Posts Tagged cognitive

[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

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[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

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[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

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[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

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[Abstract] Active music therapy approach for stroke patients in the post-acute rehabilitation

Abstract

Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study.

Source: Active music therapy approach for stroke patients in the post-acute rehabilitation | SpringerLink

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[WEB SITE] ‘CBT is a scam and a waste of money’, says leading psychologist | Daily Mail Online

‘CBT is a scam and a waste of money’: Popular talking therapy is not a long-term solution, says leading psychologist

 

  • Cognitive Behavioural Therapy (CBT) is the most popular talking therapy
  • Oliver James argues research shows it does not have a lasting benefit
  • After 5 to 20 sessions those with anxiety or depression appear to recover
  • 2 years later they are no different to those who had no treatment, he said
  • Says proponents have mis-sold CBT to the Government and policymakers  
  • He is calling on the Government to fund other types of treatment
  • Psychodynamic therapy focuses on root cause of problems, he said
Leading psychologist Oliver James say 'extensive evidence' shows that CBT is a quick fix with no lasting benefits 

Leading psychologist Oliver James say ‘extensive evidence’ shows that CBT is a quick fix with no lasting benefits.  

People with mental health problems are victims of  a ‘scam’ therapy that is wasting vast sums of money, a leading psychologist has warned.

They are being misled because the short-term fix offered by Cognitive Behavioural Therapy (CBT) does not have a lasting benefit, says Oliver James.

The most popular of the ‘talking therapies’ CBT aims to help people manage their problems by changing the way they think and behave to become more positive.

It is frequently recommended for people with problems ranging from anxiety and depression to eating disorders.

In the short-term, 40 per cent of those who complete a course of CBT, typically five to 20 sessions of up to an hour, are said to have recovered.

But ‘extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Mr James.

He said: ‘As a treatment, rafts of studies have shown it to be ineffective in delivering long-term therapeutic benefits to patients with anxiety and depression.

‘While studies show that in the short-term – six to 12 months – patients who have received CBT are more likely to report themselves as ‘recovered’ compared to those who have received no treatment, these results are not sustained in the long-term.

‘CBT is largely ineffective for the majority of patients. It is in essence a form of mental hygiene.

‘However filthy the kitchen floor of your mind, CBT soon covers it with a thin veneer of ‘positive polish’.

‘Unfortunately, shiny services tend not to last. CBT fails to address the root cause of many people’s problems, which often stem from traumatic experiences during their childhood.

The UK Government has pledged up to £400 million on treatment programmes which mostly use CBT and it is recommended as frontline NHS treatment for many mental health issues.

Mr James, a chartered psychologist, author and broadcaster, delivered his argument to the CBT industry at the Limbus Critical Psychotherapy Conference in Devon this weekend.

WHAT IS CBT?

  • CBT, or Cognitive Behaviour Therapy, is a talking therapy.
  • It has been proved to help treat a wide range of emotional and physical health conditions in adults, young people and children.
  • CBT looks at how a person thinks about a situation and how this affects the way they act.
  • In turn actions can affect how a person thinks and feels.
  • The therapist and client work together in changing the client’s behaviours, or their thinking patterns, or both of these.

He and other psychotherapists are calling on the Government and policymakers to refocus funding into alternative talking treatments, such as psychodynamic therapy, which focus on addressing the root cause of people’s cognitive problems.

The NHS has been advised that CBT may be offered to patients with a range of conditions by the National Institute for Health and Clinical Excellence (NICE), the guideline body.

It is free on the NHS after referral by a GP but not available in all areas and there can be long waiting lists.

The cost of private therapy sessions varies, but it is usually £40 – £100 a session.

Many mental health groups welcome the shift in emphasis in recent years away from medication towards personalised therapy.

But Mr James says research shows CBT is no more effective than placebo in treating anxiety or depression

He says proponents have ‘mis-sold’ the treatment to policymakers and the public, who are wasting their time.

Mr James says CBT has been mis-sold to policymakers because it is cheap. He is campaigning for  treatments such as psychodynamic therapy - which focus  on addressing the root cause of people’s problems - to be made available instead

Mr James says CBT has been mis-sold to policymakers because it is cheap. He is campaigning for treatments such as psychodynamic therapy – which focus on addressing the root cause of people’s problems – to be made available instead

‘CBT appeals to politicians and NICE because it is quick and cheap.

‘The therapies proven to work long-term, such as psychodynamic therapy, would not be so cheap because they require more sessions’ he said.

