Theory of mind in chronic migraine with medication overuse assessed with the MASC.

Theory of Mind (ToM) is the ability to infer one's own and others' mental states. Growing research indicates that ToM is impaired in Chronic Migraine with Medication Overuse (CM + MO). However, the research in this field has been conducted using static scenario-based tasks, often failing to test mentalization in everyday situations and measuring only performance accuracy. We filled this gap by administering the Movie for the Assessment of Social Cognition (MASC) to subjects with CM + MO compared to episodic migraine (EM). This test allows us to assess both affective and cognitive ToM and which, in addition to being accurate, also analyzes the type of error in attribution of mental states, distinguishing between hypo-mentalization and hyper-mentalization. Thirty patients suffering from CM + MO and 42 from EM were enrolled. Results showed that CM + MO patients were less accurate in mental state attribution than EM. In addition, compared to EM, CM + MO individuals were more impaired in the affective ToM dimensions and committed more errors of hypo-mentalization. In conclusion, the application of MASC in patients with CM + MO allowed for the detection of an alteration in their ability to correctly draw conclusions about other people's mental states. This latter contributes critically to appropriate social reactions and also, possibly, to satisfactory social interactions.

Semantic and episodic processes differently predict false memories in the DRM task.

There is a fervent debate about the processes underpinning false memories formation. Seminal theories have suggested that semantic memory would be involved in false memories production, while episodic memory would counter their formation. Yet, direct evidence corroborating such view is still lacking. Here, we tested this possibility by asking participants to perform the Deese-Roediger-McDermott (DRM) task, a typical false memory paradigm, in which they had to study lists of words and subsequently to recognize and distinguish them from new words (i.e., the false memory items). The same participants were also required to perform a semantic task and an episodic-source memory task. Our results showed that a higher number of false memories in the DRM task occurred for those participants with better semantic memory abilities, while a lower number of false memories occurred for participants with better episodic abilities. These findings support a key role of semantic processes in false memory formation and, more generally, help clarify the specific contribution of different memory systems to false recognitions.

In person versus remote cognitive rehabilitation in patients with subjective cognitive decline or neurocognitive disorders: what factors drive patient's preference?

Background: To date, there is still a lack of consensus for identifying the ideal candidate for cognitive telerehabilitation (TR). The main goal of the present study is to identify the factors associated to the preference for either TR or in-person cognitive training (CT) programs in older adults at risk of dementia or with early cognitive impairment. Methods: A sample of 56 participants with subjective cognitive decline or neurocognitive disorders eligible for CT were enrolled at the Dementia Research Center and Neurorehabilitation Unit of IRCCS Mondino Foundation. All individuals underwent a baseline assessment to capture their complete profile, including cognitive reserve and lifestyle habits, sociodemographic characteristics, cognitive functioning, and mental health. Patients were then asked their preference for TR or in-person CT, before being randomized to either treatment as per protocol procedures. Statistical analyses included explorative descriptive approach, logistic regression, and non-parametric models to explore the overall contribution of each variable. Results: The two (TR and in-person) preference groups were similar for cognitive functioning and mental health status. Socio-demographic and lifestyle profiles seem to be the most important factors to influence the preference in terms of the area under the curve (AUC) of the models. The two preference groups differed in terms of socio-demographic characteristics (e.g., level of technological skills, age, and distance from the clinic). Furthermore, participants who selected the TR modality of CT had significantly higher levels of cognitive reserve and adopted more protective lifestyle habits (e.g., regular physical activity, Mediterranean diet) when compared to those who preferred in-person CT. Discussion: These findings highlight that the preference to receive CT delivered by TR or in person is a complex issue and is influenced by a variety of factors, mostly related to lifestyle habits and sociodemographic characteristics. Availability of profiles of patients that may be more attracted to one or the other modality of TR may help promote shared decision-making to enhance patient experience and outcomes.

The selfie project: A successful approach to lifestyle monitoring and health promotion in adolescents.

