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Cognitive dysfunction in people with relapsing-remitting multiple sclerosis can improve with cognitive rehabilitation or exercise. Similar effects have not been clearly shown in people with progressive multiple sclerosis. We aimed to investigate the individual and synergistic effects of cognitive rehabilitation and exercise in patients with progressive multiple sclerosis. CogEx was a randomised, sham-controlled trial completed in 11 hospital clinics, universities, and rehabilitation centres in Belgium, Canada, Denmark, Italy, UK, and USA. Patients with progressive multiple sclerosis were eligible for inclusion if they were aged 25–65 years and had an Expanded Disability Status Scale (EDSS) score of less than 7. All had impaired processing speed defined as a performance of 1·282 SD or greater below normative data on the Symbol Digit modalities Tests (SDMT). Participants were randomly assigned (1:1:1:1), using an interactive web-response system accessed online from each centre, to cognitive rehabilitation plus exercise, cognitive rehabilitation plus sham exercise, exercise plus sham cognitive rehabilitation, or sham exercise plus sham cognitive rehabilitation. The study statistician created the randomisation sequence that was stratified by centre. Participants, outcome assessors, and investigators were blinded to group allocation. The study statistician was masked to treatment during analysis only. Interventions were conducted two times per week for 12 weeks: cognitive rehabilitation used an individualised, computer-based, incremental approach to improve processing speed; sham cognitive rehabilitation consisted of internet training provided individually; the exercise intervention involved individualised aerobic training using a recumbent arm–leg stepper; and the sham exercise involved stretching and balance tasks without inducing cardiovascular strain. The primary outcome measure was processing speed measured by SDMT at 12 weeks; least squares mean differences were compared between groups using linear mixed model in all participants who had a 12-week assessment. The trial is registered with ClinicalTrials.gov , NCT03679468 , and is completed. Between Dec 14, 2018, and April 2, 2022, 311 people with progressive multiple sclerosis were enrolled and 284 (91%) completed the 12-week assessment (117/311 [38%] male and 194/311 [62%] female). The least squares mean group differences in SDMT at 12 weeks did not differ between groups (p=0·85). Compared with the sham cognitive rehabilitation and sham exercise group (n=67), differences were –1·30 (95% CI –3·75 to 1·16) for the cognitive rehabilitation plus exercise group (n=70); –2·78 (–5·23 to –0·33) for the sham cognitive rehabilitation plus exercise group (n=71); and –0·71 (–3·11 to 1·70) for the cognitive rehabilitation plus sham exercise group (n=76). 11 adverse events possibly related to the interventions occurred, six in the exercise plus sham cognitive rehabilitation group (pain, dizziness, and falls), two in the cognitive rehabilitation plus sham exercise group (headache and pain), two in the cognitive rehabilitation and exercise group (increased fatigue and pain), and one in the dual sham group (fall). Combined cognitive rehabilitation plus exercise does not seem to improve processing speed in people with progressive multiple sclerosis. However, our sham interventions were not inactive. Studies comparing interventions with a non-intervention group are needed to investigate whether clinically meaningful improvements in processing speed might be attainable in people with progressive multiple sclerosis. MS Canada. [ABSTRACT FROM AUTHOR]

Technological innovation contributes to a personalised and integrated approach in education, journalism, communication, management, marketing, and above all, in healthcare. Facing the increasing number of new patients and the shortage of health specialists, the emergence of innovative technologies has brought the fields of health and technology closer together. This research aims to study digital environments in the context of neurocognitive rehabilitation, for the care of patients with deficits in cognitive functions, supported by Serious Games (SG). Typically, neurological patients suffer from cognitive deficits in executive, visuospatial, attention and/or memory functions. In this context, SG prefigure an appropriated tool that combines healthcare and rehabilitation, which allows the connection of healthcare specialists with a platform, as the connection of patients with life and disease companions with potential for collaboration and recording the evolution of the rehabilitation process. Aiming to identify the characteristics and requirements of SG in exposing neurological patients to a safe technological environment that simulates rehabilitation activities supported by SG (developed and oriented to their specificities), but also to make a comparison with traditional methods (TM). A model of comparison between the two paradigms was elaborated, which allowed the collection of requirements and characteristics for future developments. In conclusion, SG are not strictly better than traditional treatment (TT) methods in this context, but the elaborated comparison tends to point out that SG are sovereign to TM in improving training and producing quality data (in safety) for analysis, which allows the total rehabilitation process to be better conducted. [ABSTRACT FROM AUTHOR]

Long COVID, a term used to describe ongoing symptoms after COVID-19 infection, parallels the course of other postviral syndromes. Neuropsychiatric symptoms of long COVID can be persistent and interfere with quality of life and functioning. Within the biopsychosocial framework of chronic illness, rehabilitation professionals can address the neuropsychiatric sequelae of long COVID. However, current practice models are not designed to address concurrent psychiatric and cognitive symptoms in adults living with long COVID. Thus, we present a biopsychosocial framework for long COVID and provide treatment strategies based on evidence from current literature of postviral chronic illness. These recommendations will guide rehabilitation professionals in identifying common neuropsychiatric symptoms in long COVID that can be targeted for intervention and addressing these symptoms via integrative interventions taking into account the biopsychosocial presentation of long COVID symptoms. [ABSTRACT FROM AUTHOR]

This paper describes the protocol for a Phase I/II, parallel-group, single-blind randomized controlled trial (RCT). The RCT investigates the combined effects of 12-weeks of aerobic exercise training (AET) integrated with virtual reality (VR) and cognitive rehabilitation (CR) on new learning and memory in 78 persons with multiple sclerosis (MS) who have mobility disability and objective impairments in learning and memory. Participants will undergo baseline assessments consisting of neuropsychological testing, neuroimaging, self-report questionnaires, and cardiorespiratory fitness. Participants will then be randomized into one of two conditions using concealed allocation: aerobic cycling exercise that incorporates VR combined with CR or stretching and toning (i.e., active control; S/T) combined with CR. Participants will be masked regarding the intent of the conditions. After 7-weeks of exercise alone, the 5-week Kessler Foundation modified Story Memory Technique (KF-mSMT®) will be integrated into the training. After the 12-week training period, participants will complete the same measures as at baseline administered by treatment-blinded assessors. Primary study outcomes include new learning and memory (NLM) measured by a small battery of neuropsychological assessments that assess list learning (California Verbal Learning Test-II), prose memory (Memory Assessment Scale), visuospatial memory (Brief Visuospatial Memory Test-Revised), and everyday memory (Ecological Memory Simulations). Secondary study outcomes include neuroimaging outcomes of hippocampal structure, function, and connectivity. If successful, this trial will provide the first Class I evidence supporting the unique combination of aerobic cycling exercise with VR and CR for treating MS-related learning and memory impairments in persons with mobility disability. • The impact of cognitive impairment in MS increases with greater disease progression (i.e., mobility disability). • Cognitive rehabilitation effectively improves one specific domain of learning and memory (i.e., list-learning). • Combining cognitive rehabilitation and aerobic exercise may lead to bigger and broader cognitive improvements. • Adding virtual reality to exercise may further improve learning and memory by increasing the multisensory demand. • This trial will provide Class I evidence supporting this combinatory treatment for MS-related learning and memory. [ABSTRACT FROM AUTHOR]

• Symptoms of depression and anxiety significantly reduced post-intervention. • Acceptance of MS significantly increased post-intervention. • Participants reported that they felt more equipped to manage the "invisible" symptoms of MS. • Participants valued the peer support that evolved during the groups. • The online format was considered more accessible than in-person groups. People with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These "invisible" symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This 'Neuropsychological Intervention for Managing Invisible Symptoms' in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the 'Triflex' of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters. 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the "invisible" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection. Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS. [ABSTRACT FROM AUTHOR]

