Cognitive Rehabilitation Program 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.

Web-based cognitive rehabilitation intervention for cancer-related cognitive impairment following chemotherapy for aggressive lymphoma: protocol for a randomised pilot trial

IntroductionCancer-related cognitive impairment is common among people diagnosed with and treated for cancer. This can be a distressing and disabling side effect for impacted individuals. Interventions to mitigate cognitive dysfunction...

Effective Factors in Cognitive Functions of Patients with Temporal Lobe Epilepsy

Background: Temporal lobe epilepsy (TLE) is the most common form of partial epilepsy and increases the risk of cognitive impairment, negatively impacting the quality of life of affected individuals. Objectives: This study aimed to investigate cognitive function in patients with low socioeconomic status affected by TLE and identify factors influencing such function. Methods: This case-control study, conducted between July 2021 and August 2022, compared the cognitive function of 40 patients affected by TLE to 92 healthy controls. The Montreal cognitive assessment (MoCA) was used for neurocognitive evaluation. Data analysis was performed using SPSS 25.0 for Windows. Results: The mean age of the patient group was 33.35 years, compared to 35.37 years in the control group. Moreover, 70% of patients affected by TLE displayed cognitive impairment and demonstrated lower performance in cognitive functions than the control group (P < 0.05). Significant correlations were identified between overall MoCA scores and several factors, including seizure frequency, educational level, polytherapy, disease duration, and self-esteem scores (P < 0.05). Multivariate analysis revealed that seizure control and higher educational level were statistically significant predictors of overall MoCA scores in patients affected by TLE. Conclusions: In low-income patients affected by TLE, seizure control and a higher educational level emerged as predictors of cognitive performance. These findings underscore the importance of identifying and managing comorbidities and the need for tailored cognitive rehabilitation programs for this population.

Neurocognitive outcome and associated factors in long-term, adult survivors of childhood acute lymphoblastic leukemia, treated without cranial radiation therapy.

There is limited research on neurocognitive outcome and associated risk factors in long-term, adult survivors of childhood acute lymphoblastic leukemia (ALL), without treatment of cranial radiation therapy. Moreover, the impact of fatigue severity and pain interference on neurocognition has received little attention. In this cross-sectional study, we examined neurocognitive outcome and associated factors in this population. Intellectual abilities, verbal learning/memory, processing speed, attention, and executive functions were compared to normative means/medians with one sample t tests or Wilcoxon signed-rank tests. Associations with risk factors, fatigue severity, and pain interference were analyzed with linear regressions. Long-term, adult survivors of childhood ALL (N = 53, 51% females, mean age = 24.4 years, SD = 4.4, mean = 14.7 years post-diagnosis, SD = 3.4) demonstrated above average intellectual abilities, but performed below average in attention, inhibition, processing speed, and shifting (p < 0.001). Executive functioning complaints were significantly higher than normative means, and positively associated with fatigue (p < 0.001). There was no interaction between sex and fatigue and no neurocognitive impairments were associated with pain interference, risk group, age at diagnosis, or sex. Long-term, adult survivors of ALL treated without cranial radiation therapy, demonstrate domain-specific performance-based neurocognitive impairments. However, continued research on the neurocognitive outcome in this population as they age will be important in the coming years. Executive functioning complaints were frequently in the clinical range, and often accompanied by fatigue. This suggests a need for cognitive rehabilitation programs.

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.

Awareness and cognitive rehabilitation in Alzheimer's disease and frontotemporal dementia.

