Flu-like syndrome due to interferon-beta injections does not increase anxiety, depression, and lost working days in multiple sclerosis patients during the Sars-CoV-2 pandemic.

BACKGROUND AND PURPOSE: Aim of this study was to evaluated anxiety, depression, and possible negative implications on work activities during the Sars-CoV-2 pandemic, in a group of Multiple Sclerosis (MS) patients at risk of flu-like syndrome (FLS) compared with FLS- free treatments. METHODS: The present study included patients treated with interferon-ß (IFNß), glatiramer, and natalizumab for at least one year. Collected data included the diagnosis of COVID-19 infection, Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), together with questions about FLS, change in work habits, use of antipyretics, anxiety, and depression. RESULTS: 100 patients were included in the study. Six patients in IFNß and 5 in the natalizumab group had a confirmed COVID-19 infection. 68% in the IFNß patients reported FLS and only one reported an increase in flu-like frequency during the pandemic; 14% reported lower compliance with treatment, and 40% reported uptake of antipyretics several times. Only one IFNß patient reported having lost more working days than the previous year. The average BAI (p = 0.039) was higher in natalizumab group. Correcting these data by age, sex and EDSS to a multivariate analysis we did not find any statistically significant difference in terms of BAI and BDI-II between the three treatment groups. CONCLUSIONS: FLS were not perceived as COVID19-like symptoms but as expected by traditional pharmacological treatments indeed. These data suggest that IFNß can be used safely.

Normative data for COGITAB: An Italian tablet-based test battery conceived for the preclinical phase of Alzheimer's disease.

The number of people with dementia is increasing worldwide. Two main approaches have been adopted to identify subjects with Alzheimer's disease (AD): the neuropsychological evaluation and the identification of biomarkers of AD. The first method is less invasive and easier to perform. This study assesses the psychometric properties of COGITAB, a novel web application d esigned to be sensitive to the subtle cognitive changes distinctive of the early Mild Cognitive Impairment (MCI) and the preclinical phase of AD. We enrolled 518 healthy controls, classified according to several risk factors and the presence of a family history of dementia. The participants were given COGITAB after a neuropsychological screening. The COGITAB Total Score (TS) was significantly affected by age and years of education. Acquired risk factors and family history of dementia significantly impacted only the COGITAB total execution time (TET), not the TS. This study provides normative data for a newly developed web application. Control subjects with acquired risk factors performed slower, giving an important role to the TET recording. Further studies should examine the ability of this new technology to discriminate between healthy subjects and subjects with initial cognitive decline, even when not detected by standard neuropsychological assessments.

[Formula: see text] Post-stroke acquired childhood aphasia. A scoping review.

Aphasia has a great impact on children's lives, with stroke being its most common and studied etiology. However, our knowledge about this disorder is limited, the studies on this topic are sparse, and a consensus regarding its definition is lacking. In particular, the interpretation of this condition varied over time: from the rigid description of the so-called "standard doctrine" to the adoption of adult models for post-stroke aphasia. Therefore, this review provides a critical overview of childhood aphasia after stroke, focusing on its epidemiology, definition, diagnosis, and clinical manifestation. The scoping review approach was adopted, following PRISMA-ScR guidelines. PubMed, Web of Science, and PsycInfo databases were searched for related peer-review papers in English. Forty-six records were identified; the majority were single cases and case series, only a few were reviews and observational studies. Epidemiologic data are scarce; a few studies report that aphasia affects about one-third of children post-stroke. Despite terminological differences, there is an overall agreement on the definition of post-stroke aphasia in children as a language disorder acquired after the age of two. Approaches for the diagnosis and evaluation vary widely, including both assessments for developmental language disorders and tests for aphasia in adults. The clinical manifestations described in children are numerous and varied, similar to those found in adults, in contrast with the "standard doctrine." This review highlights the need for further studies to improve the knowledge of this condition, develop validated and specific assessment tools, and standardize clinical management.

Monitoring cognitive and psychological alterations in COVID-19 patients: A longitudinal neuropsychological study.

