Neuropsychological Rehabilitation最新文献

MEMORehab is a telehealth-based evolution of a six-week memory rehabilitation programme, featuring weekly video-conferenced group sessions and asynchronous online activities. Its multi-modal format is intended to improve service access, convenience, flexibility, and engagement. The primary aim of this pilot non-randomized trial was to explore MEMORehab's feasibility, acceptability, and user experience. Our secondary aim was to investigate its preliminary effectiveness for improving memory function. Ten participants with neurological diagnoses impacting memory joined MEMORehab. They and the five clinician facilitators were interviewed at baseline, weeks three and six, and six-week follow-up. Framework analysis helped characterize user experiences. Attrition, session attendance, and engagement with between-session tasks were used to evaluate feasibility. Preliminary efficacy measures included goal attainment scaling, memory performance, subjective memory, and strategy use. Change was assessed using repeated-measures ANOVAs. Participants regarded MEMORehab favourably, and attrition and session attendance supported feasibility. However, between-session engagement varied. We identified several factors enabling and impeding effective multi-modal online memory rehabilitation. Effect sizes suggested moderate-to-large improvements in goal attainment, learning, and delayed recall, and small-to-moderate improvements in subjective memory function and strategy use. This exploratory study offers promising support for multi-modal memory rehabilitation, and insights about challenges and opportunities to inform future intervention and trial designs.

This study examined the feasibility of the Swedish Memory and Attention ReTraining - digital edition (SMART-d), an online paediatric cognitive rehabilitation intervention combining direct training with metacognitive and behaviour modification strategies over the course of 5 weeks, 5 days a week. Six children/adolescents treated for paediatric brain tumour (PBT) participated in the study, four completing all five SMART-d training weeks (67%). Findings suggest adjustments to improve efficacy and retention rates, and that the SMART-d is a feasible and acceptable cognitive rehabilitation intervention for paediatric survivors of acquired brain injury. Further investigation within a larger scale randomized clinical trial (RCT) is warranted.

Traumatic brain injury (TBI) can lead to persistent neurological impairments and elevate the risk of neurodegenerative disease development. Despite this, clinical management and patient education beyond the acute rehabilitation period remains limited. This two-part study examined healthcare professionals' knowledge of long-term TBI outcomes and co-developed an educational infographic with individuals with lived experience of TBI to potentially aid clinicians with patient communication. In Part 1, 76 healthcare professionals from five countries completed an online survey. Respondents reported persistent impairments post-mild TBI included attention, balance, and depression, while moderate-severe TBI was associated with executive dysfunction, gait issues, and depression. Monitoring durations were longer for moderate-severe than mild TBI (M = 30 vs 13.8 months). Social supports, subjective complaints (mild TBI), and objective impairments (severe TBI) extended monitoring. 55% were aware of TBI-related neurodegenerative risk, with monitoring adjusted by pre-injury health and genetic risk. A major finding was uncertainty around communicating risks without causing alarm. In Part 2, twelve individuals with TBI (M age = 55.6, SD = 20.5; 58% female) co-designed an infographic on persistent impairments and recovery. Participants highlighted limited post-injury follow-up. Following two feedback rounds, 8 of 9 respondents endorsed the final infographic, offered as a co-designed tool exemplar for clinical implementation.

Encephalitis can cause acquired brain injury due to inflammation, leading to cognitive issues and fatigue, exacerbating daily stress. Knowledge of real-time stress coping mechanisms among people post-encephalitis and how this relates to depression is limited. Ecological momentary assessment (EMA) may address limitations in standardized cross-sectional self-report assessments. This study evaluates the feasibility and acceptability of collecting EMA data on mood and coping. Twenty adults post-encephalitis (12 women, age range 26:67) completed daily and self-initiated EMA for mood and coping over 4 months, and post-study interviews explored acceptability using framework analysis. Average daily compliance rate was 79.3% (range 37.3-97.5%), showing EMA's feasibility, though low self-initiated EMA usage indicated challenges. Linear mixed-effects model revealed significant relationships between coping style and depression levels within individuals and over time. Framework analysis categorized two themes: "Encephalitis experience and its relationship to stress response" and "Experience of EMA: barriers and facilitators'. Qualitative analysis indicated acceptability for the m-Path app and measuring daily mood. Results suggest long-term daily EMA is feasible for collecting mood and coping in adults with encephalitis. However, patient and public involvement should be utilized to establish suitability. Following adaptations, EMA may serve as a psychological intervention targeting stress coping in daily life.

Multisensory integration allows the brain to align auditory and visual signals in time, a process critical for accurate perception. This process has been shown to be abnormal in schizophrenia (SZ); patients show a wider temporal binding window (TBW), perceiving asynchronous inputs as simultaneous over longer intervals. Such deficits have been linked to hallucinations, disorganized symptoms, and impaired speech comprehension in SZ. While prior studies suggest that audiovisual simultaneity-judgment training (SJT) can recalibrate temporal perception in healthy adults, its efficacy in SZ has not yet been demonstrated. This study tested a feedback-based audiovisual SJT in 30 clinically stable SZs. Across three sessions, we assessed changes in simultaneity judgment, multisensory illusion susceptibility (sound-induced flash illusion; SIFI), and speech-in-noise comprehension (word recognition task). Mixed-effects models showed that the SJT significantly reduced the range of audiovisual pairs judged synchronous, consistent with a narrower TBW that persisted for two weeks. This change in simultaneity judgments was also associated with better word recognition in noisy conditions, both with audiovisual and auditory-only input. No training effects emerged for SIFI. These findings provide initial evidence that SJT may improve audiovisual temporal processing in SZ and enhance speech comprehension in noisy environment.

