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Frontal midline theta power (FMT) has been associated with superior rifle shooting performance. Our experiment examined whether electroencephalographic-based training could increase FMT, shooting performance, and attentional focus in highly trained/elite biathletes. Participants (n = 28; age, M = 21.7, SD = 2.3) were assigned to a control group or an intervention group (with 3 hr of neurofeedback training). FMT increased from baseline during the neurofeedback training sessions (p ≤.05). However, there were no Group × Pre–post training (test) interactions for FMT or shooting performance (p >.05). There was a small Group × Test effect for attentional focus (p =.07, η p 2 =.12), indicating a potential benefit of neurofeedback training. Superior shooters were more proficient at increasing FMT during neurofeedback training, but this did not translate to greater improvements in shooting performance. Our findings suggest that the effects of neurofeedback training are transient and do not necessarily benefit performance. [ABSTRACT FROM AUTHOR]

In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction. [ABSTRACT FROM AUTHOR]

BACKGROUND: In healthy people, the fight-or-flight sympathetic system is counterbalanced by the rest-and-digest parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults. In healthy adults, higher plasma Aβ is associated with greater risk of Alzheimers disease (AD). Our primary goal of this trial is to reproduce and extend our initial findings regarding effects of slow-paced breathing on Aβ. Our secondary objectives are to examine the effects of daily slow-paced breathing on brain structure and the rate of learning. METHODS: Adults aged 50-70 have been randomized to practice one of two breathing protocols twice daily for 9 weeks: (1) slow-paced breathing condition involving daily cognitive training followed by slow-paced breathing designed to maximize heart rate oscillations or (2) random-paced breathing condition involving daily cognitive training followed by random-paced breathing to avoid increasing heart rate oscillations. The primary outcomes are plasma Aβ40 and Aβ42 levels and plasma Aβ42/40 ratio. The secondary outcomes are brain perivascular space volume, hippocampal volume, and learning rates measured by cognitive training performance. Other pre-registered outcomes include plasma pTau-181/tTau ratio and urine Aβ42. Recruitment began in January 2023. Interventions are ongoing and will be completed by the end of 2023. DISCUSSION: Our HRV-ER trial was groundbreaking in demonstrating that a behavioral intervention can reduce plasma Aβ levels relative to a randomized control group. We aim to reproduce these findings while testing effects on brain clearance pathways and cognition. TRIAL REGISTRATION: ClinicalTrials.gov NCT05602220. Registered on January 12, 2023.

The relationship between depression and cognition in middle-aged adults is a topic of interest. Whether poor cognitive function exacerbates depression remains controversial. We clarified the association between cognitive decline and depression based on six nationwide cohorts. 89,056 participants were retrieved from six cohorts in Europe, North America, Asia and Africa. Each two consecutive interviews were collected as a sample set with a total of twenty-eight sample sets to assess changes in depression and cognitive function. Multiple linear regression was conducted within each sample set to evaluate the association between cognitive decline and depression. A two-stage meta-analysis was performed to obtain the average effect within each cohort and the overall effect excluding population and regional heterogeneity. Meta-regression and subgroup analysis were used to explore heterogeneity and potential effect modifiers. Almost all sample sets indicated negative association between changes in cognitive function and depression scores. The average effects varied across regions: Korea (−0.150 [−0.175, −0.126]), Europe (−0.130 [−0.149, −0.112]), South Africa (−0.090 [−0.129, −0.060]), China (−0.083 [−0.137, −0.030]), Mexico (−0.063 [−0.084, −0.042]), and North America (−0.048 [−0.056, −0.040]). The overall effect excluding population and regional heterogeneity was −0.094 [−0.129, −0.060], and was robust across populations of different age, sex, alcohol consumption, daily living activities and marital status. The cross-sectional design limited our ability to determine causal relationships. Cognitive decline was associated with the exacerbation of depression status in middle-aged and older adults worldwide. Country-level factors, rather than individual-level factors, are more likely to modify this effect. • It is the first global study to examine the association between cognition and depression in middle-aged and older adults worldwide. • Declines in cognitive function are associated with the exacerbation of depression status. • This relationship is more likely to be modified by macro-level factors than by individual-level factors. • Cognitive training or cognitive therapy may be helpful to control or prevent depression. [ABSTRACT FROM AUTHOR]

