Posts Tagged cognitive

[WEB SITE] Transcranial electrical stimulation shows promise for treating mild traumatic brain injury

 

Credit: copyright American Heart Association

Using a form of low-impulse electrical stimulation to the brain, documented by neuroimaging, researchers at the University of California San Diego School of Medicine, Veterans Affairs San Diego Healthcare System (VASDHS) and collaborators elsewhere, report significantly improved neural function in participants with mild traumatic brain injury (TBI).

Their findings are published online in the current issue of the journal Brain Injury.

TBI is a leading cause of sustained physical, cognitive, emotional and behavioral problems in both the civilian population (primarily due to , sports, falls and assaults) and among military personnel (blast injuries). In the majority of cases,  is deemed mild (75 percent of civilians, 89 percent of military), and typically resolves in days.

But in a significant percentage of cases, mild TBI and related post-concussive symptoms persist for months, even years, resulting in chronic, long-term cognitive and/or behavioral impairment.

Much about the pathology of mild TBI is not well understood, which the authors say has confounded efforts to develop optimal treatments. However, they note the use of passive neuro-feedback, which involves applying low-intensity pulses to the brain through transcranial  (LIP-tES), has shown promise.

In their pilot study, which involved six participants who had suffered mild TBI and experienced persistent post-concussion symptoms, the researchers used a version of LIP-tES called IASIS, combined with concurrent electroencephalography monitoring (EEG). The  effects of IASIS were assessed using magnetoencephalography (MEG) before and after treatment. MEG is a form of non-invasive functional imaging that directly measures brain neuronal electromagnetic activity, with high temporal resolution (1 ms) and high spatial accuracy (~3 mm at the cortex).

“Our previous publications have shown that MEG detection of abnormal brain slow-waves is one of the most sensitive biomarkers for mild  (concussions), with about 85 percent sensitivity in detecting concussions and, essentially, no false-positives in normal patients,” said senior author Roland Lee, MD, professor of radiology and director of Neuroradiology, MRI and MEG at UC San Diego School of Medicine and VASDHS. “This makes it an ideal technique to monitor the effects of concussion treatments such as LIP-tES.”

The researchers found that the brains of all six participants displayed abnormal slow-waves in initial, baseline MEG scans. Following treatment using IASIS, MEG scans indicated measurably reduced abnormal slow-waves. The participants also reported a significant reduction in post-concussion scores.

“For the first time, we’ve been able to document with neuroimaging the effects of LIP-tES treatment on brain functioning in mild TBI,” said first author Ming-Xiong Huang, PhD, professor in the Department of Radiology at UC San Diego School of Medicine and a research scientist at VASDHS. “It’s a small study, which certainly must be expanded, but it suggests new potential for effectively speeding the healing process in mild traumatic injuries.”

Source: Transcranial electrical stimulation shows promise for treating mild traumatic brain injury

Advertisements

, , , , , , , ,

Leave a comment

[WEB PAGE] What Is PTSD? – PTSD: National Center for PTSD

What Is PTSD?

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time.

What factors affect who develops PTSD?

PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control. For example, having a very intense or long-lasting traumatic event or getting injured during the event can make it more likely that a person will develop PTSD. PTSD is also more common after certain types of trauma, like combat and sexual assault.

Personal factors, like previous traumatic exposure, age, and gender, can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.

What are the symptoms of PTSD?

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

There are four types of symptoms of PTSD (en Español), but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

  1. Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
  2. Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
  3. Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.
  4. Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.

Can children have PTSD?

Children can have PTSD too. They may have symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

  • Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
  • Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
  • Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.

What other problems do people with PTSD experience?

People with PTSD may also have other problems. These include:

  • Feelings of hopelessness, shame, or despair
  • Depression or anxiety
  • Drinking or drug problems
  • Physical symptoms or chronic pain
  • Employment problems
  • Relationship problems, including divorce

In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.

Will people with PTSD get better?

“Getting better” means different things for different people. There are many different treatment options for PTSD. For many people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense. Your symptoms don’t have to interfere with your everyday activities, work, and relationships.

What treatments are available?

