DiaNe: A New First-Level Computerized Tool Assessing Memory, Attention, and Visuospatial Processing to Detect Early Pathological Cognitive Decline.

BACKGROUND: Detecting the beginning of cognitive decay is crucial to guarantee good management and the possible prevention of dementia progression. The present study arises from observations collected during an educational event to promote mental and physical health in which incidental neuropsychological data gathered on 290 citizens showed the importance of routine neuropsychological examination in detecting early signs of cognitive decay, since many individuals were unaware of the decrease in their cognitive efficiency. Accordingly, the availability of a screening tool that is computerized, portable, self-administrable, and sensitive to the main neurocognitive changes testifying the progression towards pathological aging is critical. OBJECTIVE: To this aim, we developed a computerized battery for the early, preclinical Diagnosis of Neurocognitive disease (DiaNe), that can be self-administered and performed autonomously by using a tablet. METHODS: DiaNe includes tests expected to evaluate the main cognitive domains involved in neurodegenerative diseases (memory, attention, executive functions) with a detailed assessment of visuospatial memory in particular. RESULTS: DiaNe is not just the translation of standard tests into telematics, rather it is a new tool that provides both accuracy and response time measurements, aimed to screen cognitive profile and monitor it over time, being able to detect changes in still normal performances that may be suggestive of an ongoing onset of neurocognitive disorders. CONCLUSION: Here we present an investigation of DiaNe concurrent validity showing that its results are comparable to those obtained by existing paper-and-pencil neuropsychological tests, and propose that DiaNe could be a useful, quick, and economical instrument for the monitoring of cognitive aging.

Two Ecological Tools for Testing Slowness of Information Processing in Italian Patients with Moderate-to-Severe Traumatic Brain Injury.

Slowness of Information Processing (SIP) is frequently experienced after traumatic brain injury (TBI); however, the impact of SIP on everyday functioning may be underestimated by standard neuropsychological tests. OBJECTIVE: we aimed to adapt two ecological instruments assessing SIP in Italian patients with moderate-to-severe TBI, as formerly proposed by Winkens and colleagues for persons with stroke, testing also its possible relation with other neuropsychological processes and functional outcomes. METHOD: we performed an observational study on 37 patients with moderate-to-severe TBI and 35 demographically matched healthy controls, who underwent the Mental Slowness Observation Test (MSOT) and the Mental Slowness Questionnaire (MSQ), which had been adapted through a pilot study on independent sample of participants; extensive neuropsychological and functional evaluations were performed as well. RESULTS: We found good clinical and psychometric properties of the Italian adaptation of the MSOT and MSQ; also, performance on MSOT significantly correlated with executive functions. Moreover, patients with TBI are significantly slower and less accurate than healthy controls on the MSOT, in particular in tasks with time limits. Even if the subjective feeling of SIP does not differ between patients and controls, we found a significant correlation between MSQ and MSOT. Finally, the performances on the MSOT correlated with measures of functional outcome and community integration. CONCLUSIONS: the results support the use of the MSOT and the MSQ to measure SIP in an ecological fashion in patients with TBI, so that specific treatments for persons with acquired brain injury can be prescribed.

Body Representations in Children with Cerebral Palsy.

We constantly process top-down and bottom-up inputs concerning our own body that interact to form body representations (BR). Even if some evidence showed BR deficits in children with cerebral palsy, a systematic study that evaluates different kinds of BR in these children, taking into account the possible presence of a general deficit affecting non-body mental representations, is currently lacking. Here we aimed at investigating BR (i.e., Body Semantics, Body Structural Representation and Body Schema) in children with cerebral palsy (CP) taking into account performance in tasks involving body stimuli and performance in tasks involving non-body stimuli. Thirty-three CP (age range: 5-12 years) were compared with a group of 103 typically-developing children (TDC), matched for age and sex. 63.64% of children with CP showed a very poor performance in body representation processing. Present data also show alterations in different body representations in CP in specific developmental stages. In particular, CP and TDC performances did not differ between 5 to 7 years old, whereas CP between 8 and 12 years old showed deficits in the Body Structural Representation and Body Schema but not in Body Semantics. These findings revealed the importance of taking into account the overall development of cognitive domains when investigating specific stimuli processing in children who do not present a typical development and were discussed in terms of their clinical implications.

Cognitive functions underlying prospective memory deficits: A study on traumatic brain injury.

This study investigates prospective memory (PM) deficits as well as the interplay between performance in executive functions (EFs), speed of processing, episodic memory and PM in traumatic brain injury (TBI), differentiating between time based and event based tasks. The Memory for Intentions Screening Test was administrated to a sample of 19 participants with TBI and 50 healthy controls. Tasks probing different EFs (i.e., shifting, updating/working memory, inhibition, and access to long term memory), speed of processing, and episodic memory were also administrated to the TBI group. PM deficits were found in participants with TBI compared to controls. In the role of EFs in PM, only tasks probing updating/working memory and access to the long-term memory showed to play a specific role in PM performance in TBI. However, while updating/working memory was related to both time and event based PM, access to the long term memory was associated to performance on time based PM task only. Speed of processing and retrospective memory abilities do not seem to play a specific role in PM deficit in TBI. Our results provide a better understanding of the PM deficit in TBI, which may contribute to improve existing rehabilitation programs for individuals with TBI.

Women outperform men in remembering to remember.

The study of gender differences in prospective memory (i.e., remembering to remember) has received modest attention in the literature. The few reported studies investigating either subjective or objective evaluations of prospective memory have shown inconsistent data. In this study, we aimed to verify the presence of gender differences during the performance of an objective prospective memory test by considering the weight of specific variables such as length of delay, type of response, and type of cue. We submitted a sample of 100 healthy Italian participants (50 men and 50 women) to a test expressly developed to assess prospective memory: The Memory for Intentions Screening Test. Women performed better than men in remembering to do an event-based task (i.e., prompted by an external event) and when the task required a physical response modality. We discuss the behavioural differences that emerged by considering the possible role of sociological, biological, neuroanatomical, and methodological variables.