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Objectives: There is increasing evidence for a protective role of nutritional factors on cognitive decline. Many studies have reported a preventive effect of specific dietary patterns, in particular of the Mediterranean diet (MD), on the risk of cognitive decline, but only limited evidence is available about its effects on neuropsychological performance. The aim of this work is to evaluate the relationship between nutrition and cognitive performance in a frail elderly population living in Northern Italy. Methods: In this study we have investigated the impact of the Mediterranean dietary pattern on cognitive performance in a frail elderly population (n = 140). Structural equation modeling was applied to highlight the interrelationship between three cognitive domains: i) Verbal Fluency; ii) Attention/executive function; iii) Memory, and two MD factors: i) Nutrition; ii) Anthropometric/physical activity. In addition, the Multiple Correspondence Analysis was performed to detect the food and nutrients with the highest association with MD and nutritional status. Results: In our sample, 54% of subjects have a medium-high adherence to MD and only 4% have a risk of malnutrition. The variable Nutrition was significantly associated (p < 0.001) with the cognitive domain Attention/executive function, with an increase in Nutrition directly associated with a better performance in Attention/executive function. Conclusions: This study provides preliminary evidence of an association between good nutritional status, related to a high adherence to the MD, and cognitive performance in a non-clinical elderly population living in Northern Italy. [ABSTRACT FROM AUTHOR]

Objective: Few data are available on the Italian elderly population with regard to adherence to the Mediterranean diet (MD) and cognitive impairment. Our aim was to investigate adherence to the MD and its association with cognitive function in an Italian urban sample.Methods: A cross-sectional study of 279 participants aged ≥ 65 years (80 men, 199 women) was carried out at a nutritional center. Adherence to the MD was evaluated using a 14-item questionnaire. Cognitive function was assessed with the Mini-Mental State Examination (MMSE).Results: The clinical and nutritional assessments performed revealed 30.1% to have a dietary pattern in accordance with the MD; 13.6% had suspected or mild cognitive impairment (MMSE score ≤ 23). The MD pattern was associated with a lower risk of cognitive impairment (odds ratio [OR] = 0.39; 95% confidence interval [CI], 0.15-0.99; p = 0.045), as was the consumption of wine (OR = 0.37; 95% CI, 0.16-0.84; p = 0.018) and nuts (OR = 0.30; 95% CI, 0.13-0.69, p = 0.005). No association was found with other food groups.Conclusion: A closer adherence to the MD was associated with a better cognitive status. Further cohort studies and randomized controlled trials are warranted. [ABSTRACT FROM AUTHOR]

Background: Speech and language impairments are the key clinical feature in several neurodegenerative disorders and primary progressive aphasia (PPA) is the syndrome where they are the prominent features. Their accurate and early identification may increase the diagnosis in the clinical setting. This approach may allow a better discrimination between the different neurodegenerative disorders and the PPA variants, i.e., nonfluent, semantic, logopenic. Aims: The aim of this work is twofold: (1) to provide an overview of the available neuropsychological tests for the diagnosis of PPA and/or for the differentiation among the PPA variants and (2) to evaluate the methodological quality and the psychometric characteristics of these tests. Methods & Procedures: This review was conducted following PRISMA guidelines. Search terms were chosen based on the research questions and used in a search in two databases. Then, inclusion criteria were formulated and papers meeting the criteria were reviewed. The methodological quality of the studies was evaluated examining the following items: (1) blindness of personnel, (2) consecutive inclusion of patients, and (3) representativeness of the sample. Outcomes & Results: A total of 907 papers have been selected from the databases, and 9 of them were included in this review. Among these, three tests aimed to differentiate between PPA variants, two tests were designed for the assessment of language disorders in PPA patients, and four tests were developed to stage the severity of speech/language disorders in PPA patients. All the included studies provided psychometric data about the clinical validity of the tests; however, they present several limitations, both psychometric and methodological. Conclusion: The number of validation studies is still limited. This brief review reveals the need of linguistically sophisticated tests, characterized by better quality of methods and psychometric characteristics, to be used to systematically evaluate the linguistic abilities of individuals with PPA. [ABSTRACT FROM AUTHOR]

Background: There is an increasing need of assessing functional communication in daily activities and the impact on the quality of life from the perspective of the major protagonists of life situations following aphasia. Several instruments are available for English. One of the most recent is the Communication Outcome after Stroke scale for patients (COAST) and caregivers (Carer COAST). These scales are comprised of two components, interactive communication skills and their impact on quality of life, assessed through 20 question items, from the point of view of patient and carer. In contrast, the number of tools available in Italian is very limited. Aims: (i) To validate the COAST and Carer COAST scales for the Italian-speaking population; (ii) to explore the applicability of the COAST scales to a wider range of people with communication problems, not limited to moderate aphasia; (iii) to explore the agreement between patient’s and carer’s perspective on communication difficulties, and the effect of severity. Methods&Procedures: The scales were translated into Italian and adapted for the sociocultural context, preserving the accessible presentation and response format. Thirty people with a history of aphasia (from mild to severe) and 28 caregivers provided usable data. The scales’ psychometric properties were measured, along with exploratory analyses on the agreement between patients and carers. Outcomes& Results: The Italian versions of the COAST scales, i.e., COAST-IT and Carer COAST-IT, showed excellent internal consistency (α = 0.94 and 0.94–0.95, respectively), good test–retest reliability (ICC = 0.85 and 0.88, respectively), and indicative evidence of construct validity as judged by the correlations with measures derived from background and current Aachener Aphasia Test (AAT) scores (rranging from 0.32 to 0.41 and from 0.47 to 0.70, respectively). The patient and caregiver scales were strongly correlated along the score range (r = 0.70–0.72) and agreement was not influenced by aphasia severity. Conclusions: The COAST-IT and Carer COAST-IT scales are practical and reliable patient- and carer-centred measures of functional communication and its impact on the quality of life, applicable to people with communication problems of different severity. These scales fill an important gap of effectiveness indicators for speech–language assessment and therapy in Italy. More generally, the results strengthen the need of complementing traditional language assessment with functional outcome measures, and considering the perspective both of people with communication difficulties and their carers. This adaptation could pave the way for cross-national sharing of functional communication assessment instruments and comparative studies. [ABSTRACT FROM PUBLISHER]

