Cognitive profile in a young woman with Susac syndrome: a case report.

Susac syndrome is a rare immune-mediated endotheliopathy affecting the microvasculature. It presents three main symptoms: encephalopathy, branch retinal artery occlusions, and hearing loss . Here we present a new case report focusing on the evolution of the cognitive profile. The patient underwent two neuropsychological examinations. The first, one month after the onset of the symptomatology, highlighted a prevalent involvement of verbal executive functions. The second, conducted six months later, revealed a global improvement in most previously deficient areas, although with the persistence of a difficulty in cognitive estimation. . This case illustrates the importance of a comprehensive analysis of patients with Susac syndrome to appreciate the whole range of cognitive deficits and reliably evaluate symptom evolution.

Advances in Neuropsychology: Top Papers Published in Brain Sciences in 2022-2023.

The spectrum of typical neuropsychology topics has gradually broadened in recent years thanks to advances in neuroimaging and electrophysiological techniques [...].

Modulation of Corticospinal Excitability during Action Observation in Patients with Disorders of Consciousness.

Brain imaging studies have recently provided some evidence in favor of covert cognitive processes that are ongoing in patients with disorders of consciousness (DoC) (e.g., a minimally conscious state and vegetative state/unresponsive wakefulness syndrome) when engaged in passive sensory stimulation or active tasks such as motor imagery. In this exploratory study, we used transcranial magnetic stimulation (TMS) of the motor cortex to assess modulations of corticospinal excitability induced by action observation in eleven patients with DoC. Action observation is known to facilitate corticospinal excitability in healthy subjects, unveiling how the observer's motor system maps others' actions onto her/his motor repertoire. Additional stimuli were non-biological motion and acoustic startle stimuli, considering that sudden and loud acoustic stimulation is known to lower corticospinal excitability in healthy subjects. The results indicate that some form of motor resonance is spared in a subset of patients with DoC, with some significant difference between biological and non-biological motion stimuli. However, there was no covariation between corticospinal excitability and the type of DoC diagnosis (i.e., whether diagnosed with VS/UWS or MCS). Similarly, no covariation was detected with clinical changes between admission and discharge in clinical outcome measures. Both motor resonance and the difference between the resonance with biological/non-biological motion discrimination correlated with the amplitude of the N20 somatosensory evoked potentials, following the stimulation of the median nerve at the wrist (i.e., the temporal marker signaling the activation of the contralateral primary somatosensory cortex). Moreover, the startle-evoking stimulus produced an anomalous increase in corticospinal excitability, suggesting a functional dissociation between cortical and subcortical circuits in patients with DoC. Further work is needed to better comprehend the conditions in which corticospinal facilitation occurs and whether and how they may relate to individual clinical parameters.

Psychological Distress in Patients Who Needed Invasive versus Non-Invasive Ventilation Following SARS-CoV-2 Viral Infection.

The COVID-19 pandemic has affected the mental health of those who survived the illness but underwent long treatment and hospitalization. Much research has highlighted signs of emotional distress in those who experienced intensive care, and the procedures implemented to fight the infection. The present study investigated the effects of the illness experience in 40 subjects admitted to a rehabilitation unit after discharge from intensive care by focusing on the possibility of differences in emotional well-being depending on the type of ventilation. The results of the administration of psychological scales for anxiety, depression, and post-traumatic stress disorder showed that many subjects experienced some form of emotional distress. There were no differences between patients who underwent invasive ventilation and those who did not.

The metrics of reading speed: understanding developmental dyslexia.

We compared reading words and pseudo-words presented in single displays (as typical of psycholinguistic research) with stimuli presented in multiple displays (as typical of real-life conditions and clinical testing) under controlled conditions. Italian sixth-grade children with and without a reading deficit showed an advantage in reading times for multiple over single displays. This finding was partly ascribed to the capacity to overlap the non-decisional component of the response, an effect present in control readers as well as children with dyslexia. Furthermore, there were several indications in the data that the requirement to read sequentially taxes performance by augmenting the relative impact of the experimental manipulations used. This effect was present in both groups of children, but proportionally stronger in children with dyslexia. The study contributes to filling the gap between single and multiple displays, a condition more like real-life situations.

