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Background: Word production difficulty is one of the most common and persisting symptoms in people suffering from aphasia (i.e., anomia). However, there is a considerable variability in patients' responses to treatment, leading to the need of new effective approaches. Also, the mechanisms underlying word (re)learning is little known in production even in neurotypical adult native language and especially in relationship with the lexical-semantic integration of (re)learnt words. The lexical-semantic network being highly contextual and multimodal, new technologies such as immersive virtual reality (iVR) may become pertinent approaches, but still need scientific proof, especially as past studies have found no advantage over a control method and have never used an immersive version of VR. Yet, the immersion has been identified as being a key factor of positive outcomes in learning. Therefore, the aim of the present study was to investigate whether iVR provides a benefit in word learning in neurotypical adults (Study 1) and in the treatment for anomia in people suffering from aphasia following stroke (Study 2)., Method: In study 1, 32 neurotypical adults learned two matched lists of 30 rare words each in their native language (French) during a one-week protocol alternating test and learning sessions with iVR and a digital static learning method. Study 2 followed the same design over a two week-period with 16 people with aphasia (re)learning two matched lists of 28 frequent words., Results: Neurotypical adults demonstrated a higher accuracy rate in word production for words learned with iVR in comparison to those learned with the digital static learning method. For people suffering from anomia, the iVR did not differ from the control method on total accuracy but led to a greater reduction of lexical errors., Conclusion: iVR has a potential of use for learning new words but also for the treatment of word production difficulties, especially in people with aphasia that produce mainly lexical errors. These two main results lead to the hypothesis that iVR promotes lexical-semantic processes., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: : With more than 60 million new cases around the world each year, traumatic brain injury (TBI) causes substantial mortality and morbidity. Managing TBI is a major human, social, and economic concern. In the last 20 years, there has been an increase in clinical trials in neurocritical care, leading mostly to negative results. The evaluation of neurological outcomes, predominantly as primary outcomes, using clinical scales (Glasgow Outcome Scale) has limitations that could explain these results. Moreover, patient-centered outcomes are seldom reported despite their recognized clinical relevance., Objective: : The aim of this project is to establish a core outcome set (COS) for patients with moderate-to-severe TBI in randomized control trials in neurocritical care research., Methods: This study will follow five distinct steps: (1) systematic review to identify outcomes that have been reported in trials; (2) semistructured interviews with patients and their families to identify their priorities after TBI and explore potential patient-centered outcomes; (3) health care stakeholder focus groups with clinicians, researchers, and policy makers to describe potential outcomes; (4) an eDelphi survey with stakeholder groups to make a list of previously identified core outcomes; and (5) a consensus workshop to establish a COS for moderate-to-severe TBI clinical trials., Results: : The systematic review was published in August 2024. Regarding Step 2, 30 semistructured interviews of patients and relatives were performed from July 2021 to December 2023, and analyses were completed in October 2024. Step 3 is currently under development, and Step 4 is planned for the end of 2025. Step 5 is expected to occur during fall/winter 2026. Conclusions: Establishing a COS, to be consistently measured and reported in TBI trials in neurocritical care will ensure rigorous reporting, avoid bias, and improve the integrity, transparency, and usability of clinical research. The French context of the study is the main limitation, but we are seeking international collaboration on the project. The results of each step of the project will be disseminated through abstracts, publications, and patient associations., Conclusions: Establishing a COS, to be consistently measured and reported in TBI trials in neurocritical care will ensure rigorous reporting, avoid bias, and improve the integrity, transparency, and usability of clinical research. The French context of the study is the main limitation, but we are seeking international collaboration on the project. The results of each step of the project will be disseminated through abstracts, publications, and patient associations., International Registered Report Identifier (irrid): DERR1-10.2196/54525., (©Raphael Cinotti, Yvan Derouin, Amandine Chenet, Lydia Oujamaa, Bertrand Glize, Yoann Launey, Claire Dahyot-Fizelier, Emmanuelle Cartron, Melodie Renvoise, Benedicte Sautenet, Veronique Sebille. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 09.01.2025.)