But, he added: ‘Working as a psychotherapist, I rarely encounter patients who haven’t been subjected to CBT, which failed to help them.’

The British Association for Behavioural & Cognitive Psychotherapies was unavailable for comment.

 

Source: ‘CBT is a scam and a waste of money’, says leading psychologist | Daily Mail Online

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[ARTICLE] Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect – Full Text

Hemispatial neglect is a severe cognitive condition frequently observed after a stroke, associated with unawareness of one side of space, disability and poor long-term outcome. Visuomotor feedback training (VFT) is a neglect rehabilitation technique that involves a simple, inexpensive and feasible training of grasping-to-lift rods at the centre. We compared the immediate and long-term effects of VFT vs. a control training when delivered in a home-based setting. Twenty participants were randomly allocated to an intervention (who received VFT) or a control group (n = 10 each). Training was delivered for two sessions by an experimenter and then patients self-administered it for 10 sessions over two weeks. Outcome measures included the Behavioural Inattention Test (BIT), line bisection, Balloons Test, Landmark task, room description task, subjective straight-ahead pointing task and the Stroke Impact Scale. The measures were obtained before, immediately after the training sessions and after four-months post-training. Significantly greater short and long-term improvements were obtained after VFT when compared to control training in line bisection, BIT and spatial bias in cancellation. VFT also produced improvements on activities of daily living. We conclude that VFT is a feasible, effective, home-based rehabilitation method for neglect patients that warrants further investigation with well-designed randomised controlled trials on a large sample of patients.

Continue —> Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect: Neuropsychological Rehabilitation: Vol 0, No 0

Figure

Figure 3 of 5 Figure 3. (A) Lesion map for individual patients. B-C) Lesion overlap map summarising the degree of involvement for each voxel in the intervention (B; N = 8) and control (C; N = 5) groups. Lesions were identified by a clinical neurologist (K.M.), who was blind to the design, group assignment and purpose of the study. Lesions were mapped onto 11 axial slices of a T1-weighted template, corresponding to the MNI z coordinates of −24, −16, −8, 0, 8, 16, 24, 32, 40, 50, 60 mm using identical or closest matching transverse slices for each patient using MRIcro software package (Rorden & Brett, 2000 Rorden, C., & Brett, M. (2000). Stereotaxic display of brain lesions. Behavioural Neurology, 12, 191–200. doi: 10.1155/2000/421719 [CrossRef], [PubMed], [Web of Science ®] ). Due to technical difficulties at the clinical facility, we were able to obtain and map digital brain scans for 13 patients only (6 MRIs and 7 CTs) as the remaining digital brain scans were either lost or corrupted. Please note however, that all brain scan reports were available and confirmed the presence of a stroke and its location for all our patients. The range of colour scale derives from the absolute number of patient lesions involved in each voxel.

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[Abstract] Cognitive motor interference on upper extremity motor performance in a robot-assisted planar reaching task among patients with stroke

Abstract

Objective

To explore motor performance on two different cognitive tasks during robotic rehabilitation in which motor performance was longitudinally assessed.

Design

Prospective study

Setting

Rehabilitation hospital

Participants

Patients with chronic stroke and upper extremity impairment (N=22)

Intervention

A total of 640 repetitions of robot-assisted planar reaching, five times a week for 4 weeks

Main Outcome Measures

Longitudinal robotic evaluations regarding motor performance included smoothness, mean velocity, path error, and reach error by the type of cognitive task. Dual-task effects (DTE) of motor performance were computed in order to analyze the effect of the cognitive task on dual-task interference.

Results

Cognitive task type influenced smoothness (p = 0.006), the DTE of smoothness (p = 0.002), and the DTE of reach error (p = 0.052). Robotic rehabilitation improved smoothness (p = 0.007) and reach error (p = 0.078), while stroke severity affected smoothness (p = 0.01), reach error (p < 0.001), and path error (p = 0.01). Robotic rehabilitation or severity did not affect the DTE of motor performance.

Conclusions

The present results provide evidence for the effect of cognitive-motor interference on upper extremity performance among participants with stroke using a robotic-guided rehabilitation system.

Source: Cognitive motor interference on upper extremity motor performance in a robot-assisted planar reaching task among patients with stroke – Archives of Physical Medicine and Rehabilitation

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[WEB PAGE] Adding ADHD drug to therapy improves cognitive outcomes in traumatic brain injury patients

IMAGE

CREDIT: INDIANA UNIVERSITY SCHOOL OF MEDICINE

INDIANAPOLIS – A combination of the stimulant drug methylphenidate with a process known as cognitive-behavioral rehabilitation is a promising option to help people who suffer from persistent cognitive problems following traumatic brain injury, researchers at Indiana University School of Medicine have reported.