Objective: Cognitive impairment affects approximately 30% of pediatric onset Multiple Sclerosis (POMS) patients with a negative impact on everyday life. The aim of this study was to evaluate the feasibility and effectiveness of a home-based, computer-assisted training of attention in patients with POMS. Methods: This was a randomized double-blind study. Subjects were randomized to specific training (ST) or non-specific training (n-ST), delivered through a customized module based on attention exercises (COGNI-TRAcK2). The main feature of the ST is the implementation of working load algorithms and procedures for intensiveness regulation. The effectiveness of the ST on attention was primarily assessed on the Symbol Digit Modalities Test (SDMT), using the Wilcoxon signed-rank test. Secondary objectives included effectiveness on other cognitive tests. The evaluations were performed at baseline, end of training and 3-month follow-up. Results: 22 relapsing-remitting patients were included: data of 8 subjects in n-ST and 5 subjects in ST were available. As for the primary outcome, SDMT score improved in the ST group (from 31.2 at baseline to 42.4 after 3 months, p = 0.043). There was no benefit in other neuropsychological measures. Conclusions: These preliminary findings point to a potential benefit of a home-based, computer-assisted training of attention in patients with POMS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this review is to integrate an important new synthesis of the literature examining the effects of cognitive training on far transfer tests of cognitive ability with the expansive literature testing for bilingual advantages in executive functioning (EF). Approach: The secondary meta-analysis of cognitive training on far transfer reported by Gobet and Sala is compared and contrasted with the many recent meta-analyses for bilingual advantages in EF. Data and Analysis: The Gobet and Sala secondary meta-analysis is based on ten independent meta-analyses with a median of 24 samples per analysis. The meta-analyses of the bilingual advantage in EF are partitioned into nine analyses that focus on inhibition, switching, working memory capacity, and general EF. Findings and Conclusions: Both cognitive training and bilingualism yield overall effects that are not distinguishable from zero when corrected for publication bias. Furthermore, both clusters of meta-analyses show that study quality moderates performance, but that type of experience/training does not. In the absence of a compelling reason for considering bilingual language-language to have a special status in cognitive training, these two conclusions mesh. Originality: Although brain training and the bilingual advantage in EF are both instances of the general hypothesis that practicing cognitive tasks can produce far transfer, they have not been considered as two tests of the same general hypothesis. However, the twin null results resonate and strengthen each other. Significance: If bilingualism does not enhance EF in children and young adults (or maintain it in older adults), the argument that bilingualism enhances EF and/or delays the onset of dementia is substantially weakened. However, it is clear and indisputable that, more broadly, there are important advantages to being able to communicate and connect with more people. [ABSTRACT FROM AUTHOR]

Background: Huntington’s disease (HD) is a rare neurodegenerative disease that causes progressive cognitive, physical, and psychiatric symptoms. Computerised cognitive training (CCT) is a novel intervention that aims to improve and maintain cognitive functions through repeated practice. The effects of CCT have yet to be established in HD. This randomised pilot trial examined the feasibility of a large scale trial to assess efficacy of multidomain CCT in pre-manifest and early-stage HD. Methods: 28 participants were randomised to either at-home CCT (2 × 60 min sessions per week for 12 weeks; n = 13) or lifestyle education through monthly newsletters (n = 15). Participants completed cognitive tasks and questionnaires at baseline and follow up, either in person (n = 18) or via video teleconferencing (n = 10). Results: All participants were retained at follow up, and adherence to CCT ranged from 96 to 100%, with 11/13 participants completing all sessions. Preliminary analyses showed evidence of a large effect of CCT on task switching and response inhibition, compared to lifestyle education. There was no evidence of specific benefit to other cognitive domains (processing speed, basic and divided attention, working memory), or psychosocial functions (subjective cognition, mood, health-related quality of life). Discussion: Whilst retention and adherence rates were high, recruitment rates were low, suggesting that a large scale trial may be feasible with some modifications to increase recruitment rates, such as by reducing time burden associated with the study, and using a multi-site trial design. Potential effects on cognitive functioning warrant further investigation. Clinical trial registration: The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000908730). [ABSTRACT FROM AUTHOR]

The study presents an adaptive technique that enables a humanoid robot to select appropriate actions to maintain the engagement level of users while they play a serious game for cognitive training. The goal is to design and develop an adaptation strategy for changing the robot's behaviour based on Reinforcement Learning (RL) to encourage the user to remain engaged. Initially, we trained the algorithm in a simulated environment before moving on to a real user experiment. Thus, we first design, develop, and validate the RL strategy in a simulated environment. Subsequently, we integrate the trained policy into the robotic system, allowing it to select the best actions based on the detected user state during real user test. The RL algorithm was designed and implemented to determine an effective adaptation strategy for the robot's actions, encompassing verbal and non-verbal interactions. The proposed solution was first trained in a simulated environment and then tested with 28 users in a mixed-method design study. [ABSTRACT FROM AUTHOR]

