Rehabilitation Of Cognitive Functions Research Articles

Rehabilitation of Cognitive Functions in a Virtual Environment: A Systematic Review

Rehabilitation of Cognitive Functions in a Virtual Environment: A Systematic Review

Recovery after ischemic stroke: Effects of FuekFone home-based program on upper limb and cognitive function

This study aimed to explore the effects of the "FuekFone (F.F.) home-based program" on the upper limb and cognitive function of ischemic stroke patients after discharge. A single group pre-and post-test design was conducted. A total of 40 patients with recovery after ischemic stroke were recruited from two university hospitals in Thailand. The study was conducted between June 2022 and January 2023. Participants underwent a six-week "F.F. home-based program," which combined an upper limb and cognitive function rehabilitation device with Android games, including stationary barrel, adventure walk, adventure stroll, sliding barrel, sauce squeeze, and cut objects. Each game has different difficulty levels. Patients can perform corresponding exercises through the games according to their conditions under the guidance of medical staff. The patients played for 24min per time, 4min each game, three days a week. The second week, let the patients play games for 30min per time, 5min each game, 3 days a week. Then, in the 3-6 weeks, let the patients play games for 1h per time, 10min each game, 5 days a week. At the pre-and post-intervention, the Thai version of the National Institutes of Health Stroke Scale (NIHSS), the Motor Assessment Scale, and the Montreal Cognitive Assessment (MoCA score) were administered to patients at discharge and at 2, 4, and 6 weeksafter discharge, and the results were compared. All participants completed this program. Participants had statistically improved upper limb function (upper arm function score, hand movements score, advanced hand activities score, total Motor Assessment Scale score) and MoCA score at 2, 4, and 6 weeks after discharge (P<0.001). In the comparison of upper limb function and cognitive function at each of the study times, we found statistically improved upper limb function (upper arm function score, hand movements score, advanced hand activities score, total Motor Assessment Scale score) and MoCA score at 4, and 6 weeks after discharge when compared to after discharge and 2 weeks after discharge, respectively (P<0.05). Continuing care of patients post-stroke after discharge from hospital, such as F.F. home-based program should be applied at home to enhance upper limb and cognitive function.

The green spaces of the city and their significance in rehabilitation of cognitive functions – The spatial method of stimulation

The article addresses the spatial aspect as a factor of significant importance for the success of rehabilitation functions. The location of cognitive rehabilitation activities in an open, urban space allows people with reduced fitness to take up stress-free rehabilitation activity without time limitations and without stigmatization. The architectural design of the positions for mental rehabilitation implemented in public space was addressed to people with dysfunctions of all ages and people suffering from covid fog as a result of a past disease. This article presents the results of preliminary observational studies conducted on a focus group of COVID19 convalescents, who were provided with an open rehabilitation space equipped with 12 rehabilitation tables. The results showed the decisive influence of the placement of rehabilitation elements in the open green space for rehabilitation results. The task of the mind training path is to raise and maintain intellectual fitness in a friendly recreational space. Prototype studies have shown that, de-pending on the arrangement of individual stops, the mind training path offers different efficiency of exercises, but it is always a better result than in closed spaces of medical facilities.

Anxiety and subjective assessment of cognitive functions after COVID-19.