Adolescence is a critical period for the physical and cognitive development. To promote adolescents' health and well-being, prevention and health education interventions are to be implemented at all levels of society, with schools and families playing a fundamental role. In 2015, the "Semi di Melo" Center for Education and Research on Childhood and Adolescence was established in Milan, northern Italy to help parents and teachers to better explicate their supportive role toward their children/students during adolescence. Through a survey called 'Selfie', conducted via an internet-based, self-administered, and fully anonymous questionnaire, Semi di Melo collects qualitative and quantitative information on the demographic characteristics, lifestyle, leisure time, risk behavior, social relationships and mental wellbeing of middle and high school students in Italy. Data are then analyzed, interpreted, and shared with teachers, parents, and students during guided workshops and focus groups aimed at raising awareness of risky behaviours during adolescence and facilitating intergenerational exchange. To date, the Selfie questionnaire has been distributed to more than 400 Italian public schools, reaching more than 90,000 students. In late 2022, Semi di Melo and the University of Pavia started a collaboration to expand research on data acquired from the Selfie questionnaire through an analytical approach, allowing a more comprehensive understanding of Italian adolescents' lifestyle, social, and psychological well-being. The gathered evidence will be made available to help educators, health and social care professionals, as well as local authorities and decision-makers to develop effective support systems and evidence-based interventions that help adolescents realise their full potentia.

Personality in Chronic Headache: A Systematic Review with Meta-Analysis.

Background: Chronic headache (CH) is a condition that includes different subtypes of headaches and that can impair different life domains. Personality traits can play a relevant role both in the development and in coping with this medical condition. The first aim of the present study is to realize a systematic review of the personality traits associated with CH compared to healthy controls; the second objective is to carry out a quantitative meta-analysis with the studies using the same instrument to assess personality traits. Method: The literature search encompassed articles published from 1988 until December 2022 on the major databases in the field of health and social sciences: PubMed, Scopus, PsychInfo, and Web of Science. Results: Thirteen studies were included in the systematic review, but only three studies were deeply explored in a meta-analysis since the only ones used a common instrument for personality assessment (Minnesota Multiphasic Personality Inventory). According to the meta-analysis, different subtypes of CH patients scored higher than healthy controls on Hypochondriasis and Hysteria Scales. The systematic review showed higher levels of depressive and anxious personality dimensions and pain catastrophizing in CH compared to healthy controls. Moreover, frequent-chronic forms and medication-overuse headache were the most symptomatic and frail categories showing higher levels of dysfunctional personality traits and psychopathological symptoms. Conclusions: These results seem to confirm a "neurotic profile" in patients suffering from CH. The identification of the main personality traits involved in the onset and maintenance of headache disorders represents an important objective for developing psychological interventions.

Social cognition in chronic migraine with medication overuse: a cross-sectional study on different aspects of mentalization and social relationships.

BACKGROUND: Social cognition refers to all mental operations to decipher information needed in social interactions. Here we aimed to outline the socio-cognitive profile of Chronic Migraine with Medication Overuse (CM + MO), given they are recognized to be at risk of socio-cognitive difficulties. Given the multidimensionality of this construct, we considered: (1) socio-cognitive abilities, (2) socio-cognitive beliefs, (3) alexithymia and autism traits, and (4) social relationships. METHODS: Seventy-one patients suffering from CM + MO, 61 from episodic migraine (EM), and 80 healthy controls (HC) were assessed with a comprehensive battery: (1) the Faux Pas test (FP), the Strange Stories task (SS), the Reading Mind in the Eyes test (RMET), (2) the Tromsø Social Intelligence Scale, (3) the Toronto Alexithymia Scale, the Autism Spectrum Quotient, (4) the Lubben Social Network Scale, the Friendship Scale. RESULTS: CM + MO: (1) performed similar to EM but worse than HC in the FP and SS, while they were worse than EM and HC in the RMET; (2) were similar to EM and HC in social intelligence; (3) had more alexithymic/autistic traits than EM and HC; (4) reported higher levels of contact with their family members but felt little support from the people around them than HC. CONCLUSIONS: CM + MO results characterized by a profile of compromised socio-cognitive abilities that affects different dimensions. These findings may have a relevant role in multiple fields related to chronic headache: from the assessment to the management.

HomeCoRe system for telerehabilitation in individuals at risk of dementia: A usability and user experience study.

Background: Telerehabilitation has enabled a broader application of cognitive rehabilitation programs. We have recently developed HomeCoRe, a system for supporting cognitive intervention remotely with the assistance of a family member. The main goal of the present study was to determine usability and user experience of HomeCoRe in individuals at risk of dementia and in their family members. The association between subjects' technological skills and main outcome measures was evaluated as well. Methods: Fourteen individuals with subjective cognitive decline (SCD) or mild neurocognitive disorder (mNCD) were recruited to participate in this pilot study. All participants received a touch-screen laptop implemented with the HomeCoRe software. The intervention consisted of 18 sessions and included a patient-tailored adaptive protocol of cognitive exercises. Usability was assessed in terms of treatment adherence and participants' performance across sessions; user experience via self-reported questionnaires and a descriptive diary. Results: Usability and user experience were overall satisfactory and suggested usability, pleasantness, and high motivation while using HomeCoRe. Technological skills correlated only with the perceived ability to start and/or perform exercises autonomously. Discussion: These results, although preliminary, suggest that the usability and user experience of HomeCoRe are satisfactory and independent of technological skills. These findings encourage wider and more systematic use of HomeCoRe to overcome the current limitations of in-person cognitive rehabilitation programs and to reach more individuals at risk of dementia.