Awareness influences the evolution of neurodegenerative dementias. We gathered participants' and caregivers assessments of dependence in daily activities and we studied how each score would be related to next year participant autonomy, independently of other explicative variables. We retrospectively analyzed data from mildly demented participants with a clinical diagnosis of Alzheimer's disease (AD, n = 186) and frontotemporal dementia (FTD, n = 29) and their relatives. A research tool was used to assess participant dependence in 98 daily activities and associated caregiver burden. A discrepancy score between the patient's and relative's judgment was calculated to evaluate awareness of dependence in activities at baseline. This dependence scores, as well as sex, age, education, and 1 year difference in Mini-Mental State Examination were taken as possible explicative variables for dependence in activities adapted by therapists during a 1-year cognitive rehabilitation program. Patients with FTD showed less awareness for daily dependence (discrepancy 20.9% vs. 11.8% in AD). Both groups benefited from cognitive rehabilitation (25% decrease in dependence) and subjective burden of relatives was decreased in both groups. In the AD group, there was a significant positive relationship between both caregiver (P < 0.001) and participant's (P < 0.02) evaluation of dependence in daily activities at inclusion and dependence of participants in adapted activities after 1 year. Awareness of impairment in daily activities is a clinical symptom that is more important at inclusion in FTD than in AD. However, in participants with AD who, as a group, significantly benefit from a cognitive rehabilitation program, not only caregiver's but also participant's assessment of dependence at baseline is correlated to subsequent, next year greater dependence in daily activities adapted by the therapists. Although discrepant, both caregiver and participant evaluations appear to be important variables to understand the evolution and the benefit of care in participants at early stages of dementia.

Social cognitive disruptions in multiple sclerosis: The role of executive (dys)function.

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system, resulting in a range of potential motor and cognitive impairments. The latter can affect both executive functions that orchestrate general goal-directed behavior and social cognitive processes that support our ability to interact with others and maintain healthy interpersonal relationships. Despite a long history of research into the cognitive symptoms of MS, it remains uncertain if social cognitive disruptions occur independently of, or reflect underlying disturbances to, more foundational executive functions. The present preregistered study investigated this directly. Employing an experimental design, we administered a battery of computerized tasks online to a large sample comprising 134 individuals with MS and 134 age- and sex-matched healthy controls (HCs). Three tasks measured elements of executive function (working memory, response inhibition, and switching) and two assessed components of social cognition disrupted most commonly in MS (emotion perception and theory of mind). Individuals with MS exhibited poorer working memory (d = .31), response inhibition (d = -.26), emotion perception (d = .32), and theory of mind (d = .35) compared with matched HCs. Furthermore, exploratory mediation analyses revealed that working memory performance accounted for approximately 20% of the group differences in both measures of social cognition. Disruptions to working memory appear to serve as one of the mechanisms underpinning disturbances to social cognition in MS. Future research should examine if the benefits of cognitive rehabilitation programs that incorporate working memory training transfer to these social cognitive processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluation of the impact of a comprehensive psychiatric rehabilitation program on the improvement of cognitive functions in patients of the Mental Health Support Centre in Tarnowskie Gory using the Wisconsin Card Sorting Test

Aim: The purpose of our study was check to how a 3-month program of physical, cognitive and social rehabilitation affected the cognitive functions of patients of the Mental Health Support Centre in Tarnowskie Gory by using the Wisconsin Card Sorting test Materials and Methods: The Wisconsin Card Sorting Test (WCST) was conducted twice among patients of the Mental Health Support Center in Tarnowskie Gory, who were undergoing a 3 month rehabilitation program that included physical, cognitive, and social rehabilitation. The test was conducted at the beginning and after the participation in the rehabilitation program. Results: The rehabilitation program led to a significant decrease in patients’ perseverative responses compared to the initial study. Other indicators were also assessed in the Wisconsin Card Sorting Test (WCST). There were no statistically significant differences between the results of the first and second studies. Conclusions: After completing the rehabilitation program, patients showed a significant decrease in perseverative responses, indicating improved speed in responding to changing task conditions. Cognitive flexibility, including the ability to respond to changing environmental conditions, is a key skill that enables adequate and adaptive actions.

Use of Virtual Reality in Patients with Acquired Brain Injury: A Systematic Review.

ABI is found in all societies as the most severe, disabling neurological disorder. A cognitive rehabilitation program is essential for the clinical recovery of these patients, improving functional outcomes and quality of life. Modern technologies such as virtual reality (VR) offer several advantages over traditional therapies, including the ability to engage people in simulated performance of functional tasks. This review will examine the studies in which virtual reality has been used as an aid, technique, or intervention in patients with acquired brain injury. Studies were identified from an online search of PubMed, Cochrane Library, and Web of Science databases. We found that TBI patients responded positively to VR treatment depending on the damaged or impaired cognitive and motor functions they acquired. It is now a tool that is available in the rehabilitation of these patients and supports the recovery of various motor and cognitive functions. This review has shown that VR is an intervention technique that increasingly exists in clinical rehabilitation practice for ABI patients. The device uses advanced technologies that can cause general changes in cognitive, motor, and psychological aspects and create a simulated environment that can partially restore these functions and behaviors, as well as the behaviors of everyday life.

