with the Clinical Trials.gov Registry (NCT00885456).

Aging is associated with subjective memory complaints. Approximately half of those with subjective memory complaints have objective cognitive impairment. Previous studies have provided evidence of an association between genetic risk for Alzheimer's disease (AD) and dementia progression. Also, aging is a significant risk factor for vascular pathology that may underlie at least some of the cognitive changes. This study investigates the relative contribution of subjective cognitive complaints (SCC), vascular function, and genetic risk for dementia in predicting objective cognitive performance. Multiple regression and relative importance analysis were used to investigate the relative contribution of vascular function, self-reported SCC, and dementia genetic risk, in predicting objective cognition in a sample of 238 healthy community-dwelling older adults. Age, sex, premorbid cognitive abilities, subjective verbal memory complaints, higher cerebrovascular blood flow during submaximal exercise, and certain dementia risk alleles were significant predictors of worse objective verbal memory performance (p < 0.001, R 2 = 35.2–36.4%). Using relative importance analysis, subjective verbal memory complaints, and certain dementia risk alleles contributed more variance than cerebrovascular measures. These results suggest that age-related changes in memory in healthy older adults can be predicted by subjective memory complaints, genetic risk, and to a lesser extent, cerebrovascular function. [ABSTRACT FROM AUTHOR]

Introduction:Telerehabilitation has been promoted as a more efficient means of delivering rehabilitation services to stroke patients while also providing care options to those unable to attend conventional therapy. However, the application of telerehabilitation interventions in stroke populations has proven to be more challenging than anticipated, with many studies showing mixed results in terms of its efficacy. Six different clinical trials examining stroke telerehabilitation were initiated across Canada as part of the Heart and Stroke Foundation's 2013 Tele-Rehabilitation for Stroke Initiative, with interventions ranging from lifestyle coaching to delivering memory, speech, or physical training. The purpose of this article was to summarize the over-arching findings from this initiative, particularly the facilitators and barriers to the implementation of telerehabilitation services within a research context. Methods:Details of the projects were obtained directly from the study investigators and from materials published by each group. Qualitative open-ended questions were posed to each group for the discussion of lessons learned. Results:Important lessons learned from this initiative included: (1) the efficacy and cost of telerehabilitation is similar to that of traditional face-to-face management; (2) patients are satisfied with telerehabilitation services when trained appropriately and some social interaction occurs; (3) clinicians prefer face-to-face interactions but will use telerehabilitation when face-to-face is not feasible; and (4) technology should be selected based on ease of use and targeted to the skills and abilities of the users. Conclusions:Overall, results from these studies suggest that telerehabilitation services work best to augment face-to-face rehabilitation or when no other options are available. [ABSTRACT FROM AUTHOR]