Cognitive Rehabilitation In Patients Research Articles

Efficacy of non-computerized cognitive rehabilitation in Parkinson’s disease: A one year follow up study

In this study, we explored the effect of non-computerized cognitive rehabilitation in patients with Parkinson’s disease in comparison with an intervention with elements of music therapy after the completion of a three-month program and one year after the end of the intervention. After the initial neuropsychological examination, the respondents were divided into two intervention groups. The experimental group (n = 26) underwent a twelve-week program of cognitive rehabilitation at a frequency of 60 minutes once a week. The control group (n = 27) underwent an intervention program with elements of music therapy at the same frequency. Respondents who underwent the cognitive rehabilitation program improved in the delayed recall from visual memory in the follow-up examination after the end of the cognitive intervention. One year after the end, the effect of cognitive rehabilitation persisted in delayed recall from visual memory and in executive mental flexibility. Cognitive rehabilitation is an effective approach to compensate for cognitive deficits in P D, but other approaches to cognitive stimulation may be equally effective.

A systematic review about the importance of neuropsychological features in heart failure: is at heart the only failure?

Heart failure can lead to cognitive impairment that is estimated to be present in over a quarter of patients. It is important to intervene at a cognitive level to promote brain plasticity through cognitive training programs. Interventions transformed by technology offer the promise of improved cognitive health for heart failure patients. This review was conducted on studies evaluating the role of cognitive rehabilitation in patients with heart failure. We examined clinical trials involving patients with heart failure. Our search was performed on Pubmed, Web of Science and Cochrane library databases. Of the initial 256 studies, 10 studies met the inclusion criteria. Cognitive rehabilitation training has important implications for the treatment and prevention of cognitive decline in heart failure patients with significant recovery for delayed recall memory and a significant time effect for total recall memory and delayed, psychomotor speed and IADL performance. It is important to include the assessment of cognitive functioning in the routine clinical examinations of patients with heart failure, discover the relationship between cognitive function and heart failure, and target cognitive rehabilitation programs that promote brain plasticity.

Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study

IntroductionIn recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. MethodFifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. ResultsCompared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. ConclusionsThe ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

Dynamic Changes in Brain Perfusion after Cognitive Rehabilitation in Patients with Type 1 and Type 2 Diabetes Mellitus

INTRODUCTION: The results of numerous studies indicate a high prevalence of cognitive impairment among patients with diabetes mellitus (DM).
 AIM: To evaluate the effectiveness of computerized training in cognitive rehabilitation in individuals with type 1 and type 2 DM, taking into account the dynamics of brain perfusion.
 MATERIALS AND METHODS: A randomized controlled study. The study group consisted of 25 patients with type 1 DM and 30 patients with type 2 DM aged 23 to 67 years. The comparison group included 20 patients with type 1 DM (mean age 28.4 years) and 20 patients with type 2 DM (mean age 56.0 years). Before and after the rehabilitation course, the patients of the study group underwent a general clinical examination, a blood test for carbohydrate metabolism, cognitive function testing using the Montreal Scale (MoCA test), contrast-free perfusion magnetic resonance imaging (MRI) of the brain. Active rehabilitation lasted 6 month; it was based on a computerized training, including exercises on verbal and nonverbal intelligence.
 RESULTS: On the initial examination, all the subjects did not have the achieved target level of glycated hemoglobin. After completion of the training program, a decrease in the parameter in both groups was noted, as well as a decrease in the mean level of fasting glycemia in people with type 1 DM. The result of neuropsychological testing in all patients at the initial stage corresponded to the diagnosis of ‘cognitive dysfunction’. The control test revealed an improvement in cognitive status according to the overall score, the abstraction scale, speech, memory and visual-constructive skills. Correlation analysis in the group with type 1 DM showed that the result of exercises on visual attention and auditory perception was influenced by memory function. In individuals with type 2 DM, increased glycated hemoglobin was associated with a decrease in cognitive functions according to the overall score of the MoCA test, as well as in tasks for speech, memory, visual-constructive skills. Dynamic analysis of changes in the MRI picture revealed hypoperfusion in the area of the right and left thalamus in patients with type 1 and type 2 DM, respectively, as well as increased perfusion of the white matter of the right parietal lobe in the group with type 1 DM, and in the putamen area on the left in the group with type 2 DM.
 CONCLUSION: In patients with type 1 and type 2 DM, as well as with cognitive deficit, who underwent a course of cognitive rehabilitation using computerized training, an improvement in cognitive status was noted, which was confirmed by the results of contrast-free perfusion MRI. to evaluate the effectiveness of computerized training in cognitive rehabilitation in people with type 1 and type 2 diabetes mellitus, taking into account the dynamics of brain perfusion.