• TPMI is the first clinical trial targeting prospective memory (PM) in MS. • Participants had moderate-to-high treatment ratings for the intervention. • The majority (88.2 %) completed all eight telehealth sessions. • There is early evidence that TPMI improves time-based PM. Persons with multiple sclerosis (PwMS) can experience deficits in prospective memory (PM) or "remembering to remember," which are associated with functional difficulties. However, no cognitive rehabilitation intervention has specifically addressed improving PM in PwMS. The Telehealth PM Intervention (TPMI) provides a novel combination of two strategies—visual imagery and implementation intentions—that have each been beneficial in other populations. This study aimed to evaluate the feasibility of TPMI and its preliminary efficacy, which could be used to inform future trials. Participants (n = 35) were PwMS who were pre-screened and endorsed experiencing problems "remembering places they have to be" and "things they have to do." After completing a baseline evaluation, which included objective (Memory for Intentions Test; MIST) and subjective (Perceived Deficits Questionnaire; PDQ-PM) measures of PM, participants were randomized to either the active treatment (TPMI; n = 17) or active control group (Control; n = 18). TPMI was offered through remote one-on-one sessions twice a week over a four-week period. Participants were asked about treatment credibility and expectancy during the first session. The MIST and PDQ-PM were repeated at post-treatment, where treatment satisfaction was also captured. Mann-Whitney U and chi-square tests were used to examine the feasibility measures, while repeated measures ANOVAs were used to examine changes in the PM outcomes. A total of 88.2 % of the TPMI group completed all eight sessions, with moderate-to-high (≥7 out of 10) treatment credibility/expectancy and satisfaction reported by 93.3 % and 86.7 %, respectively. While there were no significant effects on overall PM, the TPMI group had an improvement in objective time-based PM after adjusting for baseline differences (F(1,29) = 4.61, p = 0.040; d = 0.80). Furthermore, the TPMI group had a significant reduction in the number of time-based loss of content errors compared to the Control group, which remained significant after covariate adjustment (F(1,25) = 4.29, p = 0.049; d = 0.83). TPMI is a feasible intervention, with high completion rates and moderate-to-high treatment ratings, that can be delivered remotely. Early evidence shows its potential benefit for improving time-based PM, a particular concern for PwMS, which should be further evaluated in a larger clinical trial. [ABSTRACT FROM AUTHOR]

Children with cerebral palsy (CP) experience deficits in nonverbal reasoning. The SMART online cognitive intervention has been associated with gains in IQ and nonverbal IQ in previous studies in typically developing school-aged children and children experiencing learning difficulties. To assess the efficacy of an online cognitive intervention in school-aged children with CP. 21 children with CP (male n = 17; 76.2%), mean age 9 y 8 m, SD 1 y 1 month (range 8 y 3 m to 12 y 6 m) were randomised into the intervention group (n = 9) or a waitlist control group. A mixed-methods approach with an explanatory sequential design was used, with a randomised controlled trial followed by qualitative interviews. Participants were assessed on measures of intelligence, academic ability, attention and executive functioning, and social-emotional functioning at baseline, then after completing the training, or the waitlist period. Analyses included ANCOVAs and paired samples t tests. Semi-structured interviews explored participants' experiences with the training. Training completion was low with a mean of 16.9 modules completed out of 55 available. No significant effect of training was found for the primary outcome of intelligence, or for any secondary outcomes. Participants reported barriers and facilitators for accessing the program. Cognitive training programs addressing relational framing ability may require significant modifications before they can be effectively tested with children with CP. • RCT of a novel online cognitive intervention in children with cerebral palsy. • Intervention grounded in relational frame theory to train relational abilities. • Qualitative data on acceptability and accessibility of online intervention. • Results highlight importance of targeted, individualised intervention. • Concrete and visual aids may assist children to engage with training. [ABSTRACT FROM AUTHOR]

• Cognitive rehabilitation might induce reorganization of grey matter networks in MS. • Local brain efficiency was improved after a 5-week cognitive intervention program. • Graph analysis can provide an important tool to explore pathological connectivity. Multiple Sclerosis (MS) has been shown to significantly impair brain connectivity, as alterations in functional and structural networks have been identified and associated with clinical status, particularly cognitive deficits. We aimed to identify structural connectivity changes in grey matter networks following cognitive rehabilitation (CR) in persons with MS (PwMS). Fifteen long-standing PwMS underwent a 5-week CR-program and five healthy controls (HC) were also investigated. T1-weighted MRI scans and neuropsychological tests were obtained before and after CR. T1-weighted scans were used to examine grey matter networks with graph analytic parameters [betweenness centrality (BC), degree (D), clustering (Cl), path length (PL) and small world properties: connectedness, gamma and lambda values]. Results were analysed at the whole brain level and for each brain lobe. Before CR, PwMS displayed lower values for D in the left parietal lobe (p = 0.009) compared to HC. After CR, significant increases in Cl located in frontal (p = 0.024) and temporal (p = 0.026) regions in PwMS were accompanied by significant decreases in PL located in the right parietal lobe (p = 0.025) and BC globally (p = 0.010). Overall, CR may prevent a network worsening in long-standing PwMS by increasing local efficiency of the brain and therefore facilitating compensation mechanisms. [ABSTRACT FROM AUTHOR]

• Attention and response control are disrupted in ADHD. • RehaCom improves auditory and visual response control in children with ADHD. • RehaCom cannot improve auditory and visual attention in children with ADHD. Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in children. ADHD impairs attention, response control, emotion regulation, and other cognitive functions. On the other hand, RehaCom is a cognitive rehabilitation software that has therapeutic effects on cognitive dysfunctions in many diseases such as stroke, multiple sclerosis, and schizophrenia. The goal of the present study was to investigate the effect of treatment with RehaCom on auditory and visual response control, and auditory and visual attention in children with ADHD. Forty patients were selected. The participants were assigned to control (n = 20) and experimental (n = 20) groups, while only the participants in the experimental group were trained by RehaCom for five weeks (ten 45-min sessions, two sessions per week). At weeks 0 and 5, performance of the participants of experimental group was compared with the participants of control group. The results showed that treatment with RehaCom significantly improved auditory and visual response control in children with ADHD, with no effect on auditory and visual attention. In conclusion, RehaCom may alter brain's structural and functional properties that are related to response control. We suggest that attention deficit in ADHD may be a result of more complicated dysfunctions in the brain, that are not affected by RehaCom. [ABSTRACT FROM AUTHOR]

"Cancer Related Cognitive Impairment" (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway. We conducted a systematic literature review following the PRISMA guidelines from 01 to 01–2019 to 16–07–2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome. Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies). CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation. The review was recorded on Prospero (01–03–2020), with the registration number 135,627. [ABSTRACT FROM AUTHOR]

Tele-rehabilitation aims at increasing clinical outcomes while reducing costs and improving patients' quality of life (QoL). However, two main challenges need to be addressed to ensure its effectiveness: remote motor and cognitive rehabilitation. In this research work, we want to focus on the latter. Our idea is to integrate the concept of Emotional AI into tele-rehabilitation by monitoring the facial expressions of patients during motor rehabilitation exercises. Thus, we can assess the patient's cognitive and emotional state, with the objective of determining the relationship between motor and cognitive rehabilitation outcomes. Therefore, this study considers a Cloud/Edge continuum tele-rehabilitation scenario where a Hospital Cloud interacts with remote rehabilitation and monitoring Edge devices placed in patients' homes and/or rehabilitation centres. Specifically, we want to assess the performance of a Facial Expression Recognition (FER) system that can be deployed at the Edge. To achieve our goal, we employ the MediaPipe suite of libraries, which is optimized to run on low-resource devices. In particular, we used its Face Mesh module that is capable of generating a face mesh (i.e., a set of 3D face points) from an input image. The features of the mesh are then used to train a classifier that can identify the different facial expressions defined in Ekman's model (i.e., angry, fear, happy, sad, surprise, and neutral). In our experiments, we tested several combinations of datasets, face meshes (FMs), face feature maps (FFMs), and classifiers to identify the best-performing solution and demonstrate the applicability of this approach in a tele-rehabilitation environment. • Tele-rehabilitation (TR) aims at increasing clinical outcomes and patients' QoL. • Applying the concept of Emotional AI to tele-rehabilitation in a Cloud/Edge scenario. • Assessing the performance of a lightweight Facial Expression Recognition (FER) model. • MediaPipe was adopted to generate a face feature map used to train a classifier. • Experiments show the applicability of this model in a tele-rehabilitation framework. [ABSTRACT FROM AUTHOR]

Examine changes in cortical gray matter following computerized cognitive training for auditory information processing in chronic adults with traumatic brain injury (TBI). 14-week, quasi-experimental design. Laboratory. Nineteen adults (intervention: 11; control: 8) with mild to severe TBI (mean age = 42.6 years [SD = 11.0], male = 58%, time since injury = 124.6 months [SD = 146.1]). The intervention group underwent 40 one-hour sessions over 14 weeks with the Brain Fitness Program, focusing on auditory information processing exercises. Training progressively increased in difficulty, ensuring an 85% correct response rate. Participants used noise-canceling headphones. The control group did not receive an intervention but was contacted once a week. MRI data was captured twice (baseline & one-week post-training) at NYU's Center for Biomedical Imaging on a 3T Siemens Tim Trio or Prisma Fit whole-body scanner using a 12-channel head coil. Cortical surface reconstruction and data extraction were facilitated by FreeSurfer. While none of the results remained statistically significant after controlling for multiple comparisons with False Discovery Rate correction, the intervention group exhibited more pronounced post-intervention gray matter volume (GMV) changes compared to the control group in both the left and right brain lobes (left: f2 = 0.213; right: f2 = 0.510). Notably, the right frontal (f2 = 0.736) and right occipital (f2 = 0.617) regions exhibited large effects. Medium effects were found in the left occipital (f2 = 0.342), left frontal (f2 = 0.201), and right parietal regions (f2 = 0.156). Preliminary findings indicate that computerized auditory information processing training induces neuroplastic changes in GMV in chronic TBI populations. None. [ABSTRACT FROM AUTHOR]