BACKGROUND: SARS-COV-2 infection has been associated to long-lasting neuropsychiatric sequelae, including cognitive deficits, that persist after one year. However, longitudinal monitoring has been scarcely performed. Here, in a sample of COVID-19 patients, we monitor cognitive, psychological and quality of life-related profiles up to 22 months from resolution of respiratory disease. METHODS: Out of 657 COVID-19 patients screened at Manzoni Hospital (Lecco, Italy), 22 underwent neuropsychological testing because of subjective cognitive disturbances at 6 months, 16 months, and 22 months. Tests of memory, attention, and executive functions were administered, along with questionnaires for depressive and Post-traumatic stress disorder (PTSD) symptoms, psychological well-being and quality of life. Cross-sectional descriptives, correlational, as well as longitudinal analyses considering COVID19-severity were carried out. A preliminary comparison with a sample of obstructive sleep apneas patients was also performed. RESULTS: Around 50% of COVID-19 patients presented with cognitive deficits at t0. The most affected domain was verbal memory. Pathological scores diminished over time, but a high rate of borderline scores was still observable. Longitudinal analyses highlighted improvements in verbal and non-verbal long term memory, as well as attention, and executive functioning. Depression and PTSD-related symptoms were present in 30% of patients. The latter decreased over time and were associated to attentional-executive performance. CONCLUSIONS: Cognitive dysfunctions in COVID-19 patients may extend over 1 year, yet showing a significant recovery in several cases. Cognitive alterations are accompanied by a significant psychological distress. Many patients displaying borderline scores, especially those at higher risk of dementia, deserve clinical monitoring.

'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs).

BACKGROUND: Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). OBJECTIVE: To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. METHODS: BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. RESULTS: The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. CONCLUSIONS: After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.

The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics.

Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods.Methods: Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA).Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062).Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.

Prospective memories and working memory: shared resources or distinct mechanisms?

Prospective memory (PM) is a complex process involving multiple cognitive abilities. Several studies demonstrated the role of working memory (WM) in PM. However, to date, the extent to which PM and WM shared resources or, rather, they are distinct mechanisms is still debated. With the aim to investigate the role of WM in PM, we developed two experiments manipulating the WM load required by ongoing tasks to examine a patient with PM difficulties and dysexecutive syndrome following brain damage. Experiment 1 required a simple arithmetic activity together with a PM switching-task to be performed at a given time (time-based condition) or following cue presentation (event-based condition). In Experiment 2, we varied the complexity of the ongoing task (PASAT test). Patient MB's performance in PM tasks significantly differs from the controls only in the PASAT time-based condition. We demonstrated a partial independence between WM and PM in tasks involving automatic retrieval.

Prospective memory and working memory in comparison. New experimental paradigms.

Aim of the study: Prospective memory (PM) is a cognitive high load activity. Two main models showed the relation between working memory (WM) and PM. The preparatory attentional and memory processes model (PAM) posits an interdependence between WM and PM; while, the multiprocess framework assumes independence between these two functions.Materials and methods: With the aim to investigate this relation, two tasks were administered to a sample of 21 healthy participants. The first task (arithmetic) required low cognitive and WM load together with a prospective task, the second (PASAT) required high cognitive and WM load together with a prospective switching task. The prospective task included two modalities of administration: based on a sound cue (event-based) or at a given moment (time-based).Results: PM accuracy was influenced by WM only when paired to complex tasks that require high cognitive load on WM and active PM self-retrieval processes (time-PASAT).Conclusions: These results support partial independence between these two mechanisms.

The Vocal Score Profile in Verdi's Characters.

OBJECTIVES: Selecting the appropriate repertoire for an opera singer may be crucial for both the prevention of voice disorders and the career progression. Here, we reviewed the score of 14 Verdi's operas to gain the data for the creation of the vocal score profile of each role. MATERIALS AND METHODS: Seven musicians were involved in the analysis process. Notes were counted and reported as absolute and relative frequency. Pitch measurements included pitch range, percentage of high-pitched notes, percentage of medium-pitched notes, percentage of low-pitched notes, high-pitched and low-pitched notes rate, percentage of the notes in the passaggio, identification of the prevalent octave, percentage of notes in the prevalent octave, and percentage of notes in a moderate range tessitura. The total phonation time was calculated for each character. RESULTS: A heterogeneity among pitch and duration measurement was found among roles within the same voice type, leading to highly different vocal efforts required by the performer. CONCLUSIONS: Data on 67 Verdi characters were gained, and the vocal demand of each role was discussed. Potentially, these results may support singers, singing teachers, and vocal coaches in the selection of the repertoire. The data may also assist clinicians in the conduction of counseling and during eventual voice therapy. Future studies must investigate the predictive value of the vocal score profile in appraising the risk of vocal injury.