Purpose: Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional and vital consequences are well known. Despite recent guidelines, they are still largely neglected. A large number of recent studies have re-examined the epidemiology, diagnosis, imaging determinants and management of PSCI. The aim of this update is to determine whether these new data answer the questions that are essential to reducing PSCI, the unmet needs, and steps still to be taken., Methods: Literature review of stroke unit-era studies examining key steps in the management of PSCI: epidemiology and risk factors, diagnosis (cognitive profile and assessments), imaging determinants (quantitative measures, voxelwise localization, the disconnectome and associated Alzheimer's disease [AD]) and treatment (secondary prevention, symptomatic drugs, rehabilitation and noninvasive brain stimulation) of PSCI., Findings: (1) the prevalence of PSCI of approximately 50% is probably underestimated; (2) the sensitivity of screening tests should be improved to detect mild PSCI; (3) comprehensive assessment is now well-defined and should include apathy; (4) easily available factors can identify patients at high risk of PSCI; (5) key imaging determinants are the location and volume of the lesion and the resulting disconnection, associated AD and brain atrophy; WMH, ePVS, microhemorrhages, hemosiderosis, and cortical microinfarcts may contribute to cognitive impairment but are more likely to be markers of brain vulnerability or associated AD that reduce PS recovery; (6) remote and online assessment is a promising approach for selected patients; (7) secondary stroke prevention has not been proven to prevent PSCI; (8) symptomatic drugs are ineffective in treating PSCI and apathy; (9) in addition to cognitive rehabilitation, the benefits of training platforms and computerized training are yet to be documented; (10) the results and the magnitude of improvement of noninvasive brain stimulation, while very promising, need to be substantiated by large, high-quality, sham-controlled RCTs., Discussion and Conclusion: These major advances pave the way for the reduction of PSCI. They include (1) the development of more sensitive screening tests applicable to all patients and (2) online remote assessment; crossvalidation of (3) clinical and (4) imaging factors to (5) identify patients at risk, as well as (6) factors that prompt a search for associated AD; (7) the inclusion of cognitive outcome as a secondary endpoint in acute and secondary stroke prevention trials; and (8) the validation of the benefit of noninvasive brain stimulation through high-quality, randomized, sham-controlled trials. Many of these objectives can be rapidly and easily attained., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Olivier Godefroy: has served on scientific advisory boards (Novartis and Astra Zeneca), received funding for travel and meetings from Novartis, Lilly, Genzyme, Astrazeneca, Biogen, Teva, Pfizer, CSL-Behring, GSK, Boehringer-Ingelheim, Ipsen, Covidien, Bristol-Myers Squibb. Ardalan Aarabi: none related to this study. Yannick Béjot meeting speaker: BMS, Pfizer, Boehringher-Ingelheim, Servier, Medtronic, Amgen; Consulting: Medtronic, NovoNordisk, Novartis. Geert J Biessels: Consulting : Nestle HealthScience. Bertrand Glize: Consulting: IPSEN. Vincent MT Mok: none related to this study. Michel Thiebaut de Schotten: none related to this study. Igor Sibon: meeting speaker: BMS, Pfizer, Boehringher-Ingelheim, Servier, Medtronic, Novonordisk, Novartis, Sanofi, Astra-Zeneca; Consulting: Medtronic, NovoNordisk, Novartis, Sanofi, Astra-Zeneca. Hugues Chabriat: none related to this study. M Roussel: none related to this study.

