Background and Purpose There is an increasing interest in the effect of nonpharmacological interventions on the course of patients with Alzheimer's disease (AD). The objective of the present study is to determine the benefits of a structured, multidomain, mostly computer-based, cognitive training (MCT) οn the cognitive performance of patients with early-stage AD. Method Fifty patients with early-stage AD participated in the study. Patients were randomly allocated either to the training program group (n = 25) or to a wait list control group (n = 25). The training program group received computer-assisted MCT and linguistic exercises utilizing pen and paper supplemented by cognitive-linguistic exercises for homework. The duration of the MCT intervention program was 15 weeks, and it was administered twice a week. Each session lasted for approximately one hour. Objective measures of episodic memory, delayed memory, word recognition, attention, executive function, processing speed, semantic fluency, and naming were assessed at baseline and after the completion of the program in both groups. Results Analysis showed that in controls, delayed memory and executive function had deteriorated over the observation period of 15 weeks, while the training group improved their performance in word recognition, Boston Naming Test (BNT), semantic fluency (SF), clock-drawing test (CDT), digit span forward (DSF), digit span backward (DSB), trail-making test A (TMT A), and trail-making test B (TMT B). Comparison between the training group and the controls showed that MCT had a significant beneficial effect in delayed memory, naming, semantic fluency, visuospatial ability, executive functions, attention, and processing speed. Conclusions The study provides evidence of a beneficial effect of MCT with an emphasis on cognitive-language performance of patients with early-stage AD. Considering the limited efficacy of current pharmacological therapies in AD, concurrent computer-based MCT may represent an additional enhancing treatment option in early-stage AD patients.
Cognitive impairment is frequently encountered in multiple sclerosis (MS) affecting between 40–65% of individuals, irrespective of disease duration and severity of physical disability. In the present multicenter randomized controlled trial, fifty-eight clinically stable RRMS patients with mild to moderate cognitive impairment and relatively low disability status were randomized to receive either computer-assisted (RehaCom) functional cognitive training with an emphasis on episodic memory, information processing speed/attention, and executive functions for 10 weeks (IG; n = 32) or standard clinical care (CG; n = 26). Outcome measures included a flexible comprehensive neuropsychological battery of tests sensitive to MS patient deficits and feedback regarding personal benefit gained from the intervention on four verbal questions. Only the IG group showed significant improvements in verbal and visuospatial episodic memory, processing speed/attention, and executive functioning from pre - to postassessment. Moreover, the improvement obtained on attention was retained over 6 months providing evidence on the long-term benefits of this intervention. Group by time interactions revealed significant improvements in composite cognitive domain scores in the IG relative to the demographically and clinically matched CG for verbal episodic memory, processing speed, verbal fluency, and attention. Treated patients rated the intervention positively and were more confident about their cognitive abilities following treatment.
Down syndrome (DS) is the most common developmental disorder characterized by mild to moderate intellectual disability. Several studies have reported poor language and prosodic skills and contradictory results regarding individuals' with DS sociocognitive skills, whereas most of them have focused on children with DS. The present study attempts to explore adults' with DS language, socio-cognitive and prosodic abilities via the use of story-retellings. Twenty adults with DS and two groups of TD children, one matched to their expressive vocabulary (TD-EVT) and the other matched to their non-verbal mental age (TD-RCPM), took part in the present study. Participants listened to a story while viewing a wordless picture PowerPoint presentation on a computer screen, and then, they were instructed to retell the story while viewing the pictures for a second time. Each participant listened to two stories, one with "lively" and one with "flat" prosody. Results revealed that adults' with DS performance was comparable with the one presented by the TD-RCPM group, whereas the TD-EVT group performed significantly better in almost all variables. Individuals' with DS renarrations, however, contained significantly less complement clauses and internal state terms (related or not related to Theory of Mind-ToM) compared to the re-narrations of both control groups. In contrast, the group with DS performed similarly to both control groups in comprehension questions related to main characters' internal state terms and significantly better compared to the TD-RCPM group in questions related to ToM. In terms of prosody, all three groups performed significantly better on story structure and comprehension questions when prosody was "lively" compared "flat" prosody. DS group's re-narrations did not contain enough internal state terms, not due to their inability in recognizing them, but due to their poor morphosyntactic abilities, which did not allow them to find the proper means to express the main characters' internal states. Prosody facilitated participants with DS in the comprehension and re-narration. This suggests that intervention programs based on prosody could support the language skills of adults with DS.
