2 AbstractPurpose: The study investigated whether perceptual learning (PL) of a task consisting in detecting a low contrast Gabor patch flanked above and below by high contrast Gabor patches presented monocularly in the preferred retinal locus (PRL) of patients with macular degeneration (MD), improved their residual visual functions. Method:We measured contrast detection thresholds using both a Yes/No task (three MD patients and three controls) and a temporal two-alternative forced-choice task (2AFC; four MD patients and three controls).Results: Both tasks produced a significant improvement in contrast sensitivity for the trained target.However, only in the case of the temporal-2AFC this improvement depended on the target-toflankers distance. Furthermore, in both tasks PL improved visual acuity but with the temporal-2AFC task we found a higher degree of generalization of the training to untrained stimuli and tasks.In fact, we found a reduction of the crowding effect and an improvement of the contrast sensitivity for untrained spatial frequencies.Although PL is more effective with a temporal-2AFC task, it is also present with a Yes/No task, suggesting that PL reflects sensory enhancement, rather than improvement in decision mechanisms.Most importantly, follow-up tests on MD patients showed that PL effects were retained between four and eight months, suggesting PL induced long-term neural plasticity in the visual cortex. Conclusion:The results show for the first time that PL with a collinear configuration has strong, non-invasive and long lasting rehabilitative potential to improve vision in the PRL of patients with central vision loss.3

It is known that patients with Parkinson’s Disease (PD) may show deficits in several areas of cognition, including speech and language abilities. One domain of particular interest is pragmatics, which refers to the capacity of using language in context for a successful communication. Several studies showed that some specific aspects of pragmatics – both in production and in comprehension – might be impaired in patients with PD. However, a clear picture of pragmatic abilities in PD is still missing, as most of the existing studies focused on specific aspects of the pragmatic competence rather than on sketching a complete pragmatic profile. Moreover, little is known on the potential role of protective factors in compensating the decline of communicative skills as the disease progresses. The present study has two aims: (1) to provide a complete picture of pragmatic abilities in patients with PD, by using a comprehensive battery (Assessment of Pragmatic Abilities and Cognitive Substrates, APACS) and by investigating the relationship with other aspects of cognitive functioning (e.g., working memory and Theory of Mind) and (2) to investigate whether Cognitive Reserve, i.e., the resilience to cognitive impairment provided by life experiences and activities, may compensate for the progressive pragmatic deficits in PD. We found that patients with PD, compared to healthy matched controls, had worse performance in discourse production and in the description of scenes, and that these impairments were tightly correlated with the severity of motor impairment, suggesting reduced intentionality of engaging in a communicative exchange. Patients with PD showed also an impairment in comprehending texts and humor, suggesting a problem in inferring from stories, which was related to general cognitive impairment. Notably, we did not find any significant difference between patients and controls in figurative language comprehension, a domain that is commonly impaired in other neurodegenerative diseases. This might be indicative of a specific profile of pragmatic impairment in patients with PD, worth of further investigation. Finally, Cognitive Reserve measures showed a high degree of association with pragmatic comprehension abilities, suggesting that the modification of life-styles could be a good candidate for compensating the possible problems in understanding the pragmatic aspects of language experienced by patients with PD.

Background and purpose Many different factors have been hypothesized to modulate cognition in an aging population according to their functioning at baseline. Methods This retrospective study quantifies the relative contribution of age and sex as demographic factors, comorbidity, education and occupation (classified with the International Standard Classification of Occupation 2008) as cognitive reserve proxies in accounting for cognitive aging. All participants (3081) were evaluated at baseline with a complete neuropsychological test battery (T1) and those with unimpaired profiles were classified as subjective cognitive decline, those mildly impaired as mild neurocognitive decline and those severely impaired as major neurocognitive decline. From the first assessment 543 individuals were assessed a second time (T2), and 125 a third time (T3). Depending on whether they maintained or worsened their profile, based on their initial performance, participants were then classified as resistant or declining. Results At baseline, all individuals showed education and occupation as the best predictors of performance, in addition to age. Furthermore, across assessments, the resistant had higher levels of education and occupation than the declining. In particular, the education and occupation predicted cognitive performance in all groups considered, from the subjective cognitive decline to the one with the most severely impaired participants. Conclusions This study highlights the role of working activity in protecting from cognitive decline across all fragile elderly groups and even more so the individuals who are at very high risk of decline.

Obstructive Sleep Apnea Syndrome (OSAS) is mainly associated with executive dysfunction. Although delayed reaction times (RTs) in patients with OSAS have been reported, sensitivity of processing speed has not been adequately assessed. This study suggests sensitive and reliable measures to clarify whether different components of information processing speed, i.e. cognitive and motor responses, are equally impaired in OSAS. Thirty-three patients with OSAS were compared with thirty healthy controls. The MoCA test was administered to assess participants' global neuropsychological profile. Cognitive and motor reaction times were measured using a detector panel which allows to distinguish between stimulus encoding, decision processing, and selection of the appropriate motor response. Logistic regression models highlighted both MoCA test and motor RTs as the best predictors differentiating patients from healthy participants. Results support the hypothesis of a slight decline in the cognitive profile of patients with OSAS and identify significant slowing down in the motor component of responses. It could be hypothesized that slower motor responsiveness is the cause of the global cognitive profile of these patients. With aging, motor movements and RTs usually become impaired and hypoxia might accelerate the aging process by compromising first of all the motor component of RTs.

This study explores the retrieval of proper names and the sensitivity of this lexical category to the modulatory effect of cognitive reserve in an aging population. Thirty-two elderly patients, undergoing their first neuropsychological evaluation were matched for age and education to thirty-two healthy controls. All participants were administered the Montreal Cognitive Assessment (MoCA) to measure their global cognitive performance, the Famous Face Naming test to assess proper name retrieval, and the Cognitive Reserve Index (CRI) questionnaire to obtain an index of cognitive reserve. The two groups had comparable CRI total scores, but patients’ performance was worse in both MoCA and Famous Face naming test, compared to healthy controls. Results showed that cognitive reserve predicted global cognitive performance (i.e., MoCA score) in the patients, but not in the healthy participants. Naming proper names was independent from cognitive reserve. This might be due to their lexical nature, which lies in a poor semantic connection between proper names and their bearers.