The relationship between perceived stigma and perceived stress in cognitive decline: a survey of persons with mild cognitive impairment and their caregivers.

While Alzheimer's disease and other causes of dementia have rapidly become a global health crisis with growing incidence that is unabated, the incidence of Mild Cognitive Impairment (MCI) far exceeds that of Alzheimer's disease. Persons with MCI demonstrate some level of cognitive impairment, but daily functions remain intact and there is no certainty that they will develop dementia. Yet, the possibility conjures a considerable amount of fear and anxiety, further fueled by a vast array of misconceptions and stigma. The pervasive nature of this stigma permeates society and culture at many levels. Persons with MCI who are at higher risk for development of dementia may be especially vulnerable to fear and stigma associated with the diagnosis. Based on this premise, the primary aim of this study was to examine the relationship between perceived stigma and perceived stress in persons with MCI and their care partners, including the relationship between income and the study variables. The secondary aim was to examine the effect of a combined cognitive rehabilitation and wellness program on these perceptions. Thirty participants were recruited from Mayo Clinic's Health Action to Benefit Independence and Thinking (HABIT) program. MCI (n = 15) and care partner (n = 15) participants completed the Stigma Impact Scale (SIS) and the Perceived Stress Scale (PSS) before and after the HABIT program. Average SIS and PSS scores decreased in the MCI, care partner, and combined groups, both pre- and post-HABIT. Linear regression was used to assess the relationship between perceived stigma and stress, controlling for income. A significant relationship was found between perceived stigma and perceived stress both pre and post-HABIT. The results suggest a relationship exists between perceived stigma and perceived stress in persons with MCI and their care partners, and an educational program such as HABIT may strengthen this relationship by informing participants of potential challenges that occur in cognitive decline. Understanding these relationships may provide an opportunity to provide tools for this vulnerable population.

Stroke and cognitive impairment: understanding the connection and managing symptoms

Stroke is a leading cause of long-term disability worldwide, and cognitive impairment is a common consequence of stroke. Understanding the connection between stroke and cognitive impairment is crucial for effectively managing symptoms and improving patients’ quality of life. This abstract provides an overview of the relationship between stroke and cognitive impairment and explores strategies for managing cognitive symptoms in stroke survivors. A comprehensive review of relevant literature was conducted to examine the association between stroke and cognitive impairment. Various factors contributing to cognitive impairment after stroke were explored, including the location and severity of the stroke, vascular risk factors, and underlying mechanisms. Evidence-based strategies for managing cognitive symptoms in stroke survivors were also analyzed, such as cognitive rehabilitation, pharmacological interventions, and lifestyle modifications. The review revealed a strong link between stroke and cognitive impairment. The location and severity of the stroke play a significant role in determining the specific cognitive deficits experienced by individuals. Vascular risk factors, including hypertension, diabetes, and atrial fibrillation, contribute to cognitive decline after stroke. Mechanisms such as cerebral hypoperfusion, white matter damage, and neuroinflammation also play a role. Cognitive rehabilitation programs have shown promising results in improving cognitive function, while certain medications may help manage specific cognitive symptoms. Lifestyle modifications like physical exercise and a healthy diet have been associated with better cognitive outcomes in stroke survivors.