To investigate the effect of a metacognitive strategy-based intervention, the Multicontext Approach, on functional cognition among people with Parkinson disease (PD) without dementia. Double-blind randomized controlled trial. PD participants completed pre-treatment assessment and then were randomized to either the Multicontext (MC) or Control group stratified by gender and MoCA score (25/26). Participants in both groups received 10 ∼weekly treatment sessions and then completed 1 week post-treatment and 3 month follow-up assessments. Participants' homes. Non-demented community-dwelling people with PD with subjective cognitive decline recruited from a university movement disorders center and the surrounding community. Sixty participants were enrolled (of 237 screened), 54 were eligible, and 47 (26 MC, 21 Control) had complete data for these analyses. The MC intervention uses a metacognitive framework and mediated learning techniques to enhance awareness, strategy use and self-monitoring across functional cognitive activities. Structured functional treatment activities were used to promote transfer of learning across activities, and homework supported generalization to everyday life. The Control intervention used the same functional treatment activities and homework but did not address strategies or metacognition. Bangor Goal Setting Interview (BGSI) average goal attainment from pre-treatment, post-treatment, and follow-up ratings (scale: 1-10, with higher scores indicating better goal attainment). A mixed 2 × 3 general linear model was used to test group and time effects. There was a significant group*time interaction (p=0.009). Groups were equivalent at pre-treatment (both group Means=4.5), but the MC group had higher ratings at post-treatment (MC=7.2, Control=5.9; p< 0.001), and follow-up (MC=6.8, Control=5.6; p=0.01). The Multicontext Approach improves self-rated performance of personalized functional cognitive goals among people with PD without dementia. Future directions include a full-scale efficacy trial. None. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive training (CT) has been proposed as a treatment option for cognitive impairment in Parkinson's disease (PD). We aimed to assess the efficacy of adaptive, computerized CT on cognitive function in PD.Methods: In this double-blind, randomized controlled trial we enrolled PD patients that experienced substantial subjective cognitive complaints. Over a period of eight weeks, participants underwent 24 sessions of computerized multi-domain CT or an active control intervention for 45 min each (randomized 1:1). The primary outcome was the accuracy on the Tower of London task; secondary outcomes included effects on other neuropsychological outcomes and subjective cognitive complaints. Outcomes were assessed before and after training and at six-months follow-up, and analyzed with multivariate mixed-model analyses.Results: The intention-to-treat population consisted of 136 participants (n = 68 vs. n = 68, age M: 62.9y, female: 39.7%). Multivariate mixed-model analyses showed no group difference on the Tower of London accuracy corrected for baseline performance (n = 130): B: -0.06, 95% CI: -0.27 to 0.15, p = 0.562. Participants in the CT group were on average 0.30 SD (i.e., 1.5 s) faster on difficulty load 4 of this task (secondary outcome): 95% CI: -0.55 to -0.06, p = 0.015. CT did not reduce subjective cognitive complaints. At follow-up, no group differences were found.Conclusions: This study shows no beneficial effect of eight-week computerized CT on the primary outcome (i.e., planning accuracy) and only minor improvements on secondary outcomes (i.e., processing speed) with limited clinical impact. Personalized or ecologically valid multi-modal intervention methods could be considered to achieve clinically meaningful and lasting effects. [ABSTRACT FROM AUTHOR]

• Virtual road crossing environment for unilateral spatial neglect (USN) assessment. • Evaluation of the feasibility of VR road crossing in stroke patients. • Analysis of possible factors to distinguish between patients with and without USN. • Influencing factors on task difficulty similar to results in healthy participants. [Display omitted] We developed a virtual road crossing assessment tool called iVRoad - immersive Virtual Road , which allows to put the patient into realistic road crossing situations and to record various parameters that can be used to quantify unilateral spatial neglect. We present a study with 18 stroke patients in which we evaluate our system with respect to usability, satisfaction, sense of presence and possible occurring cybersickness symptoms. Unilateral spatial neglect is a cognitive disturbance, often occurring after right hemispheric stroke. Conventional neuropsychological tests, such as paper-and-pencil tests, for assessing unilateral spatial neglect, often lack sensitivity. Especially in mild forms, symptoms can be seen in everyday life, but are hard to detect in formal testing. We examined patients with and without unilateral spatial neglect in order to identify parameters that could be feasible to separate these patient groups. Using everyday life tasks as a diagnostic instrument, however, is challenging because it is time-consuming, hard to control and to quantify. Computer-aided diagnostic systems are promising for analysing the behaviour of patients in detail. Modern virtual reality technology allows to place the patient in realistic situations. Especially situations in which patients often have difficulties or that are too dangerous in reality can be assessed with VR. [ABSTRACT FROM AUTHOR]

A brain–computer interface (BCI) establishes a direct communication channel between a brain and an external device. With recent advances in neurotechnology and artificial intelligence (AI), the brain signals in BCI communication have been advanced from sensation and perception to higher-level cognition activities. While the field of BCI has grown rapidly in the past decades, the core technologies and innovative ideas behind seemingly unrelated BCI systems have never been summarized from an evolutionary point of view. Here, we review various BCI paradigms and present an evolutionary model of generalized BCI technology which comprises three stages: interface, interaction, and intelligence (I3). We also highlight challenges, opportunities, and future perspectives in the development of new BCI technology. Classical brain–computer interface (BCI) systems are moving beyond lab demonstrations to real world applications with the development of associated hardware and software. Brain–computer interaction systems open up a wide range of BCI applications, especially in neural rehabilitation and human cognitive augmentation. Brain–computer intelligence systems reveal promising technologies for a new generation of artificial intelligence (AI) as well as a new generation of BCIs. [ABSTRACT FROM AUTHOR]

• An historical account of the progression of neurocognitive testing for space radiation effects over the last 40 years. • A comprehensive review of the impact of space radiation on behavioral and cognitive tasks. • Space radiation exposure impairs performance in many cognitive processes, including complex analogs/homologs of human cognitive tasks. • Summary of current attempts to address knowledge gaps and the critical need for rodent studies on more complex (human) cognitive tasks. Ground-based rodent models have established that space radiation doses (approximately those that astronauts will be exposed to on a mission to Mars) significantly impair performance in a wide range of cognitive tasks. Over the last 40 years there has been a progressive increase in both the complexity and the translatability (to humans) of the cognitive tasks investigated. This review outlines technical and conceptual advances in space radiation rodent testing approaches, along with the advances in analytical approaches, that will make data from ground based studies more amenable to probabilistic risk analysis. While great progress has been made in determining the impact of space radiation on many advanced cognitive processes, challenges remain that need to be addressed prior to commencing deep space missions. A summary of on-going attempts to address existing knowledge gaps and the critical role that rodent studies will have in establishing the impact of space radiation on even more complex (human) cognitive tasks are presented and discussed. [ABSTRACT FROM AUTHOR]

Background: Individuals with major depressive disorder often experience cognitive deficits. Cognitive remediation (CR) is an intervention aimed at improving cognition in psychiatric disorders. However, its efficacy on global and specific domains of cognition in adults with depression requires systematic investigation. Further, given individual differences in treatment outcome, moderators of CR effects in depression need to be identified.Methods: We performed a systematic review and meta-analysis of published controlled trials of CR in adults with depression. We analyzed results from eight studies to estimate the efficacy of CR on global cognition and on six cognitive domains. We also examined three potential moderators, namely session format (individual vs. group), treatment duration, and participants' age.Results: CR was found to improve global cognition (g = 0.44), verbal memory (g = 0.60), attention/processing speed (g = 0.41), working memory (g = 0.35), and executive functioning (g = 0.30). No significant improvements emerged for visuospatial memory and verbal fluency. Furthermore, no significant moderating effect of participant's age, session duration or session format were observed.Limitations: Conclusions are limited by the small number of studies, the heterogeneity in cognitive measures, and the lack of indicators of everyday functioning.Conclusion: Our meta-analysis supports the use of CR in improving global cognition in adults with major depressive disorder with a moderate effect size and this efficacy varies between cognitive domains. [ABSTRACT FROM AUTHOR]

