Attention Disorders Research Articles

Multimodal mapping of spatial attention for unilateral spatial neglect in VR: a proof of concept study using eye-tracking and mobile EEG

Unilateral spatial neglect (USN) is a complex spatial attentional disorder consisting of a failure to attend to the contralesional side of space, frequently seen after a stroke. However, the majority of cases go undiagnosed due to the lack of a valid and reliable tool that is able to assess USN and its many variants. Recent technological advances in virtual reality (VR) and physiological sensors, allow for the study of this disorder under controlled, and ecologically-valid environments, which hold the promise of reliable and early detection. This proof of concept study aims to evaluate the feasibility of a system for discriminating different attentional states using a multimodal dataset derived from a spatial attention task conducted in VR. Nine healthy young adults underwent two experimental conditions: a Control condition and a Left Occlusion condition. Participants performed a visual search task while their behavioral data, including performance metrics, eye-gaze, head, and controller movement data, were recorded. Additionally, electroencephalography data was synchroniously collected to capture neural correlates of attentional processing. Analysis of results of this within-subjects study found worse performance (higher RT), changes in behavior (right-ward gaze bias, left-ward bias in head and controller movement) in the Left Occlusion condition. Neural differences were found (parieto-occipital mean alpha band power and event related potentials) between the two conditions. If validated, this system could be utilized as a diagnostic VR tool, while it holds the potential to facilitate the participation of stroke patients with USN in VR-driven rehabilitation.

“Between Scylla and Charybdis”: the influence of pregravid preparation on mental development of children born to mothers with epilepsy

Background. The emergence of the latest pharmacotherapeutic methods opened up new opportunities for delivery of healthy children born to women with epilepsy, whereas comprehensive pregravid preparation became the “gold standard” of treatment, reducing the risks of teratogenesis and the appearance of mental development disorders and adaptation in offspring.Objective: to study an effect of a comprehensive pregravid preparation for women with epilepsy on mental development and adaptation in paired children.Material and methods. A multicenter, retrospective, uncontrolled, open, observational study assessing mental development level in children born to women with epilepsy was conducted. The study involved 176 subjects: 88 children (aged 3–9 years) and paired mothers with epilepsy. Several methods we used: a medical questionnaire (biographical data, clinical data on the form, course and treatment of maternal epilepsy, course of pregnancy and childbirth, as well as information on pediatric early development), Luria neuropsychological batteries adapted by J.M. Glozman (for preschool and primary school children), Wechsler Intelligence Scale for Children (WISC) (for children aged 5 years and older), Child Behavior Checklist (CBCL) forms for parents (by T. Achenbach), and attention deficit hyperactivity disorder and other behavioral dysfunctions questionnaire modified by N.N. Zavadenko (for children aged 5 years and older).Results. In children born to mothers who did not undergo pregravid preparation, the overall indicator of developmental and adaptation disorders was higher: anxiety, attention problems, motor awkwardness, hyperactivity and internalization problems were more pronounced. They also had a higher overall index of neuropsychological disorders – gnosis, phonemic hearing, understanding of reversed speech and speech logic, and logical operations were specifically affected. A comparison of age groups showed that by the age of 7–9 years old, children born to mothers who underwent pregravid preparation were better compensated. Seizures during pregnancy is a predictor for developing large number of pediatric mental development disorders in the future (somatic problems, disorders of socialization and attention, motor awkwardness, externalization problems), whereas conducting pregravid preparation significantly lowers the predictive power of such effect, which allows to consider it as a moderator. Pregravid preparation is also a moderator that lowers a negative impact of toxicosis on probability for deliver a child with externalization (aggression) and delayed neurodynamic development.Conclusion. A comprehensive pregravid preparation exhibits a moderating effect: it lowers a negative impact of epileptic seizures and pregnancy complications (toxicosis) on further mental development and adaptation of children, as well as increases their compensatory capabilities. The study results have both scientific and significance for neurologists, obstetricians as well as gynecologists and clinical psychologists.

Cerebral blood flow differences in cognitive disengagement syndrome and attention deficit hyperactivity disorder: Doppler ultrasonography findings.