Post COVID‐19 cognitive rehabilitation effects on depressive symptoms

AbstractBackgroundMore than 600 million people have been infected by Covid‐19 since the beginning of the pandemic. Common cognitive and psychological symptoms in these patients are memory impairment, attention difficulties, anxiety and depression, and neuropsychological rehabilitation is a possible strategy to improve them. In addition, some studies have shown a decrease in depressive symptoms after starting a cognitive rehabilitation program, although this was not the main objective of rehabilitation.MethodFive patients underwent mood assessment, more specifically, depressive symptoms. For this, the Patient Health Questionnaire‐9 (PHQ‐9) was used. The application was made immediately before and after the cognitive rehabilitation intervention, lasting 20 weekly sessions of about one hour of activity.ResultThe evaluation was performed on five patients with a mean age of 52.5 years (Table 1). These presented measures that indicated the presence of depressive symptoms at the beginning of the study. After 20 sessions of cognitive rehabilitation it was not possible to observe an objective change in depressive symptoms. This can be explained by the reduced number of individuals in the sample, which may have impaired the statistical calculation. But it was observed a clinical improvement of depressive symptoms was observed in 60% of patients and 40% remained stable (Table 2). Clinical improvement was also noted in patients, who reported that they were feeling better and that they resumed activities that they have previously avoided or that they were finding it easier, in addition to perceiving their own evolution throughout the treatment, increasing their sense of self‐efficacy and feeling more hopeful.ConclusionFinally, it is noted that cognitive rehabilitation is a possible strategy to improve not only cognitive impairment, but also the clinical manifestations of depressive symptoms in post‐Covid‐19 patients.

DECREASE: Decrease Cognitive Decline in Alzheimer’s Disease Through Occupational Therapy: A Randomized Controlled Phase III Trial Protocol

Introduction: Alzheimer’s disease (AD) accounts for more than 80% of dementia cases worldwide and imposes a significant economic burden on the healthcare system. Currently, there is no cure for AD, and pharmacological treatments alleviate AD symptoms but fail to decrease cognitive decline. Occupational Therapy (OT) for AD patients targets symptoms without the side effects of drugs and may even play a disease-modifying role by preserving cognitive functions. The DECREASE trial aims to assess the effectiveness of a cognitive-based OT intervention amongst AD patients. Methods: The DECREASE Trial is a randomized, controlled, multicentric, phase III, superiority trial comparing the effect of OT and standard of care versus standard of care alone on cognition in AD patients. OT will entail a five-week group cognitive rehabilitation program with remote maintenance sessions until six months of follow-up. We will include 278 mild AD patients aged between 65 and 80. Changes in cognitive function between groups will be measured and compared by the ADAS-cog after six months. Discussion: The strengths of this OT program are that it is non-invasive, safe, highly standardized, and accessible to occupational therapists and caretakers worldwide. There is broad evidence of the benefits of functionality. Nevertheless, there needs to be more literature on its effect on cognitive function. AD is a public health emergency that needs to be promptly addressed. This trial will finally determine if an OT-based intervention can decrease cognitive decline and whether it should be included in the standard of care for AD.

Comparing the Effectiveness of Computer-Based and Task-Oriented Cognitive Rehabilitation Programs on Epileptic Children’s Attention in Tehran

Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P &lt; 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.

Effects of Virtual Reality-Based Cognitive Rehabilitation in Stroke Patients: A Randomized Controlled Trial.

During the process of recovering functional ability after damage caused by a stroke, it is important to restore cognitive function via cognitive rehabilitation. To achieve successful rehabilitation, it is important for patients to have a sense of efficacy in their ability to manage their disease well. Therefore, a virtual reality-based cognitive rehabilitation program based on self-efficacy theory was developed, and its effects were compared with conventional and computer-assisted cognitive rehabilitation. The virtual reality-based cognitive rehabilitation program consisted of sessions lasting 30 min each five days a week for eight weeks. After applying the virtual reality-based cognitive rehabilitation program, there were significant differences in group-by-time interactions regarding stroke self-efficacy, cognitive function, visual perception, activities of daily living, and health-related quality of life. In addition, there were significant group differences among the three groups in terms of stroke self-efficacy and health-related quality of life. In conclusion, our virtual reality-based cognitive rehabilitation program developed based on self-efficacy theory is effective for inpatients with stroke and improves their stroke self-efficacy, cognitive function, visual perception, activities of daily living, and health-related quality of life.