There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist. There are different types of psychotherapy:

  • Cognitive behavioral therapy (CBT) is the most effective treatment for PTSD. There are different types of CBT, such as cognitive therapy and exposure therapy.
    • One type is Cognitive Processing Therapy (CPT) where you learn skills to understand how trauma changed your thoughts and feelings. Changing how you think about the trauma can change how you feel.
    • Another type is Prolonged Exposure (PE) where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
  • A similar kind of therapy is called Eye Movement Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.

Medications for PTSD

Medications can be effective too. SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are also used for depression, are effective for PTSD. Another medication called Prazosin has been found to be helpful in decreasing nightmares related to the trauma.

IMPORTANT: Benzodiazepines and atypical antipsychotics should generally be avoided for PTSD treatment because they do not treat the core PTSD symptoms and can be addictive.

Visit Site —> What Is PTSD? – PTSD: National Center for PTSD

, , , , , , , , , ,

Leave a comment

[BLOG POST] Driving After Stroke: Is it Safe? -Saebo

After having a stroke, many survivors are eager to start driving again. Driving offers independence and the ability to go where you want to go on your own schedule, so it is no surprise that survivors want to get back behind the wheel rather than rely on someone else for their transportation needs.

Unfortunately, having a stroke can have lasting effects that make driving more difficult. A survivor might not be aware of all of the effects of their stroke and could misjudge their ability to drive safely. Driving against a doctor’s orders after a stroke is not only dangerous, it may even be illegal. Many stroke survivors successfully regain their ability to safely drive after a stroke, but it is important that they do not attempt to drive until they are cleared by their healthcare provider.

 

How Stroke Affects the Ability to Drive

Having a stroke can affect an individual’s ability to drive in numerous ways, whether it be because of physical challenges, cognitive changes, or other challenges.

 

Physical Challenges

Physical-Challenges

After a stroke, it’s common to experience weakness or paralysis on one side of the body, depending on which side of the brain the stroke occurred. More than half of all stroke survivors also experience post-stroke pain. Minor physical challenges may be overcome with adaptive driving equipment, but severe challenges like paralysis or contracture can seriously affect an individual’s ability to drive.

 

Cognitive Effects

cognitive

Driving requires a combination of cognitive skills, including memory, concentration, problem solving, judgement, multitasking, and the ability to make quick decisions. A stroke can cause cognitive changes that limit the ability to do many of those things.

 

Vision Problems

vision

As many as two-thirds of stroke victims experience vision impairments as a result of a stroke. This can include vision loss, blurred vision, and visual processing problems. Stroke survivors with vision problems should not drive until their problems are resolved and they have been cleared by a doctor.

 

Fatigue

fatigue

Fatigue is a common physical condition after a stroke that affects between 40 and 70 percent of stroke survivors. Fatigue can arrive without warning, so it is dangerous to drive when suffering from post-stroke fatigue.

 

Warning Signs of Unsafe Driving

 

Stroke survivors are not always aware of how their stroke has limited their ability to drive. If they are choosing to drive after their stroke against their doctor’s advice, it is important for them and their loved ones to look out for warning signs that they might not be ready to start driving. Here are some of the common warning signs to look out for:

  • Driving faster or slower than the posted speed or the wrong speed for the current driving conditions
  • Consistently asking for instruction and help from passengers
  • Ignoring posted signs or signals
  • Making slow or poor decisions
  • Becoming easily frustrated or confused
  • Getting lost in familiar areas
  • Being in an accident or having close calls
  • Drifting into other lanes

 

If you or your loved one is showing any of these warning signs, immediately stop yourself or them from driving until your or their driving is tested.

 

Driving Again After a Stroke

Before a stroke survivor begins driving again, they should speak with their doctor or therapist to discuss whether or not it would be safe for them to continue driving. Many states require mandatory reporting by a physician to the DMV if their patient has impairments that may affect their driving after a stroke. Even if their doctor clears them to drive, they still will likely need to be evaluated by the DMV before they regain their driving privileges.

 

Driver rehabilitation specialists are available to help stroke survivors evaluate their driving ability from behind the wheel. There are also driver’s training programs that provide a driving evaluation, classroom instruction, and suggestions for modifying a car to the individual driver’s needs. For instance, an occupational therapist can provide a comprehensive in-clinic evaluation of a client’s current skills and deficits relative to driving.