This follow-up study builds on our previous research, which showed that combining strategy based cognitive training (ST) with social engagement (SE) improved memory performance in older adults more than social meetings alone. To further investigate whether the combination of ST and SE accounts for the observed improvement, we included an additional group that received only ST without the social component. Eighty-five participants were randomly assigned to ST+SE, ST, or SE groups. The ST+SE group participated in mnemonic strategies training based on social interactions across 12 sessions. The ST group underwent the same mnemonic strategies training without the social component, while the SE group focused on enhancing social connections and communication skills. Results revealed significant improvements in word recall and verbal fluency tests for the ST+SE group compared to the ST and SE groups. These findings support the efficacy of integrating SE into CT programs, highlighting the importance of SE as an integral component for maximizing the effectiveness of cognitive training interventions in combating cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Despite transcranial direct current stimulation (tDCS) has demonstrated encouraging potential for modulating the circadian rhythm, little is known about how well and sustainably tDCS might improve the subjective sleep quality in older adults. This study sought to determine how tDCS affected sleep quality and cognition, as well as how well pre-treatment sleep quality predicted tDCS effects on domain-specific cognitive functions in patients with mild neurocognitive disorder due to Alzheimer's disease (NCD-AD). Methods: This clinical trial aimed to compare the effectiveness of tDCS and cognitive training in mild NCD-AD patients (n = 201). Over the course of four weeks, patients were randomized to receive either tDCS plus working memory training, or sham tDCS plus working memory training, or tDCS plus controlled cognitive training. The Pittsburgh Sleep Quality Index (PSQI) was used to measured subjective sleep quality. The Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog) was used to evaluate domain-specific cognitive functions. Results: Recurrent tDCS treatments enhanced subjective sleep quality and cognition considerably. The poor sleepers (i.e., PSQI > 5) who received tDCS treatment had more cognitive benefits (p = 0.031, Cohen's d = 0.605) and sleep improvements (p < 0.001, Cohen's d = 1.209) in comparison to cognitive training. Pre-treatment subjective sleep quality was linked to tDCS-induced improvement in memory function. Conclusion: During the course of two months, repeated tDCS could considerably enhance subjective sleep quality. For the cognitive benefits of the treatments, the status of pre-treatment subjective sleep quality is crucial. More thorough research is necessary to explore an efficient approach to managing comorbidities for preclinical AD patients. [ABSTRACT FROM AUTHOR]

Background: Recent research has highlighted the role of fronto-parietal brain networks and cognitive control in mood disorders. Transcranial direct current stimulation (tDCS) and computer-based cognitive training are used in post-stroke rehabilitation. This study examined the combined effects ofof computer-based inhibitory control training (ICCT) and anodal tDCS on post-stroke depression and anxiety. Methods: Thirty-five participants were randomly assigned to one of three groups: active tDCS treatment (A), sham tDCS treatment with ICCT (T), or active tDCS with ICCT (AT), for a duration of ten days. Primary outcome measures included the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAM-D), and Spielberger's State-Trait Anxiety Inventory (STAI-S/T). Statistical analysis was performed using a Mixed-model Analysis of Variance, with supplementary Bayesian analysis. Results: The AT group showed a significant improvement in BDI scores (p <.001), whereas no significant effects were observed on the HAM-D, STAI-T, or STAI-S scales. Conclusions: The combination of tDCS and ICCT reduced depressive symptoms as measured by the BDI; while no significant effects were found with either treatment alone. Further research is needed to explore the mechanisms behind the synergistic effects in the treatment of post-stroke mood disorders. [ABSTRACT FROM AUTHOR]