Amyotrophic lateral sclerosis (ALS) is a multisystem condition, in which executive and/or behavioural symptoms can occur. Deficits of social cognition, including defective cognitive and emotional empathy, have been recently reported in ALS subjects. The neurostructural correlates of these disorders in ALS are still unknown. The aims of this study were to evaluate two components of empathy in non-demented ALS subjects, and to associate performance with regional grey-matter density using voxel-based morphometry (VBM). Twenty non-demented sporadic probable or definite ALS patients and 56 matched healthy controls (HC) participated in a non-verbal task requiring the attribution of emotional versus cognitive states to identify the correct ending of comic strips, compared with a control condition requiring identifying causal relationships devoid of social components. A subgroup of 14 ALS and 20 HC joined the VBM study. Results demonstrated that, compared with controls, ALS patients showed defective emotional empathy attribution, related with reduced grey-matter density in the anterior cingulate cortex and right inferior frontal gyrus. Our study provided evidence of a specific impairment of emotional empathy in ALS patients, reflecting neural damage in a limbic prefrontal network involved in emotional processing. Social cognition disorders may represent a marker of cognitive dysfunction in ALS. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS), traditionally considered as a disorder limited to the motor system, is increasingly recognized to be a multisystem disease, involving associative areas in addition to the motor cortex and therefore affecting cognition. ALS patients may present with subtle behavioural and executive dysfunctions or, less frequently, with a manifest frontotemporal dementia. Event-related potentials (ERPs) are a high-temporal resolution technique, which can be used to explore the presence of cognitive dysfunction. All the primary studies reviewed here have shown ERP abnormalities in groups of non-demented patients affected by sporadic ALS compared to healthy controls. The ERP results support findings of neuropsychological and imaging studies. Prospective studies combining simultaneous neuropsychological and imaging investigations are needed to assess the possible role of ERPs in the early detection and follow-up of cognitive dysfunction in ALS patients. [ABSTRACT FROM AUTHOR]

We report a new case of category-specific semantic impairment, affecting living entities, in a patient with traumatic brain damage. In the present investigation we attempted to replicate as closely as possible the testing procedures which have been developed by Caramazza and Shelton (1998) to evaluate EW, a patient with a selective semantic disorder for the animal category. The results in our patient indicated a different performance profile, characterised by a more extensive semantic disorder for living entities, and by a more severe loss of specific visual rather than functional knowledge. These findings concur with other evidence indicating that category-specific semantic disorders are heterogeneous, reflecting different mechanisms of impairment, most likely associated with different neurobiological underpinnings. [ABSTRACT FROM AUTHOR]

We report the case of a patient who recovered from a clinical picture of fluent aphasia to selective dysgraphia. The features of the writing disorder were compatible with a graphemic output buffer dysfunction (errors in all spelling tasks and for all type of material, affected by word length and consisting mostly of graphemic deviations), with the exception of the lack of transposition errors and position preference. Further, the spelling disorder was selective for vowels, replicating the original observation by Cubelli (1991). A similar, although milder, error pattern was also observed in reading tasks, in particular for nonwords, suggesting that the locus of dysfunction involves a processing stage shared by reading and writing. These findings support the notion that the consonant-vowel status is a property of graphemic representations, and is compatible with that a common buffer is involved in spelling and reading. We discuss the implications of selective vowel disorders for current models of the spelling system. [ABSTRACT FROM AUTHOR]

This paper is a selective review of neuroimaging studies about recovery from aphasia. Two basic mechanisms, i.e., regression of diaschisis and functional reorganisation, have been considered to play an important role in language recovery. The results of recent investigations using positron emission tomography and other functional imaging modalities are reviewed, from the point of view of their contribution to the understanding of the respective role of these mechanisms. Finally, an integration is attempted between these findings and general theories of functional recovery, underlining the crucial role of the spared areas in the language-dominant hemisphere, and the limits to brain plasticity in the adult brain. [ABSTRACT FROM AUTHOR]

Comments on an article about the heterogeneity of category-specific semantic deficits. Association between loss of perceptual knowledge and category-specific disorder; Application of the concept of sensory-functional theory in diagnosing patients with category-specific semantic deficits; Case study of a patient with category-specific deficits.