Neuropsychological Evaluation and Quantitative EEG in Patients with Frontotemporal Dementia, Alzheimer's Disease, and Mild Cognitive Impairment.

This study analyzed the efficacy of EEG resting state and neuropsychological performances in discriminating patients with different forms of dementia, or mild cognitive impairment (MCI), compared with control subjects. Forty-four patients with dementia (nineteen patients with AD, and seven with FTD), eighteen with MCI, and nineteen healthy subjects, matched for age and gender, underwent an extensive neuropsychological test battery and an EEG resting state recording. Results showed greater theta activation in posterior areas in the Alzheimer's disease (AD) and Fronto-Temporal Dementia (FTD) groups compared with the MCI and control groups. AD patients also showed more delta band activity in the temporal-occipital areas than controls and MCI patients. By contrast, the alpha and beta bands did not discriminate among groups. A hierarchical clustering analysis based on neuropsychological and EEG data yielded a three-factor solution. The clusters differed for several neuropsychological measures, as well as for beta and theta bands. Neuropsychological tests were most sensitive in capturing an initial cognitive decline, while increased theta activity was uniquely associated with a substantial worsening of the clinical picture, representing a negative prognostic factor. In line with the Research Domains Framework (RDoC) perspective, the joint use of cognitive and neurophysiological data may provide converging evidence to document the evolution of cognitive skills in at-risk individuals.

Decision times in orthographic processing: a cross-linguistic study.

Reading comparisons across transparent and opaque orthographies indicate critical differences that may reveal the mechanisms involved in orthographic decoding across orthographies. Here, we address the role of criterion and speed of processing in accounting for performance differences across languages. We used binary tasks involving orthographic (words-pseudowords), and non-orthographic materials (female-male faces), and analyzed results based on Ratcliff's Diffusion model. In the first study, 29 English and 28 Italian university students were given a lexical decision test. English observers made more errors than Italian observers while showing generally similar reaction times. In terms of the diffusion model, the two groups differed in the decision criterion: English observers used a lower criterion. There was no overall cross-linguistic difference in processing speed, but English observers showed lower values for words (and a smaller lexicality effect) than Italians. In the second study, participants were given a face gender judgment test. Female faces were identified slower than the male ones with no language group differences. In terms of the diffusion model, there was no difference between groups in drift rate and boundary separation. Overall, the new main finding concerns a difference in decision criterion limited to the orthographic task: English individuals showed a more lenient criterion in judging the lexicality of the items, a tendency that may explain why, despite lower accuracy, they were not slower. It is concluded that binary tasks (and the Diffusion model) can reveal cross-linguistic differences in orthographic processing which would otherwise be difficult to detect in standard single-word reading tasks.

Principal Component Analysis of Oxford Cognitive Screen in Patients With Stroke.

Cognitive deficits occur in most patients with stroke and are the important predictors of adverse long-term outcome. Early identification is fundamental to plan the most appropriate care, including rehabilitation and discharge decisions. The Oxford Cognitive Screen (OCS) is a simple, valid, and reliable tool for the assessment of cognitive deficits in patients with stroke. It contains 10 subtests, providing 14 scores referring to 5 theoretically derived cognitive domains: attention, language, number, praxis, and memory. However, an empirical verification of the domain composition of the OCS subtests in stroke data is still lacking in the literature. A principal component analysis (PCA) was performed on 1,973 patients with stroke who were enrolled in OCS studies in the UK and in Italy. A number of six main components were identified relating to the domains of language and arithmetic, memory, visuomotor ability, orientation, spatial exploration, and executive functions. Bootstrapped split-half reliability analysis on patients and comparison between patients and 498 healthy participants, as that between patients with left and right hemisphere damage, confirmed the results obtained by the principal component analysis. A clarification about the contribution of each score to the theoretical original domains and to the components identified by the PCA is provided with the aim to foster the usability of OCS for both clinicians and researchers.

