Neurocognitive Rehabilitation in COVID-19 Patients: A Clinical Review.

Abstract: COVID-19 has affected many people all around the world for more than two years now have suffered many long-term consequences which is commonly referred to as long-haulers. Despite multiorgan complaints in long haulers, symptoms related to cognitive functions commonly referred as brain fog are seen in the high risk covid patients with age more than 50, women more than men, obesity, asthma and those who experienced more than five symptoms during the first week of covid illness. Long term isolation has certainly contributed to high level of anxiety and stress calling for an empathetic response to this group of covid patients as there is no specific test to detect long haulers and no specific cognitive rehabilitation techniques available as of today.

Wearable Solutions for Patients with Parkinson's Disease and Neurocognitive Disorder: A Systematic Review.

Prevalence of neurocognitive diseases in adult patients demands the use of wearable devices to transform the future of mental health. Recent development in wearable technology proclaimed its use in diagnosis, rehabilitation, assessment, and monitoring. This systematic review presents the state of the art of wearables used by Parkinson's disease (PD) patients or the patients who are going through a neurocognitive disorder. This article is based on PRISMA guidelines, and the literature is searched between January 2009 to January 2020 analyzing four databases: PubMed, IEEE Xplorer, Elsevier, and ISI Web of Science. For further validity of articles, a new PEDro-inspired technique is implemented. In PEDro, five statistical indicators were set to classify relevant articles and later the citations were also considered to make strong assessment of relevant articles. This led to 46 articles that met inclusion criteria. Based on them, this systematic review examines different types of wearable devices, essential in improving early diagnose and monitoring, emphasizing their role in improving the quality of life, differentiating the various fitness and gait wearable-based exercises and their impact on the regression of disease and on the motor diagnosis tests and finally addressing the available wearable insoles and their role in rehabilitation. The research findings proved that sensor based wearable devices, and specially instrumented insoles, help not only in monitoring and diagnosis but also in tracking numerous exercises and their positive impact towards the improvement of quality of life among different Parkinson and neurocognitive patients.

Development and validation of a typology of criminal defendants admitted for inpatient competency restoration: A latent class analysis.

OBJECTIVE: To develop a typology of criminal defendants found incompetent to stand trial using data-driven classification techniques and validate it against forensically relevant outcomes. HYPOTHESES: We hypothesized that discrete groups of defendants determined to be incompetent exist that can be identified in the structure of observed clinical, demographic, and criminological data. We also expected that class membership would be differentially associated with competency restoration. METHOD: We coded hospital records for 492 consecutive male criminal defendants committed to a secure hospital for competency restoration between 2013 and 2017 (mean [M] age = 38.7 years, standard deviation [SD] = 14.2; 61.0% White, 34.2% Black, 2.6% Hispanic, 2.2% "Other"). Clinical, demographic, and criminological data were analyzed using latent class analysis. Validation analyses modeled competency restoration outcomes as a function of class membership. RESULTS: An 8-class solution best fit the data and included 3 discrete classes of patients with psychotic disorders (Class 2, n = 74; Class 3, n = 78; Class 6, n = 68), as well as classes characterized by intellectual limitations without comorbid psychosis (Class 4, n = 54), comorbid psychosis and intellectual limitations (Class 1, n = 41), mood disorders (Class 5, n = 80), older adults with neurocognitive disorders (Class 8, n = 59), and chronic instability (Class 7, n = 38). The restoration rate in the overall sample was 87.8%, and Classes 1-7 showed restoration rates similar to the overall sample, ranging from 82.9% to 100%. The restoration rate of Class 8 was 66.1%, and this was the only class to show significantly lower odds (odds ratio [OR] = 0.181, 95% confidence interval [CI: 0.093, 0.353], p < .001) and hazards (hazard ratio [HR] = 0.511, 95% CI [0.361, 0.724], p < .001) of restoration. CONCLUSION: Older adults with neurocognitive disorders admitted for competency restoration are at increased risk of failed restoration. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evidence based practice and knowledge translation: A survey of Australian occupational therapy practice with clients experiencing neurocognitive impairments.