Research on working memory (WM) training reveals significant variability in training effects, indicating that pretraining cognitive abilities might account for these differences. However, consensus on whether higher (magnification account) or lower (compensation account) pretraining abilities predict greater training effects remains elusive. Our study aimed to clarify the role of fluid reasoning in predicting training performance (i.e. training scores at each session) and gains on near transfer WM tasks. We conducted two studies: Study 1 focused on middle-aged adults (47–65 years) and Study 2 on older adults (65–83 years). Participants in both studies were randomly assigned to either adaptive n-back training or an active control group and have all completed three WM tasks before and after 20 training sessions – the trained n-back task and two structurally different untrained tasks. Generally, greater average training scores were found in individuals with higher fluid reasoning for both age groups, although this trend did not reach statistical significance in older adults. Similarly, higher fluid reasoning predicted greater training gains only in the sample of middle-aged adults. Further analysis showed that both, middle-aged and older participants in the training groups exhibited higher gains on the trained n-back task but not on two other WM tasks. Additionally, fluid reasoning predicted n-back gains in both the training and control group. Consistent with a growing body of research, our results show limited generalization of training effects across untrained tasks. It seems that factors beyond pretraining ability should be considered when explaining between-participant differences in training performance. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive symptoms are common in Parkinson's Disease (PD), and digital interventions like telerehabilitation other an accessible way to manage these symptoms. This study aimed to assess the effectiveness of a Home-Based Computerized Cognitive Training (HB-CCT) program in individuals with PD using a pilot randomized cross-over design. Methods: Twenty-five participants (mean age 69.32 ± 7.21 years, mean MDS-UPDRS III 33.76 ± 14.25) with PD and mild cognitive impairment were enrolled. They underwent neuropsychological assessments at three time points (5-week intervals): Baseline, after the HB-CCTi, and after Standard Care. The HB-CCT consisted of the Neurotablet® platform that was used to target cognitive domains such as Attention, Memory, Perception, Executive Functioning and Language. All participants completed both the Neurotablet intervention and Standard Care blocks in a randomized order. After a Shapiro-Wilk test, non-parametric repeated measures analyses of variance (Friedman's test) and post-hoc comparisons corrected with the Benjamini-Hochberg approach were performed to compare the effects on primary and secondary cognitive outcomes over experimental intervention and Standard Care. Results: The results from the Friedman analysis revealed significant improvements in Word List Immediate Recall, Digit Span Forward and Complex Figure Recall (all p < 0.001) following the HB-CCT, compared to the Baseline. Additionally, Naming performance showed significant improvement after the HB-CCT (p = 0.02). Significant differences were also observed when comparing the HB-CCT with Standard Care, with improved performance in TMT-A (p = 0.02), Phonemic Fluency (p < 0.01), and Digit Span Forward (p < 0.01). Discussion: These findings suggest that HB-CCT via Neurotablet can effectively enhance specific cognitive abilities in PD, supporting the role of digital, home-based interventions as feasible strategies to mitigate cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Dementia is a growing public health issue. Non-drug interventions targeting individuals before the onset of overt cognitive decline may be effective. Subjective cognitive decline (SCD) is present in > 50% of older adults and associated with progression to dementia. Here, we tested the compliance and effectiveness of a Multidomain Lifestyle Intervention Program using the mini-program, Cognitive Evergreenland, (MLIP-CE), based on the Health Action Process Approach model to support home-based intervention in older adults with SCD. Methods: Cognitive Evergreenland was designed to improve cognitive reserve and maintain brain function in people at high risk of dementia and included: cognitive stimulation, cognitive training, health education, vascular risk monitoring, social support, and functional assessment, among other features. This was an exploratory trial designed to examine participant compliance with the mobile lifestyle intervention and its effectiveness, as well as changes in health-related indicators and cognitive function of older adults with SCD from baseline to 12 and 24 weeks post-intervention. Results: The retention rate for MLIP-CE was 90.2% (37/41). Mean participant age was 70.93 ± 6.91 years, 73.2% of participants were female, and mean Montreal Cognitive Assessment score was 24.51 ± 2.87. Throughout the 24 weeks of the prescribed intervention, app usage remained consistently high, with over 92% of participants using the mini-program at least once a week and successfully completing corresponding health management tasks. In terms of average usage, cognitive training emerged as the most frequently used functional module (95.73%), closely followed by health education (95.02%). The health behavior levels of older adults with SCD, measured in terms of ability, opportunity, and motivation, were significantly increased relative to baseline (p < 0.001). Regarding cognitive function, Mini-Mental State Examination scores were significantly improved post-intervention, with a moderate effect size (Hedges' g = 0.60). Conclusions: These findings suggest that MLIP-CE, which was designed based on a theoretical framework, has potential for implementation, and support ongoing research into use of MLIP-CE for individuals at high risk of SCD or other dementia conditions. Trial registration: The trial was prospectively registered at the Chinese Clinical Trials Registry with the registration number ChiCTR2200058665 on 13 April 2022. [ABSTRACT FROM AUTHOR]

AbstractTouch tables have become a common interface in recent decades. However, few studies explore their use in therapeutic rehabilitation. This review analyzes publications identified through a systematic search in four literature databases between 1970 and 2023. A total of 29 publications involving three therapeutic uses of touch tables are presented. 11 studies address work on physical remediation, 14 on cognitive training and 11 on collaborative social skills. Results indicate that research on touch tables in rehabilitation is limited in quantity, but that touch tables are regularly proposed into therapy. Their use has produced relatively beneficial effects in motor, cognitive and social therapy. This review highlights the essential role of accessibility for rehabilitation users, whether they are patients or health practitioners. We conclude by presenting recommendations for research and practices, particularly around inclusive approaches and adaptive techniques to further integrate touch tables into the care pathway. [ABSTRACT FROM AUTHOR]

Introduction: Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population. Methods: Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions. Results: The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life. Conclusion: This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study’s strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population. [ABSTRACT FROM AUTHOR]