The present study aims to investigate potential differences in cerebral blood flow between children with Cognitive Disengagement Syndrome (CDS) and those with Attention Deficit Hyperactivity Disorder (ADHD) using Doppler ultrasound. In this single-center prospective study, we included 24 cases in the ADHD group with CDS symptoms, 29 cases in the ADHD group without CDS symptoms and, 26 children in the healthy controls. The children ranged in age from 6 to 15. Participants were evaluated by diagnostic interviews and standardized measures. Doppler ultrasound was performed to measure peak systolic velocity and blood flow volume (BFV) in the internal carotid (ICA) and vertebral arteries for each participant. The right ICA and total ICA BFVs were significantly lower in the CDS group compared to the ADHD and control groups (p=0.007 and p=0.003, respectively). In addition, there was a weak negative correlation between right ICA BFV and CDS scores, suggesting a possible link between reduced cerebral blood flow and CDS symptom severity. This study provides a noteworthy starting point for research on the neurovascular basis of CDS. Our findings indicated significant differences in cerebral blood flow between CDS and ADHD, supporting the idea that CDS is a unique attentional disorder with distinct neurobiological characteristics from ADHD.

Diagnostika a trénink neurovizuálních funkcí v rehabilitaci a ve sportu

Sensory integration plays a crucial role in the smooth execution of movements. However, the repeated intake of suboptimal information from our surroundings can disrupt the motor learning process. Sight stands out as the dominant human sense, providing visual information that is integrated at the central nervous system (CNS) level. This integration occurs alongside inputs from other sensory organs, constantly influencing motor activity. The term “neuro-visual system” (NVS) is now widely recognized in the fields of rehabilitation and sports, highlighting the crucial eye–brain–body axis connection. This article provides an overview of recent findings on the NVS exploring diagnostic procedures relevant to NVS in clinical settings. These procedures include tests for visual acuity, eye motility, and the near point of convergence. Drawing on existing literature, it identifies specific patient groups for whom neuro-visual training (NVT) could significantly enhance rehabilitation outcomes. Additionally, it discusses the potential benefits of NVT for athletes as an integral part of their sports training regimen. Included in the publication are two case studies illustrating NVS assessment and the application of NVT in clinical practice. The first case involves an adolescent with attention disorder and congenital diplopia, and the second, a young tennis player suffering from headaches. These examples underscore the practical value of NVS diagnostics and neuro-visual training in addressing specific health and performance issues.

Autism Spectrum Disorder (ASD) or early electronic screen exposure – 67 month-old case study

Concerns about screen addiction have become increasingly prevalent, particularly with regard to its potential impact on children's development. This study examines the possible connection between Autism Spectrum Disorder (ASD) symptoms and early exposure to electronic screens. It focuses on a case involving a 67-month-old child who was heavily exposed to screens during the COVID-19 lockdown. The child spent an average of 5 hours per day in front of screens, which included television and mobile devices. Observations indicated delays in language development, poor social skills, and an anxious emotional state. The family initially associated these symptoms with ASD and sought professional consultation. However, it was observed that the child exhibited behaviors such as restlessness, avoidance of social interaction, and a preference for screen time over fulfilling basic needs, such as eating. These behaviors were particularly evident when the child was not engaged with digital devices, manifesting in sadness, frustration, and anger. The case highlights how early and excessive screen exposure can lead to developmental and psychological challenges that mimic ASD-like behaviors. Excessive screen time in children has been associated with attention disorders, sleep disturbances, language delays, and emotional instability. In this case, the family did not impose restrictions on screen usage during the lockdown period, which contributed to the child’s increased demand for digital media. The therapeutic intervention focused on reducing screen time and encouraging non-digital activities, including outdoor play and social interactions with peers. As a result, improvements were noted in the child’s anxiety, social engagement, and language development. In conclusion, this case underscores the importance of distinguishing between ASD and the effects of excessive screen exposure, as the symptoms of both conditions can overlap. Reducing screen time and promoting parent-child interactions are essential in mitigating these developmental issues.

