Search

Touch, particularly affective touch mediated by C-tactile fibers, plays a key role in emotional regulation and therapeutic interventions. However, tactile stimulation is underutilized in sensory stimulation (SS) protocols for brain injury patients, despite its potential to enhance consciousness and promote recovery through neural and autonomic regulation. Tools like the Neurowave enable advanced multisensory stimulation, including audio-visual and emotional inputs, but lack tactile components. Integrating gentle touch stimulation with such systems could further enhance neuroplasticity, improve heart rate regulation, and support recovery in patients with disorders of consciousness. In this study, twenty patients affected by minimally conscious state (MCS) were divided into two groups: an experimental group (EG n.10) and a control group (CG n.10). Both groups underwent standard neurorehabilitation, including conventional physiotherapy and speech therapy. The key difference was in the type of sensory stimulation. The EG received advanced sensory stimulation with the Neurowave system (which provides audio-visual and emotional sensory stimulation) in addition to gentle touch stimulation. The CG received conventional sensory stimulation without the Neurowave and neutral gentle touch stimulation. Each patient was evaluated by a multidisciplinary rehabilitation team, using clinical scales such as coma recovery scale—revised (CSR-R), level of cognitive functioning (LCF), before (T0) and after (T1) treatment. Additionally, heart rate (HR) and neurophysiological outcomes (P300) were also recorded for both groups (EG and CG). The MANOVA model revealed a significant interaction effect between group and phase on P300 latency (F (1, 18) = 10.23, p < 0.001, η2 = 0.09), indicating that the intervention involving gentle touch stimulation significantly influenced the P300 latency in the EG. The findings of this study contribute to our understanding of the therapeutic potential of emotional multisensory stimulation, which also includes gentle touch stimulation, in MCS rehabilitation. By demonstrating significant effects on both neurophysiological and functional measures, our results support the integration of tactile interventions into comprehensive neurorehabilitation programs. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction (SD) in Parkinson's Disease (PD) patients is a common and distressing concern, although it remains an underdiagnosed and undertreated condition. Indeed, the prevalence of SD in PD ranges from 42.6% to 79% in men and from 36% to 87.5% in women. PD-related SD etiology is multifactorial and includes biological, psychological, and socio-relational factors. In a previous multicenter study on 203 PD patients, we found that there was no gender difference in dysfunction severity, although men were significantly more affected by SD than women. Methods: This paper is a secondary analysis of this previous multicenter study, and aims to investigate the potential risk factors that contribute to SD. The relationship between dysfunction and the experimental factors was assessed using Generalized Linear Mixed-Effects (GLME) model. Results: The final analysis was conducted on a sample of 177 patients (76 women), after excluding individuals with incomplete data, non-compliance with inclusion criteria, or delays in assessment tool administration. The analysis, performed using the GLME model (R2 = 0.68), revealed that gender (p = 0.01), age (p = 0.02), and depression status (HAMD) (p = 0.01) were significant predictors of SD. In contrast, other factors considered in the model, such as diabetes, and autonomic symptoms, did not significantly influence SD. Conclusions: This study demonstrates that age, gender, and depression are important predictors of SD in patients with PD. Although SD is a common NMS in PD patients, it is often neglected in clinical practice and the research on this hot topic is still poor. Then, a multidisciplinary approach, including nursing and coaching, is mandatory in order to improve sexual health in this patient population. [ABSTRACT FROM AUTHOR]

