Cognitive Rehabilitation In Patients Research Articles

Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol

ObjectivesTo measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population.SettingA single centre study, Malaysia.ParticipantsAdults aged between 18 and 60...

Study Protocol for a Randomized Controlled Trial Evaluating the Efficacy of an Evidence-Based iPad-App for Cognitive Rehabilitation in Patients with Primary Brain Tumors.

BACKGROUNDMany patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive rehabilitation program. After successful completion of a feasibility study, a randomized controlled trial has been started.OBJECTIVETo evaluate the immediate and long-term effects of the iPad-based program on cognitive performance and patient-reported outcome measures (PROMs) in patients with primary brain tumors in an early stage of the disease.METHODSPrior to surgery, patients with presumed low-grade glioma and meningioma are included. Before surgery and 3 mo after surgery, neuropsychological assessments are conducted. After the second neuropsychological assessment, patients are assigned to the intervention group or waiting-list control group. The intervention consists of psychoeducation, compensation training, and retraining. Patients are advised to spend 3 h per week on the program for 10 wk. Immediately after completion of the program and a half-year thereafter, postintervention assessments take place. Patients in the control group are offered the opportunity to follow the program after all study assessments.EXPECTED OUTCOMESWe expect that early cognitive rehabilitation has beneficial effects on cognitive performance and PROMs in brain tumor patients.DISCUSSIONThe iPad-based program allows brain tumor patients to follow a cognitive rehabilitation program from their homes. Forthcoming results may contribute to further improvement of supportive care for brain tumor patients.

Когнитивная реабилитация пациентов с сахарным диабетом типа 1

Когнитивная реабилитация пациентов с сахарным диабетом типа 1

Late Cognitive Impairment After Coronary Bypass Graft Surgery: Opportunities in Rehabilitation with the Use of Computer-Based Training

Abstract In spite of recent significant advances in reduction of mortality and disability, coronary heart disease (CHD) remains widespread both in Russia and around the world. Coronary bypass graft surgery (CABG) has proved to be the most effective method of CHD treatment, providing that conservative therapy is not effective enough. The aim of the present study was to reveal and correct postoperative cognitive dysfunction (POCD), developed under the conditions of cardiopulmonary bypass (CB) in patients with CHD within 12 months after CABG. A total of 87 patients were examined, all the patients underwent a course of drug therapy, 50 patients underwent a course of rehabilitation using computer-based stimulation programmes (once per day for 20 minutes within 10 days) in addition to medical therapy. A reliable improvement in results of the conducted research suggests that the proposed method provides safety and high performance in cognitive rehabilitation of patients with impairments of the higher brain functions after CABG. A relatively short course of rehabilitation (10 days) corresponded to the length of hospital stay of patients in the cardiac unit. However, even in such a short course we could obtain significant advantage in terms of efficiency of higher cortical functions recovery. Therefore, a course of rehabilitation using computer-based stimulation programmes in patients with coronary heart disease after CABG was proved to be an effective way of correcting cognitive function.

Photochromotherapy using narrow-band optical radiation of 530 nm wavelength in cognitive rehabilitation of patients with focal brain lesions

The objective of the research was to study the nootropic effects of photochromotherapy using narrow-band optical radiation (PCT NBOR) of 530 nm wavelength in combination with the standard medical and psychological therapy in cognitive impairments rehabilitation in patients with focal brain lesions.
 Materials and methods. The rehabilitation outcomes in 141 patients with cognitive impairments due to focal brain lesions were studied. Patients were subdivided into two groups: 90 patients of the control group were treated with the standard nootropic medications and neuropsychological procedures; 51 patients of the main group were additionally treated with PCT NBOR of 530 nm wavelength transorbitally and in the neck-collar zone. The dynamics of the score increase according to Rivermid, Karnovsky, Roshina, MMSE, mRS, HDRS, SF-36 scales were analyzed.
 Conclusion. PCT NBOR of 530 nm wavelength has advantages in restoring the functional state, attention, counting, reading, and speech intrinsic to the ischemic brain damage compared to the standard cognitive rehabilitation program. In the patients with hemorrhagic stroke PCT NBOR of 530 nm wavelength has no significant effect on cognitive functions; however it improves the general functional state.

Different types of cognitive rehabilitation in patients with type 2 diabetes

Diabetes mellitus (DM) type 2 leads to the progression of cognitive impairment. The authors compared different types of cognitive rehabilitation in patients with type 2 diabetes. One hundred and twenty patients with type 2 diabetes were examined and randomized into 4 groups: the computerized training group, the exercise therapy group, the akatinol memantine group and the control group. The duration of rehabilitation was 6 months. All patients underwent general clinical examination and neuropsychological testing. All patients had impaired cognitive functions, especially in visual-constructive skills, speech, abstraction, and memory. Treatment with akatinol memantine was most effective compared to computerized training and exercise therapy. With the exception of the control group, all groups, in particular the exercise therapy group, showed the improvement in carbohydrate metabolism.