Success Is Not the Entire Story for a Scientific Theory: The Case of the Phonological Deficit Theory of Dyslexia.

In a recent paper, Share discussed four different "Common Misconceptions about the Phonological Deficit Theory of Dyslexia" and described this theory as "a model of true scientific progress" and a clear "success story". In this note, I argue that at least part of the success of this theory is due to the lack of explicit predictions which make it very difficult (if possible) to test its predictions, and, possibly, falsify the theory. Some areas of pertinent research, including categorical phoneme perception, picture naming, and phonological awareness are summarized. Furthermore, two lines of research in which groups of researchers have attempted to formulate more explicit predictions are briefly outlined. It is concluded that, although much research has variously referred to the phonological deficit theory of dyslexia, the resulting large body of evidence presents a complex pattern of results which, in the absence of an explicit formulation of the theory, is extremely difficult to frame within a unitary interpretation. Overall, what seems needed is a theoretical formulation that, on the one hand, can account for the complex pattern of available evidence and, on the other hand, provide testable predictions for future research.

Domain-General Cognitive Skills in Children with Mathematical Difficulties and Dyscalculia: A Systematic Review of the Literature.

Mathematical performance implies a series of numerical and mathematical skills (both innate and derived from formal training) as well as certain general cognitive abilities that, if inadequate, can have a cascading effect on mathematics learning. These latter skills were the focus of the present systematic review. METHOD: The reviewing process was conducted according to the PRISMA statement. We included 46 studies comparing school-aged children's performance with and without math difficulties in the following cognitive domains: processing speed, phonological awareness, short- and long-term memory, executive functions, and attention. RESULTS: The results showed that some general cognitive domains were compromised in children with mathematical difficulties (i.e., executive functions, attention, and processing speed). CONCLUSIONS: These cognitive functions should be evaluated during the diagnostic process in order to better understand the child's profile and propose individually tailored interventions. However, further studies should investigate the role of skills that have been poorly investigated to date (e.g., long-term memory and phonological awareness).

Figure Disembedding: The Gottschaldt's Hidden Figure Test in Children with Typical Development and Autism.

In two studies, we used the Gottschaldt's Hidden Figure Test (GHFT) for assessing figure disembedding ability in children aged 7-11. Study 1 demonstrated in a large sample of typically developing children that GHFT accuracy and time scores differed across age groups, without sex and socioeconomic differences. Thus, we provided normative data only taking into account children's age. In Study 2, GHFT normative values were used to assess children with autism, who were also compared with a closely age-matched group of typical controls. Children with autism achieved time scores at or above the 50th centile and significantly differed from the controls for time score. The GHFT seems a valuable tool for defining the cognitive profile of children with autism.

Motor imagery and gait control in Parkinson's disease: techniques and new perspectives in neurorehabilitation.

INTRODUCTION: Motor imagery (MI), defined as the ability to mentally represent an action without actual movement, has been used to improve motor function in athletes and, more recently, in neurological disorders such as Parkinson's disease (PD). Several studies have investigated the neural correlates of motor imagery, which change also depending on the action imagined. AREAS COVERED: This review focuses on locomotion, which is a crucial activity in everyday life and is often impaired by neurological conditions. After a general discussion on the neural correlates of motor imagery and locomotion, we review the evidence highlighting the abnormalities in gait control and gait imagery in PD patients. Next, new perspectives and techniques for PD patients' rehabilitation are discussed, namely Brain Computer Interfaces (BCIs), neurofeedback, and virtual reality (VR). EXPERT OPINION: Despite the few studies, the literature review supports the potential beneficial effects of motor imagery interventions in PD focused on locomotion. The development of new technologies could empower the administration of training based on motor imagery locomotor tasks, and their application could lead to new rehabilitation protocols aimed at improving walking ability in patients with PD.

Spelling deficits in children with intellectual disabilities: Evidence from a regular orthography.