IntroductionWide circulation of the COVID-19 has led to the high occurrence of a longcovid in which the complaints of violations of cognitive functions and affective disorders often occur.ObjectivesThe aim of this study was to assess the relation of anxiety and subjective appraisal of the states of cognitive functions.MethodsThe data of 1233 respondents of internet-research who were divided into the four groups according to their COVID-19 status and the level of anxiety. Group 1 (didn’t have COVID before, low level of anxiety) – 689 people (mean age 40,6), group 2 (didn’t have COVID before, High level of anxiety) – 364 people (mean age 39,8), group 3 (had been ill COVID-19, low level of anxiety) – 102 people (mean age 41,2), group 4 (had been ill COVID-19, High level of anxiety) -130 people (mean age 35,5). Methods include the questions about the states of their cognitive functions (attention, memory, working capacity), a question about COVID-19 status. There are the results of comparing the groups that was carried out using the Kruskal-Wallis test. A pairwise comparison was carried out using the Mann-Whitney test for two groups of people who were not ill; two groups who were ill; two groups with a low level of anxiety; two groups with a high level of anxiety. To correct multiple comparisons, the adjusted significance level calculated by the formula (p = 1 - 0,9511/n) was used, which was p=0,017 for 4 pairwise comparisons.ResultsResults are shown in table.Group 1Group 2Group 3Group 4Trouble remembering things0,500,990,771,30(*2)(*1,*4)(*1,*4)(*2,*3)Feeling low in energy or slowed down0,741,771,232,34(*2,*3)(*1,*4)(*1,*4)(*2,*3)Having to do things very slowly to insure correctness0,270,880,311,00(*2)(*1)(*4)(*3)Difficulty making decisions0,631,630,821,67(*2)(*1)(*4)(*3)Your mind going blank0,341,120,641,36(*2,*3)(*1)(*1,*4)(*3)Trouble concentrating0,581,550,721,86(*2)(*1,*4)(*4)(*2,*3)Feeling everything is an effort0,431,470,561,81(*2)(*1,*4)(*4)(*2,*3)An entry in parentheses such as (2*) means that this group for this parameter statistically significant differs from group 2.As indicated in the table, respondents with the high level of anxiety have higher levels of the subjective assessment of cognitive functions regardless of their COVID-19 status.ConclusionsA possible explanation may be the disorganizing effect of anxiety on the cognitive functions. When combined with possible organic disorders caused by the transferred COVID-19, the most marked indicators of cognitive decline are observed. An effective rehabilitation of cognitive functions after COVID-19 requires to diagnose the level of anxiety and to seek psychological and psychiatric assistance for people with a high level of anxiety.Disclosure of InterestNone Declared

Virtual Reality Technology for Physical and Cognitive Function Rehabilitation in People With Multiple Sclerosis.

Virtual reality (VR) has significantly expanded the possibilities of medical treatment, particularly in the realm of rehabilitation. VR utilizes advanced technologies to create simulated environments that users perceive as analogous to the real world. Researchers have demonstrated that VR can effectively train motor, sensory, and cognitive functions. This manuscript offers a concise review of recent evidence concerning the effects of VR training on key clinical symptoms in people with multiple sclerosis (pwMS), with the aim of highlighting VR's potential as a complementary rehabilitative tool for improving ubiquitous symptoms of multiple sclerosis (MS)-a neurodegenerative, often disabling, disease. In addition to presenting a brief overview of recent literature on VR for pwMS, this narrative review seeks to provide health professionals with a foundational understanding of VR as a rehabilitative tool in MS. Furthermore, it may aid in identifying gaps in the literature and stimulate the development of new hypotheses and theories regarding the use of VR in patients with a neurodegenerative disease.

The effect of repeated transcranial magnetic stimulation combined with cognitive rehabilitation training on post-stroke cognitive impairment.

The aim of this study was to explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive rehabilitation training on post-stroke cognitive impairment (PSCI). We retrospectively reviewed clinical data from 119 patients with PSCI admitted to our hospital from December 2021 to April 2023, of which 58 received pure cognitive rehabilitation training (control group) and 61 received rTMS combined with cognitive rehabilitation training (observation group). We calculated measures of cognitive function rehabilitation, daily living activity abilities, latency and amplitude of P300 wave of evoked potential, and serum biochemical index levels before and after the intervention in the two groups. After the intervention, the scores of the Montreal Cognitive Assessment (MoCA) scale and Rivermead behavioral memory test (RBMT) had improved in the two groups. Also, the Modified Barthel Index (MBI) scores of the two groups increased after the intervention. The P300 wave latencies in both groups decreased and their amplitudes increased after the intervention. The levels of serum neurotrophin-3 (NT-3) and brain-derived neurotrophic factor (BDNF) in the two groups were higher, and the levels of brain glial fibrillary acidic protein (GFAP) were lower after the intervention. All these improvements were more marked in the observation group than in the control group (all p<0.05). Compared with simple cognitive rehabilitation training, the training combined with rTMS was more effective at restoring cognitive function, improving daily living activity abilities, and improving the treatment outcome of patients with PSCI.