Background and aim: While conventional MS rehabilitation primarily addresses physical and cognitive symptoms, recent advances in VR technology offer immersive environments that facilitate both emotional and cognitive skill development. The purpose of this study is to evaluate the impact of VR-based training on emotional self-efficacy in multiple sclerosis (MS) patients and examine its association with cognitive function improvement. Additionally, this study aims to explore potential gender differences in these outcomes, hypothesizing that gender may influence the effectiveness of VR-based rehabilitation, which could inform more tailored approaches for emotional and cognitive rehabilitation in MS. Method: The present retrospective study analyzed data from 43 MS patients undergoing cognitive and behavioral rehabilitation at the IRCCS Centro Neurolesi "Bonino Pulejo" in Italy, comparing a VR intervention group (VR-G) and a control group receiving traditional rehabilitation. Emotional self-efficacy, depression, and anxiety were assessed, alongside cognitive function pre- and post-intervention. Results: Findings indicate that the VR-G showed significant improvements in managing negative emotions, reduced depressive and anxiety symptoms, and enhanced cognitive performance, particularly in verbal learning and working memory. Gender-based analysis revealed a trend suggesting that females in the VR-G may exhibit greater improvements in positive emotional self-efficacy, although this difference did not reach statistical significance. Spearman's correlation highlighted associations between emotional self-efficacy and cognitive gains, supporting the potential of VR to foster both emotional and cognitive resilience. Conclusions: These findings suggest that VR training may provide a tailored approach for MS rehabilitation, enhancing therapeutic outcomes by integrating emotional and cognitive training in an immersive setting. Further research should investigate long-term effects and neurophysiological correlates of VR training to optimize MS rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral and Psychological Symptoms of Dementia (BPSD) are a heterogeneous set of psychological reactions and abnormal behaviors in people with dementia (PwD). Current assessment tools, like the Neuropsychiatric Inventory (NPI), only rely on caregiver assessment of BPSD and are therefore prone to bias. Materials and methods: A multidisciplinary team developed the BPSD-SINDEM scale as a three-part instrument, with two questionnaires administered to the caregiver (evaluating BPSD extent and caregiver distress) and a clinician-rated observational scale. This first instrument was tested on a sample of 33 dyads of PwD and their caregivers, and the results were qualitatively appraised in order to revise the tool through a modified Delphi method. During this phase, the wording of the questions was slightly changed, and the distress scale was changed into a coping scale based on the high correlation between extent and distress (r = 0.94). The final version consisted of three 17-item subscales, evaluating BPSD extent and caregiver coping, and the unchanged clinician-rated observational scale. Results: This tool was quantitatively validated in a sample of 208 dyads. It demonstrated good concurrent validity, with the extent subscale correlating positively with NPI scores (r = 0.64, p < 0.001) and the coping subscale inversely correlating with NPI distress (r = −0.20, p = 0.004). Diagnosis (Lewy body dementia and frontotemporal dementia), medication (antidepressants and antipsychotics), caregiver, and PwD age predicted BPSD burden on the BPSD-SINDEM scale. Caregiver coping was influenced by diagnosis (Alzheimer's and Lewy body dementia) and benzodiazepine. Discussion: The BPSD-SINDEM scale offers a more comprehensive approach compared to NPI, by combining caregiver ratings with clinician observations. The design of the scale allows for rapid administration in diverse clinical contexts, with the potential to enhance the understanding and management of BPSD. [ABSTRACT FROM AUTHOR]

Background and Objectives: Autism Spectrum Disorder (ASD) involves challenges in social communication and daily functioning. Emerging research highlights that virtual reality (VR) interventions can significantly improve social skills in adults with ASD by providing immersive, controlled practice environments. This systematic review will assess the effectiveness of VR-based interventions for improving social skills in adults with ASD. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases without any search time range. This review was registered on Open OSF (n) P4SM5. Results: Recent studies show that VR interventions significantly enhance job interview skills, social abilities, and practical tasks in adults with ASD, with improvements in confidence, social understanding, and everyday skills. VR has been shown to be user-friendly and effective in providing immersive, adaptable training experiences. Conclusions: The review highlights VR's promising role in improving social skills, job interview abilities, and daily functioning in adults with ASD. It emphasizes the need for broader studies, standardized interventions, and exploration of VR's integration with other therapies to enhance long-term effectiveness and address comorbidities like anxiety and depression. [ABSTRACT FROM AUTHOR]

Background/Objectives: Parkinson's disease (PD) is a progressive neurodegenerative disorder that requires comprehensive and personalized rehabilitation. This retrospective study focused primarily on the usability and patient acceptability of the innovative pathway. In addition, the secondary objective was to evaluate the effectiveness of a personalized and multidisciplinary rehabilitation pathway on cognitive function, especially executive functions. Methods: We conducted a retrospective study on 80 patients with PD (Hoehn and Yahr scores 1–3). Patients were divided into an experimental group (EG), which received the innovative pathway, and a control group (CG), which received traditional therapy. The rehabilitation program included three phases: initial outpatient assessment, a two-month inpatient program, and a telerehabilitation phase in a day hospital (DH) or home environment. Interventions combined traditional therapies with treatments based on robotic and virtual reality. Cognitive assessments (Mini Mental State Examination—MMSE—and frontal assessment battery—FAB), mood (Hamilton Rating Scale—Depression—HRS-D), anxiety (HRS-Anxiety—HRS-A), and goals achievement (GAS) were the primary outcome measures. Results: At baseline, there were no significant differences between the groups in terms of age, gender, education, or test scores. After rehabilitation, EG showed significant improvements in all measures (p < 0.001), particularly in cognitive tests and goal achievement. CG improved in GAS (p < 0.001) and mood (HRS-D, p = 0.0012), but less than EG. No significant changes were observed in the MMSE of CG (p = 0.23) or FAB (p = 0.003). Conclusions: This study highlights the high usability and acceptability of VR and robotics in PD rehabilitation, contributing to improved adherence and patient engagement. The experimental group showed greater cognitive benefits, particularly in executive functions. These results are in line with the existing literature on personalized technology-based rehabilitation strategies for PD. [ABSTRACT FROM AUTHOR]