Trastornos neuropsiquiátricos asociados al Covid persistente

Persistent COVID (PC) is the term used to describe a multisystemic and multifactorial entity, which follows acute SARS-CoV-2 infection. Symptoms must persist for three months or more to define this disorder. The clinical manifestations are variable and nonspecific, but have a great impact on the quality of life of patients. Neuropsychiatric symptoms are commonly reported in CP, mostly chronic fatigue, cognitive disorders, attention disorders, among others. The pathophysiological mechanisms are not fully known, but the most described are hypoxia related neuronal damage, microvascular lesions, a persistent proinflammatory state, activation of latent viral infections, and alteration of the blood-brain barrier. There are no specific complementary tests to confirm the diagnosis of CP. There is also no specific treatment to date and most therapies are aimed at relieving symptoms and improving quality of life. This article provides a comprehensive bibliographic review of the most common neuropsychiatric manifestations of CP, including its probable pathophysiological mechanisms and the therapies proposed to date.

Evaluating the Auditory and Vestibular Functions of Patients with Multiple Sclerosis

Objective: Multiple sclerosis, a demyelinating disease of the central nervous system, is characterized by weakness of the arms and legs, sensory symptoms, ataxia, fatigue, diplopia, memory, concentration, attention disorder, and motor speech disorder. Common symptoms include epileptic seizures, cognitive impairment, hearing loss, and cortical symptoms. Materials and Methods: This study evaluated patients' mental functions with multiple sclerosis (MS) by considering their auditory and vestibular functions. A total of 30 patients, 15 healthy and 15 diseased, were recruited. In contrast, the experimental group consisted of individuals diagnosed with MS who had not had an attack for the last two months, over the age of 18, under the age of 60, and with similar characteristics in terms of gender. The audiological and vestibular tests on the experimental and patient groups were applied and the data obtained from these two groups were compared. Impedance audiometry test was performed on patients simultaneously. Result: The data obtained from our study, significant results were obtained for the right and left ears of MS patients to whom we applied the pure tone audiometry test. In the ABR test, unilateral hearing loss was observed in seven patients. In the VHIT test, while the VOR gains of 9 MS patients were outside the normal limits, the VOR gains of one patient in the left lateral canal were low. In the VEMP test, the wave latencies of 12 patients in the patient group were delayed, and the two patients' left-side P1 and N1 waveforms were not observed.

Investigating the Effectiveness of Neuropsychological Rehabilitation on Stroke Patients

Objectives: This study aimed to investigate neuropsychological rehabilitation’s effectiveness on stroke patients’ cognitive status. Methods: This quasi-experimental study examined 22 adults with ischemic stroke of the left hemisphere (with an average age of 64.31 years) before and after the intervention. The patients had fluent aphasia (10 people) and non-fluent aphasia (12 people), along with cognitive disorders such as memory or attention disorder. Medical examination and para-clinical diagnosis of magnetic resonance imaging (MRI) with different causes, along with the Persian diagnostic aphasia battery bedside version (P-DAB-AQ1, 2016), were conducted. The severity of language disorder and type of aphasia were investigated using the Persian diagnostic aphasia battery (P-DAB-1) and Persian picture naming battery tests. Also, the mini-mental state examination (MMSE) test checked the cognitive dimensions. Verb network strengthening therapy, treatment of underlying forms, Persian verb, and sentence production protocol, and semantic feature analysis (SFA) for patients were also used. Results: Findings show that the participants’ average aphasia quotient (AQ1) score increased from 74.80 to 80.12, and the average MMSE score increased from 17 to 22.59. The main variables do not follow a normal distribution (P<0.05), but the difference between scores before and after the intervention follows a normal distribution (P<0.05). Both the AQ1 and MMSE variables significantly differ before and after the intervention, according to the Wilcoxon test. The non-fluent aphasia group has a higher increase in MMSE scores than the fluent aphasia group. Discussion: Neuropsychological rehabilitation interventions can effectively improve AQ1 and MMSE. In addition, further research on neuropsychological rehabilitation interventions with two intervention and control groups and the treatment methods used during this study can be suggested for the treatment of stroke patients.