Cognitive control and impulsivity in deficit schizophrenia: neuropsychological and clinical characteristics

Over the years, various concepts concerning the nature of schizophrenia have emerged. One of the proposals put forward in the literature is the division of schizophrenia into its deficit and non-deficit subtypes. Compared to its non-deficit counterpart, the deficit type involves more severe cognitive dysfunctions. Among these, some authors enlist poorer cognitive inhibition and greater impulsivity, although their behavioral correlates still remain unclear. Structural and functional studies of the brain suggest the presence of links between impulsivity and inhibition in schizophrenia, but few studies to date have analyzed cognitive performance within these two domains in patients with the deficit type. In addition, little is known about the effectiveness of neurorehabilitation in reducing cognitive deficits in deficit schizophrenia. Thus, numerous questions in this area seem to warrant further research. In this paper we present clinical and neurobiological correlates of cognitive control and impulsivity against neuropsychological and psychopathological symptomatology of schizophrenia. In addition, we describe selected neuropsychological tools used in the diagnosis thereof. We touch upon potential benefits of cognitive rehabilitation in patients with schizophrenia, especially in terms of self-control. Last but not least, this paper presents an overview of previous research and an attempt to embed them in modern theoretical models of cognitive inhibition and impulsivity, for a better understanding of the nature of cognitive dysfunction in schizophrenia seems crucial for proper diagnosis and assessment of treatment effects, and in a broader context is important for understanding its effects on quality of life and functioning of patients and their families.

Clinical aspects of virtual reality technologies application in cognitive rehabilitation of patients with cardiovascular diseases

This analytical review considers the clinical aspects of the application of virtual reality (VR) technologies in the cognitive rehabilitation of patients with cardiovascular diseases. It is shown that VR-training is one of the actively developing rehabilitation methods. Its use has great potential for the treatment of cognitive disorders of a wide range (stroke, vascular cognitive disorders, cardiac surgery patients). Promising in the development of personalized approach in the cognitive rehabilitation of cardiac patients is the estimation of the initial level of cognitive reserve as an indicator of the possible activation of neuroplastic processes against the background of cognitive training using a virtual environment.

In person versus remote cognitive rehabilitation in patients with subjective cognitive decline or neurocognitive disorders: what factors drive patient's preference?

To date, there is still a lack of consensus for identifying the ideal candidate for cognitive telerehabilitation (TR). The main goal of the present study is to identify the factors associated to the preference for either TR or in-person cognitive training (CT) programs in older adults at risk of dementia or with early cognitive impairment. A sample of 56 participants with subjective cognitive decline or neurocognitive disorders eligible for CT were enrolled at the Dementia Research Center and Neurorehabilitation Unit of IRCCS Mondino Foundation. All individuals underwent a baseline assessment to capture their complete profile, including cognitive reserve and lifestyle habits, sociodemographic characteristics, cognitive functioning, and mental health. Patients were then asked their preference for TR or in-person CT, before being randomized to either treatment as per protocol procedures. Statistical analyses included explorative descriptive approach, logistic regression, and non-parametric models to explore the overall contribution of each variable. The two (TR and in-person) preference groups were similar for cognitive functioning and mental health status. Socio-demographic and lifestyle profiles seem to be the most important factors to influence the preference in terms of the area under the curve (AUC) of the models. The two preference groups differed in terms of socio-demographic characteristics (e.g., level of technological skills, age, and distance from the clinic). Furthermore, participants who selected the TR modality of CT had significantly higher levels of cognitive reserve and adopted more protective lifestyle habits (e.g., regular physical activity, Mediterranean diet) when compared to those who preferred in-person CT. These findings highlight that the preference to receive CT delivered by TR or in person is a complex issue and is influenced by a variety of factors, mostly related to lifestyle habits and sociodemographic characteristics. Availability of profiles of patients that may be more attracted to one or the other modality of TR may help promote shared decision-making to enhance patient experience and outcomes.