Introduction: In individuals with intellectual disabilities (ID), efficient reading and writing skills promote social integration, self-autonomy, and independence. However, research has mainly focused on reading skills, while evidence on spelling skills is scarce and mostly on English-speaking subjects. In the present research project, we compared the spelling skills of children with intellectual disabilities (ID) learning in Italian, a regular orthography, to those of typically developing children matched for school level. Methods: In the first study, the performance on a Passage Dictation Test of forty-four children with ID attending regular classrooms from 4th to 8th grades (mean age = 12.16 years; SD = 1.57) were compared with controls matched for sex and grade. In the second study, a Words and Nonwords Dictation Test was administered (with stimuli varying for lexicality, orthographic complexity, regularity of transcription, and the presence of different types of phonetic-phonological difficulties) to twenty-two children with ID attending regular classrooms from 4th to 8th grades (mean age = 12.2 years; SD = 1.37) and 22 controls matched for sex and grade. In both studies, an error analysis was performed to characterize types of misspellings. Separate ANOVAs were performed on z scores. Results: Children with ID generally had a lower performance than controls. In the Passage Dictation Test, they showed a higher number of phonological (and phonetic-phonological) errors than phonologically plausible ones, indicating, as a group, predominant phonological difficulties as compared to lexical-orthographic ones. In the Words and Nonwords Dictation Test, they performed poorly on regular stimuli presenting specific types of phonetic-to-phonological difficulties (geminates, non-continuant consonants) and committed more minimal distance, context-sensitive and simple conversion misspellings. However, deficits in the orthographic-lexical procedure, as indicated by a low performance in words with unpredictable spelling, were present in a high percentage of children. Discussion: It is concluded that children with ID have significant spelling difficulties not confined to the orthographic process but also in phoneme-to-grapheme mapping that, in a regular orthography like Italian, should be acquired early and easily.

Interpreting Developmental Surface Dyslexia within a Comorbidity Perspective.

Recent evidence underlines the importance of seeing learning disorders in terms of their partial association (comorbidity). The present concept paper presents a model of reading that aims to account for performance on a naturalistic reading task within a comorbidity perspective. The model capitalizes on the distinction between three independent levels of analysis: competence, performance, and acquisition: Competence denotes the ability to master orthographic-phonological binding skills; performance refers to the ability to read following specific task requirements, such as scanning the text from left to right. Both competence and performance are acquired through practice. Practice is also essential for the consolidation of item-specific memory traces (or instances), a process which favors automatic processing. It is proposed that this perspective might help in understanding surface dyslexia, a reading profile that has provoked a prolonged debate among advocates of traditional models of reading. The proposed reading model proposes that surface dyslexia is due to a defective ability to consolidate specific traces or instances. In this vein, it is a "real" deficit, in the sense that it is not due to an artifact (such as limited exposure to print); however, as it is a cross-domain defect extending to other learning behaviors, such as spelling and math, it does not represent a difficulty specific to reading. Recent evidence providing initial support for this hypothesis is provided. Overall, it is proposed that viewing reading in a comorbidity perspective might help better understand surface dyslexia and might encourage research on the association between surface dyslexia and other learning disorders.

Ability to Consolidate Instances as a Proxy for the Association Among Reading, Spelling, and Math Learning Skill.

Learning skills (as well as disorders) tend to be associated; however, cognitive models typically focus either on reading, spelling or maths providing no clear basis for interpreting this phenomenon. A recent new model of learning cognitive skills proposes that the association among learning skills (and potentially the comorbidity of learning disorders) depends in part from the individual ability to consolidate instances (taken as a measure of rate of learning). We examined the performance of typically developing fifth graders over the acquisition of a novel paper-and-pencil task that could be solved based on an algorithm or, with practice, with reference to specific instances. Our aim was to establish a measure of individual rate of learning using parameters envisaged by the instance theory of automatization by Logan and correlate it to tasks requiring knowledge of individual items (e.g., spelling words with an ambiguous transcription) or tasks requiring the application of a rule or an algorithm (e.g., spelling non-words). The paper-and-pencil procedure yielded acquisition curves consistent with the predictions of the instance theory of automatization (i.e., they followed a power function fit) both at a group and an individual level. Performance in tasks requiring knowledge of individual items (such as doing tables or the retrieval of lexical representations) but not in tasks requiring the application of rules or algorithms (such as judging numerosity or spelling through sublexical mapping) was significantly predicted by the learning parameters of the individual power fits. The results support the hypothesis that an individual dimension of "ability to consolidate instances" contributes to learning skills such as reading, spelling, and maths, providing an interesting heuristic for understanding the comorbidity across learning disorders.