Pattern of cognitive deficit in vascular dementia

Background: Vascular dementia (VaD) is the second most common cause of dementia after Alzheimer’s disease. Vascular dementia has heteregeneous manifestation due to varying infarct location and subtypes. Despite quite frequent in Indonesia due to high incidence of stroke, the study about pattern of cognitive deficit in vascular dementia are still limited. Methods: This study is an observational cross-sectional consecutive sampling study conducted at the Memory Clinic of Provincial General Hospital Prof. Dr. R.D.Kandou, Manado, North Sulawesi, Indonesia during the period 1 January 2023 to 31 March 2024. Vascular dementia was diagnosed based on NINDS-AIREN criteria, and further classified based on Vascular Impairment of Cognition Classification Consensus Study (VICCCS). Cognitive examinations were done by using the Indonesian version of the Montreal Cognitive Assessment instrument (MoCA- INA) and other cognitive examinations. Results: There were 100 subjects who met the inclusion and exclusion criteria. The mean MoCA-INA in the study subjects was 12.2 (SD ± 6.0), with the lowest value found in mixed type dementia followed by multiple infarction/cortical and subcortical vascular dementia. Memory was the domain that most frequently impaired in vascular dementia. Impairments in the language domain were more common in the multiple infarct/cortical subtype, while executive function deficits were more frequently found in the subcortical subtype of vascular dementia (p<0.001). Attention, memory and visuospatial disorders did not show any significant differences in the three subtypes of vascular dementia. Conclusion: Language disorders are more common in multiple infarction or cortical subtypes, while executive function is more dominantly impaired in the cortical subtype.

Multidisciplinary clinical assessment and interventions for childhood listening difficulty and auditory processing disorder: Relation between research findings and clinical practice.

Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our "SICLiD" research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests. Here we examined results of clinical assessments and interventions for these children in relation to research performance. Study setting was a tertiary pediatric hospital. Electronic medical records were reviewed for 64 children aged 6-13 years recruited into a SICLiD LiD group based on a caregiver report (ECLiPS). The review focused on clinical assessments and interventions provided by Audiology, Occupational Therapy, Psychology (Developmental and Behavioral Pediatrics), and Speech-Language Pathology services, prior to study participation. Descriptive statistics on clinical encounters, identified conditions, and interventions were compared with quantitative, standardized performance on research tests. Z-scores were compared for participants with and without each clinical condition using univariate and logistic prediction analyses. Overall, 24 clinical categories related to LiD, including APD, were identified. Common conditions were attention (32%), language (28%), hearing (18%), anxiety (16%), and autism spectrum (6%) disorders. Performance on research tests varied significantly between providers, conditions, and interventions. Quantitative research data combined with caregiver reports provided reliable predictions of all clinical conditions except APD. Individual test significant correlations were scarce, but included the SCAN composite score, which predicted clinical language and attention difficulties, but not APD diagnoses. The variety of disciplines, assessments, conditions and interventions revealed here supports previous studies showing that LiD is a multifaceted problem of neurodevelopment. Comparisons between clinical- and research-based assessments suggest a path that prioritizes caregiver reports and selected psychometric tests for screening and diagnostic purposes.

Measuring subjective cognitive complaints with covid-19 brain fog using the subjective scale to investigate cognition (SSTICS)

The term “brain fog” has emerged from the observations of neuropsychiatric conditions present in post-COVID-19 infections. This is characterized by concentration and memory problems, selective attention disorders and difficulties in executive functions, yet it is unclear how long these deficits may persist and which cognitive functions are most vulnerable. Therefore, there is a need to properly evaluate these cognitive complaints using an assessment tool that specifies their intensity and nature. Our primary objective was to explore subjective perceptions of cognitive functioning in COVID-19-associated with brain fog using a tool that was previously validated for assessing subjective cognitive complaints. A total of 68 participants were recruited and the Subjective Scale to Investigate Cognition (SSTICS) was used to assess cognitive complaints. This was the first time that the SSTICS was used for this purpose in subjects with COVID-19. In addition, participants were administered a questionnaire assessing for the presence of various symptoms, as well as COVID-19 clinical parameters. The neuropsychological basis for the construct of the SSTICS was related to the cognitive complaints expressed by participants. A reliability analysis of our sample indicated a high degree of internal consistency (Cronbach’s alpha= 0.951). Associations between various SSTICS scores and COVID-related symptomatology and the differences between group of participants who reported cognitive complaints (“complainers”) and those who did not were assessed. We performed an exploratory factorial analysis based on Principal Component Analysis (PCA). Based on their distribution, participants were grouped into: “good functioning” - scores 0-9 (35.3%); “medium functioning” - scores 14-23 (25%); and “poor functioning” - scores 26-71 (39.7%). The mean SSTICS score was 20.59 (SD 16.61) and correlated with the quarantine duration and loss of smell. Complainers differed significantly from non-complainers in the total number of symptoms, the quarantine duration and the presence/absence of specific symptoms, such as loss of smell, tiredness and aches/pains. Our study showed that >10% of patients reported subjective cognitive complaints following COVID-19, with most reporting mild or serious cognitive complaints, mostly within the domains of memory, attention, language, executive functioning or praxis.

