The Effects of Home Automation on Personal and Social Autonomies in Spinal Cord Injury Patients: A Pilot Study.

Background: Spinal cord injury (SCI) is a severe and progressive neurological condition caused by trauma to the nervous system, resulting in lifelong disability and severe comorbidities. This condition imposes serious limitations on everyday life, interfering with patients' social lives and compromising their quality of life, psychological well-being, and daily living activities. Rehabilitation is essential to helping SCI patients gain more independence in their daily routines. Home automation (HA) systems provide personalized support to users, allowing them to manage various aspects of their living environment, promoting independence and well-being. This study aims to demonstrate the efficacy of an HA system in enhancing personal and social autonomies in SCI patients, resulting in improved cognitive function and reduced anxiety-depressive symptoms compared to traditional training. Methods: We enrolled 50 SCI patients undergoing neurorehabilitation at IRCCS Centro Neurolesi (Messina, Italy). These patients were randomly assigned to one of two groups: a control group (CG) and an experimental group (EG). The CG received traditional training, while the EG underwent HA training. We evaluated the patients before (T0) and after (T1) rehabilitation using various scales, including the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HRS-A), the 12-Item Short-Form Survey (SF-12), the Functional Independence Measure (FIM), Activities of Daily Living (ADL), Instrumental Activities of Daily Living Scale (IADL), and the EQ-5D-5L. Results: The effect of the experimental treatment showed an improvement in all patients test scores in the EG, especially regarding cognitive functions, mood disorders, activities of daily living, and quality of life. Conclusion: Our findings suggest that HA may be effective in improving daily autonomy and, in turn, alleviating mood disorders and enhancing psychological well-being.

The Lack of Ad Hoc Neuropsychological Assessment in Adults with Neurofibromatosis: A Systematic Review.

Background: Neurofibromatosis Type 1 (NF1) is a genetic autosomal dominant disorder that affects both the central and peripheral nervous systems. Children and adolescents with NF1 commonly experience neuropsychological, motor, and behavioral deficits. The cognitive profile hallmark of this disorder includes visuospatial and executive function impairments. These cognitive disorders may persist into adulthood. This study aims to analyze previous research studies that have described cognitive dysfunctions in adults with NF1. The purpose of this analysis is to review the neuropsychological and psychological assessment methods used. Methods: A total of 327 articles were identified based on the search terms in their titles and abstracts. The evaluation was conducted by scrutinizing each article's title, abstract, and text. Results: Only 16 articles were found to be eligible for inclusion based on the pre-defined criteria. The selected studies primarily focus on the development of diagnostic protocols for individuals with NF1. Conclusions: The management of NF1 disease requires a multidisciplinary approach to address symptoms, preserve neurological functions, and ensure the best possible quality of life. However, cognitive impairment can negatively affect psychological well-being. This study suggested that cognitive functions in NF1 patients were not tested using specific measures, but rather were evaluated through intelligence scales. Additionally, the findings revealed that there is no standardized neuropsychological assessment for adults with NF1. To address this gap, it would be helpful to create a specific neuropsychological battery to study cognitive function in NF1 patients during clinical studies. This battery could also serve as a tool to design models for cognitive rehabilitation by using reliable and sensitive measures of cognitive outcomes.

Sexual Functioning and Sexual Health in Female Patients following Stroke: A Scoping Review with Implications for Rehabilitation.

The impact of stroke on the sexual functioning of female survivors can arise from direct neurological effects or be triggered indirectly through various psychophysiological processes. Although an increasing number of publications exist, the topic of sexuality remains seldom discussed in the stroke literature, even though patients have expressed a need for sexual rehabilitation services. A literature review on sexual functioning in post-stroke females examining existing rehabilitation programs addressing patients' sexuality and exploring the perspectives of nurses and caregivers on sexual issues constitutes a novel approach. Therefore, we conducted a scoping review to better investigate this hot topic. Studies were identified by searching Scopus, PubMed, Web of Science, Cochrane Library, PsychINFO, and Embase databases. Current data indicates substantial connections between stroke and female sexual dysfunction (SD), including factors like desire/libido, sexual satisfaction, and sexual intercourse. Some intervention programs have been created to provide specific guidance to healthcare professionals in addressing patients' requirements for sexual recovery, although their adequacy remains uncertain. However, to date, there are neither specific rehabilitation programs for post-stroke female SD nor healthcare personnel trained to deal with post-stroke sexual issues adequately and efficiently. The incorporation of sexual rehabilitation into the overall rehabilitation process for stroke patients is crucial, ideally within an interdisciplinary framework. Despite being a fundamental aspect of post-stroke women's lives, sexuality remains taboo.