Cognitive rehabilitation in Alzheimer′s disease

Cognitive rehabilitation has been defined as a comprehensive program aiming to cognitive enhancement. It has been developed as a method of rehabilitation for people with cognitive impairment of various etiologies such as traumatic brain injury, cerebral vascular accident, cerebral palsy, Down syndrome, Alzheimer’s disease, attention deficit hyperactivity disorder, and developmental disorders. Cognitive rehabilitation is a non-interventional, non-pharmaceutical personalized treatment. Due to the low efficacy of pharmacological approaches to the day, cognitive rehabilitation is expected to play an important role in the treatment of Alzheimer’s disease. The aim of this review is to present cognitive rehabilitation as a mental enhancement strategy in Alzheimer’s disease and to state the worth of cognitive rehabilitation in patients with Alzheimer’s disease, the benefits and drawbacks, the cost and the overall implementation, as well as the optimal future approach of the strategy.

Therapeutic synergism: How can psychopharmacology improve cognitive rehabilitation?

ABSTRACTDespite recent advances in cognitive rehabilitation of patients with cognitive disorders, there are many major obstacles to the optimized global use of this therapeutic resource.Objective:The authors outline the concept of ‘therapeutic synergism’, i.e. the concurrent use of pharmacological and cognitive rehabilitation therapies to maximize functional benefits, addressing the optimization of therapeutic approaches for cognitive disorders.Methods:Three psychopharmacological and rehabilitation interrelationship paradigms are presented in three different clinical settings.Results:Paradigm 1: Behavioral and cognitive symptoms that hinder a cognitive rehabilitation program, but can be improved with psychopharmacology. Paradigm 2: Cognitive symptoms that hinder cognitive rehabilitation, but can be improved with anticholinesterases. Paradigm 3: Behavioral symptoms that hamper the use of cognitive rehabilitation, but can be improved by psychotropic drugs.Conclusion:Judicious use of psychotropic drugs in cognitive disorders can benefit, directly or indirectly, cognitive functions, thereby favoring other treatment modalities for cognitive impairment, such as neuropsychological rehabilitation.

Neuro-plastic Effects of Playing Piano Within Cognitive Rehabilitation of Patients With Traumatic Brain Injury

Neuro-plastic Effects of Playing Piano Within Cognitive Rehabilitation of Patients With Traumatic Brain Injury

What About the Role of Virtual Reality in Parkinson Disease's Cognitive Rehabilitation? Preliminary Findings From a Randomized Clinical Trial.

The purpose of this study is to evaluate the effects of a virtual reality training with BTS Nirvana (BTS-N) system in the cognitive and behavioral recovery in patients with Parkinson disease (PD). The BTS-N is a semi-immersive therapy system used for motor and cognitive rehabilitation of patients with neurological diseases, by creating virtual scenarios with which the patient may interact. We enrolled 20 patients with PD undergoing neurorehabilitation. All the patients were randomized into 2 groups: experimental group performing semi-immersive virtual reality training with BTS-N and control group undergoing traditional cognitive training. Each participant was evaluated before and immediately after the end of the training. Each cognitive training consisted of 3 sessions a week, each lasting 60 minutes, for 8 weeks, for a total of 24 sessions in each group. Experimental group showed a greater improvement in cognitive functioning, with regard to executive and visuospatial abilities, as compared with the control group. Our findings suggest that rehabilitation through a new virtual reality instrument could be a valuable tool in improving cognitive and behavioral outcomes of patients with PD.

Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study.

Background: Few studies examined the effects of combined motor and cognitive rehabilitation in patients with multiple sclerosis (MS). The present prospective, multicenter, observational study aimed to determine the efficacy of an integrated cognitive and neuromotor rehabilitation program versus a traditional neuromotor training on walking, balance, cognition and emotional functioning in MS patients.Methods: Sixty three MS patients were selected and assigned either to the Integrated Treatment Group (ITG; n = 32), receiving neuropsychological treatment (performed by ERICA software and paper–pencil tasks) complemented by conventional neuromotor rehabilitation, or to the Motor Treatment Group (n = 31) receiving neuromotor rehabilitation only. The intervention included two 60-min sessions per week for 24 weeks. At baseline and at end of the training all patients underwent a wide-range neuropsychological, psychological/emotional, and motor assessment.Results: At baseline the two groups did not differ for demographic, neuropsychological, psychological/emotional, and motor features significantly. After rehabilitation, only ITG group significantly (p-corrected for False Discovery Rate) improved on test tapping spatial memory, attention and cognitive flexibility, as well as on scales assessing depression and motor performance (balance and gait). A regression analysis showed that neuropsychological and motor improvement was not related to improvements in fatigue and depression.Conclusion: The present study demonstrated positive effects in emotional, motor, and cognitive aspects in MS patients who received an integrated cognitive and neuromotor training. Overall, results are supportive of interventions combining motor and cognitive training for MS.