Sociomedical assessment: basics of assessment in general and specifically in the case of fatigue and burnout

The sociomedical report is an essential basis for making decisions about benefits from social insurance providers. As an instrument of medical information, the sociomedical assessment can be based on very different questions, such as the question of ability to work, earning capacity, participation in professional or social life, or the need for medical treatment. It is important to obtain acomprehensive picture of the individual situation in order to create the basis for decisions about benefit entitlements and support measures. The various issues in the respective sociolegal context may require not only the sociomedical report but also other expertise. The international classification of functioning, disability, and health (ICF) and the World Health Organization (WHO) bio-psycho-social model on which it is based enable health problems and their effects to be considered in the context of life and work. The components of functional ability and disability are assessed in their interaction from asociomedical perspective. What is important is not the diagnosis but rather the person and the individual impact of the health disorders on their activities and participation.In the case of fatigue and burnout, amedical symptom complex with (psychophysical) exhaustion and the resulting attention and concentration disorders are in the focus of the sociomedical assessment. It can be difficult to objectify symptoms and complaints in these diseases, which can lead to particular challenges during assessment, especially when validating complaints.

Prevalence of Brugada ECG pattern in psychiatric patients: a longitudinal prospective cohort of 550 patients

Abstract Background Brugada syndrome (BrS) is an inherited disorder with autosomal dominant transmission, which occurs predominantly in males in the third to fourth decade of life with resting syncope, nocturnal agonic breathing, major ventricular arrhythmias and sudden death. Arrhythmic complications can occur spontaneously or following exposure to triggers such as fever, or certain categories of medications, including psychiatric drugs. Aim of the study To evaluate the prevalence of Brugada ECG pattern in psychiatric patients. Methods from January 2023 to Decembre 2023, 550 consecutive patients who were admitted to the psychiatric department of our university hospital were enrolled. For each patient, electrocardiographic and anamnestic data including psychiatric diagnosis, current drug therapy and family history were collected. Results Twenty-one out of five-hundred and fifty patients (3.8%) presented with a Brugada ECG pattern. Mean age was 42±6 years and seventeen out of twenty-one patients (81%) were male. Two patients exhibited a Spontaneous type 1 Brugada ECG pattern meanwhile nineteen patients had a Brugada type 2 or 3 ECG pattern. When compared to the general population, those with Brugada ECG had longer P wave duration (110±7 vs 103±13 msec p<0.01) and longer QRS duration (97±14 vs 89±12 msec p=0.04). Evaluating psychiatric disorders, patients with Brugada ECG had high prevalence of mood disorders (10 out of 21, 47%). Other disorders were schizophrenia (3 out of 21, 14%), cognitive retardation (5 out of 21, 23%), and attention disorder (1 out of 21, 5%). Moreover 4 patients were drug addicted. Only 5 out of 21 (24%) patients had a family history of psychiatric and neurological disorders. Conclusions Brugada ECG pattern has a prevalence of 3.8% in a large cohort of psychiatric patients. Mood disorders was the most common diagnosis in this cohort. Large prospective registries are needed to evaluate the clinical feature and potential clinical implication of this findings.

Traits of Developmental Disorders in Adults With Listening Difficulties Without Diagnosis of Autism Spectrum Disorder And/or Attention-Deficit/Hyperactivity Disorder.