Telemedicine could represent an emerging and innovative approach to support cognitive and behavioral rehabilitation reducing the overload of healthcare facilities, favoring home care therapy. The present study aimed to assess the potential efficacy of Tele-VR apps in enhancing cognitive performance and improving social skills in patients with Parkinson's disease (PD). Thirty-four patients with PD were included in the study. Patients were assigned to one of the following treatment groups: Experimental Group 1 (EG1) underwent a Tele-VR program using two cognitive rehabilitation applications (app) on smartphones (Neuronation-Brain Training and Train your Brain); Experimental Group 2 (EG2) received a Tele-VR program through one cognitive rehabilitation app (Neuronation-Brain Training) and one socio-cognitive rehabilitation App (The Sims) on smartphones; Active Control Group (aCG) performed a conventional training using pencil and paper exercises (Not-VR). At the end of the study, the aCG and EG1 presented an improvement in the executive, attentional and visuospatial cognitive domains. Mood and subjective memory also improved in the EG1. Moreover, in the EG2 group, a significant improvement was found in all cognitive domains, including social cognition skills (theory of mind). The inter-group comparison showed that both EG1 and EG2 had significantly greater improvements than aCG in MoCA score. Finally, both EG1 and EG2 showed a higher improvement in the FAB score, as compared to the aCG. Rehabilitation with smartphone apps could be more useful than conventional rehabilitation in improving cognitive and social cognition skills in patients with PD. Combining cognitive and social cognition training could improve the cognitive and affective domains, also aiding in the long-term maintenance of cognitive outcomes. • Telemedicine could represent an emerging and innovative approach in rehab. • The use of Telerehabilitation with VR Apps is a new frontier in neurorehabilitation. • Few studies on usefulness of VR app in PD patients are available. • VR app could be useful in improving cognitive and social skills. • VR app could aiding in the long-term maintenance of cognitive and social outcome. [ABSTRACT FROM AUTHOR]

The applications of social robots have continued to rise in number over the years: there are now mainly used in nursing homes and hospitals, performing different tasks like assistance, physical and cognitive rehabilitation, and supervision. However, robots' ability to learn from humans remains a problem to be solved. This paper presents the development of an Active Object Learning architecture in which the robot can identify unknown objects and autonomously initiate the learning process, supported by user interactions. We study the feasibility of generating a real-time dataset, including techniques for reducing image repetition and online classification model training. The work considers the analysis of machine learning metrics such as F1-Score, accuracy, confidence, and hit rate as the robot learns new objects. The accuracy of the classifier remains constant as the number of classes increases, indicating that the regularisation methods reduce overfitting and decrease the generalisation gap. The results prove that the robot can perform the classifications correctly and differentiate between known and unknown objects. The paper also includes a case study to demonstrate the feasibility of the proposed system integrated into a real social robot. [ABSTRACT FROM AUTHOR]

Virtual Reality (VR) has been gaining increasing attention as a potential ecological and effective intervention system for treating Mild Cognitive Impairment (MCI). However, it remains unclear the efficacy and effectiveness of VR-based cognitive rehabilitation therapy (VR-CRT) in comparison with cognitive rehabilitation therapy (CRT). Consequently, a systematic review on Pubmed, Scopus, PsycInfo, and Web Of Science was conducted to assess the state of the art of the literature published between 2003 and April 2023. Only articles that adopted CRT as control group and that included some measure of at least one domain among overall cognitive function, executive function and functional status were included. Participants needed to be older adults aged 65 or over with a diagnosis of MCI. The risk of bias and the quality of evidence were assessed using the Version 2 of the Cochrane risk-of-bias tool for randomized trials. Initially, 6503 records were considered and screened after removing duplicates (n = 1321). Subsequently, 81 full texts were assessed for eligibility. Four articles met the inclusion criteria but 2 of them were merged as they were describing different outcomes of the same research project. Consequently, 3 overall studies with a total of 130 participants were included in the final analysis. Due to the high heterogeneity in the methodology and outcome measures employed, it was not possible to conduct a meta-analysis. Included studies used semi-immersive (k = 2) and full-immersive (k = 1) VR systems in their research. Two articles evaluated overall cognitive function through the MoCA together with specific tests for executive functions (n = 69), while one study adopted a comprehensive neuropsychological battery to evaluate both cognitive function and executive function (n = 61). Finally, one study evaluated functional status through instrumental activities of daily living (n = 34). A However, the limited number of studies, the small sample size, and the potential issues with the quality and methodology of these studies that emerged from the risk of bias assessment may raise doubts about the reliability of their results. Nevertheless, although scarce, results of the present review suggest that VR-CRT may be paramount in treating MCI for its additional ecological and adaptive advantages, as all of the studies highlighted that it was at least as effective as conventional CRT for all the outcome measures. Therefore, more rigorous research that compares VR-CRT and CRT is needed to understand the degree to which VR-CRT is effective with older adults with MCI and the potential role of immersion to influence its efficacy. Indeed, these preliminary findings highlight the need for the development of standardized VR protocols, as the integration of such technology into clinical practice may help improve the quality of life and cognitive outcomes for this growing demographic. • Virtual Reality (VR) may be valuable to tackle cognitive impairment. • Immersion may affect the efficacy of VR-based cognitive rehabilitation (VR-CRT). • VR-CRT may be at least as effective as CRT for Mild Cognitive Impairment (MCI). [ABSTRACT FROM AUTHOR]

Patient feedback is rarely gathered systematically in cognitive rehabilitation research. This study examined the perceptions and experiences of people with traumatic brain injury (TBI) who participated in a trial of a 6-session educational program for the rehabilitation of prospective memory (PM) impairment. A mixed methods design was used with 47 participants with TBI who completed a compensatory strategy training program (COMP) or COMP plus metacognitive strategy training program (COMP-MST) delivered by an occupational therapist. Data were collected via a participant survey, extracts from progress notes, and audiotaped discussions about learnings from the program during the final session. Participants from both programs were highly satisfied and perceived improvements in everyday PM performance post-intervention. Elements that were highly valued include setting individualised client-centred goals, repetitive training of strategy use, establishing habits and routines, and receiving experiential, verbal, and written feedback.Changes including more therapy sessions were recommended. Both the COMP and COMP-MST programs were perceived as effective by participants with TBI in improving their PM performance in everyday life using compensatory strategies such as assistive technology. Routine collection of patient feedback on cognitive rehabilitation can provide valuable information to support person-centred implementation of clinical practice guidelines. • Patients with brain injury valued learning compensatory memory strategies. • Education on the use of assistive technology was perceived as useful for managing memory problems. • Repetitive practice of memory strategies and routines was seen as beneficial. • Metacognitive approaches involving individualised feedback contributed to patients' self-awareness. [ABSTRACT FROM AUTHOR]

Cognitive impairment has a critical impact on functional outcomes in patients with schizophrenia. Compensatory cognitive training (CCT) has shown promise as a cognitive rehabilitation tool but little is known about its effectiveness when combined with medication self-management skills training (MSST) in patients with schizophrenia. Thus, this study compared the effects of a combined CCT and MSST with CCT and treatment as usual (TAU) on cognitive function, symptoms, and medication adherence. Eighty-seven inpatients with schizophrenia were randomly assigned to the TAU, CCT, or CCT + MSST groups. Assessments of cognitive function using the Brief Assessment of Cognition in Schizophrenia, symptoms using the Positive and Negative Syndrome Scale, and medication adherence using the Medication Adherence Questionnaire, were administered to all participants at baseline and at post-intervention. Compared with the TAU group, the CCT group had significant improvements in verbal fluency, total cognitive function and medication adherence, and the CCT + MSST group had significant improvements in verbal fluency, total cognitive function, positive symptoms, and medication adherence. Compared with the CCT group, the CCT + MSST group had significant improvements in total cognitive function. These results indicate that the integrated intervention may be more advantageous than CCT alone in improving total cognitive function and positive symptoms. Future research should seek to further explore the long-term effects of such a joint intervention. • CCT had improvements in verbal fluency, total cognitive function and medication adherence compared with the TAU. • CCT + MSST had improvements in verbal fluency and total cognitive function compared with the TAU. • CCT + MSST had improvements in positive symptoms and medication adherence compared with the TAU. • CCT + MSST had improvements in total cognitive function compared with the CCT. [ABSTRACT FROM AUTHOR]

Background: Patients with PTSD often voice concern over their perceived change in cognitive functioning. However, these negative appraisals do not always align with objective neuropsychological performance, yet are strongly predictive of PTSD symptom severity and self-reported functional impairment.Methods: The present study involves a secondary analysis examining the role of appraisals of a subsample of 81 adults with full or subthreshold PTSD on treatment outcomes in a randomized controlled trial investigating the effectiveness of a cognitive rehabilitation treatment, Strategic Memory and Reasoning Training (n = 38), compared to a psychoeducation control arm, the Brain Health Workshop (n = 43). Neither condition addressed PTSD symptoms, focusing instead on cognitive skills training and psychoeducation about the brain.Results: Intent-to-treat models showed statistically significant improvements for both groups on composite scores of executive functioning and memory. Additionally, both groups experienced clinically significant reductions in PTSD symptoms (assessed via the Clinician-Administered PTSD Interview) and the SMART group showed fewer negative appraisals about cognitive functioning following training. Change in appraisals of cognitive functioning was associated with change in PTSD as well as change in quality of life, with no differential associations based on group status. In contrast, neurocognitive test score changes were not associated with change in symptoms or functional outcomes.Limitations: We did not collect data on other appraisals (e.g., self-efficacy), which could have further elucidated pathways of change.Conclusions: Our findings suggest that interventions that do not directly target PTSD symptoms can lead to PTSD symptom change via change in appraisals of functioning. [ABSTRACT FROM AUTHOR]