Bilişsel Rehabilitasyonun Alzheimer Hastalığı ve Hafif Bilişsel Bozukluk Üzerindeki Etkisi

Alzheimer's disease (AD) and mild cognitive impairment (MCI) have taken their place among the most common neurodegenerative diseases by affecting countless people around the world. Mild cognitive impairment can be defined as the earliest stage of deterioration in the cognitive functions. While impairment in more than one cognitive domain can be seen in MCI, it is seen that individuals can show some level of functionality in daily life. Also, Alzheimer's and MCI cause degeneration in some parts of the brain (parietal lobe, frontal lobe, temporal lobe), and disease is progressed, shrinkage may occur in some brain regions. Thus, a series of intervention techniques have been introduced to improve the daily living activities of individuals diagnosed with Alzheimer's and MCI. Cognitive rehabilitation is an individualized process that focuses on improving daily living activities. Furthermore, the effectiveness of cognitive rehabilitation on Alzheimer's disease and MCI in numerous cognitive domains is proven by different researchers. Different researchers prove that different cognitive rehabilitation programs are effectively improving the cognitive, social, and psychological domains of individuals' lives. Therefore, this literature review aims to examine the effectiveness of cognitive rehabilitation programs applied after 2015 to individuals with Alzheimer's and MCI and to compile the examined findings.

H - 31 Stress and Cognitive Symptoms among Community-Based Survivors of Mild to Moderate Traumatic Brain Injury: Findings from a Group Cognitive Rehabilitation Program.

The current study evaluates a 12-week cognitive rehabilitation program for community-dwelling survivors of traumatic brain injury (TBI). The objective was to assess the feasibility and effects of a scalable, cost-effective group intervention. The present study was a quasi-experimental, within-subjects design that assessed survivors at baseline, week five, week nine, and week 12. Participants were survivors of brain injury of various etiologies, but only survivors of mild to moderate TBI who completed the full program (n = 12) were analyzed. Neuropsychiatric self-reported data were collected to evaluate the relationship between affective and cognitive symptoms in response to directed psychoeducation delivered within a group psychotherapeutic framework. A relationship in the rates of change between affective and cognitive post-concussion symptoms was hypothesized. Moreover, improvements in neuropsychological scores (RBANS) were hypothesized in all five domains. A panel regression revealed that slopes of stress symptoms, and not depression or anxiety symptoms, predicted the rate of change in post-concussive cognitive symptoms. Non-parametric analyses of ordinal trends revealed a significant decoupling of the association between stress symptoms and cognitive symptoms over the intervention period. Only improvements in memory performances were revealed. Qualitative focus groups were analyzed for themes to potentially explain the mechanism of change. Findings provide support for this program as a feasible cost-effective group modality for psychosocial cognitive training following mild to moderate TBI.

The effectiveness of cognitive rehabilitation intervention with the telerehabilitation method for amnestic mild cognitive impairment: A feasibility randomized controlled trial.

Although different cognitive rehabilitation (CR) approaches have been developed for mild cognitive impairment (MCI), a standard method has not been determined for interventions, especially with the telerehabilitation (TR) method, which is one of the alternative solutions to the problems of accessing rehabilitation services. The study was planned to compare the effectiveness of the CR intervention applied in the older adults with amnestic-MCI with face-to-face and TR methods. A total of 68 participants were randomly assigned to the TR and face-to-face groups. TR method was delivered by teleconference method in the participant's own home. A 12-week CR intervention was applied to both groups. Pre- and post-intervention cognitive skills of the participants were evaluated using the Loewenstein occupational therapy cognitive assessment-geriatric (LOTCA-G). Cognitive skills were increased in both groups (p < 0.001). A statistically significant difference was observed between the groups in the post-intervention visual-spatial perception, praxis, and total LOTCA-G scores (p < 0.01). It was determined that a 12-week CR program had positive effects on cognitive functions in the older adults with amnestic MCI. Both TR and face-to-face methods can be used in CR interventions for amnestic MCI. In addition, the TR method can be advantageous in terms of time and accessibility. NCT05664984.

Comparing the Effectiveness of Task-Oriented Cognitive Rehabilitation and Computer-Based Cognitive Rehabilitation Programs on Cognitive Flexibility in Children with Epilepsy

Comparing the Effectiveness of Task-Oriented Cognitive Rehabilitation and Computer-Based Cognitive Rehabilitation Programs on Cognitive Flexibility in Children with Epilepsy