Background: Some individuals have a normal audiogram but have listening difficulties (LiD). As many studies have investigated the relationship between listening and developmental disorders, the traits of developmental disorders might explain the symptoms of LiD. In this study, we examined the traits of developmental disorders of adults with LiD to help clarify the cause of LiD symptoms. Methods: In total, 60 adults with LiD and 57 adults without LiD were included. Participants completed a questionnaire for the autism spectrum quotient (AQ) test, the Adult Attention-Deficit Hyperactivity Disorder Self-Rating Scale (A-ADHD), the Adolescent/Adult Sensory Profile (SP), and the severity of subjective LiD in daily life. Results: Before analysis, we excluded participants with LiD who were already diagnosed or met the criteria for autism spectrum disorder (ASD) or ADHD, and the results of the remaining 30 participants (50.0%) with LiD were analyzed. Adults with LiD showed higher scores than those without LiD in the AQ. Attention switching in the AQ and attention ability in the A-ADHD scale were correlated with the severity of LiD symptoms in everyday life. The AQ scores were also significantly correlated with subscales of the SP. Conclusions: Adults with LiD showed greater autistic traits than those without LiD; therefore, LiD symptoms are possibly related to autistic symptoms. Furthermore, adults with LiD might have attention disorder traits of both ASD and ADHD and sensory processing problems. These findings suggest that the attention problems in adults with LiD noted in previous studies might be related to these traits of developmental disorders.

Factors and prediction model associated with resumption of social outings in stroke survivors 6 months after onset: a multicenter prospective study

ABSTRACT Objectives To identify factors associated with the resumption of social outings 6 months after stroke onset and develop a simple clinically practical prediction model. Materials and methods Participants were recruited from first-ever stroke survivors admitted to three rehabilitation wards, and resumption of social outings 6 months after stroke onset was assessed using the Japanese version of the Frenchay Activities Index. The association of physical and cognitive functions with activities of daily living at admission to the rehabilitation ward and resumption of social outings 6 months after stroke onset was examined using logistic regression and decision trees. Results Notably, 63.2% of the 57 stroke survivors who participated in this study had lower Frenchay Activities Index scores for social outings 6 months after stroke onset than before. Logistic regression analysis revealed that attention deficit and grooming on the Functional Independence Measure (FIMTM) were significantly associated with decreased social outing scores 6 months after stroke onset. A decision tree model was created to predict the resumption of social outings using the presence or absence of attention disorders and FIMTM grooming score (>2 or ≤ 2). Conclusions The results of this study suggest that attention deficit and beyond a certain level of independence in grooming (FIMTM >2) at admission to the rehabilitation ward are associated with recovery to the pre-stroke level of social outings 6 months after stroke onset. The decision tree created in this study holds promise as a simple model to predict the resumption of social outings among stroke survivors.

Study of etiology, clinical profile, and outcome of altered sensorium patients admitted in a tertiary care hospital

Background: Altered sensorium is one of the most common presentations in patients coming to the emergency room. It includes decreased level of consciousness, attention disorder, arousal disorder, and cognitive disorder. The causes of altered sensorium can be varied, some of which are cerebrovascular diseases, alcoholism, cerebral trauma, hypoglycemia, epilepsy, drug intoxication, and neuroinfection. 4–10% of the patients presenting to the emergency department may have altered mental status. The outcome is dependent on early identification and effective treatment using investigations and imaging technologies, and it might range from full recovery to permanent damage to death. Aims and Objectives: (1) To study clinical profile and etiology in altered sensorium patients. (2) To assess outcomes in altered sensorium patients. Materials and Methods: In this prospective cross-sectional study, clinical examination and investigations are done and data are collected using pro forma for patients fulfilling the inclusion criteria. In this study, all altered sensorium patients were evaluated by detailed history, clinical examination, Glasgow Coma Scale (GCS), laboratory investigations, computed tomography brain, and other investigations. All patients were followed up till discharge or death of the patient in the hospital. Results: There were 270 patients who presented with encephalopathy, 184 (68%) were males. The majority of these patients 60 (22.2%) were in the age group of 51–60 years old. The most common cause is neurological in 109 (40.3%) patients, metabolic in 64 (24%) patients, and sepsis in 50 (19%) patients. Ischemic stroke 83 (76%) is the most common neurological cause. Hepatic encephalopathy was the most common cause of metabolic encephalopathy present in 21 (32%) patients. Pneumonia was the most common infection. There were 114 (42.2%) deaths. Septic encephalopathy is the most common cause of mortality. Early presentation to the hospital, higher GCS, and conscious level at presentation were good prognostic markers of outcome in patients, while septic encephalopathy was found to have the worst prognosis. Conclusion: The common etiologies of encephalopathy are neurological followed by metabolic and sepsis. Early presentation to the emergency room within 6 h of symptom onset, higher GCS, neurological and metabolic causes are associated with a good prognosis. The mortality rate was 42.2%. Septic encephalopathy is the most common cause of death with pneumonia being the most common source of infection.

