Woodhead et al. present results from a randomized trial of a novel reading therapy app (‘iReadMore’) coupled with anodal transcranial direct current stimulation (tDCS) in patients with post-stroke central alexia. Use of iReadMore improves reading accuracy for trained words, while concurrent tDCS facilitates training and improves generalization to untrained stimuli.

No abstract

Parkinson's disease (PD) is a neurodegenerative condition, which compromises the motor functions and causes the alteration of some executive brain functions. The presence of changes in cognitive symptoms in PD could be due to the procedure of deep brain stimulation (DBS). We searched in several databases for studies that compared performance in executive function tests before and after the DBS procedure in PE and then performed a meta-analysis. After the initial search, there were 15 articles that specifically evaluated the functions of verbal fluency, working memory, cognitive flexibility, abstract thinking, and inhibition. It was found that there were differences in the evaluation of the cognitive functions in terms of the protocols, which generated heterogeneity in the results of the meta-analysis. Likewise, a tendency to diminish functions like verbal fluency and inhibition was found, being this consistent with similar studies. In the other functions evaluated, no difference was found between pre- and postsurgery scores. Monitoring of this type of function is recommended after the procedure.

We investigated the role of the left temporo-parietal regions in supporting reading abilities of 23 patients with central alexia (CA). For the behavioural data, we employed principal components analysis (PCA), which identified two components: 'reading aloud' and 'reading for meaning'. Voxel-based morphometry of the PCA results showed an association between reading aloud and grey matter density in the left supramarginal gyrus, part of the dorsal visual stream. By contrast, reading for meaning was associated with a large cluster in the left ventral visual stream, from the collateral sulcus to the anterior temporal pole. Most of the peaks were within the group lesion map, indicating that sparing of these areas results in better preservation of reading ability. However, one white matter (WM) cluster in the medial occipitotemporal lobe was outside the lesioned area. A post-hoc test demonstrated that WM density here was equivalent to controls, suggesting that this was not driven by lesion effects. The two likeliest explanations for this correlation are: 1) that pre-morbid, inter-individual differences in brain structure mitigate the effects of CA; 2) that post-morbid practice-based with reading caused compensatory plasticity. We hope to adjudicate between these explanations with longitudinal therapy data collected in this cohort.

Central alexia (CA) is an acquired reading disorder co-occurring with a generalized language deficit (aphasia). The roles of perilesional and ipsilesional tissue in recovery from poststroke aphasia are unclear. We investigated the impact of reading training (using iReadMore, a therapy app)ontheconnectionswithinandbetweentherightandlefthemisphereofthereadingnetworkofpatientswithCA.Inpatientswithpurealexia, iReadMore increased feedback from left inferior frontal gyrus (IFG) region to the left occipital (OCC) region. We aimed to identify whether iReadMore therapy was effective through a similar mechanism in patients with CA. Participants with chronic poststroke CA (n ϭ 23) completed 35 h of iReadMore training over 4 weeks. Reading accuracy for trained and untrained words was assessed before and after therapy. The neural response to reading trained and untrained words in the left and right OCC, ventral occipitotemporal, and IFG regions was examined using event-related magnetoencephalography. The training-related modulation in effective connectivity between regions was modeled at the group level with dynamic causal modeling. iReadMore training improved participants' reading accuracy by an average of 8.4% (range, Ϫ2.77 to 31.66) while accuracy for untrained words was stable. Training increased regional sensitivity in bilateral frontal and occipital regions, and strengthened feedforward connections within the left hemisphere. Our data suggest that iReadMore training in these patients modulates lower-order visual representations, as opposed to higher-order, more abstract representations, to improve word-reading accuracy.

Counterinsurgencies are conflicts where an insurgent organization conducts violence to replace or influence a recognized government. Furthering our understanding of the conditions that influence violence in different types of counterinsurgencies is important to government leaders who must deploy scarce resources efficiently. Subject matter experts (SMEs) have developed classification schemes that divide counterinsurgencies into similar groups, but no data-driven methods have ever been developed. Using the robust partitioning around medoids (PAM) algorithm, we cluster counterinsurgencies based on distances among independent variables measured on each counterinsurgency. We apply several criteria for choosing the optimal number of clusters, and then we take these groups of counterinsurgencies and build regression models for counterinsurgent deaths, an annual measure of conflict status. We evaluate these schemes using cross-validation to select the grouping whose regression models best predict counterinsurgent deaths. This approach produces a set of data-driven clusters whose predictive ability is similar to the best existing SME classification scheme, but reduces error in the assignment of a new counterinsurgency to a cluster.

Since its discovery, nearly 90 years, heparin has been used successfully for the treatment of thromboembolic processes. However, therapy with heparin has several important limitations. Most importantly, the poor predictability of its anticoagulant effects has led to the development of the low molecular weight heparins (LMWHs), which are derived from unfractionated heparin and appear to have pharmacologic advantages, require no laboratory monitoring and are more predictable than their parent compounds. LMWHs have been used for several years in the treatment of venous thromboembolic disorders. More recently, the LMWHs have been used to treat patients with acute coronary interventions. As the results of new studies are revealed, we will learn whether the use LMWH can be extended to all disorders where unfractionated heparin is currently the standard therapy.

Aunque existe un amplio desarrollo de tratamientos para la afasia para hablantes de inglés, se conoce poco de la existencia de tratamientos para la afasia específicos para personas hispanohablantes. Esta revisión panorámica tuvo como objetivo examinar la literatura que reporta tratamientos de afasia para hispanohablantes. Se realizó una revisión panorámica de los artículos publicados entre 2011 y 2021 que reportan tratamientos de afasia aplicados a hispanohablantes. La revisión incluyó una muestra final de 19 artículos que reportaron tratamientos de afasia específicos para hispanohablantes nativos o bilingües cuyo primer idioma fuera el español. La media de edad de los participantes incluidos en la muestra fue de 56.7 años. Nueve de los 19 artículos reportaron diseños de caso único y el resto estudios grupales. Así mismo, 12 estudios reportaron tratamientos individualizados, mientras que 7 estudios adaptaron tratamientos de afasia reportados previamente en otras lenguas. En promedio, la cantidad de tratamiento provista fue de 14 semanas y 26 sesiones (distribuidas 3 veces por semana) con una duración de 1.25 horas por sesión. Se resalta el esfuerzo investigativo realizado hasta la actualidad frente a tratamientos para la afasia en hispanohablantes. No obstante, se observa una cantidad extremadamente limitada de tratamientos desarrollados y adaptados para esta población en la última década. Se necesita continuar desarrollando investigaciones que sustenten tratamientos basados en la evidencia para responder a las necesidades de hispanohablantes con afasia, particularmente en Latinoamérica.