THE BENEFITS OF GAME THERAPY IN NEUROLOGICAL PHYSIOTHERAPEUTIC TREATMENT

Game therapy is a technique that uses videogames as a physical therapy resource to promote physical and cognitive rehabilitation of patients with different clinical conditions. Game therapy was developed in 2006 in Canada and arrived in Brazil in 2007, being recognized by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO) since 2015. It works through movement sensors that capture the patients’ gestures and transform them into actions in games, stimulating motor coordination, balance, cardiovascular conditioning, and brain activity. It is a complementary therapy that does not replace conventional forms of treatment, but contributes in a playful and fun way to the recovery of patients.

Functional and cognitive rehabilitation interventions during intensive care admission: A protocol for a systematic integrative review.

Long-term cognitive impairment occurs in up to 60% of intensive care unit (ICU) survivors. Early use of functional and cognitive rehabilitation interventions, while patients are still in ICU, may reduce cognitive decline. We aim to describe the functional and cognitive interventions used during the ICU stay, the healthcare professionals providing interventions, and the potential impact on functional and cognitive rehabilitation. In this integrative systematic review, we will include empirical qualitative, quantitative, mixed- and multiple-methods studies assessing the use of functional and cognitive rehabilitation provided in ICU. We will identify studies in relevant electronic databases from 2012 to 2022, which will be screened for eligibility by at least two reviewers. Literature reported as narrative reviews and editorials will be excluded. We will assess the impact of interventions evaluating a cognitive and functional function, quality of life, and all-cause mortality at 6-12 months after ICU discharge. The Revised Cochrane risk-of-bias Tool will be used for assessing risk of bias in clinical trials. For observational studies, we will use the National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Furthermore, we will use the critical appraisal skills programme for qualitative studies and the mixed methods appraisal tool for mixed methods studies. We will construct four matrices, including results describing which ICU patients and healthcare professionals were engaged in rehabilitation, which interventions were included in early rehabilitation in ICU, the potential impact on patient outcomes of rehabilitation interventions provided in ICU and a narrative synthesis of themes. A summary of the main results will be reported using modified GRADE methodology. This integrative review will inform the feasibility randomised clinical trial testing the development of a complex intervention targeting functional and cognitive rehabilitation for patients in ICU.

Сognitive rehabilitation methods in multiple sclerosis patients

The prevalence of cognitive impairment in patients with multiple sclerosis is 40 to 65%. Improvement of cognitive-oriented therapy and search for its new techniques is considered to be promising for slowing the progression or for recovery of cognitive functions. It is related to low efficacy of medical treatment, preserved neuroplasticity in most patients with multiple sclerosis, positive results of studies on selected cognitive rehabilitation techniques in other nervous system disorders. The spectrum of techniques for cognitive training varies from technically feasible methods using a sheet of paper and a pen to the most advanced ones, such as the use of immersive virtual reality. The effectiveness of cognitive rehabilitation in patients with multiple sclerosis with virtual reality technologies has not been studied in large-scale randomized placebo-controlled studies.

Innovative Technologies in the Neurorehabilitation of Traumatic Brain Injury: A Systematic Review.

Motor and cognitive rehabilitation in individuals with traumatic brain injury (TBI) is a growing field of clinical and research interest. In fact, novel rehabilitative approaches allow a very early verticalization and gait training through robotic devices and other innovative tools boosting neuroplasticity, thanks to the high-intensity, repetitive and task-oriented training. In the same way, cognitive rehabilitation is also evolving towards advanced interventions using virtual reality (VR), computer-based approaches, telerehabilitation and neuromodulation devices. This review aimed to systematically investigate the existing evidence concerning the role of innovative technologies in the motor and cognitive neurorehabilitation of TBI patients. We searched and reviewed the studies published in the Cochrane Library, PEDro, PubMed and Scopus between January 2012 and September 2022. After an accurate screening, only 29 papers were included in this review. This systematic review has demonstrated the beneficial role of innovative technologies when applied to cognitive rehabilitation in patients with TBI, while evidence of their effect on motor rehabilitation in this patient population is poor and still controversial.