Impact of pre-stroke cognitive decline on rehabilitation effectiveness and cognitive-functional status of patients in the acute period of ischemic stroke

Summary. The aim was to assess the influence of premorbid cognitive deficit on the effectiveness of rehabilitation using VR technologies and cognitive-functional status of patients in the acute period of ischemic stroke based on statistical methodology. Materials and methods: 120 patients diagnosed with ischemic stroke were examined. The IQCODE questionnaire was used to identify the patient’s cognitive decline before and the Pandas and SciPy libraries. Results: all patients had a multifunctional type of cognitive impairment with a predominant decline in the areas of executive function, memory, speech and perception. Patients of the 2nd group had a more pronounced deficit in the areas of constructive praxis, episodic memory, semantic information processing and perception. Assessment of the dynamics of cognitive impairment during therapy revealed a significant improvement in memory loss (p=0, 0034), executive dysfunction (p<0.0001) and attention impairment (p=0.0001) in patients of 1st group and regression cognitive deficit in almost all cognitive areas in patients of 2nd group. Factors impeding rehabilitation in 1st group of patients were attention (r = -0,325) and perceptual disorders (r = -0,425); in 2nd group: semantic aphasia (r = -0,425), constructive apraxia (r = -0,325), speech impairment (r = — 0,375), object agnosia (r = -0,323) and IQCODE (r = -0,395). Conclusion: pre-stroke cognitive impairments are predictors of the development and progression of post-stroke cognitive deficits and reduce the possibilities of rehabilitation and cognitive recovery. The introduction of IQCODE in the diagnosis of cognitive dysfunction in the acute period of ischemic stroke is a useful tool in predicting the course and development of cognitive deficit and studying the prospects of rehabilitation programmes using VR technologies in patients with pre-stroke cognitive impairment.

Cognitive impairments in autoimmune encephalitis: the role of autoimmune antibodies and oligoclonal bands.

The presence of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is a pivotal diagnostic marker for multiple sclerosis (MS). These bands play a crucial role in the diagnosis and understanding of a wide array of immune diseases. In this study, we explore the relationship between the cognitive profile of autoimmune encephalitis (AIE) and the presence of OCBs in CSF, with a particular emphasis on NMDA receptor antibodies. We studied a cohort of 21 patients across five tertiary centers, segregated into two distinct categories. One group comprised individuals who tested positive only for autoimmune encephalitis antibodies indicative of encephalitis, while the other group included patients whose CSF was positive for both autoimmune encephalitis antibodies and OCBs. Our investigation focused primarily on cognitive functions and behavioral alterations, supplemented by auxiliary diagnostic assessments such as CSF cell count, magnetic resonance imaging (MRI), and electroencephalogram (EEG) results, evaluated for the two patient groups. To validate our findings, we employed statistical analyses such as Fisher's exact test with Benjamini-Hochberg correction. Our study included 21 patients, comprising 14 who were presented with only autoimmune encephalitis antibodies, and 7 who were dual-positive. Among these patients, we focused on those with NMDA receptor antibodies. Of these, five were dual positive, and nine were positive only for NMDA receptor antibodies. The dual-positive NMDA group, with an average age of 27 ± 16.47 years, exhibited significantly higher CSF cell counts (p=0.0487) and more pronounced language and attention deficits (p= 0.0264). MRI and EEG results did not differ significantly between the groups. Our results point to OCBs as an additional marker of disease severity in AIE, especially in NMDA receptor-antibody positive patients, possibly indicating a broader inflammatory process, as reflected in elevated CSF lymphocytes. Regular testing for OCBs in cases of suspected AIE may aid in disease prognosis and identification of patients more prone to language and attention disorders, improving diagnosis and targeting treatment for these cognitive aspects.