INTRODUCTION: The clinical practice patterns and use of research evidence by Australian occupational therapists working with clients experiencing neurocognitive impairments has not been surveyed for nearly 10 years. This survey aimed to evaluate the current status of occupational therapy practice and evidence use and provide recommendations for ongoing evidence translation. METHODS: An online survey of occupational therapists working in Australia was conducted over four months targeting registered clinicians working with adults experiencing neurocognitive impairments. RESULTS: 191 occupational therapists from a wide range of clinical practice areas, with a significant level of experience completed the survey. Functional retraining (n = 180, 94%), compensatory training (n = 173, 91%) and task/environmental modifications (n = 161, 84%) were the most commonly reported intervention techniques, while more targeted interventions such as context-sensitive training (n = 54, 28%), positive behaviour supports (n = 42, 22%) and metacognitive strategy training (n = 37, 19%) were used less frequently. Half the respondents were aware of current research evidence and suggested a wide range of strategies supporting evidence translation. Traditional barriers of limited time, access and skills to interpret research were also reported. CONCLUSION: Consistent with earlier surveys most occupational therapists continue to use a functional/compensatory approach to cognitive rehabilitation, with an increasing number of therapists using specialist cognitive interventions. The current challenge for occupational therapists is embedding specialist techniques into occupation-based intervention. Knowledge translation and implementation strategies will be a critical component to achieving this.

Evaluating Immunopathogenic Biomarkers During Severe Malaria Illness as Modifiers of the Neuropsychologic Benefits of Computer Cognitive Games Rehabilitation in Ugandan Children.

BACKGROUND: We explored 3 immunopathogenic biomarkers collected during acute malaria illness as potential moderators of gains from a computerized cognitive rehabilitation training (CCRT) intervention. METHOD: Von Willebrand Factor (vWF), tumor necrosis factor (TNF) and Regulated on Activation, Normal T Expressed and Secreted (RANTES) were assayed from plasma and cerebral spinal fluid (CSF) of children during acute severe malaria anemia or cerebral malaria. Two years after acute malaria illness, 150 surviving children and 150 nonmalaria community controls (CCs) from their households 6-12 years old entered a 3-arm randomized controlled trial of titrating and nontitrating CCRT against no CCRT. Tests of cognition [Kaufman Assessment Battery for Children (KABC)], Tests of Variables of Attention and Achenbach Child Behavior Checklist (CBCL) were administered before and after 24 CCRT sessions over a 3-month period, and at 1-year follow-up. Differences in outcomes by trial arms and biomarker levels were evaluated using linear mixed effects models. RESULTS: Severe malaria survivors with lower levels of vWF, lower CSF levels of TNF and higher levels of plasma and CSF RANTES had better KABC cognitive performance after both titrating and nontitrating CCRT compared with no CCRT. For the CBCL, high plasma RANTES was associated with no benefit from either the titrating and nontitrating CCRT, whereas high TNF plasma was predictive of the benefit for both interventions. These biomarker moderating effects were not evident for CC children. CONCLUSIONS: Severe malaria immunopathogenic biomarkers may be related to poorer long-term brain/behavior function as evidenced by diminished benefit from a computerized cognitive rehabilitation intervention.

Parent perspectives on oncology team communication regarding neurocognitive impacts of cancer therapy and school reentry.

BACKGROUND: Neurocognitive deficits are common after childhood cancer and impact academic performance. Parents need to be knowledgeable of long-term complications impacting school and the resources necessary to support educational achievement. The oncology team plays an important role in preparing parents for the challenges of returning to school after treatment. METHODS: An online survey developed by parents and stakeholders was used to assess parent experiences and preferences associated with oncology team support around neurocognitive deficits and school transition. Recruitment included social media sites, foundation contacts, and clinic/event flyers. Topics included information content, timing, and frequency of information; and utility or perceived value of information. Inclusion criteria included respondent identifying as a parent (caregiver) of child treated for cancer who has returned to school. RESULTS: Surveys from 203 parents were completed representing diverse geographic locations. Nearly half (48%) did not recall receiving information about neurocognitive deficits. The most frequently reported time to receive this information was at diagnosis, but parents reported a need for conversations throughout the cancer trajectory, especially at transition to survivorship and school reentry. In addition, half of the parents (51%) felt inadequately prepared for the return to school. Information about neuropsychological testing, resources for learning difficulties, educational terms, and legal rights related to school services were the topics most inadequately provided. CONCLUSIONS: Parents feel inadequately prepared by their oncology team for their child's return to school. Research is needed to identify effective oncology team approaches to fill the gaps in knowledge around school reentry after cancer treatment.

[Evidence-based psychotherapy of addictive disorders]. / Evidenzbasierte Psychotherapie bei Abhängigkeitserkrankungen.