Paving the Way for Predicting the Progression of Cognitive Decline: The Potential Role of Machine Learning Algorithms in the Clinical Management of Neurodegenerative Disorders.

Alzheimer's disease (AD) is the most common form of neurodegenerative disorder. The prodromal phase of AD is mild cognitive impairment (MCI). The capacity to predict the transitional phase from MCI to AD represents a challenge for the scientific community. The adoption of artificial intelligence (AI) is useful for diagnostic, predictive analysis starting from the clinical epidemiology of neurodegenerative disorders. We propose a Machine Learning Model (MLM) where the algorithms were trained on a set of neuropsychological, neurophysiological, and clinical data to predict the diagnosis of cognitive decline in both MCI and AD patients. METHODS: We built a dataset with clinical and neuropsychological data of 4848 patients, of which 2156 had a diagnosis of AD, and 2684 of MCI, for the Machine Learning Model, and 60 patients were enrolled for the test dataset. We trained an ML algorithm using RoboMate software based on the training dataset, and then calculated its accuracy using the test dataset. RESULTS: The Receiver Operating Characteristic (ROC) analysis revealed that diagnostic accuracy was 86%, with an appropriate cutoff value of 1.5; sensitivity was 72%; and specificity reached a value of 91% for clinical data prediction with MMSE. CONCLUSION: This method may support clinicians to provide a second opinion concerning high prognostic power in the progression of cognitive impairment. The MLM used in this study is based on big data that were confirmed in enrolled patients and given a credibility about the presence of determinant risk factors also supported by a cognitive test score.

Traumatic Brain Injury and Related Antisocial Behavioral Outcomes: A Systematic Review.

Background and Objectives: Higher level of aggression and antisocial behavior have been found in the period following head trauma. These changes are attributable to specific brain alterations that generally involved frontal lobe, insula and limbic system. A descriptive review was conducted on the specificity of aggressive behavior in relation to traumatic brain injury by evaluating numerous variables, focusing on age at the time of trauma and neuroimaging studies. Materials and Methods: We searched on PubMed and the Web of Science databases to screen references of included studies and review articles for additional citations. From an initial 738 publications, only 27 met the search criteria of describing the relationship between aggression, brain alterations and traumatic brain injury. Results: These findings showed that traumatic brain injury (TBI) is related to changes in behavior, personality and mood. Conclusions: The development of aggressive and criminal behavior is associated with multiple factors, including the etiology of injury, environmental, psychosocial and personality factors and age at the time of trauma.

The Role of Telemedicine in the Treatment of Cognitive and Psychological Disorders in Parkinson's Disease: An Overview.

BACKGROUND: This literature review evaluates the use and efficacy of telemedicine in cognitive and psychological treatment in Parkinson's disease. METHODS: Studies performed between 2016 and 2021 that fulfilled inclusion criteria were selected from PubMed, Scopus, Cochrane, and Web of Science databases. All articles were evaluated by title, abstract, and text. All studies that examined the cognitive and psychological/psychotherapy treatment of patients with Parkinson's disease by telemedicine were included. RESULTS: Telehealth improved cognitive status and emotional/behavioral disorders in this population, and had positive effects on the patients' and caregivers' quality of life. CONCLUSIONS: Our literature review supports the development and efficacy of cognitive and psychological treatment with telemedicine, but the methodology of the study must be reviewed considering its limitations so as to highlight the benefits and risks of treatment via telemedicine.

The effect of Computer Assisted Rehabilitation Environment (CAREN) in cognitive impairment and coping strategies in Parkinson's disease: a preliminary study.