 

From there a client could be sent for an in-vehicle assessment for further evaluation by a certified driver rehabilitation specialist (CDRS). They can assess driving skills in a controlled and safe environment. An in-vehicle driving test is the most thorough way to gauge a driver’s abilities. Each assessment takes about 1 hour and involves driving with a trained evaluator or driving in a computer simulator.

 

The “behind-the-wheel” evaluation will include testing for changes in key performance areas such as attention, memory, vision, reaction time, and coordination. After this assessment the CDRS can determine if the client is safe to drive, can not drive at all, or may drive with additional recommendations.

 

Often times clients may require certain modifications to their car in order to drive safely. In addition, some clients may benefit from on-going classroom training and simulation training in order to meet safety standards. These are all services that a driver rehabilitation specialist can provide. To help find these resources, The Association for Driver Rehabilitation Specialists has a directory of certified driver rehabilitation specialists, driver rehabilitation specialists, and mobility equipment dealers and manufacturers.

 

Get Back Behind the Wheel

Many stroke survivors successfully drive after a stroke; however, not all are able to. While reclaiming independence is important, staying safe is the greatest concern. It is important for stroke survivors to listen to their doctors and wait until they are fully ready before attempting to drive again. With some hard work and patience, getting back behind the wheel is possible.

 


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

Source: Driving After Stroke: Is it Safe? | Saebo

, , , , ,

Leave a comment

[VIDEO] Effect of Brain Injury on Personality – YouTube

How does personality change after brain injury? In this video, NeuroRestorative’s Dr. Gordon Horn explains the cognitive, emotional and social components that impact personality. As a Neuropsychologist, Dr. Horn works with individuals and families to evaluate, stabilize, and optimize personality changes so individuals can continue their rehabilitative progress.

Interested in learning more? Watch the other videos in our “Effects of Brain Injury” series!

Feel free to rate, comment on and share these videos with others!

, , , , ,

Leave a comment

[ARTICLE] The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials – Full Text

Abstract

Physically-active video games (‘exergames’) have recently gained popularity for leisure and entertainment purposes. Using exergames to combine physical activity and cognitively-demanding tasks may offer a novel strategy to improve cognitive functioning. Therefore, this systematic review and meta-analysis was performed to establish effects of exergames on overall cognition and specific cognitive domains in clinical and non-clinical populations. We identified 17 eligible RCTs with cognitive outcome data for 926 participants. Random-effects meta-analyses found exergames significantly improved global cognition (g = 0.436, 95% CI = 0.18–0.69, p = 0.001). Significant effects still existed when excluding waitlist-only controlled studies, and when comparing to physical activity interventions. Furthermore, benefits of exergames where observed for both healthy older adults and clinical populations with conditions associated with neurocognitive impairments (all p < 0.05). Domain-specific analyses found exergames improved executive functions, attentional processing and visuospatial skills. The findings present the first meta-analytic evidence for effects of exergames on cognition. Future research must establish which patient/treatment factors influence efficacy of exergames, and explore neurobiological mechanisms of action.

1. Introduction

Cognition can be broadly defined as the actions of the brain involved in understanding and functioning in our external environment (Hirschfeld and Gelman, 1994). As it is generally accepted that cognition requires multiple mental processes, this broader concept has been theoretically separated into multiple ‘cognitive domains’ (Hirschfeld and Gelman, 1994). Although definitions vary, and the boundaries between domains often overlap, examples of distinct areas of cognitive functioning include the processes for learning and remembering verbal and spatial information, attentional capacities, response speed, problem-solving and planning (Strauss et al., 2006).

Various neuropsychological tests have been developed as tools for assessing and quantifying an individual’s overall cognitive functioning (or ‘global cognition’) along with their performance within the separable domains of cognition (Strauss et al., 2006). Performance in these various cognitive tests has been found to be relatively stable over time in healthy adults, and moderately accurate predictors of real-world functioning and occupational performance (Chaytor and Schmitter-Edgecombe, 2003 ;  Hunter, 1986). Furthermore, neuropsychological tests can detect the deficits in cognitive functioning which arise as a consequence of various psychiatric and neurological diseases (Mathuranath et al., 2000 ;  Nuechterlein et al., 2004). For example, people with Parkinson’s disease show marked impairments in planning and memory tasks (Dubois and Pillon, 1996), whereas those with schizophrenia have cognitive pervasive deficits, 1–2 standard deviations below population norms, which also predict the severity of disability in this population (Green et al., 2000). Additionally, cognitive abilities decline naturally in almost all people during healthy ageing (Van Hooren et al., 2007). In an ageing population, the functional consequences of cognitive decline may ultimately have a severe social and economic impact. Thus, interventions which improve cognition hold promise for the treatment of psychiatric and neurological diseases, an have positive implications for population health.

