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Language disorders are among the primary obstacles in care and rehabilitation process following acquired brain injuries (ABI). While early cognitive screening is considered critical for sketching a reliable picture of patients' residual abilities and devising efficient therapeutic plans, it has been shown that commonly-used screening tools-which strongly rely on verbal materials-might be inappropriate when used with ABI patients. This study aimed at testing the robustness and validity of the Cognitive Assessment for Stroke Patients (CASP) battery-devised to minimize the use of verbal materials-and two gold-standards in clinical practice-i.e. Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA)-in presence of language comprehension difficulties. Forty-two ABI patients took part in the study. Half of the cohort was classified as aphasic. Participants underwent neuropsychological assessment including MMSE, MoCA and CASP, and completed the Token test to estimate language comprehension proficiency. The influence of linguistic ability on the outcomes of the screening tools was investigated. Regression analyses highlighted that, in aphasic patients, MMSE and MoCA scores proved to be significantly and remarkably determined by patients' proficiency in linguistic comprehension, while the outcome of the CASP battery was not significantly affected by language comprehension impairments.

The need for quick tools to sketch an early but accurate cognitive profile of patients who suffered brain damage or head trauma is of primary importance. Nonetheless, in the Italian context, the most-diffused screening tools are still those originally devised to diagnose dementia. The present pilot study then aimed at investigating the potential and feasibility of a novel screening battery, the Cognitive Assessment for Stroke Patients (CASP), in a sample of Italian patients by comparing it to Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests. A total of 29 neurology patients took part in the study. Participants underwent a screening procedure including the administration of MMSE, MoCA, and CASP. Data analysis suggested that the scores of the Italian version of the CASP are relatively less affected by the presence of language difficulties-common sequelae of stroke and head traumas-with respect to MMSE and MoCA ones. Furthermore, CASP scores proved to be highly correlated with both MMSE and MoCA scores, showing good clinical potential. Finally, the outcomes of administered tests proved not to be influenced by etiology or gender, and CASP scores showed a diminishing trend related to patients' age and a positive association with patients' education.

Diagnostic accuracy and reliable estimation of clinical evolution are challenging issues in the management of patients with disorders of consciousness (DoC). Longitudinal systematic investigations conducted in large cohorts of patients with DoC could make it possible to identify reliable diagnostic and prognostic markers. On the basis of this consideration, we devised a multicentre prospective registry for patients with DoC admitted to ten intensive rehabilitation units. The registry collects homogeneous and detailed data on patients' demographic and clinical features, neurophysiological and neuroimaging findings, and medical and surgical complications. Here we present the rationale and the design of the registry and the preliminary results obtained in 53 patients with DoC (vegetative state or minimally conscious state) enrolled during the first seven months of the study. Data at 6-month post-injury follow-up were available for 46 of them. This registry could be an important tool for collecting high-quality data through the application of rigorous methods, and it could be used in the routine management of patients with DoC admitted to rehabilitation settings.