• EEG can distinguish mild traumatic brain injury (mTBI) patients at recovery stage from healthy controls in a Go/NoGo task. • MTBI patients with chronic neuropsychological defects exhibited more serious impairments of intrahemispheric connectivity, whereas interhemispheric centro-parietal and frontal connectivity was enhanced. • Centro-parietal connectivity and frontal connectivity are compensatory mechanisms of lacking executive and inhibitory responses after mTBI. To explore the multiple specific biomarkers and cognitive compensatory mechanisms of mild traumatic brain injury (mTBI) patients at recovery stage. The experiment was performed in two sections. In Section I, using event-related potential, event-related oscillation and spatial phase-synchronization, we explored neural dynamics in 24 volunteered healthy controls (HC) and 38 patients at least 6 months post-mTBI (19 with epidural hematoma, EDH; 19 with subdural hematoma, SDH) during a Go/NoGo task. In Section II, according to the neuropsychological scales, patients were divided into sub-groups to assess these electroencephalography (EEG) indicators in identifying different rehabilitation outcomes of mTBI. In Section I, mean amplitudes of NoGo-P3 and P3d were decreased in mTBI patients relative to HC, and NoGo-theta power in the non-injured hemisphere was decreased in SDH patients only. In Section II, patients with chronic neuropsychological defects exhibited more serious impairments of intra-hemispheric connectivity, whereas inter-hemispheric centro-parietal and frontal connectivity were enhanced in response to lesions. EEG distinguished mTBI patients from healthy controls, and estimated different rehabilitation outcomes of mTBI. The centro-parietal and frontal connectivity are the main compensatory mechanism for the recovery of mTBI patients. EEG measurements and network connectivity can track recovery process and mechanism of mTBI. [ABSTRACT FROM AUTHOR]

Background: Individuals at ultra-high risk (UHR) for psychosis have significant cognitive deficits that can impede functional recovery. Applying cognitive remediation (CR) before the onset of frank psychosis may improve the cognitive and functional prognosis of UHR individuals, however, little is known about the feasibility and efficacy of CR for this population.Methods: In this randomised, clinical trial 146 individuals at UHR for psychosis aged 18-40 years were randomly assigned to treatment as usual (TAU) or TAU plus cognitive remediation. The CR targeted neurocognitive and social cognitive remediation. Assessments were carried out at 6- and 12-months post baseline.Results: A total of 73 UHR individuals were assigned to TAU and 73 assigned to TAU + cognitive remediation. Compared to the control group, cognitive remediation did not result in significant improvement on the primary outcome; the Brief Assessment of Cognition in Schizophrenia composite score at 6-month follow-up (b = -0.125, 95%CI: -0.23 to 0.172, p = 0.41). Nor did the intervention improve secondary outcomes in clinical symptoms or functioning. Exploratory analyses found emotion recognition latencies to be significantly more reduced in the intervention group at 6-months. At 12-months, the intervention group exhibited significantly better performance on two measures of executive function and visual memory.Conclusion: The 20-session treatment protocol was not well received in the UHR group, and unsurprisingly global measures did not improve. The benefit found in isolated neuro- and social cognitive measures after even a few sessions points to a potential for cognitive malleability if people can be engaged sufficiently to practice the skills. Trial registration ClinicalTrial.gov identifier: NCT02098408. [ABSTRACT FROM AUTHOR]

The modified Story Memory Technique (mSMT) is a memory rehabilitation program that combines training in visualization and context formation to improve learning and memory. Previous studies have shown improvement in learning and memory in individuals with multiple sclerosis (MS) after undergoing the mSMT, including changes in brain activity related to working memory and word encoding. The current study examined changes in brain activity in 16 individuals diagnosed with MS (n treatment = 6; n placebo control = 10) when they were presented with to-be-remembered information within a meaningful context (i.e. a paragraph) from before to after mSMT treatment. We expected treatment-related changes in brain activation in the language network (LAN), default mode network (DMN), and executive control network (ECN). Consistent with this prediction, fMRI results revealed reduced brain activation in the LAN, DMN and ECN after completing the mSMT treatment in the context of paragraph learning. While no significant behavioral changes were observed, a marginally significant improvement with a large effect size was noted between baseline and follow-up performance on the Rivermead Behavioral Memory Test in persons who completed treatment. Results are discussed in terms of the impact of imagery training on patterns of cerebral activation when learning words presented within a context. • Brain activation changes in MS during an fMRI task pre- and post-mSMT were examined. • Language, default mode, and executive control networks showed reduced activation. • mSMT is effective cognitive rehabilitation technique that leads to neuroplasticity. [ABSTRACT FROM AUTHOR]

Learning and memory deficits characterize the diagnosis of amnestic mild cognitive impairment (aMCI), which is widely viewed as a clinical precursor to Alzheimer's type dementia. There is a growing interest in non-pharmacologic interventions, such as mnemonic strategies, for improving learning and memory in patients with aMCI as well as for maintaining functioning in healthy older adults. Using an ecologically relevant object-location association paradigm, we conducted a randomized, controlled, single-blind study in which healthy older adults and patients with aMCI were randomized to either mnemonic strategy training or a control group that was matched for stimulus exposure. We previously reported that mnemonic strategy training resulted in significantly greater learning and memory improvements compared to the matched exposure condition, in both aMCI patients and healthy controls. The current study examined changes in neocortical activation during encoding in a subset of participants who underwent functional magnetic resonance imaging (fMRI) scanning both before and after training. To minimize potential confounds in between-group comparisons, we employed non-linear cortex based alignment and included only correctly encoded stimuli in our analyses. When re-encoding stimuli learned during training (i.e., trained stimuli), we found a general enhancement of activation in right prefrontal and parietal regions, possibly reflecting practice-related improvement in coordinate spatial processing in all but the aMCI exposure group. Left hemisphere activation was typically only evident in the mnemonic strategy trained participants, regardless of diagnostic status, with the ventrolateral prefrontal cortex appearing especially important for strategy use. While encoding relatively novel stimuli, both mnemonic strategy groups (aMCI patients and healthy controls) demonstrated increased activation in a subset of regions showing change for the trained stimuli, indicating a mnemonic strategy-induced change in the processing of new information. These findings could not be explained by repeated exposure since there was little to no activation overlap in the respective exposure control groups. The current results reinforce the potential benefits of cognitive interventions in these growing populations and indicate that neuroplastic change in key rostral and lateral prefrontal regions mediate this behavioral change. • Mnemonic strategy training increased memory and neocortical activation bilaterally. • Similar neocortical changes were seen in cognitively intact and patients with MCI. • Mnemonic strategies appear to (re)engage the frontoparietal cognitive control areas. [ABSTRACT FROM AUTHOR]

Prior work has revealed that mnemonic strategy training (MST) can enhance memory for specific content and engages regions in the frontoparietal cognitive control network. Evidence of transfer to novel content is less clear. Here, we provide secondary analysis of functional magnetic resonance imaging (fMRI) data acquired during a randomized controlled trial that compared MST to an active education control condition in patients with amnestic mild cognitive impairment (a-MCI). In the trial, thirty participants with a-MCI were randomized to the education program (EP) or MST, where they learned to apply the technique to face-name associations during four intervening hour long training sessions. Participants underwent pre- and post-training fMRI scans, during which they encoded both the trained (i.e., those used during the four training sessions) and untrained ('novel') face-name associations. The primary cognitive outcome measures revealed significantly improved memory for both trained and novel stimuli – effects supporting near transfer of MST. Relative to pre-training, there were significant and highly similar increases in activation for both trained and novel stimuli, especially in regions associated with the frontoparietal cognitive control network bilaterally, but also in temporal areas related to social cognition and emotional processing. Critically, this pattern of activation was notably different from the EP group. Thus, the changes in activation were consistent with the strategies trained and, combined with the cognitively-based near transfer effects, suggest that MST focused on face-name association enhances performance by engaging cognitive control and social/emotional processing. Finally, our data indicated that our MST is a relevant and efficient intervention to a-MCI. • MST focused in face-name associations improves memory for faces and names in a-MCI. • Improvements after MST transferred to similar untrained stimuli. • There was increase of activation in the frontoparietal and temporal regions after MST. • The intervention mainly engaged cognitive control and social/emotional processing. • Cognitive and activation changes were notably different between MST and control intervention. [ABSTRACT FROM AUTHOR]

