This study aims to demonstrate that children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) who exhibit autism traits have a more severe clinical profile in terms of emotion regulation, clinical features related to ADHD, and functionality, compared to those diagnosed with ADHD without these traits. 50 patients with and 64 patients without autism traits between the ages of 8–16 were recruited for the study among the children and adolescents diagnosed with ADHD. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5-2016-Turkish Adaptation (K-SADS-PL-DSM-5-T) was used to exclude the diagnosis of Autism Spectrum Disorder (ASD) and detect comorbid psychiatric diagnosis. The Social Reciprocity Scale (SRS) was completed by parents to determine groups based on autism traits. Children completed the Childhood Anxiety Sensitivity Index (CASI) and the Affective Reactivity Index (ARI). The Strengths and Difficulties Questionnaire (SDQ), Affective Reactivity Index-Parent Report (ARI-P) and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) were completed by the parents. We found that the group with autism traits had significantly more hyperactivity/inattention, conduct problems, emotional problems, and peer problems and significantly more irritability and frequent separation anxiety disorder. Although there was no significant impairment in functionality in either group, the level of impairment was significantly higher in the group with autism traits. Children diagnosed with Attention Deficit Hyperactivity Disorder who exhibit autism traits experience higher levels of irritability and separation anxiety disorder, as well as greater impairment in functionality, compared to those without these traits.
In recognising emotions expressed by others, one can make use of both embodied cognition and mechanisms that do not necessarily require activation of the limbic system, such as evoking from memory the meaning of morphological features of the observed face. Instead, we believe that the recognition of the authenticity of an emotional expression is primarily based on embodied cognition, for which the mirror system would play a significant role. To verify this hypothesis, we submitted 20 parkinsonian patients and 20 healthy control subjects to the Emotional Authenticity Recognition test, a novel test using dynamic stimuli to evaluate the ability to recognise emotions and their authenticity. Analysis of variance of the test scores shows that Parkinsonian patients perform worse than controls when they had to recognise the authenticity of emotions, although they are able to identify them. Our results confirm a deficit in the recognition of the authenticity of emotions in patients with Parkinson's disease attributable to the disruption of extrapiramidal limbic circuit between ventral striatum and orbitomesial-prefrontal cortex.
Understanding the relative contribution of various factors influencing initial severity of aphasia and recovery after a stroke is essential for optimising neurorehabilitation programmes. We investigated how various significant sociodemographic, cognitive, clinical, stroke-related and rehabilitation-related factors modulate aphasia severity and language recovery following left-hemispheric stroke. Employing an innovative method, we conducted a retrospective analysis of 96 stroke participants to explore the combined impact of these factors. The initial severity of aphasia was categorised into severe, mild/moderate and no aphasia based on the severity of their language deficits in the subacute phase (Aphasia Severity Rating Scale, ASRS). To assess speech-and-language recovery, we classified 53/96 patients with aphasia into high and poor recovery categories using a gain score formula (ASRS_discharge—ASRS_admission)/ASRS_admission. Subsequently, we performed statistical analyses (univariate analyses and forward stepwise logistic regression combined with bootstrap) to identify the determinants of the initial severity of aphasia and the degree of recovery. Our analyses unveiled that more severe aphasia initially was correlated with a more severe stroke (Odds Ratio, OR = .90, p = .041), moderate/severe executive dysfunction (OR = .068, p < .001) and larger lesion size (OR = .068, p < .001). Furthermore, the degree of recovery was associated with the intensity of speech-and-language therapy (OR = 1.47, p = .043). These findings enrich our understanding of the determinants of aphasia severity and language recovery, employing an original methodology to scrutinise the collective effect of multiple variables in a retrospective analysis of stroke participants. A better knowledge of these factors may help implement personalised language rehabilitation programmes to maximise speech-and-language recovery.
Stroke causes severe long-term disabilities with a significant reduction in quality of life. This study aims to explore the predictive value of cognitive screening in the acute phase of mild stroke on patients' functional outcome after discharge. A total of 110 patients with mild stroke were recruited. Patients were included in the study if they were discharged directly home from the acute units. The cognitive profile of patients was assessed with the Oxford Cognitive Screen (OCS). The OCS was administered 3–10 days after stroke, providing a five domain-specific cognitive profile. Long-term functional outcomes were evaluated by the Stroke Impact Scale 3.0 (SIS 3.0), a self-reported questionnaire that includes physical, cognitive, emotional and social participation dimensions. All patients completed the survey online on average 10 months after stroke. Our results show that OCS is positively associated with physical and cognitive dimensions, after adjusting for age and stroke severity measured by NIHSS at admission. In conclusion, OCS in acute mild stroke seems to be an independent predictor of long-term functional outcomes and could help clinicians in the long-term management of patients.
Predicting the diagnosis of an older adult solely based on their financial capacity performance or other neuropsychological test performance is still an open question. The aim of this study is to highlight which tests are of importance in diagnostic protocols by using recent advancements in machine learning.
For this reason, a neuropsychological battery was administered in 543 older Greek patients already diagnosed with different types of neurocognitive disorders along with a test specifically measuring financial capacity, that is, Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The battery was analysed using a random forest algorithm. The objective was to predict whether an older person suffers from dementia. The algorithm's performance was tested through cross-validation.