Outcomes of a computer-based cognitive training (CoRe) in early phases of cognitive decline: a data-driven cluster analysis.

The present study aimed to identify clusters of cognitive profiles as well as to explore the effects of these clusters on demographic/individual characteristics and on improvements after a computer-based cognitive training (CCT) in early cognitive impairment. Fifty-seven subjects underwent to an adaptive CCT for 3 weeks (4 individual face-to-face sessions/week of 45 min) and were evaluated at baseline (T0), post-intervention (T1), and after 6 (T2) and 12 (T3) months. Clusters of cognitive profiles were explored with k-means analysis. The analysis revealed two clusters, which were composed by 27 and 30 patients characterized by lower (Cluster 1) and higher (Cluster 2) cognitive functioning. At T1, cognitive performance improved in both groups, but Cluster 1 gained more benefits in global cognitive functioning than Cluster 2. However, at T3, Cluster 2 remained stable in its clinical condition, whereas Cluster 1 showed a pronounced worsening. In conclusion, Cluster 1 profile was associated with a more marked but also short-lasting responsiveness to CCT, whereas patients fitting with Cluster 2 characteristics seemed to obtain more CCT benefits in terms of stability or even delay of cognitive/functional decline. These findings may have relevant implications in informing the timing and modality of delivery of CCT.

Hands-on false memories: a combined study with distributional semantics and mouse-tracking.

Although mouse-tracking has been seen as a real-time window into different aspects of human decision-making processes, currently little is known about how the decision process unfolds in veridical and false memory retrieval. Here, we directly investigated decision-making processes by predicting participants' performance in a mouse-tracking version of a typical Deese-Roediger-McDermott (DRM) task through distributional semantic models, a usage-based approach to meaning. Participants were required to study lists of associated words and then to perform a recognition task with the mouse. Results showed that mouse trajectories were extensively affected by the semantic similarity between the words presented in the recognition phase and the ones previously studied. In particular, the higher the semantic similarity, the larger the conflict driving the choice and the higher the irregularity in the trajectory when correctly rejecting new words (i.e., the false memory items). Conversely, on the temporal evolution of the decision, our results showed that semantic similarity affects more complex temporal measures indexing the online decision processes subserving task performance. Together, these findings demonstrate that semantic similarity can affect human behavior at the level of motor control, testifying its influence on online decision-making processes. More generally, our findings complement previous seminal theories on false memory and provide insights into the impact of the semantic memory structure on different decision-making components.

Individual differences in theory of mind correlate with the occurrence of false memory: A study with the DRM task.

Although long-term memory and Theory of Mind (ToM) are closely related across the whole lifespan, little is known about the relationship between ToM and semantic memory. Clinical studies have documented the co-occurrence of ToM impairments and semantic memory abnormalities in individuals with autism or semantic dementia. However, to date, no study has directly investigated the existence of a relationship between ToM and semantic memory in the typical population. We addressed this gap on a sample of 103 healthy adults (M age = 22.96 years; age range = 19-35 years). Participants completed a classical false memory task tapping on semantic processes, the Deese-Roediger-McDermott (DRM) task, and two ToM tasks, the Triangles and the Reading the Mind in the Eyes task. They also completed the vocabulary scale from the Wechsler Adult Intelligence Scale. Results showed that participants' semantic performance in the DRM task was significantly related to that in the Triangles task. Specifically, the higher participants' ToM in the Triangles task, the higher participants' reliance on semantic memory while making false memories in the DRM task. Our findings are consistent with the Fuzzy Trace Theory and the Weak Central Coherence account and suggest that a (partially) common cognitive process responsible for global versus detailed-focus information processing could underlie these two abilities.

Spatial Representations Without Spatial Computations.