Introduction: Apraxia is a neurological disorder that is common after a stroke and impairs the planning and execution of movements. In the rehabilitation field, virtual reality (VR) presents new opportunities and offers advantages to both rehabilitation teams and individuals with neurological conditions. Indeed, VR can stimulate and improve cognitive reserve and abilities, including executive function, and enhance the patient's emotional status. Aim: The objective of this research is to determine the effectiveness of VR in improving praxis skills and behavioural functioning in individuals with severe stroke. Methods: A total of 20 stroke patients were enrolled from February 2022 to March 2023 and divided by the order of their recruitment into two groups: the experimental group (EG: n = 10) received training to improve their praxis skills using VR whereas the control one (CG: n = 10) received the same amount of standard training. All patients underwent an evaluation using a psychometric battery that consisted of the Hamilton Rating Scale for Depression (HRS-D), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Spinnler and Tognoni test, and De Renzi and Faglioni test. Valuations were performed before rehabilitation (T0) and after its completion (T1). Results: Both groups demonstrated significant improvements post-intervention. The EG showed a greater enhancement in their MMSE scores (p = 0.002), and reductions in both ideomotor and constructive apraxia (p = 0.002 for both), compared to the CG. The VR-based training also resulted in significant improvements in their depression symptoms (HRSD scores improved, p = 0.012 in EG vs. p = 0.021 in CG). Conclusions: This pilot study suggests that VR could help reduce cognitive, constructive apraxia and ideomotor apraxia symptoms caused by stroke injury. [ABSTRACT FROM AUTHOR]

Background/Objectives: Burden Syndrome, also known as Caregiver Syndrome, particularly affects those who serve in the role of informal caregiver in the presence of family members with conditions. The ABCX dual model examines the impact on the caregiver of the diagnosis of autism spectrum disorder (ASD) on the family. This model considers the severity of the stressor (A), the additional demands of life stress (aA), the family's internal resources (B), the family's external resources (bB), the family's assessment of the situation (C), coping strategies (cC), and outcome (X). The purpose of the present study is to investigate the relationships between resilience, guilt, and burden of care in caregivers of children with ASD. Methods: Various assessment instruments were used, including the "Caregiver Burden Inventory" to measure burden, the "Brief Resilience Scale" to assess resilience, the "Guilt Sensitivity Questionnaire" to examine guilt sensitivity, and the "DA.L.I.A." to collect information on parent and child characteristics. A total of 80 parents/caregivers participated in the research, including 53 women (Age M = 41.72; SD = 7.8) and 27 men (Age M = 43.35; SD = 6.29). Results: The findings indicate that individuals' resilience to stressful events correlates negatively with burden, a developmental subtype. However, guilt seems not to play a significant role in the overall perception of burden. In contrast, it was found that the use of informal supports is associated with higher levels of guilt and emotional burden, whereas the use of formal supports is correlated with higher emotional burden, but not higher perceptions of guilt. Conclusions: This study provides important information about the support needed by caregivers and suggests how to address emotional burdens to prevent burnout and support families with children with ASD. [ABSTRACT FROM AUTHOR]

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the "Bonino Pulejo" Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient's care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping "those who help", for the well-being of patients, healthcare teams, and healthcare organizations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acquired brain injuries (ABI) represent neurological disorders that can arise after traumatic and non-traumatic events. In addition to the physical, emotional and cognitive challenges that patients face, these injuries can bring changes in the life of the patient and his or her family. OBJECTIVE: This study aims to understand how the occurrence of an ABI condition can disrupt and reshape family functioning by examining certain dimensions such as role in the family, gender and age, which may have a major influence on family dynamics. METHODS: We enrolled 86 caregivers of patients with ABI. Two experienced psychologists examined family functioning with Olso's Family Adaptability and Cohesion Rating Scale (FACES IV). RESULTS: The correlation between groups by generics showed a significant difference only for flexibility (p = 0.05). Specifically, flexibility was greater in male caregivers, particularly in sons. Most of the constructs defining family functioning, such as communication, remained unchanged despite the ABI event. CONCLUSION: This study provides an in-depth understanding of how families face the challenges posed by the ABI and the role caregivers play within the system. [ABSTRACT FROM AUTHOR]

Osteopathic manipulative treatment (OMT) is a hands-on therapy aiming to achieve the global homeostasis of the patient. OMT focuses on treating the somatic dysfunctions characterized by tissue modifications, body asymmetry, and range-of-motion restrictions. The benefits related to OMT are thought to be associated with the interconnectedness of the body's systems and the inherent capacity for self-healing. However, whether OMT can influence brain activity, and, consequently, neurophysiological responses is an open research question. Our research investigates the literature to identify the effects of OMT on brain activity. The main purpose of the research question is: can OMT influence brain activity and consequently neurophysiological responses? A scoping review was conducted, searching the following databases: PubMed, Google Scholar, and OSTEOMED.DR (Osteopathic Medical Digital Repository), Scopus, Web of Science (WoS), and Science Direct. The initial search returned 114 articles, and after removing duplicates, 69 were considered eligible to be included in the final sample. In the end, eight studies (six randomized controlled trials, one pilot study, and one cross-over study) were finally included and analyzed in this review. In conclusion, OMT seems to have a role in influencing functional changes in brain activity in healthy individuals and even more in patients with chronic musculoskeletal pain. However, further RCT studies are needed to confirm these findings. Registration protocol: CRD42024525390. [ABSTRACT FROM AUTHOR]