Atypical holistic processing of facial identity and expression in a case of acquired prosopagnosia.

Typical face perception is mediated by holistic processing (i.e., the simultaneous integration of face parts into a whole representation). People with Acquired Prosopagnosia (AP), who have lost the ability to recognise faces after a brain lesion, should thus show atypical holistic coding. Our aim is to use the composite-face effect (CFE) as a measure of holistic processing in ST, a 48-year-old woman with AP but normal recognition of facial expressions of emotions, and matched healthy control participants. Two experiments examining the CFE for identity (Experiment 1) and for expression of emotions (Experiment 2) were conducted. Contrary to controls, in both experiments, ST showed an atypical (i.e., reversed) CFE, thus suggesting altered holistic mechanisms affecting both components of perceptual judgement. Results also suggest that normal facial expression recognition is achievable even with holistic processing difficulties, possibly through compensatory, part-based, mechanisms.

Which Differences in Priming Effect Between Neglect and Hemianopia? A Case Description of a Bilateral Brain-Lesioned Patient.

It is widely known that visuospatial neglect and hemianopia maybe superimposed. We considered the differences in implicit information processing which is effective in patients with neglect but not with hemianopia. We then hypothesize that a prime-word in the neglected field should determine a semantic activation effect but not in a blind hemifield. Moreover eye movements could provide further details. In this work we considered a patient with a bilateral with the presence of either a left visual neglect and a right homonymous hemianopia. Our results supported implicit information processing in the space affected by neglect but not by hemianopia.

Eye movement and online bisection task in unilateral patients with neglect: a new look to the 'gradient effect'.

PRIMARY OBJECTIVE: The present study explored the behavioural and eye-movement measures in spatial unilateral neglect in response to a bisection task. RESEARCH DESIGN: Four right neglect patients were considered and compared with 11 control subjects during an online task (segment bisection). METHODS AND PROCEDURES: Eye-movements (fixation count and duration) and behavioural responses were monitored during an online bisection task, consisting of unfilled segments (two ending points) to be bisected by subjects. Segment length (six levels) and spatial dislocation (five levels) were modulated to explore a possible 'gradient effect'" (left-to-right) in neglect bias. MAIN OUTCOMES AND RESULTS: Consistent spatial biases were found for both bisection position and eye fixations as a function of segment length (from shorter to longer) and segment spatial dislocation (from right to left). However, only the more eccentric left-positions induced a greater rightward bias in patients, with increasing more right-side bisection and visual right-directed fixations. Also segment length produced significant differences between-groups for behavioural responses, with more right-side bisection for longer segment in patients, and eye movement behaviour, with increased fixation count and duration rightward oriented in response to longer segments. CONCLUSIONS: Although a left-to-right and longer-to-shorter 'continuous-gradient effect' was not supported by the results, an 'extreme left-gradient effect' was suggested and discussed.

Eye movements and bisection behavior in spatial neglect syndrome: representational biases induced by the segment length and spatial dislocation of the stimulus.

The present study explored behavioral and eye-movement measures in unilateral neglect patients in response to online bisection task (unfilled gap line). Two different tasks supported the bisection performance, a pointing and a grasping strategy. It was explored whether these different strategies may influence subjects' behavioral and eye-movement measures in response to different segment features: segment length (from shorter to longer) and segment spatial dislocation (from right to left spatial location). Consistent spatial biases were found for both bisection responses, fixation count, and duration, as well as for the first fixation count in case of pointing task. An "extreme-left" gradient effect was suggested and discussed, with patients' behavioral and eye measures more impaired. On the contrary, the patients' performance overlaps with the controls' one in case a grasping task. The direct link of visual pointing and grasping strategy, respectively, with the two cortical ventral and dorsal pathways was adduced to explain our results.