Machine learning was applied for the first time in data analysis regarding financial capacity and three factors-tests were revealed as the best predictors: two subscales from the LCPLTAS measuring ‘financial decision making’ and ‘cash transactions’, and the widely used MMSE which measures general cognition. The algorithm demonstrated good performance as measured by the F1-score, which is a measure of the harmonic mean of precision and recall. This evaluation metric in binary and multi-class classification integrates precision and recall into a single metric to gain a better understanding of model performance.
These findings reveal the importance of focusing on these scales and tests in neuropsychological assessment protocols. Future research may clarify in other cultural settings if the same variables are of importance.
Decision-making has been suggested as an endophenotype candidate for obsessive-compulsive disorder (OCD). However, few studies have examined whether decision-making under ambiguity is an endophenotype of OCD. This study aimed to investigate decision-making under ambiguity, as assessed by the Iowa Gambling Task (IGT), in patients with OCD and unaffected first-degree relatives (UFDR). Forty-seven non-medicated, non-co-morbid patients with OCD, 30 UFDR, and 47 healthy controls (HC) were compared in terms of decision-making using the IGT. The correlation between obsessive-compulsive symptoms and IGT performance was also investigated. Patients with OCD and UFDR performed worse than HC on the IGT. No correlation was found between obsessive-compulsive symptoms and IGT performance. A deficit in decision-making under ambiguity may be a trait and an endophenotype candidate for OCD.
Understanding lexico-semantic processing is crucial for dissecting the complexities of language and its disorders. Relatedness-based measures, or those which investigate the degree of relatedness in meaning between either task items or items produced by participants, offer the opportunity to harness novel computational and analytical techniques from cognitive network science. Recognizing the need to deepen our understanding of lexico-semantic deficits through diverse experimental and analytical approaches, this review explores the use of such measures in research into language disorders. A comprehensive search of four electronic databases covering publications from the last 11 years (October 2013–September 2024) identified 38 original experimental studies employing relatedness-based measures in populations with language disorders or other neurological conditions. Articles were examined for the types of tasks used, populations studied, item selection methods and analytical approaches. The predominant use of category fluency tasks emerged across studies, with a notable absence of relatedness judgement tasks or comparable paradigms. Commonly discussed populations included individuals with post-stroke aphasia, mild cognitive impairment and schizophrenia. Analytical methods varied significantly, ranging from more traditional approaches of clustering and switching to more sophisticated computational techniques. Despite the evident utility of category fluency tasks in research and clinical settings, the review underscores a critical need to diversify experimental paradigms and probe lexico-semantic processing in a more multifaceted manner. A broadened approach in future language disorder research should incorporate innovative analytical techniques, investigations of neural correlates and a wider array of tasks employing relatedness-based measures already present in healthy populations.
Spatial neglect is a post-stroke attention deficit for which there is no evidence-based intervention. Immersive virtual reality (IVR) may increase treatment efficacy, as it allows to train spatial attention in a rich environment. This study evaluated the efficacy and feasibility of an IVR patient-tailored training (HEMIRehApp). Using a cross-over design, an active (spatially biased) and placebo (spatially unbiased) IVR intervention were compared. We aimed to recruit 8 per-protocol left-sided neglect patients. The primary outcome was response times on the Posner cueing task. To evaluate feasibility, we documented the number of recruited patients, cybersickness and patients' experience with HEMIRehApp. After 2 years of recruitment, we were able to enrol 6 patients, of whom 2 completed the full protocol. The target sample size was not feasible due to a lower than expected prevalence of left-sided neglect and a higher than expected drop-out rate. The planned group-level analysis was therefore replaced by a single-case analysis. The results in the 2 per-protocol cases suggest a superior effect of spatially biased IVR training than unbiased IVR training inside IVR. IVR training was feasible as all 6 enrolled patients were able to complete 10 IVR training sessions, but the cross-over protocol itself was unfeasible. While the low sample size prevented us from conclusively evaluating the efficacy of HEMIRehApp, our preliminary single-case results suggest that neglect patients were able to improve attentional orientation towards eccentric target locations in IVR. Follow-up studies are needed to further validate these findings.
Autobiographical memory is diminished in patients with behavioural variant of frontotemporal dementia (bvFTD), and research has focused on the hampered ability of patients to retrieve specific memories. In this study, we implemented a methodology seeking to provide a qualitative analysis of autobiographical specificity. We invited patients with bvFTD and control participants to retrieve autobiographical memories and we distinguished between specific, categoric, extended and semantic autobiographical retrieval. The analysis demonstrated that patients with bvFTD produced more categoric than specific, extended or semantic memories. Thus, despite the decreased ability to retrieve specific memories, an increased ability to produce categoric memories can be observed in patients with bvFTD. These results support a positive view according to which autobiographical retrieval in bvFTD is not solely characterized by over-generality, but also by increased retrieval of categoric memories. Categoric memories, albeit lacking uniqueness, nevertheless, involve retrieval of similar or related events upon which patients may draw knowledge related to their self-image and life story.
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