Background Cognitive dysfunction is one of the most prevalent non-motor aspects of Parkinson’s disease (PD). The present review focuses on published studies investigating the effect of computer-based cognitive training (CT) on neuropsychological performance in PD. Methods A systematic search of the PubMed database and Google Scholar was carried out. Randomized controlled studies published before September 2019, investigating the effect of computer-based CT (regardless of the comparator, active or placebo) on PD patients were included. Literature search, data extraction, and Risk of Bias (RoB) evaluation (based on the RoB Cochrane tool for Randomized Trials) were performed by two authors (A.N. and M.M), independently. Results Among 31 full-texts assessed for eligibility, eight articles fulfilled the inclusion criteria and were involved in the qualitative analysis. The main outcomes of the retrieved studies (all studies used similar cognitive rehabilitation methodologies) were indicative of cognitive improvement in most cognitive domains, particularly memory, executive function, processing speed, and attention, that is, the domains primarily impaired in the disease. Conclusion Multidomain CT, which is exclusively based on computer software, leads to measurable improvements in most cognitive domains affected in patients with PD. The present review is the first to include studies assessing the effect of computer-based CT techniques without deploying CT with paper-pencil techniques. Limitations originate mainly due to the heterogeneity among included studies (differences in CT softwares, PD stages, number, and duration of training sessions.
Melodic intonation therapy (MIT) is one of the most well-known treatment methods which is based on pitch and rhythm and was developed to increase verbal output in adults with non-fluent aphasia. Although MIT has been adapted to several languages, in Greece it is almost unknown. The aim of the proposed study is twofold: (1) to translate and adapt the MIT to the Greek language, and (2) to conduct an experimental study in order to examine the effect of MIT on Greek patients with Broca’s aphasia. To this aim, a 64-year-old, right-handed male who had a 6-year primary school education level, no musical abilities and poor performance on the recognition of prosody attended the MIT intervention program almost two and a half years after the event of suffering an ischemic stroke. The MIT intervention was administered three times per week for a 12-week period, in which each session lasted from 30 to 40 min. The patient underwent three assessments all using both the Boston Diagnostic Aphasia Examination–Short Form (BDAE-SF) and brain perfusion single-photon emission computed tomography (SPECT); (1) before the MIT, (2) immediately after, and (3) 3 months after the completion of MIT. The results from the BDAE-SF revealed an impressive improvement on both trained and prepositional speech production, immediately after the completion of the MIT, and a stable improved performance 3 months after MIT. The SPECT scan revealed reactivation of the perilesional areas of the left hemisphere, and considerably improved perfusion of the frontal lobe, the anterior temporal lobe, and the upper part of the parietal lobe of the right hemisphere. The improvement persisted and even expanded 3 months after MIT. Therefore, MIT is a promising intervention program and its positive effects last for at least 3 months after the completion of the intervention.
The study investigates the ability of Greek-speaking individuals diagnosed with mild Alzheimer's Disease (mAD) and Mild Cognitive Impairment (MCI) to produce verbs that vary with respect to their grammatical and lexical aspect. While grammatical aspect has been examined in aphasia, there are only a few studies dealing with this in neurodegenerative conditions and their findings are contradictory. Motivated by this, we further investigate aspect by examining not only grammatical but lexical aspect as well and how their semantic and temporal features affect mAD and MCI individuals' performance. Thus, the major innovation of the study is that it examines aspect not only as a functional feature but also as a lexical variable, something addressed for the first time in the literature. We also address whether grammatical aspect interacts with lexical aspect and with time reference. Finally, by looking at Greek, we further contribute to cross-linguistic perspective of aspect investigation. 11 MCI and 11 mAD individuals participated in a picture naming task, targeting the investigation of lexical aspect, and a sentence completion task, targeting the investigation of grammatical aspect and its interaction with lexical aspect and time reference. Both groups of participants were found to be impaired in both tasks when compared to healthy controls. In the naming task, both group and lexical aspect were significant predictors for participants' performance. Specifically, more impaired performance was found in states (believe), achievements (break), and semelfactives (hit) compared to activities (run) and accomplishments (build) for both AD and MCI participants. In the sentence completion task, apart from group, neither grammatical or lexical aspect nor tense were significant predictors for participants' performance. While results indicate that both grammatical and lexical aspect are impaired in AD and MCI, a closer look suggests a dissociation regarding the temporal feature of duration. Specifically, as grammatical feature, duration does not appear to affect participants' choice between perfective and imperfective aspect. As a lexical variable, on the other hand, and as part of the lexical representation of a verb, duration (together with internal structure) appears to play a role in verb naming. Finally, the lack of interaction between lexical and grammatical aspect also indicates that these two subsystems can be affected differentially.
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