Parkinson's disease is a neurodegenerative disorder characterized by different motor, vegetative, behavioral, and cognitive impairments, with worsening quality of life. Virtual reality devices have given promising results in neurorehabilitation as they can provide multisensory stimulation in a realistic environment. This study aims to test the efficacy of virtual reality training by using Computer Assisted Rehabilitation Environment in cognitive impairment in a sample of PD. 31 patients affected by PD were enrolled. All PD patients underwent 24 sessions of Computer Assisted Rehabilitation Environment training. The participants were assessed at baseline (T0) and after two months (T1). Our results suggested that Computer Assisted Rehabilitation Environment training may be effective in the cognitive and emotional domains, particularly by improving executive function, anxiety, and depressive symptoms. These changes have helped to improve self-efficacy and coping strategies. These results indicate greater cognitive and physical effort to overcome stressors. Our results show that Computer Assisted Rehabilitation Environment training was beneficial in improving cognitive functions. Longer duration training may be especially beneficial for patients with mild cognitive impairment. Our findings open the door to tailored personalized treatments based on the patient's motor and cognitive profiles.

Hypnotherapy as a Nonpharmacological Treatment for the Psychological Symptoms of Multiple Sclerosis.

Context: Stress and chronic pain are the factors that most influence the quality of life and well-being of people with MS, and 90% of adults with MS suffer from persistent fatigue. These symptoms can be associated with other disorders such as depression, and drug treatments provide inadequate comfort for most people with them. Objective: The study intended to examine the impact of hypnosis and hypnotherapy in the management of symptoms of people with multiple sclerosis (MS), such as stress, chronic pain, an inferior quality of life, and a lack of psychological well-being. Design: The research team performed a systematic narrative review by searching the PubMed and Web of Science databases, including review articles and other studies for additional citations. Setting: The study was conducted at our Scientific Institute for Research (IRCCS) in Messina. Results: Only 14 of 121 publications met the inclusion criteria and were selected. Hypnotic treatment is an effective therapy that has beneficial impacts on the intensity of perceived pain, psychological well-being, mood disorders, and fatigue, and in addition, it significantly improves physical functioning in MS patients. The same effects haven't been obtained with other nonpharmacological techniques. Conclusion: Hypnosis is an appropriate psychological therapy for the management of MS patients' symptoms.

Alzheimer cafè: toward bridging the gap between cure and care in patients with dementia.

BACKGROUND: Alzheimer's disease (AD) is the most common form of degenerative dementia, whose symptoms usually appear in the pre-senile age. In the early stages, patients present social difficulties due to the general cognitive decline in memory, language and executive domains. These problems also affect patients' quality of life, emotions, and mood, leading to social isolation. OBJECTIVE: The aim of this study is to evaluate the effects of Alzheimer's Cafè (AC) on the cognitive and behavioral outcomes of AD patients. METHODS: Twenty patients diagnosed with AD, who attended the Cognitive and Behavioral Rehabilitation Laboratory of the IRCCS Centro Neurolesi 'Bonino-Pulejo' of Messina, Italy, from December 2017 to December 2018, were enrolled in this study. As these patients belonged to the experimental group (EG: n = 20), they received specific cognitive-behavior training using the AC modality. The patients were assessed by a neuropsychological evaluation at the beginning and at the end of the program. Their outcomes were compared to a matched group of patients with neurodegenerative dementia (CG: 20) receiving conventional cognitive training. RESULTS: The pre-post comparisons showed that both CG and EG had a significant improvement in global cognitive functioning (MoCA p < 0.001) and in perceived quality of life (<0.001). However, only in the EG, we observed a significant increase in social functioning (SASS p < 0.00), the perception of mental well-being (SF-12 Mental p < 0.00), and a reduction in the depressive state (GDS p < 0.00). CONCLUSIONS: The present study suggests the importance of AC for patients with AD and the potential effect on psychological and social well-being.

Feasibility, Usability, and Customer Satisfaction of the Tele-COVID19 Project, Sicilian Model.

Background and Objectives: In March 2020, COVID-19 pandemic affected the world. All countries, to limit viral transmission, imposed quarantine. This emergency exerted personal, social, economic, and psychological impact on people. For health systems, was needed to create alternative care pathways. Telemedicine can be helpful to reduce isolation, provide health care services, and monitor virus infections. Italian regions, including Sicily, have activated telemedicine services for management of patients with COVID-19. Objective: The purpose of study is to describe a Sicilian telemedicine model for management of COVID-19 patients, showing results on feasibility, usability and quality of service and patient satisfaction. Materials and Methods: This is a descriptive exploratory study on a telemedicine service for residents in Messina infected by COVID-19. It included monitoring of vital signs and specialist consultations (i.e., doctor, psychologists, social workers, and nutritionist biologists). Results: More than twenty percent (23.8%) of participants used tele-monitoring and tele-counselling services; 14.3% were only telemonitored. Participants judged positively telemedicine service (30% were quiet and 50% were very satisfied), as well as tool (70% were quiet and 10% were very satisfied). Telemonitoring had a low agreement (10% were slightly satisfied and 50% were neutral); tele-counselling had a high rate of satisfaction (40% quiet and 60% were very satisfied). Conclusions: This study showed that telemedicine model for Sicilian population affected by COVID-19 was feasible, easy to use and appreciated by patients. Our promising results allow us to assume that if in Sicily there was a return of the emergency, we would be ready to manage it This system can be the solution to remote management of these patients, to reduce isolation, provide health services, and monitor virus infections. The use of this technology should encourage future research to change the health care system and provides opportunities to ensure health and care for oneself and others.