Fortunately, interventions which stimulate the brain and/or body can improve cognition, or attenuate decline. For instance, physical exercise has been shown to significantly improve global cognition, along with working memory and attentional processes, in both clinical and healthy populations (Firth et al., 2016Smith et al., 2010 ;  Zheng et al., 2016). Interventions can also be designed to target cognition directly, as computerized training programs for memory and other functions have been found to provide significant cognitive benefits, at least in the short term (Hill et al., 2017 ;  Melby-Lervåg and Hulme, 2013). Furthermore, ‘gamification’ of cognitive training programs can maximize their clinical effectiveness, as more complex and interesting programs are capable of better engaging patients in cognitively-demanding tasks while also training multiple cognitive processes simultaneously (Anguera et al., 2013).

Previous studies have found that providing both aerobic exercise and cognitive training together may have additive effects, preventing ageing-related cognitive decline more effectively (Shatil, 2013). This may be due to aerobic and cognitive activity stimulating neurogenesis through independent but complementary pathways; as animal studies show that while exercise stimulates cell proliferation, learning tasks support the survival of these new cells (Kempermann et al., 2010), such that combining these two types of training results in 30% more new neurons than either task alone (Fabel et al., 2009).

Rather than delivering aerobic and cognitive training in separate training sessions, recent advances in technology has presented an opportunity for combining physical activity with cognitively-challenging tasks in a single session through ‘exergames’. Exergames are considered as interactive video-games which require the player to produce physical body movements in order to complete set tasks or actions, in response to visual cues (Oh and Yang, 2010). Common examples include the ‘Nintendo Wii’ (along with ‘Wii Fit’ or ‘Wii Sports software’) or the ‘Microsoft Xbox Kinect’. Additionally, virtual reality systems which use exercise bikes and/or treadmills as a medium for players to interact with three-dimensional worlds have also been developed to provide immersive training experiences (Sinclair et al., 2007).

Along with their popular usage for leisure and entertainment, there is growing interest in the application of exergame systems to improve clinical outcomes. Recent systematic reviews and meta-analyses of this growing literature have provided preliminary evidence that exergames can improve various health-related outcomes, including reducing childhood obesity, improving balance and falls risk factors in elderly adults, facilitating functional rehabilitation in people with parkinson’s disease, and even reduce depression (Barry et al., 2014Li et al., 2016 ;  van’t Riet et al., 2014). However, the effects of exergames on cognitive functioning have not been systematically reviewed, despite many individual studies in this area.

Therefore, the aim of this study was to systematically review all existing trials of exergames for cognition, and apply meta-analytic techniques to establish the effects of exergames on global cognition along with individual cognitive domains. We also sought to (i) examine the effects of exergames on cognition in healthy and clinically-impaired populations, and (ii) investigate if the effects of exergames differed from those of aerobic exercise alone, by comparing exergames to traditional physical activity control conditions.

Fig. 1

Fig. 1. PRISMA flow diagram of systematic search and study selection.

Continue —> The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials

, , , , , , , ,

Leave a comment

[Conference paper] VRAndroid System Based on Cognitive Therapeutic Exercises for Stroke Patients – Abstract+References

Abstract

It is presented VRAndroid System designed in Android and implemented on an Android Tablet, the system consists in a set of nine shapes based on cognitive therapeutic exercises for the motor rehabilitation in upper limbs, this tools provides perceptive feedback (vibration) to the patient as he follows the correct shape with his finger. There are two performed rehabilitation phases: (1) Through the Perffeti Technique (15 sessions), (2) Through VRAndroid System (15 sessions), the evolution and results of the rehabilitation are evaluated by the BOX AND BLOCK test, which shows that, the rehabilitation through this techniques help in the motor recovery of the upper limbs, moreover, the VRAndroid System is a useful tool to be used as a traditional rehabilitation supplement.