Dynamic electric neurostimulation in the cognitive rehabilitation of patients in the early recovery period of ischemic stroke

BACKGROUND: Post-stroke cognitive impairments negatively affect the results of rehabilitation, worsening the outcomes of motor functions recovery, daily activity, and also increase the likelihood of recurrent stroke and premature death. Therapeutic physical factors contribute to the activation of the body's reserve capabilities and aim at correcting metabolic and vascular disorders, improving the functional status of the nervous system, which allows them to be used in a complex of rehabilitation measures.
 AIM: to substantiate the use of dynamic electric neurostimulation in the correction of cognitive impairment in patients in the early recovery period of ischemic stroke.
 MATERIALS AND METHODS: A prospective cohort study of 60 patients in the early recovery period of ischemic stroke, with mild and moderate cognitive impairment, at an average age of 62.44.5 years, divided by random sampling into 3 groups: group 1 (n=25), in addition to the basic rehabilitation complex, which included medication, sessions with a neuropsychologist, massage and physical exercise therapy, received a 15-day course of dynamic electric neurostimulation from the "Neurodance-PCM" device; group 2 (n=20) received the basic rehabilitation complex and procedures from the placebo device similar to procedures on "Neurodance-PCM"; group 3 (n=15) received only the basic rehabilitation treatment. All patients underwent an assessment of cognitive status using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB) and the study of psychophysiological status on the psycho-physiological tester "NS-Psychotest", using the following tests: tapping test, the SchultePlatonov tables with red-black cells, test of simple visual-motor reaction, reaction to a moving object test.
 RESULTS: Over the two-week rehabilitation, it was found that the inclusion of dynamic electrical stimulation, in addition to the standard therapy of cognitive impairment in patients in the early recovery period of ischemic stroke, improves attention, memory, speech fluency, generalization functions, complicated choice reaction, increases the functions of visual attention and the speed of sensorimotor response, which was not noted in the comparison groups.
 CONCLUSIONS: The inclusion of dynamic electric neurostimulation in the rehabilitation complex of patients in the early recovery period of ischemic stroke with mild and moderate cognitive impairment may affect cognitive functions by stimulating the third block of the brain according to A.R. Luria and improving the neurodynamic support of higher mental functions.

Using Logistic Multivariate Analysis to Explore the Effects of Nursing and Psychological Factors on Motor and Cognitive Rehabilitation in Patients with Stroke: Based on a Retrospective Case-Control Study.

Objective Based on a retrospective case-control study, logistic multivariate analysis was employed to explore the effects of nursing and psychological factors on the rehabilitation of motor and cognitive function in patients with stroke. Methods A total of 200 stroke patients treated from February 2019 to April 2020 were enrolled in our hospital. According to the results of exercise and cognitive rehabilitation, the patients with good rehabilitation were divided into the control group (n = 140) and the research group (n = 60). The effects of nursing and psychological factors on the rehabilitation of motor and cognitive function in patients with stroke were analyzed. Results First of all, we compared the general data. There were significant differences in terms of age, years of education, occupational status, payment methods of medical expenses, family income and the course of the disease, and the difference was statistically significant (P < 0.05). There was no significant difference in general data (P > 0.05). Secondly, we compared the nursing effective rates. The nursing effective rates of the study group were 10 cases, 15 cases, 12 cases, and 23 cases, and the nursing effective rate was 61.67%. In the control group, 78 cases were markedly effective, 33 cases were effective, 25 cases were general and 14 cases were ineffective, and the nursing effective rate was 90.00%. The effective rate of nursing in the study group was higher than that in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in anxiety and depression scores before nursing (P > 0.05), but they decreased after nursing. In addition, the scores of anxiety and depression in the study group were higher than those in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in motor function and cognitive function between prenursing and prenursing (P > 0.05); after nursing, the motor function increased and the score of cognitive function decreased. Furthermore, the motor function of the study group was lower compared to the control group, and the score of cognitive function of the study group was higher compared to the control group, and the difference was statistically significant (P < 0.05). The results of the Person correlation analysis showed that there was a significant correlation between nursing anxiety depression and the rehabilitation effect of motor cognitive function in stroke patients. The results of logistic regression analysis showed that age, family income, nursing efficiency, anxiety, and depression were the factors affecting the rehabilitation of motor and cognitive function in stroke patients. Conclusion Age and family income may be the risk factors affecting the psychological mood of patients. Medical staff should pay attention to the negative emotion of patients and strengthen the nursing intervention of patients.