PENGARUH TERAPI COGNITIVE REHABILITATION TERHADAP FUNGSI KOGNITIF PASIEN SKIZOFRENIA

Schizophrenia is a severe mental disorder, organized into multiple dysfunctional domains including positive symptoms, negative symptoms, cognitive impairment, mood, carelessness, and aggression. Impaired cognitive function is an inability in attention, memory, consideration, problem solving, and the ability of executives such as planning, assessing, monitoring and evaluating. One of cognitive deficit therapy in schizophrenia is Cognitive Rehabilitation (CR) therapy. The purpose of this study is to determine whether there is an influence between cognitive therapy rehabilitation of cognitive function in schizophrenic patients. This research used Quasi Experiment with non-random pretest and posttest with control group design and method of data analysis used comparative test which is wilcoxon test and mann-whitney test. This research was done on schizophrenia patients in RSJD dr. Arif Zainudin Surakarta with 32 samples divided into control group (n = 15) and intervention group (n = 17). The cognitive function examination was assessed using the Montreal Cognitive Assessment (MoCA) version of Indonesia which has been validate. Interventions were done for during 6 sessions for 2 weeks and were done in groups. The cognitive function score in the control group, the pretest mean was 20.26 and the post-test mean was 21.60. For the function score in the intervention group, the average pretest score was 21.8, while the average post-test score was 25.6. The results of the research data analysis used the Wilcoxon test on the pretest and post-test of the control group with sig. 0.000 with a p-value &lt;0.05; Wilcoxon test on pretest and post-test in the intervention group with sig. 0.000 with a p-value &lt;0.05; Mann-Whitney test in the control-intervention group with sig. 000 with a p-value &lt;0.05. This indicates that there is a significant difference in cognitive function abilities between the control group and the intervention group who underwent cognitive rehabilitation therapy for schizophrenia patients at RSJD Dr. Arif Zainudin Surakarta. This research shows a significant difference value between the control group and the intervention group. The result of the comparative test of both groups found that there was a significant effect on cognitive rehabilitation therapy on cognitive function in schizophrenic patients.

High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) on global cognitive function of elderly in mild to moderate Alzheimer's disease: a systematic review and meta-analysis.

High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) is a non-invasive brain stimulation technique used to improve cognitive deficits in patients with Alzheimer's disease (AD). This systematic review and meta-analysis aimed to evaluate the efficacy of HF-rTMS in improving global cognitive function rehabilitation in elderly patients with mild to moderate AD. A detailed literature search of publications using ten databases (Chinese: Wanfang, VIP Periodical, SinoMed, the Chinese National Knowledge Infrastructure; English: PubMed, Embase, OVID, Web of Science, Cochrane Library, and EBSCOhost) was performed to identify English and Chinese language articles published up to December 2022. We only included randomized controlled trials (RCTs) that evaluate the effect of HF-rTMS on elderly patients with mild to moderate AD. The retrieved studies were carefully reviewed, extracted data, and assessed quality. Seventeen studies, including 1161 elderly patients with mild to moderate AD, were included in this meta-analysis. Compared to the control group, HF-rTMS could increase MMSE (mean difference [MD] = 3.64; 95%CI 1.86-5.42; P < 0.0001), MoCA (MD = 3.69; 95%CI 1.84-5.54; P < 0.0001), P300 amplitude (MD = 1.09; 95%CI 0.45-1.72; P = 0.0008), and total effective rate scores (MD = 3.64; 95% CI 2.14-6.18; P < 0.00001) while decreasing ADAS-Cog (MD = - 3.53; 95%CI - 4.91- - 2.15; P < 0.00001) and P300 latency scores (MD = - 38.32; 95%CI - 72.40- - 4.24; P = 0.03). Our study showed that HF-rTMS could improve the global cognitive function of elderly patients with mild to moderate AD. HF-rTMS can improve global cognitive function in elderly patients with mild to moderate AD, which is an effective and safe rehabilitation treatment tool for AD patients.