Involvement of amygdala-prefrontal dysfunction in the influence of negative emotion on the resolution of cognitive conflict in patients with schizophrenia.

IntroductionPatients with schizophrenia often have impaired cognition and abnormal conflict control. Conflict control is influenced by the emotional values of stimuli. This study investigated the neural basis of negative emotion interference with conflict control in schizophrenia.MethodsSeventeen patients with schizophrenia and 20 healthy controls underwent functional magnetic resonance imaging while performing the emotional Simon task, in which positive or negative emotional pictures were located in congruent or incongruent positions. Analysis was focused on identifying brain regions with the significant interaction among group, emotion, and conflict in whole brain voxel‐wise analysis, and abnormality in their functional connectivity in the patient group.ResultsThe regions showing the targeted interaction was the right amygdala, which exhibited significantly reduced activity in the negative congruent (t = −2.168, p = 0.036) and negative incongruent (t = −3.273, p = 0.002) conditions in patients versus controls. The right amygdala also showed significantly lower connectivity with the right dorsolateral prefrontal cortex in the cognitive and emotional loading contrast (negative incongruent—positive congruent) in patients versus controls (t = −5.154, p < 0.01), but not in the cognitive‐only or emotional‐only loading contrast.ConclusionsThese results suggest that negative emotion interferes with cognitive conflict resolution in patients with schizophrenia due to amygdala–dorsolateral prefrontal cortex disconnection. Based on these findings, interventions targeting conflict control under negative emotional influence may promote cognitive rehabilitation in patients with schizophrenia.

Effects of music production on cortical plasticity within cognitive rehabilitation of patients with mild traumatic brain injury

ABSTRACTObjective: We explored the effects of playing the piano on patients with cognitive impairment after mild traumatic brain injury (mTBI) and, addressed the question if this approach would stimulate neural networks in re-routing neural connections and link up cortical circuits that had been functional inhibited due to disruption of brain tissue. Functional neuroimaging scans (fMRI) and neuropsychological tests were performed pre–post intervention. Method: Three groups participated, one mTBI group (n = 7), two groups of healthy participants, one with music training (n = 11), one baseline group without music (n = 12). The music groups participated in 8 weeks music-supported intervention. Results: The patient group revealed training-related neuroplasticity in the orbitofrontal cortex. fMRI results fit well with outcome from neuropsychological tests with significant enhancement of cognitive performance in the music groups. Ninety per cent of mTBI group returned to work post intervention. Conclusion: Here, for the first time, we demonstrated behavioural improvements and functional brain changes after 8 weeks of playing piano on patients with mTBI having attention, memory and social interaction problems. We present evidence for a causal relationship between musical training and reorganisation of neural networks promoting enhanced cognitive performance. These results add a novel music-supported intervention within rehabilitation of patients with cognitive deficits following mTBI.

Techniques of cognitive rehabilitation in patients with disorders of consciousness: a systematic review.

Acquired brain injury can produce severe impairments of alertness, cognition, behavior, and, sometimes, an impairment of consciousness. Several studies defined the criteria to distinguish the different level of disorders of consciousness (DOC) and many tools to evaluate awareness, alertness, and response to stimuli were created. The aim of this review is to assess the advanced research of rehabilitative protocols and which rehabilitative techniques are used in the care of DOC patients.

Recovery and Associated Factors of Cognitive Function in Patients with Hemorrhagic Stroke

출혈성 뇌졸중 후 인지기능의 저하는 장기적 기능회복에 영향을 주는 주요한 인자이다. 이에 저자들은 출혈성 뇌졸중 환자에서 주요 회복시기에 따른 인지기능의 변화와 일상생활활동 독립수준 및 삶의 질의 변화를 추적하고, 인지 기능 변화와 관련된 연관 요인을 파악하며, 이를 통한 향후 관리 방안 제시를 위한 기초자료를 마련하고자 이 연구를 시행하였다. 1개 상급종합병원에 입원한 초발 출혈성 뇌졸중 환자 25명의 환자를 대상으로 발병 후 7일, 발병 후 3개월, 발병 후 6개월, 발병 후 12개월 시점에 Glasgow Coma Scale (GCS), 한국형 정신상태 간이검사(K-MMSE), 한국판 수정바델 지수(K-MBI), 건강관련 삶의 질 지수(EQ-5D)를 사용하여 연구 대상자의 인지기능을 포함한 전반적인 기능 변화와 관련한 평가를 시행하였다. K-MMSE는 발병 후 7일 13.32±11.80점, 3개월 15점, 6개월 17점, 12개월에 18점으로 의미 있는 회복을 보였으며(p=0.007), GCS, K-MBI, EQ-5D와 같은 다른 기능 평가에서도 시간의 경과에 따라 의미 있는 개선을 보였다(p<0.01). 발병 12개월의 인지기능에 영향을 미치는 요인 분석에서 발병 당시의 연령 및 출혈성 뇌졸중의 유형, 발병 7일의 GCS이 통계적으로 유의한 연관성을 나타내었다. 본 연구를 통해 출혈성 뇌졸중 환자에 있어서 지속적으로 인지 기능을 포함한 전반적인 기능 회복이 발병 후 1년까지도 이루어짐을 확인하였고, 이에 관련된 연관 요인을 확인함으로써, 출혈성 뇌졸중 환자의 기능회복에 대한 이해와 그에 대한 지속적인 관리 및 치료의 필요성을 높일 수 있는 근거가 될 수 있을 것으로 보인다.We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