BACKGROUND: Addictive disorders form the group of the most common mental disorders. A wide range of psychotherapeutic treatment interventions exists; however, the proportion of patients receiving evidence-based interventions or psychotherapeutic treatment in outpatient care is very low. OBJECTIVE: The aim of the present review was a systematic reassessment of the empirical evidence for the efficacy of the different forms of psychotherapeutic treatment, identification of new effective interventions and derivation of recommendations for treatment practitioners. MATERIAL AND METHODS: A comprehensive literature search in a multistage method in the relevant national and international data banks was conducted. Subsequent analysis of topical guidelines, systematic reviews and original studies about addictions and therapy was performed. RESULTS: A total of 3 topical national guidelines, 2 reviews and 16 original studies could be identified. In particular, cognitive behavioral therapy, behavioral interventions and motivational interventions could be identified as evidence-based interventions for the treatment of addictive disorders. Hypnotherapy can be recommended alternatively for patients dependent on tobacco. Also interesting for practitioners could be new treatment methods, such as neurocognitive training and mindfulness-based interventions. CONCLUSION: At present, although of high quality, results from existing studies are sometimes inconsistent or are numerically insufficient with respect to special treatment options. Future studies are warranted with respect to different substance use disorders and further patient groups.

Effectiveness of Occupational Therapy Interventions to Enhance Occupational Performance for Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders: A Systematic Review.

OBJECTIVE: The purpose of this systematic review was to describe the evidence for the effectiveness of interventions designed to establish, modify, and maintain occupations for adults with Alzheimer's disease (AD) and related neurocognitive disorders. METHOD: Titles and abstracts of 2,597 articles were reviewed, of which 256 were retrieved for full review and 52 met inclusion criteria. U.S. Preventive Services Task Force levels of certainty and grade definitions were used to describe the strength of evidence. RESULTS: Articles were categorized into five themes: occupation-based, sleep, cognitive, physical exercise, and multicomponent interventions. Strong evidence supports the benefits of occupation-based interventions, physical exercise, and error-reduction learning. CONCLUSION: Occupational therapy practitioners should integrate daily occupations, physical exercise, and error-reduction techniques into the daily routine of adults with AD to enhance occupational performance and delay functional decline. Future research should focus on establishing consensus on types and dosage of exercise and cognitive interventions.

Supporting Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders and Their Caregivers: Effective Occupational Therapy Interventions.

Occupational therapy practitioners play a significant role in supporting adults with Alzheimer's disease and related major neurocognitive disorders, as well as their caregivers, through all phases of the disease process. This editorial highlights the systematic reviews completed in collaboration with the American Occupational Therapy Association's Evidence-Based Practice Project that summarize the evidence for the effectiveness of interventions within the scope of occupational therapy practice for this population. Readers are encouraged to translate and integrate this updated knowledge into everyday practice.

Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer's Disease and Related Major Neurocognitive Disorders: A Systematic Review.

OBJECTIVE: This systematic review evaluated the effectiveness of environment-based interventions that address behavior, perception, and falls in the home and other settings for people with Alzheimer's disease (AD) and related major neurocognitive disorders (NCDs). METHOD: Database searches were limited to outcomes studies published in English in peer-reviewed journals between January 2006 and April 2014. RESULTS: A total of 1,854 articles were initially identified, of which 42 met inclusion criteria. CONCLUSION: Strong evidence indicates that person-centered approaches can improve behavior. Moderate evidence supports noise regulation, environmental design, unobtrusive visual barriers, and environmental relocation strategies to reduce problematic behaviors. Evidence is insufficient for the effectiveness of mealtime ambient music, bright light, proprioceptive input, wander gardens, optical strategies, and sensory devices in improving behavior or reducing wandering and falls. Although evidence supports many environment-based interventions used by occupational therapy practitioners to address behavior, perception, and falls in people with AD and related major NCDs, more studies are needed.

Effectiveness of Interventions for Caregivers of People With Alzheimer's Disease and Related Major Neurocognitive Disorders: A Systematic Review.

OBJECTIVE: The goal of the evidence review was to evaluate the effectiveness of interventions for caregivers of people with Alzheimer's disease and related major neurocognitive disorders that facilitate the ability to maintain participation in the caregiver role. METHOD: Scientific literature published in English between January 2006 and April 2014 was reviewed. Databases included MEDLINE, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. RESULTS: Of 2,476 records screened, 43 studies met inclusion criteria. Strong evidence shows that multicomponent psychoeducational interventions improve caregiver quality of life (QOL), confidence, and self-efficacy and reduce burden; cognitive reframing reduces caregiver anxiety, depression, and stress; communication skills training improves caregiver skill and QOL in persons with dementia; mindfulness-based training improves caregiver mental health and reduces stress and burden; and professionally led support groups enhance caregiver QOL. CONCLUSION: Strong evidence exists for a spectrum of caregiver interventions. Translation of effective interventions into practice and evaluation of sustainability is necessary.