Psychocorrective program aimed at recovery of cognitive productivity of persons with alcohol dependence syndrome.

The article presents data on the effectiveness of the psychocorrective program developed by the authors, aimed at improving the cognitive functioning of persons with alcohol dependence syndrome at the stage of active anti-alcohol treatment. The psychocorrective program is developed within the framework of an integrative psychotherapeutic approach, including the techniques of cognitive-behavioral therapy, body-oriented psychotherapy, art therapy, as well as mnemonic techniques used for the development of short-term memory, voluntary attention, and abstract thinking. It is shown that the use of methods of non-pharmacological correction of disorders of cognitive functions in patients of this category can contribute to the recovery of normative cognitive productivity, the formation of conditions for the optimization of therapeutic interaction, and the improvement of the quality of drug addiction treatment. Key words: alcohol dependence, cognitive disorders, rehabilitation of cognitive functions

Benefits of a targeted rehabilitation of number transcoding in secondary acalculia: A single-case experimental design.

Despite its potentially significant functional and emotional impact, acalculia is still too rarely assessed and managed by speech and language therapists. Research on the rehabilitation of numerical transcoding remains scarce in the literature and, despite positive results, presents a low level of evidence. The present study aims to evaluate the effectiveness of a targeted rehabilitation of numerical transcoding in two patients suffering from a chronic secondary acalculia. Two post-brain injury females with secondary acalculia took part in a single-case experimental design with multiple baseline across subjects according to a three-phase experimental protocol: baseline involving global cognitive rehabilitation (5-7 measurements with randomized sequential introduction); targeted intervention (10 measurements); follow-up (2 immediate measurements and 1 month after the end of the intervention). Repeated outcome measures consisted of six lists composed of numbers of equivalent difficulty that were used alternately to assess numerical transcoding. We used a reverse digit span as a control measure to assess the specificity of the intervention. Rehabilitation lasted 5 weeks and consisted of errorless learning with colour cues, tables and number-words cards. During baseline period involving global cognitive rehabilitation, transcoding scores remained unchanged. In contrast, there was a significant improvement in scores for both patients during the intervention phase targeting transcoding and maintenance of benefits 1-month post-intervention. This study demonstrates that a specific rehabilitation targeting numerical transcoding following chronic secondary acalculia can be effective in improving transcoding skills. What is already known on the subject Transcoding difficulties in patients with acalculia can cause a significant disability in everyday life activities. In secondary acalculia, rehabilitation of cognitive functions associated with number processing (attention, working memory, language) is not sufficient for improvement of transcoding. What this paper adds to existing knowledge An intervention specifically targeting numerical transcoding significantly and durably improves the skills of patients with chronic secondary acalculia. What are the potential or actual clinical implications of this work? Procedural error-free intervention using colour cueing, tables, cards with number-words, copy and repetition seems effective to improve transcoding skills in chronic acalculia.

Effect of acupuncture on unilateral spatial neglect after stroke: A systematic review and meta-analysis of randomized controlled trials

To systematically evaluate the effects of acupuncture in patients with unilateral spatial neglect (USN) after stroke. Relevant English- and Chinese- language studies published until 12th February 2022, were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang, China Scientific Journals Database (VIP), SinoMed, PubMed, Cochrane Library, Embase, Web of Science and OVID. Randomized controlled trials (RCTs) assessing the effects of acupuncture in patients with USN after stroke were included. Two researchers independently identified eligible studies and extracted the data. The methodological quality of the studies was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions v5.1.0. Twelve studies (731 participants) were included. The meta-analysis found that compared with the control group, acupuncture increased MMSE, BI, MBI, and FMA scores and reduced the USN scores (all P<0.05). These results indicated that acupuncture improved cognitive function, activities of daily living (ADLs), and motor function and relieved the degree of USN in patients with USN after stroke. Acupuncture could promote the rehabilitation of cognitive function, ADLs, and motor function and relieve the symptoms of USN in patients with USN after stroke. It may be a good complementary treatment to rehabilitation therapy for USN.