Cognitive maps are assumed to be fundamentally spatial and grounded only in perceptual processes, as supported by the discovery of functionally dedicated cell types in the human brain, which tile the environment in a maplike fashion. Challenging this view, we demonstrate that spatial representations-such as large-scale geographical maps-can be as well retrieved with high confidence from natural language through cognitively plausible artificial-intelligence models on the basis of nonspatial associative-learning mechanisms. More critically, we show that linguistic information accounts for the specific distortions observed in tasks when college-age adults have to judge the geographical positions of cities, even when these positions are estimated on real maps. These findings indicate that language experience can encode and reproduce cognitive maps without the need for a dedicated spatial-representation system, thus suggesting that the formation of these maps is the result of a strict interplay between spatial- and nonspatial-learning principles.

Decomposing the semantic processes underpinning veridical and false memories.

The exact semantic processes subserving the formation of false memories are still poorly understood. Here, we directly probed the semantic origins of false memories in a typical Deese-Roediger-McDermott (DRM) task, by predicting participants' performance in this task through data-driven distributional semantic models. Participants were required to study lists of words and then to perform a recognition task. Our findings indicate that the participants' performance is better accounted for by a local rather than a global strategy on the task at hand: the single lists composing the task activate specific semantic clusters that are responsible for the occurrence of false memories. In particular, memory performance followed a continuous semantic gradient, with higher false recognitions occurring for higher sematic similarity between the lures (i.e., the false memory items) and the words in the relative lists. Crucially, our findings also show that semantic memory is differently involved in veridical and false memories, with this pattern being consistent across two reanalyses of data from previous studies and being replicated in an independent experiment. We thus outline an empirically-driven theoretical framework to account for the semantic processes supporting veridical and false memories formation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A double-blind randomized controlled trial combining cognitive training (CoRe) and neurostimulation (tDCS) in the early stages of cognitive impairment.

BACKGROUND: The prevalence of neurodegenerative diseases is expected to increase over the next years, therefore, new methods able to prevent and delay cognitive decline are needed. AIMS: To evaluate the effectiveness of a combined treatment protocol associating a computerized cognitive training (CoRe) with anodal transcranial direct current stimulation (tDCS). METHODS: In this randomized controlled trial, 33 patients in the early stage of cognitive impairment were assigned to the experimental group (CoRE + real tDCS) or control group (CoRE + sham tDCS). In each group, the intervention lasted 3 consecutive weeks (4 sessions/week). A neuropsychological assessment was administered at baseline (T0), post-intervention (T1) and 6-months later (T2). RESULTS: The CoRE + real tDCS group only improved in working memory and attention/processing speed at both T1 and T2. It reported a stable MMSE score at T2, while the CoRE + sham tDCS group worsened. Age, mood, and T0 MMSE score resulted to play a role in predicting treatment effects. CONCLUSION: Combined multi-domain interventions may contribute to preventing or delaying disease progression. TRIAL REGISTRATION: Trial registration number (ClinicalTrials.gov): NCT04118686.

The Human Cerebellum as a Hub of the Predictive Brain.

Although the cerebellum has long been believed to be involved uniquely in sensorimotor processes, recent research works pointed to its participation in a wide range of cognitive predictive functions. Here, we review the available evidence supporting a generalized role of the cerebellum in predictive computation. We then discuss the anatomo-physiological properties that make the cerebellum the ideal hub of the predictive brain. We further argue that cerebellar involvement in cognition may follow a continuous gradient, with higher cerebellar activity occurring for tasks relying more on predictive processes, and outline the empirical scenarios to probe this hypothesis.

Identifying Frail Populations for Disease Risk Prediction and Intervention Planning in the Covid-19 Era: A Focus on Social Isolation and Vulnerability.

The early identification of fragile populations in the Covid-19 era would help governments to allocate resources and plan strategies to contain consequences of the pandemic. Beyond frailty, social vulnerability to environmental stressors, such as the social distancing enforced to reduce the SARS-CoV2 contagion, can modify long-term disease risk and induce health status changes in the general population. We assessed frailty and social vulnerability indices in 1,258 Italian residents during the first lockdown phase via an on-line survey. We compared indices taking into account age categories and gender. While frailty showed a linear increase with age and was greater in females than in males, social vulnerability was higher in young adults and elders compared to middle aged and older adults, and in males than females. Both frailty and social vulnerability contributed in explaining the individual perception of the impact of Covid-19 emergency on health, which was further influenced by proactive attitudes/behaviors and social isolation. Social isolation and loneliness following the Covid-19 outbreak may exert dramatic psychosocial effects in the general population. The early detection of vulnerable categories, at risk to become ill and develop long-lasting health status changes, would help to prevent consequences on general well-being by allocating resources to targeted interventions managing psychosocial distress and increasing young adults and elderly resilience toward the post-Covid-19 crisis.