Purpose: Repetitive transcranial magnetic stimulation (rTMS) can enhance aphasia recovery. Most studies have used inhibitory stimulation targeting the right inferior frontal gyrus. However, the motor cortex, observed to contribute to the prediction of aphasia recovery, is involved in word production and could be an appropriate target for rTMS. We aimed to observe behavioral changes in a picture naming task induced by inhibitory rTMS targeting the right motor cortex of the lips in people with poststroke aphasia., Method: Using a single-case experimental design, we included three participants with chronic poststroke aphasia who had phonological deficits. Each participant performed a verbal picture naming task 3 times a week for 2, 3, or 4 weeks (pseudorandom across participants) to establish a baseline naming ability for each participant. These were not therapy sessions, and no feedback was provided. Then, each participant received the intervention, inhibitory continuous theta burst stimulation targeting the right motor cortex of the lips, 3 times a week for 2 weeks. Naming testing continued 3 times a week, for these latter 2 weeks. No therapy was performed at any time during the study., Results: Visual analysis of the graphs showed a positive effect of rTMS for P2 and P3 on picture naming accuracy and a tendency toward improvement for P1. Statistical analysis showed an improvement after rTMS for P1 (τ = 0.544, p = . 013, SE Tau = 0.288) and P2 (τ = 0.708, p = . 001, SE Tau = 0.235). For P3, even if the intervention allowed some improvement, this was statistically nonsignificant due to a learning effect during the baseline naming testing, which lasted the longest, 4 weeks. Regarding specific language features, phonological errors significantly decreased in all patients., Conclusions: The motor cortex of the lips could be an appropriate target for rTMS to improve naming in people with poststroke aphasia suffering from a phonological deficit. This suggests the possibility to individualize the target for rTMS, according to the patient's linguistic impairment.

Background: Idiopathic scoliosis is the most common musculoskeletal deformity in children. There is a dose-response relationship between compliance and improvement in scoliosis. The literature revealed that esthetic considerations have negative consequences on the quality of life (QOL) of patients and consequently on wearing time of the brace. To minimize esthetic problems and then increase QOL and wearing time, we proposed a new relay brace named "corset Collerette" without a pelvic-trochanteric base., Methods: A prospective cohort study was conducted in the rehabilitation department of Bordeaux University Hospital. Patients consulting for adolescent idiopathic scoliosis were registered in a prospective hospital database. The patients expressing unwillingness to wear the usual brace or who had decreased compliance were offered the corset Collerette and were included in a 3-month follow-up. Outcome measures assessed at baseline and at 3 months were Scoliosis Research Society Outcomes Questionnaire (SRS-22) and Brace Questionnaire scales and wearing time. Cobb's angle evolution since the start of bracing was also collected. The primary end point was the QOL assed by the SRS-22 scale at 3 months of follow-up., Results: The first 38 patients agreeing to wear the corset Collerette were included in the study. The QOL assessed by the SRS-22 was significantly improved with the corset Collerette ( p < 0.05). There was no significant increase in wearing time and thoracic Cobb's angles between baseline and follow-up ( p > 0.05)., Conclusion: The switch to the corset Collerette allowed an improvement in the QOL of the patients and avoid a decrease in compliance with wearing the brace and maintain the same in-brace Cobb's angles., (Copyright © 2023 International Society for Prosthetics and Orthotics.)

Objective: To develop a multidisciplinary French reference that addresses initial pre- and in-hospital management of a mild traumatic brain injury patient., Design: A panel of 22 experts was formed on request from the French Society of Emergency Medicine (SFMU) and the French Society of Anaesthesiology and Critical Care Medicine (SFAR). A policy of declaration and monitoring of links of interest was applied and respected throughout the process of producing the guidelines. Similarly, no funding was received from any company marketing a health product (drug or medical device). The expert panel had to respect and follow the Grade® (Grading of Recommendations Assessment, Development and Evaluation) methodology to evaluate the quality of the evidence on which the recommendations were based. Given the impossibility of obtaining a high level of evidence for most of the recommendations, it was decided to adopt a "Recommendations for Professional Practice" (RPP) format, rather than a Formalized Expert Recommendation (FER) format, and to formulate the recommendations using the terminology of the SFMU and SFAR Guidelines., Methods: Three fields were defined: 1) pre-hospital assessment, 2) emergency room management, and 3) emergency room discharge modalities. The group assessed 11 questions related to mild traumatic brain injury. Each question was formulated using a PICO (Patients Intervention Comparison Outcome) format., Results: The experts' synthesis work and the application of the GRADE® method resulted in the formulation of 14 recommendations. After two rounds of rating, strong agreement was obtained for all recommendations. For one question, no recommendation could be made., Conclusion: There was strong agreement among the experts on important, transdisciplinary recommendations, the purpose of which is to improve management practices for patients with mild head injury., (Copyright © 2023. Published by Elsevier Masson SAS.)