Evidence for NIBS in facilitating rehabilitation of cognitive function after stroke

Evidence for NIBS in facilitating rehabilitation of cognitive function after stroke

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.

Wavelet Ridges in EEG Diagnostic Features Extraction: Epilepsy Long-Time Monitoring and Rehabilitation after Traumatic Brain Injury.

Interchannel EEG synchronization, as well as its violation, is an important diagnostic sign of a number of diseases. In particular, during an epileptic seizure, such synchronization occurs starting from some pairs of channels up to many pairs in a generalized seizure. Additionally, for example, after traumatic brain injury, the destruction of interneuronal connections occurs, which leads to a violation of interchannel synchronization when performing motor or cognitive tests. Within the framework of a unified approach to the analysis of interchannel EEG synchronization using the ridges of wavelet spectra, two problems were solved. First, the segmentation of the initial data of long-term monitoring of scalp EEG with various artifacts into fragments suspicious of epileptic seizures in order to reduce the total duration of the fragments analyzed by the doctor. Second, assessments of recovery after rehabilitation of cognitive functions in patients with moderate traumatic brain injury. In the first task, the initial EEG was segmented into fragments in which at least two channels were synchronized, and by the adaptive threshold method into fragments with a high value of the EEG power spectral density. Overlapping in time synchronized fragments with fragments of high spectral power density was determined. As a result, the total duration of the fragments for analysis by the doctor was reduced by more than 60 times. In the second task, the network of phase-related EEG channels was determined during the cognitive test before and after rehabilitation. Calculation-logical and spatial-pattern cognitive tests were used. The positive dynamics of rehabilitation was determined during the initialization of interhemispheric connections and connections in the frontal cortex of the brain.

The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review.

In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.

Effect of BCI-Controlled Pedaling Training System With Multiple Modalities of Feedback on Motor and Cognitive Function Rehabilitation of Early Subacute Stroke Patients.

Brain-computer interfaces (BCIs) are currently integrated into traditional rehabilitation interventions after stroke. Although BCIs bring many benefits to the rehabilitation process, their effects are limited since many patients cannot concentrate during training. Despite this outcome post-stroke motor-attention dual-task training using BCIs has remained mostly unexplored. This study was a randomized placebo-controlled blinded-endpoint clinical trial to investigate the effects of a BCI-controlled pedaling training system (BCI-PT) on the motor and cognitive function of stroke patients during rehabilitation. A total of 30 early subacute ischemic stroke patients with hemiplegia and cognitive impairment were randomly assigned to the BCI-PT or traditional pedaling training. We used single-channel Fp1 to collect electroencephalography data and analyze the attention index. The BCI-PT system timely provided visual, auditory, and somatosensory feedback to enhance the patient's participation to pedaling based on the real-time attention index. After 24 training sessions, the attention index of the experimental group was significantly higher than that of the control group. The lower limbs motor function (FMA-L) increased by an average of 4.5 points in the BCI-PT group and 2.1 points in the control group (P = 0.022) after treatments. The difference was still significant after adjusting for the baseline indicators ( β = 2.41 , 95%CI: 0.48-4.34, P = 0.024). We found that BCI-PT significantly improved the patient's lower limb motor function by increasing the patient's participation. (clinicaltrials.gov: NCT04612426).