Cognitive impairment is common and debilitating in persons with multiple sclerosis (MS), and further is poorly-managed by pharmacotherapy. Cognitive rehabilitation and exercise training have been identified as promising behavioral approaches for managing MS-related cognitive impairment based on systematic reviews and meta-analyses. However, each body of literature is associated with similar sets of methodological shortcomings, as has been identified by periodic systematic reviews and meta-analyses. Thus, there is little generalizability or transportability research supporting either behavioral approach for managing cognitive dysfunction in this population under real-world conditions (i.e., as a standard-of-care). To that end, this paper aims to catalyze the advancement of cognitive rehabilitation and exercise training research in MS, respectively, towards the successful implementation of generalizability/transportability trials. This first involves critical examinations of the respective cognitive rehabilitation and exercise training literatures in MS from a chronological perspective, with particular emphasis on how the fields have each evolved in response to systematic reviews and meta-analyses. Accordingly, the current paper then provides a roadmap for harmonizing research in those areas to systematically and efficiently inform the development of generalizability/transportability trials for behavioral approaches to manage MS-related cognitive dysfunction. This involves the recognition of overlapping facilitators and impediments for progress in each field, including considerations for the implementation of neuroimaging. Ultimately, the provision of such a framework aims to shorten the timeline for research to influence clinical practice and improve the lives of cognitively-impaired persons with MS. • Cognitive impairment is common and disabling in multiple sclerosis (MS). • Rehabilitative approaches are promising for managing cognitive problems in MS. • The two most promising approaches are cognitive rehabilitation and exercise. • However, there is little research on either approach under real-world conditions. • This paper provides a framework for advancing such research into clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of a new-generation integrative cognitive rehabilitation (CR) program (Rehacop) on cognition, clinical symptoms, quality of life (QoL), and subjective complaints in the elderly.Design: A randomized controlled trial study with a cohort of elderly people over 55 years of age.Setting: Communities of the Basque Country (Spain).Participants: A total of 124 elderly participants (aged 79.00 ± 8.85 years) were randomized in the Rehacop group (RG) (n = 62) and control group (CG) (n = 62).Intervention: The RG attended 39 CR sessions for 3 months (3 sessions/week, 60-minute/session) with the Rehacop program. The CG performed occupational tasks with the same frequency and duration as the RG.Methods: Participants underwent a neuropsychological assessment at baseline and post-treatment which included cognitive, clinical, and functional tests. In addition, participants and their formal caregivers completed a subjective complaints questionnaire. The data were analyzed according to the intention to treat analysis and with participants who completed the study. This study was registered at clinicaltrials.gov (NCT03435029).Results: The RG showed significant improvements compared to the CG in neurocognition (ANCOVA timexgroup interaction effect size (ηp2)=0.05, 90% confidence interval (CI) = 0.00-0.12). The RG also reduced apathy (ηp2=0.06, 90% CI = 0.01-0.15) and participants' subjective complaints (ηp2=0.11, 90% CI = 0.03-0.21) and improved QoL (ηp2=0.08, 90% CI = 0.01-0.17).Conclusions: Participants who attended the intervention improved their cognition, QoL, and reduced apathy and subjective complaints after treatment. These findings provide a new understanding of the benefits of CR in the elderly. [ABSTRACT FROM AUTHOR]

• Everyday memory and future thinking deficits are frequent in multiple sclerosis. • These impairments are explained by executive/frontal-related difficulties. • The functional consequences of these impairments are numerous. • These deficits can be alleviated by a mental imagery-based cognitive intervention. Learning and memory impairments are common in individuals with multiple sclerosis (MS) and have pervasive effects on everyday life functioning. Hence, memory and learning have received particular attention in the cognitive rehabilitation literature in MS. The effectiveness of memory rehabilitation on memory performance is supported by several studies, but the generalisability of the benefits to daily life and memory for real-life events has rarely been examined. Recently, a new line of research focusing on memory for personal life events (i.e., autobiographical memory) has emerged in the MS literature. This approach is complementary to classical learning and memory paradigms and also allows for approaching memory in a broader context, one that considers memory as the ability to remember past episodes and imagine events that may occur in one's personal future (i.e. future thinking). This review provides an overview of the findings in this line of work. The first part summarises current evidence regarding the cognitive and neural mechanisms underlying autobiographical memory and future thinking impairments in MS. It points out that these domains are frequently and early impaired in individuals with MS because of an executive/frontal-related deficit. Individuals with MS are generally aware of these deficits and their negative impact on everyday life, so the development of strategies to alleviate such deficits seems of paramount importance. Thus, in the second part, I present the main outcomes of a cognitive intervention developed by our research group, which has been specifically designed to alleviate autobiographical memory and future thinking impairments in individuals with MS. The implications of these findings for neuropsychological care and well-being of individuals with MS are discussed in the final section, with an emphasis on the functional role of autobiographical memory and future thinking in various domains, including personal identity. [ABSTRACT FROM AUTHOR]

• Higher CR level may ameliorate severity of the symptoms and delays the clinical diagnosis threshold in schizophrenia. • Some evidence claims potential effects of CR on intervention programs, but the quality of research could be improved. • Neural plasticity offers an enthusiastic approach to develop targeted interventions programs for people with schizophrenia. To perform a systematic review of the influence of sociobehavioural indicators of cognitive reserve (CR) in the risk of schizophrenia, the clinical manifestations of the disease, and cognitive intervention programs (CRT) carried out with these patients. A cross search was made by two independent reviewers in Pubmed and PsycINFO databases using keywords "schizophrenia" and "cognitive reserve." Twenty-one studies which analyzed different CR proxies were selected and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine. People with higher CR may have a lower risk of developing schizophrenia and a later onset of disease. In addition, they present better neuropsychological and functional performance in the illness course. However, the suspected influence of CR on the effectiveness of CRT in patients with schizophrenia is currently unresolved. Our findings suggest that higher CR delays the clinical diagnosis threshold and severity of the symptoms in patients with schizophrenia. However, effect of singular sociobehavioral measures on clinical expression and benefits of intervention program need further investigation. [ABSTRACT FROM AUTHOR]

• Attention is impaired in patients with chronic stroke. • Response control is impaired in patients with chronic stroke. • Activities of daily living (ADL) are decreased in patients with chronic stroke. • Treatment with RehaCom cognitive rehabilitation software improves these functions. Our world is unfortunately facing a huge number of stroke. Attention, response control and activities of daily living (ADL) are important cognitive functions affected by stroke. In line with this explanation, we aimed to investigate the effect of RehaCom rehabilitation software on ADL, attention and response control in chronic stroke patients with damage to middle and anterior cerebral arteries. For selecting participants, among chronic stroke patients who referred to our special rehabilitation clinic for patients with stroke, fifty patients selected. Participants were assigned to control (n = 25) and experimental (n = 25) groups. The experimental group was compared with the control group before and after using RehaCom (ten 45-min sessions in five weeks). There is a significant enhancement in ADL, attention and response control scores in the experimental group compared with the control group. In fact, treatment with RehaCom significantly improved the score of all studied variables in chronic stroke patients. In conclusion, RehaCom cognitive rehabilitation software has improvement effect on ADL, attention and response control in patients with chronic stroke. Our study reveals a new information about the efficacy of computerized training in the rehabilitation of stroke patients. [ABSTRACT FROM AUTHOR]

• Immersive VR environment for the training of safe road crossing decisions. • Relevant Lanes and Traffic Speed have a clear influence on task difficulty. • No clear influence could be found for the Gap Size. • The Number of Vehicles had almost no effect on the perceived task difficulty. • Two neuropsychologists stated that the system is ready for a study on patients. Patients with cognitive or visual impairments have problems in dealing with complex situations. During the rehabilitation process, it is important to confront the patient with (everyday) tasks that have increasing degrees of difficulty to improve their performance. Immersive virtual reality training offers the potential to create a better transfer to daily life than non-immersive computer training. In cooperation with two neuropsychologists, an immersive virtual environment (VE) was developed in which cognitive training in the form of safe road crossing decisions can be performed. We present the experimental exploration and evaluation of difficulty factors within such a VR-based cognitive rehabilitation program. Four difficulty factors were identified and compared (number of relevant traffic lanes, speed of vehicles, distance between vehicles, and number of vehicles). The combination of these difficulty factors resulted in 36 training scenarios. The impact of the factors on participant performance and subjective perception of scenario difficulty were evaluated with 60 healthy participants to estimate the impact of the four factors to a situation's difficulty level. For the factors Relevant Lanes and Traffic Speed a clear influence on the perceived task difficulty could be determined. No clear influence could be found for the Gap Size. The Number of Vehicles had almost no effect on the perceived task difficulty. Finally, we asked two experienced neuropsychologists about the applicability of our developed system to patients, and they stated that the system is ready for a study on patients. [ABSTRACT FROM AUTHOR]

