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Introduction: Virtual reality therapy (VRT) constitutes a powerful and motivating tool for stroke patients to actively participate in the process of neurorehabilitation, providing augmented performance feedback, with the aim of achieving better therapeutic results owing to the enhancing of neuroplasticity mechanisms., Aim: To report the most relevant data about the applications of VRT in the post-stroke neurorehabilitation., Development: We conducted a PubMed search for articles, latest books, leading clinical practice guidelines, and scientific societies, regarding such applications., Conclusions: Different performed randomized clinical trials (RCT) show that VRT safely facilitates in a statistically significant way motor and functional recovery of upper limb, gait, balance, quality of life related to health, and activities of daily living, together with conventional therapy, but have no clearly demonstrated overall superiority to conventional therapy. In this regard, underlying specific mechanisms remain elusive at this stage. Future RCT should define the good responder stroke patient profile based on the VRT used in conjunction with conventional therapy, allowing the generation of neurorehabilitation approaches that combine a customized immersive VRT with the clinical experience of the therapists, to maximize the results. It is necessary to carry out well-designed RCT, including larger samples of appropriately selected stroke subjects, to draft a consensus document that allows recommending, with a greater level of evidence and on a widespread basis, the implementation of VRT as add-on therapy in post-stroke neurorehabilitation. As well as to determine if the beneficial effects are maintained in the long term and to clarify the most suitable treatment schedule.

Introduction: The mismatch negativity (MMN) is a component of the long-latency auditory evoked potentials, that are used to check the functionality of automatic attentional processes of attentive information processing. Vegetative state diagnosis is frequent following severe traumatic brain injury (TBI). Eventually, some patients improve their condition to another one called minimal conscientious state., Aim: To evaluate the diagnostic usefulness of MMN in severe TBI patients during the subacute phase after leaving the neurological intensive care unit., Patients and Methods: We gathered MMN results from 19 patients (12 males and 7 females; 8 vegetative state and 11 minimal conscientious state) with ages between 17 and 59 years (mean: 27.3 years). The delay between TBI onset and MMN recordings were greater than 2 months (mean: 181 days). During the recording session, patients were evaluated by means of the Multisociety Task Force on Persistent Vegetative State scale., Results: All the minimal conscientious state patients (100%) showed MMN potential. In seven of the vegetative state patients (87.5%) the MMN was not found. The remaining MMN potential positive vegetative state patient improved to MCS 16 days after testing., Conclusions: MMN is a valid tool for differentiating vegetative state from MCS during the subacute phase of severe TBI. Hence it is a useful aid to the clinical evaluation. This would diminish the impact of a possible diagnostic error and its prognosis on therapeutical management, family and health costs. It can also be used for evaluating other brain disorders with altered consciousness.