Neuropsychological effects of COVID-19: A review.

OBJECTIVE: The purpose of this review is to examine review literature on the psychological effects of the COVID-19 pandemic. METHODS: Studies were identified by an online search of the PubMed database. We selected studies published from January to May 2020 (during the COVID-19 emergency). RESULTS: We found that psychological effects of COVID-19 remain serious among the most of the population, in particular for people with mental disorders, adolescents, healthcare workers, and the general population that experienced high levels of stress, anxiety, and depression symptoms, with possible long-term psychological implications. CONCLUSION: Findings revealed that living in urban areas, having economic stability, and living with parents were protective factors against anxiety for youth groups, whereas a risk factor was represented by the presence of COVID-19 infection that involved family members.

Care models for mental health in a population of patients affected by COVID-19.

OBJECTIVE: Emergency psychological interventions are needed in patients with COVID-19. During the pandemic, psychological counseling services have been provided using online platforms to address adverse psychological impacts and symptoms in patients and the general population. We investigated the effects of telepsychotherapy on emotional well-being and psychological distress in patients affected by COVID-19. METHODS: Forty-five Sicilian patients who had contracted COVID-19 joined "Telecovid Sicilia" from March to June 2020. Participants completed self-assessment questionnaires and psychological testing to measure levels of anxiety, presence of depressive symptoms, and altered circadian rhythm with consequent sleep disorders and psychological distress. Individual telepsychotherapy services were provided for 1 hour, twice a week, for 16 sessions in total. RESULTS: We enrolled 45 patients (42.2% women). We found significant changes between baseline and the end of follow-up in all outcome measures, especially depression (χ2 (1) = 30.1; effect size [ES] = 0.82), anxiety (χ2 (1) = 37.4; ES = 0.91), and paranoid ideation (χ2 (1) = 5.6; ES = 0.35). The proportion of participants with sleep disorders decreased to 84.1% after intervention (χ2 (1) = 58.6; ES = 1.14). CONCLUSION: A telepsychotherapeutic approach showed promising effects on psychological symptoms, with significantly reduced patient anxiety and depression.

Improving Upper Extremity Bradykinesia in Parkinson's Disease: A Randomized Clinical Trial on the Use of Gravity-Supporting Exoskeletons.

Hand movements are particularly impaired in patients with Parkinson's Disease (PD), contributing to functional disability and difficulties in activities of daily living. Growing evidence has shown that robot-assisted therapy may be considered an effective and reliable method for the delivery of the highly repetitive training that is needed to trigger neuroplasticity, as intensive, repetitive and task-oriented training could be an ideal strategy to facilitate the relearning of motor function and to minimize motor deficit. The purpose of this study is to evaluate the improvement of hand function with semi-autonomous exercises using an upper extremity exoskeleton in patients with PD. A multicenter, parallel-group, randomized clinical trial was then carried out at the IRCCS Centro Neurolesi Bonino-Pulejo (Messina, Italy). Thirty subjects with a diagnosis of PD and a Hoehn-Yahr score between 2 and 3 were enrolled in the study. Patients were 1:1 randomized into either the experimental group (ERT), receiving 45 min training daily, 6 days weekly, for 8 weeks with Armeo®Spring (Volketswil, Switzerland) (a gravity-supporting device), or the control group (CPT), which was subjected to the same amount of conventional physical therapy. Motor abilities were assessed before and after the end of the training. The main outcomes measures were the Nine-hole peg test and the motor section of the UPDRS. All patients belonging to ERT and 9 out of 15 patients belonging to the CPT completed the trial. ERT showed a greater improvement in the primary outcome measure (nine-hole peg test) than CPT. Moreover, a statistically significant improvement was found in ERT concerning upper limb mobility, and disease burden as compared to CPT. Using an upper extremity exoskeleton (i.e., the Armeo®Spring) for semi-autonomous training in an inpatient setting is a new perspective to train patients with PD to improve their dexterity, executive function and, potentially, quality of life.