Source: VRAndroid System Based on Cognitive Therapeutic Exercises for Stroke Patients | SpringerLink

, , , , , , , , ,

Leave a comment

[WEB SITE] Five of the best apps to train your brain

It is no secret that as we age, our brain function declines. However, studies have suggested that keeping mentally active – particularly when older – can help to maintain cognitive functioning. Brain training apps are considered a useful aid for mental stimulation, but which one is right for you? We present our pick of five of the best brain training apps around.
[An illustration of a brain and technology]

Research has suggested that brain training may be beneficial for cognitive functioning.

Brain training is based on the premise that mental stimulation can improve neuroplasticity. This is the brain’s ability to form and reorganize connections between brain cells in response to new tasks.

While some studies have failed to find a link between brain training and improved cognitive functioning, other research has found the opposite.

A study published in PLOS One in 2013, for example, found that young adults who engaged in brain training games demonstrated improvements in brain processing speed, working memory, and executive functions.

It is not only young adults who might benefit from brain training. Research presented at the 2016 Alzheimer’s Association International Conference found that older adults who took part in ten 1-hour brain training sessions over a 5-week period were 48 percent less likely to develop cognitive decline or dementia over 10 years.

Such studies have fueled the development of hundreds of brain training apps, many of which claim to improve cognitive functions such as learning, memory, and concentration. With so many to choose from, however, how do you know which one is best for you?

Medical News Today have tried and tested five of the best brain training apps available to help you make an informed decision.

Lumosity: Colorful and fun

Considered by many as the “original” brain training app, Lumosity is used by more than 85 million people across the globe. The app consists of more than 50 colorful and fun minigames designed to train five cognitive functions: speed, memory, attention, flexibility, and problem-solving.

Lumosity’s games have been created with the help of more than 100 researchers from around the world. Furthermore, their website cites a study of more than 4,700 adults that found that brain training with Lumosity improved cognition more than crosswords.

[Lumosity iOS image]

Lumosity has more than 85 million users worldwide. Image credit: Lumosity

With this in mind, we couldn’t pass up the opportunity to try the app for ourselves.

At sign-up, you are required to complete a “fit test,” which calibrates your speed, attention, and memory through three separate games.

Once the games are complete, users are shown how their results compare with those of other users in the same age group. This provides insight into the areas of cognition that require the most attention.

Each day going forward, Lumosity sends a reminder to complete a brain “workout.” The daily brain workout involves playing three minigames – five with the premium version – each focusing on the five cognitive functions.

One game we enjoyed was Train of Thought, which focuses on attention. In this game, the user must change the direction of train tracks, with the aim of guiding different colored trains to the correct home. We found that this game really challenged our concentration – although it could be frustrating at times.

Luminosity is an app that could easily appeal to both children and adults. Many of the games – such as Highway Hazards, a driving game that involves moving left or right to avoid road hazards – have a child-like appeal.

Lumosity is free to download on Android and iOS, though upgrading to a premium subscription costs $11.99 per month or $59.99 for 1 year.

Elevate: Boosting ‘productivity, earning power, and self-confidence’

While Elevate has fewer users than Lumosity, at 10 million downloads worldwide, it holds the title of iPhone’s best app of the year for 2014. So what makes it stand out?

The app consists of more than 40 minigames designed to boost math and speaking skills, as well as improve memory, attention, and processing speed.

[Elevate app]

Just like Lumosity, Elevate encourages daily brain training, which involves the completion of three games, or five games with the “PRO” version.

Elevate has more of an adult feel than many of the other brain training apps; the minigames take a more serious approach, focusing less on colorful illustrations and more on text. Each game also comes with a brief description of its goal, such as “stop mixing up commonly confused words” and “improve your reading comprehension.”

One game we enjoyed was Error Avoidance, whereby the user is required to “keep” or “swap” two words in a passage of text within a set time. For example: “He fashioned the cookie doe into the shape of a grazing dough.” In this case, the two words would be swapped.