This paper describes the protocol for a Phase I/II, parallel-group, blinded randomized controlled trial that compares the effects of 12-weeks of combined learning and memory rehabilitation with either aerobic cycling exercise or stretching on cognitive, neuroimaging, and everyday life outcomes in 60 persons with moderate-to-severe traumatic brain injury (TBI) who demonstrate impairments in new learning. Briefly, participants will undergo baseline testing consisting of neuropsychological testing, neuroimaging, daily life measures, and cardiorespiratory fitness. Following baseline testing, participants will be randomized to one of 2 conditions (30 participants per condition) using concealed allocation. Participants will be masked as to the intent of the conditions. The conditions will both involve supervised administration of an enhanced, 8-week version of the Kessler Foundation modified Story Memory Technique, embedded within either 12-weeks of supervised and progressive aerobic cycling exercise training (experimental condition) or 12-weeks of supervised stretching-and-toning (active control condition). Following the 12-week intervention period, participants will complete the same measures as at baseline that will be administered by treatment-blinded assessors. The primary study outcome is new learning and memory impairment based on California Verbal Learning Test (CVLT)-III slope, the secondary outcomes include neuroimaging measures of hippocampal volume, activation, and connectivity, and the tertiary outcomes involve measures of daily living along with other cognitive outcomes. We further will collect baseline sociodemographic data for examining predictors of response heterogeneity. If successful, this trial will provide the first Class I evidence supporting combined memory rehabilitation and aerobic cycling exercise training for treating TBI-related new learning and memory impairment. [ABSTRACT FROM AUTHOR]

• MS presents a broad range of symptoms, including sensory-motor, cognitive and behavioral ones. • Neurorehabilitation programs are aimed at reducing the disabilities due to MS. • VR is a motivational and effective tool that could improve the traditional motor and cognitive rehabilitation trainings. Multiple sclerosis (MS) is a demyelinating neurodegenerative disease with lesions involving the central nervous system. Clinical symptoms consist of disturbances in motor activity (e.g., weakness, spasticity, and tremor), sensory functioning (e.g., pain), visual functions (e.g., diplopia and optic neuritis), besides different cognitive (attention deficit and executive dysfunction) and behavioral abnormalities. This review aims to evaluate the role of VR tools in cognitive and motor rehabilitation of MS patients. Studies performed between 2010 and 2017 and fulfilling the selected criteria were searched on PubMed, Scopus, Cochrane and Web of Sciences databases, by combining the terms "VR rehabilitation" and "MS". Our findings showed that, following the use of VR training, MS patients presented a significant improvement in motor (especially gait and balance) and cognitive function (with regard to executive and visual-spatial abilities, attention and memory skills). This review supports the idea that rehabilitation through new VR tools could positively affect MS patients' outcomes, by boosting motivation and participation with a better response to treatment. [ABSTRACT FROM AUTHOR]

Abstract Objectives We aimed to identify the best form of cognitive therapy among 3 main cognitive interventions of Alzheimer's disease (AD) including cognitive training (CT), cognitive stimulation (CS), and cognitive rehabilitation (CR). Design Systematic review and Bayesian network meta-analysis. Setting and Participants An exhaustive literature search was conducted based on PubMed, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database, the Wan Fang database, and Web of Science and other database and randomized controlled trials were identified from their inception to May 1, 2018. Older adult participants diagnosed with AD were recruited. Measures We conducted a Bayesian network meta-analysis (NMA) to rank the included treatments. Cognitive functions were measured based on the Mini-Mental State Examination (MMSE). A series of analyses and assessments, such as the Pairwise meta-analysis and the risk of bias, were performed concurrently. Results Only 22 studies were included in our analysis based on a series of rigorous screenings, which comprised 1368 participants. No obvious heterogeneities were found in NMA (I 2 = 32.7%, P =.07) after the data were pooled. The mean difference (MD) of CT [MD = 2.1, confidence interval [CI]: 1.0, 3.2), CS (MD = 0.92, CI: −0.20, 2.0), and CR (MD = 2.0, CI: 0.73, 3.4) showed that CT and CR could significantly improve cognitive function as measured by MMSE in the treatment group whereas the CS was less effective. CT had the highest probability among the 3 cognitive interventions [the surface under the cumulative ranking curve (SUCRA) = 84.7%], followed by CR (SUCRA = 50.0%) and CS (SUCRA = 47.4%). Conclusions/Relevance Our study indicated that the CT might be the best method for improving the cognitive function of AD patients. The findings from our study may be useful for policy makers and service commissioners when they make choices among different alternatives. [ABSTRACT FROM AUTHOR]

Highlights • About 10% of TBI patients have a severe brain damage with severe motor and cognitive dysfunctions. • New cognitive interventions, including VR training, can be useful in TBI. • VR creates a positive, motivating and enjoyable learning experience for the TBI patients. Abstract Traumatic brain injury (TBI) is a clinical condition characterized by brain damage due to an external, rapid and violent force. TBI causes attention, memory, affectivity, behaviour, planning, and executive dysfunctions, with a significant impact on the quality of life of the patient and of his/her family. Cognitive and motor rehabilitation programs are essential for clinical recovery of TBI patients, improving functional outcomes and the quality of life. Various researches have underlined the possible effectiveness of innovative techniques, with regard to virtual reality (VR), during the different phases of rehabilitation after TBI. This review aims to evaluate the role of VR tools in cognitive assessment and rehabilitation in individuals affected by TBI. Studies performed between 2010 and 2017 and fulfilling the selected criteria were found on PubMed, Scopus, Cochrane and Web of Sciences databases. The search combined the terms VR, assessment, rehabilitation and TBI. Our review has shown that VR has the potential to provide an effective assessment and rehabilitation tool for the treatment of cognitive and behavioral impairment on TBI patients. [ABSTRACT FROM AUTHOR]

Highlights • Computerized rehabilitation games improve cognition in severe malaria survivors. • There were more cognitive benefits in the severe malaria than non-malaria cohorts. • Most cognitive training benefits dissipated at one-year follow-up post training. • Cognitive training that titrated to child's performance level improved reasoning. • More repetitive cognitive training at simpler levels improved attention & memory. Abstract Background Computerized cognitive rehabilitation training (CCRT) may be beneficial for alleviating persisting neurocognitive deficits in Ugandan severe malaria survivors. We completed a randomized controlled trial of CCRT for both severe malaria and non-malaria cohorts of children. Methods 150 school-age severe malaria and 150 non-malaria children were randomized to three treatment arms: 24 sessions of Captain's Log CCRT for attention, working memory and nonverbal reasoning, in which training on each of 9 tasks difficulty increased with proficiency; a limited CCRT arm that did not titrate to proficiency but randomly cycled across the simplest to moderate level of training; and a passive control arm. Before and after 2 months of CCRT intervention and one year following, children were tested with the Kaufman Assessment Battery for Children, 2nd edition (KABC-II), computerized CogState cognitive tests, the Behavior Rating Inventory for Executive Function (BRIEF), and the Achenbach Child Behavior Checklist (CBCL). Results Malaria children assigned to the limited-CCRT intervention arm were significantly better than passive controls on KABC-II Mental Processing Index (P = 0.04), Sequential Processing (working memory) (P = 0.02) and the Conceptual Thinking subtest (planning/reasoning) (P = 0.02). At one year post-training, the limited CCRT malaria children had more rapid CogState card detection (attention) (P = 0.02), and improved BRIEF Global Executive Index (P = 0.01) as compared to passive controls. Non-malaria children receiving CCRT significantly benefited only on KABC-II Conceptual Thinking (both full- and limited-CCRT; P < 0.01), CogState Groton maze chase and learning (P < 0.01), and CogState card identification (P = 0.05, full CCRT only). Improvements in KABC-II Conceptual Thinking planning subtest for the non-malaria children persisted to one-year follow-up only for the full-CCRT intervention arm. Conclusion For severe malaria survivors, limited CCRT improved attention and memory outcomes more than full CCRT, perhaps because of the greater repetition and practice on relevant training tasks in the absence of the performance titration for full CCRT. There were fewer significant cognitive and behavior benefits for the non-malaria children, with the exception of the planning/reasoning subtest of Conceptual Thinking, with stronger full- compared to limited-CCRT improvements persisting to one-year follow-up. [ABSTRACT FROM AUTHOR]