Body Representation in Patients with Severe Spinal Cord Injury: A Pilot Study on the Promising Role of Powered Exoskeleton for Gait Training.

Patients with spinal cord injury (SCI) complain of changes in body representation, potentially leading to negative physical and psychological consequences. The purpose of our study is to evaluate the effects of robotic training with the Ekso-GT on body representation (BR) and on the quality of life in patients with SCI. The trial was designed as a pilot, assessor-blinded study. Forty-two inpatients with a diagnosis of SCI, classified as either American Spinal Cord Injury Association Impairment Scale (AIS), were enrolled in this study and randomized into either a control (CG: n = 21) or an experimental (EG: n = 21) group. Patients in the EG received rehabilitation training with the Ekso-GT device, whereas the CG patients were trained with conventional physical therapy (CPT), which consisted of physical and occupational therapy and psychological support. We considered as a primary outcome the modified Body Uneasiness Test (MBUT), focusing on three specific subscales on the patient's perception of BR, i.e., the Global Severity Index (MBUT-GSI), which is an indicator of body suffering; the Positive Symptom Distress Index (MBUT-PSDI) that expresses an individual's psychological distress; and the Lower Limb MBUT (MBUT-LL), which indicates the subject's perception of their thighs/legs. The Short-Form-12 Health Status Questionnaire (SF12) and the Beck's Depression Inventory (BDI) were used as secondary outcomes to evaluate the effect of the training on the quality of life and the psychological status. Non-parametric statistical analysis showed that the effect of the two treatments was significantly different on MBUT (BR), SF-12 (quality of life), and, partially, BDI (mood). Particularly, patients belonging to the EG achieved a major improvement in nearly all test scores compared to those in the CG. Our data suggest that the Ekso-GT training could be helpful in achieving positive changes in BR in patients with chronic SCI, especially in reducing psychological distress (PSDI) and thigh/leg perception (MBUT-LL) with an overall improvement in quality of life (SF-12).

Embodied cognition in neurodegenerative disorders: What do we know so far? A narrative review focusing on the mirror neuron system and clinical applications.

Embodied cognition is a theoretical perspective that considers every form of human knowledge and cognition "embodied", as they pass through bodily experience. The aim of this narrative review is to investigate the importance of mirror neurons system in EC, as well as the EC role in neurodegenerative diseases. This narrative review shows deep connections between body and mind: body states influence mental functions such as perception and reasoning, while mental states cause changes in the body, especially in neurodegenerative disorders. Indeed, abnormalities in EC were found in dementia, Parkinson's Disease and Amyotrophic Lateral sclerosis, also in the absence of other cognitive deficits, negatively affecting patients' outcomes. Exploiting EC mechanisms for rehabilitation purposes, also using innovation technologies, could be a promising therapeutic way to increase motor and cognitive outcomes in patients affected by different neurological disorders.

Cognitive rehabilitation outcomes in patients with Multiple sclerosis: Preliminary data about the potential role of personality traits.

Background Multiple Sclerosis (MS) can be associated with personality changes. Personality traits affect the cognitive functions, mood, and psychological well-being of people with MS and their families. Objective The aim of this study was to evaluate whether personality traits might be predictors of cognitive recovery in people with MS. Methods. Thirty-one patients with a diagnosis of MS were enrolled in this study. Each participant was evaluated by a neuropsychologist before (T0) and after the end of the rehabilitation treatment (T1). The Five-Factor Model (FFM) has been used to describe the basic personality structure by highlighting five personality traits: extroversion, neuroticism, conscientiousness, agreeableness, and openness. The rehabilitation program included conventional physiotherapy, speech therapy, psychological support, cognitive rehabilitation, and nutritional therapy as well as robotic rehabilitation, advanced cognitive rehabilitation, and virtual reality. Logistic regressions are carried out to measure the changes score between T0 and T1. Results The results showed that patients had significant improvement in cognitive and behavioral functioning. Here, we considered the relationships between the scores of cognitive and emotional/behavioral domains, the five scales of the BFQ, besides the psychiatric symptoms. In particular, the mental quality of life, visuospatial and verbal long-term memory were positively influenced by the agreeableness trait, while depression was negatively affected by this trait. Conclusion Our data suggest that personality traits could influence cognitive and behavioral recovery in patients with MS.