Elevate provides a daily, weekly, and monthly rundown of overall performance, as well as performance in five specific areas: writing, listening, speaking, reading, and math. If you’re feeling competitive, you have the option of comparing your performance with that of other users in the same age group.

Elevate is available to download for free on both Android and iOS. Upgrading to PRO costs $4.99 for 1 month or $39.99 for a year.

Peak: Flexible training and tracking

Rated by Google as one of the best Android apps for 2016, Peak offers more than 30 minigames to help improve concentration, memory, mental agility, language, and problem-solving.

[Peak app]These games have been developed with the help of scientists from respectable universities across the globe, including Yale University in Connecticut and the University of Cambridge in the United Kingdom.

Like Lumosity, there are a number of games that may appeal to children and adults alike. One such game is Turtle Traffic – a mental agility game that requires the user to navigate a turtle through the sea and collect jellyfish.

Based on performance in baseline tests, a personalized workout plan is provided, although the user is not limited to this plan. In the “Pro” version, all games are available to play at any time.

The Peak creators recommend brain training for 3 days per week. One great feature of Peak is that you can select the days that you want to train and set reminders for these days.

Cognitive performance is also very easy to track. Not only does the app provide information on individual game performance, but it also provides data on overall performance in each of the five cognitive functions. Similar to the other brain training apps, you are also able to compare performance with other users.

Peak is available to download for free on Android and iOS. A 12-month subscription starts from $34.99, while 1 month starts from $4.99.

Fit Brains: Targeting emotional intelligence

Fit Brains is a creation of Rosetta Stone – an education technology software company best known for their online language courses.

[Fit brains app]This brain training app boasts the largest variety, with more than 60 minigames and more than 500 personalized training programs. With the input of neuroscientists, these games have been created to help exercise key cognitive functions, including concentration, memory, speed of thinking, and problem-solving.

What sets Fit Brains part from other brain training apps, however, is that it also targets emotional intelligence through games that focus on social skills, social awareness, self-awareness, and self-control.

One game we enjoyed at MNT was Speedy Sorts – a game that tests thinking speed by asking the user to arrange objects into the correct piles as quickly as possible.

Based on the results of each game played, the user is provided with a score out of 200 for each cognitive area. The app also compares individual results with those of other users.

Unlike many other brain training apps, Fit Brains also has a school edition – a brain training package that aims to boost the cognitive functions of schoolchildren.

Fit Brains is free to download on Android and iOS. An upgrade to premium costs $9.99 for a month and $49.99 for a year.

CogniFit: For consumers, scientists, and clinicians

CogniFit is perhaps the most advanced brain training app we reviewed, consisting of a variety of minigames designed to train more than 20 cognitive skills, including short-term memory, planning, hand-eye coordination, and auditory perception.

[CogniFit app]

The CogniFit developers are keen to point out that all of their brain training tools have been validated by scientists – including researchers from the University of Washington and the Albert Einstein College of Medicine in New York. Furthermore, they state that the efficacy of their tools has been established through general population studies.

Interestingly, CogniFit also offers tools that researchers and healthcare professionals can use in order to study and assess cognitive function in patients.

MNT tested the brain training games for consumers, and we found them to be a good balance of fun and mental stimulation.

One game we enjoyed was Reaction Field, which tests response time, visual scanning, and inhibition – which is the ability to control impulsive behavior. This game is similar to Whac-a-Mole; the user is required to remember the color of a mole and tap on moles of the same color as they pop up from holes in the ground.

Individual cognitive performance is assessed using the Lumosity Performance Index, which is calculated using the average scores of all games played. Like the other brain training apps, you can also compare your performance against that of other users.

CogniFit is available to download for free on Android and iOS. A premium upgrade costs $19.99 for 1 month or $189.99 for a year.

Learn about five of the best meditation apps.

Source: Five of the best apps to train your brain – Medical News Today

, , , , , , , , ,

Leave a comment

[WEB SITE] TherapWii – game suggestions

Why TherapWii

Gaming activates and is fun to do! In a playful and often unnoticed way skills are trained. Adolescents grow up in a digital world; they enjoy gaming and do it frequently. For adults and elderly gaming has been shown to be a useful type of therapy.