Graphical abstract The cooking therapy framework for the rehabilitation of the cerebellar patients. The patient underwent 18 levels divided into three courses (starter, pasta, and main) X 2 food meals (meat-fish) X 3 levels of difficulty (1°–2°–3° meal). Tomato sauce is the main food, which is prepared each time for every single meal. All cooking levels started with the preparation of this food. Task difficulty varied as a function of the number of foods (motor sequence) and timing. The factor "timing" means the number of foods to be cooked simultaneously, whilst the factor "sequencing" indicates the increasing number of motor sequences to be performed and learned. Red dot lines represent the number of motor sequences, which are executed during the three levels. Highlights • Rehabilitation approach for cerebellar patients are sparsely documented. • Cerebellar damages induced executive dysfunctions. • Cooking therapy has been demonstrated to stimulate multitasking activities. • Cooking therapy increases executive functions in cerebellar patient. • Approach where patient is aware of its deficit is preferred. Abstract Background and importance The therapeutic approach for cerebellar damages heavily relies on neurorehabilitation since there are no medications that may improve clinical symptoms mainly those related to cognitive dysfunctions. Nevertheless, neurorehabilitation programs tailored to cerebellar damages have never been validated. Here we describe a new rehabilitation approach based on cooking training (CT). The idea that cooking may stimulate cerebellar activity relies on previous evidence demonstrating the beneficial effect on the executive functions as well as in promoting neural plasticity within the cerebellum. Indeed, CT requires motor/mental coordination, thinking flexibly, planning, implementing strategies, shifting and self-monitoring behaviors, all functions drastically affected in cerebellar disorders. Case description A 68-year-old male stroke patient with isolated right cerebellar ischemia in the posterior cerebellum characterized by mild executive dysfunctions. After intensive six weekly two-hour sessions, we found that CT was effective in improving some cognitive abilities in a context of mild motor impairment. In particular, deficits in the execution of the Symbol digit modality test and Wisconsin card-sorting test were recovered. Conclusion The comparison of our data with those reported in previous studies confirmed the Schmahmann's hypothesis on the effectiveness of neurorehabilitation approaches in cerebellar patients acting as external timekeeping of conscious thoughts. [ABSTRACT FROM AUTHOR]

Abstract In 1987, Parente used the Delphi method to predict changes in the field of cognitive rehabilitation therapy (CRT). Fifty licensed professionals provided predictions about the likely occurrence and probable time courses for 31 scenarios that could possibly have occurred over the 30-year interval between 1987 and 2000+. It has now been 30 years since the initial polling; thus, the purpose of this study was to evaluate the accuracy of these Delphic predictions, via two validation methods. First, we contacted and reviewed statistical information from nationwide data bases (i.e., Center for Disease Control and Prevention, and the Brain Injury Association of America) to see If the scenarios occurred. Second, we polled 12 additional professionals, most of whom had practiced in the field of CRT during the polling period and who still maintained an active practice to assess When the various remaining scenarios had occurred. In this study, probability of occurrence accuracy was approximately 80%, although there was a significant bias towards false positives. Time course predictions were accurate within 1–5 years, although there was a general bias towards underestimating the occurrence of the events. Highlights • The Delphi method provides accurate predictions across a 30-year time span. • The Delphi method predicts whether an event will occur with 80% accuracy. • The Delphi method predicts when an event will occur within a timeframe of one to five years. • The Delphi method can help understand the developing trends among the field of Cognitive Rehabilitation Therapy. • Polling a group of experts and using public domain statistics permits an effective and accurate cross-validation of results. [ABSTRACT FROM AUTHOR]

Highlights • Schizophrenia is associated to high levels of obesity and metabolic disorders. • High rates of disordered eating behaviors may affect schizophrenia patients. • The contribution of disordered eating behaviors to an adverse cardiometabolic health appears important in this population. • More research is needed to help clarify the relationships between eating behaviors and weight-related outcomes in schizophrenia. Abstract Whilst people with schizophrenia have high levels of obesity and metabolic disease, our understanding of their eating behaviors is still limited. Our aim was to evaluate the relationships between eating behavior and clinical data in schizophrenia. A cross-sectional study including 66 schizophrenia outpatients compared to 81 healthy controls was undertaken. Eating behavior was assessed using the shortened 21-item version of the Three-Factor Eating Questionnaire (TFEQ-R21). The patients had a mean of 44 ± 11 years; a mean BMI of 30.3 ± 8 kg/m2 (vs. 24 ± 3.3 kg/m2 for controls) and a mean duration of illness of 7.2 ± 6 years. All mean TFEQ scores were significantly higher in patients (indicating poorer eating behaviors) compared to controls after adjustment for age and sex, BMI and smoking status. Among patients, mean TFEQ scores were not significantly different between men and women samples. The "cognitive restraint" factor was significantly higher in schizophrenia patients with a BMI < 25 than in the group of overweight patients with a BMI > 25. Our findings suggest that disordered eating behaviors affect schizophrenia patients regardless of gender or duration of disease compared to controls. More research is needed to help clarify the relationships between eating behaviors and weight-related outcomes in schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract Background A number of non-motor symptoms occurs in Parkinson Disease (PD), cognitive decline and mood disturbances representing the most prevalent. Recent studies reported that cognitive training could potentially help to attenuate cognitive deficits in patients with PD and several researches demonstrated a beneficial effect of active transcranial Direct Current Stimulation (tDCS) over the left dorsolateral prefrontal cortex (anode over left dorsolateral prefrontal cortex, cathode over right supraorbital area) on cognitive deficits and mood disturbances. Objective To investigate the effects of active tDCS combined with computerized cognitive training on cognition and mood disturbances in PD patients. Methods Twenty-two patients with PD were assigned to either active tDCS plus computerized cognitive training (CCT) or sham tDCS plus CCT groups. Each patient underwent two weeks' treatment of daily application of tDCS for 25 minutes during CCT focalized on functions related with prefrontal cortex. Each patient was evaluated at baseline, after treatment and at 3-month follow-up. Results A significant reduction of depressive symptoms was observed in the active tDCS group from baseline to post-treatment assessment and from baseline to 3-month follow-up. An improvement in cognitive performances, referring more specifically to language, attentional and executive functions, was observed in both groups post-treatment and at follow-up. However, phonemic verbal fluency showed significant greater changes from baseline in the active tDCS group. Conclusions We concluded that cognitive training along with active tDCS is a useful combined approach in the management of mood and cognitive dysfunctions in PD. Highlights • Two weeks' treatment of daily application of tDCS during CCT. • Reduction of depressive symptoms in the active tDCS group after treatment and at FU. • Improvement in cognition in both groups after the treatment and at follow-up. • Greater changes from baseline in the active tDCS group in phonemic verbal fluency. • Combined treatment is a useful approach in the management of mood and cognition in PD. [ABSTRACT FROM AUTHOR]

Several studies demonstrated that individuals are more likely to remember emotional than neutral information; this phenomenon is known as emotional enhancement of memory (EEM). Adults generally tend to remember negative information more efficiently than neutral or positive items. In contrast, healthy elders seem to show an opposite bias for positive information, but results are inconsistent, also because during aging, elaboration of emotional information could change as a consequence of cognitive impairment. In this systematic review and meta-analysis, we conducted literature search of studies investigating emotion memory biases in mild cognitive impairment (MCI) and Alzheimer's disease (AD) on PubMed, Scopus and PsycINFO databases following PRISMA guidelines. The findings showed that emotional memory biases are still present despite the presence of cognitive impairment, both in MCI and at least in early stages of AD. However, the direction of emotion memory biases is not consistent across studies. These results suggest that patients with cognitive impairment might still benefit from EEM and help to define targets of intervention for cognitive rehabilitation in pathological aging. • Emotional memory biases are still present in people with cognitive impairment. • Both patients with mild cognitive impairment and Alzheimer's disease (in early stages) showed memory biases. • The role of depression in memory bias in mild cognitive impairment or Alzheimer's disease patients is still not clear. • Results could help to define new targets and methods of intervention for cognitive rehabilitation in pathological aging. [ABSTRACT FROM AUTHOR]

Although trauma-focused treatment, including Cognitive Processing Therapy (CPT), effectively reduces PTSD symptoms, treatment dropout, nonresponse, and relapse are substantial. Executive functioning (EF) is essential to engage the cognitive skills involved in CPT (e.g., inhibiting/evaluating distorted thoughts, flexibly generating alternative thoughts). It was hypothesized that worse baseline EF would be associated with reduced CPT completion and responsivity. Seventy-four Iraq/Afghanistan-era Veterans with PTSD and history of mild-to-moderate traumatic brain injury were randomized to either standard CPT or modified CPT that included cognitive rehabilitation strategies (SMART-CPT). Those who dropped out of treatment prematurely performed more poorly on EF tests at baseline than treatment completers. Worse baseline performances on EF tests of working memory, inhibition, and inhibition/switching were associated with poorer response to CPT (less reduction in PTSD symptoms). In addition, a three-way interaction indicated that individuals with worse baseline cognitive flexibility did not benefit as much from standard CPT but demonstrated significant PTSD symptom improvement in the SMART-CPT condition, comparable to those with better baseline cognitive flexibility. Modifying CPT to accommodate executive dysfunction may boost treatment effectiveness and allow Veterans to fully engage in and benefit more from components of CPT (e.g., cognitive restructuring). [ABSTRACT FROM AUTHOR]