Case report of anosognosia for hemiplegia: A fMRI study.

OBJECTIVE: The aim of this study is to verify the functional activation in a patient with anosognosia for hemiplegia following left brain lesions. METHODS: We report a case of a 53-year-old right-handed female patient. She came to our rehabilitative unit with a diagnosis of an ischemic major stroke in the left internal carotid artery and important hemiplegia to the right side. She underwent functional magnetic resonance imaging (fMRI), during which she performed a motor imagery task. RESULTS: The fMRI assessment showed an ischemic lesion in the frontotemporal and insular left areas. In the fMRI experiment, we revealed activation of the residual neural patterns of both hemispheres. CONCLUSION: We underlined an interest in the compensation mechanism that involved neural networks near brain lesions and some areas of the contro-lesional hemisphere, suggesting that the synaptic plasticity permitted an intra and inter-hemispheric reorganization of the cerebral system.

Effects of domotics on cognitive, social and personal functioning in patients with Parkinson's disease: A pilot study.

Home automation (HA) is either a "smart" house or a supportive environment, which enables the patients to regain an active role in daily life. HA could allow people affected by Parkinson Disease (PD) to better manage their daily lives. This study aims to evaluate the effects of domotics on quality of life, and personal/social autonomy in PD patients. We enrolled 40 with PD undergoing neurorehabilitation, who were randomized into either the control (CG) or the experimental group (EG). Two different rehabilitative approaches were used: the CG was submitted to a traditional training, whilst the EG underwent HA training, in which the activities were carried out through the use of assistive technologies. In both the training, the exercises were performed in small samples of 3-5 patients. Results showed that both CG and EG had a significant improvement in global cognitive functioning, executive functions, and instrumental autonomy. However, only in the EG, we observed a significant increase in social adaptation, activities of daily living and quality of life. This pilot study suggests that HA training could be a useful tool for the rehabilitation of patients with PD, improving social and cognitive functioning, personal autonomy and quality of life.

Does embodied cognition allow a better management of neurological diseases? A review on the link between cognitive language processing and motor function.

Embodied cognition (EC) refers to the interplay occurring in thinking among individual's sensorimotor capacities (i.e., the ability of the body to respond to its senses with movement), the body itself, and the environment. The aim of the present narrative review is to provide an overall understanding of whether and how motor training could lead to language recovery, consistently with EC theories (action-perception cycle, mirror neuron systems -MNS-, and embodied semantics). We therefore reviewed the works dealing with EC in terms of the link between language processing, mirror neuron system (MNS), and motor function, evaluating the potential clinical implications for better managing neurological deficits. Connections between body and mind were found, as body states influence cognitive functions, such as perception and reasoning, as well as language processing, especially in neurological disorders. In fact, abnormalities in "embodied language" were found in movement disorders and neurodegenerative diseases, negatively affecting patients' rehabilitation outcomes. Understanding the link between language processing and motor outcomes is fundamental in the rehabilitation field, given that EC can be targeted to improve patients' functional recovery and quality of life.

Rehabilitation of somatoparaphrenia with misoplegia: insights from a single case-pilot study.

Somatoparaphrenia lacka ownership of a paralyzed limb, i.e., the illusion that one's limbs belong to someone else. Somatoparaphrenia is one of the many forms of body misperceptions. We report a case of somatoparaphrenia with misoplegia, characterized by the absence of anosognosia for hemiplegia and personal neglect, following a surgical operation for left parietal meningioma. The patient received a novel multidisciplinary treatment, including motor rehabilitation training, traditional physiotherapy and robotic rehabilitation using the Hunova Movendo Technology and psychological counseling. At the end of the training, the patient improved in global cognitive functioning, mood, motor abilities, and the perception of herself and her body, reducing the sense of estrangement and repulsion in the lower right limb. Our result showed the importance of a specific neuropsychological assessment in patients with parietal brain lesions and the usefulness of an integrated psychological and motor approach in rehabilitating patients with somatoparaphrenia, primarily when associated with misoplegia.