Las secuelas invisibles del ictus / The invisible sequelae of stroke

No disponible

Remediating HIV-Associated Neurocognitive Disorders via Cognitive Training: A Perspective on Neurocognitive Aging.

Over 50% of adults with HIV exhibit some form of HIV-associated neurocognitive disorder, ranging from mild asymptomatic neurocognitive impairment to HIV-associated dementia. As adults age with HIV and become susceptible to cardiovascular and metabolic comorbidities, the prevalence and severity of such neurocognitive disorders are likely to increase. With compromised renal and hepatic functioning often accompanying HIV, pharmaceutical interventions to address such neurocognitive disorders may not be the best strategy and are not without risks. Fortunately, as noted in the geriatric literature, cognitive training strategies have been shown to improve targeted neurocognitive domains and everyday functioning. A review of some of these cognitive training strategies, especially as they relate to aging with HIV, are highlighted and explained in the context of neuroAIDS, aging, and neurocognitive reserve. Implications for practice and research are provided.

Psicoterapias cognitivas / Cognitive therapies

AT Beck formuló la teoría congnitiva hace ya más de 50 años y, desde entonces, su aplicación terapéutica ha evolucionado paralelamente a los avances en neurociencias. La terapia cognitiva y la terapia cognitivoconductual se refieren a procedimientos terapéuticos similares y la denominación puede usarse indistintamente. Constituyen el modelo de tratamiento psicológico con mayor soporte empírico basado en la evidencia, y su eficacia y efectividad se demuestran para un amplio grupo de trastornos psiquiátricos y problemas psicológicos. Esta evidencia es especialmente relevante en su aplicación a los trastornos depresivos: es el tratamiento psicológico recomendado, e incluso de elección, por las principales guías de práctica clínica, al mismo nivel de eficacia que los fármacos antidepresivos para algunas formas de presentación clínica de la depresión. En los últimos 15 años, en busca de una mayor especificidad terapéutica, se ha desarrollado un grupo heterogéneo de tratamientos cognitivoconductuales que, basándose en similares propuestas etiológicas y comprensión del trastorno (la importancia del procesamiento cognitivo de la información para la regulación emocional), proponen incidir en el proceso del pensamiento disfuncional más que en su contenido. Se trata de las denominadas terapias de tercera generación. Más recientemente, la terapia cognitiva ha progresado estableciendo sus bases neurobiológicas, y de ello se derivan nuevas propuestas terapéuticas: terapias de remediación cognitiva centradas en mejorar la disfunción cognitiva de la depresión, con resultados muy prometedores, pero aún pendientes de validación (AU)

Cognitive theory was formulated more than 50 years ago by Beck. Since then, its therapeutic applications have evolved in parallel with advances in neuroscience. Cognitive therapy and cognitive behavioural therapy refer to similar therapeutic procedures and the terms can be used interchangeably. They constitute the most evidence-based empirical model of psychological treatment and have demonstrated their efficiency and effectiveness in a wide range of psychiatric disorders and psychological conditions. This evidence is particularly strong for their application in depressive disorders. In the main clinical practice guidelines, cognitive therapy is the recommended psychological treatment, and even the treatment of choice, for these disorders, and has the same efficiency level as antidepressants for some of the clinical presentations of depression. In the search for greater therapeutic specificity, a heterogeneous group of cognitive-behavioural treatments have been developed in the last 15 years. These new cognitive-behavioural treatments, based on similar aetiological models and understanding of the disorder (the importance of cognitive information processing to achieve emotional regulation), propose to focus on the process of dysfunctional thought rather than on its content. These treatments are known as "third-wave" cognitive-behavioural therapies. More recently, cognitive therapy has progressed by establishing its neurological basis, resulting in new therapeutic proposals: cognitive remediation therapies, which focus on improving cognitive dysfunction in depressive disorders. The results are promising but require validation (AU)

Caregivers' perception of patients' cognitive déficit in schizophrenia and its influence on their quality of life / Percepción de los cuidadores del déficit cognitivo de pacientes con esquizofrenia y su influencia en la calidad de vida