Rehabilitation efficacy comparison of virtual reality technology and computer-assisted cognitive rehabilitation in patients with post-stroke cognitive impairment: A network meta-analysis

ObjectiveVirtual reality (VR) and computer-assisted cognitive rehabilitation (CACR) are two emerging rehabilitation therapies for stroke patients. The aim of this study was to compare the rehabilitation efficacy of these two treatments for patients with post-stroke cognitive impairment (PSCI). MethodsA network search of Embase, Web of Science, PubMed, Cochrane Library, VIP, WanFang Data, and CNKI databases was performed from their inception to February 2022 for screening randomized controlled trials related to VR and CACR in the treatment of PSCI. The quality of the included studies was assessed using the Cochrane risk bias assessment tool. The primary outcomes of the included studies contained at least one of the following clinical outcome measures: Mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA). After screening the literature, assessing the quality and extracting the data, a network meta-analysis was performed with STATA software. ResultsA total of 21 randomized controlled trials were included, including 1,047 patients. The results of network meta-analysis showed that under MMSE index, VR group (p = 0.067) and CACR group (p = 0.054) tended to be superior to CT group, but it was not significant. Both the VR (p = 0.024) and CACR (p < 0.001) groups had significantly better outcomes compared to the conventional therapy group in terms of MoCA. The ranking results under both indicators showed that CACR had the best treatment effect, followed by VR. ConclusionIn general, VR and CACR have superior efficacy compared with conventional therapy, in which CACR may be the best treatment option.

Humanoid Robot Use in Cognitive Rehabilitation of Patients with Severe Brain Injury: A Pilot Study.

Severe acquired brain injury (SABI) is a major global public health problem and a source of disability. A major contributor to disability after SABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return to work, and reduced need for long-term care. Twelve patients with a diagnosis of SABI were enrolled and equally divided into two groups: experimental and control. Patients in both groups underwent intensive neurorehabilitation according to the severity of their disabilities (motor, psycho-cognitive, and sensory deficits). However, in the experimental group, the treatment was performed by using a humanoid robot. At baseline, the two groups differed significantly only in Severe Impairment Battery (SIB) scores. Results showed that the experimental treatment had a higher effect than the traditional one on quality of life and mood. In conclusion, this pilot study provides evidence of the possible effects of relational and cognitive stimulation in more severely brain-injured patients.

Virtual Reality and Lower Limb Rehabilitation: Effects on Motor and Cognitive Outcome-A Crossover Pilot Study.

The effectiveness of virtual reality (VR) in the motor and cognitive rehabilitation of patients with severe acquired brain injury (sABI) is unclear. This randomized, controlled, crossover, single-blinded, pilot study investigates the cognitive and motor effects of lower limb robotic therapy with and without VR visual feedback in a group of patients with ABI. A total of 23 patients with ABI were randomized into two groups: one group (VR-NVR) underwent a 2-week rehabilitation for the lower limbs training with a robotic device (Omego®) with VR feedback, followed by 2 weeks without VR; the other group (NVR-VR) performed the protocol in the opposite order. Patients were evaluated at baseline, after two and four weeks of treatment using the Level of Cognitive Functioning scale (LCF), Disability Rating Scale (DRS), and Motricity Index for Lower Limb (MI-LL) in the most affected limb. At the end of the intervention, both groups significantly improved in all the outcomes. A significant difference was found between VR treatment versus non-VR treatment for LCF (p = 0.024) and for DRS (p = 0.043) after the second week, while no significant differences were found in the group NVR-VR at T1. Our study indicates how the combination of robotic treatment with VR is effective in enhancing the recovery of cognitive function in patients with ABI, also improving disability and muscular function. Further, VR seems to enhance the early recovery process of motor and cognitive functions.

Оптимізація когнітивної нейрореабілітації пацієнтів iз бойовими травматичними ураженнями головного мозку

Останнім часом спостерігається зростання частоти бойової черепно-мозкової травми (БЧМТ) у результаті бойових дій у зонi АТО. Когнітивна реабілітація хворих iз гострими травматичними ураженнями головного мозку, а саме ЧМТ, тісно пов’язана з іншими напрямками реабілітації, включаючи медикаментозну та фізичну терапію, інтеграцію пацiєнта в суспільство, психологічну та просвітницьку роботу з членами його родини. Неадекватне та несистематичне лікування хворих із такими розладами часто є основною причиною тривалої декомпенсації захворювання, що значно погіршує рівень життя пацієнтів та знижує ефективність їх праці. Метою нашої роботи була оптимізація лікувальної тактики, а саме когнітивної реабілітації хворих із наслідками закритої БЧМТ середнього ступеня тяжкості на підставі вивчення клініко-когнітивних змін. Нами було обстежено 28 пацієнтів віком від 20 до 45 років, які знаходилися на стаціонарному лікуванні у відділеннях нейротравми та нейрореабілітації ДУ «Інститут нейрохірургії ім. акад. А.П. Ромоданова НАМН України» (м. Київ), із наслідками закритої БЧМТ (середнього ступеня тяжкості з давністю захворювання від 3 місяців до 1,5 року (шифр діагнозу за МКХ‑10 — Т90)). Усім пацієнтам на 1-й та 14-й день лікування проводилися клініко-неврологічні, інструментальні, нейропсихологічні обстеження. Усі хворi разом із препаратом Церебролізин 20,0 в/в краплинно отримували загальноприйняту симптоматичну терапію. Висновки: порушення когнітивних функцій є невід’ємною складовою клінічних наслідків закритої БЧМТ. Використання в лікувальній тактиці препарату Церебролізин у пацієнтів із наслідками БЧМТ середнього ступеня тяжкості покращує відновлення порушених неврологічних функцій, зокрема когнітивних.