Dementia and brain injury remain pressing areas for innovation and treatment that can improve the lives of those with such conditions. Every USA state has an assistive technology centre that includes aids for dementia and brain injury, and such centres are federally funded. In the Republic of Ireland, there are 22 "Memory Technology Resource Rooms', nationally funded, and they specialise in supporting conditions such as dementia and brain injury. In the UK, no such centres exist. The 10-year Health Plan for England has as its key goals applying advances in technology to healthcare and establishing neighbourhood health centres. We propose that the UK follow the examples of the USA and Ireland, and that each UK county has a Cognitive Assistive Technology centre, with a focus on cognitive aids and related smart home technologies for patients with dementia and other brain disorders that impact cognitive function.

Depression following Acquired Brain Injury (ABI) is common, persistent and debilitating, yet access to psychological treatment is limited. Digital therapies, provided alongside clinician support, may help overcome these barriers. This study evaluated the feasibility, acceptability, and potential benefits of a blended intervention for depression post-ABI, using a mixed-method approach. Individuals with ABI and depression were offered a 4-week intervention (MyACTION), delivered via a novel smartphone app, alongside weekly video therapy sessions. Measures of depression, anxiety, and self-efficacy were collected pre- and post-intervention. Feasibility was evaluated through recruitment, retention, engagement, and usability ratings. Acceptability was assessed via post-treatment interviews. Initial indication of benefit was evaluated through change in scores in outcome measures. Twenty-one individuals consented, 19 completed the intervention, and 18 completed post-intervention interviews. On average, 82% of daily app tasks were completed. Overall, the app received "good" usability ratings. Barriers and facilitators to engagement were (1) health status, (2) motivation, (3) perceived utility, (4) usability, (5) accessibility, and (6) timing. Reductions in depression and anxiety were observed post-intervention. MyACTION was feasible and acceptable for individuals with ABI and depression. High engagement and positive feedback suggest blended digital approaches may help increase access to psychological support in this population.

Meta-analyses on cognitive training (CT) for people with Parkinson's Disease (PD) report improvements in global cognition and it is recommended as a treatment for people with PD with mild cognitive impairment. However, few studies have assessed the experience of CT. Therefore, this study explored the experience of process-based CT in people with PD and focused on how participants engaged with and made use of the training in their everyday life. In this study, semi-structured, individual interviews were conducted with 18 people with PD who had completed 6-8 weeks of process-based CT. Reflexive thematic analysis was used to analyse the data. Three overarching themes were developed that reported on the participants' (1) dedication towards CT; (2) meaning of seeing change in cognitive performance during CT; and (3) inspiration to transfer the knowledge, strategies and mindset from training into everyday life. Furthermore, a route to transfer was described including emotional and motivational experiences. In conclusion, CT was experienced in an active, reflective manner whereby emotional and cognitive challenges during training are dealt with and are seen as important ingredients to attain transfer to everyday life. Future studies are encouraged to examine the link between such qualitative findings and quantitatively measured outcomes.Trial registration: ClinicalTrials.gov identifier: NCT03680170..

The valence-bias hypothesis refers to the tendency of some respondents to answer according to the positive/negative polarity of a question (its valence) rather than its specific content, potentially reducing the specificity of psychological and neuropsychological questionnaires, and increase correlations across different questionnaires and within items of the same questionnaire. This work examines the likelihood of valence-bias using findings from the 20-item Dysexecutive Questionnaire (DEX). We searched PubMed and Web of Science using the keyword "dysexecutive questionnaire" and selected studies reporting findings relevant to evaluating the valence-bias hypothesis. Included studies described the DEX's factorial structure and its correlations with performance-based executive function (EF) and other self-reported questionnaires. Subject-completed DEX (DEX-S total score) correlated positively with self-reported depression, anxiety, poor subjective quality-of-life, heightened self-awareness of difficulties, and personality traits associated with symptom reporting (high neuroticism, low conscientiousness). DEX-S correlated negatively with positive affect. Findings on the DEX's factorial structure were variable, but its reliability was consistently good to excellent. Correlations between DEX-S and performance-based EF were generally weak or non-significant, but significant when the DEX was completed by professionals. Overall, findings support the valence-bias hypothesis. While problematic for group-level studies, it may offer advantages for individualized clinical assessment and rehabilitation.

Evidence is needed about contextual-behavioural change processes that could be targeted by Acceptance and Commitment Therapy-based (ACT-based) interventions for specific populations and contexts, including those designed to help stroke survivors avoid or reduce depression. In this study, an online questionnaire survey with measures of depression (PHQ-9), psychological flexibility (AAQ-ABI), cognitive fusion (CFQ), valued living (VLQ), and stroke impact (SF-SIS) was completed by 81 stroke survivors (aged 29-85 years, 58.0% female, 49.4% post-ischaemic stroke, and 27.2% post-haemorrhagic stroke). Hierarchical linear regression and mediation analyses were used to test hypothesized associations between stroke impact, psychological flexibility, cognitive fusion, valued living, and depression. The results showed that cognitive fusion, stroke impact, gender, and ethnicity predicted depression independently of other factors, accounting for 60.2% of the variance in depression. Cognitive fusion almost entirely mediated the initially significant independent association between psychological flexibility and depression. The findings support the value of ACT-based interventions for stroke survivors and suggest that cognitive de-fusion is a change process that could be specifically targeted to avoid or reduce depression. Cognitive de-fusion may have a positive impact on depression because it helps with rebuilding personal identity following stroke.