Introduction: Unipolar and bipolar mood disorders in older adults are accompanied by cognitive impairment, including executive dysfunction, with a severe impact on daily life. Up and till now, strategies to improve cognitive functioning in late-life mood disorders (LLMD) are sparse. Therefore, we aimed to assess the efficacy of adaptive, computerized cognitive training (CT) on executive and subjective cognitive functioning in LLMD. Methods: In this double-blind, randomized controlled study we enrolled patients over the age of 50 with partly remitted LLMD. Over 8 weeks, patients participated in 24 45-minute sessions of computerized multi-domain training (CT) or an active control condition (ACC) (nonspecific cognitive activity). The primary outcome was executive functioning based on the interference score on the STROOP task (not incorporated in the training). Secondary outcomes were subjective cognitive functioning, depressive symptoms and quality of life. Outcomes were assessed before and after training (T1) and at a 3-month follow-up (T2) and analyzed with linear mixed-model analyses. Results: Thirty-eight patients were included in the study, 22 in the experimental CT and 16 in the ACC. Mean age was 67.3 years and 52.6% was female. Linear mixed-model analyses showed small within-group effect sizes, corresponding to no statistically significant improvement of executive functioning or depression severity in either group. In both groups we did observe an improvement on subjective cognitive functioning over time. From T0 to T1 the mean score of the Cognitive Functioning Questionnaire (CFQ) of the CT group decreased from 52.7 to 46.8 points (p=0.003) and the mean CFQ score of the ACC group decreased from 52.7 to 45.7 points (p<0.001). This effect remained in both groups at follow-up (T2); respectively p=0.002 and p<0.001.The patients in the AAC also showed an improvement of quality of life directly after the training (T1); i.e. the mean quality of life scores improved from 53 to 57 points (p=0.011), but this effect did not remain at follow-up. Conclusions: This study shows no beneficial effect of an 8-week computerized CT on the primary outcome, i.e, executive functioning. Subjective cognitive functioning did improve in both groups, indicating that frequent cognitive training is advantageous. Future studies with more intensive training could be designed to explore this result further. Clinical trial registration: clinicaltrials.gov , identifier NCT04006756. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical implicationsThis qualitative study explored the potential of piano training as a holistic intervention to enhance both cognitive and emotional well-being. The study aims to detail the experiences of older adults living with mild cognitive impairment (MCI) in a piano training program and recommend strategies to boost engagement.Fourteen individuals (seven older adults with MCI and their family members) participated in individual semi-structured interviews before and after a 12-week group-based piano training program. These interviews were recorded, transcribed, open-coded, and analyzed by conventional content analysis.Participants with MCI reported improvements in mood, cognitive function, and social interaction. The learning process elicited mixed emotions, with both enjoyment and frustration occurring during the learning phases. Skill mastery and positive social interactions were crucial for sustained engagement throughout the program, although group settings sometimes led to negative self-comparisons.Findings highlighted the need to address both cognitive and emotional needs in interventions for MCI. Neglecting these aspects can exacerbate feelings of low self-esteem and other negative emotions.Recommendations for cognitive training programs include positive reinforcement, personalized support, mental preparation for challenges, and rapport building to enhance participant motivation and adherence. [ABSTRACT FROM AUTHOR]

Background: No other study has addressed the effectiveness of dual-task training in the postoperative period of total hip arthroplasty (THA). This study investigated the efficacy of dual-task training in older adults with THA. Methods: Patients were randomized into the control group (CG) (n = 14) and intervention group (IG) (n = 14). Patients in the CG received the usual post-operative rehabilitation for 8 weeks. IG-group received 8-week dual-task training in addition to the program given to the CG. Visual Analog Scale (VAS), Harris Hip Score (HHS), Mini-Mental Status Examination (MMSE), Dual Task Questionnaire (DTQ), Cognitive Timed Up and Go Test (cTUG), Lower Extremity Motor Coordination Test (LEMOCOT), 4 m Walking Speed (4MWS), Five Times Sit to Stand Test (FTSST), Activity Specific Balance Confidence Scale (ABC) were used to assess the patients after the sixth week of the surgery and after the two months of the initial assessment. Results: All evaluated parameters of the intervention group (VAS, HHS, MMSE, DTQ, cTUG, LEMOCOT, 4MWS, FTSST, and ABC) improved significantly after the intervention. Also, significant improvement was seen in all scores (VAS, HHS, MMSE, DTQ, cTUG, LEMOCOT, 4MWS, FTSST, and ABC) except for HHS-pain (0.059) and HHS-deformity (0.157) (p < 0.05) for the control group. The score change of the intervention group was significantly better for all evaluated parameters (VAS, HHS, MMSE, DTQ, LEMOCOT, 4MWS, FTSST, and ABC) (p < 0.05), except cTUG. All parameters of the intervention group were clinically meaningful regarding MCID values, except HHS-pain, HHS-living activities, and cTUG score change. Besides, HHS-pain, HHS-living activities, HHS-deformity, MMSE, LEMOCOT, FTSST, and ABC score change was not meaningful clinically. Conclusion: An eight-week dual-task training provides better results on pain, function, dual-task performance, motor coordination, gait, and balance than usual rehabilitation in patients after 6-weeks of THA. The results showed that patients after THA achieved improvements with gains in motor-cognitive function. Trial Registration: The study protocol was registered to "clinicaltrials.gov" (Registration Date: 19/08/2023, Clinical Trial Number: NCT06009419|| https://clinicaltrials.gov/study/NCT06009419). [ABSTRACT FROM AUTHOR]