In a virtual environment moving, executing, learning and enjoying are appealing; if circumstances or limitations keep you from going to the bowling alley or playing an instrument, gaming can broaden your boundaries.

Gaming with the Wii can complement therapy, can make therapy more attractive, intenser and more provocative.

TherapWii has been developed to support therapists in an effective and specific way while using the Nintendo Wii and offer options to game in the home environment.

TherapWii is the product of an exploratory research project done by the Special Lectorship Rehabilitation at the Hague University. The results of this project can be found by clicking on the header ‘research’ at the end of the page.

How does TherapWii work?

Per therapy goal there are three colored tabs to help find the most suitable games. Each game lists specific information in text and symbols. There is also a level of difficulty; by moving the cursor over this button you see more information.

User information is saved in ‘explanation and tips’. To enhance this section you can email recommendations and suggestions to the email address listed below.

TherapWii has been developed, also for home use, so that experience lead to personal growth.

Advice for game adjustments

It is important that the therapist stays close to the patient’s goals and abilities and adjusts the game program appropriately. If you, as therapist, want to make the game easier, more difficult or more daring, you can change the instruction, implementation or setting.

A few examples:

Physical: strength (add weights to the arms or legs or change the starting position); balance/stability (play while standing on an instable foundation (ball, mat). Or play the games while sitting on a stationary bicycle!

Cognition: create double tasks (ask mathematics, questions or riddles); spatial orientation or visual adjustments (play with one eye covered or in front of a mirror).

Social-emotional: stimulate cooperation or competition (create bets or role-playing).

Let us know if you have other ideas to make the games more provoking.

How are the games rated?

The games were tested by several professionals (physical therapists, occupational therapists and sport therapists). Differences in opinion or scores were discussed and voted on.

Give us feedback, corrections and advice, we will adjust the TherapWii program monthly and will use your suggestions.

Which ability do you choose?

Social-Emotional

Physical

Cognitive

Visit WEB SITE

, , , , , , ,

Leave a comment

[ARTICLE] Notes on Human Trials of Transcranial Direct Current Stimulation between 1960 and 1998 – Full Text

Background: Transcranial direct current stimulation (tDCS) is investigated to modulate neuronal function including cognitive neuroscience and neuropsychiatric therapies. While cases of human stimulation with rudimentary batteries date back more than 200 years, clinical trials with current controlled stimulation were published intermittently since the 1960s. The modern era of tDCS only started after 1998.

Objectives: To review methods and outcomes of tDCS studies from old literature (between 1960 and 1998) with intention of providing new insight for ongoing tDCS trials and development of tDCS protocols especially for the purpose of treatment.

Methods: Articles were identified through a search in PubMed and through the reference list from its selected articles. We included only non-invasive human studies that provided controlled direct current and were written in English, French, Spanish or Portuguese before the year of 1998, the date in which modern stimulation paradigms were implemented.

Results: Fifteen articles met our criteria. The majority were small-randomized controlled clinical trials that enrolled a mean of approximately 26 subjects (Phase II studies). Most of the studies (around 83%) assessed the role of tDCS in the treatment of psychiatric conditions, in which the main outcomes were measured by means of behavioral scales and clinical observation, but the diagnostic precision and the quality of outcome monitoring, including adverse events, were deficient by modern standards. Compared to modern tDCS dose, the stimulation intensities used (0.1–1 mA) were lower, however as the electrodes were typically smaller (e.g., 1.26 cm2), the average electrode current density (0.2 mA/cm2) was approximately 4× higher. The number of sessions ranged from one to 120 (median 14). Notably, the stimulation session durations of several minutes to 11 h (median 4.5 h) could markedly exceed modern tDCS protocols. Twelve studies out of 15 showed positive results. Only mild side effects were reported, with headache and skin alterations the most common.

Conclusion: Most of the studies identified were for psychiatric indications, especially in patients with depression and/or schizophrenia and majority indicated some positive results. Variability in outcome is noted across trials and within trials across subjects, but overall results were reported as encouraging, and consistent with modern efforts, given some responders and mild side effects. The significant difference with modern dose, low current with smaller electrode size and interestingly much longer stimulation duration may worth considering.