Consequences of bullying on the life and health of the person being bullied

One of the most serious pathologies in the work environment is bullying. Victims of mobbing experience emotional, psychological and sometimes even physical violence, which causes consequences on an individual, organizational, social level. Due to the serious consequences of bullying, it becomes necessary to continuously monitor this phenomenon in the context of formulating possible ways to prevent and rehabilitate those who have experienced it. The purpose of the research undertaken was to learn about the consequences of bullying on the personal lives and health of victims of bullying. 13 respondents took part in the study. In selecting the sample, the assumption was made that those taking part in the study must have a court case held, during which the occurrence of mobbing in the employment relationship was found. A qualitative strategy using a narrative interview was used to obtain and analyze data. The presentation of the results of the study was divided into two areas: the consequences of bullying on personal life and the consequences of bullying on the victim's health. The most common symptoms of somatic disorders in the subjects related to the experience of bullying were headaches, dizziness, abdominal pain, nausea, pain in the heart area, sleep disturbances, and general weakness. In the area of mental disorders associated with experienced bullying, those surveyed most often mentioned: concentration and attention disorders, mood disorders, depression, addiction to psychoactive substances, and even suicidal thoughts. All the mental disorders mentioned are inextricably linked to exposure to chronic stress. It is the substrate of physiological, emotional and behavioral reactions, as well as intellectual reactions. All the listed consequences of bullying on the health of the victim, affect personal life. The experience of bullying affects a person's creative activity, which is passion. The consequence of bullying situations is the abandonment of activity, and the return to previous passions causes frustration, stress, and attacks of aggression in the subjects. Those affected by bullying transfer their problems to their private lives, so the effects of bullying also affect the immediate family. The prolongation of the bullying situation and the behavior of the victim of bullying often leads in the family sphere to: quarrels, frustration, deterioration of ties and relations, aggression and family breakdown. In order to design intervention and prevention measures, it is necessary to increase public awareness of the phenomenon of mobbing and its consequences for the individual, the organization and society.

A - 59 An Exploration of a Passive Decision Making Style within the Cognitive Disengagement Syndrome Population and its Contribution to Social Isolation

Abstract Objective Recent research has shown that Cognitive Disengagement Syndrome (CDS) may reduce decision-making independence. In this way, CDS may include a prognosis of social disengagement due to symptoms of the disorder such as apathy, low motivation, passivity, and low energy. This poster investigates the relationship between CDS symptoms and social disengagement and explores possible treatment focuses that could increase individuals’ connection to others and the world around them. Data Selection Information regarding this poster was obtained through a review of the literature including peer-reviewed articles from 2019–2024. Articles were gathered from the Journal of Clinical Child and Adolescent Psychology, Journal of Attention Disorders, Journal of Pediatric Psychology, Child Neuropsychology, and Research in Developmental Disabilities. Informal analyses were used to determine themes including keywords such as sluggish cognitive tempo, cognitive disengagement syndrome, decision-making, social isolation, and apathy. Data Synthesis CDS is associated with lower levels of assertiveness and higher levels of passivity than in the Attention Deficit Hyperactivity Disorder Inattentive Type (ADHD-IN) population. Current research suggests CDS is associated with social isolation influenced by difficulty initiating conversations and being more likely to engage in anxious rumination during conversations. Treatment interventions for CDS should target shyness, task-unrelated thought patterns, behavioral inhibition, hyperreactivity to social stressors, socially isolating behavioral addictions, verbal inhibition, and difficulty with divided attention. Conclusions Based on conclusions drawn in this poster, future studies should examine the impact of loneliness on social initiation frequency within the CDS population. The development of a questionnaire that aims to differentiate ADHD-IN from CDS may also be useful.