Background Magnetoencephalography (MEG) and electroencephalography (EEG) record two main types of data: continuous measurements at rest or during sleep, and event-related potentials/evoked magnetic fields (ERPs/EMFs) that involve specific and repetitive tasks. In this systematic review, we summarized longitudinal studies on recovery from post-stroke aphasia that used continuous or event-related temporal imaging (EEG or MEG). Methods We searched PubMed and Scopus for English articles published from 1950 to May 31, 2022. Results 34 studies were included in this review: 11 were non-interventional studies and 23 were clinical trials that used specific rehabilitation methods, neuromodulation, or drugs. The results of the non-interventional studies suggested that poor language recovery was associated with slow-wave activity persisting over time. The results of some clinical trials indicated that behavioral improvements were correlated with significant modulation of the N400 component. Discussion Compared with continuous EEG, ERP/EMF may more reliably identify biomarkers of therapy-induced effects. Electrophysiology should be used more often to explore language processes that are impaired after a stroke, as it may highlight treatment challenges for patients with post-stroke aphasia., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Adductor-related groin pain (ARGP) is the most common groin injury in athletes. If conservative treatment fails, then adductor tenotomy to relieve tension can be considered. The use of botulinum toxin A (BoNT-A) has shown good results in other musculoskeletal pathologies., Objective: Assess the effectiveness of BoNT-A injections in ARGP in cases where usual treatment has failed., Design: Retrospective cohort study., Setting: Orthopedic Medicine and Rehabilitation Unit, University of Bordeaux., Participants: Fifty patients treated by BoNT-A injection in ARGP after failure of medical and/or surgical treatment were included in this study., Interventions: One or several adductor muscles were injected with BoNT-A, according to clinical evaluation using ultrasound and electrical stimulation guidance. Patients were followed up at 1, 3, 6, and 12 months., Main Outcome Measures: The primary assessment criterion was the improvement of Hip and Groin Outcome Score subscales at day 30. Secondary outcomes included pain intensity and impact on sport, work, and quality of life (QoL), the Blazina scale, and side effects., Results: All the first 50 injected patients (45 male and 5 female patients) were included. A significant improvement was noted regarding the majority of Hip and Groin Outcome Score subscales at day 30 ( P < 0.05). Pain intensity and its impacts were both significantly reduced ( P < 0.001): less sport and professional disability and lower impact on QoL. Severity of symptoms assessed by the Blazina scale was significantly reduced ( P < 0.001). The improvements remained significant until 1-year postinjection., Conclusions: BoNT-A is promising as a new treatment for ARGP but should be fully assessed in a randomized controlled trial., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To evaluate if positioning the upper-limb promoting abduction, external rotation and flexion of the shoulder reduces the intensity of post-stroke shoulder pain at day-7 compared to usual clinical practice., Design & Setting: Prospective single-center randomized clinical trial using a superiority design comparing two preventive strategies of post-stroke shoulder pain in a stroke unit., Subjects: Patients were included within 2 days from a first symptomatic ischemic stroke affecting shoulder motor function., Interventions: Intervention group included specific positioning of the shoulder in abduction, external rotation and flexion in bed, chair and during mobilization. Control group referred to usual practice i.e. positioning using a standard support scarf., Main Measures: Primary outcome was the intensity of shoulder pain assessed by the visual analog scale (VAS) (0-100) at day-7 post-stroke. Other outcomes measured at day-7 and 2 months post-stroke were the VAS, motor function, spasticity, depression, functional independence and rates of complex regional Pain syndrome (CRPS)., Results: 76 patients (49 males; mean age = 68.3) were randomized. The shoulder pain at day-7 was not different between the control group (16.1, SD = 27.4) and the intervention group (10.3, SD = 21.5, p  = 0.18) as well as at 2 months ( p  = 0.12). A lower rate of depression was observed in the intervention group at 2 months 36.7% (CI95% 19.9;56.1) vs 52.9% (CI95% 35.1;70.2). No between-group difference in other outcomes was observed at 2 months., Conclusions: This study failed to demonstrate the benefit of a specific positioning tool in reducing the intensity of post-stroke shoulder pain which was lower than previously reported in the literature.

Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown that rTMS improves language recovery in patients with post-stroke aphasia., Objective: This systematic review summarizes the role of rTMS in aphasia rehabilitation., Methods: We searched MEDLINE via PubMed and Scopus on 30October, 2020, for English articles (1996-2020). Eligible studies involved post-stroke aphasia rehabilitation with rTMS. In some of these studies, rTMS was also combined with speech therapy., Results: In total, seven meta-analyses and 59studies (23randomized clinical trials) were included in this systematic review. The methods used in these studies were heterogeneous. Only six studies did not find that rTMS had a significant effect on language performance., Conclusions: The evidence from the peer-reviewed literature suggests that rTMS is an effective tool in post-stroke aphasia rehabilitation. However, the precise mechanisms that underlie the effects of rTMS and the reorganization of language networks in patients who have had a stroke remain unclear. We discuss these crucial challenges in the context of future studies., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Robotic devices are often used in rehabilitation and might be efficient to improve walking capacity after stroke., Objective: First to investigate the effects of robot-assisted gait training after stroke and second to explain the observed heterogeneity of results in previous meta-analyses., Methods: All randomized controlled trials investigating exoskeletons or end-effector devices in adult patients with stroke were searched in databases (MEDLINE, EMBASE, CENTRAL, CINAHL, OPENGREY, OPENSIGLE, PEDRO, WEB OF SCIENCE, CLINICAL TRIALS, conference proceedings) from inception to November 2019, as were bibliographies of previous meta-analyses, independently by 2 reviewers. The following variables collected before and after the rehabilitation program were gait speed, gait endurance, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC) and Timed Up and Go scores. We also extracted data on randomization method, blinding of outcome assessors, drop-outs, intention (or not) to treat, country, number of participants, disease duration, mean age, features of interventions, and date of outcomes assessment., Results: We included 33 studies involving 1466 participants. On analysis by subgroups of intervention, as compared with physiotherapy alone, physiotherapy combined with body-weight support training and robot-assisted gait training conferred greater improvement in gait speed (+0.09m/s, 95% confidence interval [CI] 0.03 to 0.15; p=0.002), FAC scores (+0.51, 95% CI 0.07 to 0.95; p=0.022) and BBS scores (+4.16, 95% CI 2.60 to 5.71; p=0.000). A meta-regression analysis suggested that these results were underestimated by the attrition bias of studies., Conclusions: Robot-assisted gait training combined with physiotherapy and body-weight support training seems an efficient intervention for gait recovery after stroke., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis., Aim: To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke., Methods and Procedures: We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison studies, observational studies and registries) and invite their contribution to the database. Where possible, we will use meta- and network meta-analysis to explore language performance after stroke and predictors of recovery as it relates to participants who had no SLT, historical SLT or SLT in the primary research study. We will also examine the components of effective SLT interventions., Outcomes and Results: Outcomes include changes in measures of functional communication, overall severity of language impairment, auditory comprehension, spoken language (including naming), reading and writing from baseline. Data captured on assessment tools will be collated and transformed to a standardised measure for each of the outcome domains., Conclusion: Our planned systematic-review-based IPD meta- and network meta-analysis is a large scale, international, multidisciplinary and methodologically complex endeavour. It will enable hypotheses to be generated and tested to optimise and inform development of interventions for people with aphasia after stroke., Systematic Review Registration: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42018110947).