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This paper presents an analysis of current foreign trends in neurocognitive rehabilitation of cognitive disorders in Alzheimer's dementia (AD) and neuropsychological rehabilitation of the most common form of vascular cognitive disorders (VCD) - aphasia. Two approaches to the restoration of higher mental functions (HMF), based on a different understanding of the neuroplasticity mechanisms, are described. The description presents non-invasive and functional methods of direct stimulation of HMF. Various methods of transcranial brain stimulation and Intensive Language-Action Therapy (ILAT) are reviewed and analyzed. The data of experimental studies present the application of these methods to the restoration of Broca's aphasia. The paper also considers an approach to neurorehabilitation based on the methodology of "workaround" recovery of HMF using sensory-enriched environment. The article describes and analyzes the theoretical foundations of Music Intonation Therapy (MIT), Thérapie mélodique est rythmée) (TMR), palliative MIT, Music Therapy (MT). The paper carries out an analytical review of the implementation of abovementioned methods in aphasics. Also, programs and neurocognitive correction methods in mild cognitive impairment (MCI) are considered. The paper describes the possibilities of using active and passive MT, STAM-DEM Therapy, and Multimodal Cognitive Enhancement Therapy (MCET) in AD. The study presents the data of systematic and meta-analytical reviews on their use in MCI. The paper describes the methodology of "musical" neuropsychological diagnostics in dementia.

Accurate screening for cognitive impairment in alcohol and other drug (AOD) services would help to identify individuals who may need supports to obtain the greatest benefit from substance use disorder (SUD) treatment. At present there is no screening measure that has been developed specifically to detect cognitive impairment in a SUD population. This study examines the psychometric properties of the Brief Executive-function Assessment Tool (BEAT), which was specifically designed for this purpose. This study involving 501 individuals with SUD and 145 normal control participants established internal consistency (n = 646; 0.734), interrater (n = 60; 0.994), and test–retest reliability (n = 177; 0.845), and construct (all correlations p ≤ 0.05), and criterion (n = 467; ANCOVA p < 0.001) validity. Test operating characteristics (n = 500; 87% sensitivity, 71% specificity, 21% PPP, and 99% NPP) were also established relative to an independent criterion variable made up of three established performance-based neuropsychological tests. Findings support the reliability and validity of the BEAT as a screening measure of executive function impairment with high sensitivity and a low rate of false negatives. [ABSTRACT FROM AUTHOR]

This integrative review frames a general rationale for the use of central thalamic deep brain stimulation (CT-DBS) to support arousal regulation mechanisms in the severely injured brain. The organizing role of the anterior forebrain mesocircuit in recovery mechanisms following widespread deafferentation produced by multi-focal structural brain injuries is emphasized. The mesocircuit model provides the conceptual foundation for the key role of the central thalamus as a privileged node for neuromodulation to support forebrain arousal regulation. In this context, cellular mechanisms arising at the neocortical, striatal, and thalamic population level are considered in the assessment of an individual patient's capacity for harboring underlying reserve that could be recruited for further recovery. Recent preclinical studies and pilot clinical results are compared to frame the detailed rationale for CT-DBS. Application of CT-DBS across the range of outcomes following severe-to-moderate brain injuries is discussed with the aim of improving consciousness and cognition in patients with non-progressive brain injuries. [ABSTRACT FROM AUTHOR]

Following severe traumatic brain injury (TBI), failure to adjust language to communication abilities has been described and attributed by many authors to executive function impairment. Interactional dysfunctions may damage family-based, social and vocational equilibrium, and they are of key importance in prognosis of rehabilitation outcome. In conversation, frequently occurring inappropriate formulations connote difficulties in discursive organization and are likely to include numerous digressions, if not confabulations. Objective The main objective of this study was to improve assessment of the non-verbal as well as the verbal aspects of the communication disorders observed in TBI subjects. We have developed and are proposing the grid for linguistic analysis (GALI) of free conversational interchange that constitutes an original French-language tool. We wish to demonstrate its validity as a means of measuring interactive skills in a given population. Method We assessed 17 severely brain injured patients presenting executive dysfunction, who were compared with 34 matched and healthy individuals. Fifty-one 10-minute sequences of free conversation between study participants and therapists were filmed and analyzed by applying the GALI. Three independent raters coded the conversations. Inter-rater reproducibility was considered statistically satisfactory. Results The results successfully distinguished TBI patients from healthy subjects and thereby underscored the discriminatory value of the tool. A significant correlation was found between the patients’ performances in executive tests and in the GALI. Conclusions In severe TBI a social handicap results from several associated cognitive disorders. Interactive discourse analysis combining non-verbal with verbal aspects confirms the existence of difficulties in communication that are usually underestimated in classic formal language testing methods. The GALI is likely to meet speech therapists’ need for reliable assessment of their patients’ interactional difficulties and their consequences in social life. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Individuals with phenylketonuria (PKU) treated early and continuously are reported to have psychiatric and executive function impairments. The feasibility of screening for psychiatric distress and executive function impairment in individuals with PKU was tested in 3 separate clinics in North America. Methods: Individuals were offered screening for psychiatric distress using the Pediatric Symptom Checklist, the PSC–Youth Report or the Brief Symptom Inventory and executive function impairment using the Behavior Rating Inventory of Executive Function. Gender, age and blood phenylalanine (Phe) concentrations obtained most recently and during the 2years prior to screening were assessed. Results: More than 90% of patients with PKU accepted the screening for psychiatric distress during their routine clinic visit. The screening took 15–20min. 32% of patients screened positive for psychiatric distress and 19% for executive function impairment. More individuals >18years screened positive for psychiatric distress while a similar number screened positive for executive function impairment across age groups. Lower blood Phe levels correlated with negative screening for psychiatric distress. Patients positive for psychiatric distress had higher (p=0.009) median and most recent blood Phe values (p=0.05). Discussion/conclusions: Routine screening for psychiatric distress of patients with phenylketonuria could be easily implemented in current clinic structures. High incidences of positive screens reinforce the need for regular psychiatric assessments of individuals with PKU. Identification and referral to local mental health providers might help to improve the standard of care for individuals with PKU. [Copyright &y& Elsevier]

Primary objective : The purpose of this pilot study was to evaluate an instructional package that facilitates learning and retention of multi-step procedures for persons with severe memory and executive function impairments resulting from traumatic brain injury. Research design : The study used a multiple baseline across participants design. Methods and procedures : Four participants, two males and two females, ranging in age from 36–58 years, were taught a 7-step e-mail task. The instructional package (TEACH-M) was the experimental intervention and the number of correct e-mail steps learned was the dependent variable. Main outcomes and results : Treatment effects were replicated across the four participants and maintained at 30 days post-treatment. Generalization and social validity data further supported the treatment programme. Conclusions : The results suggest that individuals with severe cognitive impairments are capable of learning new skills. Directions for future research include application of the instructional package to other multi-step procedures. [ABSTRACT FROM AUTHOR]