Introduction: Effective decision-making in ball games requires the ability to convert positional information from a first-person perspective into a bird's-eye view. To address this need, we developed a virtual reality (VR)-based training system designed to enhance spatial cognition. Methods: Using a head-mounted virtual reality display, participants engaged in tasks where they tracked multiple moving objects in a virtual space and reproduced their positions from a bird's-eye perspective. The system simulated game-like scenarios to systematically train this cognitive skill. Participants' performance was assessed before and after the training. Results: The experimental results revealed significant improvements in spatial accuracy and cognitive ability among participants after using the system. These enhancements were measured by their ability to accurately convert first-person positional data into a bird's-eye perspective. Discussion: The findings suggest that the VR-based system effectively enhances perceptual-cognitive skills critical for team sports and other tasks requiring advanced spatial awareness. This training method holds potential for broader applications in spatially demanding activities. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to systematically evaluate the most recent evidence regarding the potential short-term and long-term synergistic effects of transcranial direct-current stimulation (tDCS) and cognitive training (CT) on the memory of individuals with mild cognitive impairment (MCI) or dementia and to explore the optimal treatment protocol. Materials and Methods: Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive literature search on PubMed, Medline, CINAHL and EMBASE was conducted to identify eligible randomized controlled trials (RCTs) published up to December 2022. The identified studies were summarized and analyzed to examine the efficacy of the combined intervention. Results: Ten studies involving participants with MCI or dementia were included. Four RCTs with memory-related outcomes were analyzed. A small-to-medium effect size (ES) of 0.28 was found for the short-term effect (95% CI, 0.02%, 0.55%). However, the long-term effect was non-significant, with an ES of 0.17 (95% CI, -0.09%, 0.44%). Conclusion: The combined intervention appears to effectively mitigate cognitive decline in the short term only. Optimal treatment protocol remains inconclusive due to heterogeneity among studies. More robust evidence is required to determine whether the combined approach can serve as an effective intervention in clinical practice. [ABSTRACT FROM AUTHOR]

Physical Activity (PA) is often associated with better overall health status, especially in older adults. Numerous pieces of evidence indicate that PA would be more beneficial when applied in conjunction with Cognitive Training (CT) either simultaneously (i.e., in Dual-Task [DT]) or sequentially. Nonetheless, the underlying mechanisms of such benefits remain elusive. To help delve deeper into their understanding, we developed a cognitive-motor DT paradigm in young adult mice and subsequently tested its effect in old age. Three groups of young adults C57BL/6J mice (3.5 months of age; n=10/group) were required. They were given cognitive tasks, either alone (Control) or in combination with PA which was administered either sequentially (SeqT group) or simultaneously (DT group). Mice were trained in a touchscreen chamber: first on a Visual Discrimination (VD) learning task, then on its Reversal (RVD) which assesses cognitive flexibility alongside procedural learning. PA was given through a homemade treadmill, designed to fit in the touchscreen chambers and set at 9 m/min. Fourteen months later, we further evaluated the effects of PA administered in both DT and SeqT groups, on the performance of the now 19-month-old mice. When compared to SeqT and control groups, DT mice significantly displayed better procedural learning in both VD and RVD tasks as young adults. In the RVD task, this enhanced performance was associated with both poorer inhibition and motor performance. Finally, in 19-month-old mice, both DT and SeqT mice displayed better motor and cognitive performances than control mice. This new cognitive-motor DT paradigm in mice yields an interesting framework that should be useful for adapting DT training in aging, including providing knowledge on the neurobiological correlates, to get the most out of its benefits. [ABSTRACT FROM AUTHOR]

Origami, drawing and colouring are artistic activities that can be beneficial for cognitive abilities or emotional well-being. However, there is a lack of studies that would investigate and compare these activities and their effects within the spatial abilities' domain. The aim of this study was to investigate if and how participating in three artistic activities—colouring, drawing or origami—can enhance spatial abilities. A total of 73 young adults participated in one of the three activities organized as a 7-session training, distributed every third day. Measures of spatial abilities (Spatial Reconstruction Task [SRT]), Mental Rotation Task [MRT]), Santa Barbara Solids Task [SBST]), and Corsi Block Tapping Task [Corsi]) were administered before (pretest) and after (posttest) the training, as well as at the 6-month follow-up). The Intrinsic Motivation Inventory (IMI) was administered at the posttest. The results showed no significant interaction between the training group and the measurement time point for the spatial ability tasks. Nevertheless, effect sizes at posttest favor origami and drawing in enhancing more complex spatial abilities (MRT for origami and drawing; SBST for origami; Corsi for drawing), and colouring in strengthening spatial perception (SRT). Some effects have remained for a longer period of time. Origami led to a greater pressure and tension, and colouring to higher interest and enjoyment. These results suggest that artistic activities can potentially contribute to the strengthening of spatial abilities, but it is advised to presented them in a way that reduces frustration and increase participant's enjoyment. [ABSTRACT FROM AUTHOR]

