The coronavirus disease 2019 (COVID-19) can disrupt various brain functions. Over a one-year period, we aimed to assess brain activity and cognitive function in 53 COVID-19 patients and 30 individuals without COVID-19 (or asymptomatic). The Montreal Cognitive Assessment, Trail Making Test Parts A and B (TMT-A and B), and Digit Span Test were used to assess cognitive function. Cognitive variables and electroencephalography (EEG) data (activity, mobility, and complexity) were compared between the groups at rest and during cognitive demand (F3-F7, Fz-F3, Fz-F4, and F4-F8). There was a reduction in F3-F7 activity during the TMT-B in the COVID-19 group at 6-12 months compared to the controls (p = 0.01) at baseline (p = 0.03), a reduction in signal complexity at F3-F7 at rest in the COVID-19 group at baseline and 6-12 months compared to the controls (p < 0.001), and a reduction in Fz-F4 activity at rest from 6-12 months in the post-COVID group compared to baseline (p = 0.02) and 3-6 months (p = 0.04). At 6-12 months, there was a time increase in TMT-A in the COVID-19 group compared to that in the controls (p = 0.04). Some correlations were found between EEG data and cognitive test in both groups. In conclusion, there was a reduction in brain activity at rest in the Fz-F4 areas and during high cognitive demands in the F3-F7 areas. A reduction in signal complexity in F3-F7 at rest was found in the COVID-19 group at 6-12 months after acute infection. Furthermore, individuals with COVID-19 experience long-term changes in cognitive function.
OBJECTIVE:The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence.METHODS:This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors.RESULTS:We studied 60 patients with a median age of 68 (34–89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03–1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13–2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78–0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48–0.92], p=0.017).CONCLUSION:The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence.
The objective of this study is to evaluate the effects of physical therapy on the cognitive and functional capacity of patients with Alzheimer’s Disease (AD). This is a systematic review of randomized or quasi-randomized clinical trials, using the descriptors: AD, dementia and physical therapy. Two studies were included with a total of 207 participants. In study 1, no statistically significant difference was found on the mini-mental state examination (MMSE) (MD 0.0, 95%CI −5.76 to 5.76), neuropsychiatric inventory (MD −4.50, 95%CI −21.24 to 12.24) and Pfeffer instrumental activities questionnaire (MD 0.0 95%CI −6.48 to 6.48). In study 2, there was no statistically significant difference on the MMSE (MD −1.60, 95% CI −3.57 to 0.37), clock-drawing test (MD −0.20, 95%CI −0.61 to 0.21) and Alzheimer’s Disease Assessment Scale - cognitive subscale (MD 1.0, 95%CI −2.21 to 4.21) after 12 months. There was no consistent evidence on the effectiveness of physiotherapeutic intervention in improving cognitive function and functional capacity of patients with AD. More studies should be conducted for better evidence.
Difficulties in the integration of visual, vestibular, and somatosensory information in individuals with Parkinson’s disease (PD) may alter perception of verticality. Accordingly, in this cross-sectional study, we analyzed PD patients’ ( n = 13) subjective visual vertical (SVV) and subjective haptic vertical (SHV) perceptions and compared them to those of healthy controls ( n = 14). We compared SVV and SHV findings among participants with PD, healthy controls, and cutoff points of normality based on prior research literature, using the parametric nonpaired t test (at p < .05) and Cohen’s d (at d > 0.8) to determine clinical relevance. We analyzed SVV with the bucket test and SHV with the rod rotations task in clockwise and counterclockwise directions. We calculated Pearson correlations to analyze the association between verticality tests and the most clinically affected body side. We calculated both the percentage of A-effect (expression of body tilt underestimation to the midline) and E-effect (expression of body tilt overestimation in the upright position). Individuals with PD showed greater variability in right SHV supination compared to the healthy control participants ( p = .002). There was greater clinical relevance in right (as opposed to left) SVV ( d = 0.83), right (as opposed to left) SHV pronation ( d = 0.91), and left (as opposed to right) SHV pronation ( d = 0.88). We observed a higher proportion of E-effect in individuals with PD. A significantly higher proportion of patients with PD, compared to patients in past literature, had right SHV pronation ( p = .001), left SHV pronation ( p = .023), right SHV supination ( p = .001), left SHV supination ( p = .046), and left SHV pronation ( p = .046). Thus, subjective visual and proprioceptive perception of verticality is altered in patients with PD, compared to individuals without PD.
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