PURPOSE: The aim of the study was to explore the relationship between the caregivers' perception of patients' cognitive deficits (i.e., neurocognition and social cognition) and their quality of life (QoL), after adjusting on clinicians' assessment of neurocognitive deficits and sociodemographic confounding factors. METHODS: The study included 253 patients with schizophrenia and their caregivers from public mental health clinics in Bolivia, Chile, and Peru. The caregivers' perception of patients' neurocognitive and social cognitive deficits was assessed using the the GEOPTE scale, caregivers' QoL was assessed using the schizophrenia caregiver quality of life questionnaire (S-CGQoL) and clinicians' ratings of patients' neurocognitive deficits was based on the cognitive factor of the positive and negative syndrome scale for schizophrenia (PANSS). RESULTS: The degree of agreement between caregivers' perception and health care professionals' assessment of cognitive deficit of patients with schizophrenia was moderate. Caregivers' perceptions of neurocognitive and social cognitive deficits were significantly associated with their QoL, contrary to clinicians' assessment. CONCLUSIONS: Caregivers' perception of patients' cognitive deficit was significantly associated with their QoL. The caregivers' perception regarding patients' neurocognition and social cognition may enrich the knowledge of clinicians on patients and is important to be considered by clinicians to improve caregiver's Qo

ANTECEDENTES: el objetivo fue explorar la relación entre la percepción de los cuidadores respecto a los déficits cognitivos de los pacientes (neurocognición y cognición social) y su calidad de vida (CV), una vez ajustados los modelos con variables de confusión como la evaluación neurocognitiva médica y variables sociodemográficas. MÉTODO: incluyó a 253 pacientes con esquizofrenia y sus cuidadores de servicios de salud pública en Bolivia, Chile y Perú. La percepción de los cuidadores respecto a los déficits neurocognitivos y cognición social de los pacientes se evaluó mediante la escala GEOPTE, la CV de los cuidadores mediante el S-CGQoL y la valoración de los médicos fue evaluado con el factor cognitivo de la Escala PANSS. RESULTADOS: el grado de acuerdo entre la percepción de los cuidadores y evaluación de los profesionales respecto al déficit cognitivo de los pacientes fue moderado. La percepción de los cuidadores respecto a los déficits neurocognitivo y de cognición social presentó una asociación significativa con su CV, contrariamente a la evaluación de los médicos. CONCLUSIONES: la percepción de los cuidadores respecto a los déficits neurocognitivos y de cognición social puede enriquecer el conocimiento de los clínicos, siendo de importancia para mejorar la CV del cuidador

Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.

Plataformas de rehabilitación neuropsicológica: estado actual y líneas de trabajo / Online platforms for neuropsychological rehabilitation: current status and lines of work

Introducción: En los últimos años se ha incrementado la incidencia de las enfermedades y trastornos neurológicos y psiquiátricos y con ello la aparición de herramientas tecnológicas que facilitan a los terapeutas y familiares la rehabilitación neuropsicológica. De aquí que sea necesario establecer cuáles son algunas de estas herramientas y qué necesidades cubren. Desarrollo: El presente artículo revisa algunas de las plataformas de rehabilitación neuropsicológica más conocidas hoy día, comparándolas y proponiendo líneas futuras de trabajo para tener en cuenta en la construcción de herramientas que se adapten a necesidades reales. En esta revisión se han visto las principales ventajas y carencias de cada una de las herramientas y se han establecido unos criterios comparativos para evaluar las mismas. En la comparación de estas plataformas, podemos observar, por una parte, las ventajas que nos ofrece su uso, pero también las carencias que aún tienen. Conclusiones: Se demuestra el crecimiento de estas herramientas en el mercado, pero aún quedan muchos aspectos que cubrir de la neurorrehabilitación y estudios que muestren la eficacia del uso de las mismas

Introduction: The incidence of neurological and psychiatric diseases and disorders has increased in recent years, and similarly, the number of technological tools facilitating neuropsychological rehabilitation for family members and therapists has also grown. The purpose of this article is to describe some of these tools and indicate the needs they cover. Development: This article reviews some currently well-known neuropsychological rehabilitation platforms, compares them, and proposes future lines of work to be considered when developing tools that meet real needs. In this review, we list the main advantages and shortcomings of each of the tools and establish benchmarks for evaluating them. In comparing these platforms, we may observe their advantages on the one hand, and areas needing improvement on the other. Conclusions: This review demonstrates that more of these tools are entering the market, but many aspects of neurorehabilitation remain uncovered. Additional studies evaluating these tools’ effectiveness are also needed