High perceived isolation and reduced social support affect headache impact levels in migraine after the Covid-19 outbreak: A cross sectional survey on chronic and episodic patients.

BACKGROUND: Psychosocial variables are key factors influencing psycho-physical equilibrium in migraine patients. Social isolation and vulnerability to stressors may prevent efficient psychological adjustment negatively affecting adaptation to life changes, as that imposed during Covid-19 lockdown. Here, we explored psychosocial dimensions and changes in clinical condition during Covid-19 lockdown in migraine patients, with regard to migraine type and headache impact. METHODS: Sixty-four migraine patients (32 episodic and 32 chronic) and 64 healthy control subjects were included in a case-control cross-sectional study. A two-step clustering procedure split patients into two clusters, based on the Headache Impact Test. Perceived global distress, loneliness, empathy, and coping levels were compared in groups, as well as changes in clinical condition. RESULTS: Migraine patients reported higher general loneliness and lower social support compared to healthy control subjects. Emotional loneliness was more marked in patients with higher headache impact. This subgroup of patients more frequently reported changes in the therapeutic and care paths as the perceived cause of the occurrence of motor or extra-motor symptomatology. CONCLUSIONS: Migraine patients, especially those more severely affected, proved more vulnerable than healthy control subjects to Covid-19 lockdown. Long-lasting interruption of social interactions may be detrimental in fragile patients that are in need of structured support interventions to maintain psycho-physical wellbeing.

Closeness to friends explains age differences in positive emotional experience during the lockdown period of COVID-19 pandemic.

BACKGROUND: Studies on age differences in emotional states during the COVID-19 pandemic showed that older adults experienced greater emotional wellbeing compared to younger adults. We hypothesized these age differences to be related to the perception of closeness to family/friends or the engagement in daily activities during the pandemic. AIM: To investigate age differences in positive and negative emotional experiences and whether the perception of closeness to family/friends and the engagement in daily activities during pandemic explained such age-related differences. METHODS: Through a cross-sectional study, 1,457 adults aged 18-87 years old completed an online survey assessing positive and negative emotional experiences, the perception of more closeness to family/friends, and daily activities that participants started/re-started during the pandemic. RESULTS: Increasing age was associated with more positive and less negative emotional experiences. Age differences in positive emotional experience were explained by the perception of more closeness to friends and not by the engagement in daily activities. For negative emotional experience age, differences remained significant even after accounting for the perception of closeness to family/friends and engagements in daily activities. DISCUSSION: Older adults' greater overall level of positive emotional experience was explained by their greater perception of more closeness to friends. We speculate that social closeness provides a coping mechanism to increase emotional wellbeing employed especially in older adults. CONCLUSION: Our findings reinforce the link between perceived social closeness and emotional wellbeing especially in older adults. To cope with stressful situation, it is important to encourage older adults to increase the closeness to their social network.

Risk-Aversion for Negative Health Outcomes May Promote Individual Compliance to Containment Measures in Covid-19 Pandemic.

First-person experience of stressful life events can change individuals' risk attitudes, driving to increased or decreased risk perception. This shift to more risk-averse or risk-loving behaviors may find a correlate in the individual psycho-socio-emotional profile. To this purpose, we aimed to estimate the relationship between differences in risk-taking attitudes toward possible negative health outcomes and psycho-socio-emotional dimensions modulating the experience of life-threatening situations, in the context of the Covid-19 pandemic. In March 2020, we launched the PsyCovid Study (https://wprn.org/item/428452) to assess psycho-socio-emotional changes due to Covid-19 pandemic in the Italian population. Additionally, we distributed to 130 participants the Covid-19 Risk Task, including monetary and health-related stimuli, estimating a measure of risk-aversion toward health and classifying participants on the basis of their risk-attitude profiles. The set of psycho-socio-emotional variables was reduced to three PCA components: Proactivity, Isolation, Inactivity. The individual degree of risk-aversion toward negative health outcomes was directly related to Proactivity, encasing empathic, social support and positive coping strategies, which may prompt individuals to put in place self-protection strategies toward possible negative health consequences. These findings indicate that a risk-averse profile toward possible negative health outcomes may be associated to higher levels of individual prosocial and proactive dispositions, possibly making individuals' more compliant with the social and hygienic guidelines and, thus, reducing their exposure to the SARS-CoV-2 infection.