Association between the superior longitudinal fasciculus and perceptual organization and working memory: A diffusion tensor imaging study

The superior longitudinal fasciculus (SLF) is a white matter structure that has long bidirectional projections among the prefrontal, temporal, occipital, and parietal cortices and extends over a wide area in a human brain. Recently, anatomical details of the SLF have been clarified using a diffusion tensor imaging (DTI) template of subjects from the Human Connectome Project. However, the neurobehavioral functions of the SLF have not been fully elucidated. It is speculated that the SLF contributes to a broad cognitive domain including visuospatial nonverbal cognitive ability and verbal memory ability because of its anatomical location; however, previous findings in imaging studies are inconsistent. Showing the contribution of the SLF to cognitive function may be important for improving our understanding of the functional role of white matter structures in the human brain. This study aimed to identify the relationship between DTI indices of the SLF and the Verbal Comprehension, Perceptual Organization, Working Memory and Processing Speed Indices of the Wechsler Adult Intelligence Scale-Third Edition using regression analysis, accounting for the effects of age, sex and scanner type in 583 healthy volunteers. We showed significant correlations between the fractional anisotropy of the left SLF and the Perceptual Organization Index (β = 0.21, p = 4.5×10-4) and Working Memory Index (β = 0.19, p = 4.0×10-4). These findings may have implications for the rehabilitation of cognitive function in patients with neurological disorders.

SMR/Theta Neurofeedback Training Improves Cognitive Performance and EEG Activity in Elderly With Mild Cognitive Impairment: A Pilot Study.

Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be beneficial in elderly patients with mild cognitive impairment (MCI). In this pilot study, we investigated whether a sensorimotor (SMR)/theta NF training could improve cognitive performance and brain electrical activity in elderly patients with MCI.Methods: Twenty elderly patients with MCI were assigned to 20 consecutive sessions of sensorimotor (SMR)/theta NF training, during 10 weeks, on a basis of two sessions each week. Neuropsychological assessments and questionnaires, as well as electroencephalogram (EEG), were performed and compared between baseline (T0), after the last NF training session at 10 weeks (T1), and 1-month follow-up (T2).Results: Repeated measures ANOVA revealed that from baseline to post-intervention, participants showed significant improvement in the Montreal cognitive assessment (MoCa, F = 4.78; p = 0.012), the delayed recall of the Rey auditory verbal learning test (RAVLT, F = 3.675; p = 0.032), the Forward digit span (F = 13.82; p < 0.0001), the Anxiety Goldberg Scale (F = 4.54; p = 0.015), the Wechsler Adult Intelligence Score–Fourth Edition (WAIS-IV; F = 24.75; p < 0.0001), and the Mac Nair score (F = 4.47; p = 0.016). EEG theta power (F = 4.44; p = 0.016) and alpha power (F = 3.84; p = 0.027) during eyes-closed resting-state significantly increased after the NF training and showed sustained improvement at a 1-month follow-up.Conclusion: Our results suggest that NF training could be effective to reduce cognitive deficits in elderly patients with MCI and improve their EEG activity. If these findings are confirmed by randomized controlled studies with larger samples of patients, NF could be seen as a useful non-invasive, non-pharmacological tool for preventing further decline, rehabilitation of cognitive function in the elderly.Clinical Trial Registration: This pilot study was a preliminary step before the trial registered in www.ClinicalTrials.gov, under the number of NCT03526692.

Toward Improving Engagement in Neural Rehabilitation: Attention Enhancement Based on Brain–Computer Interface and Audiovisual Feedback

Both motor and cognitive function rehabilitation benefits can be improved significantly by patients’ active participation. To this goal, an attention enhancement system based on the brain–computer interface (BCI) and audiovisual feedback is proposed. First, an interactive position-tracking riding game is designed to increase the training challenge and neural engagement. Subjects were asked to drive one of the avatars to keep up with another by adjusting their riding speed and attention. Second, the subject’s electroencephalogram (EEG)-based attention level is divided into three regions (low, moderate, and high) by using the theta-to-beta ratio (TBR). According to the subject’s attention states, different speed adjustment strategies are adopted to adjust the tracking challenge and improve the subject’s attention. Besides, if the subject’s attention focused on the training is moderate or low, an auditory feedback will be given to remind the subject to pay more attention to the training. The contrast experimental results show that subjects’ performance indicated by overall attention level and average muscle activation can be improved significantly by using the attention enhancement system, which validates the feasibility of the proposed system for improving the neural and motor engagement.

A Game Software for Cognitive Function Rehabilitation, "Jcores"

A Game Software for Cognitive Function Rehabilitation, "Jcores"