The study, believed to be the first to systematically compare the combination therapy to alternative treatments, was published online in the journal Neuropsychopharmacology, a Nature publication.

The researchers, led by Brenna McDonald, PsyD, associate professor of radiology and imaging sciences, and Thomas McAllister, MD, chairman of the Department of Psychiatry, compared the effectiveness of two forms of cognitive therapy with and without the use of methylphenidate, a drug used to treat attention-deficit/hyperactivity disorder and better known by its trade name, Ritalin.

“We found that the combination of methylphenidate and Memory and Attention Adaptation Training resulted in significantly better results in attention, episodic and working memory, and executive functioning after traumatic brain injury,” said Dr. McDonald.

In the Memory and Attention Adaptation Training intervention – also used to assist patients with cognitive issues following breast cancer chemotherapy – therapists work with patients to help them develop behaviors and strategies to improve performance in memory and other cognitive tasks. In this study, this “metacognitive” approach was compared with Attention Builders Training, which Dr. McDonald likened to more of a “drill and practice” approach.

The 71 participants who completed the six-week trial were adults who had experienced a traumatic brain injury of at least mild severity – a blow to the head with some alteration of consciousness – at least four months previously, and who either complained of having cognitive problems, or who had been identified with cognitive problems in testing.

The participants were divided into four groups: the two cognitive therapy approaches with the drug therapy, and the two approaches with placebo. After six weeks, the researchers found that participants in the combination metacognitive-Ritalin group improved significantly better in word list learning, nonverbal learning and measures of attention-related and executive function.

However, Dr. McDonald cautioned that due to the relatively small number of participants in the each of the four arms of the trial – 17 to 19 people each – the results of the trial should be considered preliminary.

Nonetheless, she said, the work breaks new ground in providing evidence for the combination therapy.

“There have been a few small studies suggesting methylphenidate could help with attention and executive function after traumatic brain injury, which makes senses because it’s used to improve attention and focus. But this is the first to test it in combination with cognitive-behavioral therapy for treatment in traumatic brain injury,” said Dr. McDonald.

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In addition to Drs. McDonald and McAllister, researchers contributing to the study were Gwen C. Sprehn, Flora M. Hammond, Jaroslaw Harezlak, Li Xing, Rachel N. Wall, and Andrew J. Saykin of the IU School of Medicine; Laura A. Flashman, Carrie L. Kruck, and Karen L. Gillock of the Geisel School of Medicine, Dartmouth College; David B. Arciniegas of the Baylor College of Medicine; Robert J. Ferguson of the Department of Medicine, University of Pittsburgh; Arthur C. Maerlender of the University of Nebraska and Kim Frey of Craig Hospital, Englewood, Colorado.

This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (R01 HD047242). Dr. Arciniegas receives research support from the National Institute on Disability, Independent Living, and Rehabilitation Research (H133A120020, H133A130047) and Department of Veterans Affairs (CX000239) and receives compensation from American Psychiatric Association Publishing.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Source: Adding ADHD drug to therapy improves cognitive outcomes in traumatic brain injury patients | EurekAlert! Science News

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[WEB SITE] This Nifty Infographic Is a Great Introduction to Neuroplasticity and Cognitive Therapy

It’s startling to think about how we’ve got a spaceship billions of miles away rendezvousing with Pluto, yet here on Earth there are major aspects of our own anatomy that we’re almost completely ignorant about. We’ve climbed Everest, sent men to the moon, and invented the Internet — but we still don’t know how our brains work. The positive outlook is that many health, science, and research specialists believe we’re on the precipice of some major neuroscientific breakthroughs.

One example of a recent discovery with major implications is our further understanding of neuroplasticity. Simply put, we used to think our brain was what it was — unchangeable, unalterable. We were stuck with what nature gave us. In actuality, our brains are like plastic. We can alter neurochemistry to change beliefs, thoughts processes, emotions, etc. You are the architect of your brain. You also have the power to act against dangerous impulses such as addiction. The therapeutic possibilities here are endless.

Below, broken up into two parts, is a terrific infographic detailing the essence of what we know about neuroplasticity and how it works. It was created by the folks at Alta Mira, a San Francisco-area rehabilitation and recovery center.

Source: This Nifty Infographic Is a Great Introduction to Neuroplasticity and Cognitive Therapy | Big Think

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