Developing effective cognitive training tools for older adults, specifically addressing executive functions such as planning, is a challenging task. It is of paramount importance to ensure the implementation of engaging activities that must be tailored to the specific needs and expectations of older adults. Furthermore, it is essential to provide the appropriate level of complexity for the planning task. A human-centred approach was used to address the issues identified in the design of the tool. Two pilot studies were conducted with older adults to fine-tune the training task and optimize its suitability for them. This also led to an enhancement of the underlying planning engine, transitioning from a simple fast-forward planner (PDDL4J) to an advanced heuristic search planner (ENHSP). The results show that user studies enabled the development of a cognitive training system that gradually increased the proposed difficulty levels of the planning task while maintaining usability and satisfaction among older adults. This highlights the importance of conducting user studies when implementing cognitive training tools for older adults. [ABSTRACT FROM AUTHOR]

Background/Objectives: Emergency airway management is a critical skill for healthcare professionals, particularly in life-threatening situations like "cannot intubate, cannot oxygenate" (CICO) scenarios. Errors and delays in airway management can lead to adverse outcomes, including hypoxia and death. Cognitive aids, such as checklists and algorithms, have been proposed as tools to improve decision-making, procedural competency, and non-technical skills in these high-stakes environments. This systematic review aims to evaluate the effectiveness of cognitive aids in enhancing emergency airway management skills among health professionals and trainees. Methods: A systematic search of MEDLINE, Embase, CINAHL, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov was conducted from February to March 2024. Studies examining the use of cognitive aids, such as the Vortex method, the ASA difficult airway algorithm, and visual airway aids, in emergency airway scenarios were included. Outcomes assessed included decision-making speed, procedural success rates, and non-technical skills. Data were extracted using standardized protocols, and the quality of included studies was appraised. Results: Five studies met inclusion criteria, encompassing randomized controlled trials, controlled studies, and mixed-methods research. Cognitive aids improved decision-making times (reduced by 44.6 s), increased procedural success rates, and enhanced non-technical skills such as teamwork and crisis management. Participants reported reduced anxiety and improved confidence levels (self-efficacy scores increased by 1.9 points). The Vortex method and visual cognitive aids demonstrated particular effectiveness in simulated scenarios. Conclusions: Cognitive aids significantly enhance emergency airway management skills, improving performance, reducing errors, and increasing provider confidence. Integrating cognitive aids into training programs has the potential to improve patient safety and outcomes. Further research is needed to validate these findings in clinical settings and optimize cognitive aid design and implementation. [ABSTRACT FROM AUTHOR]

With the aging population rising, the decline in spatial cognitive ability has become a critical issue affecting the quality of life among the elderly. Electroencephalogram (EEG) signal analysis presents substantial potential in spatial cognitive assessments. However, conventional methods struggle to effectively classify spatial cognitive states, particularly in tasks requiring multi-class discrimination of pre- and post-training cognitive states. This study proposes a novel approach for EEG signal classification, utilizing Permutation Conditional Mutual Information (PCMI) for feature extraction and a Multi-Scale Squeezed Excitation Convolutional Neural Network (MSSECNN) model for classification. Specifically, the MSSECNN classifies spatial cognitive states into two classes—before and after cognitive training—based on EEG features. First, the PCMI extracts nonlinear spatial features, generating spatial feature matrices across different channels. SENet then adaptively weights these features, highlighting key channels. Finally, the MSCNN model captures local and global features using convolution kernels of varying sizes, enhancing classification accuracy and robustness. This study systematically validates the model using cognitive training data from a brain-controlled car and manually operated UAV tasks, with cognitive state assessments performed through spatial cognition games combined with EEG signals. The experimental findings demonstrate that the proposed model significantly outperforms traditional methods, offering superior classification accuracy, robustness, and feature extraction capabilities. The MSSECNN model's advantages in spatial cognitive state classification provide valuable technical support for early identification and intervention in cognitive decline. [ABSTRACT FROM AUTHOR]

Background/Objectives: Parkinson's disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients' quality of life. [ABSTRACT FROM AUTHOR]

