Computer-assisted cognitive rehabilitation in neurological patients: state-of-art and future perspectives

Maggio, Maria Grazia; De Bartolo, Daniela; Calabrò, Rocco Salvatore; Ciancarelli, Irene; Cerasa, Antonio; Tonin, Paolo; Di Iulio, Fulvia; Paolucci, Stefano; Antonucci, Gabriella; Morone, Giovanni; Iosa, Marco

doi:10.3389/fneur.2023.1255319

Cited by 16 publications

(10 citation statements)

References 64 publications

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“…In addition, MCI is also a common functional disorder in PD, stroke and other diseases, the main manifestations of patients with memory, attention, executive ability, speech and logical thinking ( Tatemichi et al, 1994 ; Li et al, 2019 ), seriously affect the prognosis of patients. At present, neuromusic therapy ( Galińska, 2015 ), motor therapy ( Cassilhas et al, 2007 ), computer-assisted cognitive training ( Maggio et al, 2023 ) and repetitive transcranial magnetic stimulation ( Kaster et al, 2018 ) are widely used in the treatment of cognitive impairment, and have achieved good clinical results. RASMT, in which programs follow rhythmic auditory cues (music or metronom) based on rhythmic auditory stimulation, a training method for rhythmic movements (playing percussion, playing piano, clapping, walking, etc.)…”

Section: Discussionmentioning

confidence: 99%

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Wang,

Wen,

Chen

et al. 2024

Front. Neurosci.

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ObjectiveAccording to the World Alzheimer’s Disease Report in 2015,there were 9.9 million new cases of dementia in the world every year. At present, the number of patients suffering from dementia in China has exceeded 8 million, and it may exceed 26 million by 2040.Mild cognitive impairment (MCI) refers to the pathological state of pre-dementia with the manifestation of the progressive decline of memory or other cognitive functions but without decline of activities of daily life. It is particularly important to prevent or prolong the development of MCI into dementia. Research showing effects of rhythmic auditory stimulation based-movement training(RASMT) interventions on cognitive function is also emerging. Therefore, the present meta-analysis briefly summarize findings regarding the impacts of RASMT programs on cognitive impairment.MethodsData from Pubmed, Embase, and Cochrane Library were utilized. The impact of RASMT on cognitive functions was evaluated using indicators such as overall cognitive status, memory, attention, and executive functions. The REVMAN5.3 software was employed to analyze bias risks integrated into the study and the meta-analysis results for each indicator.ResultsA total of 1,596 studies were retrieved, of which 1,385 non-randomized controlled studies and 48 repetitive studies were excluded. After reviewing titles and abstracts of the remaining 163 articles, 133 irrelevant studies were excluded, 30 studies were downloaded and read the full text. Among 30 articles, 18 articles that did not meet the inclusion criteria were excluded, the other 12 studies were included in this meta-analysis. Utilizing the Cochrane Collaborative Network Bias Risk Assessment Scale, it was found that 11 studies explained the method of random sequence generation, nine studies did not describe allocation concealment, four were single-blinded to all researchers, and eight reported single-blinding in the evaluation of experimental results. In the meta-analysis, the main outcomes showed statistically significant differences in overall cognitive status [MD = 1.19, 95%CI (0.09, 2.29), (p < 0.05)], attention [MD = −1.86, 95%CI (−3.53, −0.19), (p < 0.05)], memory [MD = 0.71, 95%CI (0.33, 1.09), (p < 0.01)], and executive function [MD = −0.23, 95% CI (−0.44, −0.02), (p < 0.05)]. Secondary outcomes indicated no statistically significant differences in verbal fluency [MD = −0.51, 95%CI (−1.30, 0.27), (p = 0.20)], while depression [MD = −0.29, 95% CI (−0.42, −0.16), (p < 0.01)] and anxiety [MD = 0.19, 95% CI (0.06, 0.32), (p < 0.01)] exhibited statistically significant differences. The GRADEpro GDT online tool assessed the quality of evidence for the outcome measures, revealing one low-quality outcome, two moderate-quality outcomes, and one high-quality outcome in this review.ConclusionThis study shows that RASMT can improve the general cognitive status, memory, attention and executive function of patients with cognitive impairment. The quality of evidence revealed that MMSE was low, attention and memory were moderate, and executive function was high. The RAMST program (type of exercise: play percussion instruments; time of exercise: 30–60 min; frequency of exercise: 2–3 times/week; duration of exercise: more than 12 weeks) was proved to be more effective in improving cognitive function. However, the sample size is relatively insufficient, the future needs further study.Systematic review registrationPROSPERO, identifier: CRD42023483561.

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Section: Discussionmentioning

confidence: 99%

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Wang,

Wen,

Chen

et al. 2024

Front. Neurosci.