Rehacom software application is effective in cognitive rehabilitation of patients with brain injuries

Rehacom software application is effective in cognitive rehabilitation of patients with brain injuries

Perspectives for cognitive rehabilitation of patients with diabetes mellitus

Currently, the problem of cognitive dysfunction is becoming increasingly important due to the raising demand for effective intellectual activity in modern society. One of the most significant causes of cognitive dysfunction is dismetabolic nature of the disorder, such as diabetes mellitus, which has recently been gaining prevalence. Much of the resistance of clinical symptoms of diabetic encephalopathy to conventional therapy requires a search for new approaches for solving this problem. Cognitive rehabilitation as a correctional technique has proved a positive effect in terms of the treatment of neurodegenerative diseases of different nature.This review present the ways for correction of cognitive impairment using the method of cognitive rehabilitation in patients with diabetes, its methodology, mechanisms of action and perspectives.

Cognitive rehabilitation for patients with schizophrenia in Korea.

Psychosocial rehabilitation programs received mental health professional support in addition to traditional medication therapy. Many psychosocial programs were developed since the 1990s, including cognitive remediation therapy. In this review, we focus on cognitive remediation therapy in Korea since the 1990s. We review several cognitive rehabilitation programs developed in Korea and their outcome studies and suggest future research directions and prospects. We reviewed cognitive rehabilitation programs including social cognitive training as well as more recent forms of computerized cognitive rehabilitation. Although there are differences in cognitive domains by training targets, almost all neurocognitive remediation trainings in Korea have beneficial effects on early visual processing, various attention types, and executive function. Future studies need to investigate the mechanisms and various mediators underlying the relationships between cognitive functions and functional outcomes. With more comprehensive cognitive and social cognitive programs, we can enhance both cognition and functional outcomes of the patients with schizophrenia.

Cognitive Rehabilitation in Patients with Gliomas and Other Brain Tumors: State of the Art.

Disease prognosis is very poor in patients with brain tumors. Cognitive deficits due to disease or due to its treatment have an important weight on the quality of life of patients and caregivers. Studies often take into account quality of life as a fundamental element in the management of disease and interventions have been developed for cognitive rehabilitation of neuropsychological deficits with the aim of improving the quality of life and daily-life autonomy of patients. In this literature review, we will consider the published studies of cognitive rehabilitation over the past 20 years.

A Randomised Controlled Trial of Efficacy of Cognitive Rehabilitation in Multiple Sclerosis: A Cognitive, Behavioural, and MRI Study.

Aim. To explore the efficacy of home-based, computerised, cognitive rehabilitation in patients with multiple sclerosis using neuropsychological assessment and advanced structural and functional magnetic resonance imaging (fMRI). Methods. 38 patients with MS and cognitive impairment on the Brief International Cognitive Assessment for MS (BICAMS) were enrolled. Patients were randomised to undergo 45 minutes of computerised cognitive rehabilitation using RehaCom software (n = 19) three times weekly for six weeks or to a control condition (n = 19). Neuropsychological and MRI data were obtained at baseline (time 1), following the 6-week intervention (time 2), and after a further twelve weeks (time 3). Cortical activations were explored using fMRI and microstructural changes were explored using quantitative magnetisation transfer (QMT) imaging. Results. The treatment group showed a greater improvement in SDMT gain scores between baseline and time 2 compared to the control group (p = 0.005). The treatment group exhibited increased activation in the bilateral prefrontal cortex and right temporoparietal regions relative to control group at time 3 (p < 0.05FWE corrected). No significant changes were observed on QMT. Conclusion. This study supports the hypothesis that home-based, computerised, cognitive rehabilitation may be effective in improving cognitive performance in patients with MS. Clinical trials registration is ISRCTN54901925.