The Simple View of Reading in Children Acquiring a Regular Orthography (Italian): A Network Analysis Approach.

In the present study, we explored the unique contribution of reading accuracy, reading fluency and linguistic comprehension within the frame of Simple View of Reading (SVR). The experimental sample included 118 3rd to 5th grade children learning Italian, a language with a highly regular orthography. We adopted a flexible method of analysis, i.e., the Network Analysis (NA), particularly suited for exploring relations among different domains and where the direct relations between a set of intercorrelated variables is the main interest. Results indicated an independent and unique contribution of syntactic comprehension skills as well as reading fluency and reading accuracy in the comprehension of a written text. The decoding measures were not directly associated with non-verbal reasoning and the latter was not directly associated with reading comprehension but was strongly related to oral syntactic comprehension. Overall, the pattern of findings is broadly consistent with the predictions of SVR and underscores how, in an orthographically regular language, reading fluency and reading accuracy as well as oral comprehension skills directly influence reading comprehension. Data are discussed in a cross-linguistic perspective. Implications for education and rehabilitation are also presented.

A Network Analysis of the Relationship among Reading, Spelling and Maths Skills.

Background. Skill learning (e.g., reading, spelling and maths) has been predominantly treated separately in the neuropsychological literature. However, skills (as well as their corresponding deficits), tend to partially overlap. We recently proposed a multi-level model of learning skills (based on the distinction among competence, performance, and acquisition) as a framework to provide a unitary account of these learning skills. In the present study, we examined the performance of an unselected group of third- to fifth-grade children on standard reading, spelling, and maths tasks, and tested the relationships among these skills with a network analysis, i.e., a method particularly suited to analysing relations among different domains. Methods. We administered a battery of reading, spelling, and maths tests to 185 third-, fourth-, and fifth-grade children (103 M, 82 F). Results. The network analysis indicated that the different measures of the same ability (i.e., reading, spelling, and maths) formed separate clusters, in keeping with the idea that they are based on different competences. However, these clusters were also related to each other, so that three nodes were more central in connecting them. In keeping with the multi-level model of learning skills, two of these tests (arithmetic facts subtest and spelling words with ambiguous transcription) relied heavily on the ability to recall specific instances, a factor hypothesised to underlie the co-variation among learning skills. Conclusions. The network analysis indicated both elements of association and of partial independence among learning skills. Interestingly, the study was based on standard clinical instruments, indicating that the multi-level model of learning skills might provide a framework for the clinical analysis of these learning skills.

Differentiation among bio- and augmented- feedback in technologically assisted rehabilitation.

Introduction: In rehabilitation practice, the term 'feedback' is often improperly used, with augmented feedback and biofeedback frequently confused, especially when referring to the human-machine interaction during technologically assisted training. The absence of a clear differentiation between these categories represents an unmet need for rehabilitation, emphasized by the advent of new technologies making extensive use of video feedback, exergame, and virtual reality.Area covered: In this review we tried to present scientific knowledge about feedback, biofeedback, augmented feedback and neurofeedback, and related differences in rehabilitation settings, for a more proper use of this terminology. Despite the continuous expansion of the field, few researches clarify the differences among these terms. This scoping review was conducted through the searching of current literature up to May 2020, using following databases: PUBMED, EMBASE and Web of Science. After literature search a classification system, distinguishing feedback, augmented feedback, and biofeedback, was applied.Expert opinion: There is a need for clear definitions of feedback, biofeedback, augmented feedback, and neurofeedback in rehabilitation, especially in the technologically assisted one based on human-machine interaction. In fact, the fast development of new technologies requires to be based on solid concepts and on a common terminology shared among bioengineers and clinicians.