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“…According to the reviewed studies, it seems that few comprehensive softwires for cognitive rehabilitation in patients with brain injuries have been created that both patients and physicians can access everywhere [ 52 ]. CogMed and Brain HQ are two famous softwires that were created specifically for cognitive rehabilitation in patients with brain injuries.…”

Section: Discussionmentioning

confidence: 99%

“…CogMed and Brain HQ are two famous softwires that were created specifically for cognitive rehabilitation in patients with brain injuries. BrainHQ is an online cognitive training system where each user can be monitored during the entire training [ 52 ]. Unlike most of the existing games [ 53 – 56 ], the current system had the ability to be installed on smart phones in two versions for physician and patient, and therefore it is available everywhere and with any quality of internet access.…”

Section: Discussionmentioning

confidence: 99%

Development of a serious game-based cognitive rehabilitation system for patients with brain injury

Rahmani-Katigari,

Mohammadian,

Shahmoradi

2023

BMC Psychiatry

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Background Traumatic brain injury (TBI) resulting from a forceful impact to the head can cause severe functional disabilities, with cognitive impairment being a major hindrance to patients' return to daily life. Encouraging patients to engage in rehabilitation programs consistently poses a significant challenge for therapists. To address this issue, gamification has gained momentum as an effective approach. This study aims to develop a serious game-based cognitive rehabilitation system tailored for patients with brain injury. Methods The study included four stages. Initially, the requirements were analyzed through focus groups. Then the system structure and game content were discussed and was agreed as a conceptual model. In second stage, the system design was drawn using various modeling diagrams. In third stage, a system prototype was developed using the Unity game engine and C# programming. Finally, a heuristic evaluation method was employed to assess usability. Results Based on the focus group meetings with seven participants, a conceptual model of the system structure and game content was designed. Game's interface was developed for both the therapist and patient versions. The focus groups determined a 2D casual gaming genre with a postman character and 10 missions on the smartphone platform. For example, in the first mission, the postman must move from mailboxes 1 to 10 and pick up the letters. This is according to Trail Making Test task. The 16 tasks in different subcategories of attention were selected to make these missions. The usability evaluation highlighted privacy, help and documentation, and aesthetic and minimalist design as the areas with the highest percentage of problems. Conclusions Cognitive rehabilitation is vital in facilitating patients' faster return to daily routines and enhancing their quality-of-life following brain injury. Incorporating a game-based system provides patients with increased motivation to engage in various cognitive exercises. Additionally, continuous monitoring by specialists ensures effective patient management. The game-based system offers different game stages to strengthen and rehabilitate attention in patients with brain injury. In the next step, the clinical effects of this system will be evaluated.

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“…Cognitive deficits are a common consequence of neurodegenerative and other neurological disorders. The rehabilitation of neuropsychological deficits represents an expanding area of neurological rehabilitation ( Taub et al, 2002 ; Stuss et al, 2008 ; Parsons, 2016 ; Maggio et al, 2023 ). Cognitive difficulties have gained increased amounts of attention in recent years.…”

Section: Introductionmentioning

confidence: 99%

Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study

Manenti,

Baglio,

Pagnoni

et al. 2024

Front. Aging Neurosci.

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BackgroundIn recent years, an increasing number of studies have examined the potential efficacy of cognitive training procedures in individuals with normal ageing and mild cognitive impairment (MCI).ObjectiveThe aims of this study were to (i) evaluate the efficacy of the cognitive Virtual Reality Rehabilitation System (VRRS) combined with anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex compared to placebo tDCS stimulation combined with VRRS and (ii) to determine how to prolong the beneficial effects of the treatment. A total of 109 subjects with MCI were assigned to 1 of 5 study groups in a randomized controlled trial design: (a) face-to-face (FTF) VRRS during anodal tDCS followed by cognitive telerehabilitation (TR) (clinic-atDCS-VRRS+Tele@H-VRRS); (b) FTF VRRS during placebo tDCS followed by TR (clinic-ptDCS-VRRS+Tele@H-VRRS); (c) FTF VRRS followed by cognitive TR (clinic-VRRS+Tele@H-VRRS); (d) FTF VRRS followed by at-home unstructured cognitive stimulation (clinic-VRRS+@H-UCS); and (e) FTF cognitive treatment as usual (clinic-TAU).ResultsAn improvement in episodic memory was observed after the end of clinic-atDCS-VRRS (p < 0.001). We found no enhancement in episodic memory after clinic-ptDCS-VRRS or after clinic-TAU.Moreover, the combined treatment led to prolonged beneficial effects (clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-ptDCS-VRRS+Tele@H-VRRS: p = 0.047; clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-VRRS+Tele@H-VRRS: p = 0.06).DiscussionThe present study provides preliminary evidence supporting the use of individualized VRRS combined with anodal tDCS and cognitive telerehabilitation for cognitive rehabilitation.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT03486704?term=NCT03486704&rank=1, NCT03486704.

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Computer-assisted cognitive rehabilitation in neurological patients: state-of-art and future perspectives

Cited by 16 publications

References 64 publications

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Development of a serious game-based cognitive rehabilitation system for patients with brain injury

Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study

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