Integration of virtual reality into the program of non-drugtreatment of pain and early rehabilitation

The article deals with the issues of non-drug treatment of pain from the standpoint of a biopsychosocial approach using virtual reality (VR) as well as the possibility ofintegrating this methodinto an early rehabilitation program for neurological patients. The historical aspects of discovery and integration of VRinto medicine and the results of using the method to reduce the intensity of pain in patients with burn disease the possibility of using VR technology in anesthesiology and resuscitation as an alternative to narcotic analgesics for certain types of intervention are presented The use of VR is promising in the motorand cognitive rehabilitation ofpatients with various pathologies ofthe central nervous system and can be used at any stage of rehabilitation at low financial costs with minimal involvement ofmedical personnel in the hospital and outpatient settings.

Remote cognitive rehabilitation in patients post-cerebrovascular accident: an experience report.

Aiming to contribute to the reduction of cognitive impairment, as well as to improve the quality of life of patients affected by stroke, it was proposed to carry out a cognitive rehabilitation focused on attentional aspects (sustained, alternate, selective and divided attention). Due to the new Coronavirus pandemic and the need for social isolation, the rehabilitation was adapted to the remote model. The rehabilitation was designed and carried out with six patients, coming from a public neurology outpatient service, who had suffered a stroke within a period of up to one year before the start of rehabilitation. Fifteen sessions of cognitive rehabilitation were carried out, lasting approximately 50 minutes, once a week, for four months. In all functions, the four types of attention were worked on. In addition, there were also unassisted activities performed by the patients after each session. The protocol was carried out by Psychology and Medicine students, who elaborated and adapted all activities to be performed by video call. The adaptations were made based on the knowledge and effectiveness of face-to-face rehabilitation for this population. Patients and family members collaborated in the activities, but the emergency adaptation to the remote model also had limitations, such as the withdrawal of some patients due to difficulty access or unstable internet connection. However, there were also positive results, such as the possibility of participation by people from other cities and people with mobility difficulties. This experience allowed students to develop skills in interacting with patients, as well as strategies to deal with the challenges of remote care. Thus, it was not necessary to interrupt the students´ education, moreover, the skills developed are important for the e-health context, which is an increasingly present demand in today's world. Remote cognitive rehabilitation is a possibility for patients who have suffered cognitive impairment due to stroke. Despite the difficulties arising from the pandemic, it was an important experience, with significant value for academic training, which stimulated the skills needed to care for patients, in addition to creativity and adaptation in the face of adversity.

Складнощі нейропсихологічної діагностики синдрому неглекту в рамках менеджменту пацієнтів з ішемічним інсультом

У статті розглядається актуальна проблема неврології, нейробіології і когнітивної психології — питання патогенетичних механізмів виникнення та розвитку одностороннього неглекту після інфаркту мозку. Проаналізовано наукову літературу щодо нейропсихологічних ознак синдрому гемінеглекту, його причин, особливостей, проявів і методів реабілітації. Показано роль законів нейроестетики у сприйнятті і відтворенні інформації про довкілля в мозку. Наведені нові дані про особливості впливу законів нейроестетики на процес формування одностороннього неглекту. Підкреслюється, що принципи нейроестетики при окиснювальному стресі після судинної катастрофи мозку створюють умови для розвитку патологічного кола, проявом якого є відсутність уваги та втрата здатності реагувати на подразники в одній половині поля зору. Визначено, що точна нейроанатомія одностороннього неглекту є складною і залишається предметом майбутніх досліджень для подальшої когнітивної реабілітації пацієнтів після інфаркту мозку.