Background/Objectives: Cognitive training paradigms rely on the idea that consistent practice can drive neural plasticity, improving not only connectivity within critical brain networks, but also ultimately result in overall enhancement of trained cognitive functions, irrespective of the specific task. Here we opted to investigate the temporal dynamics of neural activity and cognitive performance during a structured cognitive training program. Methods: A group of 20 middle-aged participants completed 20 training sessions over 10 weeks. Quantitative EEG (qEEG) parameters, including alpha and theta power, alpha/theta ratio, and fronto-parietal coherence, were analyzed at four time points to assess changes in neural activity. Results: Results revealed significant overall improvements in the trained task (n-back) performance, without an effect on the untrained task (OSPAN). qEEG analyses showed increased change in posterior (and a less robust in frontal) alpha power, particularly during mid-training, suggesting an improved neural efficiency in regions associated with attentional allocation and task engagement. Theta power remained stable across sessions, indicating a limited influence on neural processes underlying working memory and attentional control. The parietal alpha/theta ratio showed weak increases during mid-training, reflecting subtle shifts in the neural efficacy and cognitive engagement. There were no significant changes in functional connectivity between frontal and parietal locations. Conclusions: Our findings suggest that cognitive training primarily influences localized neural activity, rather than network-level connectivity. This lack of a longer-range network-level effect might also explain the failure of cognitive training paradigms to induce performance enhancements on the untrained tasks. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive dysfunctions are still very common in the chronic phase of stroke when patients are discharged from neurorehabilitation centers. Even individuals who appear to have made a full clinical recovery may exhibit new deficiencies at home. Here, we present evidence of a novel kind of therapy at home aimed at contrasting the heterogenic evolution of stroke patients using a multidomain cognitive approach. Methods: Eighteen ischemic stroke patients were assessed in a within-subject longitudinal design (age 62.33 ± 11.1 years; eight men). Patients underwent the Tele-NeuroRehabilitation (TNR) multidomain cognitive training treatment using the Virtual Reality Rehabilitation System (VRRS) five times a week for 1 h sessions for four consecutive weeks. The protocol included the stimulation of specific cognitive functions, such as logical skills, praxis skills, attention, executive functions, memory, space time orientation and perception, and speech therapy. To determine neuropsychological changes, patients were evaluated before the sessions (T0), at the end of the sessions (T1), and after six months (T2). Results: The multidomain cognitive training induced a significant improvement in the working memory and language abilities as well as depression symptoms and alleviated caregiver burden. Most of this cognitive enhancement persisted after six months (T2), with the exception of depression symptoms. Otherwise, a significant decline in attention abilities was reported, thus demonstrating a lack of effect in this function. Conclusions: Our results suggest that multidomain cognitive TNR is a suitable protocol for reducing some cognitive and behavioral alterations in patients with strokes, with a beneficial impact also on the caregivers' burden distress management. Further RCTs are warranted to validate this new kind of approach. [ABSTRACT FROM AUTHOR]

In this study, we investigated the impact of a 10-week free weight resistance training (RT) program on cognitive function in healthy young adults. In this randomized controlled trial, 18 participants were assigned to either an experimental or control group. We assessed cognitive function by using eye-tracking (ET) technology during text processing tasks. First-pass reading times (FPRTs) and total reading times (TRTs) were measured. Results revealed a significant three-way interaction between group, moment, and syntactic complexity in FPRTs, demonstrating training effects on cognitive processing. The experimental group showed a distinctive shift in processing patterns: from longer times in low complexity pre-intervention to increased times in high complexity post-intervention, particularly in early processing measures (FPRTs). Complementary analyses of strength improvements showed that increased strength was associated with enhanced attention allocation to complex structures and improved processing efficiency for simpler texts, suggesting RT's potential to modulate cognitive function. [ABSTRACT FROM AUTHOR]

The emotion dysregulation and impulsivity are highly associated with alcohol use disorder (AUD). This study explored the role of impulsivity and emotion dysregulation and the interaction with adult probable ADHD on alcohol-related quality of life (QoL). In this observational trial, we analyzed data from the randomized TRAIN study, which compared efficacy of two cognitive training programs in patients AUD recently detoxified at 5 centers in France from February 2019 to February 2023, and who completed child and adult ADHD screening data (WURS + ARSR, n = 206 of 226). We collected baseline data on AUD severity, age, sex, quality of life (AQoLS), cognitive impairment (MoCA), impulsive behavior (UPPS-P) and emotion dysregulation (ERQ expressive suppression subscore, DERS-impulse). Patients with probable and without ADHD were compared. We performed multiple linear regression explaining the total AQoLS score (dependent variable) by impulsivity (UPPS-P score), emotion regulation (DERS-impulse), and expressive suppression (ERQ expressive suppression subscore), and their interaction with ADHD, adjusted on MoCA, sex, age. Forty (19%) patients were above the screening threshold for ADHD. The impact of alcohol on QoL was greater in them than in those without ADHD (57.3 (21.9) vs. 46.4 (19.6), p = 0.002). High impulsivity and emotion dysregulation dimensions were both significantly associated with poorer QoL. ADHD interacted significantly with expressive suppression to worsen the impact of alcohol on QoL (p = 0.04). The dysfunctional attempts to compensate for the strong dysregulation of emotions in ADHD lowers QoL in AUD. • For people with AUD and ADHD, alcohol had a higher impact on quality of life (QoL) • Emotion dysregulation and impulsivity explained most of the attributable effect of ADHD on QoL related to alcohol. • Expressive suppression acted as a risk factor for worsened QoL only in individuals with ADHD. [ABSTRACT FROM AUTHOR]