Introduction

Transcranial direct current stimulation (tDCS) consists of applying a weak direct current on the scalp, a portion of which crosses the skull (Datta et al., 2009) and induces cortical changes (Fregni and Pascual-Leone, 2007; Nitsche et al., 2008). The investigation of the application of electricity over the brain dates back to at least 200 years, when Giovanni Aldini (Zaghi et al., 2010) recommended galvanism for patients with deafness, amaurosis and “insanity”, reporting good results with this technique especially when used in patients with “melancholia”. Aldini also used tDCS in patients with symptoms of personality disorders and supposedly reported complete rehabilitation following transcranial administration of electric current (Parent, 2004).

These earliest studies used rudimentary batteries and so were constant voltage, where the resulting current depends on a variable body resistance. Over the 20th century, direct voltage continued to be used but most testing involved pulsed stimulation, starting with basic devices where a mechanical circuit that intermittently connected and broke the circuit between the battery and the subject and evolving to modern current control circuits including Cranial Electrotherapy Stimulation and its variants (Guleyupoglu et al., 2013). Interest in direct current stimulation (or tDCS) resurged with the studies of Priori et al. (1998) and Nitsche and Paulus (2000) that demonstrated weak direct current could change cortical response to Transcranial Magnetic Stimulation, thereby indicating that tDCS could change cortical “excitability”. Testing for clinical and cognitive modification soon followed (Fregni et al., 2005, 2006). Developments and challenges in tDCS research, including applications in the treatment of neuro-psychiatrics disease since 1998 have been reviewed in detailed elsewhere (Brunoni et al., 2012).

This historical note aims to explore earlier data on human trial using current controlled stimulation (tDCS) before 1998 with the goal of informing ongoing understanding and development of tDCS protocols. As expected, we found variability in the quality of trial design, data collection and reporting in these earlier studies. Nonetheless, many clinical findings are broadly consistent with modern efforts, including some encouraging results but also variability across subjects. We also describe a significant difference in dose with lower current, smaller electrodes and much longer durations (up to 11 h) than used in modern tDCS.

Figure 2. Summary of study parameters on human trials using transcranial direct current stimulation (tDCS) in old literature (from 1960 to 1998). Models of commonly used montages of tDCS in early studies (A); red: anode electrode(s), blue: cathode electrode(s). Total number of subjects in each group of patients participating in studies using aforementioned montages (B.1) and leading countries conducting tDCS studies in early stage with number of published articles (B.2).

Continue —> Frontiers | Notes on Human Trials of Transcranial Direct Current Stimulation between 1960 and 1998 | Frontiers in Human Neuroscience

, , , , ,

Leave a comment

[BOOK] The Role of Technology in Clinical Neuropsychology – Google Books

Front CoverNeuropsychology as a field has been slow to embrace and exploit the potential offered by technology to either make the assessment process more efficient or to develop new capabilities that augment the assessment of cognition.

The Role of Technology in Clinical Neuropsychology details current efforts to use technology to enhance cognitive assessment with an emphasis on developing expanded capabilities for clinical assessment. The first sections of the book provide an overview of current approaches to computerized assessment along with newer technologies to assess behavior. The next series of chapters explores the use of novel technologies and approaches in cognitive assessment as they relate to developments in telemedicine, mobile health, and remote monitoring including developing smart environments. While still largely office-based, health care is increasingly moving out of the office with an increased emphasis on connecting patients with providers, and providers with other providers, remotely.

Chapters also address the use of technology to enhance cognitive rehabilitation by implementing conceptually-based games to teach cognitive strategies and virtual environments to measure outcomes. Next, the chapters explore the use of virtual reality and scenario-based assessment to capture critical aspects of performance not assessed by traditional means and the implementation of neurobiological metrics to enhance patient assessment. Chapters also address the use of imaging to better define cognitive skills and assessment methods along with the integration of cognitive assessment with imaging to define the functioning of brain networks. The final section of the book discusses the ethical and methodological considerations needed for adopting advanced technologies for neuropsychological assessment.

Authored by numerous leading figures in the field of neuropsychology, this volume emphasizes the critical role that virtual environments, neuroimaging, and data analytics will play as clinical neuropsychology moves forward in the future.

Source: The Role of Technology in Clinical Neuropsychology – Google Books

, ,

Leave a comment

%d bloggers like this: